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Tuesday, October 29, 2013

Acacia's Sweet 16



We've known Acacia since she was a positive pregnancy test in Bundibugyo.
And gotten to know her very very well as she's lived with us for the last two and a half years - while her parents, Michael and Karen, have carried on with the leadership of the South Sudan Team. We usually introduce her as "our daughter" when meeting new people here at Kijabe.  Nobody blinks because she blends into our family perfectly.  She's the sister that Julia never had and the "other sister" that Jack needed.


Today Acacia turns 16.
Karen sent the "Sweet 16" birthday sash and told her she "double-dog dared her to wear it."  Well, Acacia is courageous and bold, so off to school she went in the prom-like sash.  She's a sport.

Michael sent these "A" words to describe Acacia on her birthday
Artistic
Athletic
Academic
Attractive
Attentive
Affectionate
Affirming
Affable
Agreeable
Adaptable
Alegra (Spanish for happy)
Autumnal
American-
African
Adorable
Awesome

She is indeed all those things and more.
Today we thank God for Acacia and say
Amen.

Sunday, October 27, 2013

Surviving the Week

No small mercy.
And in fact, our sermon this morning on Rom 12:1,2 reminded us that all our living sacrifice is in view of God's mercy.
So let's look back at the mercies new and old and daily and continuous.

Shared Parenting

Karen and Liana drove from Philadelphia to Downington to see Luke play soccer this weekend.  We had a dozen kids for lunch Thursday and another ten for "second dinner" and El Classico last night.  It is a privilege to be here with other peoples' kids, and even more to have other people bless ours.

Babies

The nursery remains packed.  Two small preemies have died this month, but so far everyone else is pulling through.  I am thankful for slowly settling jaundice, slowly plumping weights, slowly resolving leaks.  I am thankful for the doctors I work with.  For the nurses we can rely upon.  For the mothers who feed these tiny ones every two hours day and night.



Needy Children's Fund

Ten people have pledged to the fund in the last few weeks, which has moved us from a deficit to be able to help more.  We paid for three doses of surfactant for the tiny baby who ended up dying.  Anyone medical can see from this xray it was not enough.  But there is an element of comfort in knowing you did all you could for your child, without regard to funds, even if in the end the baby dies.  Maybe ESPECIALLY if in the end the baby dies.

On the other hand, Baby S is moving through his second month of recovery from esophogeal atresia and tracheoesophogeal fistula.  He's had weeks in the ICU, several surgeries, too many chest tubes, IV nutrition, and in general our highest level of care.  He's emerging but not quite out of the woods.  His mom told me her bill is almost $4000 already and will be higher, and she is hoping for some help from our fund.  She has been an inspiring stalwart of faith, comforting others throughout his stay. And she firmly believes the cost is well worth the result! I told her we would help, as will the BKKH surgical team.  


One day a couple weeks ago Baby M's family showed up with this little yellow, shriveled wisp, who was the only surviving twin born at a nearby hospital weeks before. We were out of incubator space so when the outpatient nurse called to ask if we had space for her, I said no, refer her on to Kenyatta, the national hospital.  Then I felt no peace, and after praying decided on a way we could accommodate her with a heated isolation room . . my team pulled her through a few days of septic shock and ICU care.  Now she's nearly ready to go home.  She is striking a pensive pose in the picture below.  I'm so thankful God didn't let me send her away.

Family Times

God's great mercy to us is that we live a few steps away from the activities of three kids.  This week I caught one of Acacia's Titchie (elementary) soccer games--she's the coach, many of her players are our neighbors, and it was great fun to watch them play.  Wednesday we traveled into Nairobi for games and Saturday we slipped up between patient duties to see Julia play tennis and Jack soccer (football).  Julia was the only girl in the entire tournament and played with skill, and more importantly JOY.  Jack's team did quite well; Jack scored the first goal of the tournament and set up the last with his free kick that was headed in.  The team lost in the finals, but won an exciting semi-final in penalty kicks - and finished second out of  8 teams there.  Julia's choral group led worship today; it is an honor choir for Seniors only and focuses on discipleship and service.  




I lead a Sunday School with friend and colleague Bethany Ferguson that Julia and Acacia attend as well.  These times are mercies because we love seeing our kids doing the kind of things they were created to thrive in:  sports, coaching, singing, friendships, spiritual growth.  But they are also a mercy because community is built around them.  With each passing month I am more and more thankful for the depth and breadth of relationship here.

What a WORLD

Monday was a Kenyan holiday, and RVA celebrated with "Multicultural Day" in which the nearly 30 nationalities represented in the student body are recognized. The kids have a day of games, food, and learning about the world.  Scott ran in a 5K where he more than held his own with the 20 and 30-something crowd.  The day is a reminder of God's diversity reflected in culture.







Thankful for another week survived, with moments of grace.

Tuesday, October 22, 2013

Wonderful Wealth

"Dear George, remember no man is a failure who has friends. Thanks for the wings, Love Clarence."





After another exhausting night, as the kids went out the door to school this morning, the dreaded 7:30 am text that one of our patients has deteriorated even more and is landing in the ICU.  As I grab my coat and stethoscope and rush to the hospital I text the group of women I would normally pray with at 8 on Tuesday mornings, saying I'm unlikely to make it.  It takes the next 1 1/2 hours to sort out the neurosurgical baby who is crashing and I don't get her intubated until my second attempt.  Meanwhile my week-old patient in another ICU bed takes a turn for the worse, and our longest-term babies in nursery all have acute flares of chronic problems.  I've had three hours of sleep max, and one mom kindly smiles at me as I give her a detailed report on the wrong baby.  My heart was till reeling from a criticism the night before, and aching from several hours of work on trying to arrange Christmas plane tickets and wrest adequate call coverage out of a very lean horizon.  not quite as desperate as George Bailey, but not exactly A-OK either.  

But today turned into a a great day, because of the kindness of friends.  One who let me vent safely, providing a filter before I said things I shouldn't elsewhere, and didn't make me feel bad about it.  Another who let me get out early and walk my dogs in the breeze and sunshine of the late afternoon.  Another who dropped off two culinary delights, and stayed to chat.  Another who just sent a text about a patient saying she is praying for me and told me not to take the burden too hard.  All of these are women I have met in the last couple years working here.  And that reminds me that though this is a community with its own issues and failings made up of sinners like me, it is a community that has a richness of kindness which flows to my soul.

It is only in the press of the struggle that we really appreciate the wealth of friendship.  So here's to a good day, and a wonderful life.



Friday, October 18, 2013

Psalm 107: An open letter to dispersed TCk's

And to us, their parents.

Because we are the redeemed, gathered from the east and the west, the north and the south.  Redeemed does not mean we are holy, yet, or special, or immune, just that we received mercy (vs. 1-3).  This is good news.

This Psalm describes the scattered people of Israel in four word-pictures or analogies.  Read along.

They wandered in the wilderness.  I sense that sometimes our college TCK's feel like they are in the wilderness, faint and distressed.  Familiar sights, sounds, foods, friends are hard to come by.  The environment can be harshly indifferent or outright hostile. Directions seem vague and circuitous.  It's easy to get lost. Or to be lonely.  My soul's been a bit faint lately, too, stretched too thin, missing familiarity and ease.  But Jesus went willingly into the wilderness, parched and starving, He faced it on our behalf, alone, worn down, and attacked by the Enemy.  Which enabled Him to be the Way, to bring us all through this journey to the City where we will finally be home, soul-satisfied, filled. (vs. 4-9).

Those who sat in darkness and in the shadow of death, bound in affliction and irons . . . Perhaps that sounds like a bit of a melodramatic description of college or a constricting job.  But there are nights of labor and semesters that seem to drag one down.  There are requirements imposed.  Sometimes failure and discouragement.  I felt the shadow of death last night too, tied by my beeper to the halls of the hospital, sitting on a rough wooden bench as a bereaved mother collapsed in my arms, as I tried to gently break the news that the last hour of trying to resuscitate her baby had failed.  Not once, but twice, I prayed over the lifeless bodies and the wailing mothers.  Jesus walked right into captivity, into more than the shadow of death, but death itself.  Which enabled Him to break those chains and become light and life in a palpable, forever-way, for us.  (vs. 10-16)

Fools, because of their transgression, and because of their iniquities, were afflicted.  This is about the need for healing.  For physical energy, for the knitting back together of torn ligaments and broken bones, the relief from nasty colds and dangerous infections. Clearly not all sickness is a result of transgression and iniquity.  But some of our weariness and illness stems from our own bad choices.  Wrong risks or relationships.  My achilles tendons are stiff knots of pain because I don't rest and stretch them enough to heal; yet the rest of my body is winded and flabby because I don't exercise enough to be strong (classic catch-22).  I slept 3 hours (not consecutively) last night, not completely my choice but partially.  Misery all around.  Perhaps it sounds harsh to even relate suffering to sin, but the fact is this makes the good news even better.  Jesus, we are told in Is 53, was wounded for our transgressions, was bruised for our iniquities.  Which enables Him to heal us even when it's our own fault that we're in the situation that needs healing or rescue.  We don't have to deserve it, we can just cry out. (vs. 17-22).

Those who go down to the sea in ships, who do business on great waters . . see a lot of chaos, danger, and challenge, and reach their wit's end, literally "their wisdom is swallowed up."  As TCK's move into the world to do business or to compete academically, they see some hard stuff.  The sea was traditionally considered the territory of hostile forces.  Our kids are getting tossed around, and their souls are in danger of melt-down.  Some days I feel like waves of crisis are pounding and throwing me from one ward to the other, and I am going to drown.  But Jesus rode out the storm on the sea, and made the waves and winds obey.  Which enables him to say "fear not" with authority.  Those aren't just pep-talk words, those are logical injunctions to remind us that He is there in the storm with the plan to calmly lead us to a safe haven when we really need it. (vs. 23-32).

The rest of the Psalm reminds us that we are living in the Kingdom of the Great Reverser.  The universe where water springs from the desert and the poor become princes; alternatively where a river can disappear and iniquity be silenced.   Where grad schools and colleges can choose you even if you know ten smarter people in your dorm alone; where the money can come through even when you're broke; where you can be visited by a dear friend or parent even if the person is ten thousand miles away; where you can meet your true love even when you feel completely alone.  Because our God works on the principles of mercy and lovingkindness, on absolute good, even when evil looks too strong.

It was hard enough to grow up as an outsider in your country of residence, then to go back to your passport country and find out you don't really belong there either.  But this life stage where we are scattered makes all of that even more difficult.  So go to Psalm 107, written for exiled hearts, and see the goodness of God for you.


Wednesday, October 16, 2013

Lamenting Bureaucracy, and the woes of living in a corrupt country

Julia has been rejected by the SAT.

Because we live in Kenya, and Kenya is one of the most corrupt countries in the world, it is no small feat to register for standardized tests.

Instead of the on-line registration that the rest of the world does, students in Kenya must fill out the archaic bubble forms of our youth which have to be validated by the school and sent by snail mail. And RVA students only have a few options per year for fitting in the tests.   Julia wanted to take the SAT a second time, as do most serious students, having taken it the first time way back in January and the subject tests in May (the only two options she had).  She wanted to take round two of the general SAT in November so that the schools she is applying to would see the results, especially her early decision option.

 So in early September she filled out the tedious form.  We checked it over.  The guidance office checked it over.  Probably five people looked to be sure the form was filled correctly.  32 students sent their forms in; and 31 were registered.  Not Julia, because it turns out that on the fee waiver section (because we qualify for aid) there was one bubble that was left empty.

For the sake of that one empty bubble, she can not take the SAT.

Even though any logic would confirm that she is not a fraud, that multiple adults failed to catch the missing mark, that the school totally vouches for her, that the essential info was all correct and we would much rather pay for the test and skip the fee waiver than have her disqualified, that anyone can make a mistake . . with the SAT and the fear of Kenyan con men, no second chance.

In fact it is so absurd that we just have to say that this is like Elijah pouring water on the wood, or Gideon asking for the fleece to be wet one night and dry the other.  Only God can open her path to the university He wants her to attend, and He can do that with or without a second go at the SAT.

So pray for the process to be one of faith and of goodness following her all the days of her life, bubble or no bubble.

Monday, October 14, 2013

Creaky Cottage

There is a degree to which a true vacation of the soul requires a spot that reflects one’s childhood places of joy, and for this reason the Trout Tree’s Creaky Cottage is a respite for me.  Surrounded by forest and serenaded by a fast-flowing brook which curves around three sides of the property, quirky construction with logs and a porch, in the highlands of Mt. Kenya, it reminds me of West Virginia.  Scott found the advertisement on the internet and called to confirm a vacancy, and otherwise in our hectic lives we did zero preparation before noon Friday when the kids came home from school for their midterm break and we from work and we all threw clothes into bags and food into the cooler and everything into the car and set off about 2 pm.










Almost four hours of traffic and are-we-there-yet later, watching craggy snow-graced peaks of Mt Kenya in occasional partings of the high clouds, we pulled into the deserted restaurant which is the main purpose of the property.  Turns out it’s only open for lunch.  Good thing we had packed plenty of food . . . the workers on the trout farm directed us past dozens of circular ponds fed by a diversion scheme of flowing water.  At the far corner of the property we passed on foot through a little gate, and saw the cottage.  It was constructed around a tree, which still grows right up through the middle.  There is not a level surface in the whole place, and the low ceilings, brick floors, fireplace and glass-paned windows could be right out of a set for Hobbiton.  Julia and Acacia climbed a ladder to a loft with twin beds, Jack had his own double bed on the ground floor, and Scott and I had a king-sized bed at the top of rickety stairs that looked over the porch towards the stream.  We cooked dinner and soaked in the peace and soothing, quiet, background flow of the stream.

Well, mostly quiet.  The roof is intermittently stormed by troupes of Sykes monkeys or Colobus, and the tree hyraxes make shattering screams in the night or waddle around like R.O.U.S’s in the daytime. 

Two kids are in the throes of Junior Year, with multiple AP classes and sports and activities.  One is in the midst of Senior Year with College apps.  I increased my work time by about 25% when my partner-colleague followed her husband to South Africa for a year, and then by 50% again when my other colleague was pinned down to bedrest for preterm labor a couple of weeks ago.  I had worked the last two weekends and my last call had me up from 2-4 with a dying post-op patient, followed by Scott’s dying patient from 4:30-5:30.  We are both scraping for time to support teams, work on call schedules, prepare lectures.  In the last week I have also been emailing back and forth with Luke trying to help him edit umpteen essays for about a dozen med school apps.  We’ve had company, hosting residents, teaching Sunday school . . . in short, our family is exhausted.  Our kids wanted a midterm break that was RESTFUL. 

And this was just what we needed.  The first morning, as we emerged from sleep, Scott looked at his watch.  9:45.  The last time I slept that late was probably our anniversary week over a year ago.  We unplugged.  Read books.  Listened to music.  Watched “Lost”.  Cooked meals and ate by candlelight.  Basked in sunshine.  Prayed.


We did spend one of our two afternoons hiking a barely discernible train inside a little-accessed area on the slopes of Mt Kenya, which was a glorious six miles of forest and quiet.  A few worrisome buffalo and elephant signs, but no dangerous animals (though there were dangerous PLANTS).
This would not be the spot for everyone.  It’s rustic and dusty and quaint.  There is not much to “do”.  The cost is more reasonable than many options for families but not as cheap as camping; on the other hand everyone got their own bed.  You still have to plan your meals and do your dishes. 

But for us, the Creaky Cottage matched a deep chord:  erratic and unique, shady and isolated, breeze and water and sky, time to connect with each other and God.

Creaky Cottage - more pix
















In which we reach the 20-year mile-marker on this paradoxical path

October 14, 1993, we touched down on the runway of the old Entebbe airport with 8-month-old Luke as the night faded into dawn.  We stepped down the stairway onto the tarmac, inhaling the smokey air of Africa for the first time as a family.  In what would become a familiar pattern in our life, we felt a bit abandoned for a few hours, because the family who intended to meet us had all fallen sick with malaria and the trusted Ugandan friend they delegated was a bit late.  Sitting on the sidewalk with our pile of trunks, we watched what we thought were lethal mosquitos ( but were in reality pesky but harmless lake flies) swarm over our baby.  The journey of faith had begun.  These were the days before cell phones and internet.  We had no plan B.  Concerned airport personnel offered to get us a taxi, but we had no idea where we would go other than the one international hotel with a phone line to the US where the team had called us from in the past.  Our new home was a two-day drive away.  But just when we began to despair, John Wilson Atwoki showed up to rescue us for the first time of what would probably be dozens where we sat on a roadside with no options, and he whooshed in with a plan.  He loaded Scott and the trunks in the back of a pickup, and Luke and me in the front, and we were off to Kampala.

And so began what has now become two decades of loving the people, the view, the pace, the sheer in-your-face reality of Africa.  17 years in Uganda, and nearly 3 now in Kenya, with connections and visits and friends and ministry in all their neighbors: Congo, Rwanda, Burundi, Tanzania, the Somali border, Ethiopia, South Sudan.

Today we remember hither-by-grace: these 20 years are one continuous story of God's mercy in bringing us to this place.  Mercy to the few people we've had the privilege to work with?  Perhaps, but I mean His mercy to us.

(PS - click on the image of the prayer letter to download and read the original "first letter from Uganda").


Tuesday, October 08, 2013

Celebrating 17 jeweled years



Julia Kathleen Myhre, age 3, wearing the cowgirl birthday outfit my mom saved from one of my early birthdays, in our yard in Bundibugyo.  14 years later, her joy, her unselfconscious style, her friendly readiness for a party still blessed our October 4.  Julia turned 17 last Friday, and we had a lovely celebration.

The day started with cinnamon rolls at 6:30 so we could all get to work and school.  And just what every 17 year old girl wants:  new flip flops. 

Julia about age 7?  A trip to Mombasa, resulting in braids.
Back to 2013, hugging dear friend Savvy as they make pizza with the Koinonia leadership team and a few other friends.  An amazing group of kids solid in faith and carefree in fun, cooking and laughing and eating together.

We made a tree cake this year, because Julia has always had a special love for trees.  And it symbolized her roots in the Spirit and  her growth in grace, her shade and fruit that bless us all.  Plus she was born in October, and the lovely fake leaves were bought to decorate her 4th Birthday (one we spent on sabbatical in America).  Somehow they are still in our closet in Kenya.  I made the basic shapes and colors but the actual artistry belongs to Acacia who is the best birthday-partner ever, always super enthusiastic and creative.




After pizza and cake, we asked each kid of the 15 or so there plus a handful of adult sponsors and friends, to speak a word of blessing to Julia or share how she had blessed them.  And this was the greatest Birthday gift of all, the gift of seeing yourself in others' eyes, of hearing truth.  They spoke of her joy, her compassion, her prayerfulness, her leadership, her determination, her concern for others, her friendship.  It was truly inspiring to these kids affirm the gifts God has given Julia.

The party ended with us giving her three fruit tree seedlings to plant here at Kijabe:  peach, plum, and ribena (not sure what that is yet).  And we had bought flowers for each kid to take and plant around campus, by their dorms and classes, symbolizing the way Julia's life makes this place more beautiful.  Pictured below she is planting the trees with Scott the next day.



 This is a girl who would rather get a tree seedling than a new dress.  Who would rather dress ready for action than ready to impress. Who can make anyone feel welcome, who is disciplined in her spirituality, who has her heart in absolutely the right place.  Who can hold her own with the boys (including beating most of the boys on her tennis team) but who defers to the needs of others.  Who glows in the love of her distant older brothers, and has a unique symbiotic relationship with her younger one.  Who gets Acacia, and Acacia gets her, in a way that few other almost-sister pairs ever well.  Who loves to eat, loves to sing, loves to plant, loves to read, loves to be with us.  Who is the perfect combination of spunk and piety, of grit and laughter.  She has made all our lives sweeter for these 17 years.  And the hard sinking reality that this is possibly her last birthday at home for a long time, maybe for ever, hit me hard.  Launching a daughter is going to be even more excruciating than launching sons I'm afraid.  But we know she is ready, and we celebrate the girl God gave us for this time.








Tuesday, October 01, 2013

Needy Children's Fund

This little one has improved enough from his severe gastroenteritis to hold up a packet of ORS.  He represents one of the hundred kids we helped last year from our Kijabe Hospital Needy Children's Fund (70351).  This is an account within the hospital which supplements bill payment for the neediest patients.  The cost of a day in our hospital is about ten dollars for a child.  Many of our patients have bills in the $50 range.  Some, though, with complex congenital anomalies, HIV infection complicated by TB, severe malnutrition, extreme prematurity, need longer stays and run up bills of hundreds of dollars, occasionally several thousand dollars.  Even though our costs are very low, and the physician services are donated through the generosity of our supporters, the hospital has to buy drugs and pay nurses and feed patients and provide water and electricity and bandages.  So they have to charge modest fees.

Before I came, the Needy Children's Fund had been set up, though rarely used.  In the last several years however, my colleagues and I have tried to keep the fund flowing, so that when we see the poorest of the poor patients in the clinic, people who can't afford a chest xray to diagnose TB or who would rather take their baby home because they can't afford twenty or thirty dollars for an overnight stay with labs and oxygen . . we can go ahead and treat the child with the assurance that the parents will be assisted in the cost.  A trusted chaplain or social worker assesses the family's ability to pay, and in almost all cases we only pay a part of the cost so the family always shares in paying what they are able.  We also use the funds to purchase insurance for some kids whose problems are chronic and will require multiple admissions--for only a few dollars we can enroll children in the National Health Insurance Fund which will in future admissions pay about half of their costs.

We're down to the last couple hundred dollars, having disbursed thousands already this year.  And we have patients on our ward right now, widowed moms, stressed unemployed fathers, babies with complicated illnesses, that we know will need help.

If your group would like to raise funds for these kids, we've worked out a way to transfer the money to Kijabe via the Gessner's (fellow docs) church.  You write a check to the church and get a tax deduction; the church does the administration for free; and the money is deposited in America and withdrawn in Kenya for 100% use of the sickest, smallest, most vulnerable children.

INSTRUCTIONS:
1.  Write a check to "Bay Leaf Baptist Church" with "Kijabe Needy Children's Fund" on the memo line.
2.  Mail it to Bay Leaf Baptist Church/12200 Bay Leaf Church Road/Raleigh NC 27614 (USA)
3.  It helps if you email me to know to look for the transfer (drs.myhre@gmail.com)
4.  The church will send you a receipt by mail within a month.  100% of donated money goes to the Kijabe fund, so the church donates the administrative costs.

Thanks, and hoping this is a way you can respond to the sadness of Westgate by concretely helping real Kenyan children.