25.11.20

Global Missions Health Conference 2020

 by Logan


Last weekend was the 25th anniversary of the Global Missions Health Conference, normally held in Louisville, KY.  This year, however, the conference was completely virtual due to COVID-19. I was really impressed with the virtual format, especially since this was the first time they did it completely virtually. Over 2000 attendees logged on to a newly redesigned website to worship together, learn from each other, and get inspired about medical missions and God’s call for their lives. 

There were some incredible plenary speakers, sharing about topics such as hearing God’s call to go to difficult places, the Christian response to the coronavirus pandemic, and dealing with mental health issues overseas.  There were some great times of worship, as well as a variety of different breakout sessions.  I led a breakout session about healthcare education as mission. 

My hope was to inspire people who are interested in missions and global health to consider healthcare education as a primary way to answer God’s call to missions.  I shared about what we are doing at Kibuye Hope Hospital, with medical student education, the current stage professionnel (“internship”) program, as well as our desire to see FM and surgical residencies start in Burundi. I talked about how medical education multiplies the effect one person might have, because they are playing a role in treating all the patients that their learners will see in the future. I also discussed the value of discipleship and mentoring relationships that develop naturally as a result of education.  

I used Moses’ interaction with God at the burning bush (from Exodus chapters 3 & 4) as an illustration of a way to respond to potential resistance to medical mission work in general, and specifically medical education missions. I don’t think the talk is currently available, but I believe all of the sessions will be uploaded soon at medicalmissions.com.

In recent years, our team has been well represented at this conference. In 2019, Alyssa Pfister was on a panel discussion about medical education, and led a breakout session about rural medical education. In 2018, Eric and Rachel McLaughlin moderated a panel discussion about missions and marriage, and Eric also spoke about resiliency in missions, using chapters from his book, Promises in the Dark, as illustrations.  

The GMHC is intricately linked to the story of our team in a number of ways. For example, Eric and Rachel actually met at the GMHC in 2003, so the conference serves as an anniversary of sorts for their relationship. The original “McCropder” team was officially formed at the GMHC in 2007, and it was through connections that were made there that they landed at Tenwek Hospital for the Samaritan’s Purse Post-Residency Program. I would be willing to wager that this connection to the GMHC is probably true for so many other medical missionaries.  

Personally, I first attended the GMHC in 2008, when I was a third-year resident at Cox Family Medicine Residency in Springfield, MO. It served as an informal interview weekend as I was applying to the Via Christi International Family Medicine Fellowship. This fellowship led me to Tenwek Hospital and is where I first connected with the McCropders.  

In fact, I remember that a strange thing happened at that conference.  I was listening to the plenary speaker talk about how important it is for God’s word to spread all over the world and how we need to be willing to take it there, even if it’s difficult, when I heard a word from the Holy Spirit say, “Learn French.”  I even wrote it in my notes.  But I had no idea what it meant.  I had studied Spanish, and had been on medical missions trips to Bolivia, and had always assumed that learning Spanish would serve me on the mission field someday. Little did I know! It was also at the GMHC in 2013 when Julie and I felt God stirring our heart towards long-term medical missions, and eventually led us to Burundi to rejoin the same team we had first met in Kenya. 

God has a way of using this conference to speak in a unique way and guide His followers on the path that He is leading them. If you didn't get a chance to attend this year, I hope you will have the opportunity someday in the future. 

15.11.20

COTW (x2) : PSGN and diaphragmatic hernia

(from Jenn)

I've seen such a variety of diagnoses during my short period of time here at Kibuye.  I find myself reading more articles and textbooks now than I did even during residency.  I love learning and I love this job. Some diseases are impossible to diagnose  (ones where you need renal biopsies, or specific antibody or serologic testing for... which we don't have available here) while some, if you know what to order, are a joy to work through.  

For example, we had child present with edema, hypertension, and cola-colored urine.  We (the students and interns and I) worked through the differential diagnosis. On admission the doctor had asked for a study of the urine, but the lab stated the urine was to discolored and wouldn't work.  So we worked through the differential - they considered nephrotic syndrome and congenital heart disease, renal insufficiency.  I said that these were good ideas, but we should try again for a urine analysis.  It came back the next day positive for blood (causing the cola-colored urine), but only mildly positive for protein.  For the diagnosis of nephrOTIC syndrome, on expects to see A LOT of protein in the urine. So this diagnosis didn't quite fit. I asked the team to try to come up with another diagnosis to put on the differential. Someone suggested nephrITIC syndrome and I agreed.  I asked the team if they knew one more test we could do to try to narrow down the diagnosis, and we decided to obtain an ASO titer.  If positive, it tells you that the patient has had a recent infection with Group A Streptococcus (AKA the bug that causes strep throat and scarlet fever, which can eventually cause glomerulonephritis OR rheumatic heart disease).  It came back positive. So we had the diagnosis - Post-streptococcal glomerulonephritis.  

While most of the time it's fun to figure out a diagnoses, a class of diagnoses that are not so fun are congenital malformations concerning major organs that, here, result in rapid decline and death.  

This baby was born at term or near term and had rather significant respiratory distress right after delivery and was therefore transferred to us in the NICU.  The baby's distress did not improve, even with high amounts of oxygen so we decided to obtain an x-ray which showed this. 

This is a large diaphragmatic hernia - where the diaphragm does not develop correctly leaving the possibility for the intestines and sometimes the spleen and kidney to enter into the chest area.  This causes a problem because the lungs therefore cannot develop correctly.  With many disease, there is a range of severity. Sadly for this baby, the lungs seemed to be quite underdeveloped which could not be fixed by a surgery.  

Fortunately this is not the norm. More times than not, the NICU is full of babies born too early who need a little bit more time to grow and develop, who need to be closely monitored for infection and who need to live in a controlled setting before being able to go home.  

7.11.20

"Let the little children come to me"

It is a short Bible story that appears in three Gospels, and here is my summary: Adults think that Jesus shouldn't be bothered with kids during his tour of public ministry. But when they try to keep the kids away from him, Jesus becomes angry and says: "Let the children come to me. Don’t stop them! For the Kingdom of Heaven belongs to those who are like these children."

We read this passage during Tuesday night Bible study recently, and it was a needed reminder to me that God values me and all people, not because of how smart, good, useful, productive or mature we are. Kids are not known for leading the human race in those characteristics.

God loves kids as they are and thinks they are important enough to spend time with them and bless them. One Bible commentary says this about the end of this story in Mark 10:16, "Jesus' loving action vividly illustrated that His blessing is freely given to those who receive it trustingly. The intensive compound verb "blessed" (kateulogei, imperf., occurring only here in the New Testament) emphasizes the warmhearted fervor with which Jesus blessed each child who came to Him."

So Jesus didn't just tolerate the kids; he wholeheartedly, gladly, intentionally blessed each child.

This past year, God has given Matt and I an opportunity to see just how much he loves his kids in Burundi. Because nearly all of our work here has revolved around kids in some way (it just played out that way), we have started to notice how much He is intervening on their behalf to bless them, care for them and remind us all that they are important.

Of course the main project that brought us to Kibuye was the Pediatric Ward at the hospital. When we arrived, I was surprised to see that it was the largest building on the campus, more than twice the size of the next biggest ward. Why? Because almost half of Burundi's population is under the age of 15. And because kids are important to God.


The playground at the Peds ward was completed this week!


Another construction project that Matt immensely enjoyed was the preschool and kindergarten for the local primary school. I loved watching the design evolve to take into account the future users - very short learners! Hence the windows arranged at various heights, the benches built into windows, and the minimal use of steps. We loved seeing kids of all ages who were magnetically drawn to it and intuitively explored it. Hopefully it serves them and their teachers well! (You can see some of the new pre-school students in Jess's blogpost.) Why spend time creating such a beautiful space? Because kids are important to God.


All smiles and giggles!


My roles in Kibuye have gravitated toward serving kids, too. I've already blogged about boiling lots of eggs each week for kids who are supported by the malnutrition program at the hospital. But I also get to jump in on the occasional sickle cell clinic to color with kids. Because playtime is important, too.

Elise and I joined the med students and interns to color with about 50 kids last week. 


I've had fun connecting with the Serge kids, too. I start my weekdays with "read-to-self" time with elementary boys at KHA, and I look forward to spending time with the older girls during our weekly crochet club. 

Our current crochet project is to create a few of these octopuses to give to preemies at the hospital. Apparently the squishy arms remind babies of the umbilical cord and comfort them.


Honestly, I'm not a exactly a "kid-person" who just can't get enough of them, and yet, God is opening my eyes to see what he sees: not just their future potential, but their present value and God's image in them that is worth celebrating, serving and just plain getting to know. I am glad that this Kibuye season turned into a reminder for us of how important these little ones are to Him.

And maybe, keeping these kids in view will make me a little more like them, more ready to notice and receive God's kingdom and the unmerited blessing Jesus offers.

4.11.20

Saving Face, Part 2, “Shame, Pain, and Beauty”

 by Carlan

The Sunday after my ladder fall, as I was feeling just good enough to get out of the house, I decided to attend the French service at our local church here in Kibuye. I took some Tylenol and headed up the dirt road to the mud brick and plaster building at the center of our campus. It was my first time out in the community with my “new” face and I got more than the usual number of stares from kids and adults as I passed them on the trail. With two black eyes, a swollen lip, and healing wounds all over my face, I know I looked like a frightful sight, but I had to go up to God’s house and give thanks for the ways He had protected and preserved me.

During the singing time, we sang a 4-line song called “My Beautifier” by a Nigerian musician named Chris Shalom. I cannot vouch for the singer-songwriter’s character or doctrine and I likely would never have heard this song were it not for the committed musicians of our local congregation. It is a simple song yet it prompted some deeper reflections that I want to share with you. The four lines are:

My Beautifier, You’ve taken away the shame // You’ve taken away the pain // You made my life so beautiful (repeat first two lines) // You’ve made me just like You.

My first thought centered around that title “Beautifier.” I smiled at the creative use of language — the term is immediately comprehensible even though I was pretty sure it is a neologism. (I checked, neither the Oxford English Dictionary nor Merriam-Webster have definitions for “beautifier”.) It also made me think of the similar term, “beatify,” which, to my understanding, is the penultimate step in the Catholic process of investing people with the title “Saint.” In a much more profound way, Christ is the One who declares us and makes us to be saints, holy ones...not on the basis of good works we have done or miracles we have performed, but on the basis of His perfect life and vicarious death and resurrection.

The removal of shame occupied me next. Having just felt the eyes of my neighbors fall on my disfigured face, that line struck a visceral chord in me. Jesus takes away my shame. It is my shame. I deserve it. And He removes it, not by snapping His fingers and causing it to disappear, but by bearing it Himself. He took it upon His person and suffered dishonor for His beloved sheep.

The same process happened for pain. Having spent the prior five days with daily pain, thinking about the effect of Christ’s work, the relief He brought through His own afflictions, humbled and encouraged my heart. This is truly a beautiful life, the one purchased by Christ.

By the time we got to that last line, I was starting to tear up. “You’ve made me just like You.” I’m aware of my lingering sinfulness and the struggle to daily love like Jesus loves...but Romans 8:30 says, “those whom He predestined He also called, and those whom He called He also justified, and those whom He justified He also glorified.” All those verbs are past tense. So in some very real but difficult to realize way, having been predestined, Christians are already glorified. And while all people are image-bearers of God, there is some special way in which the Redeemed are image-bearers of Christ. That is, after all, why we are called “Christians” (little Christs, Acts 11:26).

So my facial injuries, the source of my shame and pain, are somehow useful in making me just like Jesus. He was beaten and disfigured, like one from whom men hide their faces (Isaiah 53:3). Could my facial injuries help me to identify with Jesus Christ? Could the visible wounds and scars serve as a reminder to me and others of what the Son of God suffered for His Passion? I will then count them as a blessing and a gift, if they make me more like Jesus.

However, beyond even the cosmetic, the character development that God is working through this trauma and its sequelae conforms me more into the image of the suffering Servant, the Lamb of God, the once-for-all Sacrifice for Sin and the Great High Priest. Wow! I have a hard time wrapping my head around the genius of God that can convert something like smashing your face into the ground into a treasure of character growth and sanctification, but I that is what He did for me all in the span of singing a few lines over and over again. May Jesus Christ be praised!

Here is the Chris Shalom YouTube video — song starts around 0::45s