Monday, June 8, 2015

In the Family way...

Shortly before I took off to teach a month and a half ago... my dog had just finished up her first cycle of being in heat.

Not fun.

I felt like a particularly hard-nosed warden as I locked her down day and night, chaining her to poles and chasing away her male suitors.

But I figured it would be worth it in the end not to have to deal with puppies.

Unfortunately, toward the end of her cycle --basically the last day or so-- I got lazy. I decided to let her out of her prison (aka: my house) and let her soak up the sun (while chained to my back porch).

I hadn't seen any suitors in a few days and thought her scent must have changed.

I was wrong.

After taking my eyes away from her for about 10 minutes, everything got errily quiet. So, I went out back to check on her.

Her chain had gotten stuck in my outside pipes and she was cornered by three male dogs. One was stuck with her... if you get my drift.

After almost a month of watching and worrying to avoid this very thing... I managed to mess it all up in 10 inattentive minutes.


Not sure if she could get pregnant on the last day of her cycle, I speculated on the probability of puppies with my neighbor and friend, Sarah.

As we debated the likelihood of it all, my dogs nipples changed.

I worried over them, insisting that she must be expecting. Sarah --always the rainbow to my rain-- suggested that I was overthinking it.

I didn't get to speculate on it too long, as I took the offer to teach a week or so later and left my dog in Sarah's care.

Every now and again, I'd return for a quick trip to Maforga. Initially, I didn't see much change in my dog's physique, so I started second guessing my initial pessimism.

However circumstances with my car prohibited me from returning for the last three weeks. By the time I got back, my dog was unquestionably 'in the family way'.

She is huge!

She waddles. She drools. She steals food from kids.

And have I mentioned.... she's HUGE!

Since I know the day she conceived, I can make the fair guess that she will deliver any day. If websites are to be believed, she will give birth on Wednesday June 10th.

Do EDDs on dogs vary as well? What happens if she goes post-dates? Do I have to induce her?

I will confess that I'm every bit the midwife to my dog as I am to women.

I rub her belly until she groans with pleasure and drools. I feed her every time she looks at me with those pathetically drowsy eyes until she falls into a food coma. And well... I basically let her be as cranky as she wants to be at any time day or night.

Just today, I was able to palpate one of her puppies. It kicked me (tehehe).

And I'm even contemplating shaving her belly so I can listen to their PHT (puppy heart tones).

This is going to be my first time dealing with puppies. I could use all the advice you can offer.

Thursday, May 28, 2015

Maternity Ward Observational

During my two week stay at the maternity ward as a clinical instructor, I had the opportunity to note some interesting cultural observations.

Day after day, I'd arrive at the maternity center with students in tow to find a number of first-time mothers in labour. Usually, the first-time mothers laboured the longest, while the multigravidas (aka: women pregnant for the second or more times) came much later in labour.

One G2 (aka: mother for the second time) came striding in, calm as the sea after a storm, only to discover she was fully dilated. She delivered (to my and my students dismay) while we were out of the room. It took her less than five minutes from beginning to end.

But labours like hers were not the norm. Most of the women who laboured and delivered there were first-time mothers-to-be. They arrived after the first or second contractions and then stayed until the baby was born.

For some this was quick. However more often than not, they were there for the long haul. One young girl (having more than likely braxton-hicks contractions) had arrived three days before. She had not had contractions in over two days, but she was not discharged nor did she seem interested in leaving. For the life of me, I am not sure why.

Several women came in at 1 or 2 cms dilated and chose to stay. The maternity ward was bustling but they did not seem to mind. They waddled around and watched as others delivered around them one by one.

When it was their turn to push, they were watched as well.

A lot of the first-time moms had hypertonic (aka: abnormally strong) contractions even though they were only 2 cms dilated.

After talking with the staff about it, I discovered that it was common for women to try and induce labour by drinking traditional herbs. These herbs cause painful and frequent contractions that don't always dilate the cervix. I saw similar things in the Philippines.

One nurse tsked their use of herbs, explaining that usually the ineffective contractions led to exhaustion, an inevitable referral to the hospital, and an (avoidable) cesarean for fetal distress. 

I also saw things done by the staff that caused me to pause.

One nurse sutured a woman up without using local anesthetic. Naturally the woman cried out in pain with each stitch. Meanwhile the nurse yelled and berated her for making so much noise. I didn't stay to watch. I couldn't.

One day while evaluating one of the labours, I noticed her family had purchased cytotec. When I asked her about it, she informed me the nurse had insisted she buy it. The nurse denied this since she was already well advanced in labour. However when I inquired the woman's family about it again later, they presented me with the prescription the nurse had given her. I never saw what the nurse did with those drugs but they were certainly not for the woman who purchased them.

I also saw a nurse be given a 'gift' of a capulana (a traditional cloth) at one point. She hurriedly rushed to put it away in her purse as the gift-giver went back to her friend in labour. I had been told that such 'gifts' were expected by the nursing staff but I confess I was still disappointed to see it.

Labor of Love May 2015

Wednesday, May 20, 2015

On the Road Again!

For those of you who prayed and gave.... thank you! My car is in working order again. It took 3 frustratingly long weeks but my new mechanic, Luis, has finally returned her in excellent condition.

In fact, I don't think she's ever been working so well!

He had to put on a new engine head (as the one that I got fixed in Zimbabwe last year was in fact cracked) and all the valves, gaskets, and what-nots that usually go into such things.

Plus, he fixed my emergency brake (which was loose), replaced my starter (which was finicky), put in a new clutch (which was smashed to bits), and fixed the door handle on my trunk (which had been broken while I was on furlough)!

The man is magic. Magic! I say.

My engine now purrs as she bounces down the road.

Mind you, I still need new tires... but other than that, the car is better than ever.

Thank you for your precious prayers!

Wednesday, May 13, 2015


The third birth I observed seemed normal enough to begin with. The mother was 27 years old and expecting her second child.

When we arrived, her contractions were strong and frequent but she seemed to be handling them well. Within no time, her water broke displaying a yellowish puddle of meconium stained fluid.

The nurse set up the room for the birth (which means she got a bed pan, some non-sterile gauze, and a birth kit and placed it at the foot of the bed). The bed pan was slipped under the mother's bottom and she was told to push.

She pushed for only 5 minutes for the head to be born. But then the nurse reached in and wrenched him out. The mother stayed quiet while the nurse literally pushed and pulled and twisted and turned his little body every which way imaginable.

Two minutes later, the nurse lifted his body free of the mother with a gush of more mec-stained fluid.

The nurse then injected her with oxytocin to precipitate the placental detachment, then started massaging her uterus.

She massaged and pushed on it externally until 4 minutes postpartum it popped out in a gush of clots and blood.

She placed the boy in his mother's arms and evaluated her tear.

There was a tear but it was not deep. At most i would have put it at a shallow 2nd degree. However, as the nurse considered it, I overheard her worry how she was 'out of stock'.

I thought nothing of it, until a few minutes later I watched her suture her up with 3-0 acrylic (aka: non-absorbable) suture material.

She placed interrupted stitch after interrupted stitch, burying the deeper stitched beneath the more shallow ones.

My jaw dropped in surprise and my legs snapped closed in horror... but I didn't say anything. How could I?

We were guests there. I could not make those kind of calls... nor could I criticize them in their work. But I confess, I worry still what those buried sutures might do. Perhaps her body just rejected them and the string fell out as they healed.

That is my hope at least.

Monday, May 11, 2015

Fit To Be Tied.

The next birth happened a day or so later.

The young mother-to-be was alone but apparently unconcerned by this fact. Not all of the labours have companions.

So as she laboured, I taught the students how to evaluate her contractions and take her history. She was 20 years old and expecting her first child.

She readily admitted to taking traditional herbs to prepare her body for birth... and even to start her labour.

Since her contractions were strong and frequent, the nurse decided to do a vaginal exam at 10 am. The nurse was VERY aggressive during this exam, manually dilating her cervix despite the patient's vocal protestations.

Afterward the nurse informed us she was 90% effaced but only 6 cm dilated. But after such forceful manipulation of the cervix, I did not think it true for long.

Sure enough, an hour later her water broke and she immediately got pushy.

In fact, there was no stopping her. So we called for the nurse. 

The young mother was already fully dilated and wanting to push. The nurse tried to get her to focus and push effectively but she would have none of it.

All she wanted to do was scream. 

One scream was so piercing and so long, it could have shattered glass.

After some negotiation, we convinced her that screaming like that was not actually helping. In her defense, she did really try to push. But each time she did, she would close her legs and withdraw.

It was going no where. 

The nurse was not pleased and she argued with her.

She then tried to push again but ended up kicking the nurse and swatting her hands away.

The nurse was even less pleased with this behavior. 

After more negotiating, the young mother confessed that she needed help controlling herself and requested that two of the male medical students hold her down while she pushed.

Yes. She wanted them to forcibly hold her down so she would not hit or kick the nurse.

So they did.

Mind you, they seemed more than a bit surprised by this. I don't think either one of them woke that morning thinking that they'd have to tackle a pregnant woman while she pushed her baby out. But you know... some days are surprising like that.

I soon found myself out of my depths and stepped away from the melee to watch at the foot of the bed. The remaining two students shuffled a step closer to me with each new scream. One (who plans on being an obstetrician) was wide-eyed and mesmerized by the beauty of it all. The other (who is unlikely to choose obstetrics as a specialty) kept hiding her eyes and furtively glancing my way for assurances that the woman was not in fact dying.

Meanwhile the young mother continued to scream and abuse the staff while pushing. The nurse, more than likely frustrated with the abuse, decided to perform aggressive perineal stretching. The baby was born quickly but caused a significant 2nd degree tear in the process.

The placenta was pulled from her body within minutes of the birth with strong cord traction. It was so strong in fact, that the cord snapped, squirting blood all over the foot of the bed.

The nurse decided to suture the tear before presenting the baby to the mother. The young mother screamed and fought the sutures just about as much as she did the birth, despite being anesthetized.

When the nurse finished up the stitches, she reached down for the baby's ankles, lifted her high in the air and presented her genitals for the mother to see.

The young mother whispered, 'a girl' to herself and smiled.

Then the baby was taken off to be wrapped and weighed.

Friday, May 8, 2015


Her contractions were strong and frequent when I first met her. She lay on the bed and her mother held her hand.

The pain contorted her face and forced the occasional groan, but she didn't seem to notice it much. For the most part, she was surprisingly quiet.

So quiet in fact, that I didn't think she was even close.

As a 17 year old G1 (aka: primigravida or woman pregnant for the first time), I expected things to go a little slower. But her body had other plans.

Shortly after we arrived, her waters broke and she started getting grunty. One of the students informed the head nurse, who started setting up the room.

She started pushing before the nurse was ready, so I encouraged her to breathe through contractions and taught her how to push effectively.

The grandmother, looking a mixture of exhausted-relief, excused herself to the corner of the room and said nothing. Absolutely nothing.

The mother pushed effectively despite the five extra medical student faces huddled around her bed. She didn't seem to notice or care in all the pain.

The nurse on duty expedited the birth by doing perineal stretching and the mother remained silent. She pushed only a handful of times before the head was born. The nurse didn't wait for the next contraction, she just reached inside and wrenched the shoulders free. Again, the mother made no noise.

The baby was out less than a minute when the cord was cut. She too made not a sound. Just like her mama.

The nurse grabbed the child by both feet and swung her in the air, presenting her upside down for the mother to see. The mother smiled when she saw it was a girl, then dropped her head back on the bed in a rush of exhaustion.

The nurse lay the child on her breast and it mewed quietly.

Within 3 minutes after the birth, the nurse aggressively massaged the mother's uterus and applied traction on the cord. The placenta wasn't budging. She forced it harder and massaged even more aggressively.

This continued until the nurse found herself with a torn placenta (only 5 minutes postpartum) and decided to do a manual extraction. Reaching her right hand in up to her elbow, the nurse extracted chunk after chunk of the placenta from the uterine wall. Each time she reached in, she came out with chunks, clots and membranes.

The mother made not a sound. 

Afterward, the nurse reached in repeatedly with non-sterile gauze to evacuate the uterus and vaginal canal of any remaining blood. But still the young, new mother remained silent.

Inside, I screamed for her. Inside, I cried out in pain.

For her.

How she remained so stoic... so quiet, I'm still not sure.

As I looked through the nurses' bloodied hands, several baffled expressions caught my eye. "What must these medical students be thinking?"

For many of them, this was their very first experience with birth. I shuddered to think that this was considered 'normal' in Mozambique.

Perhaps... it is normal. 

Wednesday, May 6, 2015


The last two weeks of May involved teaching at a maternity ward downtown. My job was to help introduce fourth year medical students to 'normal' birth. Much of our time was spent labour watching, timing contractions, evaluating fetal heart tones, and palpating fetal positions. However, we also got to do a number of newborn exams and assist in a few births.

One day we arrived to find a young woman occupying one of the labour beds. Naturally, we assumed she was pregnant (as her fundal height was marked), so I told two of the students to time her contractions. Ten minutes later when I came back to see how things were going, I was informed she was not in labour and that her babies were in the other room.

So I instructed them to get her obstetrical history instead.

The new mother explained that she was a 20-years-old mother of six. Earlier that day, she had delivered twins at home. She came to the maternity ward for the birth certificate but did not seem very interested in any other service. Since her babies (a boy and a girl) were cold and covered in sand, the nursing staff had taken them for evaluation and placed them in a warmer.

The mother explained that she had delivered her first child at the age of 11 and that her previous four pregnancies were simple. This was her first set of twins, however. 

She didn't want to talk much about the particulars, so we didn't press her for more information. Although I know 11-year-olds can get pregnant, my heart hurts to think that this mother has so many mouths to feed and so much responsibility...  at such a young age.

What were you doing at the age of 20?

Monday, May 4, 2015


As I mentioned previously... during the months of April and May, I was invited to be a clinical instructor for a medical school in a neighboring city. The people I met and the opportunities this experience afforded me were equally wonderful and heartbreaking.

The first four weeks, I worked with nursing students doing clinical rotations in a busy hospital. The school gave me a white coat, a pen, and pointed me to the various departments. I was working in the pediatric department and the malnutrition center.

Needless to say, what I saw was...

Stressful: Each morning I had to rush from where I was staying (my commute was anywhere from 40 to 90 mins one-way) to get to the hospital in time for roll call. The hospital was crowded. The needs were overwhelming.

Disconcerting: The manner of teaching was very different from my own (educational) experience. I felt like I was wading eyebrow-deep in murky waters for the first few days. Every day brought new challenges with no cultural insider to ask if I was making a fool of myself or standing tall. Sigh.

Heartbreaking: No one forgets the gaunt and wasted face of a 8 year old boy dying of AIDS. It's hard to silence the wails of a mother who just watched her two year old die.

Fascinating: One day a 4 day old neonate was brought in to determine the sex. The genitals were ambiguous. After the examination the doctor explained the mother had an hermaphrodite. The news was not well received.

Overall, my time there was...

Exhausting: Most days turned out to be 10 to 12 hr days. Speaking all day in Portuguese was a challenge as well... mentally and physically.

Expensive: Though friends let me stay with them for free, the public transport was either cheap or inconvenient. Getting back and forth from work took an hour and a half in the morning if I went with 'cheap' (costing less than a dollar). But if I needed to get there quickly (30 minutes or so), it cost 8 dollars. Sigh.

Insightful: After two years of stories about policies and practices in governmental hospitals, I was finally able to see first hand that they are true. I saw corruption, neglect, abuse, and incompetence. But I also saw many who did not fit the mold and strived to do well.

Blessed: I was able to make lots of new friends and learn how the medical system works in this country. Often I was impressed by the caliber of medical professionals in this country despite the obstacles they must face to care for their patients.

Thursday, April 30, 2015

Overheated: The Saga Continues

Again, please forgive me for this rant. I feel like I’m complaining all the time. I probably am though. As I have more bad (expensive) news to share.

My car... the one that overheated last fall and got a complete new engine... started having troubles again a few weeks back.

My local mechanics (aka: my team members) poked and prodded and said all was good to drive. I was not so sure.

I took it on short trips for the day and it appeared to be fine. But apparently when I decided to come to Beira to start teaching, everything heated up a notch.

The three hour trip turned out to be too much for my car. It overheated.

But oddly, there was no mad cloud of steam and the engine did not freeze. It just got hot and I stopped to cool it off and eventually add more water.

Delayed but not stuck (Praise God!), I eventually made my destination and started volunteering. But almost immediately, it was using more water and oil and acting all hot and bothered.

So I asked around for a good mechanic. That’s how I met Luis.

Luis is Zimbabwean of Indian descent. Nice guy from all appearances. He took a few hours to check ‘Hot and Bothered’ out. The diagnosis was not pleasant.

Though he won’t know for sure until he takes the engine out --Yep. The engine must come out. He says I got really bad work done in Zimbabwe last year. The hack job they did has to be re-done.

All of it.

The price tag is likely to be the same.

This news has been just one more thing in a series of bad this week (i.e. lost paperwork, roofing delays, team drama, etc.). Fortunately, it has not got me shaking in my boots.

Though pressed on every side, I know I’m never abandoned. I feel His presence so intensely. I feel so close to birthing this clinic.

So. Very. Close.

The enemy is shaking in his boots. If he thinks that by frustrating my papers and breaking my car that I’ll somehow turn tail and leave, than he’s a mighty big idiot.

His tactics are base, desperate and ultimately powerless in the face of God’s divine will.

He will fail.

Please pray for me (and the team here at Maforga) to daily find ways to become more than conquerors.

Some battle scars are still fresh. To be honest... some are actively bleeding. But I turn to my Healer for these wounds to be bound up and make whole.

May I come out of this battle stronger and more suited for the next task at hand.

Oh... that His people would PRAY.

Labor of Love: April 2015

Wednesday, April 29, 2015

Lost in Maputo-land.

I’m not sure how to update you all on my equivalencia paperwork without coming off as hostile, morose, or defeated. So I’ll try to stick to the facts.

Fact number one. I got promises for immediate action (meaning an answer in less than one week) from the director of education in Maputo.... 5 weeks ago.

Fact number two. Last week, I got a call that there was an answer to my paperwork but since it was a Friday, no one could be bothered to open the envelop and read those results over the phone. My friend in Maputo would have to show up in person on Monday.

Fact number three. My friend was busy so he went in on Tuesday. While there he was told that the department of education had LOST my most recent application. We’d have to resubmit everything. --everything since January that is. That equates to 5 months of wasted time.

Fact number four. I’m really disappointed, somewhat angry, and overall unimpressed.

How does a country, that has lost or misdirected my application four times in almost two years, get anything done?

Seriously, are you kidding me?!

Please pray as this next round of paperwork should be submitted next week. Pray for supernatural results.

This is beyond ridiculous.

Tuesday, April 28, 2015

Roof Going On...

Your prayers for the roofing material were heard. Last week I got the call that they had arrived and were ready for pick-up. I arranged for my friend to cart them out to our community but the following day... I was informed that not all of them had been picked up. I had to pay (again) for the remaining two roofing sheets to be delivered before I could start thinking about tearing things up.

The thing is... since the roofing material took 4 1/2 weeks longer than expected to arrive, I was no longer able to oversee the project. (I had already committed myself to teach for 6 weeks at a medical university several hours drive away.) So I asked a team member to do it for me.

Thankfully, he agreed.

This week, the old roof was torn off and the new roof is going on! Yeah!!!

Though I’ve missed the process, it is probably for the best. I’m discovering that I’m too nit-picky when it comes to construction in this country.

For example on the first day of construction, when my team member told me that a quarter of the roof had been torn off but they still hadn’t purchased the nails to put the new roofing on, I almost started hyperventilating.

Not good.

After first reassuring myself that the sky above was a perfect cerulean blue, I told him that it was probably best not to know the details. We’ve had too much rain in the last few weeks for me to comfortably tear off the clinic roof... and leave it off.

Even for a day.

Since then, I’ve heard nothing but good things. Apparently, the old roof has come off completely... and the new roof is more or less on.

A team member is taking pictures. I’ll be sure to add them as soon as I can.

Thank you for your prayers. And thank you to all those who have given to make this new roof possible! You all are awesome!

Sunday, April 19, 2015

More Papers Than Sense

Last year after getting the license to open the clinic, I headed off to Beira with a spring in my step to buy supplies for the clinic. Beira is the best place to buy medicines since it’s a coastal city and there are a number of pharmaceutical companies that import medicines directly to the port. 

When I approached them for catalogs and supply lists, they told me with tight-lipped condescending smiles they could only sell them to me if I had an AVARA.

Never having heard of this document before, I returned to Maforga empty handed. I asked around for help in obtaining it and got a LOT of conflicting information. Once the dust settled and I was able to filter though yet ANOTHER set of paperwork requirements, things got even more confusing.

I won’t bore you with the details. But I will share that I’ve been working on the process for over 9 months and I don’t feel even one step closer.

After spending lots of money getting the building inspected and registered, I was informed that my efforts were wasted. You see... I had been seeking a way to establish a pharmaceutical license/AVARA for the clinic. That way I could buy the medicines in Beira and then provide them to the community.

But I should have done my homework better.

The Mozambican laws prohibit a private clinic from also owning a private pharmacy. And even though the clinic is a charity/non-profit clinic, there is no way to have a non-profit pharmacy.

So... I was denied that route.

The only route that remains is to get the AVARA for the clinic. This is still a possibility and it might permit me to buy some medicines. I’m not sure. But to complete the process, I must wait on others.

So I wait.

And I pray.

Please pray with me.


Saturday, April 18, 2015

Water Anyone?

As I alluded to in my earlier posts, our water situation at Maforga still has a few leaks in the system.

Metaphorically speaking, of course.

Last fall after almost a year of no and/or very poor water supply, we were able to reconnect the water for the orphans. This dearly improved the quality of life on a whole. But if memory serves me right, that fix appeared to be electrical, resulting from a faulty pump.

If you recall, that was also around the time I was pushing for the water tank at the clinic to be completed. After months of delays, a wonderful short-term team of construction workers in connection with local workers finished the water tower and installed the tank.

However due to continued water shortages, I was not able to test out the tank until I returned from furlough in January. Only then did I learn that the water supply was not good enough to fill it as well as provide for the orphans.

Fortunately, God had foreseen this problem and had already provided through some very generous donors enough money to dig another well.

However after some months of unforeseeable delays, Roy (the director of Maforga Mission) was finally able to contract the well digging company to come out last February.

I’m told the first place they dug was no good. They hit granite. We didn’t have enough money to pay them to dig again and again, so Roy asked them to re-dig an unused well instead.

Though they did re-dig it, they then did not have the right casing or pipes or even a pump to fit it and so it sits waiting.

The un-used well, I’m told by Roy, was abandoned after having to repeatedly repair the pump due to sand clogging the system. He expressed a hope that with new casings and a better pump it could be much better and the water would be diverted directly to the clinic. This would avoid having to share the water with the orphans.

The problem is... no one seems to have the right size of pump for this kind of casing. He must look for it in S. Africa. He tells me he intends to get it next time he goes.

I’m sorry I don’t have better information than that. Please pray that the parts come together for the well to be useful or for us to find another way to resolve the water issue.
Currently, there is no water at all to the clinic and I cannot open it without it.

Thank you for your prayers.


So on Monday, one of the team borrowed my car. After a day of running errands, he returned with news that it appeared to be overheating.

Not good.

I took a look at it, and sure enough. It was hot and bothered.

The water boiled furiously out the hoses. The engine strained and sizzled each time it started. And even the tires appeared to be constantly losing air.


I tried a little bit of this... and a little bit of that; I asked you all to pray; And then finally, on day three of the confusion, it became clear.

There was a hose problem.

Another team member lent me his hose to see if it was something so simple. And now it works like a charm.

Please pray for me to know how to take care of this precious ministry tool. Getting from point A to point B is more important than I can express. Everything hinges on transportation in a place as remote as this.


Friday, April 17, 2015

Invitation to Teach

You’ll be happy to know my mud-encrusted toe nails are bright and shiny again. It’s amazing what a tepid bucket bath can do for the spirits!

I don’t remember ever going so long without a shower --when one was available, that is-- and I can only attribute it to my muddled mind and burdened heart. I forget to do things like eat and shower when I’m tied up emotionally.

To say, I’ve had a lot on my mind lately would be inaccurate. ‘A lot’ indicates more than the usual load. What word describes more than ‘a lot’?

A ton? A mountainous weight? Atlas’ burden?

No. That’s not accurate either. Because it’s the number, not the weight, of the issues that trouble me most these days.

As I sit and type, I’m reminded of one of my dad’s favorite sayings: ‘If it’s not one thing, it’s another.’

So yesterday I shared about one of the things. In the days to come, I’ll be sharing even more. I’m finding it’s remarkably helpful to write them down.

The simple task of typing them out reminds me of catching butterflies. I bounce after each thought in my head, trap it with a gossamer net, and gently pull it free. As I examen the specimen, I marvel at its intricate markings.

So delicate. So beautiful. So distracting.

I lay this butterfly aside and it stays... remarkably.

And I pick up my net for the next.

So... as every good story needs a beginning. That is where I’ll start. Here goes...

While in Maputo for my paperwork a few weeks back, I stayed in a missionary guesthouse where I met a missionary couple from Beira. They were leaving to come back North the same day as I was and I asked to hitch a ride. They kindly obliged.

This lovely couple shared their stories with me as we traveled and we told them of my plans as well. We discovered that we had similar interests.

They work with the youth near a Catholic medical school in Beira. Many of their Bible study students attend the school and over the years they have made many friends there. They offered to connect me with their friends.

When they dropped me off, I promised to stay in touch and come visit at the first opportunity. I wanted to meet with the school directors to see if they would send nursing or medical students as volunteers once the clinic opened.

About a week later, I was able to arrange the trip out there and I called them up. They generously invited me to stay the night. However the day I was to head out, I got delayed and called them to say I’d be running a few hours late.

-- “Hi, B. So sorry but I won’t make it for lunch,” I explain by phone. “I’ll see you later in the evening. I had an emergency to take care of this morning... and I’m delayed”.
-- “Oh, dear. But we arranged for you to have a meeting with school director at 2pm,” she worried aloud. 
-- “What?” I stuttered. “Um.... thanks. But had I known I would have tried harder to be there. I’m three hours away.... I don’t think I can make it in time.”
-- “Oh, dear. But they can’t meet tomorrow....”
-- “I’ll try to come now. Please see if you can push it back a bit.”
-- “Okay. See you soon.”

As I made a mad dash back home to pack and raced off down the road, I couldn’t help but be simultaneously confused, irritated, and thankful.

  • Confused.... because I had no idea about the meeting and was surprised. 
  • Irritated... because I was now late for a meeting I never knew was happening and I might not make it in time.
  • Thankful... because they had made such a sweet effort to bless me.

I was three hours away. The meeting was to start in three hours exactly. By the grace of God... I made it.

I had just enough time to park, meet up with my friends, then hurry off to the medical school. They tried to catch me up as we walked.

We arrived and I shook Dr. E’s hand with a smile.

-- “Hi”, he smiled back. ‘We are excited to have you here today... but before we go any further we need to know what kind of midwife you are... and whether or not you expect to be paid?”

I shared my experience with him a bit confused and denied any interest in payment. In my head, why would they pay me to send me interns? I shrugged it off and let him lead the conversation.

He was pleased to know that I didn’t need payment and offered to introduce me to the woman in charge of the nursing department.

I confess, the meeting was one big confusion. There were three languages being spoken simultaneously and questions that didn’t connect with my expectations.

Forty minutes later, I was sitting around my friend’s dining table sipping coffee and trying to make sense of it all. As I strung all the questions together in a play-by-play evaluation, it occurred to me that the meeting felt more like a job interview than anything else.

So I asked the obvious.
-- “Was that a job interview?”
-- “Yes, it was. What do you mean...” he asked in confusion.
-- “But I thought the meeting was so I could ask for volunteers... not be one,” I explained.

This revelation brought on more confusion, prayers, and phone calls of explanation. I called Dr. E to apologize for the miscommunication. He didn’t seem to mind at all and insisted that they could really use volunteers.

Although I no longer saw the reason for another meeting scheduled the next morning, he didn’t want to cancel it. Rather he asked me to come and hear them out about what volunteering would be like.

The next morning I went and met several doctors and directors. They told me they had teaching modules and I could be a huge help in two modules in particular and that I’d be useful as a clinical instructor for both the nursing and medical department.

If I agreed, I’d be teaching students three days a week in the morning and my afternoons could be spent working in their HIV department where I could learn the country’s protocols. This is a HUGE answer to prayer. I know I’m hopelessly uninformed on HIV protocols and treatment options (there was almost no HIV in S. Sudan), but I wasn’t sure how I’d be able to learn them... until now.

Needless to say, I told them I’d pray about it and get back to them.

That was a week ago.

Since then, I’ve talked to my director here at Maforga and he agrees it’s a God-opportunity. Moreover, God has provided a place for me to stay while in Beira and the right uniform. I’m only missing white nursing shoes.

If all goes well, I’ll tentatively start next week. However, that depends on my car working. Since my return from Beira, it has started overheating.

I’m hopefully getting it fixed today. Pray that it can be sorted quickly and that I can volunteer without any issues. I’m eager to see what God has planned for this new adventure.

A Roof-to-be

A Roof-to-be

Last year I planned to put a new roof on the clinic. But before I could arrange the details, my car engine exploded. Resolving my engine problems took precedence and then I had to leave for furlough.

By the time I had returned, the rainy season had made getting a new roof on impracticable as the rain rarely let up long enough to give me hope.

Well, now the rainy season is passed. Mostly.

In anticipation of this drier season, I got the funds together, checked around for the best prices, and ordered the materials. I was informed, at that time, that it would take 10 days at the most.

It has been almost a month.

I went in to the roofing supplier with questions and was told the equipment that cuts the metal roofing tiles is broken. All their orders are backlogged.

They could not promise or even estimate how long it would take to get the roofing.

Foolishly, I pushed and prodded for a time frame. They hedged and made empty promises.

So I wait.

Please pray that the supplies will arrive soon and that I can arrange to get the roof on in the next month or so.

I’m told it’s a week long process.

Only time will tell.

Please pray.

Thursday, April 16, 2015

Equivalencia Update

You know it’s an off week when you look down at your mud stained feet and wonder when you took your last shower.

Yes. You read that correctly. And when I say shower... I really mean bucket bath.

In the midst of my feet-inspired reverie this morning, mini flashes of strange and various adventures this week confused my counting and I had to start again.

Finally I determinde --with much self-incriminating horror-- that it has been 7 days.

One week since I showered.

Oh the shame!

It’s at times like this that I’m thankful God hasn’t married me off. Who would share a bed with such a stinker?!

So as I stop to type this out, imagine my grimy toe nails and greasy hair and laugh with me.

I have much to share.

In fact, I have so much to share. I’m going to do it in mini segments because, honestly, who has time to read diatribes on Mozambican corruption or shady mechanics?

I will start at the beginning though. The question is... which beginning?

The Maputo Adventure (and all that came after)

In my most recent newsletter I told you how I went to Maputo to talk to the US ambassador and various heads of departments at the Ministry of Education and Health. I won’t belabor those points again but I will add what has happened since.

The consulate staff has corresponded with me and told me basically their hands are tied. They can (and have) tried to address the delays in my equivalencia process on a more systemic level, but to no avail. They are even willing to make phone calls for me if and when it seems necessary. However, the extent of their influence is limited at best.

I believe them.

Moreover shortly after my visit to Maputo, the Ministry of Education director promised to expedite things (according to my helper in Maputo) but no concrete evidence to this fact has surfaced. She promised to have results by the end of the week. It’s been 2 1/2 weeks since then.

The cogs of bureaucracy move slowly here... if they move at all.

So the long of the short of it is... I must wait and pray. So, I wait and I pray.

The locals are chomping at the bit to see the clinic open. Eyes are on me. Not a day goes by that one of the workers doesn't ask me ‘how long?’.

Can I blame them?

I’ve been encouraged by some on my team to ‘just open it’ and to ‘forget getting government approval’. I’ve been told that the ‘law of love supersedes the laws of man’ and I’m commanded to just start healing people.

How can I argue with that?

Except... except... except, the Bible tells us to abide by the laws of the land. If we don’t abide by them we disgrace God and bring shame to His name.

How do I reconcile the two?

I tell my would-be encouragers that if I practice medicine without a license I can be arrested. No one seems to believe me. No one really thinks I’ll be thrown in prison or kicked out the country for ‘doing good’. But who wants to risk it?

What kind of Christian would I be to openly defy the government on such an important issue? Why put myself in such a predicament, especially in such a litigious society, so I can have the pleasure of handing out medicines?

Yes, the law of love supersedes the laws of man. But am I qualified to pick and chose which laws to obey?

But we are not talking about being forbidden to speak about Jesus or pray in His name. I’m not being forbidden to preach... I’m being told they need to vet me before I dole out malaria meds and catch bambinos.

To me... these are quite different circumstances.

Moreover, I must explain that my equivalencia is not the only thing holding up the clinic’s opening.

The three main issues blocking my way at the moment are:
  • a new clinic roof is needed but delayed.
  • there is currently no water to the clinic and there is no way to determine how long it will be to resolve the problem.
  • the AVARA document process is stuck. This is the document which allows me to buy medicines in bulk and for discounted prices.

Other issues come into play (such as my car is broken again!). But I won’t rant about that at this time. I will, however, promise to write about them all individually and in more detail in the days to come.

But please know... I’m tired and discouraged. I feel like a failure and daily want to give up. I could be inches from my destination... or I could be a million miles away. I cannot know for sure or clearly see what is next. Pray for me.