Christmas at Tenwek

Although we all missed spending the holidays at home with family (except for Heather, Anna, and Abi, who DID spend the holidays back in the States), we still had a good time here at Tenwek. Thought you'd enjoy seeing a few pictures of our weekend events.

First of all, Aunt Alyssa had all the kids over for a projector-sized viewing of Polar Express (Micah enjoyed watching it on the small screen off to the side, apparently):
Jess served a fantastic Christmas Eve dinner for all of us complete with ham, scalloped potatos, and green bean casserole. Yum!
After dinner, it was time for the Christmas Eve candlelight service, with carols and Scripture led by Jason and Eric:
Christmas Day all the kids enjoyed opening gifts at home:

If it had only been 30-40 degrees colder, we would have enjoyed a white Christmas. Oh well, the cows grazing in our front yard were a unique Kenyan touch:
And finally, we wrapped up Christmas Day by having a Happy Birthday Micah and Jesus party. Good thing Micah isn't old enough to resent sharing his birthday yet! :)


While Shepherds Watched: Wisdom and Foolishness

Our Christmas service didn't go the way that we planned. We got started late, but this is Africa, and I consider myself flexible. We sang a couple opening songs, and then, according to the program we were given to follow, we invited a group of kids up to do a Christmas skit. Except they weren't there. So we finessed a pass on that and invited some people up to share a special song, but of course we now caught them off guard. Then, we were to light the last advent candle, but the people assigned to that weren't there either, and likely didn't know they had been assigned. A little later the kids' skit happened, but the delay had been caused by a number of kids not showing up, a situation which the 15-minute delay had not remedied, and it definitely showed in the skit.

According to the grand image of myself that I keep in my own heart, I am a laid-back and culturally-sensitive individual. But I really love Christmas, and moreover, I love the Christmas that I'm used to. Not just because I enjoy it, but because I feel drawn to Christ through the experience. And so, I was quite disappointed with this particular celebration of Christ's Incarnation.

Then our pastor came up to preach his small Christmas homily. Honestly, I don't remember much of what he said, but he mentioned that God sent his message to the shepherds. Here, I've met quite a few shepherds, and they are here as they likely were in Bethlehem, shepherds by virtue of a lack of options. Shepherds by virtue of limited education, resources, and opportunities to do anything else.

I've often enjoyed thinking of them as hidden sages, wise, just not in a way that the world recognizes, like David might have been, had he not been made king. But this is romaticized and not often true. This kind of sheltered upbringing is just as likely to produce shepherds who have many unjustified prejudices, extreme misconceptions about things to which they haven't been exposed, and maybe even bitterness at all that life hasn't brought them. And they would most certainly botch the Christmas program, if anyone would dare to give them a role.

"For unto you is born this day in the city of David, a Savior who is Christ the Lord."

Paul says: "But God chose what is foolish in the world to shame the wise; God chose what is weak in the world to shame the strong; God chose what is low and despised in the world, even things that are not, to bring to nothing things that are, so that no human being might boast in the presence of God." (1 Cor 1)

This is what God has done, and let those who consider themselves wise (and laid-back and culturally-sensitive) be warned that He may do it again. He may have given his message to the low and despised many times, and I may have missed it. He even gives His reason: "so that no human being might boast in the presence of God." And so it is that my veneer is pulled away, and my true motives unmasked.

We need Paul's words because we need to be often encouraged in our lowliness that God can work through us. We can relate to the shepherds, and are awed that He would send us good news. But all of us (and myself more than most, I think) need to also heed the warning in Paul's words. You who are wise, regard the foolish. Regard the weak, for through such as these God may speak and shame the strong. For none can boast in the presence of God.

Yet, even now, take heart. Do not fear, for there is good news of great joy that is for all people. There is a Savior, he is Christ the Lord. He is lowly and wrapped in a manger. "For the foolishness of God is wiser than men, and the weakness of God is stronger than men."


IDP Camp in Mau Forest

Mau Forest is the largest montane forest in all of East Africa.  During the 1980's - 1990's large parts of this "protected" land were dolled out in the form of political favors resulting in the destruction of large swaths of the virgin woodlands.  During the 2000's, political pressure began to build as Kenya experienced significant droughts attributed by many to the loss of the forest.  In fact, when we arrived to Kenya in the fall of 2009, I was pretty sure I had landed in the Southwest USA because the place was a dust bowl.  Serious evictions began to be carried out by the government shortly after our arrival.  

Tenwek sits just a few kilometers from the edge of this forest.  Internally displaced people (IDP) camps have popped up along the edge of the forest, and I've heard estimates that as many as 100,000 people will be displaced by the evictions.  This December, on request of the government, Tenwek sent a convoy deep into the forest to an IDP camp with ~4,000 people in the area.  We took 5 Toyota Land Cruisers with 30 medical personal and supplies on some seriously wild two tracks.  After converging all of the pieces of the puzzle at 5 am at Tenwek, we arrived at the below IDP camp around noon time.  

We made the make-shift "school" our medical facility for the day, and a big crowd quickly gathered for medical care.  Dr. Spriegel and the head Tenwek chaplain gave encouragement from God's Word and instructions for the day to the crowd.   

We were all impressed with how the IDPs handled themselves.  These situations can sometimes be tricky as people fight to make sure they and their loved ones get the care they desperately need.  But none of that happened.  Instead, we heard stories of tremendous faith as mothers with nothing to their name trusted God for their family's daily bread in the most literal of ways.  Most of the children wore tattered clothes and had signs of malnutrition.  The African Gospel Church has worked extensively in this area with nearly 150 churches estimated in the Mau region.  It was obvious these people had a joy and a peace that could not be explained by their earthly state, but came from their trust in Christ.  

The eye team, ("macho" in Swahili, "konda" in Kipsigis), were assigned station five.  After a little artistic touch, we were ready for business.

Eye sight was checked,

eye pressures were measured,

and exams were performed.   

From 1 - 5:30 pm, nearly 600 patients were seen by the medical team (~100 of those had eye problems).  We then packed up as fast as we could to get over the worst of the roads before nightfall.  We took a longer route home in order to use paved roads at night instead of taking the "short-cut" through the middle of the forest.  We arrived home at 9:30 pm exhausted, but deeply grateful for the chance to bear just a small part of our brothers' and sisters' burdens.  Please pray for these IDPs as well as the Kenyan church and government as the try to minister to their needs and find a permanent re-settlement site.


An Acute Accent

Whenever she speaks with a Kenyan person, Anna subconsciously slips into her Kenyan accent. Play the video below to hear her describe our upcoming trip.

In case you have trouble (as I still do sometimes) understanding the Kenyan accent, I will translate. Anna is saying that she is going to Wisconsin for Christmas, where she will see her grandparents, and where she will see snow. Then she explains snow and cold, since her Kenyan friends have never experienced snow. I don't think she even remembers how cold she is going to be.

That's the story. My parents could not bear the thought of another Christmas without their grandchildren, so they wanted to fly Anna and Abi to Wisconsin. Since the girls are too small to fly alone, I get to accompany them. We are scheduled to leave tomorrow but might not, depending on the snow situation for our layover in Europe. You could all pray for us on the lengthy flights ahead. Hopefully every person on the airplane will be full of good Christmas cheer. Of course, if anyone needs additional in-flight entertainment, perhaps Anna could whip out her Kenyan accent....


McCropder Update III: Blog Features

And now, for the anticlimax: A couple new blog features we wanted to make you aware of.

First of all, through the generous help of a friend, we have secured the domain mccropders.com. That's right, no more "blogspot" in the address, though you can still use that one, as mccropders.com just forwards to mccropders.blogspot.com.

Objection from the peanut gallery: "The blogspot part wasn't the hard part to remember. It was the word 'mccropder' that I couldn't remember." True. But for some people, the blogspot part was tough also, and we couldn't come up with an address better than this, so we kept it, but tried to simplify it.

Second of all, there is now a handy "Free Items" link in the upper right corner, and you can currently follow it to 2 different Items. First, there is a link to download Eric's music for free. Second, we have pooled some of our favorite Kenyan pics to make some desktop wallpapers for you to download as a pictorial reminder to pray for us. Likely more free items in the future. Enjoy!


McCropder Update: Part II

Well, we don't want to keep you on the edge of your seats any longer. Part II of the update involves the "where next" question. First of all, we appreciate the many prayers and counsel that have come our way as we've sought out how to take this next step. There are a great many people that put a lot of effort into helping us make this decision--various missions agencies, people in a number of different countries setting up travel plans and itineraries, and many of you back home asking thought provoking questions--thanks to you all. And when we say we've "made a decision" on where to go next, what we mean is that it seems like all the right doors are opening to one particular country, but we are not saying that it is here or nowhere. All of us know that God can move in a variety of ways and we want to be open to hearing His calling in the months to come.

That being said, the country that seems to make the most sense for us at this point in time is Burundi. We have decided to pursue that option above all others, for several reasons. One is that, as Eric said, "they seem to have a McCropder-shaped hole there." We feel that the needs of Burundi in staffing a Christian hospital to be the primary teaching site for a Christian medical school, in one of the poorest countries in the world, fits us quite well. We would be meeting a medical need and a discipleship need at the same time, word and deed together instead of one or the other. There are many loose ends and uncertainties, and probably a lot of difficulties on this path as well, but such would be the case with any site we have looked at.

Also, what helped us make the decision was that initially there was no obvious missions agency to send us to Burundi. Almost no one is working there right now, aside from the Free Methodist church who runs the school, and we didn't feel like that would be the best fit for our group. But through a series of events, it seems that an organization called World Harvest Mission, known and recommended by our home church, is interested in partnering with us and starting a new site in Burundi with us. They are a small non-denominational organization with only a few medical missionaries so far. The ones we know are great though, and WHM's two longest serving docs are on their way to Kijabe hospital near Nairobi, to work part time and be the area field directors the rest of their time. They would be our oversight, which is exciting to us as well.

So, next steps. We're beginning the application process to WHM, although we won't know for sure if they would commit to accepting us and the work in Burundi until their board meeting in April. We won't become "official" WHM missionaries until after we attend a week-long candidate school back in the US, likely next fall. In the meantime, we hope to take another scouting trip to Burundi and take a closer look at the hospital and some opportunities there. We need your prayers now more than ever, as we seek to confirm this calling from God. Pray that the right doors will be opened and closed to us, and that our calling would either be confirmed or not. Thanks for coming along with us on the journey, and we are excited to be bringing you along.

Stay tuned for an (anticlimactic) update, part III, on some new blog features in the next week or so.


Eye M.D. to 10 Million

Click here for a great article on John's work from the American Academy of Ophthalmology's Online Magazine. It has some great Q&A with John as well as a chance for him to use all that cool, obscure lingo that only ophthalmologists use, like "VR surgery with ILM peels." Awesome.


McCropder Update: Part I

As 2010 draw to a close, we realize that it has been a big year in so many ways, just as big (if not bigger) than 2009. We thank you all for your prayers and support this year as we have journeyed together through so many things. 2010 brought an adjustment to Kenya, to Tenwek, to life in community. We had struggles and joy at home and at the hospital. We began more actively seeking what God wanted us to do as a team, and where to do it, through visits to Burundi, Madagascar, and Liberia. And now we want to take the opportunity, in several parts, to give you an update on the conclusions we feel God has led us to. I'm sure what everyone wants to know first is, Where Next? And that's coming soon.

But first, we are excited to announce some special McCropder expansions. These would be in addition to the McLaughlin baby coming in March. :) First, many of you know that Carlan Wendler, a friend of all of ours from Michigan/Knox church, has long expressed interest in joining up with us long term. Earlier this year he moved past interest and into commitment phase. We are excited to have him along for the ride! He is currently in his third year of emergency medicine residency at Los Angeles County Hospital, and will finish June 2012. He was out visiting us last February, and everyone enjoyed having him around with his fun personality and willingness to play with our kids.

The other important expansion is that Alyssa Pfister, the other Post Resident at Tenwek, has also just decided to come on board! She has been working and living alongside us (literally--she moved into the upstairs apt next to the Cropseys) this past year, and has quickly become a wonderful friend. She is from Nashville, and did her Med-Peds residency at the University of Alabama. You can check out her own blog here. Although we are all thrilled that she is going to become a long term part of her team, Eric is especially happy that we have two more primary care docs to round out our surgery-heavy team.

Now the real question is, what to do with the McCropder name? We worked out some new configurations, like PMcCropdlers (silent P, like Alyssa's name), but decided in the end to just keep the original McCropder name. The Cropseys might be willing to share their "p", and the Faders could share their "er" with Carlan. :) Stay tuned for more parts of the update, including the where next question, as well as exciting new blog features!


True Tenwek Love

Our daughter Anna loves many things about Kenya. In fact, she will tell you that the only thing she does not love about Kenya is the pincher ants.
These pincher ants may euphemistically be called safari ants. They pinch hard, sometimes drawing blood. And they are sneaky. They usually plan a cooperative climb inside a person’s clothing, and then after some secret signal is dispersed, the whole horde of them begins pinching simultaneously.

Last week Anna had a miserable run-in with several dozen pincher ants. They slyly climbed up her hair as she was playing in the grass, and at the appointed time, they launched their painful pinch attack. This is Anna’s depiction of the fiasco:

And then came the true Tenwek love. Three neighbors ran over to help in the ant battle. They directed the counter-attack, wielding a brush, a can of insect killer, and eight hands smooshing and extracting the ants.

It was a tangible lesson for a five-year-old (and her mother) in self-sacrificing love. No one particularly wants to volunteer to help extract pinching ants from a screaming child, especially since helpers are sure to get some pinching in the process. But again, I am challenged and inspired by my neighbors to love more selflessly. We’re all just hoping we won’t have another opportunity to love against safari ants any time soon.


Tenwek Coffeehouse

Last week, we finally did something that we've talked about for at least four months. Rachel and I hosted the first (ever, we think) Tenwek Coffeehouse. The idea was this: Tenwek usually has anywhere from 25 to 40 young Kenyans in medical training, apart from the nursing school. They come out to this rural area because of the reputation of the hospital, and the desire to be trained here, but almost any other training site would have more social life than here. And most of these trainees have lived at least part of their life in a big city. We've done other things, such an hosting various social activities and game nights at our homes, but I thought we might try something a little more unique.

And so we decided to try a Tenwek Coffeehouse Music Night. This was a pan-McCropder event. Cookies and tasty bread were baked. Coffee and chai were brewed. Lots of cups were obtained (none of us have more than 10 or so), and we invited all the docs and interns to the church meeting room for an evening of music.
Interns, med students, residents, and attending docs all signed up to do some music, and we had a great time. Most everyone who wasn't on call made their way down.
Rachel and I did a small set of four songs, and I had the chance to accompany one of the residents as well. Afterwards, they set the keyboard to play some rhythmic loops, and a group spontaneously broke into a dance circle around the keyboard, which probably lasted around 20 minutes. There was only one white face there (though mostly blocked in the photo below), which was John, who not only danced with gusto, but actually was leading the dance at a certain point.
Overall, the feedback was very positive, so we'll probably try to replicate this in a few months, when we have a new class of interns. Much thanks to everyone who helped.


Celebrating One Year

Today marks one year since we (the last to arrive) touched down in Nairobi, were ushered through the visa line by our over-tired 7-month old, rejoiced at all our bags being present, drove through the dark across a new city, and fell asleep in this new country.

Has it gone fast or slow? I'm not a good one to ask, since this experience, like almost all experiences to me, was simultaneously incredibly fast and slow. A few weeks ago, I was orienting a new American student, and one of the Kenyan interns asked me, "Are you going to take tea?" The American brightened and said, "That's how they say it? They take tea?" I have no idea when (if ever) that became normal, but I know it's been a very long time.

And that's a fun part of making a new home, when the things that were so hard and unfamiliar become easy and second nature. When you start to automatically interject Swahili into a conversation. When you know a "back way" to avoid traffic jams in Nairobi. When you can reminisce with new friends about "old times". And all of this is true here.

Yet a sense of home, in some ways, remains beyond our grasp. The feel is much different compared to when I had been in Ann Arbor for a year. We're still on the outside in many ways, and there are still many things we don't understand, and many who don't understand us. And this can result in pangs of homesickness at the strangest time. I can be stopped in my tracks by a couple random leaves falling or by a brief chill breeze and the sight of my breath on a particularly chilly Kenyan morning. Or the memory of talking with a patient from my own culture. Or the idea of having well-marked roads and an accurate road map. The point is not that our current situation is all that inconvenient, but that all these past familiarities seem so very far away.

My niece is getting older everyday, and I've never met her.

On January 8th, we'll celebrate intern graduation, and this group of Kenyan interns will look back at an internship that we were all present the entire year for.

And my time here is also my time away from home, and thus my life is full of such juxtapositions. God has given us much grace, and I would say that it hasn't been as hard as I thought it would be or as hard as it is for many people. Thank you for your prayers, and today we celebrate.

"I'm home anywhere if you are where I am." - Rich Mullins


COTW: Variety of cases

Most of the time when I am on call for surgery, things are relatively quiet - such as a few cases over 24 hours. Not so this past 24 hours. We (the surgical resident, intern, and I) have had a number of cases, and an interesting variety: a perforated duodenal ulcer, an emergency tracheostomy on a man in his 30's with esophageal cancer that had blocked his airway, a 12 year old with his bowels obstructed from worms, and a 2 year old who swallowed a coin (see x-ray below). We also had 3 men who assaulted each other with hoes on the head, two of whom needed big lacerations closed while the other needed his skull elevated. We almost had to put a tracheostomy in a 2 month old, but she was successfully intubated. There was also a 3 year old who swallowed a nail (see x-ray), but we will wait to see if it makes it through (swallowed objects like nails usually do). We also assisted the OB team on an operation for an intra-abdominal pregnancy which was attached to the bowels. Then we did two operations (a wash-out and a bowel anastemosis) on a 5 year old girl who had bowel ischemia from sickle cell disease.

Anyway, my favorite part of the night was as we were closing the kid with the bowel obstruction from worms. I asked Elijah, my resident, whether he thought I should show the bowl full of worms to the family. He thought it would be a good idea as it would likely encourage them to go to their local clinic every 3 months and get the free de-worming medicine. If they did that, the worms wouldn't grow to such a population that they could cause an obstruction.

So I walked out to the waiting room with a bowl full of worms and called the family. In my broken Swahili I explained that when we did surgery, there was a blockage, and this is what we found - and I uncovered the bowl. They were quite shocked, and started chattering rapidly to each other in Kipsigis, the local language. As they were talking to each other, the Kipsigis nurse who was with me started giggling and then leaned over to me and said that this was the family of the patient who got the tracheostomy for the obstructing esophageal cancer!


The McCropders Turn 3

November 2007 marked the official decision to pursue working as a community of families, after years of pondering and joking about it. Thus, we have crossed the 3-year mark, and thought we would post some photos to commemorate it.

At the 2007 Louisville conference, with Elise missing.

June 2008: Ann Arbor on a kidless afternoon.

May 2009: Maggie arrives, and Abi is expected.

September 2009: Right before Cropseys left for Kenya

December 2009: The final McCropders arrive in Kenya

July 2010: Visiting with the Lynns

November 2010: A few nights ago after a big soup dinner with the Popps.


The Superior Intelligence of Kenyan Mice

Here in our apartments, we have regular visitors, including friendly lizards, skinks, chameleons, beetles, bees, spiders, slugs, and oodles of mosquitos. Once in a while some cockroaches. Occasionally a bird. And MICE. This week we undertook a major mice-eradication effort.

When we were in town recently, we found this metal rat trap.
When this picture was taken, the trap had been set in this set position for TWO DAYS. Empty. Just accumulating fresh mouse droppings all around it an ON it. Evidently Kenyan mice are much more intelligent than American mice.

So I set to work on a different type of trap.
It's essentially a ramp leading to a bucket in which a tin can with bait is suspended. Theoretically, the mouse leaps from the ramp onto the tin can, where he scrambles for balance as the tin can spins, causing the poor animal's descent into the bucket from which he cannot escape. The mice did not fall for it.

So I did some on-line investigation, which means that I was getting desperate. On-line investigation is a last resort here where lately it can take 10 tries and/or 10 minutes to load a web page. But at last the search yielded directions for assembling the perfect trap.
A baking dish on a tray is propped up by a bent stick. Peanut butter lures the mouse to jostle the stick, causing his certain entrapment as the baking dish falls.
And it works! Fantastic! Not surprisingly, Anna really wanted to keep the little creature. And even I had to admit that he's a cute little mouse. Cute and smart, but finally outsmarted.


Kenyan Pregnancy Taboos

(A Kenyan doctor friend Mike comes up to Rachel and says congratulations, with a gesture towards the baby bump.)

Wait a second, Mike. I had heard that Kenyans never acknowledge a pregnancy until the baby comes.

That's totally true. You can't mention it, even when she is almost ready to deliver. But you're a Westerner, and everyone knows that you guys don't mind, so we can say it to you.

Well, what if we went out to a rural village, and saw a very pregnant lady, and said, "Congratulations, mama! When is your baby due?"

Oh, that would be fine, because even in the remote areas, they know that Westerners are different on this. But, if I were with you and said the same thing, they would be very offended.

But there's an indirect way that you can ask, right? You can say, "When will you be inviting us over for tea, or lunch (implied: to see the new baby)?"

Absolutely, that is what you would say. But you can't mention it or even prepare much for it. But younger generations of Kenyans are now having baby showers and things like that. But even them, even at a baby shower, you can't verbally mention it. It's still taboo.

Wait. You're at a baby shower for a pregnant lady, but you can't acknowledge she's pregnant? Then what do you say when you give her a gift of a crib or some baby clothes?

Oh, you just say, "Here, these are for you. I thought maybe you would like them. Just put them away somewhere, and maybe you fill find them useful one day."

So, Mike, I gotta tell you that as an American, I find this pretty strange. Do Kenyans find it equally strange that Westerners would ask freely about a pregnancy?

Oh, of course, they would be like, "Eh, why are you talking about a baby that isn't even born yet?"

--The sobering part of this awesome conversation is that we were in agreement that the likely source of this cultural difference springs from the vastly differing neonatal mortality rates, and the reluctance to expect too much in a society that loses so many babies. Nevertheless, we remain grateful to friends like Dr. Mike to help us navigate the cultural waters.


Liberia Report

Since 1989, Liberia's history has been one of great tragedy.  A peace agreement signed in 2003 led to the resignation of Charles Taylor and ended a 14-year civil war in which over 250,000 Liberians were killed and untold numbers scarred in unimaginable ways.  No family was left untouched.  

View of Monrovia -- note the sea of shanties along the beach

A transitional government was put into place until President Ellen Johnson-Sirleaf (first and only female African head of state) was elected in 2006.  Not only did most of the educated leave the country during the war, but nearly all major infrastructure was looted and destroyed.  The country is now in a rebuilding phase and the world is watching and hopeful that the elections next year will be peaceful.  

Ministry of Health building that was never finished after the war

Monrovia City Hall -- one of the buildings that has been renovated

The Cropseys were sent to explore the medical opportunities.  In 2003, there was not a single remaining Liberian doctor in the country per the Dean of the medical school!  In 2005, the number had increased to a whopping six.  Some estimate a total of 60 docs in country now, but they are mostly in Monrovia.  So the need is great, no question, especially for educating the next generation of doctors for the country.

A.M. Dogliotti College of Medicine - they have some beautiful new buildings and labs.  JFK (the big government hospital in Monrovia) seems to be doing pretty well.  The people that we met with at both of these institutions were very eager for us to come.

On arrival, we were warmly welcomed by the Colby family, who are working with SIM (Serving in Mission) at the historic ELWA campus.  ELWA was given 137 acres by the government over 50 years ago and has been involved in radio ministry, education, and medical outreach at ELWA Hospital.  Prior to the war, ELWA was considered the "Cadillac of mission hospitals" with over 200 ex-pats on campus.  Today, there are only a few SIM missionaries (none of them doctors), handling a very large load.  Three doctors on loan from the Ministry of Health are keeping ELWA going while Dr. Rick Sacra is on home assignment in the USA.  

View from the guesthouse -- ELWA housing is right on the beach!

One of the many houses on ELWA's campus that hasn't yet been renovated.

 ELWA Hospital 

Our welcoming team (L to R) -- Jackie (dental hygienist), Kristin & Keith Chapman (dentist), Dr. Alfredma Chessor (Liberian doc trained in the U.S.), Natalie & Ben Colby

Liberia is certainly a place with huge need.  If we go to Liberia, we would primarily be stationed at ELWA Hospital with opportunities to teach at the medical school and JFK, eventually helping to start residency programs in country.  Please pray for ELWA Hospital as they are going through some tough transitions right now.  And keep the McCropders in your prayers as we try to discern God's calling for our team.