Labor of Love June & July 2011 ~ Newsletter

Labor of Love June-July 2011

Burgundy

When I need a change I typically need changes in all areas of my life. So this week, I decided to color my hair.

I don’t normally care what color my hair is. Nor do the random gray streaks concern me. When I notice them, I tend to laugh and try to imagine me with a whole mess of kinky white streaks sticking up in every direction.

Will I look like my grandmother?         -- I hope so.

So, what would inspire me to color my hair?         -- Curiosity.

I wanted to see if Burgundy would look good on my skin tone.

I’ll let you decide.

Animal Orphanage

There are a number of attractions to see in Kenya, not the least of which is its amazing wildlife!

Kenya is home to a number of animal orphanages. I am told they get most of their animals from illegal animal trafficking. They are able to release many of the animals back into the wild but many of the Big Cats (lions, leopards and cheetahs) can never be re-integrated.

Instead they endure hours of baking in the sun, sleepily watching as tourists pass with cameras in hand.

What they must think of the show... I can only imagine!

Stripped hyenas and civet cats have little havens next to a whole mess of lions and one eerily large ostrich.

(Honestly, I didn’t think they could get so big! Now I see how people could saddle and race them! But riding one looks like a disaster ready to happen. Images of bull riding mixed with a chicken with the speed of a pedigree stallion jumps to mind. Just saying.)

I got to have a monkey eat from my hand. Which was fun. I like monkeys.

And we almost got to hold a 3 month old lion cub... but in the end couldn’t be arranged. The guide would have had to sneak us in and well, the bosses were watching. We came at the wrong time of day.

It was worth it, of course.

Oh... and I even saw a Zee-donk!

What’s a Zee-donk?

It’s what you get when a donkey and zebra fall in love.

Think grey body, pointed ears and stripped legs. Beautiful and unique, but definitely an Oops.

Cooking Up a Storm!

My time off has been pretty chill so far. I have to admit I’ve done little more than sleep, eat and catch up on emails.

A sad way to spend a vacation... but refreshing nonetheless!

The friends I’m staying with have been gems. In addition to putting up with my longer-than-expected-visit, they have let me take their kitchen hostage and cook to my heart’s delight.

Can I just say... I’ve missed cooking!

So far we’ve had sun-dried tomato stuffed chicken breasts, sausage pasta, two different types of apple tarts, a number of couscous salads, hamburgers with an Asian coleslaw. And tonight, I’m making a Filipino fish recipe!

Oh, and I’ve been on a hummus kick, too.  A few days ago, I soaked too many chickpeas and had to do something with them. So I made three different types of hummus. But no one seems to be complaining!

We all love hummus!

So... if you are wondering what I’ve been doing with my time. Imagine me in the kitchen surrounded by fresh ingredients and exotic spices!        -- Culinary heaven!

South Sudan's Independence Video

Here is a link to the video of the dancing in Tonj done to celebrate South Sudan's Independence on July 9th 2011.

Sports Outreach

This past week, two Kenyans came to head up a sports outreach in our community. Their goal was to use football to win souls for Christ!

Walter, the director of Michezo Afrika (or Sports Africa) has been doing sports outreach for years. He said he got involved in it not long after university, and has been working in some way with sports ministry ever since. He calls himself a sports missionary. And I’d have to agree.

He came with Franklin Shelimba a footballer who played for the Kenyan team Mathare United and has been doing sports outreaches like this for many years as well.

In preparation for this outreach, Sabet organized a number of local football teams and put together a tournament. The young men chosen to participate were all between 12-15 years old.

So when Walter and Franklin got here, they could hit the ground running. They started by training team captains in a series of workshops, sharing the gospel and discipling them all the while.

Afterward, those captains went back to their teams to pass on the skills they had learned in preparation for the tournament.

Walter told me the goal behind this kind of outreach is to disciple disciplers and train trainers. Teaching football is just a platform to share the gospel.

It proved to be a powerful platform indeed. 

By the end of the week, several players joyfully gave their lives to the Lord and prayed for God to do a work in their hearts. Others, I’m told, recommitted their lives. And still others expressed tearful determination to do sports ministry in the future.

I’m so blessed to see the young men being reached in this way. If we can reach these men early, think of how it will impact this region for good!

Franklin & Walter

So praise God with me that God is doing this new work in the youth. I look forward to seeing how God grows this ministry in the future!

If you would like to know more about Walter and Mechizo Afrika, check out this website. It’s a fantastic tool for preaching the gospel.

Resuscitation.

Abuk came to see me on Monday. She was terribly sick and had been that way for a week and a half. But she lived so far away, she wasn’t able to come earlier.

She was expecting her second child and was term. She could deliver any day.

I diagnosed her with malaria and dysentery and gave her the medicines, praying she would not start labor until they were finished.

But that didn’t happen.

At first light, she was back in the clinic and pushing. And would you believe it... she was fully! 

Listening to her baby’s heartbeat waver and peak irregularly, I knew we had a problem. He was showing signs of severe compromise with erratic variables and late decelerations.

I called for Sarah and Margaret. I wanted as many hands available as possible. Images of Nyiriak’s birth crowded my thoughts.        

--Lord, please don’t let me have two babies die in a row. Please!

It wasn’t long before her precious boy was born.

He came out covered in thick meconium. Limp, cyanotic and with just the slightest will to live, he didn’t do much but lay there listlessly.

--Lord, help this baby to breathe!

With both Sarah and Margaret right there, we were able to work on him quickly. Sarah got the oxygen machine set up and flowing; Margaret breathed for him and stimulated him like mad; and I tried to stay focused on Abuk.

She delivered her placenta before he was fully recovered. Although we got him breathing, we couldn’t keep him warm.

So I asked Abuk to do Kangaroo care. She complied at first, but eventually decided it was too much trouble.

Confused I tried to explain to her that it was important for her baby to live. But she didn’t seem to care.

Was she just too tired?

Fortunately, her brother volunteered to do it for her baby instead. He stripped off his shirt in haste and happily took the tot in his arms. It was so amazing to watch!

So few Dinka men help in such matters. What a delight to see this exception!

Once her boy’s temperature stabilized, she was able to breastfeed without any difficulties. We watched them both the rest of the day, and discharged them with strict instructions to return if anything went wrong.

In my heart, I was ecstatic. Finally a baby that would live. The resuscitation worked!

However, the next afternoon she returned saying her baby had a fever. Sure enough, he was showing signs of neonatal sepsis which was probably due to meconium aspiration.

We admitted him for treatment and observation. And I started praying hard.

But I found out the next morning that Abuk had discharged herself in the middle of the night. I was told that she said she didn’t see her baby getting better so she refused to stay.

I haven’t seen them since.

Admittedly, I’m disappointed. I wish I could have found a way to communicate to her that this baby was going to live... he just needed the right medicines and time.

Please pray for Abuk, her son, and the rest of her family. Pray that this boy might thrive despite not getting the rest of the medicines he needed. Thanks.

Neonatal death.

Nyiriak has been coming to prenatals for months. She has probably heard my lecture about the importance of delivering at the clinic a half dozen times at least.

In that lecture, I warn of the high infant and maternal mortality rate in Sudan and how by coming the clinic such losses can be prevented.

Nyiriak listened.

So when she went into labor on Monday, she came to the clinic. Her face shone in health and expectation.

Beautiful.

Expecting her fourth, I didn’t have to do a vaginal exam to know she’d deliver soon; her contractions were well underway. So I got her settled and asked her to call if her water broke or she needed to push.

Her baby was doing well and so was she, so I headed to devotions (we do a staff devotion each morning before the clinic starts). She promised to call me if anything changed.

Twenty minutes later, our guard called saying she was pushing. So I ran.

She was close but not fully dilated when I did a vaginal exam. Her baby’s heart was solid and strong. All was well.

So I called for Sarah to come help. I wanted her to get another ‘catch’ under her belt.

This month we’ve been using her as our pharmacist and she hasn’t been able to help with as many births as we would have liked. She came quickly, gloved up as Nyiriak continued to push.

Once the water ruptured, thick meconium oozed out. Not a good sign. So I got things ready for resuscitation and checked the heart tones once again. They toc-toc-toc-ed happily.

All was well. Or so I thought...

However, once the sweet girl was born she was flat. Sarah and I stimulated her and wiped her down in unison, but she didn’t respond. We cleared her airways, but she didn’t seem to notice.

Limp and growing paler by the second, she didn’t seem to want to live. 

What was wrong?

After a minute or two with no progress, I sent for Margaret, cut the cord and moved her to a table where I could work on her better.

Although we gave oxygen and pumped her heart for her, she didn’t take her first breath for over 10 minutes.

It was hard to watch her limp body turn blue then pink then blue then pink. When she finally breathed on her own, we rejoiced. But it was short lived. Her shallow breaths turned to gasps and her heart rate would plummet within minutes.

Not good.

We bagged her and did chest compressions for an hour and ten minutes in total. She couldn’t maintain her own breathing and died thirty minutes later in her mother’s arms.

Her pale frame lay peacefully as everyone gathered to weep.

I can think of no reason why she couldn’t breathe on her own. She was not premature; she did not appear to have aspirated any meconium; she had no indication of heart trouble antenatally. My best guess is that perhaps her lungs were not fully formed.

As I watched her family weep silently, I wanted to join them but I couldn’t.

I had no tears to offer.

Sure, I was grieving, but I could not seem to find even one tear. Why?

All I know is that this death felt very different than the others. This death was not marred with regrets. I gave my all and so did Nyiriak. In fact, the whole IDAT team worked tirelessly to get her to breathe. But in the end, she died.

Had Nyiriak delivered at home, her little girl would have died instantly. Coming to the clinic, her little girl lived just short of two hours. But they were hours spent fighting for life, giving our best and praying like mad.

I can live with that.

What I’ve learned is that grief is not always displayed with tears and it is somehow easier when not mixed with regret.

Please pray for all those involved in this terrible loss. Thank you.

Lightening

The house which was struck.

Although the clouds roll and rumble above, this ‘rainy season’ has been considerably dry. In fact, daily the Sudanese staff are praying for more rain; their farms are languishing; their river beds are mucky and low.

But when the rain does come, it stomps its way in like a two-year-old having a tantrum, and makes everyone stop to take note. But then it’s over.

However, these tantrums often cause significant damage.

A few weeks back, Sabet told me that 3 people had died in a nearby village when their tukel hut was struck by lightening in the night.

Confused I asked him to explain why the lightening would strike a place that had no metal in it. Was this common? He couldn’t explain to me why --only that three had died and we should pray for the family’s loss.

Well, it happened again. But this time, it was much much closer.

Last Thursday, I was standing under my veranda talking to my translator about a patient. The rain was falling so hard we had to shout to be heard over the drumming on the tin roof.

Electricity crackled above in the clouds, hanging low. Then CLACK! --a sudden bolt hit not far away and fire flew skyward.

It was impressive ... and close. But I didn’t think much of it until later when I got back to the clinic for another patient.

I could smell wet ash, like an enormous bonfire was extinguished and I asked my translator about it.

-- Don’t you know? The house over there was hit by lightening.
--What? Really?
--Yes, didn’t you hear?
--Well, of course I heard. How could I not? But really, a house was struck?
--Yes, and the woman inside was killed.
--A woman was inside?

Together we went to investigate. A tukel just over the fence from our clinic, no longer had a roof. The woman and her belongings were taken by her son (who was outside the tukel when it hit) to a friends house.

I was told that Sabet went to pray with them and find out how we could help.

Remarkably, the lightening hurt no one else, even those just a few feet away.

Please pray for the woman’s family during this sad time.

The Celebrations Continue...

After most of the day’s heat had passed, more people flooded to Freedom Square to celebrate in dance. As usual, the main ceremonies were invisible to anyone under 7 feet tall, as it required seeing through the throng of people bunched up around the city officials.

Fortunately seeing the show was not necessary to enjoy the festivities. Impromptu dancers gathered for the cameras; a sea of black milled about and kicked up dust with each celebratory step; it was a party.



Different tribes danced according to tradition. The Bongo tribe moved in undulating waves to the sound of a steady drum and hollowed out tree trunk. Whereas the Dinka jumped like spear wielding locust to a distinctly metallic rhythmic tune.



Everyone tried to get the kowajas to join in.

I laughed to see some in our group deftly mimic the difficult movements and steps. However, I declined to even try; the movements for the women are outwardly seductive and revealing and I’m not interested in attracting Dinka suitors.



All in all, it was a wonderful way to celebrate this nations new found freedom!

(Once I get on faster internet, I hope to show you all what the dancing looked like. I got lots of videos.)

Some extra photos of that day:

Independence Ceremonies.

Following the dancing crowds and whistle blowers was easy; they were all going the same direction. Hundreds gathered, crowding in to see and hear the electronic voice blasted through the microphone.



Who was speaking? I couldn’t tell. Nor could I see him; the wall of people stood in my way. But I figured it had to be one of the city officials.

When I asked, Sabet told me that it was in fact the commissioner speaking. He was obscured by the crowd at first, but when I finally got to see him I was impressed. He wore a cloak designed to look like the new South Sudanese flag. It hung over his suit, trailing all the way down to his leather shoes.

He looked very official.

But what caught my attention at first really wasn’t the cloak or the shoes; it was his hat.

Made of entwined black and silver Christmas tinsel, it moved briskly each time he moved, shimmering in the harsh afternoon heat.

It was mesmerizing.

After a few minutes of standing in the sun, a nice young man in a new suit and gold lapel pin offered the women in our party seats. To reach them, I had to walk past even more elaborately decorate officials in suits and cloaks, then a mass of military dignitaries in green army uniforms.

The soldiers were wizened with age but tough and proud. Several turned to stare at the Kowajas in brief interest, and one even smiled at me kindly.

We were directed to sit just behind them and to the right. Everyone else privileged enough to have a chair in the shaded tent area looked withered from the heat, like I was.

Dressed in their finest, many wore wool suits and massive hats. But no matter how hot they might have been, no one took any of it off.

At one point a marching band filtered past us in brocaded red uniforms, toting brass instruments. The women in the band wore thick grey stockings, and I shuddered to think how hot they must have been.



One girl had numerous runs in her stockings. Why I fixated on this I cannot say. Perhaps it was because I could understand nothing the droning voice said.

Too hot to sit any longer, I got up abruptly to go photograph a man wearing a strange costume. Was he wearing leopard skin over his biker shorts or was it hyena? I had to get a closer look.



To get to him, I had to walk between two of the most official looking men in the group. One I had seen before. In fact, I’m pretty sure I saw him earlier this week at the clinic when he came to speak to me about a sick relative.

I recognized him by his mustache. It was grey and white but only grew in two curly masses on each side of his mouth, like two commas. It suited him well.

But his mustache wasn’t the fist thing I noticed. In fact it was hard to see it at all under his hat.



He, like the commissioner addressing the crowd, wore a very unique hat. It was metallic blue and shimmered intensely every move he made. It, too, was made of Christmas decorations and tinsel. But the tinsel was bigger; each strand had circular cut-outs dangling from them.

As I started clicking pictures of the man in the speedo and animal skin, I got brushed off to the side by what appeared to be the commissioners personal guard --a special forces unit. They wore dusky blue fatigues and looked very serious, and even more serious holding their gazes locked with AK-47s in hand.



After they cleared the path, Mr. Commissioner concluded his speech and made his way back to his seat. He sat next to Mr. Mustache in the blue hat, who I believe was the Secretary to the Commissioner (but I’m guessing here).

Then for the next few minutes I proceeded to take all of their pictures over and over again. They didn’t seem to mind or get tired of the attention. The Commissioner immediately took off his black-silver tinsel headdress and put on a metallic blue one just like his friend.

The crowd did not clap after the speech; however there appeared to be some cheering and celebratory whistle blowing. And the band played loudly and off-key.

Then the commissioner’s car was brought, the special forces cleared the scene, and he left quickly.

It was over.

Most of the crowd exited en masse, but I stayed to take a few more pictures. Several small groups were dancing and listening to music through the PA system.



Children ran around asking me to take their pictures, and I happily complied.

Just before I left, I pushed my way behind the dwindling crowd to my right and found a bull tied to a post with its neck slashed.

Cow dung appeared to be mixed together in the blood which was attracting flies.



“Why would they sacrifice a bull?” I wondered. Was this an animistic tradition. I took a picture determined to ask Sabet about it once I got a minute.

During lunch, Sabet explained that the Dinka Christians try to do everything in the Bible. Meaning they uphold the Jewish tradition of animal sacrifices for their ceremonies.

“Really? This is done because of the Christian influence here, not animism?” I asked a bit confused. He assured me that it was the Dinka church trying to fulfill the Old Testament law.

Oh...

The ceremony was hot but I’m so glad I got to see it. I’m thrilled that I got to walk among the crowds, see the dances and hear the shill cries of delight.

This is truly a day to celebrate!

To echo one man who cried out to me in the festivities: “Happy Freedom South Sudan!”

Sudanese Independence.

As the countdown to South Sudan’s independence grew near, excitement and hope tinged the prayers of all our Sudanese staff during devotions.

Each day as the prospects of war seemed farther away, hope clung on a bit tighter.

Could it be? Would they really see the day of their independence come? After years of war and countless lives lost, could it really be happening?

Their hope and enthusiasm is hard to describe, but it’s certainly contagious.

For decades this land has been in labor. Pain. Suffering. Death. But today we see the birth. And what a glorious birth it has been. Long awaited but alive!

People are dancing in the streets. Horns are honking. Drums are beating. The land is finally free.

So, this is what it looks like to birth a nation.

I’m in awe.

Happy Birthday South Sudan! May this land be forever dedicated to God. May your people sing His praises and rejoice in this miracle continually! May your leaders seek God for wisdom in how to rule well. May God be glorified in your midst! May peace fill your land and your hearts!

God bless South Sudan!

South Sudan’s National Anthem

South Sudan’s National Anthem

We praise and glorify you
For your grace on South Sudan,
Land of great abundance
Uphold us united in peace and harmony.

Oh motherland!
We rise! Raising flag with the guiding star
And sing songs of freedom with joy,
For justice, liberty and prosperity
Shall forever more reign.

Oh great patriots!
Let us stand up in silence and respect
Saluting our martyrs whose blood,
Cemented our national foundation
We vow to protect our nation.

Oh God! Bless South Sudan.

Chubbiest of All the Land.

Amouk arrived in the morning with a fountain of gushing amniotic fluid each contraction; it pooled on the floor -- a puddle but not quite a lake.

Splish-Splash

Expecting her 7th child, she looked like she was carrying twins by the way her belly hung. It was a mountain beside her lake.

When I checked her, she was 4 cms dilated with abysmally short contractions. But with a G7, you can never guess how quickly labor might go. So I admitted her and watched.

She spent the morning trying to augment her contractions with nipple stimulation and walking. And I knocked off prenatal after prenatal from the line. There were at least 35 prenatals to see.

Each time I checked her baby’s heart tones, she would comment on the fact there might be two inside. What did I think?

I told her that I honestly didn’t know. I felt and heard only one baby, but she was the size of two babies... maybe even three!

We’d laugh each time and she’d go back to waddling around the clinic. I’d go back to my prenatal ladies.

When the very last prenatal was seen, I brought her back in for another vaginal exam. It had been hours (8 hours to be precise), and she was looking no closer to delivering. What was wrong?

Her second vaginal exam showed her to have made no progress whatsoever. She was still 4 cm and 50% effaced.

Hum...

But by this time, her helper had changed. It was no longer her mother but a young lady named Martha. When Martha saw me she laughed excitedly and asked if I remembered her. When I said I didn’t and that I was sorry, she laughed again.

“But you delivered my baby last year! I’m Martha,” she exclaimed, “I named my son Stephen after you!”

And together we slapped hands in excitement and caught up on how my namesake had been doing. Martha was Amouk‘s niece and had no doubt encouraged her aunt to deliver with me.

So back to my story. When I told Amouk that she was not progressing and that I wanted to augment her labor with an IV drip, her only concern was whether or not she’d get home before dark.

Hum...

It was about 4 pm already and it gets dark around 7:30 pm. Would she deliver before dark? I couldn’t say. But we induced/augmented anyway.

However once the oxytocin was running, her contractions kicked up a notch. In fact, just 30 minutes later she was asking to push.

Not sure if she was exaggerating things or actually ready, I did another vaginal exam. Not only had she dilated to 9 cms, but his head had dropped 2 stations. It was a go!

I let her push a few times but she wasn’t making progress so I asked her to hold off pushing until she was fully dilated.

Another 30 minutes later she started pushing with earnest. Although fully, her baby’s head wasn’t coming.

She pushed and pushed. The head molded and molded. I could see it crinkling up inside; but it would not come.

Hum...

After 40 minutes of this, I tried the vacuum. And even then... he wouldn’t come. No doubt we were dealing with a bigger baby than normal.

However, with time his head started to crown and he eventually emerged.

Roughly the size of a mac truck, he squealed and complained as I wiped him down. Rolls of stocky legs and chubby arms, he flayed his arms in excitement.

He was HUGE!

If I hadn’t watched him come out, I would have sworn he was a 3-month old! And would you believe it, he is officially the biggest baby I have ever delivered!

10.3 lbs (or 4.7 kg) of kissable cuteness!

Twins he was not, but he could have been!

Afterward, Amouk laughed in relief while her mother --eyes greyed with age and cateracts-- took my hands and lifted them to the heavens --this is how the midwife is honored in this culture-- and together we praised God for His goodness in giving us a healthy baby!

Inchelich Nalich! Praise God! Inchelich Yesu! Thank you Jesus!

Busy-Busy!

Last month we had 19 births and roughly saw 500 woman for prenatals. That might not seem like much but let me tell you it is! If all of these woman came to deliver at the clinic, I’d have 50 births a month easily!

Perhaps I should be happy that they are not all coming to the clinic after all!

Think about these kinds of numbers. If I’m seeing on average 15 NEW patients a day then, many of the women are either coming only once for prenatal care, losing their prenatal books, or I’m on a run-away train to prenatal mania!

Aside from going a bit crazy from the sheer number of women seeking care, I’m getting tired. Margaret is helping me as she can, but the reality is there is just too much work for one midwife.

There is another thing influencing all this. HALF OF SUDAN got pregnant during the referendum in January. I kid you not, HALF of the woman I’m seeing for prenatals are DUE in October!

Something has to give.

My brain is swimming with fundal heights, malaria, STDs and heart beats! I break out in sweats just thinking about what October will bring.

Pray. Pray. Pray.

Jaundice: The Color of Kernicterus

I never got to hold him --my day was too busy-- but I did get to pray for him. And as I lay my hand on his chest to pray, his gaped-jaw expression and labored breathing jarred me.

Would he live?

By the time I saw him, Dennis and Margaret had already completed a Ballard’s score on his tiny frame. A Ballard’s score helps determine how old the newborn is in terms of weeks. This is particularly useful when the child is preterm, like he was. He was roughly 32 weeks gestation.

His parents said he was born 4 days earlier but refused to breastfeed. Margaret was able to help his mother manually express, then fed him with a syringe --the first time in four days!  But ultimately it made no difference.

He died.

I’m told his mother came once for prenatal care. She delivered prematurely at home and then for four full days stayed there watching her child become progressively weaker and yellow.

Did she not know we could help?

However by the time she came, there was little we could do. He was lethargic, dehydrated and yellow. Pathological jaundice --or possibly Kernicterus-- had already set in.

For those who don’t know, jaundice is caused by the build up of the levels of unconjugated bilirubin in the blood.

It is more common in preterm babies and was perhaps caused or compounded by the fact she was not able to breastfeed. Treatment for it is helping to establish breastfeeding and exposing the baby to sunlight (or bilirubin lights).

When bilirubin levels are high for too long, it leads to Kernicterus which is when bilirubin is deposited in the brain, causing brain damage.

Had he lived, he would have been severely brain damaged.

Please pray for the family that lost this precious child. Pray also I’m able to teach these women about breastfeeding better. Frankly, I don’t know where to start on this one. Thanks.

Third Trimester Malaria

On Sunday, Aguak arrived in a lot of pain. Even though she complained of everything BUT malaria, I knew she had it.

She was burning up. She was writhing in pain. She was pregnant.

I admitted her and started her on IV medications because she couldn’t keep anything down. At one point she said she had only been sick a day at most, but her symptoms seemed too severe.

Malaria will cause contractions, and she kept insisting she was in labor. I assured her that once her fever came down and the medicines took effect, her ‘labor’ would stop.

While the quinine slowly dripped into her system, I assessed her baby. This was her first pregnancy, and she was well into her third trimester. Perhaps she WAS in labor.

As I measured her belly and listened for the heartbeat, I was disturbed by the silence. Even though she insisted in a half-dazed malarial rant that the baby was alive since it was moving, I didn’t believe her.

I could feel no movements. I could hear no beating heart.

That was two days ago.

Last night as her medicines had finally worked their magic, she was well enough to understand her child was dead. She took it bravely but it was hard news nonetheless.

Normally, I’d be willing to induce her. But she is still so weak. I’m worried she won’t be able to handle the induction.

After informing the family of the death of the child and potential dangers it poses --the baby decomposing and causing her to get septic or her developing disseminated intravascular coagulation-- I asked them to take her to Wau.

At first I was hopeful. They have the money and even took her home this morning. But then they came back again this evening.

Apparently, despite all their searching they were not able to find a ride to Wau. They seem to be unwilling to go on the bus (I can’t figure out why) and private transportation is too expensive.

Perhaps they will go tomorrow. Please pray that they do.

Pray for Aguak and her child. May mercy, grace, love and peace surround them all during this difficult time. Thanks.

Weekend away.

 When my directors saw how tired and discouraged I had become, they worked hard to get me some time off. It’s not simple getting away for the weekend in Sudan, but they made it happen and I cannot thank them enough.

My time off came in the form of a mini-retreat in Rumbek at a hotel called Safari Style. They have air-conditioned rooms (not so important now that the rains have come, but nice nonetheless), fancy meals and a pool!

It was the first time I’ve donned a swimming suit in at least a year and half! My oober white skin didn’t look all that strange since most of the others in the pool where all Kowajas too. Safari style caters to expats and NGO workers based in the area.

I met people from all around the world, each with a story to tell. Hearing about what Sudan life has been like for them was strangely cathartic. It helped me gain perspective on the many different kind of works taking place here. It was good.

One of those people I met told me about a number of chimpanzees that they had rescued over the years. They were due to be flown to Uganda in a few days to be placed at a sanctuary and one of them liked to hug.

A hugging chimpanzee? This I HAD to see. When I asked if I could meet her, he shrugged and suggested I come the next morning. His compound was just around the corner and the hotel director promised to take me there.

The next morning I woke excitedly, scarfed down my breakfast and then jetted over to see the chimps. I found there were four in total. The three adults had long leashes and lived each in their own tree. The last was a baby who had adopted one of the more aggressive females as her surrogate mother.

The chimp that hugged was super friendly. She loved to be tickled and was quick to play with anyone willing. She particularly loved her keeper, Charlie. She made a hissing-laughter sound anytime he tried to tickle her and curled up in a ball. Too cute!


When it came my turn, she simply looked at me, cocked her head to the side as if to size me up and then lifted her arms like a toddler for me to pick her up. How did she know I needed a hug?

Then together we hugged without moving for several long minutes. I should say, she hugged me. I could have lifted my arms and she would have stayed in place. I was perhaps no different to her than a tree, but I LOVED it.

Getting to hug a chimp was definitely a highlight to the whole trip!

One year anniversary.

Culture is a hard thing to get away from. A person’s culture is so ingrained in them that to extract it morsel by tiny morsel is impractical --if not outright impossible.

If one cultural fiber is shed, it tears at the others leaving ragged holes and insecurities.

I’m not suggesting that a person cannot change and adopt new ways of doing things or seeing the world; that would be foolishness. But I am saying that a person’s foundational culture --the stuff that motivates us and moves us in ways we don’t fully understand-- is tenacious and unbending.

But shouldn’t it be? I mean, come on. If it isn’t, won’t it all fall like a house of cards?

Sorry. I digress.

My point is: I am American.

I have had the privilege of living in a number of wonderful countries over the years. Each of those countries and cultures has changed me in countless ways. But at the base --at my very core-- I am American.

Why is this important? Well, lately I have been praying and thinking about life and the work I’m doing here, and I have been asking myself a lot of questions. But strangely, each time the answer to those questions is the same.

Culture.

Why have I felt so frustrated? Culture. What is shaking me to the core? Culture. What is at the source of this disconnect? Culture. 

My point is: As an American, I am faced with a new culture clash. This culture clash has been the hardest one of my life. To call it culture-shock is just not strong enough because the idea of a shock is fleeting. It assumes that eventually it will pass.

My culture-shock here in Sudan is not passing. It’s constant and unrelenting.

Part of my recent struggles is due to personal sickness and fatigue. But another part is due to this deep gulf of disconnect between my American culture and my adoptive Sudanese one.

I have been here a year and I’m still trying to build bridges of understanding. Will I ever make it?  I honestly don’t know.

My American enthusiasm has been stripped naked. Clinging to a limp and nearly dead ideal of optimism, I wonder if it has not all been in vain. Can I survive if it has? 

Let’s face it, Americans look for results. They like facts and figures. They want statistical and incremental proof that what they are doing is helping. Or else, they scrap the project and move on. Americans are a ‘bottom line’ people.

I am a ‘bottom line’ American. Hence, the disappointment.

It doesn’t help, either, that I am a product of my culture’s ‘microwave generation’. I expect results in minutes not years. I have been trained to believe that every story should be tied in a tight 20-minute knot which includes two commercial breaks and a preview of next week’s show.

Yes. I know. It’s stupid. Sigh. Nevertheless it’s true.

I am American.

I’m an American struggling to slow down and trust in a culture that has no sense of hurry. I am an American trained to insist, strive, work hard, and expect results in a culture that wants to talk and not do.

Yes. I am an American in Sudan. Sigh.

So recently when I looked at my calender and saw that I had been here a year, I stopped to take account. Has my coming made one iota of difference?

I’m not sure.

Yes. In this year, God has done some amazing things in this ministry. He has brought several to salvation, countless lives have been touched at the clinic, and the church is growing. God is obviously moving. And I’m honestly glad to be a part of it.

So why the struggle?

Again. It’s my American-ness. My cultural core is begging for a stay of execution. Will I be forced to throw out time expectations and perceived usefulness? Perhaps. Am I ready to do that? I’m not sure. What will have to change for me to make it through another year?

Culture. Specifically my culture.

Am I being too dark again? Can’t I just pretend all is well and bright and shiny? I could. But it wouldn’t be honest. This is me being honest. This is my struggle this month. This is what living in the mission field looks like for me. These are the questions I face.

Am I strong enough to make the necessary changes?

I hope so.

Please pray for me. Pray that I would not hold fast to culture but to God. Pray that I can gain new perspective for this work and live well among these people, showing them the love of Christ in culturally appropriate ways for them. Thank you.

Black Hole.

Two weeks ago, I realized I was empty --a black hole kind of empty. Perhaps a spinning vortex of black matter is not the best image here, but it’s the one that jumps to mind. Needless to say, it was dark, and each miserable day started the same.

I woke up with dark thoughts. I drank my coffee with heavy sighs. And thoughts darker than the sludge I sipped would raced through my brain. The work you are doing is lousy. No one wants you here. These women don’t care. Nothing will ever change.

I would then sit through devotions, clapping to the beat of the African refrains, but my heart was far from worship. Lord, I have lost my joy. Fill me, Papa. Help me to worship You in this dark time. However, trying to drown these thoughts out with praise didn’t always work.

My third cup of sludge in hand, I would then walk with lead feet toward the clinic, murmuring to myself. Is any of this helping? Am I not just wasting my time? These women don’t care. Things will never get better.

Like I said, it was dark.

Then as I would work through the long line of prenatals, I found myself not only gloomy but defeated. These treatments are not working. The women are still coming back week after week with STDs. No one is willing to deliver at the clinic. They don’t want my help, they want the free stuff I hand out.

Sigh.

What is worse is I found myself lecturing them and trying to make them feel bad. Who was this miserable cuss of a person I’d become? I didn’t even want to be around myself.

It was bad.

Oh Lord! What is wrong with me? Help me gain new perspective. Please, open my eyes to see Your marvelous works! Show me Your hope for this nation.

It was a battle. Some days I won out over my dreariness. But other days, I caved to fatigue and frustration. I’m not proud of this; it just is the fact.

“Why are you downcast, O my soul? Why so disturbed within me? Put your hope in God, for I will yet praise him, my Savior and my God.” Psalm 42:11

Hope. I talk about it frequently because it is where I am attacked the most. Why God would let me wonder and waver on this issue is interesting to me. What is it that He desires me to understand? Why does He constantly bring me back to HOPE?

I don’t know yet... but I’m confident it will be good when I do!

Today, a full two weeks later, my weary weeping has passed, and I cling once again to hope. But the battle scars are still a bit raw.

Are all my questions answered? No. Do I know what the future holds? Not exactly. But in the end if hope remains, does it matter?

He is God and I am not. His ways are higher; His plans are good; for He is good. In this I can and do delight.

Thank you for praying for me through this dark time --even if you didn’t know it had come.

Expect more stories soon. I have so many to share. I’m just running low on time to write them! Suffice it to know that the ‘slow season’ has ended; the clinic is now wildly busy again.

Please hold up the staff in prayer, that none of us would grow weary in doing good. Thanks.