Pray for Goma & A Living Parable

January 27, 2025 

In Goma a few years ago

There has been as escalation of fighting in Goma, North Kivu Province, between M23 and the Congolese army over the last weeks.  The military governor was killed this last Friday.  It became a desperate situation as the rebel army M23 has taken over all roads leading into Goma and other port cities along Lake Kivu.  Over the weekend there were power and water outages with escalation of the conflict.  The news today, January 27th, 2025, is that Goma has been taken over by M23/Rwanda, there is street warfare, and the airport is closed. It is a serious situation and we do not know what the broader implications are. There are many new sources covering the situation namely Reuters, Aljazeera, and BBC.  This is a chronic conflict over mineral rich land.  M23 last overtook Goma briefly in 2012-the conflict which delayed our arrival into DRC.  

This conflict does not affect us directly in Ituri Province, as we do not border Rwanda.  It is a complex situation which has persisted for years.  There are no easy solutions and civilians are suffering and hundreds of thousands are displaced. Pray for Goma and surrounds, for food, water, electricity, and peace. Lord have mercy.

A Living Parable

The beautiful girl in a shining white dress with beads in her braids is called Mavita.  Mavita means ‘War’ in Swahili.  She was born in a time of war and conflict, of flight and displacement in Nyankunde 3 years ago.  Mavita came to the hospital with non-descript fevers and then starting having seizures.  We confirmed that she had meningitis as she was transferred to the ICU.  The day after her ICU transfer I asked her mother if she ever received her vaccine series as an infant.  A quizzical look came over her face, like she was searching for the answer in the dark recesses of her mind.  After a brief pause, she said, “No she didn’t receive anything after birth.  We were on the run and we weren’t stable.”  I nodded in understanding, as I understood this reality.  During the period she described only 2/12 health centers were functioning due to armed conflict.  Maternal and neonatal mortality was at an all-time high.  Women lacked prenatal care.  Vaccine campaigns did not happen and people had difficulty accessing care.  There were roadblocks and people fled violence.  It was a devastating time.  It all made sense- Mavita was an innocent victim of war.  She developed meningitis after not receiving protective vaccines during a time of war.  Mavita is an example of how the vulnerable suffer the most from war and displacement. The effect of war lasts for years and is difficult to quantify, such as an increased incidence of meningitis.  

A Water Project

We were blessed by the visit of our water engineer friend Janet Ausel and her son over New Years. It was the first time that one of Emmanuel's friends has come out to visit. The goal of the visit was to map out the 2km underground water system, determine out how much water the system is capable of producing and how well it is functioning, and to do some water testing. We walked many miles following water lines, measuring flow, and looking at water taps. It was very interesting to have a better understanding of things. The next job is to determine how to improve flow to the system, how to maintain it, and how to plan for possible shortages. It was an encouraging time and we are so grateful for their visit.

Infectious Diseases and Other Challenges

The hospital continues to challenge and keep us busy.  We have seen a rise in vaccine-preventable diseases such as meningitis and tuberculosis…of infectious diseases like hepatitis and HIV.  I am caring for three children with measles at the moment, that's right MEASLES.  One case of measles is a public health emergency and means a high population mortality rate. We are reminded daily that the world is a fallen place and we long for a new earth, not in a depressing, but a UNDENIABLY REAL way.  We often have an opportunity to be present in very important times in peoples’ lives-birth, death, and everything in between.  Not a day goes by that we wonder if what we do matters…but it doesn’t mean that it is always easy.  Hard conversations, blood, and guts and struggling to make things work.  Sometimes it is a painful decision to not operate due to inoperable cancer…sometimes it is too late to stop the bleeding.  

We are fortunate to be able to help orphan and vulnerable babies in our health zone.  This month we began supporting two babies whose mothers died from post-partum hemorrhage.  This hits close to home for me as I experienced a hemorrhage myself after giving birth.  We usually hospitalize these babies for a short period to sort out home care and ensure that they are healthy.  These beautiful babies now receive formula support through the help of the organization Saving Moses, with monthly weight and health checks.  

Honey

Warren harvested honey for us this weekend!  Then began the process of heating, filtering, and filtering again.  It is a labor of love just like it is for the pygmees in the forest.  It has been 6months or so since the last harvest.  Our 12-year old hive is still going strong!  One of the hives that was destroyed by an out-of-control fire two years ago has re-populated with bees and appears to be stocking honey again.  In other news we just harvested over 1 kg of vanilla pods!  

Many prayer and blessings from eastern DRC,

Lindsey

Prayer Requests

-Pray for security to return to North Kivu Province, specifically Goma and surrounds, for security meetings, for access to basic needs. Pray for diplomatic solutions and that this won't turn into a regional, larger-scale conflict.

-Pray for the hospital leadership as they make strategic decisions.  Pray for discipleship of staff physicians.  Pray for the health crises of tuberculosis and other diseases that plague our region. 

-Pray for an upcoming medical conference we plan to attend in February in Asia.  Pray that Emmanuel would have meaningful interactions and for his spiritual development.

-Pray for our little soccer team that has started, for kids to grow in their skills and cooperation.  Emmanuel has been so encouraged by the things he is learning from his Congolese coach.  Pray for his coach, that we could be an encouragement to him.

-Pray for our short-termer Paul that he would be blessed by his time in Nyankunde.  Pray for him as he makes decisions about medical school,

Fall Break Away

November 11, 2024.

Travel in Africa takes motivation and time!  Our fall break was spent in the Rwenzori region of western Uganda…but not without a little effort on our part.  First we had to travel over a bumpy road down the escarpment and cross Lake Albert, one of the African great lakes.  Now there is a speed ferry that is available which shortens the trip significantly from 3-4hours to 1-1.5hours.  It is a beautiful journey with green cliffs on either side-men standing on long sturdy wooden fishing boats pulling in nets or transport boats moving goods across the lake.  You can watch a storm coming >100km away while the sun beams down on the peaceful waves while you sit and take it in. The trip brings back memories.  We first entered DRC by the lake border crossing 12years ago when there wasn’t regular service across the lake…one had to hire a pirogue, or jump on a fishing or tug boat.  There was no way to predict when the boat would be available and one would wait for hours in the blazing African sun.  Years later, you can feel the wind in your face from a speedboat in an assigned seat, wearing a life preserver.  WOW!  We used to travel with our own life preservers.  Even though the journey is tiring it seems like a privilege to be able to travel.

You see movement in eastern DRC is quite restricted for security reasons.  Roads are in poor condition and it is ill advised to go long distances.  It feels like a luxury to be able to move on the water.  Semuliki National Park awaited us as we passed through and up the Ugandan steep hillsides of terraced farms.  Baboons and large birds are found throughout.  We spent the week in the region on a crater lake in a beautiful nature preserve.  Our cabin sat high on the hillside in full view of two kinds of colobus monkeys-the black and white and red colobus and vervets.  It was like we had broken into a monkey family convention.  There was a monkey and baby in every tree.  You could hear the call of the turaco, cranes, and ducks.  It was really beautiful and one did not need to go very far to do birdwatching.  We went on a 9-mile hike one day around crater lakes, to Makuma Falls.  Warren and I were surprised to see how interested Emmanuel was in all the bird species, and his ability to spot various species all while walking 9 miles!  Our favorite bird is the Great Blue Turaco, a stately blue bird with a long crest and bright red beak.  If you enjoy birds, the Merlin App from Cornell University is a great way to identify birds by their appearance, flight pattern, and call.  Recently I found a recording of a robin chat from 1977 from our province in DRC and a couple more recent recording….same species but a unique and different generation.

It was a week in nature for us, a week I needed.  Warren was along for the ride.  Even coming back to DRC I am noticing the birds in the trees anew.  These birds are around me all the time, but I do not always notice them.  It takes a bit of effort to make the journey, but somehow the effort is part of it.  I appreciate greatly the beauty that surrounds us here in the village, and the fields that produce ample food.  We continue to pray for this village that we call home.

Western Medical Training & Difficult Realities

The hospital keeps us busy.  I (Lindsey) am learning what palliative care looks like in this setting.  I have had a couple of children with serious health conditions for which chemotherapy and home oxygen would be available in the west.  In our setting these resources are very limited and done in the hospital.  So palliative care becomes more hospital-based with breaks to go home.  It is grounded in family and repairing relationships.           

I (we) am often reminded that my training is different.  It can be a challenge to practice in a resource poor environment with comparatively high level of medical knowledge.  In a resource poor environment one needs to adopt a public health mindset, step back and ask what is an appropriate use of resources in this situation?  Sometimes we lack medications to treat tuberculosis and HIV.  How should I anti-coagulate a child with a calcified blood clot in the atrium?  How should we handle children with chronic diseases like sickle cell anemia?  Labwork is expensive and the medications a bit dangerous if not used correctly.  How do we do no harm?  How do I share/apply my medical knowledge in this setting with people who have folk beliefs?  Sometimes I feel like I am practicing medicine in another era…but I carry on and try to provide good care to each child in front of me.

A couple of weeks ago on the maternity ward a mother of twins slipped through the cracks.  After she had been discharged she was spotted giving her babies sugar water because she was not lactating.  The mother had benefitted from formula for her twins during her hospitalization, but she had already been discharged and the formula had run out.  No one realized what was going on and that she was essentially homeless.  We sat down with this mother and her severely underweight babies to find out what was happening.  It was heartbreaking.  The woman lived alone, selling charcoal to provide for herself, and did not currently have a home or family to go back to.  I am a foreigner in this context, but this did not seem like a good home situation to go back to...spending hours in the country burning wood to make charcoal. We are still working on a good discharge plan for her.  We need to improve our maternity and neonatal care to avoid this happening again.   Needless to say, we began feeding her babies immediately and they are thriving!  

The bittersweet realities of medicine breeze by us daily, but sometimes smack us in the face. Birth is a joyful time, but can also be one of the riskiest times in life for a woman. A few weeks back a pregnant woman came in very agitated, febrile, and extremely ill. She underwent an urgent c-section and then died of meningitis. She left a beautiful baby girl behind...a beautiful baby also suffering from meningitis. After a couple of weeks of treatment and formula the baby is thriving and went home with her grandmother yesterday. What a joy it was to see the baby's recovery, but what sadness to lose a pregnant mother.

Visitors

We are so grateful for the help of Ellen and Iyad in the surgical department these last few weeks. It was their second trip to Nyankunde. Iyad fixed anesthesia machines, helped with odd jobs in addition to providing anesthesia/patient care. Ellen organized storerooms, worked on surgical sets, and looked at ways to systematize what we are doing in the theater. They brought some important equipment and personal items for us. What is so remarkable about this couple is that they really love to be the hands and feet of Jesus and look for ways to serve others. We were so blessed by them and their willingness to come out!

“Oh when the ants go marching in..”

It was a casual Saturday afternoon…this is until the ants invaded our house!  Emmanuel was in his hammock and declared that the ceiling and walls were moving.  We mobilized very quickly with various products and even a blow torch inside.  Cut them off here and contain them from going further, then take them out!  I tell you it was war!  At the end of it all, I swept up over 100grams of ants.  Today our gardener has been working on clearing the ant kingdom from our front yard.  I am told that locals don’t mind too much when ants pass through because they clean up organic material.  All I can say is that this would not have worked for us! I fear what would have happened had we not been home.  The ants would have eaten us out of house and home.

Rural Africa

Rural Africa is changing, especially in places like DRC.  More and more people are flocking to cities for security, better schools, and availability of resources.  This is all fine I suppose, but the rural areas are suffering greatly.  The military has an vested interest in the economics of region (to the extent that it affects cities) and roads between cities.  Outside of these limited areas, much of our region is controlled by armed groups.  This means it is more difficult to move between areas controlled by different armed groups.  There is a group called Allied Democratic Forces, a M*sl*m extremist group, that preys on these rural areas.  They have hampered agriculture in both Ituri and North KIVU Provinces such that people do not feel safe going to their fields.  This affects people that we know and their ability to farm and make a living.  One consequence is that more and more food is imported from places like Uganda and prices go up.  The poor get poorer and the rich get richer.  The few brave enough to plant and harvest, such as the cacao farmer, put themselves at risk from extremists.  People often plant fields in several locations with the hope that at least one will succeed.  Very little is assured. These are daily realities that we see and sometimes forget to put into words.

Prayer Requests

-Pray for our medical work to glorify the Lord.

-Pray for hospital leadership to honor their word and fiscal responsibilities.

-Pray for security of our region, especially rural areas, and improvement of travel. Pray specifically that the efforts of extremist groups will be thwarted.

-Pray for the feasibility of an upcoming hospital mission water survey.

Lindsey for us

ADVENT, a time of anticipation, of waiting with hope

December 4, 2024

   

 

ADVENT, a time of anticipation, of waiting with hope.  Christmas is a busy time, but we are also forced to slow down by Advent traditions of singing hymns and Scripture meditation.  We try to incorporate these spiritual elements in our daily lives, but Advent beckons our hearts in a special way with so many beautiful traditions.  Together with Emmanuel we are examining the visits of the angels, the importance of every character in the Christmas narrative, and their receptiveness to the work of God in their lives.  Like the anticipation of gazing on the face of a long-awaited baby, we wait for an opportunity to meet the Christ child. This is prophetic of the second coming of Jesus also. 

“O come, all ye faithful, joyful and triumphant, 

O come ye, O come ye to Bethlehem;  

Come and behold him born the King of angels; 

O come, let us adore him, O come, let us adore him, 

O come, let us adore him, Christ the Lord.”  

Let us wait with expectation and purpose in our daily lives, this Advent, but all year long.

Soccer Lessons

Emmanuel has been taking individualized soccer lessons with a local man who knows the game and is good at teaching it.  It has been very encouraging to watch them.  In a funny way, I am learning lots of life lessons as I listen to his feedback.  “Keep your eye on the ball!  Look up!”  “Fast feet, keep moving!” ”Anticipate what is coming next (the pass)!”  “Look for the pass.”  Sometimes I think we don’t have our head in the game of life and we need a reminder to keep our eyes on the goal.  Keep moving forward, don’t get discouraged or let your guard down.  It’s not to say that every moment of life has the intensity of a soccer game…sometimes it is like a solo walk in the woods.  But we are meant to keep moving, to keep pursuing what is important.  Make small attenable goals and keep them.  We are meant to live with intention and make the most of every moment-Carpe Diem.  But the Bible goes a step further as to WHY we should seize the day.  It says in Ephesians 5: 15-16, “Be very careful, then, how you live-not as unwise but as wise, making the most of every opportunity, because the days are evil.”  

Cross-Cultural Humor

Sometimes I forget to share the everyday moments that bring a smile to my face.  Maybe it is a sign that we have been here for a few years already, but I think I am able to appreciate subtle local humor.  Some of the Swahili gets lost on me, but the essence of what is funny in this culture I am able to “get.”  A few weeks back I was preparing to discharge one of our malnutrition kids and the topic of follow-up came up.  She was from an outlying rural area.  I said that I wanted her to follow-up in 4 weeks.  She looked at me with a smile on her face and said in all seriousness, “How will I know when 4 weeks have passed?”  Everyone in the room erupted into laughter at the honesty of her question.  But seriously, when you don’t have a calendar or smart watch, +/-literacy-how do you keep track of time?  I have told people to collect stones or make marks on a piece of paper.  This time I said, “Is there a church in your village?”  She said, “Yes.”  To which I replied, “Go to church for 4 weeks in a row and then come back to see me.”  Again more laughter and smiles.  Everyone seemed in agreement that this was a workable plan.  The next day then as she was packing up her things to walk home, everyone applauded as she left with big smiles all around.  I said, “See you in 4 weeks!”

There is joy and humor in the subtleties of life!  

Our PetsThere is a lot of drama at our house everyday, mostly between the dogs, cats, parrot, and bunnies.  The cats tease the dogs, the dogs chase the cats (and anything that moves), the parrot thinks he is “BIG stuff” and tries to nip the dog on the nose…and we have to keep the male rabbits far from each other or they fight mercilessly.  Each animal needs their own personal space in which to live peacefully!  I am not sure if all dogs have such a strong prey drive or just ours?  It seems like animals in the US are somewhat more domesticated than out here in central Africa.  Now if you mix in the arrival of a wild animal (or a bunch of ants) and our animals go crazy. Today a forest cobra upset the apple cart when it came for a visit!  Shortly after its' arrival, it met its' demise. Let’s hope the dogs don’t get mix with any cobras!

Warren is always busy with projects around the house which everyone appreciates.  He made (with a little help from me) some beautifully engraved chairs with the first part of Psalm 121 on them.  This Psalm has always been a theme  verse for us out here, so it was a natural choice!  We put the beginning part on one chair and the continuation on the other.  Perhaps it will become a conversation piece in our house-pictures to follow.  

Psalm 121

A song of ascents.

1 

I lift up my eyes to the mountains—

    where does my help come from?

2 

My help comes from the Lord,

    the Maker of heaven and earth.

3 

He will not let your foot slip—

    he who watches over you will not slumber;

4 

indeed, he who watches over Israel

    will neither slumber nor sleep.

5 

The Lord watches over you—

    the Lord is your shade at your right hand;

6 

the sun will not harm you by day,

    nor the moon by night.

7 

The Lord will keep you from all harm—

    he will watch over your life;

8 

the Lord will watch over your coming and going

    both now and forevermore.

Blessings on your Advent,

Lindsey for us

Prayer Requests

-Pray for leadership of our hospital as they negotiate staffing challenges. Pray for the right handling of a recent situation at the hospital that involved theft of some surgical instruments.  

-Pray for security of our region. At the holiday times, theft can become a problem.

-Pray for a young woman we know who is struggling with a personal issue.

-Pray that people would desire to know the Lord and love their neighbors.

-Pray for Emmanuel to feel encouraged in his soccer, studies and friendships.

-Pray for a documentary film project in the works, that it will come together and bring honor to God.  We are excited for what this will become. 

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