Seeing with New Eyes & Trip to Adi

July 12, 2020

Looking in on Dad

This is how we roll

Seeing

Do you ever feel like some days life is more in focus than others?  Or perhaps you didn’t even realize that you weren’t seeing well until suddenly things looked clearer with a new pair of glasses?  I recently saw the video of a colorblind man who is suddenly able to see color for the first time, and it was immediately shocking and brought tears to his eyes.   Similarly there are experiences in life that cause us to pause and truly “see”, as if for the first time.  

Many things about working as a doctor in the hospital become routine.  It even becomes routine to walk by a still bundle in a bed that is a child who died from malaria overnight, acknowledge the sadness of it all, and then see the patient two beds over.  These are things we see here every day and I am used to it, even hard things.

I had an experience a couple of weeks back that brought into focus the preciousness of every person to God. I had been visiting a young man named Alpha who was suffering from complications of surgery done at an outside hospital.  I brought him therapeutic milk almost daily at noon and established a routine of greeting his family.  He was getting weaker and weaker due to our inability to feed him with intravenous nutrition (not available in this part of the world). One day his grandmother told me that he was sleeping almost all the time and shared her sadness with me.  The father asked if I could come for a visit when we has awake “tomorrow.”  I sensed that this was important and I promised to see him tomorrow.  The next day I went to visit him with two of the other doctors.  A few ICU nurses joined us.  It is hard to know what to say to someone who is dying and I asked the Lord to give me a few words for him.  I felt like it was important to acknowledge the meaning of his name, Alpha.  I told him that his heavenly Father knew him before he was even born and knew his name: Alpha.  I told him that God has had a plan for his life and that he was deeply loved by God.  I told him that God himself referred to Himself as the Alpha and the Omega, the beginning and the end.  I told him that life would never end for those who know God and have confessed their sins before him.  His eyes opened and closed as he drifted in and out of sleep.  He nodded that he believed this.

One of the nurses said that they had been talking about eternal life.  Then we asked if there was something that he still desired to do or for us to do for him.  At this point he affirmed that he wanted to be baptized and named people that he wanted to be there.  It was a beautiful moment that he was able to express this desire.  We affirmed this desire.  We weren’t sure that we would have enough time to pursue, but we took his request to the pastoral staff.  We all experienced a sense of peace just being together and hearing him speak.  

I was so blessed to have this time together with Alpha’s family.  I wasn’t sure what would happen next.  The next morning I walked into the ICU to learn that he had just taken his last breath and passed into eternity.  He had already passed through the deep waters.  I believe that God heard his desire to be baptized.  Who knows?  Maybe that happens in heaven.  I don’t see Warren cry much, but cases like this touch him deeply.  It is so hard for him to watch people die that he would like so much to help.  Sometimes God has other plans and he holds all of our days in His hands.  Alpha reminded me of the beauty and importance that each of us has to God.  We are known and deeply loved.  I am thankful to God for bringing his life into focus at the end and giving him peace. Each individual life is fragile and beautiful, and heaven will be so beautiful because it is made up of people like Alpha.  

A Trip to Adi

This past week we had the opportunity to travel north to the Sudanese/Ugandan border to a place called Adi Hospital.  Adi was an old stomping ground for Warren, and it had been many years since he had last visited.  It was my first visit.  We were invited by our German friends Matthias and Sabine Holmer and traveled with one of our nurses, Ayiko, and our friend Maike. We had an encouraging week together with the staff of Adi Hospital.  Warren was able to help them to get an electrocautery working that hadn’t been used in years. He gave a little workshop on cautery that involved operating on an avocado.  He is a gifted teacher and

can make things practical.  He helped them out with a few cases and used ultrasound on rounds and for decision making.  It was funny to walk in the old operating theater with him and hear about the many hours he had spent there…or sit in an old chair he spent many hours in. He has many fond memories of his friend Congolese friend Akuma, who he trained in surgery in the 2000s.  Akuma died back in 2011 and Warren hadn’t been back to the area.  It was good to visit his gravesite on the hospital grounds. 

I rounded on pediatrics with Dr. Matthias and we discussed what to do with all the complicated malaria cases, and dreaded complication of blackwater fever or “coca-cola urine.”  I learned a lot as we sought help to these clinical questions together.  I was able to reflect on our pediatric practice at Nyankunde and considered some changes I want to make.   It is good for people to be stimulated to think in different ways.  We were then able to reflect on our own team of doctors and the learning environment that exists at Nyankunde.  

It was fun to watch Emmanuel make friends so easily!  He has an endearing phrase:  “Bodubodu” that he uses to greet people.  It sounds silly and makes everyone laugh.  It sounds a bit like the local greeting in Kakwa “Aloboo aloboo.”  He became known as the white, blond-haired “bodubodu” kid.  They taught him all the local games (even a version of duck duck, goose and tug-o-war without a rope)!  He was able to communicate with them in French and gestures.  I hope that he will always make friends this easily!

 

This trip to Adi reminded me of the importance of encouragement in all of our lives.  We hope to be able to return sometime soon.

Continuing On

We continue to provide medical care at Nyankunde Hospital during challenging times.  The security situation in Ituri Province continues to be poor.  There are more internally displaced peoples in our province than anywhere else in the world at present.  The borders to surrounding countries remain closed.  We continue to pray that God will use our witness in these days to turn hearts back to Him.  There is spiritual oppression around us…Covid seems like something quite far away actually. I am reminded that God holds the solutions and sometimes sends drought and plagues to get our attention.  

2 Chronicles 7: 13-16 says “ When I shut up the heavens so that there is no rain, or command locusts to devour the land or send a plague among my people, if my people, who are called by my name, will humble themselves and pray and seek my face and turn from their wicked ways, then will I hear from heaven and will forgive their sin and will heal their land.  Now my eyes will be open and my ears attentive to the prayers offered in this place.  I have chosen and consecrated this temple so that my Name may be there forever.  My eyes and my heart will always be there.”

Pray for security of our village and area and the work of Nyankunde Hospital.

Pray that we would represent Christ in word and deed.

Pray that Covid-19 would not reach the many displaced peoples.

Pray that borders would open soon and we can get the break we need, and be reunited with family.

Lindsey for the Cooper Family

Evening fun drives with our friends

Father's Day Projects, Gorilla Adventures, and a Loss

June 21, 2020 

Happy Father's Day 

Wishing you all a very Happy Father's Day to all the dads out there!  Warren is a great father to Emmanuel.  They are always making something together.  Today Warren made him a little treehouse and showed Emmanuel his handmade crossbow.  It is a blessing to have a handy husband who likes to try new things!  He invests in his son.  Thanks for being a great dad and husband!  We love you!

Building a mini-treehouse

A handmade crossbow

Virunga National Park

Last week we had the opportunity to visit Virunga National Park, the oldest national park in Africa. We had been hoping to do this for years and we jumped at the chance.  We needed desperately to get out of the village for a short time.  The national park is officially “closed” due to Covid restrictions to protect the gorillas.  The park headquarters has a gorilla sanctuary for orphan gorillas whose parents died prematurely.  There are currently 4 orphans: 3 females and 1 male.  They have one guardian who cares for all of their needs and has learned to communicate with them.  We were told that there are 15 gorilla sounds/calls that they have mastered.  I tried to imagine spending most of my time with gorillas instead of people and what a commitment that really is.  

It seems that the gorillas have learned how to escape from their enclosure, climbing over

the electric wire without being electrocuted!  While we were there with their guardian, two of the gorillas were very interested in us and jumped the fence!  No sooner had this happened that it was peering over the observation deck with its’ big hands scaling the wall between us!  Then the second female came to join us.  They wanted to take turns approaching us.  At this point Emmanuel got a little nervous and the guardian was between us at all times.  They were not aggressive just very curious.  I am sure they would have come up and touched our hair, etc.  IT was enough excitement for one day!

It is amazing to watch these creatures scale trees with such agility and size, to see the size of their hands, etc.  Their eyes are so inquisitive, as if they want to know what we are thinking about them. They are very deeply respected by the Congolese, almost hallowed.  In fact when a gorilla dies they hold a funeral procession and give them a proper burial.  It felt like such an honor to spend part of the morning together.

Virunga NP has become increasingly a difficult place to protect.  In Africa conservation is akin to actively protecting animals from poaching and land from exploitation for natural resources.  It is not an easy job.  Our pilot friend wears a bullet proof jacket when we flies doing surveys. Much of this is done from the sky. Our hospital has cared first hand for many rangers who have suffered accidents from national parks.  I have great respect for those who work to protect these rare habitats.  It often comes at great cost.

Perhaps someday we will have the opportunity to visit gorillas in the wild as Emmanuel gets older. We take any chance we get to expose him to these wonderful wild animals.  He is becoming a bird watcher and  loves chameleons.  He just loves animals and is learning that animals have limits and get tired too.  

The descent to the Semliki Valley

Close to Boga

Loss

This past week one of our nurses died of complications of a stroke.  His name was Bara and

Bara's family

CME Colleagues, Friends, and Family

he was chief of the pharmacy.  He worked at Nyankunde before the war and was one of the few who came back to re-start the work afterwards.  It affected our staff deeply.  I was very touched to hear of many staff members who came to sleep in the hospital chapel alongside the family the night of his death.  It is very cultural for family members to “veuil” (night guard) alongside the body of their loved one.  The following day there was a large procession to attend the funeral in a neighboring village.

Today the hospital held a prayer meeting for his family,  friends, and co-workers.  One of the Swahili songs was about how there is only one way to get to God and we need to know Jesus to inherit heaven.  We need to prepare ourselves for this reality.  Death has a way of exposing what is really important: knowing and following God in this life and helping others to do so.  I was reminded of the passage in John 14: 6: “I am the way and the truth and the life. No one comes to the Father except through me.”  

I could almost hear Bara’s chuckle and see his dry smile as we sang and prayed over his family.  

An Update on Security

Many of you have expressed concern for how we are doing, given the recent event of insecurity in our village.  Thank you for contacting us.  We are doing all right.  There has been continued movement of the population-many women and children have left, most shops have closed, etc.    The governor of our province visited a couple of weeks back in an attempt to promote peace and the laying down of arms. There is military presence here which isn’t always reassuring, but they are here to protect against any insurgences. We have taken more frequent breaks out of the village to breathe which has been good.

We appreciate your prayers and support.

Blessings,

Lindsey for the Coopers

Our new baby goat Jackson

Emmanuel climbing the cell phone tower with his dad (Level 1)!

A Miraculous Recovery & Pictures from Everyday Life

May 3, 2020

Kid in the bucket!

A Miraculous Recovery

Yesterday I saw a woman in the clinic named Dora.  She had a terrible dental infection that she had been hoping would get better. It did not and by the time she came she had a large abscess under the chin.  It was pushing up her tongue and she was very ill.  We did an emergency drainage of the abscess and she seemed to be much better.  

I was called to the hospital several hours later to see her.  She had been having more and more difficulty breathing.  I think that she may have had bleeding into the abscess cavity and her tongue was obstructing her airway.  We had an inexperienced doctor on call who did not appreciate the extent of her symptoms. By the time I arrived, she had stopped breathing and her pupils were dilated.  This is a sign of profound anoxic brain injury. We rushed her into the OR hallway and I went to the supply room.  In front of me I found a cricothyroidostomy kit.  It was 4 years expired, but I had been keeping it around just in case.  There was no need for anesthesia as the patient was virtually dead.  I got the tube in her trachea and we began ventilating her.  Her oxygen saturation came up with ventilation but she was making no spontaneous respirations.  After bagging her for an hour or so, I was about to give up.  I remembered that we had received two old ventilators on a container from WMM.  I hooked her up to one of them and it worked fine.  It was an old and very basic ventilator, but it did the trick.  

At midnight, the power went out and the ventilator stopped. The nurses bagged her for a while and then she started breathing spontaneously. This was about 6 hours after she stopped breathing.  I had fully expected her to die, but she basically woke up, started breathing  and responded appropriately. 

This morning, I found her breathing on her own, communicating and asking for food and water.  I had utterly given up hope, but here she was alive and neurologically intact.  She may have lost a few brain cells, but she seems ok.  

The airway kit and the ventilator were both gifts from Samaritan's Purse, stored on a shelf. They were procured, packed and shipped by people who care.  The ventilator was checked out by the biomed team. Even the OR is here because of Samaritan’s Purse. 

This morning Dora and her husband are praising God for his mercy.  Her four children will hear the story of how her life was spared.  She is by no means out of the woods, but she has come back to life.  In the days to come we will continue to speak with her and her family about God's goodness.  

 Few Photographs of Life

We want to share a few photographs depicting life in Congo.  This is an agricultural society.  People's ability to provide for their families depends on what they are able to grow with their own two hands.  Here are some photos showing a traditional wheelbarrow, hoe, and a mix of soybeans/corn going to the mill.  We mill our own soybeans and corn to make nutritional porridge for our outpatient malnutrition programs.

Corn and soy mix prior to milling

There is nothing quite like freshly ground peanut butter!  It is a process to harvest, shell, decorticate, and roast peanuts.  Then you pass it through this mill to make peanut butter...or you grind it by hand.  The natural oils are pressed out of the nut giving the peanut butter a very smooth texture.  There is no need to add sugar or any preservatives!

We have been growing Arabica coffee for a few years now and have had several harvests.  The berries turn pinkish/red on the vine indicating that it is time to pick them.  Then you float the berries in water to determine which ones are good and which ones are not.  Then either you can de-pulp them by hand or run them through a manual mill like this one.  Next you are left with the bean covered in parchment to be dried in the sun and then stored.  The parchment protects the bean until it is ready to be removed and beans roasted.

There is not a Home Depot around the corner to purchase tree and shrub seedlings.  We start our trees from grafts.  This takes a bit of time.  Here is a pomegranate tree which was started from a graft years ago.  Now it is producing beautiful fruit!

This is a vanilla vine growing up a tree seedling.  We planted 4 vanilla vines within 2 meters (social distancing) of each other.  This is the way it is done in the forest.  Eventually, the vines will cover the trees and cross-pollinate one to another.  It takes years to harvest vanilla pods and at least initially cross-pollination is done by hand.  I have no idea what this involves, but it is fun to learn these things!

Vanilla vine

The rainy season has begun!  Rain is a blessing and waters the plants to provide food we desperately need.  It is my prayer that we will feel more connected to creation as we tend and water the fields and animals around us.  

Psalm 104:13-15 says, "You send rain on the mountains from your heavenly home, and you fill the earth with the fruit of your labor.  You cause grass to grow for the livestock and plants for people to use.  You allow them to produce food from the earth-wine to make them glad, olive oil to soothe their skin, and bread to give them strength."  

Blessings and love,

Lindsey and Warren Cooper

A traditional hoe

A critical time

WARNING!  This blog will contain nothing about the Coronavirus. I know that in these times, there can be no other topic of concern or information which more important,  but I am going to take the bold step of actually talking about something else.  Feel free to stop reading now. 

What I would like to mention first is that our little village of Nyankunde is in a state of conflict. I won’t say the word “war”,  but the security situation is at a low point. There have been rumblings for several months. The local tribe here is Bira.  For reasons that we do not fully comprehend, a local Bira militia has been formed.  Their purpose was ostensibly to protect the local population, but whenever you mix tribal issues and bands of enthusiastic armed youth, things are liable to go astray. Go astray, they did.  There have been a number of “incidents” over the preceding months.  There were some attacks of people in the community. There were a number of murders which took place. It was difficult to get an accurate account of what was going on and why. It was hard, and still is, to understand whether this movement was supported by the local population or not.  

Anyway, things came to a head last night.  The militia had openly come into Nyankunde town for the first time, brandishing arms.  There was some incident regarding a shopkeeper who was accused by the Congolese army of supplying the militia.  The army moved in, and last night, we heard shooting in town. One Congolese soldier was seriously injured and several bodies were found around the town this morning. 

They called me to the hospital last night to see the injured soldier.  He had a thoracoabdominal wound appeared to have injured his lung and liver.  He was in shock from bleeding into his abdomen. Everyone was convinced that he had been shot. The patient himself asserted this.  There was an entrance wound, but no exit wound.  Trauma surgery is pretty simple stuff.  The question is, “where did the bullet pass and what did it injure en route.”  I got an X-ray and discovered a bullet in the left lower quadrant.  This meant that the bullet had passed all the way thought the abdomen, from side to side and top to bottom.  There was a potential for devastating injury and we took him immediately to the operating room. I opened him up and discovered that there was a wound to the diaphragm and the right lobe of the liver, which was bleeding, ...but nothing else.  I just could not figure out how the bullet ended up where it was, without injuring something else.  After some head-scratching, I ended up packing around the liver to control the bleeding, and closed.  After closing, it hit me that this was not a gunshot wounds all, but a stab wound.  The knife had cut cleanly into the diaphragm and liver.  The bullet I discovered on X-ray, had been there for years, and he had forgotten about it.  This morning he admitted that there had been a lot going on, and that yes, it might be possible that he was stabbed instead of shot.  He needs more blood, but seems to be doing fine, for now.  

Excuse the medical diversion. Our peaceful little town is now in a state of fear and confusion.  The majority of the population left. The Congolese army is firmly established in town.  The militia have reported pulled back, but it is uncertain whether or not they will attack again.  We do not know what the future holds.  For the moment we do not feel personally threatened. I feel that my presence here is needed at the hospital and it is my desire to continue to demonstrate that I wish to stay.  There is always a tendency for all expatriates to run away in time of need.  This obviously is a decision which must be carefully weighed.  There is a time when non-essential personnel should be evacuated. We are discussing what we should do as a family.  It is hard to contemplate evacuation in a time when the world seems be a on lock-down and any other place may be scarier or more dangerous.  

On a less dramatic note, I have been waging another war, against dust.  We have been embroiled in a project to redo the floors in the OR/ICU in terrazzo.  Our floors had deteriorated to a point where we could not properly clean them.  We got some funding and we have had them redone in terrazzo.  This is a durable and beautiful option, though very expensive.  It involves pouring a mixture of cement and small stones.  When it hardens the surface is ground down, leaving a beautiful surface with small colored stones.  The process of grinding down the floor puts out a fine dust powder which is EVERYWHERE!  I’ve spent the last week cleaning every surface, every window, every piece of equipment and moving them back into the rooms.  It has been an massive job and it has nearly done me in.  We are finally nearing the end, and we actually operated in the our “new” OR on the stabbed patient who though he was shot, see above. 

On the homefront we have offered shelter to two large extended Congolese families in our guesthouse.  This is a record for the number of people we have lodged.  We have 21 people in a 3 bedroom house!  There is plenty of room for cooking outdoors and a bit of a yard which is helpful for the kids to play.  Many Congolese families have sought shelter in other villages, but since the hospital side of the village is more peaceful, we are lodging these people here.

So that’s the news from Nyankunde.  It is disturbing and unsettling. All over the world, we are coming to terms with the reality that this world can be a scary place, and none of us can think that we are somehow “safe” in the bubble we have created. Here, in our troubled little village, as you are wherever you may be, we assert that we are in God’s hands and we can rest in that calm assurance of his peace.  

We appreciate your prayers and support.

Warren, for the Coopers