Last night Jeneson and I returned from the Global Mission Health Conference. There is just something magical about being in a room with over a thousand other people who feel the call of medical missions in their lives and lifting up our voices to praise our God.
It was a fabulous time together listening to some great speakers and learning a TON of new information about fun stuff like vaccinations, TB, malaria, intestinal worms, etc... The main speakers had many encouraging words for us and we often felt that they were speaking directly to us!
One of the speakers was Charles Fielding, the author of Preach and Heal. During one of his talks in reference to medical missionaries he said that:
"It may not be safe or easy, but it is right."
This profound statement hit us like a ton of bricks! There are many out there who question our sanity and reason for going over to Sierra Leone with three small children. This statement sums it up. While there may not be any clearly logical reason for us going, this is what we have felt God lay on our hearts to do and where we feel that God is leading us.
And yes, it WILL NOT be easy. We will face many challenges both as a family and medically. There will be physical, emotional, and spiritual hardships.
And yes, it WILL NOT be safe. While there is not much violence in Sierra Leone, there are plenty of other dangers in terms of disease, snakes, and poor road conditions.
But it is RIGHT. This is where we are supposed to be going. This is what we are supposed to be doing.
But, we also need your help. It will be the prayers of the people that will help us during those rough times. Even if we don't know when or what you are praying, just knowing THAT you are praying will give us encouragement.
Sunday, November 13, 2011
Monday, November 7, 2011
Physical and Personal Preparation
Some days I feel like my To Do List is never ending. On top of the daily duties of being a stay at home Mom of three young children I constantly have in the back of my mind 'What do we need to do before we leave for Sierra Leone?'
First, health wise we need to make sure that all of our immunizations are up to date. So in addition to the routine childhood vaccinations they also need typhoid, meningitis, Hepatitis A & B, and yellow fever vaccinations. This on top of thinking of what we are going to do about malaria prophylaxis for ourselves and our children.
All of us need to have dental exams and Jeneson and I need to have eye exams. Since I wear contacts I have to carefully plan on how often I am going to change them and how many bottles of cleaner to take.
One big change that we made a couple of months back with Sofia (our 15 month old) is switching to cloth diapers. I am keeping it really simple by going 'old school' and using flats and prefolds with simple covers. For those of you out there who hear cloth diapers and think mess, laundry, diaper pins, and hassle, just do a quick 'cloth diaper' Google search. You will be astounded at the extent of cloth diapers available! It has gone quite well other than not having a nighttime solution that she doesn't soak through. I almost wish that I would have done cloth with our older two.
The other list that I am constantly going over and updating in my head is the 'what will we bring list'. More on that the next post.
First, health wise we need to make sure that all of our immunizations are up to date. So in addition to the routine childhood vaccinations they also need typhoid, meningitis, Hepatitis A & B, and yellow fever vaccinations. This on top of thinking of what we are going to do about malaria prophylaxis for ourselves and our children.
All of us need to have dental exams and Jeneson and I need to have eye exams. Since I wear contacts I have to carefully plan on how often I am going to change them and how many bottles of cleaner to take.
One big change that we made a couple of months back with Sofia (our 15 month old) is switching to cloth diapers. I am keeping it really simple by going 'old school' and using flats and prefolds with simple covers. For those of you out there who hear cloth diapers and think mess, laundry, diaper pins, and hassle, just do a quick 'cloth diaper' Google search. You will be astounded at the extent of cloth diapers available! It has gone quite well other than not having a nighttime solution that she doesn't soak through. I almost wish that I would have done cloth with our older two.
The other list that I am constantly going over and updating in my head is the 'what will we bring list'. More on that the next post.
Thursday, November 3, 2011
Professional Preparation
So how does a Physician Assistant and a Family Nurse Practitioner prepare professionally for caring for a rural population in a poor developing country. First some stats to give you a glimpse of what we will encounter. To give some perspective the numbers in purple are the US stats.
Human Development Index 180/187 countries (4/187 countries)
Average life expectancy 47 years (78 years)
Maternal mortality 970/100,000 live births (24/100,000 live births)
42% of births attended by skilled health personnel (99%)
Infant mortality rate 157/1000 live births (8/1000 live births)
Under 5 years old mortality rate 192/1000 live births with 58% of them due to malaria, pneumonia, and diarrhea (8/1000 live births with 43% attributed to prematurity and congenital abnormalities)
28% of children under the age of 5 can be categorized as being moderately to severely underweight (1%)
HIV prevalence 16/1000 adults age 15-49 (6/1000)
In Sierra Leone there are 0.2 physicians and 1.7 nurses or midwives for every 10,000 people (26.7 physicians and 98.2 nurses/midwives for every 10,000 people)
49% of the population uses clean water (99%)
This is the grim reality of life in Sierra Leone: there is great chance that you or someone you love will get very ill and great chance that they will not be able to see anybody who can help them and end up dying from a relatively simple disease process where prevention or early intervention could have made all the difference in the world.
There are a number of ways that we are preparing for this medical adventure.
Last fall we all moved to Slidell, Louisiana to enable Jeneson to attend Tulane University's Diploma program in Tropical Medicine. It was a lot of information crammed into one semester. He is also a class or two away from getting his MPH.
Last summer I attended a two week International Medicine and Public Health course held by INMED in Kansas City, MO. I was able to network with many others who are working in developing countries or preparing themselves for that task. Also, inspired by my recent observations in Sierra Leone, I am taking a two day crash course on Midwifery in Developing Countries down in Nashville. I am really looking forward to this class and hope to glean lots of information that will help improve the pregnancy and labor and delivery experiences of the women in Mokanji.
Additionally we feel like we are constantly preparing in many little ways. Next week we will travel to Louisville, KY for the Global Missions Health Conference where we will hear some excellent speakers and get some great teaching on medical and spiritual care in missions. Jeneson can often be seen walking around the house reading the Handbook of Medicine in Developing Countries. We are frequently checking out websites that might offer us some information about health care in developing countries. I follow a few blogs of people I know who are caring for people overseas.
But, most of all, we pray. We know that there will be some tough times ahead; that we cannot prepare for everything we might see or do and that there will be times when there is nothing we can offer the patient except prayer. We pray that God will sustain us during those times.
Human Development Index 180/187 countries (4/187 countries)
Average life expectancy 47 years (78 years)
Maternal mortality 970/100,000 live births (24/100,000 live births)
42% of births attended by skilled health personnel (99%)
Infant mortality rate 157/1000 live births (8/1000 live births)
Under 5 years old mortality rate 192/1000 live births with 58% of them due to malaria, pneumonia, and diarrhea (8/1000 live births with 43% attributed to prematurity and congenital abnormalities)
28% of children under the age of 5 can be categorized as being moderately to severely underweight (1%)
HIV prevalence 16/1000 adults age 15-49 (6/1000)
In Sierra Leone there are 0.2 physicians and 1.7 nurses or midwives for every 10,000 people (26.7 physicians and 98.2 nurses/midwives for every 10,000 people)
49% of the population uses clean water (99%)
This is the grim reality of life in Sierra Leone: there is great chance that you or someone you love will get very ill and great chance that they will not be able to see anybody who can help them and end up dying from a relatively simple disease process where prevention or early intervention could have made all the difference in the world.
There are a number of ways that we are preparing for this medical adventure.
Last fall we all moved to Slidell, Louisiana to enable Jeneson to attend Tulane University's Diploma program in Tropical Medicine. It was a lot of information crammed into one semester. He is also a class or two away from getting his MPH.
Last summer I attended a two week International Medicine and Public Health course held by INMED in Kansas City, MO. I was able to network with many others who are working in developing countries or preparing themselves for that task. Also, inspired by my recent observations in Sierra Leone, I am taking a two day crash course on Midwifery in Developing Countries down in Nashville. I am really looking forward to this class and hope to glean lots of information that will help improve the pregnancy and labor and delivery experiences of the women in Mokanji.
Additionally we feel like we are constantly preparing in many little ways. Next week we will travel to Louisville, KY for the Global Missions Health Conference where we will hear some excellent speakers and get some great teaching on medical and spiritual care in missions. Jeneson can often be seen walking around the house reading the Handbook of Medicine in Developing Countries. We are frequently checking out websites that might offer us some information about health care in developing countries. I follow a few blogs of people I know who are caring for people overseas.
But, most of all, we pray. We know that there will be some tough times ahead; that we cannot prepare for everything we might see or do and that there will be times when there is nothing we can offer the patient except prayer. We pray that God will sustain us during those times.
Tuesday, November 1, 2011
Spiritual Preparation
Preparing for moving our family of 5 to Sierra Leone can be a daunting task if I focus too much on the little details. So how have we prepared so far? What are some of the ways that we have been preparing spiritually, professionally, physically, and personally?
I think that, by far, our spiritual preparation has been the most integral to getting us ready for Sierra Leone. One things that has helped our spiritual preparation is knowing that this is where we are supposed to be going and what we are supposed to be doing. While we have not had any auditory revelations from God, He has certainly been showing us the way and guiding our steps of ministry by closing and opening doors and answering prayers of need in unimagined ways.
It has been a long journey to get to this point of preparation. We have been imagining our day of embarking on long-term missions for over 10 years now, from even before we were engaged. The fall of 2001 we travelled down to Texas to take a 2 week seminar on medical missions run by Mercy Ships. We were engaged December of 2001 and married June of 2002. Our honeymoon was a labor mission trip to the island of Roatan, Honduras (don't worry we did have a couple of days on the beach toward the end of our trip).
We pray often for the people of Sierra Leone and the Mokanji region that their hearts be open to our teaching and to hear the Gospel of Jesus Christ. We pray often for the people who support us in prayer and financially. We pray often that we are able to hear the still, quiet voice of God and follow his leading. We pray often for patience and provision.
We are growing in our trust and faith in Jesus Christ. I think that by relaxing our expectations and what we can achieve on an individual level we allow God to work more in our lives. One great example of this is Jeneson's job situation. He has not worked a regular full-time job in over a year, but God has amazingly provided. I guess that I should not be all that amazed about God providing because He did it all through the Bible. (Let me know if you need references for this, because I am sure I can find them). We made the decision, after much careful consideration and prayer that after coming back from India this past January that Jeneson would not take a full-time position and instead take locum tenens (short-term contracts) for work. We wanted to be completely open to God's timing for departure to Sierra Leone.
The biggest lesson we have learned is that in order for God to be faithful to his promises, you need to stop trying to do it all in your own strength and step out in faith.
I think that, by far, our spiritual preparation has been the most integral to getting us ready for Sierra Leone. One things that has helped our spiritual preparation is knowing that this is where we are supposed to be going and what we are supposed to be doing. While we have not had any auditory revelations from God, He has certainly been showing us the way and guiding our steps of ministry by closing and opening doors and answering prayers of need in unimagined ways.
It has been a long journey to get to this point of preparation. We have been imagining our day of embarking on long-term missions for over 10 years now, from even before we were engaged. The fall of 2001 we travelled down to Texas to take a 2 week seminar on medical missions run by Mercy Ships. We were engaged December of 2001 and married June of 2002. Our honeymoon was a labor mission trip to the island of Roatan, Honduras (don't worry we did have a couple of days on the beach toward the end of our trip).
We pray often for the people of Sierra Leone and the Mokanji region that their hearts be open to our teaching and to hear the Gospel of Jesus Christ. We pray often for the people who support us in prayer and financially. We pray often that we are able to hear the still, quiet voice of God and follow his leading. We pray often for patience and provision.
We are growing in our trust and faith in Jesus Christ. I think that by relaxing our expectations and what we can achieve on an individual level we allow God to work more in our lives. One great example of this is Jeneson's job situation. He has not worked a regular full-time job in over a year, but God has amazingly provided. I guess that I should not be all that amazed about God providing because He did it all through the Bible. (Let me know if you need references for this, because I am sure I can find them). We made the decision, after much careful consideration and prayer that after coming back from India this past January that Jeneson would not take a full-time position and instead take locum tenens (short-term contracts) for work. We wanted to be completely open to God's timing for departure to Sierra Leone.
The biggest lesson we have learned is that in order for God to be faithful to his promises, you need to stop trying to do it all in your own strength and step out in faith.
Wednesday, October 26, 2011
Religion in Sierra Leone
While two weeks in Sierra Leone is not nearly enough time to make a spiritual analysis of the region, there are a few things that I did observe.
First some facts:
Sierra Leone is approximately 60% Muslim, 30% Animists, and 10% Christian.
Since animism is largely entrenched in society there is often some crossover into the Muslim and Christian populations. Despite what we often read in the news about sectarian violence around the world, there is a significant absence of that in Sierra Leone. One can often find Christians and Muslims intermarrying, working together and living side by side. They still observe many of the customs of Islam (praying 5 times a day, fasting for Ramadan, dietary restrictions) but cannot be described as fundamentalist in any negative sense of the word. Even during the decade long war religion was rarely pulled into either side of the conflict. Another common misconception involves the role of religion in female genital mutilation/cutting (FGM/C) (AKA female circumcision). While FGM/C has been associated with Islam it is not a requirement of the religion and many women who do not practice Islam have had FGM/C. It is more of a cultural ritual, not a religious one.
While this amity between religions is fantastic when it comes to daily life it can make things a little more difficult to a Christian sharing their faith and trying to effectively convey the Gospel message to others. Many will say that Allah is the same as our God. This is a delicate issue that needs to be approached in a culturally sensitive manner with a lot of truth in love.
Now if you want to witness some great prayer and worship, visit a West African church! I have now gone to church in Benin and Sierra Leone and nothing matches it.The worship is lively with singing, drums and dancing all to the glory of the Lord. Listening to the prayers of the people puts my meager prayer life to shame. It is nothing for pastors to have all night prayer sessions.
And their faith is evident in their prayers for they have nothing else to fall back on. They cannot afford medications (no social agencies to help here) or to buy food so they pray. I will never forget a prayer session during my first trip to Benin. One of the members of our team is a type 1 diabetic well controlled using an insulin pump. Here in the US we would often pray for the doctors to have wisdom and for the medications to work effectively. These pastors in Benin prayed for the diabetes to 'pack its bags and leave'. How often do we pray for healing like this in the US? Probably not very often. Probably only when we have exhausted the knowledge of the doctors and tried many medications to no avail. Prayer takes on a different tone when you are in a situation where the only thing that will make the situation any better is an intervention from God.
I have a feeling that my prayer life will become more intense and focused when we get to Sierra Leone. My goal is to start that intensity and focus now because we need just as much God intervention now as we prepare for the trip as we will need once our feet hit African soil.
First some facts:
Sierra Leone is approximately 60% Muslim, 30% Animists, and 10% Christian.
Since animism is largely entrenched in society there is often some crossover into the Muslim and Christian populations. Despite what we often read in the news about sectarian violence around the world, there is a significant absence of that in Sierra Leone. One can often find Christians and Muslims intermarrying, working together and living side by side. They still observe many of the customs of Islam (praying 5 times a day, fasting for Ramadan, dietary restrictions) but cannot be described as fundamentalist in any negative sense of the word. Even during the decade long war religion was rarely pulled into either side of the conflict. Another common misconception involves the role of religion in female genital mutilation/cutting (FGM/C) (AKA female circumcision). While FGM/C has been associated with Islam it is not a requirement of the religion and many women who do not practice Islam have had FGM/C. It is more of a cultural ritual, not a religious one.
While this amity between religions is fantastic when it comes to daily life it can make things a little more difficult to a Christian sharing their faith and trying to effectively convey the Gospel message to others. Many will say that Allah is the same as our God. This is a delicate issue that needs to be approached in a culturally sensitive manner with a lot of truth in love.
Now if you want to witness some great prayer and worship, visit a West African church! I have now gone to church in Benin and Sierra Leone and nothing matches it.The worship is lively with singing, drums and dancing all to the glory of the Lord. Listening to the prayers of the people puts my meager prayer life to shame. It is nothing for pastors to have all night prayer sessions.
And their faith is evident in their prayers for they have nothing else to fall back on. They cannot afford medications (no social agencies to help here) or to buy food so they pray. I will never forget a prayer session during my first trip to Benin. One of the members of our team is a type 1 diabetic well controlled using an insulin pump. Here in the US we would often pray for the doctors to have wisdom and for the medications to work effectively. These pastors in Benin prayed for the diabetes to 'pack its bags and leave'. How often do we pray for healing like this in the US? Probably not very often. Probably only when we have exhausted the knowledge of the doctors and tried many medications to no avail. Prayer takes on a different tone when you are in a situation where the only thing that will make the situation any better is an intervention from God.
I have a feeling that my prayer life will become more intense and focused when we get to Sierra Leone. My goal is to start that intensity and focus now because we need just as much God intervention now as we prepare for the trip as we will need once our feet hit African soil.
Tuesday, October 25, 2011
After thoughts
As can be imagined witnessing the birthing experience brought me quickly back to the realities that Jeneson and I would be facing as medical personnel in Sierra Leone.
This is country of almost 6 million people.
The average life expectancy is 47 years.
Out of 1000 live births, more than 123 of those children will die before their first birthday
There are 0.016 physicians for every 1000 people
These are the stark facts about life in Sierra Leone.
Many people have a romanticized view of missionaries and of the adventures that they are having. It doesn't take but one of these experiences to realize that the reality is anything but.
Reality, like Satan, comes to steal, kill, and destroy.
But I will not let Satan squash the burden that God has placed on my heart for the people of Sierra Leone; to tell them of God's love for them and to show them through caring for them physically, emotionally, and spiritually. I will continue to pray in earnest that God will prepare me as a follower of Jesus Christ, as a Wife, as a Mother, as a Nurse Practitioner to go to Sierra Leone and minister to them. While I know there are many things that I want to show and teach them, I know from experience that they will teach and show me many things also. I need to be open to how God will work in me and through me.
Will you pray with me?
This is country of almost 6 million people.
The average life expectancy is 47 years.
Out of 1000 live births, more than 123 of those children will die before their first birthday
There are 0.016 physicians for every 1000 people
These are the stark facts about life in Sierra Leone.
Many people have a romanticized view of missionaries and of the adventures that they are having. It doesn't take but one of these experiences to realize that the reality is anything but.
Reality, like Satan, comes to steal, kill, and destroy.
But I will not let Satan squash the burden that God has placed on my heart for the people of Sierra Leone; to tell them of God's love for them and to show them through caring for them physically, emotionally, and spiritually. I will continue to pray in earnest that God will prepare me as a follower of Jesus Christ, as a Wife, as a Mother, as a Nurse Practitioner to go to Sierra Leone and minister to them. While I know there are many things that I want to show and teach them, I know from experience that they will teach and show me many things also. I need to be open to how God will work in me and through me.
Will you pray with me?
Monday, October 24, 2011
An African Birth
I have struggled and prayed often over the past several weeks about this post:
How should I frame my experience?
How much should I go into detail?
How much did I want to relive those moments?
Would people even want to read about it?
What is the significance of my experience?
Suffice it to say that I don't know all the answers to those questions, but know that what I saw did cause me to pause and reflect on what it is that Jeneson and I are doing in going to Sierra Leone. What is our purpose and how will God use us there.
It started out as a typical evening after dinner relaxing on the porch talking when we were summoned by a nervous father wanting us to go with him to his daughter who was in labor with her first child. After some miscommunication we realized that, as previously requested, one of the traditional birth attendants in Mokanji was letting us observe a birth.
We entered the dark stick and mud, thatched roof hut as dusk was falling over Mokanji and met the mother-to-be who was uncomfortable and in labor. As we comforted her and tried as best we could to demonstrate how to effectively push there were a number of things that were unsettling.
You could see the scar from the female genital mutilation (i.e. female circumcision).
You could sense her hesitation to push because of the pain.
The traditional birth attendant was encouraging other women to assist in the birth by pushing on the pregnant belly and pinching her belly and inside of her thighs (they thought this pinching would stimulate contractions!).
I saw her puffy feet and asked about her blood pressure (she did not have a blood pressure cuff to take one with).
This was not the supportive, empowering experience I had with all three of my children!
Then the worst happened. After about an hour and a half of pushing, the mother's body suddenly shook with a seizure. She was eclamptic!! This is not a good situation to be in here in the US and certainly not out in the middle of Sierra Leone!
After about 2 minutes the shaking stopped and pushing resumed on her abdomen in attempts to get the baby out. Fifteen minutes later the mother again regained consciousness and after another 15 minutes the beautiful baby boy was born. But things were not good. The cord was wrapped around his neck and when he emerged you could see meconium (the baby had pooped while still in the uterus, a sign of distress and not a good situation for the baby). He was limp and lifeless......
I have never felt so utterly helpless or prayed so much in all my years.
After rubbing his back, slapping the bottom of his feet and trying to wipe out his mouth with gauze, attention turned back to the mom to deliver the placenta. The cord was tied off with string and cut with a razor blade. There was no bulb suction to even try to clear the baby's nose and mouth (probably would not have helped in this case though).
He was gently wrapped up and put off to the side while they they continued to attend to the mother.
She continued to deteriorate during the night and have seizures (she needed medication to get her blood pressure down and medication to stop her seizures, none of which are available right now in Mokanji) until the next morning when we drove her, the birth attendant, and the woman's sister in the back of a pick up truck to the nearest hospital 2 hours away.
I did hear that she seemed to recover physically with no long-term problems.
Sierra Leone has one of the highest maternal and child mortality rates in the world.
More on my thought from this experience tomorrow.
How should I frame my experience?
How much should I go into detail?
How much did I want to relive those moments?
Would people even want to read about it?
What is the significance of my experience?
Suffice it to say that I don't know all the answers to those questions, but know that what I saw did cause me to pause and reflect on what it is that Jeneson and I are doing in going to Sierra Leone. What is our purpose and how will God use us there.
It started out as a typical evening after dinner relaxing on the porch talking when we were summoned by a nervous father wanting us to go with him to his daughter who was in labor with her first child. After some miscommunication we realized that, as previously requested, one of the traditional birth attendants in Mokanji was letting us observe a birth.
We entered the dark stick and mud, thatched roof hut as dusk was falling over Mokanji and met the mother-to-be who was uncomfortable and in labor. As we comforted her and tried as best we could to demonstrate how to effectively push there were a number of things that were unsettling.
You could see the scar from the female genital mutilation (i.e. female circumcision).
You could sense her hesitation to push because of the pain.
The traditional birth attendant was encouraging other women to assist in the birth by pushing on the pregnant belly and pinching her belly and inside of her thighs (they thought this pinching would stimulate contractions!).
I saw her puffy feet and asked about her blood pressure (she did not have a blood pressure cuff to take one with).
This was not the supportive, empowering experience I had with all three of my children!
Then the worst happened. After about an hour and a half of pushing, the mother's body suddenly shook with a seizure. She was eclamptic!! This is not a good situation to be in here in the US and certainly not out in the middle of Sierra Leone!
After about 2 minutes the shaking stopped and pushing resumed on her abdomen in attempts to get the baby out. Fifteen minutes later the mother again regained consciousness and after another 15 minutes the beautiful baby boy was born. But things were not good. The cord was wrapped around his neck and when he emerged you could see meconium (the baby had pooped while still in the uterus, a sign of distress and not a good situation for the baby). He was limp and lifeless......
I have never felt so utterly helpless or prayed so much in all my years.
After rubbing his back, slapping the bottom of his feet and trying to wipe out his mouth with gauze, attention turned back to the mom to deliver the placenta. The cord was tied off with string and cut with a razor blade. There was no bulb suction to even try to clear the baby's nose and mouth (probably would not have helped in this case though).
He was gently wrapped up and put off to the side while they they continued to attend to the mother.
She continued to deteriorate during the night and have seizures (she needed medication to get her blood pressure down and medication to stop her seizures, none of which are available right now in Mokanji) until the next morning when we drove her, the birth attendant, and the woman's sister in the back of a pick up truck to the nearest hospital 2 hours away.
I did hear that she seemed to recover physically with no long-term problems.
Sierra Leone has one of the highest maternal and child mortality rates in the world.
More on my thought from this experience tomorrow.
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