Community−What the South Teaches the West
It was my first visit to Africa. I was working at Tenwek Hospital in Kenya in Casualty, which is what they call the ER there. I had only been there a couple weeks when I got the chance to care for an eight year old boy who had come in for appendicitis a week prior. His wound was infected and his parents had brought him to be evaluated. After assessing his abdomen, his old chart was brought from Records and I saw the bill for his surgery and hospitalization. But before I could make sense of a bill for several thousand Kenyan shillings, I needed to know something about the cost of living in the region, so I asked a nurse.
“How much does it cost to feed a family of four for a month here?”
It was a question that only made sense in the West and she corrected me immediately.
“A family of four? You mean a family of ten.”
“Yes, [laughing], a family of ten.”
“Well, that’s easy. You have your maize, your vegetable and your milk.”
“OK. How much does the maize cost?”
“Oh no, that comes from your fields. That is free.”
“What about the vegetable then?”
“What you don’t grow in your garden may cost a few hundred shillings a month.”
“Alright, then what about the milk? How much does that cost?”
“No no, you don’t understand. That comes from your cow or cows. That also is free.”
Frustrated but undeterred I pressed, “How much does a cow cost then?”
She quoted me a price precipitously close to the cost of that boy’s surgery. The logical conclusion came immediately to my lips, “Then this family, to pay for their son’s surgery, will have to sell their one cow?”
“Yes, or part of their land.”
I thought of how much I had brought with me on that trip. Could I survive for the next couple weeks five thousand shillings poorer. We had to do something so as to not break the financial back of this family.
She continued, “But don’t worry. Everyone in the family and the village will contribute something so that they don’t have to sell their cow or their land.”
I was appropriately humbled. I had such a short grasp of the way life worked in Kenya, and, as it turned out, worldwide. It seems to me that the Lord had a special lesson in for me and our team in that moment. We exist in relationship. We belong to each other.
We work so hard to insure against disaster and loss. We hedge our funds and diversify portfolios and stock our fridges and pantries. We erect better walls, build better fences, affix better locks and install better safes. And though I don’t want to speak against prudence and planning, I note in my own heart that in doing so, I often neglect the more difficult task of knowing and meeting the needs of my neighbor. Those relationships take time, take effort. And even less do I make myself really vulnerable, speaking my true needs to my community.
I impoverish myself of relationship when I live as if God has not deliberately placed me in a community with strengths that serve me in my need (and which needs me to volunteer my resource for their needs). That is the lesson that Kenyan family and village taught me way back then. They enriched my soul without knowing and without trying.
A Life Well Lived
I first met Sarah at the Prescription for Renewal conference in Asheville, North Carolina. She had just finished her surgical training program and was so excited about beginning the Samaritan’s Purse/World Medical Mission 2 year post-residency training program. Her heart’s desire and dream was to be a career missionary surgeon. She had been assigned to Mukinge Mission Hospital in Western Zambia.
The next year I spent several months with Sarah at Mukinge. She was a talented and gifted surgeon and she was a caring and compassionate doctor. She was immediately embraced and loved by her colleagues at Mukinge. She had such great vision for the future of Mukinge—a new operating room complex, perhaps a PAACS surgical training program. She was actively putting down roots to serve at Mukinge for the “next 35 years”.
I last saw Sarah at Mukinge in July of last year. She was one of the first people that I asked to speak at our M3 conference coming up the following February. She was so excited to be a part of this first conference. Sarah mentioned that she had been sick for the past few weeks with probably just a viral illness. Little did we know that just a few weeks later she would be diagnosed with Stage IV breast cancer. Despite great care and aggressive treatment, Sarah’s tumor progressed. And on Wednesday afternoon, she passed from this life to the next. From the loving and tender care of her family to the loving and tender care of her Heavenly Father.
All who knew and loved Sarah are grieving her loss—from her immediate family in Indianapolis to her many friends all around the country to her extended missionary family around the world. She will be greatly missed. Sarah will not speak at our conference this year. But she spoke clearly with how she lived her life. Her example of genuine devotion to Jesus, her desire to give her life away for others, her radical obedience to what she felt like God called her to—will live on as a legacy that will continue to inspire and challenge us all. -Paul Osteen
You can read Dr. Kent Brantly’s tribute to Sarah here.
May 7th, 1981 ~ January 13th, 2016
The First Woman Of Women: How Melinda Gates Became The World’s Most Powerful Advocate For Women And Girls
Dr. Jenny Dyer, one of our speakers, sent us an interesting article that we think is a great read.
“Women account for six out of ten of the world’s poorest and two-thirds of the illiterate, according to the UNDP. “Excessive female mortality” in the developing world, in the parlance of the International Monetary Fund, means some 3.9 million women and girls are “missing” annually: About two-fifths are never born, one-sixth die in early childhood and more than one-third die during their reproductive years.”
Sofia
Sofia is a nobody, by the world’s standards. At 75 years of age, with long dangling earlobes from tribal piercing at a young age, now mostly toothless, she looks like hundreds of other old Kipsigis women in southwestern Kenya. But to her large family, she is the “Batiem”—the much loved and respected grandmother. And to all of us, Sofia became a living, breathing lesson about the transforming power of Jesus Christ.
I first saw Sofia in November, 2011, when she was admitted to the Intensive Care Unit at Tenwek Hospital in dramatic fashion. This was actually her second admission to the ICU after suffering a cardiac arrest. I saw this old woman attached to one of the ventilators and inquired of our Kenyan Internal Medicine specialist, Dr. Matilda Ongondi, about the patient’s condition. When I heard that she had just come through our emergency department, having presented in cardiac arrest requiring an extended resuscitation, I questioned the wisdom of utilizing precious resources on a patient who had such a poor chance of survival. Dr. Ongondi shared my concern, but stated that Sofia had already survived one such event, and felt that God had something special still in store for this “Batiem”. It seemed a miracle in itself to see Sofia recover, come off the ventilator, and be discharged to home. Several weeks later, Dr. Ongondi introduced me to Sofia once again in our outpatient clinic. She seemed full of life, but was limited to a wheelchair, since her energy level was very low. I assumed this was likely due to congestive heart failure, or cardiomyopathy which had been the cause of her cardiac arrest. However, Dr. Ongondi informed me that Sofia suffered from a third degree heart block. This means that there is essentially no electrical communication between the upper and lower chambers of Sofia’s heart. As I looked over her ECG, I saw that this was indeed true, and that Sofia’s heart would not increase beyond a rate of 35 beats per minute, despite all medical intervention. This accounted for her significant lack of energy. Her family informed me that she had been very active until she developed this complete heart block. Matilda asked me whether we might be able to find a mechanical pacemaker for Sofia. I once again questioned the use of such an expensive item for an old patient (she looked even older than her 75 years). Again, Matilda impressed me with her belief that God was at work in Sofia’s life, and I told Matilda that I would try. If Sofia could survive until I could locate a pacemaker, I would put it in for her.
By January, 2012, I had obtained a donated pacemaker through the generosity of the Medtronic Corporation. Sofia was scheduled for surgical implantation of the unit on a Friday. However, that day turned out to be incredibly busy with surgical emergencies, and we had to postpone her case. Monday and Tuesday of the next week, the same thing happened, and Sofia and her family were getting discouraged. Finally, late on Wednesday, I purposed that our surgical team would stay late until her case was done. The scrub technician working with me that day, Daniel Ngetich, has been a friend for a long time and is also a pastor of a local church. Daniel had been the one to inform Sofia’s family the day before that once again, we could not get to her case. When I told him who the “late case” would be, he agreed that we needed to stay into the evening to finish. The operation went smoothly enough as we exposed the lower portion of Sofia’s heart through a small incision under her breastbone. Our chief resident in surgery, Dr. Agneta Odera worked with me to stitch the small electrode patch to the slowly beating surface of Sofia’s ventricle. We tested the electrode with an external pacing device, and found that we could achieve a much better heart rate, but that it required a slightly higher voltage than expected. We then disconnected the external pacing device and connected the implantable pacemaker to the wire attached to her heart. To our dismay, we were not able to get electrical “capture” with the implantable battery pack. We assumed this was due to poor connection on the surface of the heart, and so we removed and replaced the electrode on the surface of the heart two additional times. However, it was all to no avail, and we still could not pace her heart. I scrubbed out of the operation and called the company representative in the US. We came to the conclusion that the manufacturer settings were not high enough to capture in this case, and that we would need to get a separate instrument from Nairobi to reprogram the implantable unit. It seemed like the best course of action to complete the implantation of the device, and then try to reprogram it later (which can be done without any further surgical intervention). I went back to the operating room and we created the subcutaneous pocket which would hold the pacemaker generator which until this time had been attached to the heart by a wire, but was sitting on the skin of her chest. Much to our surprise, as soon as we inserted the device into Sofia’s tissue, it began to capture the ventricle, and her heart rate doubled. We were stunned for a moment, until we realized that the pacemaker was most likely not well grounded while sitting on Sofia’s skin. It was not until it was actually implanted within her body that it would function in the life-saving way in which it was intended. All the parts were present and properly assembled, but until it was placed inside Sofia’s body, it wasn’t doing her any good at all.
In the 6th chapter of John, Jesus told his disciples “Most assuredly, I say unto you, unless you eat the flesh of the Son of Man and drink His blood, you have no life you.” Jesus was alluding all the way back to God’s words to Noah, when he said “But you shall not eat flesh with its life, that is, its blood.” (Gen. 9:4). In the mind of the disciples, Jesus was asking them to break one of the oldest commandments—i.e. that they were not to take the life (the blood) of another into them. Now Jesus is instructing them to do exactly that—to take His blood (his life) into them. Do you see what this means? You can have all the necessary parts assembled in the proper way. You can have your Bible held closely to you and even memorize large portions of Scripture. You may have undergone baptism or confirmation or confession or catechism. You may be keeping all the rules, doing all the right things and not doing the wrong things. But until you take the life of Christ within you, all of those other things are as worthless to you as Sofia’s pacemaker was to her sitting upon her chest. There was ample energy within the pacemaker battery to power Sofia’s heart for the rest of her life, but it was doing her no good at all. It is only when you take the life of Christ into your very self that the power of the Gospel can energize your heart and mind in the way that God intended.
Sofia is a nobody like so many other nobodies that we treat every day at Tenwek Hospital. But she is not a nobody. She is a beautiful lesson to all of us. Where is Jesus today? Is He far away? Is He in a church or in a book on your shelf? Perhaps he is as close to you as Sofia’s pacemaker was to her. Will you take the very life of Christ within you today and experience the life-giving, life-sustaining presence of God?
By Russ White, M.D., Tenwek Hospital, Bomet, Kenya