Power!!!

July 2024

Electricity. You are probably taking it for granted right now. You flip that switch and the light comes on. It’s kind of amazing, but we see it as part of normal life. 

At Nyankunde we do not take it for granted. We are totally off-grid, in fact there is no grid. We have to generate our own electricity in some way. We do this through solar power or generators. Solar power is incredible, but it’s a challenge. You have to get the system working just right. If you happen to be in the rainy season, as we are now, it’s difficult. No photons, no electrons. That’s the simple math that we’re up against. Generators are also a pain. They are expensive to run, fuel is hard to get, they require maintenance, they wear out. Plus they’re noisy. Also you don’t feel great about the whole carbon footprint thing. 

The challenge of electricity is difficult at home. At the hospital, it is devastating. Sterilizing instruments, performing surgery and giving oxygen are all things that require electricity. The most important thing is simply light. Ever tried examining a patient, putting in an IV or sewing up an episiotomy by candle light, or the light of a cell phone? I have, and it’s not fun. So this is where we’ve been at the hospital for several years. We would occasionally buy lead-acid batteries, but they get tired after a few years. We found ourselves running the generator more frequently, but this was a huge expense for the hospital. Diesel fuel is around 6$ a gallon. 

The difficult part of the equation was that Samaritans Purse had purchased for us a solar power system with 60 panels and Lithium Iron Phosphate batteries. Unfortunately the wrong inverters had been sent and the system lay dormant for around 5 years. I had despaired that the system would ever be up at running. For several years I looked at 60 solar panels on the roof and felt sad that they had not produced one bit of useable electrical power.

God has his own time and his own way. He knew that in July 2024, the pieces would fall into place. Our long-awaited container arrived with the new inverters. A visit from our friend Dr. Bob Spencer (Cardiologist and all-round fixit man) would lay the groundwork for our team of electricians to come. Bob and I spent several weeks pulling wire, changing wiring, installing inverters, charging batteries, refurbishing the oxygen system, fixing autoclaves, installing equipment, moving generators and so many other things I can’t remember. I am handy in my own amateurish way, but I quickly reach the limits of what I can do. Bob brings a level of expertise and experience which brought us to the next level. Without his help we would not have been able to finish. 

Dave Bucklin and Peter Schmitz were on site for about a week. They completed the final stages of wiring, installed the oxygen system in the ICU and sorted through the complicated settings necessary to throw the final switch and make the transition to the new system. In all it was a long, hard month. I did very little patient care, thanks to the presence of Dr. Peter Stafford running the surgical department. Most nights I came home exhausted, after too much sun, too much heavy lifting and too much time in precarious places. Dave was down for the count for a couple days with a stomach bug, but he kept on going. 

The result of all the effort was that we have switched over to a solar power system with a huge capacity. We have a newish generator that is more suited to our needs. We have a new oxygen system in the OR and a refurbished oxygen system in the ICU. We have working autoclaves. With the new system we have not lost power one time. It has been an amazing, incredible blessing. There are already patients who would have died for lack of oxygen in the ICU, who have survived. According to Lindsey there are 3-4 babies who have survived because of this system.  

This project has been a shot in the arm for the hospital. I believe that it is improving our standard of care. It will represent a huge saving in diesel fuel alone. There is also a tremendous level of satisfaction knowing that we are using the energy of the sun to run the hospital. The system is also connected to the internet and there is an app on my phone which tells me how much energy we are using, what state the batteries are in and many other details that most people wouldn’t be interested in. I’ve been glued to this app and I just can’t get over it. 

God’s timing works better than mine. I’m learning a bit of patience. Congo is a good place to learn that you can’t just make things happen by sheer will and frantic effort. At this time we have the incredible joy of electrical power. The hospital has many a flaw and many a need, but for the past two weeks, when I’ve flipped the switch, the lights have turned on and that is a good reason to thank God. We also thank the many faithful servants at Samaritan’s Purse, who had gave generously of time and resources to make this happen.

Warren

Back in the Saddle Again

July 17, 2024 Coming Back 

It is always a joy to be back home in Africa, to drink fresh passionfruit juice, to hear the robin chat “chat, chat, chattering” in the evening, and to re-connect with friends and colleagues.  I hear and see things with new eyes.  Africa is a sensory experience.  It is like plunging in a cold pool and immediately swimming a work-out.  It is all-engrossing and a shock to the senses.  I live in a place where children come to the hospital barely holding onto life.  This last week a now orphaned toddler died several months after being discharged from the outpatient nutrition program.  It is just heart-wrenching.  It is a place where life and death come to the forefront.  Our province runs out of essential medicines to treat perinatal HIV and tuberculosis.  We are currently in this situation.  Even among animals….life hangs in the balance.  Last Sunday we rescued our friends’ young kitten as a falcon repeatedly swooped down to try to kill it.  

 

There is no air conditioning, just the wind and setting of the sun.  We do not have a dishwasher and there is no grocery store to buy pre-pared food.  Beans get served in different forms until they are finished.  All food is fresh.  Everything takes a bit longer, especially cooking.  It is a different rhythm and it takes a good week or two to get re-acquainted with life.  On the equator the sunset is at 6:30pm, so most outdoor activities need to be completed by this time.  

 

Everyday life is more work, life and death are at the forefront, but somehow life is invigorating and there is joy in the simple things.  If you are tired you rest.  If it rains you plant.  

 

A New Solar System 

Currently Warren and Dr. Bob Spencer are preparing the installation of a new solar battery system for the hospital.  This has been about a 5-year project between all the challenges we have faced in recent years from lacking certain components, Ebola, and insecurity.  We are hopeful that this will bring us back to where the hospital needs to be from a power and oxygen perspective.  There really is a need for biomedical equipment expertise here.  We are preparing for a couple of electrical engineers who will come out next week to finish the work.

 

A Rabbit House  

   

We are officially (or unofficially) raising rabbits!  On last count we have 9 babies and 5 adults.  As it turns out rabbits need a very clean living environment and love all “root based” vegetables and accompanying greens.  Sweet potatoes and carrots are their favorites!  We are finishing our very first rabbit house with different rooms that is well aerated.  It seems a bit fancy!

 

Summer Break   

Emmanuel loves summer break!  He has been hard at work with his friends on a treehouse with accompanying moat (for protection from unwanted guests).  We have been reading, playing outside in water, riding bikes, and adventuring together.  He has a great imagination and is learning problem-solving skills.  Homeschool starts in about a month and we are looking forward to a great year!

 

Medical Challenges

 

Today I could not find an infant nasogastric tube anywhere!  I had 3 babies in the ICU that needed one.  This is not a new problem of course.  I found an old bag of feeding sets that we will never use and started to disassemble one to see what I could jerry-rig together.  After cutting a few tubes, re-shaping some rubber pieces, I had found a way to make two feeding tubes from each set.  Somehow this represents many things: lack of resources, on-going need, the need to look past the challenges and tendency to say “there simply aren’t any” and simply a desire to make things work.

 

One of my 1.5year-old kids has a cyanotic heart condition called coarctation of the aorta. His pulmonary artery and aorta are switched, bypassing the lungs to oxygenate the blood.  It is a very serious situation and he lives with an oxygen saturation between 30-50% all the time and is generally irritable.  He is simply not growing.  This condition is usually surgically corrected in the first weeks of life.  There is very little that we can offer in this environment other than managing his heart failure and giving them a diagnosis.  It is hard to know if there is more that we should do.  Is he a candidate for surgery?  If so where?  Families understand that surgery is not available in the country and have an easier time accepting this.  I usually have at least a couple of babies with various heart malformations that I am following in the community.

 

Ministry   

I am thankful that I can use my medical skills in the direct care of patients.  Everyday I have the opportunity to ask people how I can pray for them and share the hope that I have in Jesus Christ.  So many people are spiritually lost, looking for answers, making idols to worship.  It is my prayer that the Lord will give me spiritual insight to the situations we face.

 

There is a beautiful lady from the forest who was brutalized, injuring her and cutting her ear off.  It hits close to home to see people suffering in this way.  Our colleague Dr. Peter has been faithfully tending her wounds, doing a skin graft, and showing love in tangible ways.  Sometimes we hear afterwards about spiritual growth in peoples’ lives, but it is often through suffering that God reaches people.  

 

There is no place that we can go to escape the presence of God, “If I say, Surely the darkness will hide me and the light become night all around me, even the darkness will not be dark to you; the night will shine like the day, for darkness is as light to you.  For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well.”  Psalm 139 11-13.

 

As physicians we can appreciate how we are fearfully and wonderfully made.  It is an honor to care for people, and see how God made them.  As a surgeon Warren often says that he can modify and remove things from the body, but he can not add anything back.  How simple and yet how profound!

 

We appreciate your prayers as we continue to adjust and adapt to being back in eastern Congo!  -Pray for a hospital staff member who is struggling with a serious health problem.

-Pray that we would be able to finish the work on the new solar system and that this will help many people.

-Pray that we would see the spiritual needs around us and encourage staff members to pursue a deeper walk with the Lord.

 

 

Lindsey (for us)

 

Finishing up our time in the US

June 10th, 2024 

Signing in from North Carolina…we are finishing up our time in the US and preparing to return to Congo.  It has been a full 3months’ time and a blessing to reconnect with friends and family and for Emmanuel, his classmates at Grace Academy.

 

It really is amazing to live overseas and be able to travel back as we need to.  Emmanuel completed third grade and was able to participating in many end of the year activities.  Warren and I even jumped into helping host the parachute game for Field Day and go on a field trip or two.  Emmanuel received an award for his expressive reading and we are proud of him!  He also graduated from U10 spring soccer season! 

 

We squeezed a long weekend trip to Colorado to visit Bethany Church and visit with our dear friends there.  This is where Warren and my marriage began so it will always have a special place in our hearts.  Bethany has many faithful saints who have supported us over the years and become like family.  One day we crossed the majestic western continental divide with our friends the Petersons and the next day we drove over the verdant Appalachian eastern continental divide.  It is amazing how air travel really is and how varied the landscape is in the US! 

We spent a fun weekend with our friends Andrew and Sandy Barton in the coastal city of Wilmington.  Andrew asked us what we wanted to do, to which we responded “Whatever you want to do, we are up for it.  We don’t get to do this very often.”  The first day we got up before sunrise to fish for mackerel…it turned out to be a good day for fishing as we reeled in about 3 dozen fish!  Emmanuel loved wave jumping on the beach and collecting shells.  Then Andrew took us sailing on his racing lightning boat which was really fun!  It became clear immediately that he had advanced sailing skills which made it fun for us.  It was all a wonderful, stretching experience for Emmanuel!  Andrew asked if we were up for more adventure, to which we have an enthusiastic “YES!!!”  This led to a fishing trip on the middle of the night (2am) out to an island where we anchored at low tide and walked to shore and hiked a mile on the dunes to a shoal where we set lines for red drum.  Red drum is a very large fish that likes to feed at low tide during full moon…but the wind needs to be about 10mph to move the shrimp onto the shoal (something like that).  Well, we went and learned the ropes, but the fish were not biting as the wind was not strong enough.  It was still very interesting.  The good news is that this operation was repeated a week later (without us) and red drum were biting!  I feel that this gives one a healthy appreciation for God’s creation and the mysteries therein, things we can’t control.  Sandy fried up the fish many ways for fish tacos and other tasty things and accompanied us on beach adventures.  A couple of long nights of sleep concluded our adventures with the Bartons! 

  

Sometimes I feel like we have adopted certain behaviors from living in central Africa….one must stop in to see people along the way (or at least call to say you are in the area).  We were able to see more friends in the Raleigh area-the Miranda family, Joy, and Camille our way back to our NC home.    

We just returned from a week in Wisconsin visiting family and friends.  It has been about 3 years since we have been all together with my parents and sister in Wisconsin.  What a blessing it is to sit down to meal made by my mom.  The farming fields, prairies, and wetlands are still a solace to my soul and remind me of my childhood.  We stayed in a river cottage and enjoyed paddling in kayaks everyday!  I am so thankful for friends like Erin and Kate that I can just call up like little time had passed. I was able to reconnect with a couple of old roommates, Marie and Nina and reminisce on our UW Madison days over Babcock ice cream!  How is it possible that over 20 years has gone by? I am thankful for these formative years that preceded medicine and living overseas.  I wonder what it is like to be an undergraduate these days?!   

 

 

Now we shift gears and re-organize our lives for travel once again.  It forces us to give things away and think about what we need for the next season of time.  Yes, this means school materials and Christmas gifts in June, and adopting a different kind of mindset.  

 

We appreciate your prayers for us as we prepare to return-emotionally, physically, spiritually.  There are always some details to wrap up.  Pray that we can be an encouragement to our family and friends, and for our church visits.

 

Many blessings

Lindsey

It is true that I have not written a blog post in a long time.  Lindsey has kept this going and I’ve allowed myself to go dark.  

Part of the reason is that is the lack of any good answer to the question “How is your eye?”  My vision really was not great.  I could see well enough to operate but it was a struggle to do very meticulous work.  There was debris floating in the back of the eye.  It would swirl around and just gave me the sensation that something wasn’t right.  I would get fatigued at the end of the day and driving was difficult.  It was kind of like seeing through a smudged windshield.  I could see, but it just bugged me, all the time.  I fixated on it and it gave me an excuse to be more irritable than I needed to be.  Lindsey can elaborate. 

Anyway, long story short, I underwent a vitrectomy.  This involves removing the jelly behind the eye (mine had turned to something more like jam) and replacing it with clear fluid.  I’m now two weeks out and I know it was the right decision.  My vision is clear!  I actually see great.  This has been a huge encouragement and an answer to prayer.  

Emmanuel and a friend. 

It is remarkable to think of the complexity of the parts which make up our bodies, and how much we forget about them, until they start to malfunction.  I’ve reached the age where I’ve begun to notice these little glitches. There’s an element of comedy in it, as we transition from the invincibility of youth to the stage where things start to fall apart.  It’s like driving a 2006 truck with 140,000 miles on it.  You’re just waiting to see what goes out next.   

For my part, the experience has filled me with a sense of gratitude that God has allowed me to continue to serve despite my frailty.  Surgery is one of those jobs which you can’t do forever.  Eventually the eyes don’t see well enough, the tremor gets too pronounced and the hands can’t be relied upon to tie a good knot.  Then I’ll do something else, I guess.  

We’ve been back in the US for a couple of weeks now.  It has been a time of refreshment as we’ve caught up with old friends.  We’ve enjoyed attending our church in Boone and attending our small group.  We’ve also enjoyed the chance to catch up on projects around the house.  These have included patching up a driveway, replacing boards on a deck, spreading mulch and such.  There is joy in doing these manual tasks, and also a relief in knowing that no one is going to call me with a life-threatening problem.  We’ve enjoyed
seeing Emmanuel interact with friends, play soccer and experience all that Boone has to offer in the springtime.  

We love the Blue Ridge parkway.

Despite being away from Congo, it is always on our minds and hearts.  I continue to receive consults from afar and there is always some pressing matter to attend to.  We continue to pray for the peace of the region.  Nyankunde has enjoyed a period of peace and tranquility, but there continues to be a darkness which is under the surface.  Recently we heard a distressing story involving several children who were suspected of sorcery and put in prison.  Through much prayer and discussion they were released.  It could have well taken a darker turn.  Anyway, I mention this just to explain that in the context in which we live, people are not surprised at the notion that a child-sorcerer might be a “thing”.  Such is the degree of superstition, fear and evil. On the surface, we live in a village that appears to have been “Christianized” but sometimes the veneer seems pretty thin.  In a way it’s discouraging, but in a way, it is confirmation that we are there for a reason, to speak out against the darkness.  

Our container has arrived in Nyankunde!

We will be around until the end of June.  Emmanuel will finish up the third grade and we have a few trips planned.  We are enjoying the springtime in Boone and giving thanks to God.   

Warren, for all of us