Happy Birthday McCropders!

The Global Missions Health Conference in Louisville, KY has a special place in each McCropder's heart.  (For the McLaughlins, it is particularly special since it is where they first met.)  It was at this conference in 2007 that the McCropders first came to officially be.  You can read more history about that here.

For those of you not familiar with this conference, it is one of the largest annual medical missions conferences.  It's an amazing experience to rub shoulders with thousands of people who are all passionate about the same thing -- bringing the gospel of Jesus Christ through medicine.

We went into this conference with very different goals than previous years.  Instead of visiting every booth trying to figure out what to do with our lives, we were able to stay primarily at the World Harvest booth and talk with people.  Of course, there were still other booths to visit.  The LandCruiser booth was particularly popular with the boys as were the organizations that help provide engineering expertise, water, lab equipment, etc. for mission hospitals.

One of the highlights this year was meeting up with friends.  There were lots of people that we met at Tenwek who were at the conference as well.  It was fun to catch up.

Happy 4th birthday, McCropders!  During our first 4 years together, God has nearly doubled our numbers (with the addition of 5 more children, Alyssa, & Carlan), provided us with two invaluable years of experience and service at Tenwek Hospital, and guided us to a wonderful teaching opportunity in Burundi.  He has been so faithful.    

The McCropders (minus Elise & Micah who were in Michigan with grandparents) in front of the world map at the conference.  We were excited to see several other tacks besides ours pinned in Burundi!  

Reunions

When people ask me what I miss most about Kenya, many things come to mind, but mainly the wonderful people we got a chance to know.  Sometimes people are surprised by my answer: the community (of course, had they read our "top 10" list this would be expected, right?!).  These past 2 1/2 months the McCropders have been together just a handful of days, and never in complete form.  We met in September for our World Harvest orientation, sans kids.  We met in October for PFR, but without the Cropseys, Carlan, and Fader kids.  Finally in November we were all together for the Knox Missions Weekend (except Carlan), but it was such a busy time that we barely saw each other!  The year has been a whirlwind so far for all of us, with many miles on the car or a newborn in the house.  It has been wonderful to reconnect with friends and family, but our kids were especially excited when they finally got a chance to see each other again.  I was holding Maggie when she saw Elise for the first time in 3 months and she got rigid with excitement, then super wiggly!  It was sweet.  Here are a few photos of our kids reconnecting.  What a blessing to have McCropders.

The "boys' club":  Micah finally has some friends!

Maggie and Abi hiding behind the snack table at a speaking engagement...

The girls are all helping Ben out with some tummy time:

Kids' picnic at Danny and Abby Fahim's house:  Elise, Abi, Greta Bast, and David Fahim

Maggie and Ben meeting up with an old friend from Tenwek, Liam Banks:

COTW: My toughest case

As we travel around these days, one of the questions that often arises is "what is the toughest case you have done in these past two years at Tenwek?" My thoughts usually fall back to the time when a baby was born at Tenwek with respiratory distress. An x-ray confirmed that the baby had an abnormal left lung which was too big, thereby compressing the heart and the normal right lung. For those interested, the baby had Congenital Cystic Adenomatoid Malformation.

Although I had never done a pneumonectomy in a neonate, it was necessary to remove the entire left lung to save the baby's life. I was thankful to have one of my very competent residents, Agneta, operating with me on this 3-day-old baby as we removed the abnormal lung and tied off some very small, yet important blood vessels right next to the heart (see second picture if your stomach will not be queasy). One bad move and the baby’s life could have been in jeopardy. We finished the operation and closed the chest, and since there was then a big empty space in the left chest, we filled it with water (sterile, of course). The baby did quite well, and I recently heard from Agneta that she saw the baby back in clinic and the baby continues to do fine.

Although this child will likely never run with the Kenyan marathon team, it seems that God has granted her a normal life through this nervous surgeon and his resident.

Autumn and Things of Home

We arrived in Michigan last week, and the effect was immediate.  All the leaves were either gold, red, or already on the ground.  We had left an early autumn in Tennessee to arrive the next day in late autumn.  We bundled up in sweatshirts, and stepped out into an evening of 40 degrees fahrenheit.  It was the coldest weather I had experienced in two years, hands down, and it felt wonderful.

All of these external cues: the pumpkins, the raking of leaves, the football games, the Michigan cider, the winterizing of the patio furniture... All of these bring back an entire sphere of the world that I couldn't ever seem to conjure in my imagination, no matter how I tried, surrounded as I was by equatorial climate.  It's a sphere filled with decades of people and places, some long gone, now rushing back.  In short, it's my home.

I sympathize with people who read this and have trouble fathoming how I would rejoice at this after living 2 years with 60-80 degree weather year round.  And maybe I will be taking a different tack by March.  However, I'm learning that though these seasons may not be better than year round temperate weather, it is still good.  It's good, and it's my home.  My Kenyan friends can yearn for the dry and rainy season.  I'll take spring, summer, autumn, and even winter.  And this is itself a good gift and a reason for rejoicing.

Last Sunday, for the first time in two years, we pulled up to Knox Presbyterian Church.  All these friends, all these acquaintances.  Some elements of the church service so skillfully done.  Some idiosyncracies are a little more quirky, but all of them so wonderfully ours.  So wonderfully home.

A good gift.

Knox Missions Sunday

Dear Friends and Family in the Ann Arbor area,

We would like to invite you to Knox Missions Sunday this weekend.  The McCropder team (minus Carlan in LA) will be leading this year's missions Sunday at Knox Presbyterian Church.  Eric will be involved in the music, John will be preaching the sermon and Jason will be leading the Adult Education hour.  We would love for you to be there to hear about what God taught us in Kenya these past two years and the plans He has called us to in Burundi.

Worship Service: 9:30 am
Adult Education:  11:15 am
Address:  2065 South Wagner Road, Ann Arbor MI, 48103

Hope to see you there!

Case(s) of the Week: Corneal Transplants

The cornea is the clear "windshield" of the eye.  If anything causes it to opacify (as in photo #1) or become warped, vision is lost and the patient is rendered blind.

Photo #1:  Severe Limbal Vernal Conjunctivitis with corneal overgrowth in a teenager

In Africa, many lose their vision from corneal diseases such as trachoma (chlamydia of the eyes transmitted by flies (#2a & #2b)), ulcers (#3) and keratoconus (warpage/bulging of the cornea (#4)). 

Photo 2a:  Masaai woman with trachoma

Photo 2b:  Above woman with trachomatous corneal scarring, right > left;

also with cataracts in both eyes causing "white pupils"

Photo #3:  Boy with severe allergies (giant papillary conjunctivitis) causing "shield" ulcer

Photo #4:  Teenager with keratoconus (notice the cone shape of his corneas)

These blinding diseases often cause permanent damage, requiring corneal transplantation to recover sight.  Transplanting the entire front of someone's eye is no small task.  Here is the story of how God enabled us to undertake such a project at Tenwek.

During residency, Dr. Sadeer Hannush (corneal specialist at Wills Eye Hospital) was a mentor to me, and we discussed the possibility of some day setting up a transplantation program in Africa.  So it was with much excitement in March 2010 that Sadeer stepped off the airplane in Nairobi with his teenage daughter Monica and a large ice cooler.  Inside the cooler were 30 corneas given by American organ/tissue donors and the Lions Eye Bank of Delaware Valley.  Bringing human tissue on an airplane across several international borders was NOT an easy task!

Dr. Hannush, Cropseys and Monica in our home at Tenwek

In order to establish a permanent transplant program at Tenwek, Dr. Hannush was able to persuade several companies (Lions Eye Bank of Delaware Valley, Moria, Alcon, AMO, Wills Eye Hospital and BioTissue) to donate over $200,000 worth of tissue, surgical supplies and instruments.

Dr. Hannush presenting the eye staff with a new Goldmann Tonometer donated by Wills Eye Hospital for checking intra-ocular pressures

Dr. Hannush performed 22 corneal transplants in four days while at Tenwek.  These are likely to have been the first transplants of any kind done in Western Kenya or at Tenwek.

   Dr. Hannush doing a corneal transplant at Tenwek with Dr. Roberts assisting

Since that week, we have received many shipments of corneas from Delaware Valley as well as the Alabama Eye Bank.  Can you believe that a box of fresh corneas can be sent via Fed Ex from the U.S.A. to Tenwek in 4 days?!  Over the last year and a half, Dr. Roberts and I have performed over 50 corneal transplants.  The eye unit is now receiving referrals from all over Kenya.  We even received an e-mail inquiry for a boy in Cameroon, West Africa, through a crazy connection with Dr. Hannush's church in Pennsylvania.  Dr. Ben Roberts just performed the boy's transplant surgery last month at Tenwek.

A corneal transplant in Nairobi costs thousands of dollars, and the waiting lists can be over 6 years.  Due to the generosity of U.S. eye banks and other donors, we've never had to turn anyone away for lack of money, and we've been able to keep our waiting list under 6 months.

There are many stories to share from this program.  One that really struck me was the story of Silas.  Silas is a university-educated teacher in his early thirties with keratoconus.  As his disease progressed in both eyes, he found himself unable to teach.  He saw the best eye care providers in Kenya, but was left blind because he was unable to afford transplantation.  He told me that he had nearly lost all hope for life and God.  Dr. Hannush was able to transplant his right cornea in March 2010.  He recovered 20/20 vision as his eye healed!  He told me God had given him back his life.  He was so excited to be able to see again and to teach his students.  Just before I left Kenya, he became one of only two patients at Tenwek to have his second eye transplanted.  See both patients pictures below.   

Silas, one week after his first transplant (left eye).  

Note: Africans often do not smile for “formal” pictures.  He really is happy -- trust me!

 Silas, the day after his second transplant (right eye) just before we left Kenya.

Kiptum (a teenager with keratoconus), one day after transplantation #2.  He was my only other patient to have both corneas transplanted before we left Kenya.

In conclusion, we are very thankful for the more than 70 patients who have received their sight back through this transplant program.  We pray that many more will continue to be blessed in body and soul over the coming years at Tenwek.

*All patient photos and stories used with permission*

He had no name

He was the third foster baby that we had this summer in Kenya. He only stayed in our house for a week, but he has stayed in my heart and in my mind every day since then. If you could know this baby, then he might stay with you for a while, too.

This baby boy was wrapped in a blanket at the door of a church somewhere near Tenwek. The police found him and brought him to the hospital. Because he was in good health, he came to our house the next day. He received immediate, constant, and enthusiastic affection from Anna and Abi. Lots of it.
He was beautiful! In my opinion (general consensus?), many Caucasian babies seem to require several months to grow into themselves before they become cute, but this baby boy, like most African babies, was unbelievably cute. The only thing that may have detracted from his cuteness was his scabies. I discovered his scabies when I began to feel strangely itchy myself. A small price to pay to be able to take care of such a sweet baby.
We began to pray for his birth mother, who is certainly facing bitter circumstances. And we began to pray for God to work in the hearts of a family (who must be residents of Kenya) who would adopt him.

He had no name.

This was a jarring thought to me. He was about four months old, and he was well-fed, indicating that he surely had a name and a mother who took good care of him. But suddenly he lost his identity, his family, his name.

I gave him the name Joseph. Joseph is a common name in Western Kenya, but I chose it for another reason. I chose the name Joseph as a reminder that God can use baby Joseph's life the way he used the life of Joseph in the first book of the Bible. The original Joseph was also abandoned by his family and faced severe trials as he grew to adulthood. In the end, however, Joseph testified that "God meant it for good" as God used Joseph's awful past in order to bring good for thousands of his people. Let's pray and believe that God will do the same in this Joseph's life.

Busy

We thought everyone would be asking "So, how was Kenya?"  A lot of times they don't, and maybe this is because we have managed to keep people abreast through this blog and other means.  Instead they ask "What is it like being back in the US?"

This is a great question, because it takes a bit of consideration, and with any luck, the fruit of the conversation may be of benefit to both people.

If I were to pick one word, it would be Busy.  On one level, this is surprising.  After all, this is America, land of convenience and efficiency.  Websites open instantly.  You can drink water straight out of the tap. You can drive (at night) to a grocery store that is open (at night) and well-stocked (always) on excellent roads with traffic lights that have little triggers to turn green when people drive up.  Usually, conversations are shorter, because I don't have to repeat myself three times to get my American accent understood.  Meals instantly appear from freezers and/or delivery vehicles.  You get the idea.

And yet, we feel like we are running around constantly, with far fewer hours than we need for the tasks before us.  Why?

#1: We are sort of working from home, which means that all of our planning, networking, and presenting goes from the moment we wake up, until the moment we go to sleep.  This maximizes our productivity. Except that it doesn't.  Because of #2:  We have multiple small children.  This effectively means that we may as well stay on "Africa time", because that is really the only option available to us.  And #3: America is a land where your productivity is a common proxy for your worth, and thus being here makes us all feel that we have to be producing all the time if we are worth anything.  We are definitely talking about quantity over quality here.

And thus, without doing any medicine, in a land full of "time-saving" devices and systems, I feel busier and less efficient.

And yet, at the heart of things, none of the above are the root reason.

The year before us is somewhat daunting.  We have a lot of catching-up to do, a lot of training to complete, and a lot of support to raise.  I overstretch myself trying to get all this done.  I have confidence that this path we're on is one that God has started.  In fact, he promises to finish it (Phillipians 1), but I take it on myself.  I show my lack of trust in God's faithfulness by bearing these burdens myself.  Seemingly, this is what Paul calls starting with the Spirit, then finishing with the flesh.  (Galatians 3) Just as the burdens of patient care in Africa could loom too large for my abilities, so now.  And just as then, God is not calling me to do all things perfectly, but to obey and trust him with the times and gifts he has given me.

Can I rest?  Do I dare let things out of my control?  Will I trust God that he will complete his work in us?  Will I honor him by recognizing that it is not dependent on me?

Isaiah 30:15: "In repentance and rest is your salvation.  In quietness and trust is your strength."

Take a deep breath.  Know that he is God.  He will be glorified in the earth.  This is against our culture in a big way.  And, you who read this, I pray that God would lead you in it.  As you read this, please pray for us that we would led as well.

Prescription for Renewal

This last week, many of the McCropders got a chance to do something they've never done before:  speak at a CME conference.  During our last year at Tenwek, a general surgeon named Mike Cheatham came for a few weeks with his family, and got to know us.  He helps put on an annual conference called "Missionary Medicine" which provides CME (continuing medical education) along the lines of things doctors would encounter if they were trying to practice overseas for the first time.  The conference lasts for a day and a half and leads into Samaritan's Purse's annual "Prescription for Renewal," a time for doctors to get together in Asheville, NC for spiritual retreat.  Jason, Alyssa, Eric, and Rachel were able to give the majority of the dozen or so lectures presented at the CME seminar (John was supposed to be there too but was unable to come due to...family issues!).  It was a great chance for us to tell our story to a larger population, give thanks to SP and the post-residency program for the support they've provided, and reconnect with friends.

As we joked several times during the conference, we were basically the youngest docs there, and felt rather underqualified for the task at hand, but really enjoyed a chance to lecture and teach people some of the things we've learned these past 2 years.  Eric gave lectures on suffering, typhoid, malaria, and the "word and deed" aspect of medicine.  Jason gave lectures on the public health value of surgery and late presentations of surgical diseases, as well as the value of educating nationals as a missionary doc and the McCropder story.  Rachel spoke on HIV in pregnancy and OB in a resource limited setting, and Alyssa talked about vaccine preventable diseases (all this to say if you'd like a 30-45 min lecture on any of the above topics let us know!).

It was a great weekend, and the leaves were at peak color in Asheville, so the setting was beautiful.  We hope lots of people were able to connect with our story and will come visit us in Burundi in years to come.

Introducing the Newest McCropder

We (the Cropseys) were excited to be heading to the University of Michigan hospital at 2:00AM last Thursday.  Cropsey #3 had given us a few false alarms the week before, but it now appeared his arrival was imminent.  John was scheduled to speak at the Prescription for Renewal Conference in Asheville, NC later that evening along with the other McCropders.  His flight was booked for 1:50PM in the afternoon.  Since this was a third baby for Jess, surely we thought he would arrive relatively quickly and John could still catch his flight in time for the conference.  Well, things don't always go as expected!  By late morning, it became apparent that this baby wasn't coming anytime soon due to his poor head positioning, so John canceled his trip.  The munchkin finally arrived at 3:28PM, October 13th, weighing 7 lbs, 15 oz and measuring 20 inches long.  After prolonged negotiations, nearly requiring arbitration, a name was decided just in time for discharge:  Samuel Isaiah Cropsey.  

Elise & Micah were super excited to greet their new little brother.  Elise definitely has natural mothering abilities, but Micah will need some continued coaching about what it means to "be gentle" with Baby Sam.    

It's been a harder transition than expected...thus the long delay in getting this blog up.  We're pretty tired, but very thankful for all the support that we have.  Our parents have been awesome.  Many thanks to the Mc__ders and others who covered John's conference slots at the last minute.  We'd appreciate your prayers for our family as we continue to adjust.  We're looking forward to introducing our newest member to many of you soon!