A week about death

Seems that some weeks are better than others.  You've been there I'm certain.  This past week has been emotionally challenging.  Seems to be a lot about death. Thinking about it, seeing it, seeing the effects of it, not liking it.

Sunday we drove to Kigali, Rwanda in order to take Kelly to the airport.  We thank God she is back safely in Michigan.  As we drove into and around Rwanda, I was continually reminded of the horrible genocide that occurred there in 1994.  800,000 to 1,000,000 people murdered in about 8 months.  As I saw youth walking the streets of Kigali, I thought about how they have grown up under the shadow of a horrific time in Rwanda.  I saw old people and wondered how all the deaths that they saw affected them.  I thought about the fact that most likely there were people still mourning while those who committed untold atrocities walked the streets.  We drove past a memorial for some of those brutally murdered.  All that, along with saying goodbyes to Kelly was draining.

Tuesday, Sally and I returned to Kigoma safely.  Praise God!  It is always a blessing to have traveled in E. Africa for 22 hours on the roads without an 'event.'  As I passed the road that goes to our hospital I thought about the 45 year old mom/grandmother that I had admitted to the ward right before we left for Rwanda.  She came complaining of headache and arm weakness with a blood pressure of 300/180 mmHg.  I am not kidding.  On Wednesday I saw her on the ward.  She was recovering from a stroke, but doing well.  The plan was for discharge.  I went to OPD to see patients.  After a while I got summoned to the ward to help.  I was informed that just after seeing her grandchild from across the ward and waving to her, she suddenly collapsed and stopped breathing.  CPR was attempted but from the signs it was clear she had most likely  suffered a sudden bleed into her brain.  The family went from planning her return home to planning her burial.  We were all shocked and saddened.  I had seen and and been touched by death once again.

Thursday morning upon reaching the hospital for our morning worship time, I learned that one of our Baptist pastors, Pastor Timothy Mbiha, had died.  He was about 50 years old.  I had yet to meet him.  At his funeral, I heard some of his life story.  He heard the good news of the gospel of Jesus Christ in 1980 and decided then and there to receive by faith, the free gift of salvation.  He began serving as an evangelist while getting bible training.  I'm sorry that I do not know his complete history, but I can say that I heard testimony after testimony about his life of serving Christ, preaching the truth of the gospel, of befriending many people and sharing Christ with them.  Many shared about his life of serving his people as pastor of Mwasenga Baptist Church.  He has left behind 8 children and his wife.  We continue to pray for them.

I estimate that over 400 people attended the funeral and burial.  People representing several denominations of churches as well as several Muslims attended.  The gospel was clearly proclaimed at his funeral.  At the end of the funeral service, after all had passed by to pay their last respects, something happened that I didn't expect.   Apparently, as is the custom, the men stood in two columns stretching from the door of the church to the grave.  His coffin was passed out through the door of the church and then was handled/passed by each of about 100 of us men until it reached the grave side. Once again I had seen and 'handled' death.  His body/coffin was then carefully placed on the ground and again the gospel was preached.  It was a humbling experience.  

But what was clearly different from Rwanda and the death of that dear mother/grandmother, was that in the death of Pastor Timothy was the hope of the resurrection.  The promise of Jesus Christ that by faith we receive forgiveness of the penalty of our sins, that we are born again, a new creation, empowered to live a Christ-like life through the indwelling Holy Spirit.  And then, when 'God calls us' as was preached, we leave this temporary life on earth and continue to live eternally in the presence of Jesus Christ.  That is the hope we have.  That is the truth of the Holy Scriptures.  We have a sure hope, and that is the person of Jesus Christ.

I have to say that this week of 'death' has not been what I expected or hoped for or prayed about.  But I know that God has allowed us to pass through the events of this week for a reason that He knows.  In this week of thinking about, seeing death, seeing the effect of death on families, I am thankful that I have a living Lord and Savior that conquered sin and death through his sinless life, sacrificial substitutionary death on the cross, and amazing resurrection!  

Let me close with the words of the chorus from the song "Because He lives."

Because He lives, I can face tomorrow, Because He lives, all fear is gone.

Because I know he holds the future,   And life is worth the living, just because He lives!

Continuing to serve, daily by His grace…

Road Trip Again - Please Pray!

I knew that this day would come, but I have been dreading it, in some ways avoiding thinking about it.  You see, it is the day we head to Kigali, Rwanda to take Kelly to the airport.  

We have had a fantastic time with her over the past weeks.  It began with her arrival in Dar es Salaam after her missions trip in Rwanda and Uganda.  Then a short vacation to the island of Zanzibar.  After 4 days of total relaxation, we did the long drive across Tanzania to our new home here in Kigoma.  Kelly has helped us (once again) unpack and set up our house – to become a home.  She is a hard worker, has an eye for things, and is an encourager.  She's learned some Swahili over the weeks as well.  It has been blessed days to have her here for the summer. Every single day has been wonderful – I really mean that.  We savor our days with our kids.  Sally told Kelly the other day, 'why can't you remain small?'

This is one of the hardest things that missionary families face – saying good byes.  It is hard on all of us.  It will be a long series of flights for Kelly to get back to Detroit.  At least Sally and I will have each other as we drive back.  These drives are usually kind of quiet.  Tears are shed, and memories flood our minds.  I'm not trying to be dramatic, just sharing the truth.

When we say goodbye at the Kigali Airport, we won't see Kelly again till her graduation, May 2012.  The last time we saw our daughter Megan was August of last year.  I was blessed to see Adam in July of last year when I went to the USA for a medical meeting.  Sally hasn't seen him since May 2010.  This is really hard…

Our lives continue on by the grace of God.  Ours lives on one continent, and our kids lives on another.  We miss out on events in their lives, and they miss our presence.  We are so grateful for email, and for Skype.  We are thankful that we now can do video skype, but nothing can compare to a hug, sitting together drinking coffee, listening to what has been happening in their lives, seeing the excitement of new discoveries, offering advice, sharing what God has been doing in each of our lives.  We miss that one-on-one contact.  This is really hard.  I'm struggling holding back the tears as I write this, sitting in my chair in the living room, while Kelly does her toes and Sally is packing her things.  I know this is our last night together with Kelly in our home.

We knew about this when we began our life of missions service back in 1995.  Thought it would get easier as the years have gone by, but it has only gotten harder.  Sally and I are so thankful for our families back in Michigan and Ohio, how they have made sure our kids have a 'home' in the USA as well.  They have been a huge blessing to our kids, and to us.

So I ask, if you would, pray for us.

• Pray for safety as we drive to Rwanda and back.  About 220 miles of the road tomorrow is dirt, really bad, dusty, and dangerous.  The remainder  of the road that we will travel on in Tanzania and Rwanda is paved.  We never take it for granted that we will have a safe journey.  Pray for safety in my driving, in the other drivers, for our truck to not break down.
• Pray for Kelly as will make her long journey of connecting flights to get her to Detroit.  Pray that she will have kind seat mates, safety in flight, peace and comfort in her heart as she leaves us, and opportunities to share her love of Jesus with others that she meets along the way. Thanks Sherri for picking her up!
• Pray for Sally and I as we make the long and lonely drive back to Kigoma.  Pray we will experience the grace of God and the comfort of the Holy Spirit as we grieve sending Kelly back to the USA.  God has always been faithful and we know in our minds that he will be faithful again.  
• We thank God for the amazing support system we have that provides us with a great vehicle to make this journey (Toyota 4WD).  Thank you SBC churches for your giving each and every week that makes it possible for us to be here, serving Tanzanians in the name of Jesus Christ.  Providing compassionate Christ-centered care and hope.  All for His glory.
• Pray that Kelly has a sweet time of re-uniting with her aunts and uncles and grandparents and cousins and friends.
• This is hard…

Daily by His grace,

Larry and Sally

The Sting of Death; The Comfort of God's Promises

I knew it would happen eventually.  Practicing medicine in a developing country inevitably involves death.  The overall condition of people's lives is much poorer than in the USA for example.  There are many more diseases that are still present, like rheumatic heart disease, typhoid, and TB.  You may recall from my last post about a boy I was treating for complications of rheumatic heart disease and something more.  We decided that he likely had extra-pulmonary TB (TB outside of the lungs) and started him on treatment.  It was touch and go Friday and Saturday.  He died early this morning, 1AM our time Sunday.

I learned of his death when Sally and Kelly and I went to the ward after the church service.  We were met by his mom.  She told me he had died.  I was shocked.  I was sure he was going to get better, but he was really sick.  He is the first of my patients here at Kigoma Baptist Hospital to die.  I know he will not be the last.  I remember vividly to this day the first patient who died when I first began treating hospital patients in Mbarara.  In one week in Mbarara, I had more patients die than I had in 8 years of practice before.  Of course I had been practicing Preventive Medicine Aerospace, but even so, it was shocking.  By the way, it wasn't that I wasn't a good doctor, it was that the diseases back in 1996 were so severe and the patient's conditions were so bad to begin with.  I recall coming back to the ward the day after losing 2 patients and stopping at the door way.  I prayed "Lord God, please I ask you to help me not to become accustomed to death, not to become hardened to the pain and suffering, but also, Lord, I need help!"  God has been faithful to help me over the years to remain with compassion for the sick and their families.

After learning that her son had died, we prayed for her and then we returned home.  I called up Pastor Jackson and asked him what we as a part of Azamio Baptist Church could do.  He asked that I pick him up and we would go to the hospital.  The challenge was this mother had come from the village, 35 kilometers (21 miles) with just her sick son, and had forgotten her cell phone.  Her husband was on a journey to a town several hours away.  We decided that with the help of some of the church members and another pastor we would take her and her son's body back to the village.  After he died, his body was washed and wrapped in a sheet.  Then he was wrapped in another piece of cloth.  Four men sat in the middle seat with his body across their laps.  4 women sat in the back of the truck on the bench seats.  Pastor Jackson sat up front with me.  We stopped just outside of town at a market so a special white sheet could be bought to be used to wrap his body prior to being buried.  The church members contributed to pay for it.  We made the 1hr 15 min drive to the village of Kaseke.  20 km on paved, then 11 km on reasonable dirt road, and the last 4 km on a single track path to the village.

We went as far as we could with the truck and then the men carried his body to the family home, about 200 yards further.  Fortunately someone had been able to reach some family members and there were about 30 people waiting (not sure who all were but some were family and others were people from the village).  His body was placed in the house where it will lay until tomorrow morning when he will be buried.  His father will be back tomorrow morning.  The rest of today and tonight, people will offer their 'poleni' (like condolences) to the family and some will remain and sing throughout the night.  The pastor from Darajani Baptist Church in Ujiji stayed and will help to conduct the service tomorrow and then his body will be buried.  Gadson's mom, father, and 7 remaining brothers and sisters will be comforted by family and friends from the village.

Before we left the family and the village of Kaseke, Pastor Jackson shared some words of encouragement.  You see, just over a week ago, when he went to visit Gadson and his mom at his bedside on the ward, they both made a decision to receive Jesus Christ as their Lord and Savior.  The grace and mercy of God are so amazing.  I didn't know until today, on the drive to the hospital, that last Sunday, Gadson and his mom had gone to Azamio Baptist Church to give testimony of their decision before the church.  (We had gone to a different Baptist church last week).  Pastor Jackson told me how that both Gadson and his mom shared that they were happy to know that had received salvation through believing in Jesus Christ.  As a part of that church service, the members took up a special offering to help them as they had come from so far.  Twenty one miles to us Americans is nothing at all.  We might go that far just to go out to eat.  But for this family, it was incredibly costly to get to the hospital.  The generosity of the church family at Azamio was wonderful.

It is always hard to know what to say, and what not to say in the face of death.  Both Pastor Jackson and I shared a few words of encouragement to Gadson's mother.  Pastor Jackson voiced a prayer, and then we came back to Ujiji/Kigoma.

It's been a long day.  I grieve over the death of this young boy, only 12, but looked about 8.  I grieve for his parents and his brothers and sisters.  But I also rejoice in the promises of God that when as a believer in Jesus Christ, our time on this earth is over, we will instantly be in the presence of Jesus Christ.  God promises that as I write this, Gadson is enjoying the wonderful presence of his Savior.  And his family is being comforted by the Holy Spirit, by the Word of God, and by friends.

Please pray for Gadson's family.  For safety for his dad as he cuts short his trip and returns home to bury his son.  For his brothers and sisters as they grieve his death.  For his mom who comforted him day and night at his bedside in the hospital.   For those attending the grieving time tonight and the burial service tomorrow to clearly hear the gospel message.

I ask that you continue to pray for me as I endeavor to provide compassionate Christ-centered care to the people of Kigoma/Ujiji.  My one desire is that Jesus Christ be glorified in all that I do and say.  That people clearly see the love of Jesus demonstrated in our actions, and hear of the hope of Jesus when they come to Kigoma Baptist Hospital.

All for His glory…

It's all about perspective.

Two of the Inpatient Wards

This weekend I did my share of complaining and whining.  We went about 70 hours without power because the power company had no fuel for their diesel generators.  We live in a part of Tanzania that is completely dependent on the diesel generators as we are not part of the national power grid.  Our food in the freezer thawed as well as the fridge/freezer, but didn't spoil.  The weather was hot.  I complained. 

Of course, there were those reminders from God, like when I remembered the passage in the book of Philippians about being thankful in all situations; and Jesus' words about how he has given us his peace, and his joy…but still, some of us like to complain, and whine a bit too.

But we had food, we had water, we had a great house to live in with a beach, our daughter Kelly is still with us (she's on summer break), we are healthy, we have the Word of God, we've known and experience daily his saving Grace…as I said, It's about perspective.

"Serving Kigoma in the name of Jesus Christ"

Then today, I was really reminded of how good I really have it.  It doesn't at all sound fair, but this is what I experienced today at the hospital.  After our morning worship time and our clinical meeting, I went to do rounds on the ward.  We only have 6 patients on the ward (we can handle about 36 right now).    I carefully reviewed each patient (3 adults and 3 kids) and discussed what was next in their treatment.  A lady with a stroke that showed all the signs of impending death; infant recovering from malaria and dehydration; lady with acute pneumonia on a chronic one; a child with severe diarrhea and dehydration; elderly lady with a huge poorly working heart; a youth with cerebral malaria.  Each suffering the consequences of serious illnesses – and I was whining about no power…God forgive me for my pettiness.

After ward rounds I went to OPD (Out Patient Department).  What really shook me, brought me back to 'reality' was the 9 year old boy who was struggling to breath because of his heart disease.  He likely has rheumatic heart disease, a consequence of an infection that then turned into a autoimmune disease (were his body mistakenly attacks itself – in his case, his heart).  His mom shared his history of having gotten worse over the past months, but especially in the past few days.  I carefully listened and then examined him.  He was breathing faster than normal, and had a distended belly.  His heart was very big, noisy from a valve dysfunction, and his liver and spleen were enlarged from back pressure from his heart.  He has a 'shida ya moyo' - a problem of the heart that leads to lung, liver, spleen, kidney and other problems.  I finished my exam and explained to the mom that we needed to admit him to the ward.  When he heard it, he tried to hide the tears that came…and to think that last night I was whining that 'it's hot, I can't sleep good.'

I thank God that we have medications to help this acute problem, although he is likely past the stage where heart valve surgery would help him.  After OPD I went to check on him before heading home.  Got an oxygen concentrator for him (a machine that scrubs oxygen from the air to help him) and made sure he had gotten his first meds.  He was a little bit better, and was smiling this time when I saw him.  He and his mom had already been visited by Pastor Jack, our hospital chaplain.

I drove home in my air conditioned truck to our home on the lake, with electricity, and food, and water, and Sally and Kelly.  My heart is working fine physically, but it hurts a bit for this little boy.  I prayed for him tonight and will see him again in the morning early.   And to think I was whining about 'stuff.'

Take a moment to thank God for all you have, and for what He has done.