Visit from the Chairman

He hopped on a bus at 6:00 am and traveled for 7 hours just to come and visit us. He brought us a live chicken and a bag of apples as a gift (apples are a rarity in this country!). After 30 minutes of visiting he left to catch his departing bus for the long 7 hour return ride to the village. He just wanted to see the mgonjwa (sick person) and to give his greetings from our village of Kahunda.

This man has shown hospitality, grace, courage, integrity, and honor at every step of the way. I am so thankful that he is the chairman of the Board of our Tanzanian organization. It has been a difficult journey to find people of quality character to be the leaders of our NGO (Non-Governmental Organization: equivalent of a non-profit in USA). We asked Mr. Mzaire to serve as our chairman after many months of witnessing his selfless sacrifice and service to our boys.

When we first moved to the village, Mr. Mzaire began volunteering to visit our campus and sit with our boys every Saturday - just to talk, and ask them about their lives and backgrounds. He wanted to know their worries, their pains, their aspirations, their needs. He wanted to let them know that they were loved. He wanted to encourage them that their lives had unlimited possibility if they would only work HARD in school and LOVE getting an education. On Sundays he would return to announce that he had paid the local barber and all the kids could go get a haircut - courtesy of him. Some days he would bring a crate of soda just to sweeten up the conversation. Our boys only get soda on special occasions. He wants them to know that they are special.

Mr. Mzaire got his name because it identifies him with his origin. When he left his home country of Congo (when he left it was still called Zaire) over 30 years ago it was during a rare time of peace. Now his home country is torn in war, filled with child soldiers, rebel armies, revolution... He was an educated man - a veterinarian who spent 6 years in University. He came to Tanzania and began a new life. In that new life he met with many sorrows, but he never became bitter - rather he continued to be refilled with new energy and calling. When his wife abandoned him along with their 6 children he took up the role of Baba and Mama. He even took in other children in need to make sure they would get an education. When we opened up our campus in Kahunda he was thrilled... here was a chance to serve other desperate children in need of love and fathering - a chance to serve his community in a greater capacity. He knew that these children were the responsibility of all citizens - the village was needed to raise them. When he caught word that there were teachers in the schools verbally abusing our boys, calling them street kids, isolating them and humiliating them... he marched up to the school and demanded audience with the school board. He explained that this was unacceptable behavior. He shamed them. He reminded them that these children, while not our flesh and blood, are our responsibility and duty. He told them that these children who were without parents needed to be loved as if they WERE our flesh and blood - because there was nobody else to claim them if not their fellow citizens. Over and over again he has advocated for them, using his position in the community to demand a change. And because he is a successful, well known businessman he gets respect. He has a voice and he uses it for our boys. Mr. Mzaire has been asked to join many boards over the years, but has always declined... he is extremely humble and worries of the pride that can often be associated with leadership, the temptations that come with power. He prefers to be a servant leader, one who makes change from the sidelines. But when we asked him to be the Chairman of our board he accepted - it was a ministry in which he could fully devote his gifts and energy. He takes our work very personally.

His kindness has not only extended to our Kwetu Faraja family, but to our own personal family as well. He has always gone out of his way to extend hospitality and friendship. I am humbled and honored by the ways that he cares for us and our boys. For such a long time Paul and I prayed for Godly Tanzanians to come beside us in this work. And we have been heard.

Mr. Mzaire is an example to me of what it means to be a friend and a leader. I wonder how he makes it look so simple. I want to be this type of person who overflows with love and tenderness. I want goodness, kindness, and patience to radiate from me. Sometimes it seems we are given people who show us these qualities so that we can be reminded in our own hearts and lives that we should do the same. What a different world it would be indeed, if we could cherish one another as brothers and sisters. I know Mr. Mzaire would hate to be put on a pedestal - so I will testify on his behalf that it is only Christ within him that we see so well. But he is allowing himself to be used as a vessel to hold these treasures - these unmistakable gifts of the Spirit.

Giving up control

I got out of bed today, took a little stroll on crutches to the kitchen. I haven't been to the kitchen in 2 weeks! The room where I have spent so many hours each day has become like a stranger to me. My kitchen was not as I left it. Dishes have found new homes, shelves are arranged differently. It is another piece of evidence that I am not active in my usual role around here. I love taking care of my family. I love cooking and planning meals, keeping everything in a specific order, having control over my position in our home. But I am not in control.


There have been many people this past two weeks who have taken over my kitchen - washing dishes, cleaning, cooking, doing all the things that happen in a kitchen. Those people have also done the laundry, swept and mopped, taken care of all the things necessary to make a house run. I am being cared for so well. I have every single need tended to and not the slightest need to lift a finger. Breakfast, lunch, and dinner in bed, being waited on hand and foot... every hard working mama's dream at some point in time. There have been so many times during the past year when I have wanted a vacation, a break from the demands of running a home and caring for such a huge family. I have wanted to retreat to a quiet place where I could relax and stop worrying about the thousands of details that must be sorted out daily... and now I have been given that. It's not what I thought it would look like.

One of the hardest lessons I am learning in this time is to allow myself to be cared for. I have spent the last decade of my life caring for others. It is who I am. I thrive when put in difficult situations, loving the helpless, serving the "least of these". It is the life of ministry - especially to orphans and vulnerable children. On my most stressful days, I have always found joy in taking food to the starving children in the street, or taking medicine to clean their wounds, a needle and thread to mend their tattered clothing. I am a servant... I want to be a servant. How difficult it is for a servant to accept the service of others. It is hard to accept the care of others. But what a tremendous blessing it is to be cared for. I am thankful for all of the children who accept my care.

I am left to reflect on the satisfaction and value I feel when caring for others. To try and maintain control is to deprive others of the joy of serving. My husband has not complained once about the added demands to his life this past few weeks. By my giving up control and acknowledging my weakened state, he gets to experience the joy of caring for me. There will be a day when I can walk again without any pain - I will be able to carry baby Joseph, I will be able to make bricks and build cow sheds, plant seeds in my garden, cook and clean and... heck, even get dressed without help. But that time is not yet here.

Each day I choose to give up control or at least my perceived control... obviously I am not the boss of things - this accident demonstrates all to clearly that I was not in control. But as humans we love to cling to the idea of control. Life takes us on many journeys that we would not always have planned to take. But there are lessons to be learned, and joys to be had on those paths. We must open our eyes and put down our stubborn ways so that we can be fed and cared for in each season of our lives. So today I give up my control. And tomorrow I pray to do the same.

Cracked

I am back in bed after 4 longs days on the road. Strange to travel 15 hours, crossing international borders, just to see a doctor who can give a thorough examination. We are so thankful to know what is happening in my body - it is so much better than all of the questions of uncertainty. My pelvis has several cracks in it - one of which could be operated on - but it is not recommended in pregnancy. So for now I rest. For now I try to manage the pain and heal. There are so many types of pain... the pain of my broken body being re-knitted together, the pain of not being able to do the work that I love - spending time with our 30 boys at Kwetu Faraja, the pain of not being able to hold my precious 14 month old Joseph Kitebha, the pain of not being able to cook for my family and care for them as a wife and mother....

Pain is manageable in the USA and many other countries, but in Africa it seems that people must learn to live with pain. There are very few medicines available. When Tylenol was just not cutting it, my husband Paul went to a chemist to ask about Hydrocodone.. "That drug is illegal! you wont find it in Tanzania" he was told. I am often amazed to think of how frightened Tanzanians are of pain medicine.

Imagine laying on your death bed - you have AIDS, untreatable cancer, or kidney failure (and there are no dialysis machines or kidney transplants). You are dying and you know that you are dying... and the pain is fierce. A little morphine would give you peace in your last days - except that morphine is illegal... so you are given Tylenol to ease the pain. The good painkillers are "addictive and dangerous" I am told.  I have a Doctor friend from UK who comes each year to volunteer at one of the local hospitals to teach the doctors about palliative care. He tries to reason with the local doctors "if you are dying it doesn't matter that the pain medicine is addictive, the medicine is only dangerous if you don't know how to use it". So the first big battle of pain medicine is trying to find a way to teach Tanzanians how it can be beneficial - only then will it become available.

There are some good anti-inflammatory medicines - all of which are dangerous for developing fetuses. We finally found a good pain medicine, and it worked great until it ran out... we went back to the pharmacy for a refill and the adventures started once again.

The next complication of African medicine - Most available drugs on this continent are counterfeit, meaning they are made in some back ally someplace in China or India and they would NEVER pass the international standards. Most of these medicines are missing the active ingredients, some have poisons in them, but the bottom line is that they don't work. Fake medicine is a thriving international business - just Google "Counterfeit medicine and Africa" and you will get hundreds of pages coming from the World Health Organization, the UN, every news network imaginable... It is a HUGE problem, yet one that many people are unaware of. It is so nice to go to a pharmacy in Indiana and pick up a prescription knowing that it is going to heal you. Here, filling a prescription is like playing Russian Roulette.. it could heal you, it could kill you, or it could do nothing.

So here I am on my bed with 6 different brands of Tramadol (pain medicine) hoping that at least one of these will actually have the active ingredients so that I can have some relief. Once we find a brand that works we will stick with it! I have been without a "working pain medicine" for 4 days now - I guess we will either find one that works or I will just manage through the pain like the all of the other Africans.

I am reminded of what one of my boys said to me 6 years ago when faced with a devastating situation... the children's center where I worked had a huge fire that destroyed the dormitory. Standing in the ashes, water, and charred ruins I was so sad and shocked. One of the boys came to me and said "Mama it is okay to be sad for a little while, but then you have to choose to be happy. This is Africa, we are used to pain, we know all about pain... the pain will control you unless you decide to be happy."

New Life

I had no idea I was pregnant. It wasn't planned or expected. What a way to find out - the nurse announcing loudly to you and your husband in a room crowded with patients that they will not give you an X-Ray because your pregnancy test was positive... Wow! What ever happened to patient confidentiality???

So the news of this baby came as a shock to us. But already we love this small person. Already we want to shower this new life with our love and care. Already we are imagining who this person will be and how he or she will fit into our family. Already we are terrified because of the terrible trauma that this baby's mama just experienced.

I have been struggling with the question of whether or not to announce this pregnancy. We have no idea how far along I am because I was taking birth control shots that are "effective" for three month intervals. The ultrasound was inconclusive for determining gestational age. It is still so early in the pregnancy - most people don't share such news until much later... But this situation is complicated. We need prayers for this baby - and so we share our journey with you all.

We need prayers for my health, for this child's health, and for all of the difficult steps that lay ahead as we walk down the path of healing. So I lay myself open to share with you all whatever future is in store for us. My hope is that this pregnancy will go smoothly and at the end of it all we will share the joy of a precious new baby.

How fortunate I am to have the option of seeking good medical care. I am left to remember all of the terrible stories of mothers losing their babies or babies losing their mothers, when medical intervention could have made all of the difference.

In 2013 I spent many nights at the main hospital here in Mwanza - one of our boys was attacked and stabbed, his life hung on the line numerous times... and we waited in the hospital for endless hours holding vigil - praying for his life to be spared. On three separate visits I encountered the same repeated story - a mother somewhere had given birth and then proceeded to hemorrhage uncontrollably. In each incident there was a female relative clutching the newborn infant with a look of terror plastered on her face. In each story there was a dying mother somewhere in the depths of the hospital who would be left to bleed on the cot where she lay until enough money had exchanged hands and the doctors sufficiently convinced to do their job. In each story a dying mother would be transferred from her cot to the morgue and a new infant would struggle through the next days of life without milk and with little hope of survival. In one of those stories I had the opportunity to intervene and advocate for the infant. The baby's grandmother clutched her day-old granddaughter to her breast in shock - the cries of the baby filled the room in desperation and hunger. The baby had not had any milk since birth and was in misery. I held my own fat 4-month old child in my arms and was overcome with emotion... perhaps it was the hormones, perhaps just the call of humanity and love. My heart broke with each cry from that infant. I had pumped an extra bottle of milk and it lay unused in my bag... It seemed against all sanitary logic or sense, but I took that bottle and pressed it into the hand of the grandma.. "this is my milk that I pumped for my baby, I can always just nurse my baby so please take this milk to give your granddaughter". I can't imagine ever accepting some stranger's milk to give to my child... but i knew I was healthy and the grandma didn't think anything strange in my offer. The baby gulped down the 4 ounces immediately. We then proceeded to figure out how to keep feeding this hungry child. We went to the hospital pharmacy to see if they had any formula - no luck. We went to the maternity ward to see if they had any formula or any way to provide care for this infant - no luck... they wouldn't even think of helping the baby without a hefty bribe and even then they didn't have any milk to offer. What type of hospital was this - the major hospital of our entire region - the hospital responsible for serving millions of people... and not a drop of milk for a hungry infant? Finally we left the hospital and found a duka where we could purchase a bottle and a few jars of formula - the baby would at least have a full belly for a few days while the family figured out what to do next.

Time and again this story plays out. Time and again pregnant women die in their homes while giving birth, or worse yet they die in the hospitals while "receiving medical care". When it came time for me to deliver our son Joseph, Paul and I made the decision to go to the capital city, Dar es Salaam. Bugando, our major local hospital is a place "you wait in line to die". We didn't anticipate any complications but knew that we wanted to be in a place that really had doctors, not just in name but in ability. A few days after our arrival in Dar I went into labor - well, my water broke.. but I never had any contractions. The doctors didn't know what was happening but realized the baby was in distress. Upon performing a last minute ultrasound they discovered our son was in breech position. I needed an emergency C-Section. As I lay on the operating table preparing to receive the anesthetic the electricity went out. I remember thinking "I am going to die...". Eventually the backup generator turned on and my surgery was performed without complication. Our baby Joseph was indeed in distress. The umbilical cord had wrapped around his neck three times and he was struggling. Once freed into the world he cried and screamed and his little lungs filled with air. We both made it! Paul and I are convinced that had we stayed back home and gone to the local hospital, Joseph and I would probably not still be here on this earth.

How devastating for those mamas who don't have the money, the resources, the luxury of traveling to a competent hospital. I am no better than those millions of women who struggle without any medical care. I am no different than the poor mother in her village hut who just wants to have healthy babies. I mourn beside them in their struggle, but I am so thankful that I have options for myself and my family.

So here we are embarking on a new journey of motherhood. There is an unnamed child growing within me, and that baby means the world to us. We don't know what is in store, and we only pray to have the strength to face each day and each challenge as it comes.

Where there are no doctors

I have been laying in bed for 6 days now. It is plenty of time to reminisce on the many times I have nearly gone insane with worry because of the lack of medical resources here in Tanzania. How I long for the care that is available in the West- for the resources, tools, medicines, sanitation...

I recall being 8 months pregnant and with a terrible cough that had been going strong for 2 months. I told the "doctor" that I was worried about pneumonia. "Not to worry" he said, "You can only get pneumonia if you have AIDS"... I shook my head in disbelief. This man was considered the number 1 baby doctor in our city of 3 million. Not only was his statement WRONG, but he never even thought of using a stethoscope to listen to my lungs.

In Tanzania an individual finishes high school and then proceeds to study for 2 years at a Medical School... upon completion they are considered to be doctors. No need for an Undergraduate degree, no need for anatomy labs or practical work in the medical field... these "doctors" study for 2 years out of antiquated books and then enter the field making life and death decisions for the poor underserved members of society.

So here I am laying in bed - I have had a freak accident, the type of thing that "never happens". It is the most terrifying thing I have ever experienced. We were pushing the car to start it - the battery was dead (not an uncommon problem in Africa where nothing ever seems to work right). Out of nowhere the car overpowered us and began rolling down the incline towards me - I should have jumped, ran, gotten out of the way somehow... but in that fraction of a second the huge 3,000+ lb Land Cruiser had pinned me to the wall of the house. I knew what was about to happen, but couldn't react fast enough. The loud crunch that ensued told me my spine would never be the same. The pain was overwhelming and then there was numbness and the feeling of death below my waist. I was trapped and there was no way to move the enormous vehicle. My dear husband Paul shouted in pain as he tried to pry the car from me - pain of using all his strength, pain of worrying that his beloved wife was in such a desperate situation, pain of feeling that he could have somehow prevented it...

And in his desperation he moved the car, and I was able to pull myself onto the hood of the car where he came and carried me off to examine my wounds. My breathing was short and labored, my vision filled with stars and signs that I would faint... I recall thinking that if I passed out I would die and my poor baby Joseph would be left without a mama. I was overwhelmed and devastated thinking I was leaving my dear husband to pick up the pieces of our life alone... but I didn't die. I abandoned the world and entered a place of prayer - God keep me alive, God heal me, God comfort my husband and my child, God use this for your glory!

My legs regained feeling, the pain returned and nearly took away my breath. I continued to fear that I would never walk again - but I knew I would not die.

We continue to question what will happen to my body. The story is complicated because I am newly pregnant... the doctors that refused to give me an x-ray because of pregnancy had no problem prescribing me with an NSAID for pain (NSAIDs are notorious for causing miscarriage). Thankfully I had the wherewithal to investigate the medicine and stop using it within a day of the accident.

We will travel to Kenya in the morning to see Western doctors who are ready to handle our case with care and professionalism. We will drive 14 hours to see those doctors - such a tragic reality that so few doctors are available in Sub-Saharan Africa... We don't know what they will find, but we know we are in good hands.