Uveitis

Uveitis

Fact: we human beings are made of pretty fragile jellies.  As a surgeon I know this to be true.  I spend my working hours cutting it, burning it and tying it with small bits of string. This is not our impression of our own bodies.  I generally see my body as a fairly capable entity.  I have a reasonable expectation that it will do what I want it to.  The experience of the past two weeks have caused to me to question this.

We are currently in Kinshasa.  We came here from Eastern Congo to deal with our visas, and to visit a hospital called Vanga.  Upon arriving at Vanga, my left eye started to hurt.  I did what most doctors do, and automedicated with antibiotic eye drops.  The next day it was worse and my vision was blurry.  I visited the eye clinic at Vanga and was informed that I had anterior uveitis.  My pupil was a bizarre inverted heart-shape, due to adhesions between the iris and the lens.  I was prescribed atropine drops and steroid drops.  Over the next couple of days, my vision deteriorated to the point where I could not see my hand in front of my face.  They tried to measure my visual acuity in the left eye, but I couldn’t even see the eye chart on the wall.  Meanwhile I was still doing surgery. Ever tried to remove a thyroid with one eye closed?  I don’t recommend it.  I would have to touch the patients neck with my fingers to see how far away it was, before making the incision.  Anyway, to make a long story short(er), we were able to get a flight to Kinshasa to see a specialist here.  This was not easy for us, as we had to leave patients behind in Vanga who also have critical problems. I even did two cases while we were waiting for the plane.  Now, in Kinshasa,  I am now on systemic steroids.  I have undergone a battery of negative tests.  On the positive side, I have learned that I do not have toxoplasmosis, yaws, or syphilis.  The vitreous humor (in the back of my eyeball) is affected and is cloudy.  I see blurry floaters drifting by, which is kind of entertaining. On a positive note, my retina has not detached.  I’m supposed to be seen by the specialist tomorrow. My vision is not any better, but it’s at least not worse. Perhaps you are wondering why we are not on a flight back to the US right now.  Our passports are sitting in some office here in Kinshasa and it is not clear to me when they might be available. We absolutely need these visas to be completed. 

So that’s my news. I’ve gone through a range of emotions. Posterior uveitis is kind of a big deal and there is a chance that it could resolve, but also a significant chance that my vision could be permanently damaged or that I could become blind in that eye. I start to wonder if I can continue to serve as a surgeon.  Maybe it’s time for that second career I’ve always dreamed of, one that might be more suited to monocular vision. Perhaps this all sounds terrible, but there have been many blessings. If this had happened in Nyankunde, I don’t know what we would have done. Here in Kinshasa I am getting appropriate treatment and I am not forced to do surgery. I’ve been resting, with the exception of the forays into the city. In the taxi, I just close my eyes.  It is less stress on the brain and spares me from observing the madness that is Kinshasa traffic. Lindsey and Emmanuel have been great. They drip endless drops into my eye and count out the pills I’m supposed to take. They guide me over the ditches and piles of garbage. 

Maybe it’s a good thing.  We get so wrapped in our abilities, our capacity to serve, our “indispensability.”  The poet Milton went blind and this was the subject of perhaps his most well-known sonnet.  Don’t get me wrong..I haven’t gone blind, just blurry in one eye, and I’m certainly not Milton.  Still the message is apropos.  God doesn’t need our abilities to accomplish his glorious purposes. He wants us simply to do what we can, to accept the “mild yoke” he places on us.  Sometimes what he wants from us is to simply be his children, to rest in that.  Here’s the sonnet, by the way. 

Warren

When I consider how my light is spent,

Ere half my days, in this dark world and wide,

And that one Talent which is death to hide

Lodged with me useless, though my Soul more bent

To serve therewith my Maker, and present

My true account, lest he returning chide,

“Doth God exact day-labour, light denied?”

I fondly ask. But patience, to prevent

That murmur, soon replies, “God doth not need

Either man’s work or his own gifts; who best

Bear his mild yoke, they serve him best. His state

Is Kingly: thousands at his bidding speed,

And post o’er land and ocean without rest;

They also serve who only stand and wait.”

Bare Feet

May 23, 2023

  

RURAL LIFE

Living in rural Africa has its advantages…so does having a husband with lots of willingness to try new things.  Warren braves the hillside to harvest honey from our two hives.  Among the pygmees of the forest, the pursuit of honey is a sign of true love for another...and it seems to be Warren's love language too.  These bee hives have survived for 8 years, including various bug infestations.  It looks like we have several liters of honey to show for his efforts!  I will never forget the day he went out to harvest a bee colony.  Emmanuel had just been born that morning and we were resting at home.  He started to receive phone calls from people who had heard his radio plea for a swarm of bees to capture.  I suppose when you are informed of a bee colony on the move, you have to seize the opportunity (even if your son was just born)!  Needless to say, we captured a swarm of bees that we still have to this day.

 

We have been realizing all the fun food we can harvest in the village…without leaving the house.  We have cocoa and coffee trees which has afforded lots of opportunity for learning agriculture and processing.  Our vanilla plants are producing pods for the first time.  Peanuts turn into peanut butter.  We grow beans that are a staple in our diet.  We plant cooking herbs and roots like carrot, and greens like spinach and squash.  Mango season is amazing every year!  Our one coconut tree has been giving lots of coconuts…which when put in a juicer yields coconut milk.  Then there is honey…

 

Some of the foods are essential, like beans, but many foods we grow are considered luxuries (coffee, cocoa, cinnamon and vanilla).  The local population grows crops like cassava, which yields to root and leaves for food.  Tomatoes and other vegetables require a bit of finesse and specific growing conditions.  What a blessing it is to know where your food comes from!

 

TRIP TO UGANDA

We recently returned from adventurous trip Uganda where we had some official business to conduct.  It started with descending to the shore of Lake Albert and taking a ferry to the other side to enter Uganda.  We have traveled this way before on pirogues and tugboats, but this boat traveled FAST, 20km/hour!  It was interesting to see the fishing villages on each side of the lake and appreciate the many goods that are loaded on boats and transported to DRC.  In Uganda we rode in a bush taxi piled high with goods on the roof and through a game park, up a cliff, and to the nearest city.  Crossing Lake Albert involves sitting in the hot sun, sitting in border offices, and trudging through the mud!

 

We spent time with our dear friends the Millers in Kampala.  They are kindred spirits who hzve walked through many similar seasons of life with us.  Their kids are close to Emmanuel’s age, so they had fun together...even go-carting is available in Africa now.  We have shared a season of life together here in Nyankunde, including when Emmanuel was born.  We continue to see one another whenever the opportunity affords.

 

Returning to DRC, we passed through the breathtaking Rwenzori region of western Uganda.  We were hoping to see the blue turaco and as many species of monkeys as we could...but the turaco was elusive.  Sure enough, just before our departure a blue turaco appeared!  The great blue turaco is a stunning bird with dark bluish-jade feathers.  Emmanuel found a feather and promptly transformed it into a writing quill. 

 

MEDICAL WORK

The hospital has not been overly busy lately, and yet the needs are always there.  I am thankful for various community initiatives that are able to address true medico-social needs.  The Nyankunde health zone has a program for mothers with at-risk pregnancies for closer follow-up prior to delivery, formula for babies who have lost their mothers or do not have adequate milk intake, and nutritional supplements for children with moderate malnutrition.   For example, a woman with poor nutritional status and low milk production is able to be hospitalized with her baby for assistance.  The baby gains the necessary weight on formula, while the mother receives hospital meals.  After a few weeks, the baby is discharged with monthly receipt of formula.  It fills a necessary gap and provides holistic care in a moment of need.

 

Since starting our at-risk pregnancy program (antenatal ward) 6 months ago, we have had 21 women participate and 21 babies born!  We are thankful to God for this.  We know that the community needs for women and children are enormous.  We continue to look for ways to meet these needs.  I will never forget encountering a woman on a footpath who gave birth prematurely on the road to the hospital.  These are the women this program is trying to reach!

 

Malaria, pneumonia, diarrheal illness, meningitis, and tuberculosis are common illnesses here.  There are always children admitted with sickle cell anemia who need blood transfusions.  We have been able to stock a medication called hydroxyurea which can reduce hospitalizations and need for transfusions.  Sometimes it is a simple intervention, like using hydroxyurea and monthly antibiotics that make a tremendous difference in this population.  Sickle cell anemia is the most common chronic disease of childhood here.  I dream of one day being able to have a more organized clinic at our hospital for these patients.  

 

VISITORS

We have had many visitors these past few weeks which has been a tremendous encouragement to us!  Dr. Robert Spencer, an American cardiologist, returned for his 4^th visit this month.  Even the chief of our village knows Dr. Spencer and his annual follow-ups with him.  We welcomed physicians from the Ituri Province to attend a 2-day cardiology conference here in Nyankunde.  We had a dozen participants and lots of practical sessions on managing heart failure, stroke, and how to read an EKG and perform an echocardiogram.  It brought us joy to welcome physicians from many tribes and regions in the province for this opportunity.  We hope that Nyankunde can continue to encourage a high quality of care in the province and facilitate opportunities to advance medical knowledge.

It is said in this part of Africa that visitors bring blessing.  We have found this to be true, especially people like Dr. Spencer who remind us how important this divine calling in medicine is.  He sets a great example of a physician who wants to encourage missionaries like us and we are grateful for him.  Many people and organizations have chosen not to serve in this region due to perceived risk.  The needs are great and it can feel lonely.  Dr. Spencer always asks, “When can I come back?”  

 

THE SEEMINGLY ORDINARY

Today I discharged a child with malnutrition.  Much of what I do is routine, but the care of each child is unique and not routine.  Each child is created by God in His image.  Each parent is fighting their own battle.  Today we prayed for this sweet mama of 5 children who is trying to make ends meet.  Her husband was in the wrong place at the wrong time and was killed.  We prayed for the little boy and his momma.  The mother had tears in her eyes as we prayed.  God sustain and watch after Your people.

 

We are guilty of many errors and many faults, but our worst crime is abandoning the children, neglecting the fountain of life.  Many of the things we need can wait.  The child cannot.  Right now is the time his bones are being formed, his blood is being made, and his senses are being developed.  To him we cannot answer ‘Tomorrow’, his name is ‘Today’.”  Gabriela Mistral 1948

 

 

 

We appreciate your prayers and support as we live and serve in eastern DRC.  

-Pray for peace in Ituri Province, not a transient peace, but for lasting peace that comes from God.  

-Pray against spiritual strongholds, witchcraft, etc... that keep people in fear of others and can lead to violence.

-Pray for a struggling hospital that wants to care for all people and the Church to accompany people in truth.

 

Blessings

Lindsey

 

I leave you with a poem entitled  “Bare Feet” about the value of farming among the Bira people

 

 

 

Bare Feet

Take off your shoes and stay awhile.

Dig your feet into the soft, warm, dark soil.

Walk where your ancestors once trod.

Water the earth with sweat from your brow 

            As you struggle on to provide.

Sing as you work

Weep as you struggle 

Only to salvage what crops remain after a bad storm

 

 

This is your land.

O my people, I see your labor and struggle.

You are my home.

May I take off my sandals and join you?

My feet are thickened and scarred too.

            As I have walked many miles, farmed many fields.

Can I help you with your labor?

Two hands make light work

            There is a better return for their labor

 

The two figures meet on the hillside and start to work in tandem.

Row by row, step by step, they descend the field from top to bottom.

At long last, the rhythmic staccado striking of the earth trails off, conversation stills.

Two silhouettes stand back to examine their work.

Mounds of earth dot the hillside like an earthen checkerboard.

 

Energized by the hard work, I feel stronger than I was before.

Now where did I leave my shoes?

We walk across the field to a small threshold between the trees.

I see a second pair of well-worn sandals sitting right next to mine.

I asked the stranger, “How did you know I was here?”

            My shoes are off the path and my field sheltered by trees

Did you know that I was tired, alone?”

 

“I see you every time you come, my child.

Today seemed like a good day to pay a visit.”

A baby falcon in our house

 

Give Me Your Arms

March 24, 2023

I have gone back and forth about sharing this personal poem in a public way.  I wrote it last year in a difficult time as we returned to Nyankunde.  It is raw.  Memories came in waves, of beauty and conflict juxtaposed.   One of the beautiful memories was of the youth strolling down the street playing the guitar, groups of friends singing.  Then youth began walking in formation and the guitars were replaced by weapons.  There was a spirit of fear, not of joy and ease.  Then came war, followed by silence, and we left.  

It has been two years.  A lot has changed since then.  Things are still changing.  Most people desire to live in peace and to farm their fields.  We are hopeful.  We continue to pray for resolve to tribal tensions..  We believe that peace is not an absence of conflict, but rather an active process that people need to pursue.  During a church service last year, the Lord gave me an image of people trading their arms for guitars.  The voice in this poem is the Lord, beckoning to his sons to come back and talk with Him.  He is powerful and can bring people to their knees.  The poem is called "Give Me Your Arms."

 

Give me your arms and I will give you a guitar.

Melodious sound is better than deafening explosions.

Walk with me, strum the strings again, remember the harmonies.

The passage of time has left you out of tune

Do not worry, I can handle the brutality of your sound.

 

Give me your arms and I will give you a guitar.

Your music can bring people together again.

Share with me your stories.

I want to hear your sorrows and your joys.

I invented sound, and even painful dissonance.

 

Give me your arms and I will give you a guitar.

Go ahead, hold it the same way, it won’t hurt or scare anyone.

Dare to bring joy and not fear when you walk down the road.

Remember the sounds of your youth.

 

Give me your arms

I can change your defensive heart and take away your fear.

You don’t need to fight with charms or call on the gods of your ancestors.

I know what you need before you even ask.

I am waiting and I will intervene.

 

Can you hear that my voice is more powerful than your gun?

It can bring down a cedar as I breathe through the trees.

My voice shakes the soil, even before the storm arrives.

My voice resonates even after the storm passes.

My voice can bring you to your knees.

I alone can truly change things and pick up the broken pieces of your life.

 

Give me your arms and I will give you a new song.  

Fill these verdant hills again with songs of penitence, of deliverance, of new life.

May the hills again become an amphitheater of harmonious music, speaking of a God who saves.

I believe that God wants to invite His people into a new song, declaring that He is a God who saves.

Psalm 98: 1; 4-5

Sing to the Lord a new song,

    for he has done marvelous things, 

his right hand and his holy arm

    have worked salvation for him...

Shout for joy to the Lord, all the earth,

    burst into jubilant song with music;

make music to the Lord with the harp, 

    with the harp and sound of singing,

with trumpets and the blast of the ram's horn-

shout for joy before the Lord, the King.

Be blessed!

Lindsey