The Growing McCropder Family

As noted previously, the McCropders consists of three families and 2 children, for a total of 8 individuals. Recent events have pretty dramatically increased that to 11 individuals.

As many know, little Elise Cropsey is set to have a baby brother in the early part of the next calendar year. After an enthusiastic conversation with a Swaziland ophthalmologist a few months ago, John has taken to calling his new son "The Swaz". Of course, John is kidding (we think), but this no longer matters, as the rest of us will most certainly call this kid The Swaz for the rest of his childhood. In fact, the "the" part must also stay, as in "Hey The Swaz, come here for a minute."

The McLaughlin family will be increasing by 50% with the coming of a new baby in late April. We may choose to save the more flamboyant baby names for later children, but we are nonetheless very excited.

And Anna Fader will be getting up close and personal with Amharic culture, as the Faders adopt a little girl from Ethiopia, some time between now and the time we depart for Africa. We are blessed and we thank God, who has filled us to overflowing.

Sharing with the Studs

Last week, one of the national medical student organizations was holding "Primary Care Week" to spotlight some of the disparities and needs in primary care. As part of this, some medical students at the U of M were holding a series of lunchtime talks. One was centered on international medicine, and I was invited to speak.

It was a great opportunity, and fairly well attended by the medical students (or "studs"), with whom international medicine is a very popular topic. For my part, I talked a little about what our plans are for the future, as well as my past experiences abroad both as a medical student and as a resident.

Afterwards, multiple students came up and asked us about a number of topics. The motivations towards international work are various, and for the most part, admirable. The enthusiasm seems to be highest earlier on in medical education, when principles shine bright, and seeming problems with practicalities seem easy to overcome. Given that the options entertained in Africa for us now all have to do with education of Africans, the way to most effectively guide students and residents remains a particularly important topic.

Operating Onboard the Africa Mercyship, Part II

The most poignant and thought-provoking case I experienced while in Liberia was that of the 6 week old boy pictured here. He was finally brought to the Mercyship after a one week history of a painful lump in his groin accompanied by persistent vomiting and lethargy. It turned out to be a strangulated hernia (intestines which died as a result of getting stuck in a defect in the abdominal wall). When he came to us he was severely dehydrated, weighing only 3 pounds! He was too sick to even survive an operation, so we did our best to resuscitate him. In the end, we could not save him, and he died in his father's arms the following day. The father's faith challenged me, as through tears he acknowledged God's sovereignty saying, "God gives and God takes away." This was also Job's response to losing his entire household and all his children as a result of Satan testing his devotion to God in Job 1:21.

While I know that God can, and will, ultimately bring good out of this situation (Romans 8:28), I am also convinced that God did not design for this child to die for lack of a simple surgical procedure. So how is it that this baby died? The simplest answer is that we live in a fallen world, where death is as certain as life. All the same, God has chosen to redeem this fallen world through his church (Ephesians 2:10). What a privilege to be a part of bringing about the Kingdom of God on this earth! Though everything will not be made completely new until Jesus comes again, until then, I hope to be found redeeming the world, one hernia at a time.

Fat = Healthy

The Tompkins family at Mukinge Hospital, Zambia, who are currently part of the Post-Residency Training Program (which we will enter next year), have a great comment on one of my favorite Africa cross-culture-isms. Their blog is here. Enjoy:

"While we were sitting outside at Violet’s house, several kids came around to stare at the funny visitors. Some of the kids were Violet’s grandchildren or nieces/nephews and some were just neighbors. Violet was commenting on the fact that Zachary is as tall as her 5 year old granddaughter and then she said that it made good sense that he was tall because “his father is tall and fat, and his mother is tall and fat.” She said this complete with hand motions demonstrating the enormity of my body habitus. Well excuse me, but Elissa is with child (and looks beautiful by the way) and I’m down over 20lbs in the last 3 months. So I’m not sure if by fat she meant “healthy” or just “fat”, and I didn’t bother to ask. We laughed and I know she didn’t mean anything hurtful but, speaking only for myself, I know I’m quite huge compared to most folks in the village. However, by my calculations, if I continue to drop pounds at this rate, I’ll weigh about 13 lbs when we return home in 2 years. And in 6wks Elissa is going to drop 30lbs pretty quickly. So there you go…there is hope for us after all."

Most and Least Corrupt Countries

This was getting some press today, as the new rankings of corruption have been published. I have no idea how valid these are, or what the criteria are. Out of 180 countries, here are some selected corruption rankings:

#1: Tie between New Zealand, Sweden, and Denmark
#4: Singapore
#18: USA (in case you wanted to know), tied with Belgium and Japan
#36: Botswana, the best ranked in Africa
#54: South Africa
#72: Swaziland (interestingly high for the last absolute monarchy in Africa)
#115: Niger, Zambia tied with others
#138: Liberia
#141: Cameroon
#147: Kenya
#166: Zimbabwe
#171: Equatorial Guinea
#173: Sudan
#180: Somalia

Most of the above African countries have received some attention (sometimes just a bit), so for those trying to catch of hint of our future location from the above list, take your best shot. =)

We're not at all trying to be secretive about that question, but there's a lot of exciting stuff happening on that front, and we'll be better equipped to give you some news in a little while, we think.

Operating Onboard the Africa Mercyship

The large vessel pictured here is my temporary residence in Monrovia. This enormous hospital boat is docked here in the country of Liberia for a couple of months and is run by Mercyships. I am here for 3 weeks doing surgery (mainly hernia repairs).

The six operating rooms on board are shockingly well-equipped, and the amenities are fabulous - we even have air conditioning. The boat is so large that I sometimes forget that I am even on a boat, until I look out and see the horizon bobbing up and down.

One highlight thus far has been experiencing the community life on the boat. Eating, working, worshiping, playing, and interacting with the same 400 people from dozens of countries creates a very unique environment on board. Despite the diversity and rapid turnover of short term personnel, relationships are rich and the hospital care is of a very high quality. I'm looking forward to 2 more great weeks.

Jason Departs

The Faders are driving to Chicago tonight and Jason will depart for Monrovia, Liberia, tomorrow, as Heather and Anna go on an extended road trip visiting family and friends while he is gone. There is some Internet connection on the ship, so check in to the blog in the next few weeks, as we hope that Jason will be able to relay some of his experiences. Please remember the Fader family in your prayers until their return (and even afterwards, if you really want to).

The University of Michigan and Africa

All of the McCropders have lived in Ann Arbor for part of the years of medical training, and this makes for an irresistible association with the University of Michigan, stronger for some of us than others.

As a whole, we see this as a huge plus, and the connections with the University will likely have effects in years to come that we can only hypothesize about at the present. As it turns out, within this vast health system, there are a number of medical projects in Africa, and we have been trying to understand these and how we might fit in.

Yesterday morning, Jason and Eric had breakfast with Dr. Andy Haig, Professor of PM&R (physical rehabilitation), who has been involved in two of U of M's Africa projects. The largest project is in Accra, Ghana, where for many years the health system, particularly the OB-GYN department, has been involved in medical education. The most impressive thing that I've heard from this thus far is that, during the time of their involvement, the number of trained OB-GYNs who finished and then stayed to practice in Ghana has risen dramatically. In these times of the highest educated Africans leaving their homes in the so-called "Brain Drain", the significance of this can not be overstated. It is our understanding that U of M is wanting to expand their involvement in Ghana in a big way over the next several years across the board, to include not only different medical fields, but business, pharmacy, nursing, engineering, social work, etc. - a very large endeavor with ambitious but feasible goals.

Dr. Haig has been involved in a smaller project in Liberia, in conjunction with Mercy Ships, in which he has met with numerous people in the government and medical education, regarding possibly developing some kind of Rehabilitation program, which is virtually non-existent there at present. He told us about the state of education, namely that clinical faculty to teach the students are exceedingly rare in these years of post-civil unrest, and thus the graduating physicians are notably undertrained. It's interesting for us to consider this (or a similar opportunity) as a place to invest in the future.

The last project with which we've become acquainted is headed up with the help of Dr. Rusty Chavey, who is also Eric's advisor within Family Medicine. A couple years ago, he teamed up with the U of M business school and they have been working with a hospital in Uganda, with a goal of helping them to improve the delivery of medical services and their own business model, to the end that they could be more financially self-sustainable, and stretch their resources further to provide more care.

What is the PRTP?

We have written a little bit about this before, but given the recent news that all of us will, in fact, be spending our first two years abroad with this program, we thought it worthwhile to give a little more explanation.

The Post-Residency Training Program is a 2-year fellowship funded by World Medical Mission, the medical arm of the larger international relief organization Samaritan's Purse (which is chaired by Billy Graham's son Franklin). WMM does a lot of short term work (including sending the McLaughlins to Bangladesh last year), but is not a long-term agency, and thus we will be looking for another sending agency when our 2 years is up. This fellowship program has been sending people out for a few years now (not just to Africa, but all over the globe), and its purpose is to bridge the gap between residency and longer term work by providing funding and mentorship while you work in a hospital in the developing world.

WMM partners with dozens of hospitals around the world, that are run by other organizations. When someone (like us) is accepted into the PRTP, they will work under one of these mission hospitals, where the fellow provides staffing, and the long-term docs provide mentorship - medical, cultural, spiritual, etc... A big plus for this is that expenses are covered by WMM, including travel, and they partner with Project MedSend, who, in the past, has been very ready to cover student loan payments for the fellows for the 2 year period.

They have never taken on a team of 3 families (4 doctors) before, and we appreciate the flexibility they have shown in working with us. Now begins the location question, but more on that later.

A Big Step Forward

As of yesterday, we received word from Scott Reichenbach, director of the Post-Residency Training Program for World Medical Mission, that all of us have been accepted as fellows into their program, for the two year term starting next fall (2009).

We will be posting more in the next few days regarding this development, regarding more specifics of the program, as well as what this means for location, which is always everyone's big question (ourselves not excluded). For the time being, we'll say that we are all very excited, because (1) this was our preferred path for starting out on this road to African medicine, and (2) that after many months of plans and discussions, we are taking a large step forward together.