Happy World Hospice and Palliative Care day

I believe in and am proud to dedicate my life to this...

Because I don't think 18 million people in the world should die in pain and distress each year (WHPCA)

Because I matter...

And so do 7.63 billion others. 

(And, I LOVE everything about this video!)

World Palliative Care Day

I love being a nurse! Since I was a small girl I wanted to be a nurse (one in Africa actually, but I didn't know what I was asking for at the time!). I don't mind in our American culture when the first question asked is, "What do you do?" I feel proud every time I get to say, "I'm a nurse." I didn't always like being a nurse, though. When I first graduated from university and got my first job I spent many days thinking, "I went through all of that (years of school--I took the long route) to do this? I hate it!" Thankfully that was just a season of preparation and I would soon find the area of nursing that I love. At that time, I didn't have a clue that I would one day be where I am, doing nursing, as I am.

October 13, 2018, is World Hospice and Palliative Care day. My heart really wants to celebrate this day because of how the philosophy of palliative care has formed my life. And even more, I love the idea of celebrating this day because of the theme for this year, "BECAUSE I MATTER"! I love that, because, that's my goal in life-- to help those who who may not know it--"THEY MATTER!" I love being among those who haven't heard since they were wee, that they matter. And, I love that no matter where in the world I will ever live, I can always do this work. In America, we need to continue to integrate palliative care into our most advanced health care institutions, here in Mozambique every chronically ill patient needs, and deserves, palliative care. No matter where I find myself in the world, there will always be people in need of palliative care. There is little that makes me happier than being able to be that faithful person that returns to patient's houses every week. I love hearing that Sena greeting, "Kwetcha (We meet again)!" Through these long, faithful visits, sometimes for years, I have been able to see people go from not understanding their value, to a place of being able to say, "I matter." Sometimes we're the only people in their lives that treat them as if they matter.

Do you know what else? I LOVE that here, in central, rural Mozambique, there are 3 young woman who live and breathe the phrase "There is never nothing that we can do." Living in Mozambique it can be easy to look at the medical side of life and shrug your shoulders saying, "there's nothing we can do." But, here we believe, that there is always something we can do. I feel so blessed that sometimes what that means is we have the opportunity to give someone an audio Bible. Through this, they always have something to distract them. They never feel alone and are always able to hear the word and hope of God (in their first language). Sometimes what we can do is simply hold a hand and pray or sing together. Sometimes it's giving pain medication, sometimes it calling a family meeting. Sometimes it's talking about HARD issues. There is always something that can be done, simply because I believe "I matter" (and so do you).

As I and others around the world celebrate, World Palliative Care day and especially the theme "Because I matter", I urge you to do something in this honor. If someone you love is sick, or if you've walked along someone in need of hospice or palliative care, do something special to honor this important philosophy and value of life. We all matter and there's no better way to spend your time and days than helping someone who needs to know they matter! Hold a hand, dry a tear, push for better pain management or ask someone to help you. Or simply reinforce to someone that you care and, they matter! We matter! And, the world deserves to have equal treatment, there should be no short straws for being born in one country over another. We ALL MATTER and we ALL DESERVE equal, quality health care-- addressing physical, spiritual, emotional and psychological care! BECAUSE I MATTER!

***

So God created man in His own image; in the image of God He created him; male and female He created them. Genesis 1:27

I am your Creator. You were in my care even before you were born. Isaiah 44:2a

let's keep running

At the beginning of this year, I needed to gain control of a few things in life. One of them was to put an end to my nearly 10 year hiatus from running. This wasn't a choice that I ever made, to stop the sport when I moved to Africa, but I find it super embarrassing that I need to intentionally force myself out to door to get exercise. Nearly everyone around me is doing intense physical activity nearly every minute of every day (hauling water, fetching firewood, washing clothes, all super strenuous-- which I could never manually do!). I get that it's even more ridiculous to then do NO form of exercise but that's how it went, a battle for my time and an insecurity of my safety and pride. It's just now, after my husband's vision, and a lot of hard work and hoes clearing a path, (yes, someone else did massive amount of manual labor so I can force my body to be pushed into so some sort of health and fitness. Also, embarrassing.)  in order for me to be able to get out and run a few miles each week. I'm not 21 any more, let's just make that clear! The point of the story comes now....

I've always prided myself in my running. Always wanting to be good and so much better. I hate to walk even when I'm out of shape and old(er). But man, it just hasn't come back like it use to. So, I've humbled myself to the point that I may never win an award for the sport again. Ever. In. My. Life. So, I now, occasionally, run and walk. Recently, I was winded and walking and up ahead were my 2 girls, exploring something near my path. And, the moment they saw me, they both started cheering, "Mommy! Mommy! You can do it Mom! YEAH!" And that's all it took, I no longer needed to walk, their little voices gave me the desire, encouragement and strength to keep running and to push a little harder. I smiled again (smiling and running often don't go together for me) and whizzed passed them (okay, that's a stretch!). I trodded past them, is probably more accurate.

As I continued through the banana trees and past the pineapples I thought-- "even this, my weak, tired steps makes my girls proud." They don't care that I was walking. They wouldn't care if I finished last in every race I ever ran. I know they'd be there cheering me on. If only for their love for me, they stand proudly by me and encourage me in anything I do.

I then thought, "Is that the same way my heavenly Father feels about me?" Right now, when I don't feel I'm adequate. I don't know if I can keep doing all I'm doing. I don't feel like I am worthy to home-school my children. I don't feel loved, appreciated or noticed in much that I do. But, is He up ahead just cheering me on? Even when I'm staggering and out of breath, barely getting one foot in front of the other He's there cheering me on as if I'm the only one in the race? He's there encouraging me as if I'll surely take home the gold? Yes, I suppose that is how He really feels. He's ALWAYS there, thinking I'm the best and so darn proud of me. That encourages my heart. That makes me feel faster and noticed.

That makes me grateful that I have 2 kids teaching me the Gospel.

I'm going to keep running-- the many races I find myself in. It doesn't matter who's coming up from behind. I am good enough and strong enough and He's so proud chanting, "Dara! You can do it!" Let's keep running.

a day for weeping

Today marks 4 months since the message came in. The battle was over, my dear friend entered into her glory and she no longer had to suffer. Four long months. It feels like a life-time since I got to have that life-giving conversation with that friend that "got" my life. She "got it" here, she "got it" there. She worked hard to still be close when  7 time zones separated us. She worked hard to understand what I face daily. She made time in her busy schedule to have me be part of that busy schedule. No wonder the hole in my heart feels gaping. 

There was a moment in the last 4 months when I was able to attend to my grief. In talking to a friend she said, "your dear friend was such a part of you that perhaps something within you died when she did." Oh, how that resonated with me. It put a finger on what I had been feeling. The gaping pain I feel in my heart persists and it's only occasional that life is quiet enough for me to attend to it. And, when I do, it feels that only then, the healing can start to happen. It seems I've been walking around with this wound festering, and the longer I do, the more infected it has become. And while it seems that I should be okay, as I juggle many hats, it's just too easy to dance around not addressing the hole in my heart. And today, on the 4 month anniversary, the wound is stinging and oozing. It feels good to let the tears fall. Like saline cleaning the wound with the hope that I'll walk strong again one day. That even though there will always be a gap in my life without her, I'll continue to grow and be strong again, with the love and support of many others around me. 

Today it just feels good to cry and listen to "Remember When" and "It is Well with my Soul." Dear friend, I weep for you. 

reviving the ramblings

(A long winded, muddle of emotion and muck...possibly making no sense at all but bringing a deep breath to my soul.)

Ya, it's true. I haven't written on here for greater than 6 months. It makes me sad too.  It hurts that I see there's a Christmas message I never posted. Partially because the conclusion of it never came. Partial because it felt like I couldn't be 100% real and if I can't do that, I don't feel authentic enough to be.

I guess seasons change. Sometimes life is harder than others. Much time I can gloat about this wonderful life I'm living. Sometimes it feels so hard I don't know how I ever ended up here. It hurts that the biggest distraction of my life has had to be a social media secret to protect our family and the future of it. That makes it hard to be true.

During these last 6 months we've hosted visitors, we celebrated birthdays  and other days. My patients on the palliative care program have come and gone (and shoot, I haven't kept up on the tributes I promised). We've started homeschooling 2 eager children. I've planted flowers that have come and died. I've planted them again. Life trucks on and you find what you need to do to keep trucking with it or risk being lost in your bed looking for a Narnia door under your covers.
I've found other things that I love to do that have provided some refreshment that I desperately needed.

And now, as I sit to "revitalize" my blog my words are all muddled and my heart is all twisty. There's a part of me that just wants to cry and cry for hours, there's another part that wants to stand tall with all the strength that I can must and sing out "Whatever my lot thou hast taught me to say, it is well, it is well, with my soul." There's another part that wants to crumble on to the floor and say "but it isn't." There's a part of me that has so much hope and excitement for the future that I don't want to go to bed tonight but then there's that other part that knows what every morning feels like -- I don't want to get out of bed.

You see, my best friend died 3 weeks ago. Thankfully I was able to return for her service and time with friends and family. It was as beautiful and wonderful and necessary and healing and worshipful and absolutely amazing as I could ever have dreamed it could be. But, in addition to all that "hard" it doesn't take into account the jetlag and the nauseous feeling it brings. Or, that you leave your family behind and run to catch flights and maneuver around 115# of luggage on your own because you don't get to go to Target every week. Or, what it feels like to see REALLY special people (like Mom's and Dad's, Sisters and families, friends and nieces and nephews and Trevors) for a few minutes just to scratch that surface of "how are you" without time to hear the response. Or, if you had time to hear the response the context is so different I can hardly get to the point of understanding that I'd like to obtain. And then you come home and many are sick and the poor still live just there and you wonder yet again, "how was I just there" in the blizzard and sushi, and now I'm here. How do these coexist and how was it that I found my place in it all?

While this may sound like complaining or a cry for help. It's not meant to. It's meant to say "Wow! We live in a confusing world. Where your healthiest best friend can get cancer and die and your kids also lost their mom's and you find yourself in the middle of it and you want to help but sometimes you wonder if your helping hurts and sometimes it's so easy to lift your arms and praise God and sometimes you just bawl when you hear "It is Well" because she believed it and you want to but you only want to with her at your side. And sometimes you can't believe how lucky you are in the life that you get to live and sometimes you just want to be a normal cafe barista and not know the difference." But, in the end, what I think I come to is this, don't waste it. Don't do anything to get by, do what you do to make a difference and do something that's worth it, no matter what. With all that I feel and have felt, I'm still SO GRATEFUL to sit right here, staring at these make-shift curtains dreamed up from someone else's rags. I feel so lucky to have hard questions to wrestle and deep pain to seek healing for. Because when I can actually clear my head of my dramatic emotions I do believe with every ounce of me, and I know she would say and is saying over me, in the end (and even now), IT IS WELL, IT IS WELL WITH MY SOUL!

Tribute: tough love

This is a tribute I wrote many months ago but never posted. It was one of the hardest lives and deaths I dealt with in my hospice years of nursing...


Dear Mano,
After visiting you for nearly 2 years, walking through the thick and thin, of course we ache after your death. More than anything we hope that when we were "hard" on you, when we were frustrated with your decisions, when I yelled at you in anger, I pray you knew it was out of love. Tough love hurts. And, when we saw you making decisions that hurt others, it hurt us. And after your death, we saw the aches and our hearts ached. We loved you despite, because, who are we to judge your brokenness?What you needed most was love. I hope you felt loved, to the end. To the last breath. And, in those moments, I pray that you knew His love, his forgiving love of reconciliation and new life. Yes, this is what I pray.  You left behind beautiful children and we'll always stand to testify that you loved them. That, we know for sure. Tough love hurts but it was out of love. I promise.
Forever loved,
your team

Happy Thanksgiving

I woke up today and as per my norm took a quick glance at Facebook before getting out of bed. It was only a few minutes after that that I started to feel decently sorry for myself as I saw all the beautiful thanksgiving greetings. My mind wandered to what my family in the US would be doing today. I remembered the years of waking to mom cooking and me being lazy watching the Macy's Thanksgiving Day parade. And then I realized what I'd be doing today. The same exact thing I've been doing EVERY SINGLE Thursday for 21/2 years.

I got busy with my morning routine and all was well. We listened to Christmas music as we drove down the dirt road visiting the patients we visit every Thursday. I told my friends what a special day it is in America and I thought about things I'm thankful for. At one visit, the girls sang a song and I looked around, clapping, taking in where in the world I was. I felt grateful to be right where I was.

As our day wrapped up and we were heading home we were flagged down on the road. I stopped the car and several children came running to the road. Following them was a young woman and her son. Several times this lady has stopped us on the road asking us for help in caring for her young son. Last week she stopped us because her son had a large wound on his little leg. She had taken him to the local hospital  and was only given one piece of advice. "Open an ink pen and spread the ink from inside it on his wound." I laughed in frustration and gave her an antiseptic and the appropriate wound ointment. She gratefully thanked us and we went on our way. Today, she stopped us with a chicken in her hands. I tried to decline it and assure her that is was our pleasure to help her dear son. But, as generous Mozambicans do, she insisted that we accept her gift. Then she responded, "Este è boa festa!" (translated: this is for a good holiday). She didn't know that it's a special day in my culture but her thanksgiving towards us made me thankful to be away from the US today. I am grateful to be right where I am.

We will celebrate. On Saturday there will be pie. There will be stuffing. There might be turkey (or chicken). There my be cranberries if they can be rehydrated from craisons. And there will be friends. Special friends that I never would have known had my journey not lead me to this place, a world away, away from the USA.

I am so grateful! (But I still miss my family and friends.)

Happiest Thanksgiving from our hearts to yours!

something's changing

Something's happening. There's a shift coming. I do believe it. I await eagerly to continue to see what the Lord is doing. There's darkness here. MUCH. There's witchcraft, just plain evil. People dying. People being abandoned, forgot, left for dead.

A few weeks ago we saw him. A listless 4 year old, barely catching a breath every few seconds, floppy and as good as gone. Eighteen family members were there waiting for him to die because, you see, as long as they're there “paying their respects” the spirit of this dying boy won't be mad. And, they'll likely get a good meal. Worth the wait.

They thought.

Along came a crazy white woman and her faithful friends and they would NOT stand to see this child thrown a way. It's the first time in my life that I got so mad I wanted to start a fist fight with this young father how seemed indifferent in the passing of his beautiful son. And what about the mom? What all has happened that she's too scared or too lost or too paralyzed from her motherly instinct of life and love for those who have come from her womb. Imagine if I ever lost the fight for my cherished ones? The hopelessness and guilt must suffocate.

The family put up a strong fight. They were not willing to the hospital. They were NOT going to go. But, they were toe to toe with this white woman willing to fight and determined to win. I prayed. I prayed and prayed that God would use this opportunity to bring His glory to this DARK place-- where witchcraft is given far more respect than fear of the Lord. Will God shine through this time and start the needed shift in this area?

I doubted this little one would live. He was far gone. I prayed anyway.

I prayed. We all prayed. Wouldn't it be wonderful???....

We got news twice that he was still admitted in the hospital. Will he come home? Alive?

The next week we were visiting another patient and, walking towards us was the man whose face I had wanted to punch in. The change was incredible. Had I not been told, I wouldn't have known who this man was. And, in his arms was a bright eyed, glowing, chatty 4 year old boy. My heart sang praises. “The Lord has done a miracle! Can you recognize this and give glory to the one and only in whom it is due?” THANK YOU LORD! Not only to the testimony of modern medicine to treat malaria but to the fact that you are the God who fights for the voiceless. Those who awaited his death went home hungry because you Lord care about the least of these!

Even my team needed this amazing encouragement. Though the cerebral malaria has robbed him the use of his legs we've continued to see improvement and we prayerfully believe he will be running and playing again. This area needs to turn from the darkness and see the LIGHT that is Jesus.

And then this week, we were called 200 meters from this young boys house to a very ill man. We arrived to hear the witch doctor's casting out the curses that they believed to have been possessing this young man. Our team refused to be okay with this practice being the solution. I prayed with all of my being that the Holy Spirit would show up and shift this environment. His glory must keep shining in this area-- He promises to complete any good work that He has begun, I needed to remind myself. Come on Lord be visibly present again! Come on, my spirit shouted!

And, after a fair amount of time praying and dwelling in this dark hut with 2 witch doctors, we left the man who had been groaning and contracting his arms in agony, in peace. Yes, peace! And, as the witch doctor ran after us trying to give us money we were able to decline it and say, “It's only God. Praise be to Him!”

I don't know how he'll be next week. But...I wonder if we'll find him sitting up conversing with us? I think we might because, God is up to something big! The environment is shifting and may the love of Jesus that we bring be the change that this area needs-- to bring Him the Glory!

Pray with us! Come Lord Jesus, on earth as it is in heaven!

we fight for life

It's surely not the first time that I've realized this, that sometimes we're the only ones fighting for life. Despite what some may believe, our palliative care team spends a heavy portion of our time educating and fighting for the value of one's life.

Yesterday was one of the hardest visit days that I've had. My heart had been heavy all week about the loss of a long time patient and then, we were unexpectedly called to see one of our patients grandsons. Four years old, holding onto life with every breath. Parents sitting by waiting for death. For whatever reason of darkness they have lost their parental fight. To make it worse, in their dark state, they've likely hastened death by using witch craft and false prophecy-- paying large sums of money and then telling us they don't have the few dollars necessary to utilize the local hospital.

I shook with anger. Words were flying from my tongue-- if the parents won't fight for him then we must. And, what about the other 15 family members that had gathered around waiting for death? My righteous anger boiled!

These events of the week broke me. I cried.

I sat and cried, tired of the fight, tired of decisions that others make and there affects. Though I know  what we do is of  most importance, sometimes I'm tired.

And in my tired state I said "Lord, it's too much..." and He, as he  graciously does,  he reminded me that...

"Those who sow in tears will reap with songs of joy." Psalm 126:5

And that, dear friends, is enough to know that we must keep going. Sometimes we are the only ones that seem to care. And often my day may end with nursing notes that turn to prayers simply stating...

Please Lord-- we fight for his life! 

Tribute: Grateful

And you, sweet soul, were the first of our 70+ patients that wanted to offer your financial gratitude for our care. On our first visit you pulled out the money that you had to reimburse us for our "trouble". Oh, how I hope that you knew you were NO TROUBLE. Of course we declined your money and assured you that  we were there to help because God asks us to. Oh, how we all hoped things would end differently for you because we knew you cherished your life and every breath. We wanted to "fix" everything and make you well. We couldn't. You obviously were a special woman. We saw this clearly through the eyes of your dear mother. Who, like everyone else, ached as she buried her daughter-- we wish no one had to do this.

But your gratitude, it's your gratitude that stands out in my mind. You were so grateful. Just as I believe the Lord desires us to be-- full of gratitude, no matter our circumstances. And, yours were not easy, but your attitude remained positive and your heart was grateful. I'd like to be more like you beautiful one!