Westerners hold watches, but Africans keep the time.

So the old adage goes.  I must say that there is profound truth in this wise old proverb.  There has been nothing more infuriating than the seemingly cavalier, no-care, slow-paced attitude of the Cameroonian people, especially in situations where urgency is required.  This is probably the biggest 'thorn in my side' keeping me humble before the Lord, just like Apostle Paul wrote about (2 Corinthians 12).  For doesn't the Lord require such patience (and forgiveness) of us?  Forgive as you have been forgiven (Ephesians 4:32 and Ephesians 5:1-2). For if God is love and love is patient, kind, long-suffering (1 John 4:7-8; 1 Corinthians 13:4-8), we too are to be 'Christians' which literally means 'Christ-like or imitators,' to share in His attributes (the highest of all being love).  

I have never faced such hard lessons in patience and long-suffering as dealing with the local people here.  I don't want my reflections of them to seem derogatory.  I simply want to relate, with candor, my firsthand impressions. Cameroonian people are so so terribly passive in most things or just slow to react.  If something is broken and a band-aid fix cannot be utilized to preserve limp-along functionality, they will throw their hands in the air and say 'oh well' and just make do without (instead of getting to the crux of the issue).  Stark difference from the west where we are much more 'let's fix this and efficiently' minded.  The contrast in attitudes has been almost incomprehensible! The same goes for running out of medications in the pharmacy, which happens almost every other day. (Their response being 'oh well' nor will anyone try to figure out how to rectify the situation).  Or running out of supplies on the ward (Oh well!). Such practices would be considered unacceptable system flaws back home.   

But then I started to think of the country I've been living in and experiencing, how tumultuous the geo-political and economical landscape is for most, where the schools can just close on a whim...and a year later are still closed, children are left at home uneducated (and even then, children can only go if their family has means to send them!), where the government can just kill people in the streets for being critical of the governing party, or shut off the internet indefinitely, or the phones, or electricity, where today food may be abundant and tomorrow not so much.  The people just float along and persist.  

This is a country where most people can't even trust the the banking institutions, and so they keep what little savings they accrue under the mattress or in a jar...where rats can eat at the money edges.  And get this!  Here, if money becomes damaged in the least, it becomes un-spendable, worthless!  You laugh (or gasp) but this happened to my cook who showed me hole-ridden, rat-chewed currency with utter dismay! (Oh well!) 

Lets not forget that in this small country the size of California, most individuals have little or no access to healthcare.  Most people can barely afford to come for medical treatment in their most dire hour let alone seek out regular health maintenance. As such, the norm is people presenting way too late for our limited capabilities, and then they die.  Death is so palpable and matter of fact here (Again, the people have become desensitized and have an 'oh well' attitude).  In residency I can remember only 2, 3 maybe 4 of my patients dying in my three years of training.  To die in the US has become an almost rejected possibility, especially among the pediatric population! 

After having walked in Cameroonian shoes, I am beginning to understand their global worldview, one of utter unpredictability, where people literally do live one day at a time.  If it happens, it happens, if it doesn't, so what? I am beginning to understand how the pharmacy could be out of medications today.  And I am beginning to empathize with their 'oh well' responses to the many troubles that plague them because I see just how oppressed they are.  My prayer now is that through my wizened perspective, God would grow in me greater love, patience, and forgiveness towards the people whom I'm serving.

The Cameroonian people have many tormentors (disease, poverty, unsatisfactory government) but 'father time' is not among them.  Surely , surely  while the locals seemingly control very little in their lives, bowing to the clock as their task master, absolute nonsense! And perhaps, that's one lesson I'll try to learn from them. 

Give to Everyone Who Asks

"Give to everyone who begs from you, and from one who takes away your goods, do not demand them back.  And as you wish that others would do to you, do so to them." Luke 6:30 & 31 (ESV).  

I have had to contemplate just how literally to take this commandment, especially since arriving in Africa.  Begging here (like in most parts of the world) is a bonafide profession, and it is hard to discern sometimes who is actually in need and who is just running with the usual bag of tricks.  But does it really matter?  At the end of the day, we will all stand in judgement (Romans 14:12, 2 Corinthians 5:10) Surely, the Lord has not said to give to EVERYONE, for if we did that, would there be anything left for ourselves?  Or did He?  I guess we all need to work that one out in our own hearts and between us and God.  What about the chilling example Jesus gives regarding the rich man and Lazarus (Luke 16:19-31)?  Am I the rich man, and are 'they' my 'Lazarus'?  Or what about Jesus' admonishment to the rich young ruler (Luke 18:18-30)?  And God forbid we turn away someone who was actually an angel in disguise who the Lord sent to test our giving hearts (Hebrews 13:2)!  Doesn't He also tell us that whatever we do to the least among us, we are doing unto Him? (Mathew 25:31-46) Convicting!

I believe God sent me two divine appointments in the past two weeks as He continues teaching me about giving.  

The first was a young Fulfude man a few years younger than myself named Umaru.  He approached me as I emerged from the hospital one afternoon.  I had one thing on my mind, getting home for lunch before having to rush back.  Usually, in my focused state, I pay little heed to those along the way, but this guy was persistent. He came begging with open hands, asking for food to settle his hunger pangs.  Then, he began following me.  I decided to bring him home for lunch, and so I hosted an unexpected dinner guest.  He spoke a very broken pidgin dialect, could barely understand two words between us, but he was thankful for the food I warmed up.  I did manage to pick up on his incessant ask for alcohol (which I refused); maybe the Lord really didn't mean to give always to those who ask?!?  Umaru had spotted olive oil in my cupboard and yearned for a sip as he thought it was my stash of whiskey.  I poured it for him to entertain his notion, and he readily drank down a few gulps of the stuff (gross!)  Before we were through, he requested to wash in my kitchen sink (like head and full upper body) and for a towel to dry and then proceeded to ask for more olive oil, this time to rub on his head, face and arms.  I just stood there in my kitchen wondering if this was culturally the norm or if he was drunk or perhaps mentally handicapped.  Still am unsure, his affect seemed normal enough.  Anyway, made for an eventful lunch hour and am thankful I could give him everything he asked of me (except the booze).  

Another man approached me last evening as I headed home from an exceptionally difficult day in maternity.  I surfaced from the unit late in the afternoon just wanting to go home, shower, wash off the grimy day filled with really sick babies.  This man was middle aged and absolutely pathetic.  I mean that in the most empathetic way!  My heart really went out to him as he explained that his wife just died in child birth the previous morning (not at Mbingo but at a health facility over an hour away, making it more difficult for me to determine truth in his words).  While his little daughter was thriving, the woman died from complications of her emergent C-section for footling presentation.  The man had to pay all that he had (240,000 CFA or $400+ USD) for the operation, but needed 20,000 CFA more before the hospital would give him the corpse of his dead wife.  His grief and words, "I beg of you in the name of God" really struck me.  Let me tell you, I was no saint in my initial dealings with this man.  My heart was hard in my original response, and I brushed him aside.  If I recall, I think I even lied to his face stating that I could not give him the funds...I mean, sure I could, I had a few extra bills in my wallet.  The correct response would have been, "No, I'm unwilling."  As we carried on conversation for a few more minutes and as I began to pray for this man, I began putting myself into his shoes.  I can't even fathom such momentous tragedy.  God ultimately reminded me of Luke 6:31, the famous Golden Rule, and so we parted ways, and my acquaintance received all that he asked (Matthew 7:7).


Enjoy some pics from life here!

Taví and Killian, a boy who sought shelter on my porch during a rain storm this week.  

We (mainly my surgeon friend) did an at-home neutering of poor Tavyeh.  His bucket will stay in place for a few more days as his wound continues to heal! The bone was his consolation prize : )

A snake in my back storehouse.  The people here are convinced it was either a green mamba or a mountain cobra.  Couldn't really see the head as it escaped into the ceiling.  

Visited the Batwa (pygmies) people on my travels in Uganda.

And had a fascinating time with the gorillas!

Our Father Understands

Suddenly, I have grown aware that I am witness to the crux of the Gospel message almost every day at Mbingo.  Last week was an especially hard week regarding patient losses.  The premature 27 weeker twins weighing less than 800 grams, one passed almost immediately after delivery while the other lingered for 48hrs. The HIE/meconium aspiration syndrome who sustained such devastating anoxic injury perinatally and eventually met demise after hanging on for 2-3 days.  The 14mo old boy who had idiopathic pulmonary hypertension (again, for reasons unknown) causing right sided heart failure (cor pulmonale)  and liver dysfunction. Two young boys both less than 24mos admitted within a day of each other with overwhelming septic shock, for whom we could not resuscitate aggressively enough.  And the list goes on...

Wails fill the hospital wards as mothers and grandmothers feel pangs of death.  The men are usually more stoic and 'strong' in facing such tragedy, but I know they are hurting just the same.  Mothers' screams ring out shrilly, heard over the normal evening symphony of crickets and chorals of tree frogs.  Yet, death is not nor ever will be the enemy here.  God is the victor whether we understand the difficult circumstances at hand.  God is the author and finisher of life, orchestrating when we take our first and our last breaths on this earth.  I rest in knowing that.  I couldn't practice here without clinging to this truth.  

Amidst all the death of this past week, God gave me a 'eureka' moment when I was praying with the parents of those 27 weeker twins.  My heart aches especially for the fathers, many of whom are about my age, and I cannot bare to imagine what I would be feeling if our roles were reversed. The Lord gave me a simple prayer to point these hurting parents to our Father, One who knows all too well the devastation of losing a Son.  It's the message of Jesus, powerful and pure, and the full sum of the Christian faith. My enduring prayer for these families is for them to have open eyes, that their hurt would not shroud the very thing that they are experiencing.  For in a very literal way, their loss parallels perfectly the sacrifice of the Cross.  May their suffering produce only greater intimacy in knowing the God who gave it all.     

While we have had challenges here, and it seems especially true in maternity, our efforts to revive those 27 weekers was the litmus test of how much our neonatal resuscitation review has improved patient care throughout our hospital. Even though our twins didn't make it, I was impressed with our nurses' stabilization efforts and was encouraged to see their improved performance. Perhaps last month's teaching has not fallen on deaf ears; perhaps, our being here is making a lasting impact on future outcomes, and, just perhaps, we will be leaving this hospital and Cameroon a little brighter than when we first arrived.  

Take care y'all.  Always appreciate you!

Glenn  

Some of my favorite examples of God's Sovereignty:

Job Chapters 1 & 2; Chapters 38-42. 

Lamentations 3:37-38 

Daniel 3:8-30; 4:24-37; 5:17-30; 6:16-28

John 19:10 & 11

Acts 17:24-28

James 4:13-16

Me, Taví (my pupp) and Sampson (the horse) out for our weekend ride! 

Taví and me (in traditional African dress)

One of my coolest patients, Alex.  He suffers from HIV like so many of the kiddos here.  He was admitted severely cachexic and is now doing well on HIV treatment and nutritional rehabilitation.   

Working with our maternity nurses to improve their neonatal resuscitation skills (April 2017).

The Swing

Boundaries in Africa are a grey zone (or just plain nonexistent).  Perhaps, the lack of boundaries and the intrusive intertwining of people's lives (whether they are related or not) is what makes life here attractive and so different from whence I come where lines in the sand are more tangible (and often times welcomed). While intriguing, boundary minimalism that is, the lack of personal space can also be the most maddening.  

I did something that has highlighted this cultural difference. A few months back, I hung a swing on the jacaranda tree out front.  I hung it on the perfect branch that allows the occupant to swing right off the rock wall ledge into the garden.  The intent for this swing was purely selfish...one can have awesome prayer time and reflection on a swing, and it's just downright fun!  However, what I did not foresee, kids have come out in droves playing on the swing all the day long and well into the evening hours.  At first, I was delighted that my house has been the favorite neighborhood hang out, but when the children started knocking down the rock wall and destroying my gardens, throwing their trash down on my lawn, and creating ruckus even on quiet off days (as their laughter and screams reverberate throughout the house when they're playing), it's enough to drive one to the edge of sanity.  

The swing has taught me that Africans and Westerners have very different ideas regarding personal boundaries.  I'm used to my own house, my own car, quiet time away from everyone where I can just shut out the world, and that's something that has become invaluable for me the older I become.  But here, the Cameroonian way does not provide such luxury.  They travel 8 people per crowded taxi (which is a mere 4-door sedan). They live in cramped housing conditions, several people to a one or 2 room house, and houses are built right up next to the other.  They have no space, so how can I expect them to give a second thought regarding mine?  I can't, and so the community continues to barrage my residence, and for now I'll make peace with it.  

Perhaps this is the Lord calling me back to a place of rest and peace in Him despite my frustrations with the cultural differences and whatever other 'storm' is raging on around me. (Matthew 8:23-27; Matthew 11:28-30).  It's an applicable lesson for all of us, regardless of the current stressors of the day. We can wait on Him, find renewal, and keep on effectively tackling life, one bend in the road at a time (Isaiah 40:30-31).  

Although my sanctuary is regularly threatened, it hasn't been all bad.  While I usually spend my days away from the hospital in welcomed isolation, I've had unlikely acquaintances crop up as a result of that ridiculous swing! A few Saturdays back, when my swing was getting an extra hefty work out, I wanted to escape the high-decibel swing-time shrieks and shrills and head up the mountainside to run my dog. However, 3 tag alongs who couldn't take no for an answer, decidedly walked beside me, Jude, Steve, and Ephraim, all about 10-12 yrs old. They seemed especially infatuated with my pup, and I suppose Taví was the real reason for their affinity for me this day. While I thought I desired solitude, it was also pleasant to have hiking buddies for a change :) And perhaps we will go again sometime.  

Have a blessed Memorial Day, y'all.  I always appreciate you! 

Glenn  

Some kiddos having a Sunday afternoon dance party; me and the pupp just happened to stumble upon them on a leisurely afternoon hike.  Nice to see healthy, happy pekins (Pidjin for child) for a change!

Taví enjoying kiddos we met heading up to 'The Knob'.  

His Promises

"Finally, be strong in the Lord and in the strength of his might.  Put on the whole armor of God, that you may be able to stand against the schemes of the devil.  For we do not wrestle against flesh and blood, but against the rulers, against the authorities, against the cosmic powers over this present darkness, against the spiritual forces of evil in the heavenly places." (Ephesians 6:10-12)

Standing on the promises of God is an essential Christian discipline, expelling the lies of a very real enemy (1 Peter 5:8) and reiterating the life-giving and refreshing Word that restores the spirit man.  The valleys of life are a certainty just like death and taxes. I have found plenty of valley terrain over here in Cameroon, and I am sure you all can relate to various storms in your own life. But I am so thankful for the God we serve whose promises and kingdom are everlasting.  

In 4th grade, my teacher Ms. Rhonda Evans gave me (along with the rest of my classmates) a small gift that I have cherished even to this day...a promise that I have kept coming back to in some of my most tumultuous times.  It was a bookmark with my name and its Biblical meaning with associated Bible verse:  Glenn ~ Prosperous One.  "He is like a tree planted by streams of water that yields its fruit in its season, and its leaf does not wither.  In all that he does, he prospers." (Psalm 1:3) This verse in particular has been God's constant whispering throughout the many years of preparation that has brought me to the present, and its an ongoing reminder that I am planted here (at Mbingo) to thrive not to be forsaken.  Psalm 139 is my confirmation: "You search out my path and my lying down and are acquainted with all my ways.  Even before a word is on my tongue, behold, O lord, you know it altogether.  You hem me in, behind and before, and lay your hand upon me.  Such knowledge is too wonderful for me; it is high; I cannot attain it.  Where shall I go from you Spirit? Or where shall I flee from your presence?  If I ascend to heaven, you are there! If I make my bed in Sheol, you are there! If I take the wings of the morning and dwell in the uttermost parts of the sea, even there your hand shall lead me, and your right hand shall hold me.  If I say, 'Surely the darkness shall cover me, and the light about me be night,' even the darkness is not dark to you; the night is bright as the day, for darkness is as light with you." (Psalm 139:2-12)

"All authority in heaven and on earth has been given to me... And behold, I am with you always, to the end of the age."  (Matthew 28:18-20)  God is there in the midst of every circumstance that He is leading you and me through.  It is imperative to remember such promises when everything goes pear-shaped. Perhaps the topsy-turvy craziness of the day is the perfect prompting to abandon our own understanding and trust instead in His perfect ways.  (Proverbs 3:5)  

Blessed Easter everyone!  The Risen Savior reigns forever; to His kingdom there shall be no end!  (Isaiah 9:6-7) (Revelations 1:17-18)

Start listening around 1min 20sec in..."Walk on Water" has been my daily theme song as of late.  

  

Ten Shekels and a Shirt

I left you last praying for all of us to walk humbly before the Lord in 2017. Truly, we should be careful (and even cautious) of what we ask...sometimes we don't even know what we are asking.  Rarely does God answer prayer the way we think He should, yet He DOES answer.  What He has been teaching me is that I still have much MUCH more to learn in my daily walk.  

Paul spoke about being content in times of plenty as well as in times of dire need (Philippians 4:11-13).  God has been dealing with me and unveiling my heart, that perhaps I'm not as content in every circumstance as I should be.  I talked about the recent challenges we've had with the internet, but as of Feb 1st, I've been the only pediatrician here as the other has taken much needed leave.  Thus, I have been lacking in joy as the overwhelming burden of the hospital busy-ness has now fallen on me.   I'm working 7 days a week and have felt run down and exhausted.  

Then I attended a C-section back in January where the mother had HIV.  While awaiting to receive baby, the cord was cut, and it sprayed HIV blood into my face (and eyes) prompting me to take a month of post-exposure HIV medications.  (No way of checking maternal viral load here or gauging how compliant mother had been on her treatment.)  These meds made me jaundiced, gave me nagging GI upset, and just made me even more fatigued forcing me to sleep 9+hrs a night...and still I managed to feel unrested every day while taking. (Thank God, I'm off the pills and still HIV negative.)  

Now, for the past 2 weeks, we've been struggling with water issues.  My bathroom pipes burst 3x just in the last couple of days alone, and always at inconvenient times (mid-night or 3am).  There were several days that just taking a shower or having any running water was impossible.  And I've been a grouch, a big bad meany as a result of all of my creature comforts having been stripped away one by one.  Surely, I must have forgotten what it's like to be in true need, need of the basics that we often take for granted, like our health, running water, a comfortable bed and a goodnight of uninhibited sleep.  Needs that I must be in tune with to have any hope of genuine empathy and love for the hurting people I'm here to serve.  

These past 6 weeks, God has been right there holding my hand and answering my outcry for humility, bringing me to the end of myself and reminding me that my whole existence is dependent on Him and His provision.  I have not always been sensitive to His teaching, but surely this was His response to me. 

If you recall too, 6 weeks ago, I was feeling a little blue questioning even why God brought me to Cameroon and wondering what good I was affecting for Him. I shared my speculation with a colleague of mine here.  He and his family have been awesome comrades in the trenches.  Chris reminded me that we were brought to Cameroon not for our pleasure and not even for the sake of the local people.  We are here simply for the pleasure of God and for His divine purposes (whatever those purposes may be and despite whatever capacity we have to discern His bigger plan!) (Romans 12:1-2)   Chris referenced the famous sermon by Paris Reidhead "Ten Shekels & a Shirt" which can be accessed on youtube:  https://www.youtube.com/watch?v=nDQC45_RA2c.  This sermon has been helpful for me to gain fresh perspective, refocus.

So now,  I leave you with a different prayer, that we may diligently give thanks in all circumstances as surely that is the will of God! (1 Thessalonians 5:16-18)  

Pondering the Burning Bush

We are apparently deep in the throws of meningitis season as today brought too many children with stiff necks, fevers, headaches.  Lumbar punctures were done.  Antibiotics were started.  Nurses were hounding and hounding to discharge patients to make room for the new ones as they kept filing into the ward one right after the other.  I was frustrated, overwhelmed even. 

Then I received a call from OB/GYN stating that they were going to do an emergent C-section.  Mom had severe pre-eclampsia (bad hypertension, risk of seizures…definitive way to treat is get baby out!), but the child, while term, had multiple cystic abdominal deformities and renal anomalies on fetal ultrasound…this was not going to be a routine STAT C-section. 

So it’s now 7pm on Wednesday night and I find myself, after a hectic day treating really sick kids, standing in the OR going over my checklist of things I need for neonatal resuscitation, getting the table set, the intubation equipment ready.  I really wasn’t sure how the baby would do.  Prenatal care is so limited here…we can only tell so much on ultrasound.  The real test is life outside the womb!  As the OR staff also prepares, I remember leaning my back up against the wall just praying for peace for me and the rest of the staff, peace for the mother who had already lost 2 previous pregnancies, and above all, praying for the baby that it would thrive despite whatever I could do. 

The mother was cut, the baby came out, alas with the multiple deformities that we were expecting.  There was no cry, no spontaneous breaths.  We quickly worked to intubate and ventilate.  Chest compressions were started.  Epinephrine was pushed.  We worked on the child for about 30min before I pronounced death.  We did everything we knew to do.  And I could be at peace with that.  It was still so hard showing mother her child and being witness to the pangs of grief that gripped her. 

I didn’t cry…I usually don’t or can’t…it would be too hard to endure in this kind of environment if I lost composure for every child that passes or every kid I see in pain that I can’t fully help with my medical expertise or the tools afforded me here.  But inside, I was grieving.  And it made me question again my calling to come here. 

Not that I am doubting, just questioning, wondering why God chose me.  Will His purpose of bringing me here be made fully clear?  Am I really making much of a difference?  Am I really touching and saving lives?  …It’s hard to see Him through all the death sometimes.  I thought I was coming here to find more intimacy with Jesus, but instead of fullness of His presence, I am feeling a lot of heavy heartedness.  I guess God speaks volumes in times of tragedy or hurt, at least that is how the old time saying goes.  A friend of mine once said that God rarely calls the qualified, but rather He qualifies the called, and I forget from where she got that quote.  I don’t feel qualified to be here, I’m not even going to pretend that I do.  I am beginning to identify with Moses at the burning bush, one of the best examples of God empowering the most unlikely of candidates (Exodus 3 & 4).  Surely with Him we can do all things (Philippians 4:13) and apart from Him we are nothing (John 15:5).  As a testament to Him, the Lord has never left me nor has He forsaken me, and He continues to provide all that I need. 

The questions I am asking myself and asking God are similar questions we all ask in the usual humdrum and challenges of life, whether it be from a new exciting environment in some obscure corner of the world or whether from the comfort of our own homes and all that’s familiar.  My prayer for myself and for all of us in 2017 is that we all seek to walk humbly before the Lord Jesus Christ, trusting in His guidance despite our lack of understanding in whatever circumstances He brings our way.  Surely God’s ways are not man’s ways
(Isaiah 55: 8 & 9), and that’s exactly what makes Him God, to be revered and worshipped. 

Ecclesiastes 12:13

Warmest greetings in 2017 and beyond!

Steps & Storms

This isn't the first time I've had to adapt to being in a very new place for an extended period.  I am finding so many parallels to what I was thinking and feeling when I left for Ireland during my study abroad semester in college.  I remember the anxious anticipation of boarding the plane, thinking of all the possibilities and the kinds of adventures I would have along the way, the people I left behind, and the new friends who were awaiting my arrival.  It was exhilarating in my 20 year old mind, but then reality hit when I actually landed.  I was a stranger in a strange land, and somehow I was going to have to make this work.  I remember being in a frank panic one day coming back from classes wondering how to even navigate the very different European higher educational system.  I totally felt like Peter, absolutely about to drowned among the waves, but thankfully God kept bringing my mind back to the time when Jesus silenced the storm (Mark 4:35-41).  Surely the Lord keeps him in perfect peace whose mind is steadfast on Him (Isaiah 26:3).  I think the story in Mark exemplifies this promise from Isaiah.   

I have been at M'bingo now for just over 2 weeks, and I feel like it has been a relatively smooth transition with a few minor bumps along the way.  Is it because the other missionary docs have been so gracious to welcome me into their family here?  Is it because I've been through these crazy big moves before and each time seems to be preparation for the next? Perhaps a combination of both?  I'm not sure, but I do know that God has reiterated to me the importance of keeping my gaze on Him.  It's when we get distracted, start looking around, feeling our world spinning out of our control that we are filled with panic, and panic is crippling and NOT of God.  Quite honestly, that kind of fear stems from the lie we are buying...that God isn't bigger than all the craziness around us, greater than our storms. 

Another storm hit this past Monday.  It was the first time I was truly on my own in the hospital without the other pediatrician there as my back-up, and it was busy.  I honestly don't know how he has been able to balance everything by himself this past year.  We cover well-baby/NICU, PICU, inpatient pedi, and outpatient clinic as well.  That day I was getting called from PICU for children who weren't doing so great, while NICU was exploding with premature twins, who again, weren't doing the greatest health wise, all while trying to get through rounding on inpatient wards.  And in the midst of all of this, out patients were tracking me down wanting a pediatrician's opinion, medications, evaluations...I felt like I had to be 10 people all at once and I was getting really frustrated...just another moment when I needed the constant reminder to look to Jesus for my solace amidst the wind and waves.  

I'm getting better, better adapted to the new hospital system and the various diseases I've only ever read about.  I'm getting better organized for rounds to help guide the residents and students in their learning.  I am really appreciating the hospital culture that encourages us to pray with our patients.  I try to do this with everyone I'm seeing, It's really fun for me to openly invite Jesus into the healing process for these children and families.  After all, He is the Great Physician, and I only ever saw him do miracles and heal the sick from the accounts of His time on earth, so why shouldn't He do the same now?  We have a beautiful mix of Christians, tribal religions, and Fulani, who are Muslim among our patient population.  I think the Fulani originally migrated down from Northern Africa and the Arabian peninsula but have been in these parts for centuries.  So the fields are ripe for harvest,  I would say.  M'Bingo is really special in that it attracts people from all over, which is a wonderful thing to minister to people and have them go back to their home communities.  Hopefully they only have good things to say about our hospital and keep bringing their family and friends back to see us : )

The past 10 years have culminated with my launch into medical missions.  It's amazing to me how God has ordained every step along the way to prepare me for such a time (Proverbs 20:24).  He has been gracious and gentle all the while stretching and molding me with each phase of transformation into the pediatrician I am today.  Every storm that arises is just His way of calling me back to deeper intimacy, a place of resting in His strength and not my own.  He is truly great, absolutely trustworthy in all things including with my life and the lives of my patients, and you all have been apart of this process because God has placed you in my path to leave your mark on my life, helping me, training, me coming alongside and encouraging me, and I am so humbled and grateful.   

Orientation and Beyond

"If you aren't serious about deepening your relationship with Jesus, then you shouldn't go." ~Keir Thelander (Chief Medical Officer of PAACS-Pan African Academy of Christian Surgeons)  

These were the first words out of Keir's mouth as he stood up to address us that first day of orientation. 'Us' being a group of almost 20 docs fresh out of residency in various fields (orthopedics, neurosurgery, gen-surg, obstretics/gynecology, pediatrics, family medicine, internal med) and now preparing to enter medical missions with Samaritan's Purse. We are headed to various corners of the world (Honduras, Peru, Nepal, Papau New Guinea, Malawai, Togo, Niger, Nigeria, Cameroon, Kenya, and Ethiopia), but the majority of us to the PAACS hospitals scattered across the dark continent.  Keir was dead serious in his statement, and he set the precedent for the next ten days of reflection and anticipation as our mentors prepared us for all that we may encounter in the field.  

They did not sugar coat their advice and admonishments, things that they wished they had known before stepping out, some of them over 10-20 years ago.  Our predecessors recounted how pervasive death will be and how that will affect the young physician.  Doubts will flood in from every direction, as we will question our abilities and whether there was anything left to do.  We will struggle with the schedule, as most of us will be the only docs in our specialty serving a never-ending stream of patients.  Burn out will be much more of a demon ready to pounce upon us than any other time in our lives, definitely more real than when we had certain hour limit protections in training.  And it will be up to us to strike a balance for our time.  Because the reality is, that not being at the hospital will result in people dying, yet even more people will be hurting if we burn-out and pack our bags and return home.  

In much of the world too, death is not the enemy.  I think we have made death an 'evil' entity in western culture, but anywhere else (probably because of lower standards) death is just the way of things, a part of life, not to be railed against (and thus crushed by).  Somehow though, this shift in cultural mindset will not assuage the hurt I will endure when I watch my first patient die.  And that's not an if, it's only a matter of time.  I have been in contact with the pediatrician who I will be working alongside this next year Ethan Helm, and he has had only 1 week since starting this past January where all the children in his ward had survived.  The norm is the passing of at least 2-3/week.  

So, I bring us back to what Keir initially proposed, 'if you want more of God, then, by all means, go because you are running to a world of hurt.'  And that's exactly right, aren't we all called to be the salt and light.  Matt 5:13-16.  Thank God, He has overcome the world and it's darkness,  John 1:5 John 16:33 and has given us His Helper to show his love to others John 7:38, and that's precisely why I'm going.    

***A shameless shout out to an awesome brother of mine John Parker, you were right, Dan Baumann's "Intimacy with Jesus" talk regarding his transformative experience in Iranian imprisonment has changed my life.  Thank you John for sharing, and in turn, I would like to pay it foward.***

https://www.youtube.com/watch?v=LSlTVHXF5T0