Tribute: Bless his soul

I'm sure I'd be embarrassed if I looked back at old blog posts, from when I was green to Africa 9 years ago! Because, unfortunately, too many of us coming here thinking we're going to teach people from the wealth of knowledge that we possess. I think the longer I'm here, the more I realize how much I have to learn from the people I came to serve. This family taught me this most of all...

It's easy to scrutinize families and traditions of other cultures because perhaps they haven't had the opportunity to learn the Word like we've heard since we were wee. But this one, it gripped me beyond the scrutiny.

I'm not sure when they married or the complete history, but what we did learn from this patient was that he was married, and perhaps life got tough so he went looking for a better way. This landed him in Zimbabwe and eventually with another wife. Then life threw a twist again, he got sick-- started with dementia like symptoms, his wife in Zimbabwe was fed up and sent him back to his homeland. He found his way back to his first wife in Mozambique. I don't know if she welcomed him back like the Prodigal, or how that went for her, but by the time we met them...

she was caring for an advanced dementia patient beautifully! This isn't a diagnosis/situation we've seen a lot of. It was classic of the patients I once cared for in dementia units in the US. The thing that blessed my heart the most was how this woman cared for him. He was ALWAYS clean. Usually he was wearing his t-shirt that had 3 cartoon toads on it. They were wearing funny clothes, one with boxers on his head. The caption of the Tee said, "Toad-ally Wasted"! I laughed every time, they didn't know what the shirt said.

Upon admission to the program, as per usual, he received our "comfort care pack" including a Storyteller with Bible stories and songs. Unfortunately, a few weeks later in his curious way, he had pried it apart and it was no longer working. I took it from them to see if Chad could repair it. It was beyond repair. And, I feared giving him another one because I figured he'd just destroy it again. But, he NEVER forgot that I was the one that took his broken one away. From that day on he called me a THIEF!  Until...until it was the day that what his restless soul need was the Word. Of course, we gave him a new Storyteller. And, as I've shared before, the evidence spoke for itself. He was restless, in obvious pain, thrashing to the point that I wished we had morphine more than ever. We gave what we could and the minute he heard my girls singing on the Storyteller he calmed, he held the device to his heart and we left him in peace. I trust the Holy Spirit did the rest. A few days later we heard that he had died. His dear wife wept in our arms when we visited her. She had done everything and more that a loving wife of any culture would do. Indeed it was beautiful.

I now hope he now knows what his t-shirt said. I hope he laughs. We will always remember. Bless his soul.

a normal thursday

Many people ask, "Tell me what a 'normal' day is in Mozambique." First off, I usually laugh because it feels like there is no normal.

Let me tell you about my Thursday, as "typical" as a Thursday can be.

Thursdays are my day to "go in the bush." I drag myself out of bed at 645am. No matter what I'm doing, that's too early. Chad's already up with coffee waiting. Nede's usually bouncing around in her pajamas, chasing her dogs. Well, not this week, it was rainy and cold. I contemplated do we go out? Are the roads going to be muddy? What if we got stuck or, chose not to drive and have to walk in pouring rain. Awe, well, the clouds aren't that dark. We'll go.

By the time 8 o'clock rolls around I've gotten myself ready, filled our 20 liter water buckets in the house, had my breakfast, packed my backpack and the pickup with our makeshift mobile office/clinic. I meet my 3 colleagues we fill our bags with the necessities-- Tylenol, wound care supplies, soap and toothpaste. We pray and off we go.

Five patients on our agenda for today. Our first stop, a toddler who's been affected by malaria. Family, belonging to a church that doesn't believe in going to the hospital, left a malarial fever too long. Our little friend suffered a huge seizure leaving him without sight, with one-sided weakness and with little hearing, he's now requires total care. Family struggles and a new born baby makes it hard for a young mother to feed and care well for her children. We assess, encourage, pray and treat as able. Off to the next visit.

We joke about the challenges the next one brings.  A young mom, full of fears, misunderstanding and stubbornness to face the reality that she has HIV and needs to take medicine daily to prolong her life.

Today's no different, our battle continues, she refuses to swallow the tablets. Her two children watch on as their mother makes choices that will greatly affect their future. We feel we've made no progress after weeks of talking and praying. It seems there'll have to be a miracle to move this mountain.

On we go. Cruising down the dirt road, I make a quick stop to check out a snake I've seen in my rear view mirror. We stop to contemplate and get a good look. Seems like a gaboon viper or a puff adder. Awe well, let's keep going...

Next stop, a new patient we've only seen once. A tumor distorting her face, I can't imagine the pain she must feel and the social rejection that could be hers. We stop at the cellphone antenna as we had been instructed, got out of the truck and started asking where we'd find this woman's house. "Can we walk there?" we ask. It was meant to be near.

"No, lets go in the truck." It's down the valley, "close."  Two young boys we've just met climb in the back of the pickup. But...before we go another elderly woman stops us. She tells us she has a growth on her back. She's in much pain. Can we help? We go behind a building, she lifts up her shirt...gulp. I can't believe my eyes. I've never seen such a thing. Deep breath. Okay, where is your house? We'll stop there after and get more information.

Off we go down the valley, in our truck on what appears to be a foot path. The trail gets skinnier. I get more nervous. If it starts pouring...will I be able to maneuver this vehicle up the hill? I pray a lot.

Finally, I park the car because we can't drive any further. Thankfully the walk is only a few hundred meters. We sit and hear her story. We then educate on how to take the medicine and I sit in adoration of the ruralness, the trees that have not been logged away to China. It's beautiful. As long as you're healthy, this is paradise.

After counseling another man on how to take the medicine the hospital gave him for his dizziness, we're off up the hill to meet the new patient. Phew...we made it.

There's one thing I love about a cold rainy day in Mozambique (they are few and far between). Sometimes, to get out of the cold and wet, you're invited inside their home. Modest would be a generous adjective. We entered this woman's mud brick home and listen to her story. Yes, she would be happy for us to do surgery on her! Whoa, whoa, whoa...let's back up and explain our program. We will not be performing any surgeries! :)

Okay, this day is not what we expected it to be but let's keep pressing on.

Next stop, a patient that we've been seeing for months. Here we all feel quite victorious. Our patient has been improving now that we have him on the proper medications. We join him and his family in their "cooking house", two fires are going. We find ourselves quite cozy-- singing and praying, I could stay all day!

Next stop, to discharge a teenage boy. Much to my surprise, not to heaven but to a long-full life, I pray. We did not find him at home. A young man who used to not be able to walk, if he did hobble around, it was definitely with 2 sticks and a lot of effort. Today we hear he now has a "shop" in the near village where he's selling dry fish and bread. A little entrepreneur found hope, health and happiness.

We popped down to the village to give our love and blessing to this young man. On the way we run into family members of others we've cared for. We greet the community health worker. I wave at the "Mama" of the village-- the lady you want on your side when you're in need. Thirty miles off the dirt road this little village is in my heart and I feel comfortable here. We buy some bolos (fried dough similar to flat bread). The girls know "sister Dara" likes hers with sugar. We take off for home. It's only 2 in the afternoon. I feel like I ran a marathon. We bounce home after stopping long enough for the girls to make their tuna sandwiches in the backseat. They're tired to-- the Thursday afternoon giggles have set in. We all look forward to a long weekend.

By the time I arrive home I'm beat. I can't think another thing as I'm processing the worlds I know-- life in America, life in my "tiny house" in Nhambia with my family and then the life that's such a part of mine up the dirt road. They each feel so vastly different from the other. I'll wrestle with it tonight-- how to live between the three. What an honor it is to be involved in so many different life styles.

And so there it is, I heat my kettle of water on the stove, ready my bucket bath, put on some warm clothes, sip my Chai tea and reflect on my "normal" day. Grateful I don't have to cook supper tonight as we'll be joining our Irish counterparts.

If you actually read this to the end and it felt long, yes, so did my day. This is my normal Thursday.
If you think of it, Dara and her team could use some extra prayers on these normal Thursdays.

Tribute: All He was Meant to Be

We didn't get to know him long. No, we really knew nothing about him. But, we knew enough.
No matter WHAT happened in the past, no matter whose back you stabbed or how many friends you've betrayed, this is NO way for a human being to live at the end of their life.
No, this was not okay.

So, we did all we could. We gave within the limitations of our project, always believing that we will never say, "there is nothing we can do."

And, the next week all was different.

A bit of love,

A lollipop,

Hope of eternal salvation with a Storyteller.

The 3 best things we find healing, more than any other.

And, the next week,

he was gone, crossed over to the other-side. 

Into Glory I pray.

I can only hope that he had been reminded, through hearing God's word, that he was loved,

That he knew again, he deserved more,

And he entered into the fullness that he deserved, and now, 

He is all that He was meant to be! 

Sweet man, I hope to see you in paradise! 

Where you belong! 

You've been forgiven. You are loved.

He promised.

celebrating 6 years

From day one she was a blessing, 

even though I called my friend and said,

"she's here, now what do I do?"

(June 2010)

It helped when we finally figured out how to speak the same language,

(June 2011)

And you kept blessing everyone that you met,

(June 2012)

 And then the time came when 2 of us got the privileged to be your parents,

(August 2013)

And, all the happier I was

Together we could face all the challenges with significantly fewer tears!

(June 2014)

Then, we got to build a new house together,

and you get to be where you were with your first momma,

(June 2015)

 And it's here where we'll all keep growing together,

Where you'll speak your mother tongue,

And daddy and I will try.

Where we get to care for your people,

And give them the Word in a language they best understand.

And you become more beautiful every day,

And we'll watch as God unfolds miraculous plans for your life.

And, you keep blessing everyone who gets a chance to know your face.

(June 2016)

We couldn't love her more

Or be more blessed to have had the last 6 years together.

And praise Him for ALL HE HAS DONE! 

office underway

"We are simply God's servants, by whom you were led to believe. Each one of us does the work which the Lord gave him to do...for we are partners working together for God, and you are God's field. You are also God's building. Using the gift that God gave me..." 1 Corinthians 3

Blessed to dedicate this land...

With these hands,

And these people...

The Mvura Ya Upenhu Palliative Care office is underway. We praise the Lord for the provisions to enter this next stage. We pray that the we continue to respond to what he has called us to and  joyful serve Him with what we have. Pray for protection as they build and wisdom as we grow. Thank you for being with us! xoxo

discharged with hope

It's something your taught never to do, in the hospice world, don't predict how much life some has left. We don't know the number of breaths one will take. But, I suppose, after being in the field of death and dying for sometime, you've seen enough to start to feel you know when someone is nearing death.

Well, I guess there are many things that have surprised me in working with the palliative care program here. Many things have been heart-wrenching but this one thing has been amazing. Nothing short of miraculous.

We're in the process of discharging 5 of our patients (that's a third of our census. We're wee.) Discharging them because they are no longer declining. They no longer seem near death. That's great you might say but the thing you have to get is that almost every patient we start on our program is ill-- VERY, very ill. Typically we don't start anyone unless we feel they are going to die in the not so distant future, unless there is major intervention from the Lord. But, far more often than I ever expected, it's looking different. And, it surely isn't from amazing medical interventions we provide! Oh, no. It's been about love, about education, about consistent visits that gives value to a previously unvalued life. It's reminding them and showing them that there is always hope. I think if you sat with 5 of our dear patients they would tell you a story that you'd find hard to believe...

...one's a story of a boy, 6 years old with osteogenesis imperfecta (ie brittle bones). He used to cry in pain. By getting regular Tylenol and simple teaching with his family on how to care differently for a child with this disease, he got a wheelchair and in is in school for the first time in his life...

...She's HIV + and had TB. A stroke put her in the hospital with right-side hemiparesis. For a long time the family struggled with "embarrassment" that she was totally dependent in her activities of daily living. I'm pleased to say that her sister-in-law took it upon herself to give this woman the medicine she needed, keep her clean and feed her. She's now borderline overweight and cared and loved by her family. Her tears have been turned to laughter...

...We still don't understand the situation with this teenager, at some stage he had severe abscesses which lead him to several operations "taking out bone" leaving him with deformed extremities-- walking only with sticks. I can't explain what happened with him-- regular Ibuprofen, a Story teller (audio device with stories and songs), weekly Bible stories from a children's Bible, lots of laughs and friendship. He now is working with his uncle, hopes to go back to school next year and is walking WITHOUT sticks! Praise HIM!!!...

...Then there's a middle aged man that needed to be educated. He needed to understand his disease, the importance of medicine compliance and to be empowered to care for himself. Previously having gaping wounds on his legs, he's now often not home and we see him driving by on his motorbike...

...And finally, I remember taking this one on knowing we would not have long to care for her, she was so close to the end. With a wound on her inner thigh she could not walk. She had a flat affect, a malnourished child and a lack of hope. Wound care, disease education, songs and stories,  listening ears and words of life seem to be the cure for this dear woman. Life is now hers, may it be for many years to come...

We may not be seeing someone rise up and walk the moment after our prayer but we're seeing a lot as we walk with each of our patients. Whether they're discharged from the program or discharged into their eternity we are honored to share the Gospel, share words of life and share our love with them. And perhaps, the best thing about our job is that either way, we share hope!

Thank you Lord for your promises!

pain to peace

I wish you all could have been with me today, when we walked into that little house, to see him there, laying in pain. Nursing school 101 burns you out on "pain being the 5th vital sign". I could name you the non-verbal signs of the pain assessment in my sleep. And, if I were to explain this to a novice, I'd have pointed to this patient. Textbook.

 All the clues were there-- facial grimacing, moaning, restlessness. If I had to give it a number, we'd be pushing a 10! (1 being no pain, 10 being the worst imaginable). In America, we'd be calling in the order for morphine and I'd be confident pain relief was on it's way. We did what we could. We re-positioned, we encouraged rest. And then, I thought, he needs a new storyteller (the audio device we use to share Bible stories and songs in the local dialect). Despite the fact that he had destroyed his previous one, this was the time he needed distraction the most. I ran to the car to grab one. We turned it on and as he heard the words of his language, he alerted saying, "where is that, I need it." He reached out his hands, we gave him his player.

My friends, the whole situation changed. He relaxed. His facial expression changed. What was a grimace turned into a relaxed smile. He no longer moaned. He no longer was reaching out for his wife. He had found peace. He held the player in his hand next to his ear. When his edematous hand got tired, he switched to his other swollen hand, never  allowing the hope to be more than a few inches from his ear.  If I were to have to chart his pain now, his number would have significantly dropped. To a 3? A 2? Could I really say that his non-verbals now tell me he's a 1? The evidence proved itself on this visit. We did little but the resources did much. HE did much.

We finished our visit, gathered our things. Headed on our way. I left in awe. A holistic approach-- the beauty of not just thinking about pharmacology! Friends, I wish you could have seen it. The hope and peace was tangible!

Come for a cup of coffee...I'd love to show you the picture or walk with you to see yourself.

Peace.

Tribute: our old friend

"Have you always been this joyful? Laughing so much?"

"Me? Joyful? I never even used to talk to my wife!"

Yes, these are the exact words we heard from this man months after we started caring for him. He became one of our most enjoyable visits. We would laugh, sing and joke together. He held the history of the land in his years. He remembered when the road we drive on did not exist. He helped in clearing the forest to create the road during the colonial days. It then was the main thoroughfare, then after the civil war, the bridge was bombed out and never repaired and now it's our one way dirt track. The dirt track that takes us to these treasured souls.

He was a bit of a medical mystery to us. I'm not sure he'd ever been to a doctor. He'd surely never seen a stethoscope. He reported that his leg had been so swollen and caused him so much pain that he could hardly walk. The pain and body itching kept him up at night. It grieved him, that because of this ailment, he wasn't able to be in the field helping put food on the table for his wife and family. He's one of the few patients that we have that has only one wife. And, once he was feeling better, the joy that they had in the presence of each other was evident. If he was resting, she was shelling her beans near by-- they liked to be together. They loved each other. 

One of the most beautiful things was the simple interventions we were able to do to help improve this man's quality of life. It was impossible for him to get to any sort of health care facility so for us to arrive at his home eager to help was a real blessing for him. And, the response that we saw from giving him calamine lotion, daily Tylenol, Epsom salt soaks for his leg and something to help him sleep at night, turned him into a new man. And fit him back into his old trousers that hadn't fit over his leg in years! Wow!

 Yes, these simple things improved his life but may I share that what REALLY changed him, as a man, was his having his very own audio story-teller. He cherished this bit of God's word and songs of praise. One day when we were visiting and trying to do an interview with him, he wouldn't turn the audio player off. So, in order to get his attention we asked to have the audio player. Well, that didn't work either! He was so concerned that we wouldn't give it back to him that NOW he couldn't concentrate on what we were asking because he wouldn't take his eyes off of his audio player. Yes, he cherished the word of God in his shirt pocket more than life itself. On one visit he was so sad because the cat had knocked the audio player off the roof (while solar recharging) and it no longer worked. He reluctantly let us take it so Chad could repair it. He didn't want to miss a week, a day, of not being able to hear the Word of God! 

We were delighted to be reunited after my 7  months away from Mozambique. I thoroughly enjoyed seeing him, despite a decline, we were pleased at how he was still doing. Laughing and joking with us-- singing and dancing...

...remember when he said he never even used to talk to his wife because he was in so much pain? Praise the Lord!

I took this video last Thursday. I share it because I know he'd be so proud to to have people see it. He was full of joy. As we left last week he said, "Next time you come, I'm going to be dancing on my feet!"

Well, he is right, this week he is dancing on his feet, only he's dancing on golden streets!! Maybe he knew that in a weeks time his body would be healed to fullness and he would be in the presence of His Glory!

We will miss you our old friend. Thank you for all the laughs and all the praises that went up from your home! We praise the Lord as we imagine you dancing on your feet this week! Thanks for sharing your life story with us!

Until...

Tribute 2: a family man

You can tell a lot about an individual from their family.
This patient I only got to see a couple of times upon my return.
From that I learned--
He was a family man.
He cared for and provided for his family.
Many were there, surrounding him on his last day.
Not only were they present out of social obligation but they were present with concern.
And, to see the care and responsibility that his oldest son was already taking on tells me that his father has been his role model, his example, his hero.
This man has obviously worked hard,
on each visit there was produce and harvest busily being prepared and distributed--
not easy horticulture in this desperate land.
After our last visit we didn't know what to pray.
His situation was bleak, his diagnosis grim, not just in Mozambique but it would be anywhere.
What we knew was we didn't want this big, strong man to lose his dignity,
To have to be cared for like a child,
for too long.
We knew this provider would struggle with these changes.
So we prayed, I prayed, asking for mercy and freedom from suffering.
Then, within 36 hours of our last visit, he took his last breath.
To be home with his Father, I pray.
And left in his legacy are his beautiful children,
some being teeny, tiny replicas of this strong, stoic man.
May they not soon forget the care, love and concern their father had for them and their future.
I wish it had been different,
I wish there had been more thorough, wise treatment for this man,
his days weren't meant to be this short--
he had much to teach
and he taught well.
What a privileged it was to know him and to advocate on his behalf.
You are remembered in our hearts.

Tribute: my little guy

To you it may just be a statistic. Besides, what's 1 lost in the mass of 1.1 million who died of AIDS in 2013 (WHO). And, it's far away, they should know better, we have our own problems, whatever it may be that makes you feel separated, far from and really, not connected to problems on the other side of the world. Well, dear friends, I'm here to say, they're not just a number. There's no dignity in regarding a soul as a statistic.  We each have a story to tell. We each have a purpose to share. There are stories that must be heard. Our patients that we care for deserve to be known, they are NOT just a number, far-away....

Tribute #1: MY LITTLE GUY

Born somewhere between 2005 and 2007 he lived with his mother and father. His older brother was there, perhaps others. I'm sure as he learned to walk, he learned to work at the same time. Hauling water, gathering fire wood, cooking over the fire, working in the field. I know he loved his sudza (similar to corn flour grits) and dried fish. I don't know when he started to be sick. Too early though, I know that. I wonder if he ever got to be a kid, carelessly playing, learning, loving life? When I first met him I pegged him at age 4. I was several years off-- blinded by his malnutrition, skinny legs, tumored face and broken soul. By this age he likely had already cared for and watch his mother and father die. And then, finally, grandma was called in-- to step up to care for this critically ill child. She did the best she could despite being sick herself.

Dear friends, he wasn't just a sickly child. That's not his story. He was who wiggled into my heart and the hearts of everyone who got to meet him. He had a tenderness, a gentleness that was paralyzed by a disease that held him back. He was so excited to receive an audio player with Bible stories and songs of faith. Within weeks he had all the songs memorized. And in a few months he was reciting a-long-with the 2 hours of Bible stories-- delighted to hear the word of God in his mother tongue for the first time. His grandma never took him with her to church. He listened to his player so much that within a year the speaker was worn out, we replaced it for him. The thing that grieved me so much about my 2 year involvement in his life was that he wanted his situation to be different. He didn't want to not be able to help his grandmother. He wanted to go to school. He wanted to play with friends. Of course he didn't want to be excluded from other children because he wasn't well. He wanted more than anything for his situation to be different. When asked what we could pray for, he requested, "Please pray that I don't have to take my tablets anymore." I cried with him many times because I too wanted his circumstances to be different.

There were periods when we had glimpses of all that he was meant to be. When he was well enough to be vivacious and full of zeal. Like the time when we came to visit and he was "out" but, as we walked to his house we heard his audio player playing and he came running from behind us. Chad called out, "He's coming from behind you." There he was, chasing us down, winded but ready for his visitors. Or, the time that he saw us walking up to his house and he came out of the veranda chanting, "Sister Dara! Sister Dara!" We would sing, we would dance, we colored and told Bible stories. His million dollar laugh and smile was worth anything that I may have had to sacrifice to be in Mozambique and to start a palliative care program.

We sat with him for hours at the hospital waiting to be attended. We fought to get his cardiac situation checked into. The doctors did all they could. Grandmother did the best she could. He gave us memories and confirmed again and again that yes, this work is worth it, even though it's hard.

I didn't get to see him in his last days. He couldn't hold on until we got back despite asking when Sister Dara was returning. He was fully aware of his situation of injustice until his last breath. The morning before he died he told his grandmother, "Vovo, I'll never live old enough to build you a new house (as would be culturally expected of him)" his was tired of the fight. He passed away a couple hours later.

Our team grieves over this lose. My heart will weep for years because of the love I got to experience for this one. And, may I tell you what a blessing it is that one soul from Remer, Minnesota gets to tell the story of one soul in Cafumpe, Mozambique. Two distant worlds with one loving Father-- caring equally for each of us.

My little guy, I'll see you on the otherside! I'm so glad you're no longer in pain. Tell Jesus we can't wait to be with you both and oh, will we dance!

No, he was not a number.