A Birthday Boy, Refugees, & An Unusual Case of Tuberculosis

August 31, 2020

 

Emmanuel’s 6^thBirthday

 

Emmanuel’s long awaited birthday finally arrived!  We had a reptile themed party, complete with attendance of his chameleon!  The missionary kids played musical chairs for the first time…but it was a little stressful for Emmanuel.  We played pin the tail on the chameleon and ate cake over the campfire in our new fire pit. It was a special day and I think he felt treasured.  He told us the other day that he thinks being 6 is more work.  Maybe he has taken his dad’s counsel to heart that he needs to think about the consequences of his actions before acting.  He is already asking when his next birthday will be!

 

We have a new appreciation for birthdays here in Congo.  It really is something to be celebrated when there is so much disease around, especially malaria.  We are so thankful to God for our son Emmanuel and for health!

 

Pericardial Tuberculosis

We have formed more of an intentional relationship with Adi Hospital.  Adi is located about an hour (by plane) north of here on the border of Sudan and Uganda.  We were called on to go and place a pericardial drain in a child with probable tuberculosis. This is a rare, life threatening complication of tuberculosis.  The procedure went well and the child had immediate improvement in his cardiac function. We are hopeful that he will survive. It was worth the long arduous road between Aru and Adi to be able to help this little boy.  Emmanuel was touched to know that he was almost this boy’s age.

 

While we were there for 48hours, Warren operated on another complicated case.  I consulted several kids and gave a medical conference on pediatric tuberculosis (TB).  I always learn the most when I prepare such a large topic.  We discussed an often neglected topic which is maternal TB and consequent neonatal TB.  As it turns out that in childbearing years, women have the highest prevalence  of TB activation than any other time in their lives.  Pregnancy in and of itself is a risk factor for TB re-activation and it often goes undetected.  We see at least two cases of year of suspected maternal-child transmission of TB.  It is a very relevant topic!  Then we discussed how to manage pericardial TB, the prognosis, etc.  

 

It sounds like they want us to come back quarterly to do some teaching on practical bedside ultrasound skills, and medical/surgical support.  This was so encouraging!  

 

Sickness

 

Emmanuel and I were both sick with a flu-like illness a couple of weeks ago.  His fever last for two weeks and mine one week.  We were both quite tired with upper respiratory symptoms.  Because we are in Covid times and we have had Covid cases in our hospital, we treated this illness like Covid even our tests were supposedly negative.  I am feeling much better and the cough had gone away.  Still it is pause to think and really protect oneself and family, other staff. I hope that we can improve our protocols to better protect people hospital staff and other patients.

 

We are thankful to be back to health again.

 

Refugees

 

Our community has absorbed an additional 600 households due to the insecurity around us.  There is no UNHCR camp, there are no food handouts, etc. People are settled in traditional homes by the village chief and the neighbors are expected to help to provide for their needs, until they can get back on their feet.  Many people can not access their old fields due to insecurity and they are forced to abandon their crops and start over.  This leads to food insecurity and undernutrition.  We sent a hospital vehicle to evacuate a desperately sick man from a neighboring health center.  We have admitted babies whose mothers’ are not making enough milk.  These are hard times.  We are seeing a very exaggerated number of malnourished children, and often their mothers are not well.  We are living through difficult times.  When security is threatened, so is food.  If everyone does their part we will be able to provide for people in desperate need.  

 

Tribalism is an ugly thing. Hate is ugly and makes people do horrendous things.  This geographic area feels quite tenuous at present.  We find that we really need our evening walks and to get out from time to time.  I have a new understanding of Jesus' words about worry.  

"Therefore do not worry about tomorrow, for tomorrow will worry about itself.  Each day has enough trouble of its own."  Matthew 6:34

"Do not be anxious about anything, but in everything by prayer and petitions, with thanksgiving, present your requests to God.  And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus." Philippians 4:6,7

Thank you for your interest in our lives and continuing story in Congo.  We trust that God is working through us to represent Him even in tough times.  Continue to pray for reconciliation and lasting peace in our area.  Pray that God will convict peoples' hearts.  Pray for the difficult financial situation our hospital is facing with less patients and consultations, that our staff would have their needs met and have the strength to carry on.

Blessings,

Lindsey (for the Coopers)  

 

Our home soy harvest

Emmanuel loves to help in the field

Gold mining in the forest

Opening of "Le Petit Jardin" & Growing Refugee Needs

August 9, 2020

 

Refugee Situation & Tremendous Needs

Our hospital is a BRIDGE over troubled waters, food insecurity, and illness.  It is a blessing to watch a child that has refused all food accept food again.  It is a blessing to see a child walk for the first time at age 3.  It is a blessing to see a child smile and extend a hug when he sees you instead of breakdown in tears.  As Emmanuel says so astutely, “Kids in the hospital need love Mom.”  He gets it and wants to give his clothes and toys away.  He wants to extend a hand in friendship. He finds true joy in giving.  There is so much that I have learned about love from our son.

If the health of our children is a litmus test of societal health, then our immediate geographic area is in trouble.  We are beginning to see that children are collateral damage of armed conflict.  Collateral damage!  Every day we are admitting 3-6 children to the hospital with severe protein-calorie malnutrition!  If we continue in this way our hospital admission rates will be 4-5times that of last year, and we could approach 600-700 hospitalizations..  We simply will not have enough beds.  I looked at all of the charts today to see who I could possibly discharge to home. Almost all of the 30 current children have come in the last 2 weeks.

 

How can this message be heard?  Shout it from the rooftops:  "We are HURTING our own children!  Lay down your arms!"  

 

 

Pandemic & Play Garden Opens

The pandemic has officially arrived in our hospital.  This virus exposes all the weak points in a health system, including ours.  There are many things that we need to improve to be able to provide care safely without endangering other hospitalized patients (and our families). This is why infection control and isolation is so important.  Hospitals, like ours, can truly be daily “super spreader” events in places like Congo.  

 

Do we open the children’s play garden or do we wait?  

As I walked around the hospital I saw at least two dozen people in one of our pediatric wards…sitting together on beds and the floor…kids crawling everywhere, I said to myself, “Yes, we need outdoor space in such a time as this. Outdoor spaces will decrease transmission risk in a place where social distancing is unheard of.  Staff wears masks, but patients (by and large) do not wear masks.  So in the end we opened the pediatric play garden with a word of blessing from our chaplains and guidance of administration.  It was a fun event as you can see!  Don't worry...we will limit the number of people/children who can use it at a time.

 

Our province has more internally displaced people (IDPs) than anywhere else in the world.  There are thousands of people in refugee camps and living in less than ideal conditions.  Social distancing is very difficult in this part of the world and it simply is not cultural.  Now the capital of our province, Bunia, is seeing lots of Covid cases.  There are difficult times to come.  Pray for us.

 

A Soybean Harvest

Our hospital nutrition program has its’ first soybean harvest!  Now the work begins to dry and

separate the beans for use, storage, and sale. The crop did very well with seed pods growing waist high and very little maintenance!  We continue to have a lot of rain which is good for soybeans.  It seems that soybeans will be an excellent choice for future planting.  It is a learning process and a time to try new things.  It is great for me to learn traditional farming practices and how valuable land is to the people here.  

 

A Project

This past week we completed work on the renovated foundation behind our house.  It was

cracked and overgrown, completely unusable space. Now it is a fenced in play area with room for a basketball hoop….and complete with a hoist for various lifting needs.  It is something we have wanted to do for years and have been saving to do.  

Thanks for your interest in our lives and ministry here in Eastern DRC.  We thank you for your prayers for peace in our region.  We would love to hear from you!

Blessings,

Lindsey for the Coopers

 

 

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)!