Thursday, May 23, 2013

Abundance in May




May 23, 2013

Greetings from DR Congo!  Thanks for your interest in our lives here in DR Congo...a land of endless green and colorful, hard-working people.  We celebrated our 3rd wedding anniversary in May with a handmade cake and an evening stroll down to the airstrip.  It has been really nice to be together all the time, and serving together in the hospital.  We are thankful for the marriage that God has given us and pray that we will steward this well and grow in love in the years to come.
An evening motorcycle ride



Our furry and feathery friends, Peterson and Bubu

Our pets provide a source of continual interest.  Peterson, the dog is getting huge.  She is barely 4 months old, but already weighs in at 30 kg.  She will be a very large and strong dog.  She has a sweet temperament, but she doesn’t quite know her own strength.  When she gets excited and starts tearing around the yard, it is nothing short of terrifying.  Warren is trying his best to establish himself as the “alpha male”, while he still can.  We have a beautiful African Grey parrot.  We have experimented with a few names.  For the moment it is “Bubu”.  This is Swahili for “mute”.  We hope she will talk one day, but so far things have not been promising.  She imitates a few birds in the morning and eats tons of peanuts!  We think she fell (or jumped) off her perch last night as Warren found her perched in the pantry this morning.  It is possible to be a missionary in Congo without a parrot.  It is possible to be a pirate without a parrot, but both of these professions just work better with a parrot.  In the absence of television, the parrot provides hours of entertainment.  Warren is working hard to socialize her (which amounts to chasing her a lot), but it has been a slow process. 
Peterson at 4months

Bubu, the African grey



Hospital Staffing
This last month the hospital fell upon a staffing crisis.  The census has only been increasing since we arrived, yet the staffing has not increased to meet these needs.  Many nurses were working long hours and many were getting sick.  Warren decided to temporarily close the elective surgery program, as he did not feel that we could provide adequate patient care in the OR/ICU.  This raised the attention of the larger organization, Centre Medical Evangelique.  Overnight they had hired several new nurses and somehow we acquired 2 new physicians.  The nurses here work very hard.  We care a lot about their morale and health and have observed a renewed desire to learn. Already there is an improvement in patient care.  We are thankful for the recent changes.  Since our staffing has improved, people seem more rested and interested in professional development.  We have started hosting movie nights complete with popcorn on Sunday nights. 

On surgery from Warren

Things are going well in the surgical department.  We have been blessed to have John Troke here.  He is a nurse with surgical training.  He is helping us to revamp and reorganize our surgical supplies and procedures.  I feel strongly that we need to try to uphold high standards in the Operating room.  This includes thing like counting sponges, organizing the instruments, gowning and gloving properly.  It is possible to get used to doing things incorrectly.  If we can present a higher standard, then people will see it, and potentially change procedures where they work.  A lot of surgery is done careless here in Congo.  Having John around also makes me look at the ways that I have cut corners.  I can’t remember the last time I actually did a five minute scrub.  I generally espouse the philosophy that “the surgeon’s hands are always sterile,” but I realize that this sets a poor example.  Anyway, it has been a great joy to see things starting to take shape.  There is so much potential here, but victories are won inch by inch.  An ongoing challenge is simply that of maintaining equipment.  The surgical department has a lot of moving parts and it seems like I am always trying to fix something.  Cautery, x-ray machine, ultrasound, monitors, air compressor, OR tables, lights, etc.  It is annoying at times, but it keeps me from being bored. 
Warren and John on a hike



Swahili/French
Both of us have a proficiency in French already and are trying to pick up Swahili.  A lot of language learning is simply a desire to learn and use the language on a regular basis.  I (Lindsey) understand more and more of what people are saying around me and can halfway conduct an interview in Swahili.  Warren tells me that I (Lindsey) speak in French in my sleep.  Is it a sign of immersion?  Learning a language takes time, patience, and definitely discipline.

On Malnutrition from Lindsey
I am finding that malnutrition is one of the largest medical problems I face here, right after malaria.  On any given day, about 20-25% of hospital admissions are children with malnutrition and associated problems.  In the past 4.5months we are have 30 new cases of malnutrition, compared to 37 cases in all of 2012.  If we keep up at this rate, we will have around 120 cases in 2013.  Perhaps we are picking up more of these cases this year, but this seems extremely high.  A couple of weeks ago the Samaritan’s Purse nutrition assessment team came out to do a rapid nutritional survey of some nearby communities.  In just two days and three surveyed villages, this area is considered to be in a state of nutritional emergency.   Two of our twelve children in the nutrition program died this past week, despite our best efforts.  It is really difficult.  I don’t know how to solve these issues.  I don’t understand the causes.  I do believe there is a poverty of spirit in this area.  I believe that God wants to work in powerful ways to renew people’s hope and work ethic.  What can I do?  Sometimes I think awareness is the first step.  If we can identify these cases and help families identify potential causes, walk with them as they make dietary changes, plant new crops, then we are on the way to a solution.  I choose to believe that God can do a work in people’s lives, and even do the impossible.
Malnutrition Follow-Up Clinic at Nyankunde Health Center
 19 kids in attendance


Our little boy named Munganga (who has lost two siblings to malnutrition already) is gaining weight and is walking and looking at a discharge in the next couple of weeks after 2months in the hospital.  We are still hoping to help to coordinate the planting of a field around the family home so that the mother can harvest the crops.  This is a very challenging social situation and one that we will have to follow closely, probably with home and frequent health center visits.  Is this a small victory?  I think so.  This little boy has a chance at life.
Munganga with Dr. Chantal eating his morning porridge

Munganga walking for the first time at 20 months














Our Garden
The garden has been interesting.  So far we are eating okra and cucumbers from the garden.  I think each of us is eating on average 2 cucumbers/day.  It is immensely satisfying to go out and pick something and eat it fresh.  The cabbage has been a challenge.  It was doing well, but somehow we got some tiny caterpillars which are wreaking havoc.  We have lots of things growing that we are not accustomed to eating.  This includes beets, Swiss chard, kale, eggplant, mustard greens, pinto beans, even something called rapeseed.  It will be a grand adventure to harvest these mysterious items and figure out how to eat them.  We have six different varieties of watermelon seeds that we are trying to grow.  That one we know how to eat!
Our garden this last week



Hospital Donations

There are many ways to contribute to the work that God is doing here at Nyankunde.  Some of you have wanted to contribute to the work.  You can do this online at www.samaritanspurse.org/wmmgiving (project number: 002121; project name: cooper).  Here are some of the most immediate needs:

      1) Mattresses for hospitalized patients.  We are hoping to help fund the purchase of about 120 new hospital-grade mattresses.  Each will cost around $50-60 and will cost an estimated $6000.  Our census is only increasing and we are starting to ask families to bring their own mattresses.  This is an important aspect to hospital care, just not one that we often think about. 

    2) Expansion of the malnutrition program.  Currently the hospital malnutrition program is funded through generous donations (coming from our generous donors).  It costs about $6 to provide whole milk and high protein porridge per child per week.  It takes about $300/month to fund this project.  We are making plans to plant a demonstration garden adjacent to the hospital to educate and directly benefit patients and families.  We are hoping to help employ someone to do this work full-time.

    3) Needy patient fund.  On a fairly regular basis, patients who lack family and the means to medical care or food, have their surgeries or care sponsored.

   4) Ultrasound repair.  Our second ultrasound here at Nyankunde needs to have some significant repair work done.  The hospital is in the process of figuring out how to re-structure finances.  We are hoping to help subsidize this cost alongside the hospital.  

   5) New guest house next door.  This Samaritan’s Purse project is in full-swing to anticipate the arrival of the Tenpenny family who will be living here in July.  Elliott is an ER doctor in the post-residency program who will be working with Warren to learn basic surgical principles and Sara plans to care for their two kids.  They are finishing up their French studies in Switzerland.  We are anticipating some extra costs for furniture and various household items.  
   
      Thanks so much to everyone who continues to pray for us and support us in the work here.  We are so grateful.  It is humbling to see God working here through our pitiful efforts.  We believe that He is working a miracle, and it is wonderful to be a part of it.  This is what keeps us going through the long days, the tragedies and the challenges we face daily.  God bless you.





     Blessings,
     Lindsey and Warren



Sunday, April 28, 2013

April at Nyankunde: A little time off


Nyankunde on a hike tonight

Wild orchids


April 25, 2013

Vacation to Uganda

We just returned from a much needed R&R in Uganda.  We didn’t even realize how tired we had become, working every day.  Everyone here at Nyankunde works very hard-the Congolese put in many long call hours.  One really needs to leave to have time off to maintain a marriage, health, and relationship with God.


 Our first stop was Murchison Falls National Park, situated in Northwestern Uganda around the Nile, close to Lake Albert.   Hemingway crashed his Cessna plane on a telegraph wire whilst flying over the Falls in 1954.  The Falls provided the backdrop for the filming of the movie African Queen in 1950.  It is kind of surreal to drive into the park in a Land Cruiser and see elephant families romping about.  We took a bit of a river safari and saw many hippo, species of kingfisher, waterfowl, elephants, and crocodile.  We stayed in tents close to the river, swam, and had wonderful food.

Murchison Falls National Park (looking downriver at the Nile)







On to Jinga, a city known to be at the headwaters of the Nile, known for its’ rafting possibilities.  This
was also a beautiful spot with eagles and plenty of waterfowl.  We did a little kayaking and sight-seeing.  A very peaceful spot.

The next stop was Kampala to some shopping for medications for the hospital, for our household, and for a dog.  We found a beautiful puppy, a bullmastiff who we have named Peterson.  We have been talking about getting a guard and family-friendly dog.  She looks a bit like a tiger and is going to be HUGE!  She is already 50 pounds and put on 4.5pounds since her arrival. 

Warren exerting his "masterdom" on a hike tonight

We feel fortunate that Uganda is so close-by and offers much opportunity for recreation.  I know there are some beautiful spots in Congo too, but with recent uncertain times some of these parks are closed or animals have been killed.  We are hoping to visit some caverns and falls south of here, yet we need to have contacts in this region to travel.  We are hoping to fly into Nebobongo sometime soon, known to be in heart of the rainforest.  Congo is an incredibly beautiful country, yet incredibly complicated to travel within.  The view outside our front door every morning takes your breath away.  I am thankful to have so many areas nearby to explore. 

Perspectives

We deal with life and death on a daily basis.  It gives a realization that every day on earth is a gift from God and we need to make the most of it.  Close relationships and love should be the center of our lives, the thing that motivates our actions.  Sometimes I get overwhelmed by the gravity of situations that seem to lack a solution.  Sometimes a cure is out of reach.  Sometimes things seem hopeless.  Sometimes people suffer greatly.  Yet, God is there in those difficult times when we reach for him and point others to Him.  We need Him and He is waiting for us to cry out to Him.  At times I struggle with the larger issues and struggle to see the patients before me.  As I deal with drunken fathers, negligence, and unknown cultural issues…single moms…I ask God to show me the needs of the child and ways to encourage parents to be better parents.  How does God see these people?  What might He say to them? 

Psalm 34:17-18  “The righteous cry out, and the Lord hears them; he delivers them from all their troubles.  The Lord is close the brokenhearted and saves those who are crushed in spirit.”

Agriculture and Malnutrition

Our garden is growing with each passing day…cabbage, eggplant, lettuce, spinach, okra,  squash,
peppers, carrots, peas, beans, corn, pumpkins, etc.  We are looking forward to benefiting from the produce in the coming days.  It was a regular topic of conversation at the hospital last month to talk about what everyone is planting in this upcoming season.  To really prosper here, one needs to plant a variety of foods on a regular basis.  Food can be hard to come by and farming really does take a lot of effort as it is all by hand.

I am really thankful for good, healthy food and clean water!  Give thanks when you open your tap and drink clean water this week.



A child of 18months came in on the verge of death from malnutrition 3weeks ago.  If that is not sad enough, two children in the family have already died from malnutrition.  We have made a couple of home visits and are really working to build a rapport with this family.  Fortunately we have a team of agriculturalists with Samaritan’s Purse who are here giving counsel and assistance with planting seedlings to families.  We are helping this family plant food crops for these next 6-months.  I believe this is going to be a long-term commitment on our part.  Although we can treat acute malnutrition in the hospital, this child will return to the same environment from whence he came on discharge.  What we really need to do is help people overcome obstacles to food acquisition and knowledge about healthy eating. This child is gaining strength and starting to walk for the first time, all good signs.

 Malnutrition really hangs on my heart here…there is so much to be done. I was shocked to see that over about a 3-month period last year, 8 of 30 children died.  This seems like a very high statistic.  I think we really need to do some survey work to get at the causes and best interventions for these problems.  War and separation are large contributing factors.  We are hoping to help start a hospital demonstration garden whereby we can hire an agriculturalist to plant, harvest, and teach families good farming practices.  Families with malnourished kids will directly benefit from these efforts.  We are gaining a vision for this, but simply need to find the right people to take charge of it


Josh

It has been a pleasure to have Josh, a medical student from Eastern Carolina University, stay with us these last 4-months.  Josh is planning to pursue surgical residency and feels called to the mission field.  Warren served as his mentor and teacher.  He learned a tremendous amount and was even doing c-
Bulo before surgery
sections and his own ultrasounds at the end.  He built a tremendous rapport with a young man named Bulo, a boy who suffered a cranial fracture from a stray bullet.  He was literally missing part of his skull with his brain protruding.  Many weeks later with grafting and surgical intervention, his defect is covered and he is walking and even dancing, even flirting with the nurses here!  Josh played many late games of checkers with Bulo to stave off the boredom and we have seen his confidence return.  Josh has really been part of our family these past few months and we will miss him.  We wish him the best in his future training.  Congo is in his blood!
Josh and Bulo playing checkers
The Josh and Warren partnership


A note by Warren

The surgical side of things is going well.  I feel like we are pushing the envelope of what can be done in this sort of setting.  We are doing laparoscopic surgery.   We did a thoracoscopy/thoractotomy.   We are venturing into orthopedic surgery.  I have done several SIGN nails and this past week I operated on man with a hip fracture.  I just happened to have a box of dynamic hip screws.  I didn't quite have all of the necessary material to put it in, but we managed somehow to make it work.  This is the curse and the challenge of this sort of work.  You never seem to have everything you need, but it is always an adventure.  I always hear that little nagging voice asking me whether I should be doing this, but the alternative is to do nothing.

The technical demands have been daunting.  We have a lot of great equipment, but it is hard to keep it all working.  This past week I had a laparoscopic case ready, but I couldn't get the machine working which pumps air into the abdomen.  For want of that one little piece of the puzzle we had to give up and take the gall bladder out the old fashioned way.  It was not a big deal, but it would be nice to work in a place where everything functioned properly.  The fact of the matter is that it will simply never happen.

One major advance has been anesthesia.  We have started using general anesthesia with inhalational gas for big cases.  It is such an incredible blessing to have a patient who is safely anesthetized and lying peacefully on the table.  The Congolese staff have come a long way in their mastery of anesthesia.  They still have a lot to learn, but we've put a bunch of patients to sleep, and by the grace of God we've woken them all up!

My time with Josh, the medical student is drawing to a close.  It has been fun to have my little shadow.  It has been fun to see him improve his skill, and to watch him interact with staff and patients.  Last Friday I assisted him as he did a c-section and it was a beautiful thing!  It was a woman who was having her tenth baby!  I suggested we name it Joshua in his honor.  I can't take all the credit.  He's had good training elsewhere and he has a natural aptitude, but I feel gratified to have taught him at least a couple of tricks.  I also feel that having him here has been a ministry and an investment for the Kingdom of God.  

Until next time…

Warren is always onto a new project….designing zip lines for the puppy, using an air compressor to
“speed along” charcoal coals on the grill, not to mention all the use he is getting out of his new welder.  I think you get the idea from the photo.  Stay tuned for more adventures of the Coopers!

Thanks for your interest in our lives.  Keep us in your prayers.

Love,

Lindsey and Warren


Taken on Easter at Nyankunde with some of the Samaritan's Purse DRC team