Christmas 2012

Amy & Jim Lusaka March 2012

As you may know from following our blog, 2012 was a memorable year for our family. We are all growing up and growing old. By far and away the defining event of the year was Jim's emergency surgery in South Africa in April. Having turned 50 in September,  Jim decided to have a screening colonoscopy during a trip back to the States in March. It wasn't particularly smooth, although everything was reassuringly reported as normal. He felt a bit run down for the next three weeks. Then in April, while Amy was off in Petauke village at a Community Health Evangelism (CHE) training, things unraveled.  It seems his colon was 'nicked' during the procedure and  the pelvic abscess which had developed began draining into his bladder. Antibiotics on board and intravenous fluids in hand, he met Amy at the airport and they took off for South Africa. It's still not clear how she made it back through the mountains on Zambian roads so fast.

Jim in Pretoria

We learned many things over our three week stay: 1) our kids are pretty resourceful (John spent extra nights in France and Ethiopia due to plane cancellations), they step-up when they need to (sharing cooking, shopping and driving responsibilities), 2) we have many friends around the world who pray for us regularly (thank you!), 3) South African doctors do not believe in pain medicines, and 4) you can outlast everyone in a meeting if you have a colostomy and foley catheter in place!

Amy managed to find the beauty in an otherwise difficult event - locating a lovely bed and breakfast , The Crane's Nest, across from a bird sanctuary in Pretoria so that Jim could recover before going back to Zambia. Just as Jim was getting the hang of managing a colostomy, he had his final repair and reconnection in Chicago in July. In October, Jim participated in the second annual all night Relay for Life event in Lusaka - while many participants proudly announced that they had survived cancer, he simply smiled and said, "I survived cancer screening".

Of course, the year had many enjoyable celebrations and less traumatic events:

Miriam  said goodbye to all the children and orphans she had been ministering to and returned to Evanston. She and Amy found a lovely apartment where she lives with a young woman from the PACE transition program. She is doing quite well negotiating independent living; cooking, shopping, bill paying and cleaning, although finding a job has been difficult. She enjoys being involved with the children's ministry at First Presbyterian Church in Evanston (FPCE), and gets to see her grandparents each Sunday.  We have been so impressed with how well she is doing and look forward to watching her continual blossoming. She and John will travel together from Chicago to celebrate Christmas with us.

Ruth spent less than a month in the US, checking out art schools and visiting her Aunt Linda and Uncle Grant in CA before returning to work at the US Embassy in Lusaka. She is a roving administrative assistant and has managed to get to know many more people than anyone else in the family. We regularly hear, "Oh, you're Ruth's dad/mom, she is such a great worker." She has even received an award for her work and an unsolicited letter of recommendation. She has also started a small business as a child entertainer - making piñatas and  organizing children's parties - complete with games, face painting, and balloon animals. The pottery wheels at Afrikolor have provided a creative outlet as well. Her next project is the portfolio for art school.

John at Mt. Rainier during new student week

John finished his senior year with an acting debut in Great Expectations and met friends from Evanston in France for spring break. In June we celebrated his graduation from the American International School in Lusaka. He spent the summer being a church camp counselor, getting life guard certification, and hanging out with friends working on a "bucket list." In September, Jim took him to Seattle Pacific University where he is thriving. We think he has become some sort of covert operative as he has maintained 'radio silence' quite effectively since then. Thank goodness for bank card transactions and Facebook posts!

Chris (left) as Aaron Schultz in Legally Blonde

Chris took guitar lessons and driver's education in Evanston this summer. Both he and John went on the FPCE PYGs Mission Trip to work with HIV/AIDS patients in the Bahamas. He is settling in at AISL as a tenth grader. He has become a setter for both the junior varsity and varsity volleyball teams. His coaches report he is a hard worker and an excellent sportsman. His athletic intensity led to a serious sprain which made him have to practice his role as Aaron Schultz in the musical Legally Blonde on crutches.  He sometimes misses his older siblings, because now his parents focus their undivided attention on him! For his 16th birthday,

Morning sky filled with bats, Kasanka December 2012

Amy and Chris went to Kasanka National Park to view the annual fruit bat migration - some 8-10 million bats fly in from the Congo to feast on special fruit trees.

Amy teaching a thoracentesis in Nkhoma

Amy travelled in February to Nkhoma Hospital, Malawi to provide pediatric coverage during the peak malaria season, while PCUSA missionary Dr. Barbara Nagy was away. Fulfilling her vows to Jim "in sickness and in health" kept her busy for four months of the year. Yet she managed several trips to support CHE trainings and co-facilitated a course on Peacemaking and Conflict Mediation for evangelists at Justo Mwale Seminary. Since developing a cervical spine nerve injury in July, daily PT and cervical traction has become a routine and she limits lifting to keep from aggravating her spinal arthritis. Yes we are ALL getting older. After seven months, government permission to provide care to women and their children in the prisons has been granted and she is visiting Lusaka Central Prison several times a week.

CDC Team Zambia with President Bush

Jim has continued in his work with CDC, focusing on maternal mortality reduction (www.savingmothersgivinglife.org) and cervical cancer activities (www.pinkandredribbon.com). There have been many, many, many official visitors, including six US senators, a congressional staff delegation, and President GW Bush (again). It is chaotic, but it is good to see so much interest in health care for Zambians. He enjoyed the opportunity to give a keynote address to the Zambia Interfaith Network Group (ZINGO) on how the faith community can address AIDS.  He is doing less direct patient care than he would like.



Through the year we have been sustained by the prayers of our faithful church and friends. We consider ourselves to be incredibly blessed to be here together to celebrate another year. We thank God for his grace and mercy in our lives and the light of His Son shining into the world and our lives. Blessings to all of you for 2013.

The family at John's graduation from AISL, June 2012

Eastern Province Adventures



Nancy, Kari, Lovemore, Debbie, CHE trainer, Dr. Chilenje

Several weeks ago I traveled to the eastern province with Rev Kari Nicewander, new PCUSA mission co-worker to Zambia and a discipleship and church growth specialist, Rev Debbie Braaksma, PCUSA area coordinator for Africa and Nancy Collins, PCUSA regional liaison for East Africa. We went to hear about the work and plans of the CCAP church, to visit several church schools and clinics and to attend a special ceremony for those completing course work at Chisefu Theological College. Lovemore Zulu, Zambia CHE (Community Health Evangelism) director updated us on our four hour drive to Petauke where we had lunch with several of the CHE trainers that I had previously met and worked with in April and May.

Mphamba Basic School

We drove on through Chipata to Lundazi arriving around 11:30pm at the "castle." I stayed in the room with a turret on the right.

During our trip we visited several basic (primary)schools and several secondary (high schools). The schools were all challenged by a high teacher to student ratio, a lack of books for students, safety issues for the high school girls, insufficient facilities but motivated and passionate staff. On the right is a blackboard with a lesson on "Common Faults of a Sewing Machine", including things such as causes for skipped stitches, broken needles etc. Students do not have books but dutifully copy lessons into their notebooks. The school does not have a sewing machine for the students so they are memorizing lessons in the hopes that one day they will have access to a machine not just pictures in the teacher's book.

Newly "collared" pastors ready for service

 

 

We also visited two medical clinics both of which lacked medical personnel due to housing issues. In both clinics cleaners were diligently passing out medications and continuing to see patients though they have had no formal medical training. Jim tells me that this is not uncommon in other rural areas of Zambia.

Patients waiting to be evaluated at the clinic

    



The Pinnacle of God's Creation

I (Jim) was recently asked to give the keynote address for the annual breakfast meeting of the Zambia Interfaith Networking Group (ZINGO, www.zingo.co.zm). The invitation to speak was actually given to the US Ambassador, who declined and passed it along. ZINGO is a group started in 1997 with the goal of bringing together all of the leaders of the various faith communities in Zambia to address the HIV/AIDS epidemic. The breakfast corresponded with a two day meeting that brought together the deans of the various theological training institutes in Zambia to begin designing ways to incorporate HIV education into the training of pastors.

It was an interesting time for me to explore one of my passions - weaving faith and medicine together. I think the organizers wanted an update on "The State of the Epidemic". They got something a little different.

I have always viewed Genesis 1:27 "So God created mankind in his own image, in the image of God he created them; male and female he created them." as an important verse for those of us who serve others through medicine. I have used it while teaching medical students at Rush - knowing that it is a sacred text for the majority of the world (Muslims, Jews, Christians). I emphasize our need to see each patient in front of us as created in the image of God (Imago Dei) and therefore of immense value, worthy of our compassion. But as I contemplated the HIV epidemic in Africa and re-read the verses I began to see something quite different. Amy helped me see it even more clearly, thank God for her, but more on that later.

In Zambia the group of people with the highest rate of acquisition of HIV is girls aged 15-24 years. It is actually a shockingly steep "epi-curve" - meaning there is a steep and rapid rate of increase in HIV infection, not seen in boys of the same age. Of course this is because young girls are preyed upon by older men, who are often HIV infected. A recent study found that slightly over 80% of secondary school girls in Zambia had experienced sexual abuse - often by male teachers, but also by fellow students. There are many reasons for this, but fundamentally it is an issue of the mistreatment of women which is driven by a misunderstanding of the relationship of men, women, and God. Keep in mind that 80% of Zambians attend a Christian worship service at least once a week.

So, in my lecture I discussed where we have been as a faith community (borrowed from Dr. Peter Okaalet, MAP International) - condemning apathy, helpless resignation, apprehensive involvement, wholehearted involvement. All somewhat self-explanatory. I did suggest (okay so really I stated) that some of these responses were sinful and likely to invoke the displeasure (wrath?) of God.

I concluded by challenging the participants to re-think their views of women. Only then will we stop the HIV epidemic. I explained that doctors and public health experts can speak to the science of HIV prevention, but they (the religious leaders) could speak to the moral issues. I told them that I saw Genesis as telling me that women were equally created in God's image - there was no room for the idea of subordination, at least as typically understood and practiced. If they mistreated women, they mocked God and risked invoking His wrath and condemnation. I told them they must practice and teach the honoring of their women. I said that we need to see that men and women are equal. Not really a radical conclusion for me, as I have always considered myself a bit of a feminist (Gal 3:28, Eph 5:25). It was actually well received and I have been asked to come teach in the Muslim Institute, the Baptist Seminary, and the Presbyterian Seminary.

But when I came home and talked to Amy about the lecture she pointed out something I should have noticed before. The sequence of creation ends with the woman, suggesting she is the pinnacle of God's creation. I read Genesis as a text that is inerrant in what it teaches - the theology of creation (not necessarily the science). So why did God tell us that He made man (the first time in the creation story He fails to say "it was good", rather He says it was not good [for man to be alone]), and then made woman? I have begun reading the Hebrew and digging a bit deeper. I would be curious to hear from any of our blog followers.

But, I am struck with several ideas - maybe women reflect a part of God that men do not - a spirituality? a relationality? Maybe Eve was attacked by Satan not so much because she was the most vulnerable (as is typically taught) but because she most reflected the image of God (relational, spiritual, one who bears life - and would someday bear God [Mary=Theotokos]). Lots of ideas that bear a bit more thought.

Anyway, lots to think about. I thank God for the opportunity to teach and share here in Zambia, but especially for a wife who helps me think more deeply.

Jim

PS - interesting article on the church and HIV:

http://www.firstthings.com/article/2008/03/002-aids-and-the-churches-getting-the-story-right-27

Be Thankful At All Times

Happy Thanksgiving! As our South African turkey roasts in the oven, the electricity cuts out and I turn the oven back on once again, I have time to remember these last months of God's provision, God's timing and God's sufficiency. I am grateful to be without constant pain. When I returned in September, I was tired most of the day; the result of a painful cervical spine injury, unresponsive to heat and medication and a lack of restorative sleep. I had enough energy to complete my physical therapy, read and pray. Driving to the store, shopping and making meals were arduous and exhausting. I read Nancy Guthrie's book Hearing Jesus Speak into Your Sorrow  twice and began Chip Ingrim's  Invisible War (on spiritual warfare). I felt I was under attack. I listened for God's still small voice hoping for victory, healing and understanding.

In Matthew 26:30 Jesus says, "Father, If it is possible let this cup of suffering be taken away from me. Yet I want your will to be done, not mine." I wanted to wake up one day completely healed. When this did not happen I prayed to be like Jesus who "learned obedience from the things he suffered." Hebrews 5:7-9. Ironically, for years I had Philippians 3:10 posted on the website at Lawndale as my favorite verse. (I want to know Christ and the power of his resurrection and the fellowship of sharing in his sufferings, becoming like him in his death, and so, somehow to attain to the resurrection from the dead). I assumed fellowship of sharing in his sufferings might mean personal suffering (physical, emotional), engaging with those in the world who suffer (poverty, abuse, illness...) or spiritual persecution.

Unremitting pain and purposelessness took me back to the garden of Eden to be tempted by the Evil One. I asked the question Eve struggled with, Is God really good? Can he be trusted?  I was devastated to imagine if He really loved me He would withhold meaning and purpose from my life. But perhaps my understanding of meaning and significance were the problem. I realized I had lived and directed my life from the philosophy to whom much is given much is required. I assumed that since I had been given much (education; a Master's in International Health Education, special training in Christian Counseling, extra training in Community Health and an MD) that much would be required. I was ready to serve and minister but not ready to suffer, to be still and do nothing I valued.  After all my hard work and dedication I realized God didn't "owe me" anything. I had an attitude of entitlement, surely after all these years of study and training and preparation I would have something of significance to do for God.

These last few months have been a lesson in waiting. I heard God saying, "If I ask you to sit and praise me in your pain will you do that? If that's all I ever ask you to do, will you do that for Me?" I thought I could tolerate the pain and even remain thankful as long as I could still do something useful, something worthwhile, even when I had no energy to think of what that might be. As I have gotten better, I have continued to struggle when people ask me, "What do you do?" God asked me during this time of waiting, If you never get to use any of those skills and talents... will you worship me with joy not resignation? So like Abraham I have been trying to put it on the altar, tie it down and kill it.

 I still struggle to surrender to God in faithful obedience to the life/testing that He has given but believe that this is an important part of what it means to develop Christ likeness. To suffer well is to endure with confidence whatever God asks us to endure believing that even if we cannot see the purpose, He does. As Nancy Guthrie puts it "It takes great faith to say to God, 'Even if you don't heal me or the one I love, even if you don't change my circumstances, even if you allow me to lose what is most precious to me. I will still love you and obey you and believe that you are good.'" Becoming like him in his death (Phil 3:10)most significantly means "Your will, not mine" Surrender, obedience, submission.

When Miriam was in preschool we were driving in wintry weather and hit a pot hole and popped a tire. I exclaimed in frustration, "Miriam we have a flat tire and we have to pray" (I had never changed a tire and the slush and cold looked formidable) Miriam dutifully bowed her head and said, "Thank you God for the flat tire!" I was flabbergasted. No we were not thankful for the flat tire, what was she saying? But then I realized she was right we are told to be thankful all times. A lesson to remember for Thanksgiving!

Break a Leg

Right Ankle Day 2

Right Ankle Day 14

Well Chris has had an exciting few months. He has been a valuable setter for both the under 16 (JV) and under 19 (Varsity) American International School of Lusaka volleyball teams. This has meant twice the games and twice the tournaments. He has recently been to Johannesburg and Kampala. He likes setting but he does occasionally lament his genes - "Wish I was taller...". He thinks the fun of being a spiker is more appealing at times. I try to remind him - no sets, no spikes. He is now just a bit taller than me (Jim), so perhaps by senior year he will be a spiker. He really plays hard - during the last play of the last tournament (Kampala) he dove backwards, made a save (got the point) but really hurt his ankle.

They went right from the game to a closing dance, then the airport and two flights. No chance to elevate and ice properly. I have to say I have never seen a worse looking ankle that was not broken. We had some fun watching the many colors. Even the webbing between his toes turned many shades of blue-green-yellow. There is still some swelling 3 weeks later, but we are ready to move from the full 'boot' to a smaller ankle brace. 

Although there was no fracture on x-ray, we insisted he use crutches for the first three weeks, which led to some funny scenes during his role as Aaron Schultz in the AISL production of Legally Blonde. Of course it meant he could not participate in the group dance scenes but it is the price you pay for being such an intense athlete!  I have to say when I heard the play selection I was less than enthused and had somewhat low expectations. But the kids did a great job and it was quite entertaining.

He sang a fun song introducing himself as a freshman at Harvard Law, "I got a Fulbright and a Rhodes, I write financial software codes, but that is something I've outgrown, how many yachts can one man own?..."

Now back to focusing on school work - right dad.

Breaking the Silence

Well, upon reviewing our blog I realize we have not posted for over three months! Time to break the silence. Of course a lot has happened since the last post. I (Jim) flew back in mid-September to take John to Seattle Pacific College for the start of his freshman year. Although he has not communicated much, his debit card use, facebook posts (yes, I am actually a friend), and our spies all indicate he is doing well.

Christopher has started 10th grade and is busy - he is currently in Uganda for a volleyball tournament and was in South African two weeks ago for a tournament. He is the setter for the U-16 and U-19 (JV and Varsity) teams. He is also in the school musical. Academically he is also doing well. I do think he is struggling to find kindred spirits at school, although he has good friends through a youth group that he attends.

Miriam seems to be thriving in her independence - some of her emails have been absolutely delightful in their maturity and depth of understanding. She is clearly doing well on her own, with support from family and friends.

Ruth is working hard at the US Embassy here in Lusaka. I constantly hear praise for her work ethic and people skills. It is fun as a parent to see your child in the work force doing well. She keeps herself quite busy running children's birthday parties on weekends - making pinyatas, face painting, doing games. She continues to aim for Art School next fall.

Amy had a bit of a tough time with neck pain and cervical neuropathy but is slowly improving. She has been back to the US for her board meeting of the Medical Benevolence Foundation - last one as president of the board! Next week I think she may head out to the villages with some PC-USA missionaries and visitors.

My work has been busy - new tasks and responsibilities as our staff changes. Generally going well. I do miss more direct patient care but keep reminding myself that it is important to keep the programs and resources flowing. I need to spend some time thinking and writing about the whole culture around international assistance - I have been amazed, and saddened, by the ways in which various NGO's, Universities, and individuals use the system to build their own little kingdoms. Disappointing.

Amy and I will likely be teaching at Justo Mwale next term and she is considering another month at Nkhoma (I think she too misses direct patient care). We look forward to both John and Miriam returning for Christmas. We would appreciate prayers as we continue to engage in various ministry activities and find our way. We are also beginning to explore next summer and beyond - prayers appreciated.

Kinda glad to miss the intensity of the election. May the winner be directed by God. Jim

Re-connecting

It has been some time since we last updated our blog. Our sincerest apologies. A great deal has happened in the past few months. Amy participated in the week Training of Trainers 2 in Petauke for community health evangelism. John graduated from high school and Chris completed 9th grade. Both recieved the President's Award for achievement and Sports Awards. Chris recieved the award for best student in Spanish, quite an achievement given that this was his first year of Spanish. He does have a gift for languages. Ruth continues to do well in her job at the Embassy. Jim helped coordinate a second visit by George W. Bush. He came to Zambia and helped remodel a rural health center as well as dedicate a new African Center of Excellence for Women's Cancer Control. It was a very successful visit. He and Laura spent the 4th of July with the Embassy community and it was a nice event with square dancing and a bar-b-que.

The entire family has been back in the States. John is enjoying his summer before college re-connecting with friends. Chris is taking driver's ed. Miriam has found an apartment and will re-engage with the PACE Program for next year. Ruth has already returned to Zambia after a three week visit that included volunteering at Church Camp and visiting Art Schools in Los Angeles. Amy continues to basically hold the family together. Jim has returned to the scene of the crime, as it were, to have his colostomy taken down and all the holes closed. The surgery was on July 9th and it went well. The recovery will take about a month and the family (Jim, Amy, Chris) hopes to return to Zambia August 13th.

The past few months have been quite an experience. I have learned to deal with my physical fragility, to wrestle with the concept of being disabled (a colostamate), and to turn to God for strength and sustainance. I am not sure all lessons have been fully learned yet! We continue to seek your prayers as the healing process goes forward. During the surgery they could not find the hole in the bladder so we are trusting it has closed. Still some tubes and drains to remove and open wounds to heal up, so not out of the woods yet.

In Christ

A Mother's Day Gift to the Women of Zambia

This past year many of us here in Zambia have been working on a project to reduce maternal mortality called Saving Mothers, Giving Life. The basic idea is to help the Zambian Ministry of Health to implement the Campaign to Accelerate the Reduction in Maternal Mortality in Africa (CARMMA). It has been an amazing experience - working with some 20 partner organizations and all of the US Government agencies (USAID, CDC, DoD, Peace Corps, Dept of State) and the Government of Zambia Ministry of Health.

Reducing maternal mortality has been one of those public health efforts that has seemed somewhat impossible to achieve, even though we basically know what it takes - good prenatal care, access to good delivery services, and a safe blood supply (the number one killer is maternal hemorrhage). I am optimistic that this time we may be able to make progress. Right now Zambia's maternal mortality ratio is about 591 deaths per 100,000 live births (about 3,000 women each year die in child birth), compared to about 13/100,000 for the US (about 520 women total despite almost 7 times as many pregnancies in the US). I am optimistic because the folks here in Zambia are working together better than ever, and we are receiving some much needed attention from the US and Europe.

Take a look at the project, just launched this past mother's day: http://www.savingmothersgivinglife.org/about_smgl.html

A New Family Member!

Well we finally broke down and did it. It was not a decision we took lightly. We considered the added responsibility and expense. But we are sending John off to college, so why not add another child? Now that we have made the plunge, we are asking family and friends to help us decide on a suitable name for....our latest edition to the McAuley's in Zambia. He is a full bred German Shepherd who was imported by an Embassy family. They are now moving to a location where a big dog is not practical. We have plenty of space and several children who have been lobbying for a dog for some time. He is 14 months old, still very much a puppy. So far he seems very bright, a quick learner, and eager to please - not to mention all vaccines are up to date and he is neutered. He does come with the name Kayber, but we feel free to change it, so any great ideas are welcome. He arrived on Mother's Day - not at all what Amy wanted for Mother's Day (she did also receive some plants as seen in the photo). The dog is definitely what we in the family refer to as a basket gift - a long story, ask Norm and Alice for full details, but basically a gift that really is something you want. As always Amy is willing to support her children and husband. Jim and Amy like the name Dietrich, having just finished a biography of Dietrich Bonhoeffer, but other ideas are welcome. The dog and Rascal are slowly getting used to each other. We have never seen Rascal shoot up a tree before proving how spry he is for a 15 year old cat. Send in your name suggestions.

The Road to Recovery

Well we returned to Zambia late Tuesday May 1st. The children had done a great job keeping the house in order, or frantically cleaning up that day! I have been getting better day by day, but the energy and focus is not quite the same yet.

On May 2nd I jumped back in to the craziness at work - Zambia was to host five US Senators over the next several days as they made a whirlwind tour of projects in Africa (stops included South Africa, Namibia, Malawi, Zambia, Ivory Coast, and Morocco). I became involved in various aspects including a small lunch with two senators, and escorting them as they toured one of our projects screening for cervical cancer (the same site that President Bush had toured). It went quite smoothly. The senators (both parties represented) were quite honest about how difficult it is to work in DC - trying to balance a budget with extreme polarization. I learned several interesting things I want to share:

Polling data show that Americans believe we spend 20% of our federal budget on foreign assistance (health, economic, development, etc.) - we actually spend 0.5 % (that's right - one half of one percent), post World War II we peaked at about 3%. When these same folks are asked how we should balance the budget and eliminate the debt they say, "First eliminate fraud and abuse, second cut foreign assistance..."  Most say don't touch defense, medicare/medicaid, or social security, which make up almost 80% of the budget. So the senators I spoke with said they are at a true impasse. No one knows how much fraud and abuse there is and exactly how to get rid of it so its not clear if there was zero what the budget would look like. If the US literally closed all its embassies and stopped every penny of foreign assistance (how good would that be for US companies trying to enter new markets?) - the national budget and debt would be practically unchanged!

I had a few ideas but I knew they would not work politically - like do we really need 11 aircraft carrier attack groups? (no other country has more than 1, we spend almost 8 times as much on defense as the next highest spending country - China). Now I am not a passivist, and I think aircraft carriers are really cool, but really? Of course people argue that the military employs lots of people, but so does our foreign assistance infrastructure. And just maybe doing foreign assistance well - having stable democracies that like us - is just as important as a big military, I am just wondering. For example, Zambia is a stable democracy now, the people love us. This is because there are some 400,000 Zambians with HIV alive and on treatment today, they are developing an expanded and improved system for training doctors and nurses, some 150,000 babies each year are born free of HIV, etc...all because of the wisdom of of our foreign assistance. Makes me proud of being an American.

My other ideas were even more radical - if I am blessed to have saved a lot for retirement by living and working in the US, no need to give me social security, even though I paid into it. Maybe we should think of it as if it is term life insurance - thank God I never needed it, but it was good to have it there in case. 

Then there are medical costs and medicare. None of us will live forever and we should stop spending enormous resources trying to do so. Fifty percent of all health expenditure occurs in the last month of life.  This is complicated of course - because we don't know in advance it will be the last month. We need to get smarter on how we make decisions, especially as Christians, who know the final outcome - eternity with God. And we need to get smarter on how we pay for health care - there are really warped incentives in how we pay doctors (and how much for some specialties). And of course as a doctor I feel we need reform of our tort system - maybe a no fault system like auto insurance? It runs too much like a lottery these days.

Well, now that I have finished fixing the US economy and alienated all my family and friends, I will get back to life here in Zambia. Amy continues to connect with the church here, exploring options for engagement in places like prison health ministry, taking care of seminary students and their families, and supporting Peace Corps Volunteers. I think it moves too slowly for her liking (now who is the workaholic in the family?). My work is interesting, but less direct patient contact than I would like. I was just about to begin direct care at the University Teaching Hospital when my health unraveled, so I will re-start that process. We will all come back to Evanston this summer - John and Ruth to work at Church Camp and John to prepare for college. Ruth will visit some Art Schools. Miriam is exploring re-connecting with PACE and therefore may stay in Evanston. Chris simply wishes to connect with friends. Amy to support all of us, as always. And I am aiming to be put back together again sometime between June 20th and July 10th...

Much love. prayers appreciated. Jim

The Parents are Coming!

So Mom and Dad will be back tomorrow night and our two house guests left today. Which means just the four of us kids left to frantically clean the house tomorrow. Good thing it's a holiday! I'm kidding, nobody's thrown any parties. We were all too tired out after having to do things for ourselves. Grocery shopping, making meals, taking people places, there are so many things we had to take care of.
For example I am terrible at waking-up early, especially on weekends, and after the first week when everyone missed church because of me I made arrangements to get them a ride the next two weeks. The Ellington family kindly agreed to stop by and bring anyone ready along with them to church, they had 4 open seats in their car. They, and many other families, have been stopping by and inviting the boys out over the weekends or inviting all of us out for dinner.
But even with all the help we've all noticed how much Mom and Dad do things we really miss around here. Chris probably misses having Dad make him breakfast every morning, John doesn't have school any more. Last night I just gave in and bought pizza for dinner. I drove with Chris to this bible study so he could go to the youth group and we ended up back home a little after 6 without any dinner plans. Chris was lobbying for going out somewhere and I decided it would be way easier. We're all definitely ready to have our parents back.
-Ruth

Time for a brief medical update. I have been out of the hospital for a week now. Forced to recover in a local bed and breakfast here in Pretoria. It is actually a nice place, but mostly I am resting and reading, not really site seeing. The State Department Medical Unit would not let me go back to Zambia with drains, tubes, and staples in place for fear I might develop an infection or other complication and get septic. They said, "Do you know how expensive it is to evacuate a septic patient?" The compassion was touching. I said, "Come on what are the odds of that..." Well, probably greater than the odds of developing a hole in one's colon, a pelvic abscess and fistula following a routine colonoscopy! It did strike me as somewhat ironic that an infectious disease doctor would be done in by septic shock. I did mention that I was well aware of the risks and as soon as I developed fever and evidence of a pelvic abscess in Lusaka a few weeks back (hematuria and pneumoturia for the medical people) I started oral ciprofolxacin and flagyl which I just happened to have on hand. I have always firmly believed that oral antibiotics are just as good as intravenous and I am sure this kept me stable during my transport here. They did not take this as reassuring but probably as a good reason to not let me go too soon - who knows what this guy might do if we send him back to Lusaka.

It is very tedious being away from everyone (except Amy who has been a true helpmate) with not much to do. I have managed to walk to the local CDC office and put in time on the computers there - teleworking. But one still feels pretty disconnected from work. I have always known that my self-image is tightly connected to what I do at work, but this has really highlighted that in my mind. How dare they survive without me! I also realize how much my self-image is tied to being a parent. Makes me wonder a bit about how I will do when I retire and the kids are all gone...maybe I will have to take up golf afterall! Not likely.

I have been much more tired than I expected. I also have a fair bit of pain with most movement thanks to the urinary catheter so I am looking forward to its removal on Monday. The actual incisions and holes are not so bad, although I am not sure I am ready for sit-ups just yet. I appreciated Sue Makin's comment that I am holier than most right now, probably the only time.

Enough for now. We appreciate your prayers. Jim

The Question and Call of God

Recovery takes time. It cannot be speeded up. We are waiting for Monday’s visit to the surgeon and the OK to return to Zambia. Each morning we share devotions. In the evenings we play cards and read books. I have just finished the inspiring Bonhoeffer, Pastor, Martyr, Prophet, Spy by Eric Metaxas. Bonhoeffer’s impressions of American religious life in 1930, seem prophetically relevant for today, 82 years later. “In the conflict between determination for truth with all of its consequences and the will for community, the latter prevails. This is characteristic of all American thought, particularly as I have observed it in theology and the church, they do not see the radical claim of truth on the shaping of their lives. Community is therefore founded less on truth than on the spirit of fairness.” According to Metaxas, as Bonhoeffer reflected on the American church scene he was fascinated that “tolerance trumped truth.” It was fascinating to read about the birth of the Confessing Church which came about in response to the “bastardized theology…coming from the German church” and which chose to repudiate “anti-Semitism and other heresies of the German Christians and their “official” church.” I am reminded of the struggle the PCUSA faces today as some are leaving the denomination and others are forming groups such as the ECO (Evangelical Covenant Order) as they try to work out how to respond to tolerance and fairness trumping the Word of God.

“Who stands fast? Only the man whose final standard is not his reason, his principles, his conscience, his freedom, or his virtue, but who is ready to sacrifice all this when he is called to obedient and responsible action in faith and in exclusive allegiance to God-the responsible man, who tries to make his whole life an answer to the question and call of God.”-Bonhoeffer

What is the Question and Call of God today? To Adam and Eve God asked “Where are you?” to Cain he questioned “Where is your brother?” to Peter Jesus queried “Who do you say that I am?” and later “Do you truly love me?” to Paul he inquired “Why do you persecute me?”  What question is God asking each of us? Is it one of these questions or something else? What if we made our lives an answer to the question and call of God?

Waiting

It is Sunday, five days since surgery. I still have a fair bit of abdominal pain around the various holes. No appetite but I am careful to eat a full balanced diet to help the healing process. We walked about 5 blocks to a large mall in Pretoria. It was so much like any mall in the US or Europe, hard to believe we are in Africa (at least not the Africa of my stereotypes).  We had declined to interview for a CDC spot in Pretoria and both Amy and I commented that we are glad – it really would have been like being back in the US. We went to a movie and out to lunch, stopped in a bookstore where I purchased a tome on colonialism in Africa, and then walked back to our bed and breakfast.

Amy found this place which is within walking distance to the CDC offices – but I think the real reason she picked it is because it is across from an amazing bird sanctuary! I may never get her to go back to the kids, at least not until she sees the 108 birds listed as being found in the sanctuary! I have to agree with her that it is healing to observe God’s wonderful creation.

Thank you for the continued prayers.

Jim

God is Good , All the Time......

 “I sought the Lord and, and he answered me; he delivered me from all my fears” Psalm 34:4

“For I know the plans I have for you, declares the Lord, plans to prosper you and not to harm you, plans to give you hope and a future. Then you will call upon me and come and pray to me, and I will listen to you. You will seek me and find me when you seek me with all your heart.” Isaiah 29:11-13.

I want to share with you how good God is and how the body of Christ works in such an amazing and interconnected way. When I received the SMS message from Jim  "hematuria, pneumaturia..." I was four hours away from Lusaka Airport in the town of Nyimba at the first CHE, Community Health Evangelism, training of trainers program for the CCAP, our PCUSA partner church here in Zambia.  The CCAP picked a very ecumenical group to be trained, representing at least 6 different churches and denominations from Nyimba and Pitauke. Half of those being trained were women and half were men. I was staying in a locally owned guesthouse with meals cooked over a fire out back and bathes in a bucket of water heated over the fire. As soon as I got his text I realised I need to leave right away or miss the flight to Johannesburg. Before I left the group training, I was surrounded by a chorus of prayers and support in multiple tongues, only two of which I understood. It took me four hours to drive to Nyimba in the Eastern Province, but only 3 hours and 15 minutes to return to the airport in Lusaka, slowing down only for the skid marks on the winding road.This morning we moved from the lovely Lizas Cottage, run by Gert and Alida, a retired Dutch Reformed pastor and his wife, as a ministry to families with loved ones receiving care in the Urological Hospital to The Crane's Nest. Those who know me will suspect that I had this secretly planned since it faces the Austin-Roberts bird sanctuary but as it turns out it is the closest accomodations I could find only three blocks from the CDC headquarters in Pretoria where Jim can work until the foley is removed and he can travel safely back to Zambia. We had a lovely lunch at the Blue Crane Restaurant on the pond in the middle of the sanctuary. While Jim ate soup and I had vegetable quiche, three blue cranes kept begging Jim for food through the fence posts on the veranda. It is very peaceful here. Jim is sleeping again after walking back the 500 meters to our B&B.  I just happened to have my new South African bird book, a gift from Dr. Boyer and binoculars in the village so I am all set. 

In the airport, waiting for the flight with Jim, Caryl Weinberg called me to join the weekly international Tumekutana steering committee conference call to discuss the summary document report from our October 2011 conference "Women as agents of peace, healing and reconciliation". I explained the situation and immediately women from partner churches in Ghana, Nigeria, Congo, Kenya, Rwanda, and the US began lifting up prayers. Within hours of arrival, we were visited by two pastors from a partner church in South Africa thanks to mission co-worker Janet Guyer who was on that phone call. The St. Columbas church secretary even began looking for housing for me.

When it was clear I would not be able to travel to Houston for the Medical Benevolence Foundation board meeting this weekend,  I emailed the MBF President-Elect Shelley and our new Executive Director Andy Mayo and then the board went into action too. Jerry Veldman contacted former MBF trustee Tom Logan who had been a patient in South Africa some years ago. We contacted his former doctor and were given the name of a first class GI surgeon, Dr. van  Niekerk, who we have since discovered used to work at Nkhoma Hospital where I served in February. Our experience has been a demonstration of how amazingly the universal (worldwide) Church can function to support, encourage, care for and build up the hurting body of Christ.

Notes from the bed and breakfast

Discharged from the hospital yesterday and had an uneventful night in the local bed and breakfast that has served as Amy’s home for the past 10 days. Typically the first day or so out of hospital is difficult, or so I have always told my patients, because there is no one to provide for your needs and one is more physically active. Most of the time the patient is exhausted and even seems to take a few steps backwards. Although I am tired I do feel that the pain and mobility is improving steadily. Sitting up can be uncomfortable – after all they did create four holes in my lower abdomen. I am not ready for doing sit-ups just yet.

While it fresh on my mind I should share an observation of health care in South Africa. They are one of the few ‘westernized’ countries that does not have a national health insurance (guess the other). Private practice is thriving. My second day in the hospital I was somewhat surprised to be waiting in the radiology waiting room, assuming it was for transport back to my room following a CT scan with bladder contrast. In fact we were waiting for the bill which they handed me as they gave me directions to walk back to my room! Later that morning the pathology lab came to my room and asked if there was someone there who could come downstairs and settle my bill from the morning blood draw. Amy and I got the impression that one needed to travel the day with credit card in hand, sort of a pay as you go system. It was both maddening and funny. In some ways it makes sense from a business model point of view, collect while you can rather than run the risk of not being paid. Fortunately for us it turns out we just turned the bills over to the US Embassy Health unit. Seems they will pay, give me the bills, I will send to my insurance who will pay me and I will reimburse the US government. I am only liable up to my annual deductable. The actual care seems to be every bit as good as one would receive in the US.

Other noteworthy experiences include: patients are to bring their own pajamas, no one uses hospital gowns – kind of nice, less dehumanizing, but unexpected if one doesn’t actually have pajamas! Amy ran to the local store and bought me some; every morning at 4:45 am the sisters (nurses, not Catholic nuns) start the day with a hymn sing and prayer – nice, but perhaps a little early; tea is served three times a day, with cucumber sandwiches in the evening; and apparently infectious disease consultants are quite rare in South Africa, though I must say they might benefit (I was unable to convince the surgeon that oral levofloxacin is just as good as IV…some things are universal).

Thank you again for the prayers and thoughts.

Jim

Letters from the Hospital

As most of our family and friends know I (Jim) was flown to Pretoria last Wednesday for emergency surgery – seems I developed a hole in my colon which led to an abscess and fistula to my bladder. It has been quite a ride this past week. Up until now I have never really been a patient and my only stay in a hospital was as a small child when I had my tonsils out. All I remember from that episode is lots of ice cream and a new toy truck. I am waiting for the same this time.

I have taken the opportunity to read the new Bonheoffer biography, it was quite good. It also served as a healthy perspective on real suffering, by so many millions of people.  I won’t minimize the pain I have had this past week, but I am fortunate and have so many resources to address my physical problems; which is not the case for most people in the world. I am glad we came to Africa to do our small part to correct the situation, and am looking forward to getting back to work. However, I am afraid it will be at least 6 weeks before the king’s men can put me back together again.

I have so many somewhat random thoughts to share and I know that most of us have very short attention spans, so I will share just a few. I have been amazed and touched by all the family and friends who have wished me well and offered prayers and thoughts, I think I will make an even greater effort to do the same for others in the future, it means so much. I have been delighted to see my children rise to the occasion of living ‘alone’ (can you ever be alone with four adolescents in one house) – they come from good stock, on their mother’s side of course. I have been uplifted by the “coincidences” that have supported us here – from Zambian friends who just happened to be in South Africa and could come visit, a surgeon who worked at the same mission hospital that Amy and I have worked (Nkhoma, Malawi), a local Presbyterian Church, St. Columba’s (same name as ours in Lusaka) who came to visit, and a retired pastor and his wife who run a bed and breakfast that Amy happened upon and has served as a place of respite for her. I am reminded of the comment by Albert Einstein, “There are two ways to view the world, one is as if everything is a miracle, and the other is as if nothing is.” I am seeing a lot of miracles.

So, thanks to all of you for your prayers, looking in on the kids, researching treatment options for me, and covering in my absence at work. I anticipate discharge tomorrow but will need to remain in Pretoria for at least another week or so. Sometime in May or June I will return for a reconnection of the pieces. Pray specifically that I adjust to life as a colostomate (didn’t know that was a word until now) and learn to convalesce well. –Jim

Strength and Refuge

"God is our refuge and strength, an ever present help in trouble. Therefore we will not fear though the earth give way and the mountains fall into the heart of the sea, though its waters roar and foam and the mountains quake with their surging.....the Lord Almighty is with us; the God of Jacob is our strength." Psalm 46

Jim is sleeping with only a little pain. He is on antibiotics and we are praying that the infection will be healed, that the passage from bowel to bladder will close as the infection resolves. God is able and we are prepared to face surgical correction in His strength if it does not. Thank you Lou for the insight that "Our God is with us recovering Himself." I AM is also praying as the Holy Spirit with us. Certainly I have always been comforted that He is deeply aware of our condition, our hurts and our suffering but I had not thought of healing in quite that way. At times of personal pain I have thought about Christ's obedient suffering and that strangely beautiful passage in Philippians 3:10 "I want to know Christ and the power of His resurrection and the fellowship of sharing in his sufferings, becoming like Him in his death, and so somehow to attain to the resurrection from the dead" It seems to me that surrendering with open hands "Thy will be done" is to become like Him my Savior. It is not fatalistic acquiescence but obedience to a loving Father for the joy set before me. We are being "Held." Natalie Grant fans will know what I mean. Thank you for watching and praying with us.

-Amy (via email to Ruth)

United by Prayer

Dad has to fly to South Africa for an emergency surgery right now. He's been sick for a few days and it turned out that his intestine has been ruptured. This could be a long hospital stint since there is clearly a high risk of infection. Mom, who is already in South Africa, will be meeting him at the airport in a few hours and the doctors want to preform surgery tonight.

This leaves John still in Paris, since his plane was canceled, for another day and the rest of us kids home alone with our two house guests. Please be praying for all of us. Dad's surgery, Mom who will be anxiously waiting for the outcome of her husband's surgery, John who will be flying home tomorrow, and those of us at home awaiting news of the other three. Although we'll be in three different countries, four when you count our grandparents and the rest of our family in the States, our prayer will unite us. Right now I'd like everyone to keep one goal in mind as they think of us: health and safety for our family.

-Ruth

Conflict can be fun

Last week I had a wonderful opportunity to work with15 student evangelists at Justo Mwale Theological University College. Selina Zulu graciously asked me to co-facilitate "Peacemaking and Conflict Resolution"a course for their certificate program. In preparation, I read The Peacemaking Pastor: A Biblical Guide to Resolving Church Conflict, Working With Conflict: Skills and Strategies for Action, and World Report 2012:Events of 2011 (Human Rights Watch World Report). I was able to share some of the crazy cross-cultural conflicts I have experienced such as repeatedly saying "Ah... no" when relatives in Czechoslovakia kept bringing food out only to discover a day later "Ah, no" in Czech means "YES." The class was wonderful with skits, dramas and practical exercises each day. One day, I taught principles of using "I" statements and active listening during conflict mediation. Then the students created skits and performed in Chichewa. In one skit I could only tell there was a conflict over "mbuzi"/ goats. Otherwise, I was clueless. I began questioning the two actors and the audience. "Sooooo, tell me what happened in that skit? Did he use active listening techniques? What did you notice about his body language? Did he use "I" statements? How did you feel when he was talking to you? Did you trust him?" Even though I did not understand exactly what was said I about the goats, (It turns out they had gotten loose and eaten the neighbor's garden) I was still able to conduct a dissection and analysis of the conflict. Great fun. On the last day many of the participants thanked me and gave speeches about what they had learned. I felt so honored and was reminded about how much I enjoy small group participatory learning.

Malawi Mission Trip

Thanks First Pres Youth for the cards. We appreciated your prayers, humor, encouragement and artistic creativity. Thanks Jennifer for the birthday card. Thank you all, for praying for us during my three week trip to Nkhoma Malawi. I felt such strength knowing prayer warriors were going before me and standing beside me.

During the month of January when malaria was at its height there were 1,061 children admitted to the pediatric ward with an average census over 200. The blood bank reported 400 units of blood transfused during that time. Imagine my relief when I found only 148 patients on arrival. Several clinical officers, Malawian, Dutch and Norwegian nurses, Scottish, Malawian and Dutch medical students made up the team. We were quite the international group. There was a good spirit of comraderie and unity inspite of the language and cultural differences.
I spent my first day with the sickest children, several in status epilepticus (convulsing) at the same time. I found myself moving from bed to bed ordering diazepam, phenobarbitol and phenytoin. Most of the children had severe malaria; cerebral malaria with convulsions and coma, life threatening anemia in heart failure requiring emergency blood transfusion or heavy parasitemia requiring IV quinine. Most of the children were under 5 years of age.They have little to no immunity which is only gained after multiple bouts of malaria over time. Critically ill children requiring oxygen were placed in six beds with two to three per bed to be close to the oxygen concentrators. In addition to malaria,TB, pneumonia, meningitis, malnutrition, diarrhea and AIDS were common diagnoses.

Amy's blood

Malaria is found in over a hundred countries and the parasite threatens 40% of the world’s population causing over a million deaths each year. Malaria kills 2 children every minute in Subsaharan Africa. Malaria in a pregnant woman increases the risk of maternal death, miscarriage, still birth and neonatal death. Nine to fourteen days after being bitten by a mosquito carry plasmodium falciparum symptoms occur including fever, chills, sweats, cough, diarrhea, anorexia, nausea, vomiting, muscle and joint pain, headache, and lassitude. The most important severe manifestations are acute encephalopathy (cerebral malaria), severe anemia with heart failure requiring transfusion, renal failure, hypoglycemia, respiratory distress, coagulation defects and shock. Case fatality rates among untreated children can reach 10-40% or higher. Treatment involves checking a blood smear, doing a rapid malaria test for p. falciparum, monitoring blood glucose and beginning IV quinine and medication for fever. When the hemoglobin, normally around 12, falls below 6 a blood transfusion is given. Children in heart failure from severe acute anemia require blood immediately. It is life saving.

There are preventive measures which can be effective in reducing infections. One method is using insecticide treated mosquito nets at night when the anopheles mosquito is active. Although these bed nets cost less than ten dollars each, families living on less than a dollar a day cannot afford them. Indoor residual spraying with insecticides is another preventive method targeting the adult mosquito. It must be applied before the transmission season and coverage rates must be high. It is expensive. This year funding for indoor residual spraying came late and there have been fuel shortages. Avoiding going out between dusk and dawn is unrealistic when people live in mud huts without doors or screened windows and when they cannot afford insect repellent or daily prophylactic medications.

Each morning, I awoke in the dark between 5 and 6am and read from 40 Days with Jesus the devotional sent by the mission team. It lifted my spirit and guided my thoughts. On Day 3, I read, "Follow me one step at a time. I will equip you thoroughly. Keep your mind on the present journey. Walk by faith, not by sight." I started rounds between 6 and 7 am with prayers in Chichewa with the guardians, mostly mothers, asking God for wisdom for the staff and healing for the children. Then I would begin, "Mwauka bwanji?" How have you woken up? Ali bwanji? How is he/she? I worked with a wonderful young man, Pearson, as my translator, who was eager to help me to improve my speaking. I tried hard not to look at the masses but to look at each one placed before me. I learned the children's names and tried to look in the faces of the mother's, touch a shoulder and smile.
People are filled with fear of witchcraft, sorcery and curses. They frequently delayed coming for care while they sought help from a traditional healer. They wear protective aumulets and herbs and strings.

Two weeks after admission

One boy of 11, Khalani, was carried in emaciated and jaundiced covered with scarification. There were small one centimeter scars in rows up and down his arms, legs, chest, back, neck, abdomen and forehead. Some were fresh and scabbed while others were well healed and hypo pigmented. I wondered if his jaundice was due to hepatitis from unsterile blades used by traditional healers.  During the morning, the clinical officers would send puzzling cases to me for advice some from the outpatient department like a young boy with bilateral proptosis of the eyes which could have been due to Grave's disease, hyperthyroidism or a malignancy but there was no way to be sure (Thyroid tests are not available and there is only one CT scan machine in the entire country far from Nkhoma Hospital). I did email a few photos of rashes and x-rays to my ID consultant in Zambia via Blackberry technology.

scarification from traditional healers

Every day 20 to 25 new patients were admitted. I would try to review all of the patients admitted. I spent time every day teaching medical student (two from Malawi, one from Holland and one from Scotland). I would always take a break however brief for lunch and then return until 4 or 5 in the afternoon. Every day for an hour, at 7am, staff met for various activities; morning report, prayer, a presentation, chapel devotions. The chaplaincy program has expanded from one to four pastors and they offered comfort and encouragement when they visited the ward.

It was challenging when the electricity went out (which was a daily occurrence), the generator did not come on and children did not receive oxygen. At one point the generator broke down completely and had to be taken away for 5 days for repair. Praise God the electric company agreed not to cut the electricity during that time. The ultrasound and chest x-ray machines broke down. Without electricity we could not perform blood tests or surgery. Patients had to be driven an hour away to Lilongwe by ambulance for services we could not provide.

Children came to the hospital extremely ill, sometimes they died within minutes or hours of arrival. Despite the difficulties and perhaps becuase of them, I was filled with great joy as I served. It was a priviledge to be the hands and feet of the Great Physician, Jesus. Thank you all for supporting us. (You can check out more patients' stories at my blog http://missionmed.blogspot.com/ ).

Toad in the Toilet?

When the kids were little we took turns praying at meals. John was known as ' John the Confessor' since he used to pray, "Thank you for this food and today I broke .... and I push my brother and...." He was an honest and penitent little guy. There have been many examples of his truth telling over the years. When Chris was in Kindergarten and John was in 3rd grade, they attended a childcare program before school so I could get to work on time. John told me the caregivers yelled and let only one boy use the computer. One day he reported this child had thrown him up against a locker and the adults did nothing. I found these stories hard to believe. Surely John was exaggerating? I did not want to have to search for another childcare situation. I did not want to believe what he said. Then another mother reported that she had contacted the police to get an order of protection for her son who had been hit by the same child. I was filled with remorse. How could  I have doubted John? I immediately hired a woman to come to our home and care for the boys before and after school. Given that John has a history of integrity and honesty you may be wondering why we didn't believe him when he reported there was a toad in the toilet. We lacked faith and like the disciple Thomas demanded to see proof in order to believe. Jim, Chris and I went in to the bathroom to investigate and poked the murky brown water in the toilet which failed to move, even a bit. We concluded it was not a toad much to John's chagrin.  John insisted it had jumped but we laughed at his imagination. That was a month ago. Recently, John insisted we all come to view another toad in the toilet and sure enough it was (see photo). Just the other day the Ellington's who stayed at our home in January asked if we had ever seen a toad in our toilet..... Dustin had tried to catch it but it dove before he could grab it. This toad episode gives new meaning to things we learned growing up. "Put the lid down." "Always flush." "Be aware (beware) of your surroundings." "Look before you leap."Yesterday Jim told us of several families that have found cobras in the kitchen or pantry this rainy season. I think I would rather stick with toads.

Musings on faith, health, and healing

Last Sunday we went to a local church where there was a testimony given by a woman whose sister in law had recently been diagnosed with breast cancer. She shared how the woman and her husband decided to have faith and not have the surgery as recommended by her doctors. Indeed they seemed to see the idea of using standard medical care as a sign of weak faith, and a sure way to jeopardize miraculous healing.

It pained me to hear such a testimony.  The woman clearly understood her healing to be dependent upon her (and her family and friends) faith and prayers; if she demonstrated enough faith by eschewing medical care and praying earnestly, she would be healed. It did not even occur to her that God might actually work through the medical people in her life.

It reminded me of one definition of an idol - an object used to manipulate God. In essence she had made her prayers and behavior an idol - she was trying to manipulate God. And yet, isn't it appropriate to have faith? Doesn't God promise that we can do greater things than even Jesus, now that we have the Holy Spirit? Aren't we told in the book of James that we should have elders lay hands on us and pray and we will be healed?

And yet has there been a single Christian since Jesus' time here on earth who has not died? And haven't many (most)of the faithful servants of the Lord in the last 2000 years suffered at some point in their lives? Were the apostles just weak in their faith, all but John suffering a martyr's death? Am I weak in my faith when I suffer, when those around me suffer and die despite my prayers? Can my faith handle the reality of suffering and death?

I realize a blog spot is not the place to fully discuss the theological nuances of such difficult questions, but I was glad for the chance to have a good conversation with my children about faith, God's love, suffering, and death.

I find great comfort in two Old Testament books - Job and Daniel. In Daniel 3:17-18 Shadrach, Meshach, and Abednego are about to be thrown into the fiery furnace for refusing to worship the idol king Nebuchadnezzar had created and they said (words I hope to be able to say in times of deep suffering), "If we are thrown into the blazing furnace, the God we serve is able to save us from it, and he will rescue us from your hand, O king. But even if he does not, we want you to know, O king, we will not serve your gods or serve the image of gold you have set up." I hope to say to Satan - "God is able to rescue me from this suffering and illness, but even if he does not...I will serve Him alone."

The other book, Job, is a beautiful piece of literature and deserves attention from all people of faith.
My quick take away message is that I am not God, I will likely never fully understand God's ways, but that is okay, and as it should be. I took great comfort in reflecting upon Job some 23 years ago when my first born was seizing in the neonatal intensive care unit clinging to life, and my wife was re-admitted to the hospital with post-partum infection/sepsis. I remember standing in the call room in the hospital praying to God and saying, "You are God, in control of this universe, may Your will be done, and may I have the strength to endure it..."

May we all cultivate a faith that believes in the miraculous yet accepts God's will and refrains from trying to manipulate God.