Two sparrows

My office door

Many doctors delight in their first "office" - which typically has a plaque with their name and specialty posted on their door somewhere in their clinic.  I suppose I'm no different, though my door may not look like those dreamed of by medical students and residents in the States.

In our OPD (out-patient department), patients come one-by-one to each of the different doctors.  No appointments, no insurance forms, minimal paperwork, two to four dollars per visit - but plenty of broken and hurting people.  In my few hours in the OPD this week I've seen everything from deafness caused by untreated ear infections to Tuberculosis.  

 Yesterday I saw a child in the office and once the parents laid the baby on my exam table I knew we would have a fight on our hands for him.  Steward had been sick several times the past few months though he just recently celebrated his first birthday.  He barely cried as I examined him and he reflexively raised his entire body off the table when I held his head up.  I believe Steward contracted pneumonia which progressed to meningitis.  He is now receiving IV fluids and antibiotics in our pediatric ward but will need a miracle to thrive after this illness.

Pleased to get Steward's spinal fluid

 I've been working in the Operating Theatre this week with Dr. Jim Radcliffe.  My first experience in the OR last week for a C-section felt like a train wreck to me.  Dr Erin was very gracious.  I worried about how I would cope with the procedural medicine I need to be able to practice here.  I received a lot of OR and procedural exposure during my Family Practice training.  Some of the skills I learned then are returning thanks to this extra time with Dr. Jim.

Please pray for Haddie, who needs a miracle

 

 One of my patients on Surgery ward needs a miracle.  Haddie suffered from a bowel infection unique to PNG called Pigbel.  Dr. Jim performed surgery to remove the infected and dead tissue and now she struggles to recover her ability to eat.  Each day she suffers while we give her fluids and antibiotics and pray that God will touch her.  Healing for Haddie will have to be supernatural at this point.

 Last night I was on call and treated a lady in our Emergency Room.  She suffered from obstruction of her lungs (COPD) and needed oxygen and breathing treatments.  While preparing her to stay in the hospital, the ER staff nurse told me about another child who came and left just prior to my arrival.  Apparently the child experienced diarrhea for a few days and then developed dysentery.  The family brought the little four year old girl to Kudjip, but when they arrived she had died en route.

My first reaction to this news was, "Why wasn't I called?  Someone, a child no less, came to our hospital dead and then the family left and the doctor on call wasn't even notified?!"  I am ashamed to admit I thought this, because I now see that it is selfish.  In this place, the loss of a child is no less tragic than if I lost my own Anna - but it is tragically more common.  Now I struggle knowing that despite the years of school, months of preparation and all of the hardships that went into our moving here I still could do nothing for this particular little one.  In fact, I will never see her face or know her name.

In Matthew 10 Jesus says "Are not two sparrows sold for a penny?  And not one of them will fall to the ground apart from your Father."

I take comfort knowing that those I can't help or don't even know are not lost to God.  I may not get notified of every patient that comes here, whether they leave healed or to their eternal home.  But God sees each of them.  He will not part from them.  And their lives are not lost, nameless or faceless to Him.

Home

Hold on to me as we go.  

As we roll down this unfamiliar road.  

Although this wave is stringing us along, 

just know you're not alone - 

'cause I'm gonna make this place your home.

On October 1st, 2013 Esther and I moved away from our home in West Tulsa.  In the 97 days that followed, our family of four changed houses five times!  At long last, we are home in Kudjip, Papua New Guinea.

  

The first six days of our new lives in PNG we spent in a nearby village called Ambang.  The Lenzs working with New Tribes Mission looked out for us and helped us to learn the local language and customs.  During our six days, three of the local villagers died from various causes. 
What follows a death in this culture is the "house-cry" - a multiple day event in which people from the community express their grief by wailing and crying out loud multiple hours at a time.  A couple years ago I treated a young woman at the hospital for profound dehydration from a "house-cry".  Unfortunately, the wailing for some serves as a way of expressing enough remorse to convince the deceased's family that they didn't practice any sorcery to cause their death, or to keep the ghost of the dead from haunting them.

 Looking out from our house in Ambang at the sunrise.

I worked with a man called Gabriel on learning the language.  In the shade of our patio, looking out over the mountains covered in mist, I stumbled through narrating Anna's picture book Bible to him.  It felt agonizing, but as Levi Lenz pointed out, this is how our children learn language and it was easier than just writing / copying / parroting phrases.  I now command maybe 5% of Tok Pijin.

 Gabriel, my language helper.  He wasn't sure if the Canada shirt had a marijuana leaf on it.  We straightened that right out.

We've had very generous hosts at Kudjip thus far and have enjoyed home-made meals from neighbors the past couple days.  This allowed Esther and I to unpack some as well as make grocery / supply lists for our trips to town this week.  While we need a few things to make our home, the house here is everything that we need and then some!

Anna has struggled a little while here.  She does well during the day, but she frequently wakes up in the nights crying, without any real specific reason or complaint.  I think that she realizes now that we have moved away from cousins and friends she cares for.  There are plenty of play-mates around though and she is getting close to a girl named Reegan.

 Anna in Ambang

Levi seems content as long as he can run around in the mud outside and occasionally play with an airplane or "choo-choo".

 Levi gets a ride with the boys

This Thursday I start orientation to the hospital and will begin work next week.  I take call on the 30th with another physician as well.  Please pray for my medical skills to return!  I worked an urgent care office for the past year but haven't done much medicine the past couple months as we transitioned.  I know there will be trying times and difficult days ahead, but trust that God will provide the reserves of strength, skills and knowledge I will need as I need them.

Thank you for thinking of us, praying for us, caring for us and supporting us!

Settle down, it'll all be clear.

Don't pay no mind to the demons, they fill you with fear.

The trouble it might drag you down,

If you are lost you can always be found.

Just know you're not alone,

'cause I'm gonna make this place your home.

-Phil Phillips, "Home"

... and back again

About 20 hours ago we arrived at our new home in Papua New Guinea.  Though it seems this journey stalled frustratingly along the way, I look back at the past season of preparation and see God's hand at work in it.

After spending Christmas at home with my parents, we began our earnest preparations for moving to Kudjip.  Packing and repacking, confirming baggage allowances, buying or replacing items to take with us and, most difficult, saying goodbye to our familiar haunts as well as our loving family and friends.

 12 pieces - which all eventually made it into our new home

 

 Our send-off at my parent's home before leaving

Esther and I have both felt somewhat overwhelmed these past couple weeks.  I remember approaching our wedding and feeling that we lost track of the marriage ahead of us in the logistics and details of the wedding plans.  Our move to PNG feels that way to me.  While we've been in various stage of preparing for this the better part of 8 years, I feel that getting luggage sorted, paperwork in order, tickets purchased, etc has affected the amount of time I would have wanted to prepare my heart.  Esther said it more poetically - "The burden of the urgent crowds out the important"

Now that the journey is behind us, the real adventure begins, and I covet prayers that I would approach this time with a focus on what God wants for me, my family and our work and ministry here.

On our arrival, the kids quickly bonded with several other children on the station.  We got a very warm welcome, with banners, flowers, visits, groceries in our home and a wonderful meal with Bill and Marsha McCoy. 

Anna spent a good chunk of the morning with Reegan, another 4 year old girl here.  They pulled fruit from the trees and then snuck under her bed to eat chocolate Maltesers. 

 Anna and Reegan pulling down lemons.  Fresh bananas hanging on our back porch.

They have both adapted well, but Anna woke up from her nap yesterday to say that she wanted to go "home."  I'm sure I should have taught her that his is our home now, but we were both so tired that I just curled up into her bed alongside her until she fell back to sleep, and has since been enjoying the time.

 Our living room.  About 500 pounds of luggage are just outside the frame of this picture.

Today we leave for a mission station about 45 minutes away from Kudjip to begin an immersion experience for language / culture acquisition.  We feel at peace about this now after some initial reservations given Esther's pregnancy and Levi's recent illnesses, but things have worked out that we can study our language in safe setting.  We will be gone for six days and then return to our house to finish settling in while I orient at the hospital and we set up bank accounts and get driver's licenses.

Pray that our family transitions well and that we can teach the kids the importance of following God's call even if it means we are far from "home"

Nearly there

I am borrowing Esther's most recent blog to give an update of our status here - she did a lot of excellent work recruiting the appropriate pictures to include so I've just modified the content a little!

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"We're still here?!"

As Christmas approaches, we ask ourselves this question.  The answer, obviously, is 'yes' - and it's one that gives us mixed feelings. Back in the spring, when we tentatively put together a time frame for leaving for Papua New Guinea, we planned to celebrate Levi's second birthday (which falls in the last week of November) in PNG. Honestly, this was a somewhat arbitrary date, since we made the decision in part because we celebrated Anna's second birthday while we were visiting the hospital back in 2001 and thought it would be fun to do the same for Levi - but it gave us something to aim for.

As we raised our support during the summer and fall, we realised that from a financial standpoint we were still on track to move by the end of November. God has truly amazed us during the fundraising process, and it's been both humbling and encouraging to see the group of people He has drawn around us to support us through funding, prayer or both. We are fully funded!

However, our visa paperwork has been a somewhat different story. And based on previous missions experience (both our own and that of friends and family living in developing countries), this hasn't come as a huge surprise to us ... but certainly brings us days of frustration! After initial hold-ups surrounding my medical license were cleared, it looked as though adjusting our plans to move in the first two weeks of December may be realistic. As I write this on December 4th, without visas and therefore also without plane tickets, we are sensing this departure timeframe, too, sliding by us unmet...

It is a mixed blessing, though, and there are things we're very thankful for even in the delay. We had some really precious time with family and friends over Thanksgiving - some of our family doesn't live in Tulsa so the holidays gave us some extra time with them that we might not have had otherwise.  Celebrating with family on Friday enabled us to also invite good friends over on the Thursday and get the chance to connect with them before leaving.

Esther has been able to get a few more weeks of OB care in with our doctor here, which has allowed us to see a reassuring formal ultrasound and gestational diabetes test while we still have access to those kinds of care.

The packing is able to happen in a more relaxed and methodical way with more time to spend on it, which we know will make unpacking much easier on the other end and hopefully reduces the chances that we leave any 'necessaries' behind!

And it looks like we have a winter storm headed our way, which is so far promising the kids an atypical couple inches of pre-Christmas snow before we move to a climate that definitely won't be affording us any snow days!

As we are in this final stage of waiting before we leave, we are trying to be patient and just enjoy this time of stillness that God has given us before all of the travel and uprooting begin (although stillness may not actually be a very accurate descriptor, as I think about all the 'last' things we are trying to do and people we want to see, ha!).

We would love for you to join us in praying that there aren't any unnecessary delays and that all of our paperwork would be processed in God's timing for us - thank you so much for standing with us in this time.  We'll keep sending out updates as things change!

Across the pond

Thank you to those who were praying diligently about our visas.  The first hurdle has been officially cleared.  There are a couple more, but within a week of bringing our need before our church and supporters we saw a breakthrough.  We still await paperwork processing in PNG before having the go-ahead to submit our passports and final applications to the embassy in Washington.  We are still praying and hoping for a Fall departure!

Now the secret is out!  We are in the UK until November 1st giving our children a chance to reconnect with their grandparents here before moving to Papua New Guinea.  We have not seen Esther's family since June 2012 when they visited Tulsa for my graduation from Residency, so this time together is somewhat overdue. We surprised Esther's mother, Mathilda (pictured above with the kids at the River Thames in Marlow), who knew nothing of our trip until we rang the doorbell.  We are staying in a missions home in Thame for this month and express great thanks and appreciation to Long Crendon Baptist Church, Esther's church growing up in England, and the Shunem trust for this.

While here, Esther continues teaching Anna's homeschool and we look for ways to enjoy the time with family.  We spent a day last week in Marlow on the River Thames with the whole family, and plan a week near the Welsh countryside as a family for Mathilda's birthday later this month.  Several of Esther's friends plan to visit during the month and we look forward to each of them.

I'll update again later this week or next with the most recent happenings here.  Thank you for supporting our family in your time, finances and especially in your prayers.

On the move

In the past three days we have made our first move of this next season.  The home in west Tulsa that we enjoyed for the past four years is now empty, save a few items that remain behind awaiting a Salvation Army truck's acceptance.  We're temporarily living in a missionary home in Tulsa while preparing to move overseas.

The move was difficult for me.  I grew up in Tulsa and certainly think of it as home.  Though we're only a few miles from our previous house, the reality of leaving this place hits me in a more certain way now.  Many of our items we simply discarded, others we donated.  I believe the Goodwill donation center staff have grown concerned about our frequent visits.  Some things are still waiting to be picked up as I mentioned.  But this move feels different than others because for the first time we had to take down hand-made decorations hung by our children, give away some of their belongings or throw them away, and bid farewell to the four walls that have sheltered and shaped our young family.

As I took nails out of the walls at the old house yesterday, tears came while memories of Christmases, Thanksgivings, Birthday parties or just the daily fun and games of life replayed in my head.  We have known for a while that God called us overseas, but the actual parting is more challenging than I anticipated.

I've recently started reading David Platt's book Radical.  I'm only through the first chapter or so, but I'm realizing that when Jesus calls to us, it is exactly a complete abandonment that he expects.  In Mark chapter 10 a successful, affluent and influential young man approaches Jesus and asks him what he should do to inherit eternal life.  At first, Jesus replies with a simple list of "do this" or "don't do this".  But the young man already follows that.  So why did he come to Jesus in the first place?  If doing the right things were enough, shouldn't he have already felt fulfilled?  Why would he seek him out?  Jesus sees that this young man has followed the right "rules" but still isn't fulfilled or secure ... and verse 21 says that Jesus looked at him, loved him, and told him to give away his things, take up a cross and follow Him.

That cost pushed many people away from him.  When he called fishermen from their boats or a tax collector, did they come to Him skipping and singing a merry tune whilst leaving their lives and their families?  There's nothing that I see in scripture that says they didn't lay awake at night, tears in their eyes, missing their old familiar things and places.  But in John chapter six, when Jesus challenges them severely and asks if they wouldn't rather go back to their comfort zones, Peter replies, "Lord, to whom shall we go?  You have the words of eternal life."  Something about Him made their sacrifice worthwhile.

I pray that as my family leaves our familiar places, familiar things and friends and loved ones we would anticipate receiving a new kind of fulfillment. 

We need your prayers more now.  Our visa applications (a process we began in May) is being hampered and is threatening to delay our departure.  We made our move in faith that God will provide for us to go to the field this Fall and trust that He is working in His timing.  However, we need a miracle to avoid ending up in a difficult situation if we are delayed.  Pray for favor with authorities, efficiency in processing paperwork and for granted visas so that we can buy our tickets to PNG.

We are grateful to those who have joined us in this process.  Your gifts toward our ministry are preparing our home in Papua New Guinea, paying some processing fees and have reassured both us and our receiving mission that this is for real!  Soon, those funds will buy plane tickets for four passengers to Kudjip hospital and provide for healing and our ministry there.

Progress

We are making progress!  A big thank you to those that have been giving toward our mission.  We have surpassed the amount needed to purchase our tickets to move to Papua New Guinea this Fall.  Any funds we receive between now and when we move to PNG will offset our start-up expenses, with the remainder applied to our monthly stipend while we are in the country.  Our pledged support amount covers the $2000 monthly living expenses we were quoted and we have all but a couple hundred of this coming in now.  However, some pertinent changes have occurred since our initial estimates - more to follow on this development. 

The process of moving to Papua New Guinea is complex and a large part of it entails getting licensing, work permits and visas to enter the country for an extended stay.  In May I sent a packet of information with everything from my driver's license to medical license and board certifications to Papua to apply for a medical license there.  I now have a valid PNG medical license and we await approval of my work permit and then visas from the embassy in D.C.  Our contacts in PNG have suggested that this should be able to happen by the end of November, we are praying this is the case and for favor with authorities.  This is about a month later than our projected departure, but I have felt God's divine provision in some of our delay.  (Romans 1:9-13)

Recently we consolidated many of our belongings in preparation for our move, including a thorough excavation of our garage and attic as well as one of our closets.  This is a tricky endeavor as we will not only be moving but needing to trim down the majority of our belongings in preparation for living overseas.  Pray that we would be able to part with our belongings in a responsible way.  (Matthew 10:10)

The most exciting information to share though is that we will be making an addition to our family around March of next year!  This little one will be delivered at Kudjip.  While I felt privileged to deliver Levi, although inadvertently, we plan for this one to be delivered by one of our colleagues. 

This is our most recent ultrasound courtesy of Dr. Ashley Hildebrand at Family Medical Care.  After a challenging pregnancy with Levi and a history of an early miscarriage, these little pictures and heartbeats encourage us.

Do we still need support?  Yes - for those giving now, your gifts are preparing our home in PNG, our departure costs including airfare, visa fees and some basic medical supplies for my work in the hospital.  For those who have pledged, thank you for your gifts to come.  For those who want to support us, we will now have additional expenses with our little one coming while in PNG. 

While MissionCorps has slightly adjusted our monthly expenses to cover insurance for an additional family member ($70-100 premium), there will be some supplies we need on a regular basis once we are there that will adjust our monthly budget to include diapering, additional clothes, etc.  While we can't give exact estimates on these needs, supplies in PNG are typically slightly more expensive due to how remote our location is.

As of this writing I have cut down my hours at the Urgent Care centers to just 10-20 hours per week to focus on packing up our home and enable us to travel some to reconnect with family and friends before moving this Fall.  We can manage this situation for a few months, but if our departure is delayed any further, it will likely be unsustainable.  My work arrangement will last through the Fall and we have lodging through November in the States but are eager to settle into our new home at Kudjip.  For this reason, please pray that the rest of our paperwork gets processed smoothly / efficiently.

Thank you for your support of our family!