Riding the epidemic wave AGAIN

March 24, 2020

A funny sight... chickens perching on the parrot perch in the house.  They came in through the aviary window.

Riding the Wave

I have pinched myself a few times this last week as we read the news of the Coronavirus pandemic striking the world by storm.  I keep hoping that I will wake up.  Is this really happening?  How is it possible that countries have closed their borders and people are repatriating home? It seemed at first like a disease that was only affecting China, and now the whole world is trembling.  Even the Congolese border is now closed, as are many borders around us.. It feels like the world is riding some giant wave of unknown magnitude, with so many unknowns.  The lives of so many people has changed overnight and we are scrambling to make our own medical masks!  Even our jobs and livelihoods look less certain these days.  These are crazy times. 

This new pandemic has given me pause to look back on the last 1.5years.  We have been living through an Ebola epidemic here in DRC for the last 1.5years.  This epidemic has drastically changed our lives and caused us to mitigate risk.  I (Lindsey) chose not to provide patient care so as to reduce the risk of exposure of our son.  We were vaccinated against this terrible disease.   We don’t shake hands.  I still haven’t shaken hands with anyone for 8months since coming back.  We don’t touch patients with ungloved hands anymore.  Sometimes we have had to delay life-saving care due to the need to test patients.  We have practiced social distancing and avoided large markets and public areas for weeks on end.  We spend more time at home and less time traveling.  Our daily lives have changed in significant ways.  Ebola is not a forgiving disease-it is a deadly one if not detected and treated early.  We have learned that vaccines and novel therapies are game changers for the prevention and treatment of Ebola.  At long last, Ebola appears to be coming to a close.  In just 2 more weeks with no further cases and they can declare the epidemic is over. It has been a long haul to get to this point and we are so grateful!

Some of the same principals we have learned from living through an Ebola epidemic may apply to treating coronavirus.  Even some of the drug therapies may be similar.  Let’s hope that we can properly put on/take personal protective equipment, wear N95 masks, dispose of waste properly, self-quarantine, wash our hands in bleach multiple times a day, and identify patients with this disease early.  I am thankful in a strange way for everything we have learned.  Probably the most aggressive thing we can do is test/isolate/trace and isolate contacts. We need to equip health care workers to do their jobs safely to protect their lives and the lives of others.  Hospitals need to treat only essential conditions to avoid exposing people to the virus.  Health care providers need to cohort care to limit exposures.  We need to educate the general population from ALL angles on why it is important to limit contacts.  People need to limit their movement and interactions and consider the essentials of life.  On a community level in Africa this does not mean staying in one’s often very small house 24/7, but avoiding large groups.  Here we need to consider things like food security and the possibility that goods could become scarce.  For this reason we are planting more of the fields around us and considering how we can anticipate the needs of others.  

Now life is back to basics. Many parents need to school their kids and find new activities together.  This brings challenges, but also rewards.  We are forced to slow down our frenetic life….unless of course you are in healthcare.  If you are working in healthcare your life just got infinitely more complicated and risky and may separate you from family temporarily.  We need to pray for those in health care and public service who care for others.  We need courage for the tasks ahead of us.  We need a way to surrender our worries to God, lest they overwhelm us. He is faithful and He hears our prayers and I believe we will see His intervention.

Let’s take care of our mental health-getting outside to appreciate nature.  Let’s get enough  physical exercise.  Let’s check-in with the needs of others, help a neighbor.  If possible, let’s limit our news intake as hard as that is.

A visiting doctor

Just before the DRC/Ugandan borders closed, we were able to welcome a visiting surgeon

Dr. Peter Stafford who was traveling from Togo.  He and his family are trying to discern where they should serve as medical missionaries. There were a fair amount of obstacles affecting his trip: obtaining a “letter of invitation” with signatures from mayors/chiefs/important people in our province, a temporarily lost passport, a wife approaching her due date, the on-going Ebola epidemic, and then now the coronavirus epidemic.  Somehow it worked out and he was able to get back to Togo two days early!  We had a good time together and hopefully helped him to understand a bit more about Nyankunde Hospital, its’ history and vision for the work here.

Planting

We are getting ready to plant our fields as the rainy season begins.  Warren loves driving

Dr. Peter Stafford with our family

around the tractor and Emmanuel loves to ride along.  We are hoping to plant peanuts, soy, and corn in a couple of fields around us.  I really am thankful that our vegetable garden is starting to produce okra, onions, tomatoes, squash, and beans among other things.  Our gardener has been working hard to get things re-established since we were in the USA much of last year.  I always gain greater respect for how the Congolese

Tractor shenanigans

live off the land around us. How would we all do if we had to grow almost verything we eat?  That is how people live in this part of the world.  

A few special patients

I have a lot of special patients.  One in particular is a little girl with a protein losing kidney disease (a nephrotic syndrome).  It can be a very serious problem to treat and cause a reduction in kidney function. She has been dependent on steroids which have not really controlled her disease.  We needed to try something else.  We have had a small surplus of a immunosuppressant drug called tacrolimus which was about to expire.  Well she has been on that drug for the last month or so and seems to have better control of her disease.  In the USA, this little girl would have had a kidney biopsy and countless tests to better define her disease.  I would love to do that!  We don’t have a pathology department and it is really challenging to send biopsies out. So we treat her disease using clinical measures and she is getting better!  It is so rewarding to see her improving and getting off steroids.

One of our nutrition kids is almost 3years old and only weighs 6kg.  As a point of reference,

Mixing a corn/soy blend for our outpatient porridge

this is usually the weight of a 6mo baby.  She simply isn’t growing and is cradled in her mother’s arms most days.  She has never walked or crawled.  She simply hasn’t gained weight since birth.  The mother has been displaced from a few communities over time and her father is no longer alive.  She does not have an immunodeficiency like HIV/AIDS.  She does not appear to have cancer or a heart condition.  She does not have a thyroid deficiency.  It is more likely that she could have tuberculosis which is effecting her weight gain.  Many of the nutrition kids get better with just a little support and then there are others which confound us.  We will keep working with this little girl whose Swahili name means “Looking for peace.”

I would like to close with a song called “It is Well With My Soul” written by Horatio Spafford

In 1873.  It is a well-known hymn,a favorite of my grandmother.  It is about our hearts being at peace because of the work of Christ on the cross for our sin.  We can have a deep peace even when we go through great hardships.  A little background on the hymn’s author:  Horatio was a devout Christian and successful lawyer in the Chicago area.  He was married with 4 daughters and 1 son.  He was doing well, yet his faith did not spare him from adversity.  His son tragically died and then he lost property in the Chicago fires.  Then he sent his wife and children on a boat trip to Europe in the wake of this turmoil at home.  The ship was shipwrecked and all 4 of his daughters died.  He wrote this song when he was passing over the ocean to meet his wife, an ocean that had claimed the lives of his daughters so tragically.

When peace like a river, attendeth my way,
When sorrows like sea billows roll
Whatever my lot, thou hast taught me to say
It is well, it is well, with my soul

It is well
With my soul
It is well, it is well with my soul

Though Satan should buffet, though trials should come,
Let this blest assurance control,
That Christ has regarded my helpless estate,
And hath shed His own blood for my soul

It is well (it is well)
With my soul (with my soul)
It is well, it is well with my soul

My sin, oh, the bliss of this glorious thought
My sin, not in part but the whole,
Is nailed to the cross, and I bear it no more,
Praise the Lord, praise the Lord, o my soul

It is well (it is well)
With my soul (with my soul)
It is well, it is well with my soul

Weathering the pandemic storm from DRC.  Let’s encourage each other while today is today.

Lindsey Cooper

Bob the parrot who likes to socialize (eat) with us in the morning

Saying "goodbye" for now to some of our friends in  Kenya

Coming Back

February 19, 2020

Coming Back

Jacob our new puppy

Did you ever take a long pause from something, then return to it to find it was like you never left? I have experienced that this week after returning to consulting patients after an 18mo hiatus.  It is as if I closed one computer app and started another, to find it like I left it.  Even some of the patients/parents are the same.  The same challenges are these of providing medical care in a poor area, the same joys also.  It feels like a favorite pair of old shoes.  As I have often said the nutrition kids are like an extension of my family and they consider me a bit like a mother.  It really is a special relationship.  

It feels good to be back. I think most of you know that our family was in the USA for an extended period in 2019.  Since returning to Congo in August 2019 I have had very limited patient contact due to the possible risk of exposure to Ebola.  The risk was real, even this fall as our hospital received patients with Ebola and triaged many others for testing.  I have been teaching at the nursing school, preparing sessions with our young physicians, as well as taking on various projects like a children’s garden for hospitalized children.  I did homeschooling for our son Emmanuel as well.  THANKFULLY, for the last 1.5months there have been no new Ebola cases in Ituri Province which has opened the door for me to start providing patient care again. 

In a way, I am thankful for the time away from patient care because it has opened my eyes to other ministry opportunities and relationships.  A pediatric garden, a farming project, etc… I have been able to play a role in the rehabilitation of the hospital chapel and the installation of a memorial in photographs inside.  It is so important to consider the past in the present and honor those who have preceded us.  One sees things with new eyes after being away for a while.  It is easier to try new things.  

A Pediatric Play Garden

This week a project two years in the making is coming to fruition.  Our pediatric play garden

The beginnings

is going up!  It is very exciting to see something happen that has required a lot of planning/ordering/begging for material and funding.  It was designed for children who are hospitalized for long periods of time, especially for children in the nutrition program.  It is an essential part of the healing process to have a place to play and explore the world again.  The children have been sitting on the wall alongside the garden, looking longingly at the slide and swings.  In another two weeks they will be playing inside the garden.  I hope that it will be a pretty place and one that people want to visit and contributes to the healing process.

A couple of pediatric patients

We are currently caring for a little girl who was attacked by bees last weekend and had an anaphylactic reaction.  I am reminded that we need to always look in every orifice.  Everyday she sneezed out another bee!  Today we gave her anesthesia and pulled more bees out of her ears. She is fortunate to have survived.

There is another little girl with chronic kidney disease, a sort of nephrotic syndrome that doesn’t respond to normal treatment.  These are the conditions that you see a specialist for and probably have a renal biopsy to better define the disease.  We are limited here in our ability to analyze a kidney biopsy, so we are left with clinical management and observation.  It can seem limiting at times, but I can honestly say that it probably makes us better clinicians to make decisions in the absence  of all of these things.  For now we changes doses of steroids and we observe.

Then there is a 11mo baby with growth retardation and the beginning signs of malnutrition.  I remember the mother with short stature from previous hospitalizations with other children.  She confirmed that she had 4 girls that all died, seemingly from malnutrition.  The family is living in the village of Sezabo which has suffered from insecurity these previous days.  Life can not be easy.  Most people in the area walk to Sezabo to farm in the fields and then return to their respective villages.  We want to do everything we can to discover why this baby is suffering from malnutrition: immune status, hypothyroidism, etc so that it doesn't happen again.

The last interesting case is a young girl with an abscess between her liver and rib cage.  Very unusual location and we still don’t know why it is there.  Warren says that pain is often pus that needs to be drained.  It is very true.

On the homefront:  Jacob, the new puppy

Jacob is his name.  He is a native breed of the Congo, one of the top African breeds of dogs, the basenji.  He gains about 1lb a week so far!  I had forgotten how much puppies bite!  But he is really cute, smart, and has a nice disposition.  We hope that Emmanuel will learn responsibility in caring for his needs.  Right now we are trying to teach Emmanuel how to not overly excite the dog and be his master. We have struggled to keep dogs healthy in this environment and we are really hoping that a native breed will have a stronger immune system.

Thanks for your interest in our lives.  Pray for our little hospital in our little corner of the world, unknown to many.  Pray that the Lord might be honored in our work and ministry.

Lindsey

Fun with missionary kids

Valentines Day picnic

The slick back look

Upside down heart for Valentines Day

Building Community: Barn-raising

January 20, 2020

Living cross-culturally isn’t always easy. There are many things I don’t understand.  Just when I think I understand someone or something, something happens and I realize how little I understand.  It can be frustrating at times.  On the other hand it is exhilarating when you make a meaningful connection.  It is a process that requires a lot of patience,  flexibility, and understanding.  

One question I continue to have is: “What is meaningful community look like here in Congo?”  What do deep, meaningful relationships look like here? I am not talking about outward friendliness or niceties, I am referring to the Biblical concept of koinonia-of mutual dependence and trust.  I am realizing that koinonia requires people to be vulnerable and to ask for help and advice.  This is a rare thing here.  So how does this deeper level of community develop?  

One definition of community I found said that it “is the condition of sharing or having certain attitudes and interests in common.”  I find this to be true, but lacking in the idea of interdependence.  Community is not always natural and needs to be worked on.  Sometimes it is hard to find agreement and common ground.  Sometimes it is hard to work through differences, ethnic or otherwise.  Building community takes time and intentionality, sweat and tears.  It is true that activities which hold mutual benefit have the ability to build community.  

This past weekend I was blessed to participate in a community building activity.  The Women of CME mudded a barn!   I have never been part of something exactly like this before and it felt like a privilege to take part.  We are preparing to farm about 8 acres together, with the purpose of supporting the malnutrition program and women’s ministry activities.  It was a great opportunity for me to learn

something new and be together with some amazing women, all around something we believe in.  I was struck by many things.  There were over 20 people who participated and everyone was important.  I drove, made multiple trips to the water hole for water to make mud, I mudded a few sections of walls, and I watched the process.  Others cooked, erected door frames, mixed mud, shoveled mud, etc.  What would be heavy work for one or two people is light work for a team.  Even beans and rice tastes amazing after having worked hard together!.  We hope that there will be many more opportunities for these kinds of koinonia activities.  We hope that farming will be an activity that builds trust and deepens relationships between the women.  We hope that we will grow closer to the heart of God.  We hope that we will have opportunities to share our lives and faith with the neighbors and field hands in this area.  We pray that this can be an example for CME to follow.  There should be an almost unnatural unity in the Church because we have Christ in common.  


With many blessings,
Lindsey

Wishing you a Happy New Year

January 1, 2020

Christmas Celebrations & A New Year

Another year has come to a close, just like that.  There is something about opening a new year and marking the year gone past.  We are thankful for friends and family near and far, churches and individuals who support our ministry.  We are truly blessed that you are in our lives.  It seems like 2019 was a time when the Lord was ploughing a new field for us and we are planting some different crops.  Emmanuel is more rooted in his identity as an American kid and what it means to be a valued son.  We enjoyed our time in the Blue Ridge mountains and we are happy to be back in Nyankunde these last months.  We are trying to treasure our days more as gifts from God.  

                                                         It wasn’t a white Christmas here in Congo, rather a

balmy and tropical one.  Our tree is artificial with many handmade ornaments and LED lights. Emmanuel had to be convinced that Christmas would still come even if there wasn’t any snow.  I think he was really worried about it.  I told him that we could read about snow and make snowmen on paper to make up for the lack of snow.  He accepted this.  On Christmas morning he was happy to see his stocking full of treasures and presents under the tree.  He said something

A balloon Christmas tree for a party

Making crown hats

Baking cookies

like, “Mom, Christmas comes even in Congo.”  His favorite present was a camera.  He opened it and said, “Oh wow.  I have been dreaming about this.”  It brings such joy to see someone experience joy!  This year he also said, “Christmas is about Jesus being born, I didn’t know that before.”  It is fun to see his wonder and understanding grow.  Celebrations are more simple here and butter for baking in limited quantities. Advent takes on new meaning, the period of waiting for Christmas to come.

This Christmas I meditated more on the fact that Jesus came to earth as a recognized King.  He was a long anticipated king, but came almost 600 years after the last recognized king of Judah.  He was recognized initially by those from foreign lands, not by his own people.  I love that Jesus was recognized as a King by other Kings who weren’t even a part of Israel. The kings of Persia came specifically to find the “one born king of the Jews.”  I don’t often think of Jesus as King, but it was at the core of his identity. He was a perfect King with the authority to rule and judge, to give pardon, and to lead the direction of a peoples’.  Someone his Kingship became more clear at the end of his life, just as the Magi foretold. It is fascinating that Jesus taught more about a KINGdom than about any other subject.  And Jesus does accept the title of King when questioned by Pilate. ”My kingdom is not of this world. If it were, my servants would fight to prevent my arrest by the Jews.  But now my kingdom is from another place….You are right in saying I am a king. In fact, for this reason I was born, and for this I came into the world, to testify to the truth.”  John 18: 36-37

We celebrated on Christmas day with our fellow medical missionaries and Congolese

colleagues. It was a lovely afternoon with fun activities for the kids, complete with making crowns and re-enacting the Christmas story.  And food, there must be food if it is a Congolese Christmas party.  It was lovely watching the children play and enjoy simple joys.  It really felt like “OUR” Christmas party, not just something we hosted, but a Christmas we shared together.  There is a lot of joy in living life together.

New Plants

I am finding simple joys in trying new plants and trees in this environment.  This year I have

Tree seedlings for the hospital

planted a cinnamon bush, lemonbalm, various herbs, and most recently vanilla.  To plant trees, one really has to have the long-term perspective of what it will be like in 10-15years.

An Extended Project 

All of you who know Warren know that he always has a project at hand…a treehouse, a climbing gym, a re-furbished toy, etc.  Ever since returning to Congo he has been working on a rocket stove hot water heater. It has been at least 3 months and there have been multiple iterations of it.  The rocket stove is a very efficient wood burning stove with steady air intake. Add a water jacket, water reservoir, and pressure regulator and whaalaa!  We now have an outdoor shower and bathtub in the garden which receives hot water from the rocket stove.  This is what one does for a good hot shower in a limited resources setting.  I am hoping that we are nearing completion of this water heater.

Medical Work & Hospital Garden

We continue on with medical work and teaching here at CME-Nyankunde.  Warren sees his share of trauma and foreign bodies and difficult surgical cases.  Just offering good medical care in the face of poor medical care is a significant part of our ministry here.  To do our work with integrity and compassion in the name of Christ is a powerful thing. These have been challenging times for our staff who has not received a true salary in the last 3months.  We are a government hospital, receiving support from the European Union.  So we are put in a difficult situation.  

Our pediatric garden is shaping up slowly.  We have a fence in place and now comes the

Beginnings of a pediatric garden

placement of more trees/shrubs/flowers and play equipment.  It will be lovely to have a green place for the hospitalized children to truly play and explore the world.  Stay tuned for more in coming weeks.

Prayer Requests

-Pray for encouragement of our staff in the face of difficult financial times.

-Pray for the initiation of the CME women’s farming project and various other hospital projects.

-Pray that we would have vision for where God is leading in the New Year.

-Pray for more prayer and financial ministry partners

Many blessings,

Lindsey for the Coopers

Warren dressed up as a Gibeonite for a costume party from the book of Joshua

Visiting Emmanuel's friend with a burn injury

Dr. Davin at the Joshua costume party