Tuesday, April 8, 2014

Abundant grain on the hilltops

April 8, 2013
Nyankunde Mountain

On top of Nyankunde mountain looking down at the village

“May there be abundant grain throughout the land, flourishing even on the hilltops.  May the fruit trees flourish like the trees of Lebanon, and may the people thrive like grass in a field.  May the king’s name endure forever; may it continue as long as the sun shines.” Psalm 72:16

It is planting season here at Nyankunde.  I have been marveling at the hillsides and how much of the land on the hillsides has been cultivated this year.  Compared to last year I would say that much more of the land is being farmed.  I believe this is a sign of community development and prosperity.  I also think it is a sign that this is a sign of security, of people feeling that this is their home once again.  After the many lives that were lost here in such a tragic way, it is a beautiful thing to see.  New life has come to Nyankunde.

In the evening it is a common scene to see people climbing the hillsides to their fields with sickle in hand to work/harvest grain in the fields.  You can’t help but see the dependence of people on the land “May there be abundant grain throughout the land.”  Every time it rains I feel thankful.  We have a medium-sized vegetable garden and a large plot of beans/peanuts, so I only experience “dependence” on the land in a small way.  We are certainly not eating only what we grow, unlike many of the people here.
Planting rows

Re-feeding a child
I think Congolese people understand many things as it relates to the soil and agriculture.  I have started to use the analogy of a seed growing up to be a small seedling to a child’s progress in the feeding program.  Progress is slow and lots of work in the beginning.  The kids refuse food over and over.  They have no appetite, no energy whatsoever.  All they do is sleep and eat, eat then sleep.  It seems like nothing is happening.  The beginning of re-feeding is like placing a seed in the ground and then waiting over it…is there enough sun?  Are the conditions right, enough fertilizer, enough rain?  This is when parent’s get discouraged and it is really important that they understand this process and to get support of the extended families (especially the fathers).  We don’t focus very much on weight, rather on behavior and frequent feedings.  So the child refuses again….not to worry.  Try hard not to show frustration…offer the same thing again in a hour.

Then parents start to notice small changes such as the child asking for food, or waking up to eat.  They
A recent graduate of the nutrition program
may be less clingy and fearful and generally happier.  This is when we can introduce new foods.  This can be likened to the small sprout beginning to appear.  It is fun to watch!  This is usually the sign that we will succeed, even if progress is slow.  Now we start talking more about weight and developmental goals.

The last thing we notice is a child’s activity picks up.  He curiously explores his environment again and maybe starts standing and walking again (or for the first time).  This is the flowering/fruit stage.   

Some children progress through these stages rapidly, but for many it takes literally weeks.  Some succumb to infection and complications of their energy deficits, but most succeed.  I would say it is the most rewarding thing I get to witness.  Generally parents are thankful for the time to recover in the hospital. 

I have one little 12year-old boy with cerebral palsy who came in to the hospital completely emaciated with signs of both protein and calorie malnutrition.  He weighed 8kg, what you would expect a 1year-old to weigh.  During the initial few weeks he slept a lot and lost his edema (a normal process), decreasing his weight to 6kg (his real weight).  Now he is on the rebound and is approaching 8kg once again.  We have placed a g-tube and are using this for therapeutic milk and protein-rich porridge, while he takes many of his calories by mouth.  A 20% increase in body mass is substantial over a period of 6weeks!  He remains very developmentally delayed and non-verbal, but he is genuinely happy and smiles most of the time.  Will his life ever be truly normal?  No, but he is greatly loved by his family and gives them much encouragement.  This is often the case with children who have special needs.  Perhaps some day we will have him up in a wheelchair and able to explore his world.  It is a blessing to be part of his recovery.

Who are the Poor and Needy?
As Warren and I were reading through Scripture and praying last week, I started to weep over the passage in Psalm 72.  Warren just stared at me as my voice cracked.  Maybe it’s pregnancy making me more sensitive in general, but this Psalm describes the heart of God for those in need.  It was as if the Lord were saying to me personally, “Help him to defend the poor, to rescue the children of the needy, and to crush their oppressors” (74:4) and “Help him judge your people in the right way; let the poor always be treated fairly.”  It is the heart of God that people are treated fairly, that they have an advocate, and the opportunity to prosper.  Why?  As the Psalm says, “for their lives are precious to him” (72:14).  God wants us to have an active part in the process of caring for people, looking for those with special needs.  Most of the time you don’t have to look very far.  This is part of living out the Gospel, “true fasting” in the words of Isaiah 58:6-7:
“Is not this the kind of fasting I have chosen: to loose the chains of injustice and untie the cords of the yoke, to set the oppressed free and break every yoke?  Is it not to share your food with the hungry and to provide the poor wanderer with shelter-when you see the naked to clothe him, and not to turn away from your own flesh and blood.”

The question is, who are these people in our lives?  Who are we asked to defend and treat fairly?  I don’t think this is simply charity work, but rather standing in someone’s place and advocating for them.  Is it simply about giving money?  It seems like Isaiah is telling the reader to share his own food and resources (time, energy, etc).  This Lenten season, may the Lord show you how to turn your lives outwards to embrace the needs of others.  May this be part of our sacrifice to Him.

Blessings and love,

Tuesday, April 1, 2014

April showers will bring May flowers

Looking back at this past year, April was my favorite month.  Everything is green and lush and it rains almost everyday.  Fields are being planted all around us and people are hard at work.  When it rains here, it really rains!  Our garden is flourishing and we are harvesting vegetables on a daily basis for dinner.  We plan to plant peanuts in the the field behind our house this week...rather with our hospital work we will pay a group of people to prepare the ground for planting.  

Our newest Warren-designed oven

March finds me more than halfway through my pregnancy (22 weeks)!  It is such a
My little baby bump

miracle to watch a baby growing and developing inside of you.  It is such a slow but certain process.   I am finally certain when the baby is kicking and moving about.  I am incredibly thankful for my good health and plenty of fresh
foods to eat.  All I have experienced is fatigue; it is more difficult to work all day long without sitting down.  I plan to slowly reduce my hours as the pregnancy progresses. 

I often wonder what kind of parents will we be.   I know how to take care of a child’s medical and emotional needs, but I have never had my own child. There are so many unknowns. Who will this little person be?  What will they be good at?  We're getting more and more excited about what the future holds.  I can identify a bit with Mary when she says "My soul magnifies the Lord...may it be onto me as you have said. ". We want to be good parents who point to the Lord in all we do and say.  We leave the rest up to Him.  He already knows who this child will be and is our job to trust Him and not worry too much.

Being pregnant in a different culture that my own is an interesting experience.  Overall I would say that pregnancy is a private affair here....in fact most people do not announce their pregnancies.  I have told a few people, but I know the word spreads rapidly.  This is so different than American culture where
everyone celebrates upcoming babies with showers, gender revelation parties, and excitement.  Maybe pregnancy is such a regular part of life here.  Most women here spent most of their adult lives raising children and having babies.  Babies come and babies go with infant mortality as high as it is.  Maybe women don't want to set their hopes too high.  I do miss being able to rejoice and wait in expectation
alongside family and friends.  In a funny way, I miss being able to announce something to a group of people.  Warren and I share much of this together as we look at weekly ultrasounds and see the baby's physique taking shape.

Pediatrics is as busy as ever.  Most days I am responsible for about 50 patients.  I care for more patients on a daily basis than I would ever have in the states.  This past week I diagnosed two children with tuberculosis, one of the spine and yet another case with meningeal involvement.  Our nutrition program
is "hopping!"  This month Samaritan's Purse is starting up community nutrition care groups for at-risk children and their families.  We are hoping to provide community follow-up to those being discharged from the hospital nutrition program.  This will involve community gardening and hopefully engage the fathers in field preparation. Last week the SP team was doing a community assessment in a nearby
community and was led to the home of a new mom and her twins struggling to survive.  The woman was too weak to stand and needed to be transported to the road for emergency evacuation.  I am convinced that this little family would have died.  Pray for them.  The babies
are gaining weight and looking stronger everyday.  They are not out of the woods yet.

This last month I said "goodbye" to a little girl named Anifa.  She had been under my care for much of the year for her advanced skin condition pemphigus vulgaris.  She experienced many complications related to the side effects of steroids and was more and more debilitated.  The family could see that it was time to shift gears and go home.  She spent five days out of the hospital before going to her
eternal home.  Her mother visited us today in pediatrics and told us the last thing Anifa said before she died was that she could hear children singing.  She said that she wanted to join them.  I love the thought of children welcoming Anifa to heaven, it brings tears to my eyes every time.  DR Congo was not Anifa's home, she was only passing through.  I am thankful for the healing that took place within her family as they rallied around her during her last months.  May the Lord give us the eyes to see the significance of our lives and cherish our days.

Nyankunde Hospital is undergoing a rebirth.  It is a Congolese mission hospital 
once again, this time run by nationals and the local church and not ex-pats as
it once was.  Many buildings in the area are still in shambles from the war but 
many have been re-built.  People who once lived here come back to see the
renewal and life starting again.  People cry, they reminisce..."I used to live
here, " or "I was born here."  For many there still is a significant fear
factor, some do not want to live here again because of the memories, but overall
life abounds once again.  Nyankunde is a prospering village again, the people
continue to struggle with food security but they have plans for the future. 
There are more fields being cultivated this year than last and we have to fight
to keep our small garden plots.  Now displaced peoples take shelter in
Nyankunde.  It is exciting to be part of the changes happening here, the
training of Congolese doctors and nurses again.  We see people from all over
eastern DRC for a diagnosis and treatment.  We see our share of heartaches and
many with advanced disease.  It is my prayer this next year that the spiritual
ministry here continues to grow, and that we would be known for this.

We have a beautiful young pup named Rosie, a bull mastiff.  She is growing by leaps and bounds and
Rosie at about 9 weeks old
is 12 weeks old.  She doubled her weight this past month and is about 12kg!  She was so small at first that I insisted we keep her enclosed from the threat of owls at night.  I no longer fear the owls!  She is lots of fun and already knows “sit” and is learning “come.”  She has no fear of goats or pigs and approaches everything with a curious spirit.  Most passer-bys pass to the other side of the road when they see us coming with one phrase: “mama wey.”  We are spending lots of time with her and exposing her to lots of new things.  She loves picking everything up, eating bugs, chewing shoes, and eating fish and Goma cheese rind.  We are thankful to have a dog again.  We hope that we can train her well before the baby comes in August. 

Rosie now at 12weeks of age

We are grateful for your support and interest in our lives.  It is a privilege to serve here and see God at work. 

Some prayer requests:
 1) Pray for the health of our baby we wait with anticipation.  Pray that God would continue to give us joy in this season of preparation.
2)   Pray for our future plans to serve in Congo to become clear.  This is a logistically challenging place to live and work.
3)   Pray for a profitable time at an upcoming medical conference in Greece at the end of April/beginning of May and for the week following that we will spend with Warren’s parents.  Greece here we come!
4)   Pray for the many medical challenges we face daily and for insight into the spiritual needs of patients and families.  Pray that Jesus would be known here at Centre Medical Nyankunde.
5)   Pray for humility of spirit and service as we treat and work alongside our Congolese colleagues.


Lindsey and Warren Cooper
Pediatrics team
A night with Dr. Chantal before her departure to Bunia.  We miss her.