Tuesday, August 14, 2018

An epidemic and a full life on the field

August 14, 2018

An Epidemic

Mixing chlorine hand wash stations 
There is a lot going on in our minds and hearts these days.  Last week was one of the longest weeks of our lives overseas...so much happened.  Many of you have probably heard that eastern Congo is experiencing an Ebola epidemic, the country’s 10th epidemic.  The declaration came only days after the previous one ended in western Congo.  The area affected is in North Kivu, 3 hours south of here.  We have not had any active cases of Ebola here, but it is cause for much preparation and testing of suspected individuals.  Samaritan’s Purse (SP) has been a great resource as we work on hospital sanitation protocols, isolation, decontamination and overall ways to protect ourselves from pathogens such as this.  Our SP nursing friend, John, has been here working with the staff.  One never wants these things to happen and my heart goes through many emotions everyday.  Keep praying for the Congo, for the people who are incredibly fearful, and that hospital ministry will be able to continue.  We want our presence to be an encouragement to our Congolese colleagues.  We really should not write more details here, but feel free to contact us and please pray for these preparations.

“We put our hope in the Lord.  He is our help and shield.  In him our hearts rejoice, for we trust in
his holy name.  Let your unfailing love surround us, Lord, for our hope is in you alone.”  Psalm 33:20-23

Pediatric Victories
We have had a run of amazing recoveries from extrapulmonary TB, close to 14 cases!  It is such a blessing to see kids recover their strength and ability of play, gain weight, and for some to walk
A child with peritoneal TB and
drainage of a pancreatic pseudocyst
again.  I am reminded of how miraculous the human body is.  One little boy whose name is Emmanuel is recovering from TB meningitis.  He had a classic presentation of the disease complete with nerve palsies, inability to swallow, seizures….scary stuff.  After weeks of treatment and a few setbacks he is recovering slowly.  After almost 2months of nasogastric feeds he regained neurological function enough to swallow again.  Absolutely amazing!  There have been 7 other kids just like this who have recovered.  Our number of pediatric hospitalizations increases in July due to malaria and many get diagnosed with chronic infections.

Sometimes families communicate a profound sense of thankfulness to me and it all feels worth it.  I am just an instrument God is using to further His kingdom and blessing here.  It is an sacred honor to care for the physical body.  To see these recoveries makes it all worth it!  

Congo Impact Team
In July, Nyankunde hosted a sports evangelism team from California called “Congo Impact.”  The
local kids called it “Summer Camp”.  It was a much anticipated event with music, Scriptural teaching, and fun.  We took care of the team’s lodging, health, and food during their stay here.  It was hard to participate in the daytime activities so this was a way we could be involved.  There is some amazing videography of the village and hospital.  As always with visitors I see things with a little different lens, a new lens.  I see beauty in a new way, as well as brokenness.  I see that the Congolese are a colorful and strong people.  They have a dynamic walk with God.  They have a real sense of spiritual combat and that all is not well in the world and that we must fight with prayer.  It is always a blessing to have visitors come, even as a reminder of what I am doing here.

During their time here we took a few video clips of the hospital, including the old chapel that CME is looking to rebuild.  It was encouraging to me to hear how the chapel was used for evangelical
There is no roof

music groups, theater, graduations, weddings and spiritual counseling.  The chapel was a centralized building for the entire community.  One of the hospital personnel mentioned how the building had housed many instruments, all of which were pillaged during the conflict.  Upon moving back after the war, everyone talked about how medical care had to be prioritized for a displaced population.  The chapel was not the most pressing need.  There isn’t currently enough space for large group meetings in the current temporary meeting place.  It is moving to see that the Congolese have started to make bricks to rehabilitate this chapel.  We
Hospital administration testifies to the importance of the chapel
are encouraged by several churches who have shown interest in giving to this project.  Feel free to contact us independently if you are interested in what is going on!

Family Newsroom
In other news, we have added a new animal to our family, a friendly goat named Elsa.  She is very accustomed to people and tries to get in the house.  Emmanuel dotes his love on her.  Emmanuel is learning to swim in a small pool 2m x 2m and spends most afternoons running and plunging into the water with his friends.  It is great to see kids have so much fun with such simple things.  A few weeks ago a few of our Congolese neighbors came over for a little swim and the pool turned into a giant instrument.  I am told that girls grow up playing rhythms in the river with their hands while the boys swim.  It was very interesting for us to see.  We are harvesting our peanuts, turning over the garden, and trying two new beehives.  There is not a dull moment and there is always a project to be done (or cleaned up).  

-Pray for the containment of the Ebola crisis here in eastern Congo.  It has been stressful time and difficult to know when/if to separate myself from the risks at the hospital.  Pray for encouragement of our staff who have been feeling a lot of fear and uncertainty.

-Pray that we would love well in Jesus' name everyday.


from Warren:  the Mysterious case of the Exploding water bottle. 

So it seems we are the referral center for weird and wonderful cases.  Recently we saw a man with an unusual story.  He came home from work thirsty...very thirsty. He got a bottle of water and was about to open it up when...it exploded!  

Me:  Exploded?
Him:  Yes, it exploded!
Me:  Was it ordinary water, or was there some alcohol in it, or maybe some alcohol in you?
Him:  No.  Ordinary water.  Then I passed out, woke up and found myself wet with water, and I had a sharp pain in my chest.
Me:  Fascinating...

I could continue on in this vein, but in the interest of time, I will summarize.  He was surprised to see that the plastic cap of the water bottle was missing.  The pain in his chest became worse and he found that he could not eat or drink without pain.  After consultation with a series of hospitals, he came to Nyankunde, concerned that the missing bottle top might have ended up inside him somehow.  He arrived at our facility about a week after the incident. I made him try to drink some water and it was pretty clear that something was wrong. We decided to take a look with a scope.

After he received sedation and some ketamine, I decided to question him again.  It was such a ridiculous story that I couldn’t believe it.  Under the influence of my “truth serum” the story remained the same; exploding water bottle, chest pain and inability to swallow. 

We put the scope down and halfway down the esophagus, there was a flash of blue. It looked kind of like the top of a water bottle.  Actually, exactly like it. We were able to push the bottle top into the stomach, then get a snare around it.  Even then, it was not easy to remove.  It took a fair amount of pulling to get it out of this upper esophagus. We had to move his neck into different positions before it came out.  A quick check demonstrated that he was still breathing and was not bleeding. 

In the end, it was a nice little case and we were able to help the man.  I don’t ever say that I’ve seen it all, there is always something surprising. 

Another surprising event that has struck has been the Ebola outbreak in the neighboring region of North Kivu. It has now officially spread to Ituri.  This is where we live.  You can read about it in the news, I guess.  So far we have not had any cases here, but we are doing our best to prepare for what may happen.  

Our team is rejoicing. Look closely and you will see the bottle cap at the end of the snare. 

A recent trip to the top of cell-phone tower hill, AKA Nyankunde Mountain.  Quick tip: you get a really good cell phone signal when you are at the base of the tower!

A bit of a hairy drive, a few gasps/prayers along the way, plus one bonked head...

...but worth it for the sunset!

Friday, July 6, 2018

Independence Day and Other Musings

July 6th, 2018

We hope you had a happy and healthy 4th of July!  We brought out our $7 American flag that has
 been sitting in our linen closet for the past few years.  We bought the flag from a woman selling used clothing across from the hospital.  It was completely random and of course we needed to buy it.  Some years we forget about the 4th of July until the day is already passed...it is harder to remember these things living over here.

Being far away from my home country, I was inspired by a friend to read our Declaration of Independence again. I am thankful for my American heritage and to those who have given their lives to protect the rights of others. I do not take this for granted. Permit me to share the preamble to this famous document: 
“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn that mankind are more disposed to suffer, while evils are sufferable than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.”

A Visit to the Health Center
During a recent visit to our hospital’s outpatient nutrition clinic, I talked to one of the medical residents about the power of observation.  I asked him, « How can one walk into a room of 60 malnourished kids and identify the one who is in trouble? »  We talked about the fact that most of the kids were under 5 accompanied by their mothers.  We discussed noticing which children were able to walk and which needed to be carried.  We talked about criteria for hospitalization such as the third standard deviation weight for height, medical complications, edema, food insecurity, etc.  There didn’t seem to be any children that needed hospitalization.  I was gathering my things to go home for the day, when a father walked in carrying a little boy.  Two things were out of the ordinary: the child’s inability to walk and the fact that the child was being carried by his father.  The child was wearing a hat many sizes too big for him, baggy clothing, and no shoes.  I couldn’t tell his age, but glanced at the outpatient record which indicated he was 2.  He weighed less than 6kg.  The public health workers noted that last week he had edema and today he did not.   This was very concerning.  As quickly as the father appeared, he walked away to stand outside where he come from minutes before.  I scrambled for details, discovering that the father had refused hospitalization the previous week due to lack of resources.  The medical resident followed him out the door and talked with him in private. 

The problem is usually money and resources.  This father wanted the boy to get better but simply could not afford a hospitalization.  He asked to come back tomorrow which is another way of politely refusing a hospitalization.  I have heard this before with children in similar conditions, I received word later of their deaths.  We didn’t want this to happen.  We kept talking.  There were other mothers who contributed their words of support.  We promised to help him with cooking by providing Mama Ruth’s assistance.  We told him he would receive 5-grain porridge, therapeutic milk, and nutritional foods.  He finally accepted. 

We don’t know his story yet, but we will learn all that we can.  Each child has a story, a struggle.   Often there is separation/divorce/death in the family.  Often there is a story of gold-mining and lack of farming.  There is always a reason for children to fall into a state of malnutrition.  It is our job to do our best to understand these individual situations and provide the needed support.

Graduation from Nursery School (Year #1)
Our BIG news is that Emmanuel successfully completed French preschool!  Last year he was just too
Emmanuel and his nanny Maziga and his beautiful teachers
young and 
learning how to communicate and wasn’t able to do a recitation in French. stood up with so much pride (some timidity) and spoke in French in front of parents and his classmates.  It really has been important for us to help the preschool in whatever ways we can and encourage integration.  At this early age children are already learning very important life skills:  how to accept one another, share, work together, how to work through differences.  I am not sure if Emmanuel realizes that he has light skin and I love that.  I wish more children could have these kinds of experiences.  I am very grateful for our nanny Maziga who has helped our son learn language and some very important life lessons.
Emmanuel's class of 27 (including 6 missionary kids)

Do you see something?

Truth and Lies
There is a spiritual nature to our medical work.  Sometimes I forget that there is an enemy at work in these communities and homes.  There are some very serious social and physical problems which have a spiritual cause.  Lies need to be exposed and bound before people can hear the truths of Scripture.  Silence the enemy. 

This week I was rounding on a 3month old baby when the family told me he had “jacombe.”  The nurses looked at me for a response.  Did I know what this word meant?  I did.  I looked at the family and said that I understood what they were describing:  the child’s skin condition and "something else."  “Jacombe” is a local term that is used to describe a severe skin condition usually affecting the area around the rectum and mouth.  But the word has more meaning than simply a skin condition.  It has a deeper spiritual meaning which has to do with being cursed and being controlled by evil.  It is kind of a self-fulfilling prophesy because people stop touching and caring for their children and in doing so their children die.  I said that I understood but disagreed with this statement.  I said with a boldness that surprised me, “Your child is a child of God and Satan has no control over them.  Don’t believe this.”  They nodded in agreement that the child was a child of God and were genuinely surprised at me questioning this commonly held belief.  Sometimes we fall prey to lies and we don’t even know where they come from.  These lies compromise our relationship with God and we lose our way.  It is my hope that this family will hear the truth of Christ in a new way.

I am reminded that we need to surround ourselves with things and people that encourage our walk with God.  We need to be dlilgent about what we allow to occupy our hearts and minds.

A Little Trip
We recently had the opportunity to travel out to Uganda as a family.  We used our big Marmot tent for   Emmanuel thinks that camping is fun .  I think he will remember the troops of elephants and giraffes he has seen in the wild.  We were so close to elephants on the Nile that the night watchman occasionally had to discharge gunfire to deter them from coming too close.  It is fun to be making these memories together.   Here are a few pictures from our trip.
the first time and camped in and around the Nile River and Murchison Falls National Park in western Uganda.

We enjoy hearing from you and we need your prayers.  
-Pray for an upcoming visit of an evangelistic sports team from California, that they would be a continued blessing to the youth of Nyankunde.
-Pray for the many cases of tuberculosis the hospital often sees this time of the year.
-Pray for continued ministry opportunities in the community and throughout the hospital.

Lindsey (for the us)

A rocket stove with a battery powered fan...creative

With the older bros

Passionfruit juicing day