Togo Pics

Here's a link to pictures of our time in Togo...Hope you enjoy.

http://www.facebook.com/media/set/?set=a.10151434443138864.501675.702253863&type=1&l=94a2c8afef

Home!

We are home, for those of you who haven't heard. We had a few minor delays but arrived home this morning safe and sound, just tired. Evelyn did really well over all. Thank you for your prayers everyone! We'll post pictures when we can.

A little planting, a little watering

  Well, this will be my last post from Togo. Once again, the time is drawing to a close… hard to believe! But I am ready to come home, in the sense that I feel like our time here (for this trip, I mean) is wrapping up and coming to an appropriate closure. We accomplished what we were hoping to, learned a lot, and have much to think and pray about for our future. And let’s be honest… there’s nothing like being in your own bed, and having your own home to “homemake” in! Not to mention having your toddler in her own room…

  This post will probably be a little random and disconnected, as I just wanted to write about a few experiences that stick out to me that haven’t fit into any other blog posts. Some of the ABWE churches here (or former ABWE churches I should say, they are actually independent now) have started a network of Christian schools in Togo. The issues with the school system here in Togo could take up a whole post in itself… suffice it to say that it is a very needed area of ministry (though the Christian schools struggle in many ways too). There is a young missionary here named Christy who helps these schools – there are 14 – by training the teachers and helping with curriculum development. One of the schools in a village (Bodje) about an hour from here is particularly struggling, and the teachers there decided to have a Bible club every Wed. afternoon in order to reach out to the community (the teachers, by the way, are Togolese – not missionaries). I went along with Christy and one of the other short term ladies (Donna) to help teach the club. We had about 80 kids, all eventually packed in to an itty bitty (maybe 25’ by 25’?) concrete structure. But that was after the most disorganized, rule-breaking, hilarious Awana games I had ever seen, all around a faintly chalky circle scrawled in the schoolyard dirt =-) Now, I know that plenty of those kids were there out of curiosity to see the “yovos” (white people), or out of hope to get a craft, bouncy ball, or lollipop (which they got!). But they heard the gospel, and that contains the power of God for salvation! Who knows where and when and how God will later bring that to mind and use it in their life? And really, it was also just plain fun to hang out with so many eager, enthusiastic kids! Especially when they sing =-)

  Another favorite thing I’ve been able to do is give some of the nursing students here (they have a nursing school to train Togolese nurses) some “conversational English” practice. I was asked to do this but honestly wasn’t super excited, because when you speak almost no French and the person you are talking to speaks very little English and you are supposed to sit down and have a conversation… things can get a little, well, awkward. But I loved it! I talked to two nursing students for over an hour, about all kinds of things – family, nursing, etc. They asked me about nursing in the US and various other things, and wrote down the funniest English words to remember on their little notepads. When we had been talking for awhile and I was about to say something like “Well, we should wrap up”, one girl (Filomen) then asked me to tell her how I came to know Christ. After 10 minutes of me stammeringly trying to share my story in the simplest English words possible, I was then able to hear from them in their sweet halting English how they had come to know Christ as well. And seriously, I had the best, deepest conversation with these two students. Due to language barriers, I don’t often get to have “real” conversations with the people here – it was such a blessing to me to be able to do so! And to see them truly overflow with joy as they talked about how they came to know Jesus and how He has changed them! And you know what? Both of their stories started with something like “My family did not go to church or know about Christ, but when I was a child two men from the church came to my house and talked to me…” I could not help but think of the kids in Bodje. One day, will they also have a similar story to tell?

  Finally, I will close with one brief thing I have been thinking about and learning. To quote a corny phrase (because apparently I love corny phrases) – “There is no ‘I’ in team”. If I view my time here merely about what “I” have done and accomplished, I will be discouraged. I didn’t really share the gospel much, personally. I didn’t have too many “quality” conversations. I didn’t save any lives, and I’m pretty sure there won’t be any Togolese talking about how eternally grateful they are that I was here. In general, if I view ministry as about me – I will either be falsely inflated and proud, or full of discouragement and self-pity. But if I see my time here as just part of what the entire team here in Togo is doing – and even more importantly, as just a little part of what God is doing in the world – then I find its meaning. The smallest acts of love – whether kisses blown from an enthusiastic toddler, giggles shared among children, friendly greetings from one mom to another, or even an encouraging arm squeeze – have meaning in light of the gospel. God uses many things to open up closed hearts. Some plant seeds, some water, some even get to reap, but God causes the growth. And not only am I ok with that, I rejoice in it. My little bit of planting and watering have meaning, because God is at work here causing growth.

  Please pray for our traveling on Friday/Saturday. We will leave here about 10am Friday (5am EST) and arrive home (hopefully!) at 11-something on Saturday morning. I think that is about 31 hours. That is a looooong time with a toddler. Evelyn was quite sick over the weekend, but is ok now. Please pray for all of us to stay healthy, be well rested before we leave, and of course – for Evelyn to SLEEP on the flight! Thanks so much for all of your prayers and encouragement, everyone. Looking forward to seeing many of you soon!

P.S. – For those requesting pictures, don’t worry – we have many! We will post them as an album soon after we get home.

A Doctor’s Life in Togo

  Greetings are important in Togo.  They are a sign of the priority that the culture places upon relationships.  When I walk into the hospital, I go around to many of the nurses and staff saying, “Hello.  How are you?  And your family?” They reply, “Hello.  Very Good.  Good,” and then ask me the same questions.  It first struck me as formulaic, but as time has gone by I realize there is a warmth in these greetings and that the Togolese really do appreciate these relationships.

  Apparently, the one place greetings are not required is in a medical encounter.  Sometimes I can squeeze in a, “Hello, I’m Dr. Wreesman,” before my translator asks why the patient is here and the patient subsequently goes on a several minute monologue that I’m convinced contains every symptoms they’ve experienced in the past two months.  Sometimes I don’t get in any greeting, not that the patient seems to be the least bit concerned about that.  Maybe it’s just me, but wouldn’t you want to know the name of the person who could be doing a rectal exam on you?

  Another humorous challenge is trying to discern what a patient’s medical problem is through a translator, when your patient has almost no medical knowledge.  Sometimes you’re going through multiple translators (you -> translator -> son -> father -> son -> translator -> you).  It’s like playing a game of telephone, except people’s lives are at stake.  Then there are complaints that you have no about what to do.   For example, “I have total body pain!”  I guess that might be useful a complaint, if the four previous patient’s hadn’t also complained about the same thing.  At that point, I get the hint that there’s something cultural in the meaning of this complaint, and I have no idea what it is. 

  Next, I have to figure out what the patient is expecting me to do about their complaints.  Some refuse an indicated test, saying they don’t have enough money (understandable for people who make only a few dollars a day).  Others demand the test, even when you try to explain that the treatment is the exact same one no matter the results and are just trying to save them a little money.  They (or their family member or friend) usually tell you this after you just wrote their prescription. 

  Finally, people like to convey their medical concerns in dramatic terms.  For example, “I have belly pain.  It hurts very, very much,” as if having moderate belly pain would be grounds for dismissal of the entire complaint.  And this comes from men and women whose ability to endure hard labor, heat, pain, and hunger has my utmost respect for, knowing I could not have lived so well under the same conditions.   I guess no one has explained that hurting “very, very much” may be an indication for surgery.

  (Please note, none of the above is meant to convey a since of superiority.  I just share the humor of approaching medicine from one cultural perspective among a people from another culture.)

  Perhaps the best way to convey the variety of what I’ve been able to do would be to give a brief account of my last call stretching from yesterday to this morning.  Though it was an especially busy time, it shows the variety of medical needs that exist in a place like Togo and the fun of being a family physican in this setting.  Days typically begin with hospital rounds.  We started on seeing our handful of medical patients: an ulcerative colitis case with incidental BPH and urinary retention, a man recovering from tetanus (saved by administration of intrathecal tetanus toxoid a few days previously), and girl with persistent abdominal pain.  After medicine rounds, I went stopped by maternity to say hi to the mother whose twins I had delivered on Saturday (my first breech and first twin delivery).  Then I went to the pediatric ward – which could be better called the malaria and premature baby service.  One young boy had recovered from a case of cerebral malaria (20% mortality).  We also currently have 5 premature babies ranging from 26-29 weeks when they were born.  Our set of 26 week twins started at just 640 grams, but have now reached a kilogram and are doing well 5 weeks into their stay.  There is a 29 week baby that I delivered at the beginning of the month (see previous post) who is growing well and probably will go home in the next week.  One 28 week baby is a month old; thankfully she is still at the hospital because we had to fight with her parent to keep the baby.  Sadly, our 27 week baby is looking pretty sick only 4 days into life and may not make it.

  After rounds, I head up to clinic.  I admit the first patient I see, a 12 year old boy with sickle cell, fever and anemia (likely sepsis or malaria).  I also see his mother who has a 12 year tooth infection that drains from a tract on the bottom of her jaw; the xray she brought in shows an impacted molar with osteomyelitis and extensive erosion of the bone.  Though she isn’t acutely sick, we’ll probably operate on her before the end of the week.  I see a couple more patients, then go back to the hospital to check on our DKA patient that I admitted during rounds (glucose 1540, potassium 7.9, calculated osmolality 419 for those of you medical people).  Forturnately, I get a moment to break for lunch.  After lunch I head back to the clinic and see a few more cases including back pain, infertility, and breast cancer (she had a mastectomy, but unfortunately the cancer has spread and we send her home with pain medications knowing that death may come soon).   Meanwhile, the hospital has been filling up with new admissions.  I go down to check on them.  New cases include the following: a lady with HIV with likely pneumocysitis pneumonia; a man swollen neck and pleural effusion after being “stoned” a month earlier; a lady with generalized lymphadenopathy, giant splenomegaly, abdominal pain, fever, and treated HIV/tuberculosis; a child with an 8 cm eye/cheek tumor vs infection, plus a smattering of gastritis and malaria.  Before dinner, I get called to OB clinic to give some input on a 26 week pregnant lady with nephrotic syndrome.  Apparently being a third year family medicine resident makes you the local expert for this case.  Later, I get called back down to the hospital because my sickle-cell patient had a transfusion reaction.  Then I end up of L&D to see a new patient.  I call the surgeon to come do a C-section because the baby is breech and she is likely preeclamptic.  I go into the OR and actually do the C-Section and tubal ligation with the surgeon assisting and teaching me.  By this time its 1230 am.  Fortunately, there are no more calls.

  Next morning, we’re back rounding in the hospital on the 9 patients we admitted yesterday, plus those already there.  During rounds we admit a stroke patient and a man with cerebral malaria vs meningitis.  On ultrasound, we find that the man who has been “stoned” actually has a giant empyema.  The surgeon lets me place the chest tube with his assistance, and we drain a liter of pus.  By this time, it’s lunch time and I’m more than happy to take off the rest of the day. 

  It has been a blessing to serve here.  I’m thankful to see how much I have learned in the past 3 years and what I can contribute.  Being a family physician, it is exciting to practice such a broad spectrum of medicine.  Additionally, I’ve been thankful to serve at a hospital that doesn’t just treat physical needs but talks with people about their spiritual needs in Christ.  As we sat around dinner last night, one of the doctors shared how a patient he saw in clinic accepted Christ as his Savoir.  After praying, the man told him, “God is good; this is why I had to come here today.”  What a blessing to see this, knowing that in Christ alone is eternal life.  I am grateful to be a part of that process by serving here in Togo.

These are a few of my favorite things… about ‘Toto’ (by: Evelyn)

  It’s just not fair that Mama and Da-eee have been taking up all the blog posts, so in honor of my 18month birthday I decided it was time to write one myself and tell you about all the truly interesting things in Togo (or, as I like to say, Toto)!

  First off, I really like it here. Mama says I fit right in! I guess if you are Togolese, greetings and goodbyes are really important and extensive. Well, I’m a Togolese in disguise I guess because they are really important to me too! For instance, in the morning while I eat my breakfast I often say “hi!!!” (in a loud shriek) to the guest house staff ladies (Miss Amavi, Mrs. Florence, Mrs. Elizabeth, or Mrs. Enyonam – some of my new best friends) at least 60 times or so. And the best part is, they answer me back every time! But I have to say I don’t really like being grabbed… and here the grown-ups do like to grab my hands in greeting. But no worries, I just get even by attacking their kids – usually with hugs and kisses, uninvited. Oh, and I never met a baby or kid I could walk by without stopping to talk and play. I usually have one of two effects – I either make them really excited, or really scared. My favorite thing to do every morning now is to go to the hospital, and when Mama tells me we’re going to go see Daddy and the babies I get really excited. The first thing I do is walk right in the door and shriek “Daa-eeee!”. This usually gets everyone’s attention, just the way I like it. I usually bounce from doctor to doctor for a few minutes while they say hello, and then the Togolese nurses come up and say hi to me. After that I have a few favorites I go and visit. There are a few preemie (I’ve learned that means itty bitty baby) babies and their mommies around who are always there, so I kind of know them now and will let them hold me and everything while I point at their babies and shout “Beebee!!”, just in case someone missed the obvious. Mama tries her best to keep me from doing such things as licking the floor and swiping a baby’s bottle (which I did!). After blowing a few kisses we move on to see the kids. I have two friends named Delphi and Sarah that I play with every day. Their little brother is one of the itty-bitty’s so they are always there. We really like to blow bubbles, play with stickers, and color together. I think their favorite is bubbles, because it just makes them giggle and giggle. After that we go to the peds ward. The little kids there are pretty sick, so we usually just greet them and give them a few goodies (coloring books, or little beanie babies). We then go visit the women’s ward, which actually has some pretty young girls in it too. We greet everybody and then spend some time playing with the younger ones. Today we taught one girl how to play tic tac toe! At least, we think we did… but it’s kinda hard to say when we can’t exactly understand each other. Sometimes we share some lotion and stuff too. Then we move into the maternity ward, my favorite! We go from bed to bed to say hi to the babies. For some reason all the babies here are always asleep? And I find it necessary every time to declare each one “Night-night!”. I blow them kisses of course, because that always makes their mommies laugh. Sometimes the moms try to hand their babies to me, at which point Mama insists on rushing to my side and helping me “hold” them. I mean, what does she think I’m going to do, drop them?!?! Squish them? Poke their eyes out? Sit on them? I digress… Anyways, I always talk to the nurses here, and if there are older siblings around sometimes I play with them too. By this time I’m pretty exhausted and ready to head back to read a book, cuddle with my Quack-Quack, and take my pre-lunch nap (not to be confused with my pre-dinner nap – life here is tiring!). Though I always have to stop to talk to the pet monkey that belongs to my friends on the way back…

  Don’t tell anyone I said this, but the doctors here aren’t very smart. They are always asking me where my trachea, xyphoid, liver, and spleen are. I keep having to tell them over and over again! Sheesh, what would they do if I wasn’t around? I’ve noticed around here mealtime talk is usually about something medical or gross, so I just join in by pointing out everyone’s body parts – you know, I’m trying to help them out with their medical education. My current favorite is pointing out everyone’s “Belbows” – especially when they lean them on the table. I’m the only toddler around here, but there are some other MK’s (missionary kids) around. I really like hanging out with them and they like me too. What in the world am I going to do when I go back to boring ol’ home and it’s just me and Mama all day? Oh, and another cool thing about this place is the basketball court and swimming pool! I was afraid of swimming at first, but now I’m pretty much over that. And everytime we leave our room I point to the basketball court and talk about balls and kicking them. Of course, when we go down there to play – I still just want to talk about playing with the balls, rather than actually doing it.

  Well, those are a few of my favorite things about Togo. In conclusion, and in honor of my 1 ½ yr birthday, I will give you a list of “firsts” that I have experienced here in Togo:

·           1. Skinned knees (and 2^nd, 3^rd, 4^th … all “Oweeeees”)

·         2. Riding in the car without a carseat! (don’t worry though, that’s only for short, squished trips)

·         3. Cooo-keees, Ca-ca (chocolate), and cu-cakes at almost every meal! I now ask for them all by name     =-)

·         4.  Mangos! Mmmmm…

·         5. Soda (ok, this one has a story – the Fulani shopkeeper we met gave me one, and Mama thought it would be rude to refuse so I got to try my first Pepsi =-)

·         6. I have consumed part of a stick. Strangely, that wasn’t quite as good as the previously mentioned items.

·         7. Money… for some reason this one lady in the hospital keeps giving me coins to keep! I’m rich…

·         8. Bugs – I now recognize them and talk about them!

·         9. Fufu, Gawu, and various other African dishes

·         10. Medicine every morning! Mommy says I’m weird that I actually like my anti-malaria medicine that is supposed to be so bitter and awful

·         11. I now say Amen! I especially like to say it right in the middle of prayers, loudly =-)

·         12. Saying I love you (I wuh-woo), and singing along with the song in the “Love You Forever” book too!

·         13. Dancing in church – I’m a huge fan! =-)

·         14. Going to work with daddy…I think I help his patients feel better!

·         15. Antibiotics – yay…

P.S from Evelyn’s mommy… Sadly, the little stinker got quite sick yesterday with a very high fever. She likely has typhoid or something similar, but she is being treated for it and seems to be improving. Please keep her in your prayers!

"Wawa" II

  Please pardon the double use of the corny title, but I think I have a good reason. As I was thinking about it, I really thought it was a perfect description of Mango. A place where West Africa has been “winning” for… who knows? Centuries? Millennia? The town is beaten town, one of the poorest and most undesirable in Togo. It is a dustbowl this time of year – the most immediately striking thing about the town is the dirt and trash everywhere. It seems like no one really wants to be there. There are 5 main tribal groups in town, and traditionally they all hate each other. Even now, most people walk around with a stony expression on their face. I guess there isn’t much to smile about living in Mango. As one of the missionaries here said, “Living in Mango is like living in hell; it’s incredibly hot and the people hate each other.”

  But things are changing. ABWE has been present building this hospital (which the town leaders begged for) for about 5 years now. Church planters are already at work learning languages, building relationships, and building the hospital. They are also building trust. Now, when you stop and greet someone you are normally met with a warm smile. Children excitedly wave and call out “Batture!” (white person) when they see you. A handful of people in this Muslim dominated town have already come to know Christ as their Savior. The church here is beginning to sprout. It is a young fragile sprout, and does not yet have roots. Nonetheless, for the first time in Mango – there is life, and hope.

  The hospital being built here is called “Hospital of Hope”, and for good reason! In a town with no resources, it offers hope to the sick and hurting where none exists. But more than that, the opportunity to be a beacon for the gospel in this whole region (the hospital will be attracting those from surrounding countries as well, as there will not be anything like this anywhere nearby) will be unparalleled, here at least. During our trip up here, Stephen and I really had the opportunity to pick a lot of people’s brains. We are super excited about the team’s vision and philosophy of ministry. The medical work here is only a part of something much, much bigger. It is a part of the unreached ends of the earth, but it appears God is doing something. He is beginning to make His name known, and He is planting His church. And from Mango, who knows the influence that church could have? The opportunity for evangelism and then discipleship through medicine here is huge!

  We spent some time with Anna, an incredible young missionary lady working here who took us around town to meet her friends. She is focusing on the Fulani people group (she is the only one working with them, and this is the people we are very interested in too!), and so we were able to meet and “talk” with several of them. We reeeaaallly enjoyed that! We also were able to have a lot of meals with the other missionaries, pick their brains about the plans for the hospital and ministry up here. We got to hang out in their incredibly cool pool. We went to market and met some amazing people. We got to help the DeKryger’s unpack, and we got to attend the little church here. In all, it was a privilege. Yes, there are a lot of inconvenient things about the place. The water is not clean (the hospital is working on digging its own well, but has so far come up dry). The dust is unlike anything I have ever experienced. The bugs are annoying. The heat is, well… “uncomfortable”. It’s more isolated and not really as pretty as down south. But I hardly think those things should really be a consideration in deciding whether to move to a place, do you? ;-)

  Pray for Mango. Pray for the missionaries in Mango, that they would not grow weary because life there can be hard! Pray for the people there, that the Holy Spirit would soften their hearts and they would be receptive to the message of Hope. Pray for real discipleship and true strong churches to grow. And pray for us, as we consider whether this place and work is where God is calling us to be. There is a unique opportunity here to combine our two loves – medicine and discipleship. You see, “Wawa” has been true in Mango for a long time. But by God’s grace, West Africa WILL NOT Win Again – God will, through the power of His gospel. 

"Wawa"

  The missionaries have a phrase they like to use here. When things go wrong in a uniquely frustrating but almost humorous way, when you get the run around instead of straight answers, when the horrible roads beat up both you and your cars… they will have often shrug their shoulders, give a little laugh, and say “Wawa” – West Africa Wins Again. Because sometimes it is better to laugh than to cry ;-)

  Such as yesterday. A driver from the hospital in Tsiko came up to get us on Sunday, and the plan was for him to drive down one of the missionary’s cars to try to sell in Lome (the capital), dropping us off in Tsiko on his way. Why did the missionary want to sell his car, you ask? Well, ‘cause it was a dump (and why was it a dump, you ask? Probably ‘cause they have car-eating and man-eating roads here). By the time we pulled out of Mango at 8:45am yesterday (much later than planned), the car had already been to the mechanic because it wouldn’t start, had its battery changed, and had a flat tire changed. Oh yeah, and then it still wouldn’t start at first. And when we got gas on our way out of town, it wouldn’t start again. I joked with Pericot, our driver, that we would have to pray the car to Tsiko. Well, I guess someone wasn’t praying hard enough (kidding!) because less than an hour out of town the car started pouring out black smoke. For a second we all thought the car was on fire as Pericot started pulling us out. Well, it wasn’t. But it definitely wasn’t going any further. Wawa.

  By the way, we were stuck on the side of a little two lane road (I say little, but it’s the main highway in Togo!) that’s riddled with enormous potholes out in the middle of nowhere. It’s 100+ degrees (glad it wasn’t their “hot” season yet, or it would have been 130+!). Thankfully, our driver had a cell phone and could call for help. Also thankfully, we had plenty of water. But we spent the next couple hours toasting by the side of the road. I spread out my “pagne” skirt (the traditional African cloth) under a shrimpy little tree and Evelyn and I sat and read books and sang our ABC’s, as we waited for an unknown amount of time and had no real idea of what was happening and what the plan was. And you can imagine the stares we got from the occasional truckers passing by. What, you don’t normally see a white woman and baby camping out in the African bush by the side of the road? Have you ever been in one of those weird situations when there is absolutely nothing you can do to fix it and you can only sit and wait? Yeah, it was one of those. Wawa.

  Well, eventually help arrived in the form of a mechanic to try to get the car to Mango and a driver +taxi to take us the rest of the way. This guy drives crazy fast so we actually make pretty good time, until we get to the mountain pass. It’s blocked by a traffic jam, caused by a semi towing another broken down semi up the mountain at a rate off approximately 0.25mph. Once we finally start moving again, on our way down we pass truck after truck that is turned over, burned out, or just plain not working. I’m telling you – they have car-eating, man-eating roads here. Wawa.

  The rest of our trip was uneventful. We made it back in record time, exhausted and covered in red dirt (no a/c so the windows were down the whole time). Evelyn did amazingly well, a little whiny at times but that was the worst of it. Our only injury was the thorns I stuck my bare foot on while we were sitting on our pagne under our tree (oops). So that was our trip back, and we learned a few lessons. Such as: if/when we move here, a reliable car is a must! Cell phones are pretty useful too…

  On a more serious note though, we are so thankful for God’s protection in an uncertain situation that could have been much worse than it was. Without that, “Wawa” would be more than just a little joke you say when you are trying to roll with the punches! So that is the story of our adventurous trip back – tomorrow I will write more about our actual time in Mango, which was just what we were hoping it would be.

Home again, home again, jiggedy jog!

Only a quick update so that everyone knows we are safely back in Tsiko. We had a terrific time in Mango, and Evelyn did really well. Our trip back though was an "adventure"... ;-) I'll try to update more tomorrow! We just filled our bellies and are off to get this 1/2in thick layer of dust off ourselves... Au revoir!

Learning to Rest

  (I'm posting this for Stephen, who wrote it last night and didn't get a chance to post it. He is currently on his way to Mango, and we will be joining him tomorrow)

  Did any of you look at the title of this the post and think, “Wait, we didn’t support Stephen so that he could have a vacation”?  Besides, Togo is not exactly the place one would come if he had relaxing in mind.  So why this post?  In seeking to be open and honest about what we are learning and how we are serving, I wanted to share how sometimes the challenges we face come in ways we may not expect.  I pray that it can lead you to better pray for us and for other missionaries you serve.

  Serving in Togo is like working in most of the world – there is more work than time in a day.  For the past week and a half, I was essentially the OB department from the hospital.  Considering there are about 400-500 babies delivered at the hospital (per year), that makes for a significant amount of work.  Unfortunately, babies are noncompliant little creatures who don’t work with their doctor’s requests to come between 9-5 on weekdays, but avoiding the lunch break (come to think of it, they don’t always comply with your request that they sleep through the night either as the get older).  Add into that the occasional birth emergency, the phone call about a new patient when you try to take a nap, the missed meals – and you can see the potential for being a bit tired.  On top of this, my daughter has had a cold (hence the other cause of interrupted sleep) and I want to be a good father and husband by spending time with my family.  You can see how this can lead to being tired and even (gasp!) grumpy.

  Don’t feel sorry for me…I’ve enjoyed serving, I’m learning a great deal, and I’m getting experience that would be hard to get back at home.  It’s not like things cannot run without me – the nurses here are very good, there is another Family Medicine doctor here who knows OB (but usually does surgery), and I’ve been told to take time off so I don’t work too hard.  However, I’ve noticed there can be a proud part of me that says, “I can do this,” and wants to feel indispensable.  Yes, I should work hard – I know how to and the Lord’s work is worth it.  Besides, there are full time missionaries who face these situations every day, so it’s an honor to take some of the load off them, even if it means expending myself.  But it’s a fine line between putting your all into your work for God’s glory and seeking your own glory. 

  I’ve realized it’s necessary to take some time off.  I can’t operate on 5-6 hours of sleep every night.  My family needs me.  God calls me to enjoy spending time with him.  None of these things happen if I make my work my sole focus.  Additionally, I come from a task-focused culture.  Here in Togo, the people are much more relationship-focused.  The reality is, God is very relationship focused.  If I neglect relationships (spending an extra minute getting to know the Togolese believers, praying with my patients, enjoying the company of the other missionaries) to accomplish tasks, there is something wrong with my focus no matter how hard I work.

  At the end of the day, God is teaching me to balance several important principles.  First, we should work hard in the service of ministry because God deserves this effort.  “Therefore, my beloved brothers, be steadfast, immovable, always abounding in the work for the Lord, knowing that in the Lord your labor is not in vain” (I Cor 15.58).  “For you remember, brothers, our labor and toil,” I Thess. 2.9.  Second, all we do must be done in love or none of my efforts are worth anything (I Cor 13.1-3).  Third, all success ultimately comes because God is at work.  “And he said, ‘The kingdom of God is as if a man should scatter seed on the ground.  He sleeps and rises night and day, and the see sprouts and grows; he knows not how” (Mark 4.26-27).  So we must work hard for the kingdom of God, but we cannot in pride think that its success is dependent upon our efforts.  So even rest becomes an exercise of faith, not because we are being lazy but because we realize our limitations and trust in a limitless God to accomplish His purposes.  We pursue faithfulness in love in all our responsibilities, pray for God to work through us and give us strength, and leave the results to His sovereign plan.

- Stephen

To Mango, to Mango, jiggedy jig...

   Stephen and I have the chance to visit Mango again this trip, and we just decided today that we will go. If any of you followed our blog during our last visit to Togo, you may remember we made a trip there last time (on the menu on the right, look up 2010 and find the post titled "Our Mango Adventure"). This is exciting for us because that specific town is where we are actually praying about coming back to long term. I'll tell you a bit about it so you can share in our excitement =-)
    Mango is in the far northern part of Togo, about an 8hr drive from here. It is kind of the "ghetto" of Togo. A mostly Muslim town made up of an assortment of not-very-well-liked tribes, even their own government ignores them (case in point - the government has recently decided to turn off their water supply and no one knows why! Also, when the president decided he needed an extra generator for some political rally, he simply took theirs). While they do technically have a government "hospital" in the town, it receives virtually no money and therefore its personnel, supplies, and equipment are negligible. After some of the leaders of the town saw and experienced the care and love at the hospital down here in Tsiko, they begged ABWE to start a hospital up there too. Yes, a Muslim town begged a Christian evangelistic gospel-sharing organization to come to their town and start a hospital. Who can say no to that? For many years ABWE has been raising money to build this hospital, and it is in the final stages of construction - set to open in early 2014. For about the past 5 years, church planters have already been at work there - helping to build the hospital, and in the process building relationships with the community (oh yeah, and learning the tribal languages!). Stephen and I are excited about this project because 1) it is in a completely unreached area 2) the town is full of Fulani, an unreached (and despised) people group that Stephen and I particularly have a heart for 3) the medical work is just part of a team where the whole focus is on planting a church and discipleship, and 4) we really like the team that is already up there working!
   Having said all that, it is also HOT. Dry. Dirty. Not nearly as pretty as the tropical forest and mountains in this area (savannah-type region). Life is pretty hard there. We are visiting now because we likely will not have another opportunity to make a survey trip before we make a decision about where and what we will be doing in the future. On Thursday, a missionary family that has been working here in Tsiko since 2007 (the DeKrygers) will be moving to Mango, and Stephen will hitch a ride with Todd and follow their moving truck up north. Friday morning Jennifer and her boys (along with "Aunt Kelly", a wonderful older missionary lady who has been here forever teaching MK's) will be driving up in their van, and Evelyn and I will join them. I think we'll be headed back down here on Monday via taxi (don't worry, we will drive back with a trustworthy taxi driver known to the missionaries up there - I'm pretty sure it'll be better than the public bus we took last time!). I highly doubt we'll have internet access up there, so please don't worry if you don't hear from us until next Monday. Please do pray for us, though. Obviously road trips don't tend to be super popular with toddlers. Evie has been sleeping great here for almost a week now, and I'm a little sad to potentially mess that up again. Pray for safety, health, wisdom, and all-around happy attitudes =-)
   Thanks all for your prayers and encouragement and love! I believe Stephen has a half-written blog post he will likely try to post before we leave, but other than we probably won't be posting anything until we return.

What a Mommy and a baby do in Togo

  I think Evelyn and I are finally reaching our "new normal", thankfully. She's really pulled it together the last few days and seems quite adjusted now (she still has her moments, but doesn't she always!). It is such a blessing and so much fun to have her here. Children bring lightheartedness and joy to those around them, and they also serve as an instant connection and conversation starter for me with fellow moms. Of course, sadly... those conversations last for about 15 seconds, because that is how long it takes me to exhaust my French! 

  This is probably only going to be interesting to my fellow mom friends, but this is what a typical day now looks like for us here: Stephen gets up and goes to breakfast at 6:45. A couple days a week all the missionary medical staff meet in the dining room to have devotions around 7:15, and everyone always goes to the hospital for "rounds" (where the docs go around and see each patient, assess their condition and review their vitals etc, and make a plan for their treatment) by 8am. Evie has been waking up around 7:15 for the day, so we get ready and then head to the dining room for a late breakfast - Stephen always saves some food for us!  After that we head back to our room. I clean up while Evelyn plays (hmmm... that seems vaguely familiar - oh yeah, just like at home!). Now that Evelyn is coughing less, I've been taking her down to the hospital in the mornings to visit Daddy and all the "beebees". We don't stay too long (because I'm trying not give Evie a chance to share her germs, and because she's only now returning to her normal happy self!), but we walk around and greet all the moms and babies. I coo at them and Evelyn shrieks at them - "Beebee!" with her pudgy little pointed finger. We then head over to the peds ward and do the same thing there. After that we head back to our room for a short rest for Evelyn. Lunch is at 12:15, and then the Togolese have this beautiful tradition of napping (or resting) until 2 or so. We often just hang around and talk with the other short termers in the dining room, come back to the room to play, or (now that our swimming suits have arrived, woohoo!) go swimming at the pool they have on the compound. We also spend time playing outside, or with some of the other kids that are around. Evelyn takes her "real nap" around 3, dinner is at 6, and we try to put her to bed by 8 (after a shower). I usually have lots of time to rest or read during the day as you can see - Stephen, on the other, continues to be pretty slammed at the hospital! So there you have it - not toooo much different than life at home, huh?

  It is sometimes hilarious to watch Evelyn interact with people here. The adults often kind of get up in her space and reach for her hands - she's not so much a fan of being grabbed and sometimes gets a little scared, but she will usually happily give them a high five or fist bump if I ask her to =-) She takes her revenge on the kids though, haha! When she sees a fellow little person she excitedly walks right up to them. She often does a little dance, blows a few kisses, tries to give fist bumps, and then best of all - knocks them over with a bear hug! If the kid is younger than 3 or 4 she usually scares them ("who is this freaky looking tiny white person and what is she doing to me?"). The mothers love it though when she tries to play with their kids, and the kids who are a bit older love it too. It's so funny, because she notices no differences and doesn't seem to care either that her "love" isn't always reciprocated. 

  Ok, hope this wasn't too boring of a post! Just wanted to give you all a snapshot of what life is like for this mommy and baby here in Togo. It is not dramatic, or full of life and death experiences, or even full of good conversations (after all, I can't really communicate). But I have no regrets that we made the decision to come. This is a ministry we do as a family. For me right now, that is looking like supporting and loving my husband, mothering and watching out for my girl, and trying to show the people here the love of Christ in any way we can. Sometimes it is hard to leave all the life-saving and gospel-telling and soul-saving to others. But after all, isn't that all God's anyway? I can't tell you, exactly, at the end of each day what we "accomplished", but I can tell you this - we are, as a family, doing what we believe God has directed us to do. So it is not my job to "do" and "achieve" - only to love and obey. I am learning to rest in that, and it is good! Praise the Lord for His sovereignty and goodness in using even us broken earthly vessels to accomplish His work in the world, whatever and wherever that may be. And not only in using us to do that work, but also in deciding what exactly that work is going to be! "For we are His workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them." Eph. 2:10

Sometimes things happen because of what you do...sometimes in spite of

Several things have become obvious during my trip here...I have learned a ton since my time here as a medical student, Family Medicine is a perfect specialty as it allows me to care for a host of patients, and there is much I still don't know.

Here's a little example of this:

A few days ago I was attending a delivery.  Mom had been in labor a long while, but thanks to a few interventions she was able to avoid a C-section.  After an hour of pushing, the baby finally delivered.  Unfortunately, there was a large amount of meconium in the amnionotic fluid right behind the baby (in layman's terms - the baby had pooped a lot while mom was in labor; this is both a sign of a stressful labor for the baby and there is a risk of problems if it gets deep into the baby's lungs).  The baby wasn't breathing after delivery (not too abnormal - but something that needs to be rectified), but since there was meconium I knew I should intubate and suction the baby before encouraging her to breath on her own (which could lead her to aspirate the fluid deep into her lungs).  I relayed to the nurses, "I need the intubation and suction supplies."  The nurses search frantically.  A minute later the laryngyscope to intubate the baby is still unavailable.  "I can't let the baby not breath forever," I think.  Finally, they find a laryngyscope.  I make an attempt; the light doesn't work on it, making the equipment useless.  Since the baby must breath I go ahead and suction the back of throat and place the suction catheter down the nostril to see what I can get back.  Not the normal order of things, but at this point I'm having to improvise.  The baby starts breathing a little better.  Someone has finally fixed the laryngyscope.  Since I still hear fluid in the lungs I decide to try another intubation but at this time the baby is fighting me so I abort this attempt and suction more.  Thankfully the baby is starting to breath well.  When we discharge the baby a day later it shows no signs of aspiration.

Fast forward a couple of days, and this time I have a 29-week premature baby that is precipitoiusly delivering.  Mom's water had broke, but she hadn't sought care, so she had an infection her body has gone into labor.  "The head is here," shouts the nurse.  Looks like I'm not stopping this delivery.  I deliver the baby and place it on the bed.  She is nice and pink, but still not breathing.  I try to stimulate her.  She's still not breathing, and the heart rate is less than 40.  I drag my neonatal resuscitation algorithm from the recesses of my mind.  Next step is to provide ventilation with a bag mask.  I hope this works.  After a minute the baby starts crying an the heart rate is up.  I thank God, because I didn't feel as confident about the next steps, especially in Africa with limited equipment.

I share these experiences to give a picture of what life is like.  The past week I've been running the maternity department here, which is increased responsibility from what I am used to.  Thankfully, I've had good training that God has allowed me to use during this week.  Thankfully, He also hears my prayers and works even when I am at my limitations.  Thankfully, I can see all of your prayers at work too.  The time has been challenging, stretching, encouraging and I'm glad we could serve the missionaries and Togolese here.  We pray God would use these tangible demonstrations of love to give them a picture of Christ.  Keep praying for us!

"My grace is sufficient for you, for my power is made perfect in weakness." Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me...For when I am weak, then I am strong.

2 Cor 12.9-12

~ Stephen

A Daily Brush with Life and Death

(A short disclaimer – after our last time in Togo, my pastor informed me that Lisa was the better writer; feel free to read on, but if your time is short you might be better with sticking to her posts. ;-)

This post is bit somber…I realize this as I write. That’s not to say we aren’t enjoying our time serving in Togo and aren’t experiencing many of God’s blessings. Yet my time has also impressed on my mind the brevity of life and the urgency with which we must consider our condition before God.

“So teach us to number our days that we may get a heart of wisdom” Ps. 90:12. Whether it’s in America or Togo, our time on this earth is brief. It is just more evident here in Africa because people face death in starker terms. Two days ago, a mother brought in her daughter pulseless to one of my colleagues. He attempted a short resuscitation, but it was evident this girl had no life in her. She had been treated at an outside clinic with malaria medications, but had not been able to receive the blood she so desperately needed. This girl was the exact age of my daughter Evelyn. Two days ago a pregnant women came in for “swelling.” It turns out she has nephrotic syndrome (a type of kidney disease); she is also 23 weeks pregnant. Sadly, there is often no cure for this in adults and she won’t have access to dialysis. Will she live long enough to see her baby delivered? During rounds today, a middle age lady passed away from a massive variceal (in the esophagus from liver disease) bleed…she had come in too late for our care to make a difference. Even in the US, our best medical care only postpones death. Only God has raised the dead, and though some doctors may think they are God, I have never seen one do this.

Yet still a greater question remains. How do you face death knowing you are right with God? Whether it’s in the US or Togo, this is still the crucial question: “…it is appointed for man to die once, and after that comes judgment” Heb 9:27.

Medicine doesn’t have the answer to this question. In addition, there are so many other areas of life that intersect with the medical conditions my patients have, and yet medicine answers none of these. I can treat HIV, but that doesn’t solve the sense of betrayal a young pregnant woman feels towards her husband after receiving this new diagnosis. Nor does it help her deal with the stigma those diagnosed with HIV face in her culture, nor the guilt she may feel at knowing she can pass it on to her child and may have to those she has already given birth to. After I had diagnosed another lady with a recent miscarriage, she looked at me with tears and asked why each of her four pregnancies had ended this way. She desperately wants a child; she faces scorn from society and even possibly her husband for not being able to produce one. Maybe we can find a medical solution, though the answers are fewer to the poor in Africa. But how do we deal with these deeper questions of shame, despair, and betrayal?

It is moments like these, in the midst of the sadness, that I am so grateful I have a sovereign God. Some may ask why He allows such things. Yet I ask why He should give us anything good when we have turned our backs on Him. I’m not going to try to answer all these questions here. But I want to express what I have been reminded of – that my frailties are matched by an infinitely powerful and loving God. Medicine is humbling; I have some answers, but many things I don’t know. Medicine definitely does not provide the answers to these truly important questions. This is why I am so blessed to know a God who gives His answers in His Word. He is the Creator of all things, He provides hope in suffering, and He can make all things good for those who trust in Him. “Come to me, all who labor and are heavy laden, and I will give you rest” Mat. 11:28. Praise God we have this answer! ~ Stephen PS Our bags came...didn't realize I'd be so thankful for my boxers and sandals.

~ Stephen

PS  Our last bag came...didn't realize I'd be so thankful for boxers and sandals!

A Hope Worth Sharing

I heard my Savior say

“Thy strength indeed is small

Child of weakness, watch and pray

Find in Me thine all in all”

Jesus paid it all, all to Him I owe

Sin had left its crimson stain,

He washed it white as snow!

  These words have been echoing through my mind the last couple of days. I don’t even remember hearing the song anytime recently (though ironically, today the song was randomly playing from Stephen’s itunes – but that was after I had already been thinking about it!). I expected life with a toddler here to be a challenge, but in some ways it has been an even greater one than I anticipated! Especially when said toddler has not yet started sleeping well here… as a result, I have at times felt tired and weak. And yet the Lord has softly and sweetly encouraged me with these words. In Him I have all I need, and to Him I owe all I am. I am so thankful for the “precious and magnificent promises” my God has given me, such that I have “all things that pertain to life and godliness” – including to life here in Togo (2 Pet. 1:3-4). What hope I have!

  Well, Evelyn and I have still been laying low the last couple of days. She is not seriously ill or anything, but she has developed a cough that is interfering quite a bit with her sleep. She isn’t quite herself and I haven’t wanted to spread her germs around, so we have only done a couple quick visits to the women and kids in the hospital so far. We will see what the Lord has for us to do in that area later on, but for now I am just taking care of my girl – which is, after all, one of my main purposes/roles in life right now anyway =-)  Stephen has been super busy still at the hospital… I’m trying to let him tell you about that part, but anytime the poor guy sits down to write a blog post he gets another call to go down to the hospital. =-p

  On Sunday we had such an… interesting? fun? thought provoking? slightly sad?... experience at the little village church we went to. At first Stephen and I were planning to walk down the road about a mile to Tsiko Church, which is the closest (and also the local “mega-church”, haha!). We decided Evelyn couldn’t handle the walk in the sun, so at the last minute we hitched a ride with one of the missionary ladies to her church, which is in a small village about 20 minutes away (by car, phew!). It was just a little hut made out of bamboo-type sticks, a dirt floor, and a thatched roof – about the size of most people’s master bedroom =-p There were probably about 50 people packed in there! What I loved about this little church was how they worshipped. Many of the Baptist churches around here sing a lot of American/western hymns they’ve learned from missionaries, and just give them a kind of African flavor in their delivery =-) This church did sing a hymn or two in Ewe (the most common local tribal language) that we recognized,  such as “How Great Thou Art” – which is always a treat to worship along with them! Our hearts can sing a long in English. But what we really loved was the rest – the most truly Togolese and heartfelt worship service I have seen here. In addition to those hymns, they sang their own music in their own particular way, and it was a joy to watch and even participate in! Yes, believe it or not – percussion and dancing in a Baptist church! ;-) The people welcomed us kindly and though we couldn’t understand the service (it was in French, then translated into Ewe), worshipping with God’s people is worshipping with God’s people. The sad part though was what Stephen told me later (I had to take a restless Evelyn out). The missionary lady, Brenda, translated enough of the sermon into English that it left us feeling a little troubled. Like our experience with some of the other little churches in our previous visit, this pastor (and seemingly the rest of the congregation) had much passion for the gospel and for salvation, but Scripture was not explored in depth. “Jesus saves!” was excitedly proclaimed, but the riches of what Scripture has to say about the gospel and the inheritance that is ours in Christ, His instructions for life and godliness are usually not touched on much. Many of the churches here are in such great need of teaching and discipleship. In addition to sharing the love of Christ through medicine, this is where our heart really longs to help these people. We can (at times) postpone death through medicine. We can also (at times) improve people’s quality of life. But we all eventually die – the gospel is the true answer to death, and only in Scripture do we find true quality of life! That is hope, and that is what we long for these people to fully know. The hope that encourages my heart when life is hard and gives me purpose is the same hope we want to share!

  

  Well, I was going to tell you about some funny interactions Evie has had with the people here, especially the kids at church on Sunday… but that will have to wait for another post because this one is already long winded =-p Thank you friends and family for your prayers!

Getting Settled

In reflecting on the last couple of days, I think this is the best way to share how it’s going: (I’ll call it “Bad News, Good News”… because I always think you should end on a good note ;-)

11.       The bad news is almost all of Stephen’s clothes and my shirts were in our lost luggage… the good news is none of Evelyn’s were!

22.       The bad news is I have to handwash our underwear every night… the good news is I packed an extra shirt and pair of said underwear in our carry ons ;-)

33.       The bad news is most of our food was in our lost luggage… the good news is none of Evelyn’s clothes, diapers, etc. were

44.       The bad news is Stephen and I don’t have a brush or comb… the good news is Evelyn does and is willing to share! (we appreciate all two inches of her comb, trust me)

55.       The bad news is we are all still pretty exhausted and Evelyn hasn’t been sleeping well since she’s been here (jet lag I think, plus all her teeth have been trying to come in at once =-/ )… the good news is our traveling here went off without a hitch (except for previously stated bag fiasco), and Evelyn even slept for 3/4 of the flight – which, if any of you know my daughter, you know could only have been a direct result of prayer!

66.       The bad news is my stomach is having some issues while it adjusts to the new foods and normal but different bacteria and flora in the produce here (I’m not sick, this happens every time I travel internationally)… the good news is the food here is terrific and even Evelyn has been eating amazingly well, and the food and water here at the hospital compound are clean and trustworthy

77.       The bad news is we do have some bugs, spiders, and crickets (which are nothing compared to the enormous crickets I had in my basement at home!) in our room… the good news is we also have geckos, and they eat bugs! And they are cute, especially the little ones – unless of course I step on one barefoot in the middle of the night =-)

88.       The bad news is there’s nothing quite like your own home and bed… the good news is we have a terrific large room and bathroom that is perfect for a family and very comfortable!

99.       The bad news is Evelyn sometimes finds all the people that stare at her and reach to touch her a little overwhelming… the good news is we have been treated with welcome and kindness by everyone, from the airport all the way to here

110.   The bad news is Evelyn seems to have come down with a mild cold… the good news is she has no sign of malaria, typhoid, meningitis, yellow fever, tetanus etc!

  Ok, I’ve had my fun =-) To summarize, our biggest struggles since we have been here have been improvising without our luggage, and Evelyn not sleeping well at night. Sadly the bag that didn’t make it (which apparently Delta couldn’t fit all the luggage on our flight from BWI, so they just decided to leave it in Baltimore – thanks Delta) was kind of a key one. I tried to spread our stuff out but in retrospect didn’t do a very good job with mine and Stephen’s clothes! But it’s ok, we have borrowed a few things and are making do. We’ll probably get our bag back on Wed, when another missionary family arrives in Ghana and drives here.

   Evelyn’s sleep has been a struggle, so please pray for that. I thought she would be so exhausted she would sleep like a rock the first night here and then would be changed over, but it hasn’t worked like that. We really are quite comfortable here in our room – it’s large and has plenty of shelves and drawers for our things (which makes this organizer’s heart happy!). Not only do we have a clean sink, toilet, and shower – we have two of each! I would kind of compare it to a retreat center – not a fancy HBC Women’s Retreat center, but more like your typical youth retreat in the mountains kind of place. I’m grateful for it!

Stephen jumped right in to the hospital the morning after we got here, and is the only doc here doing OB at the moment so he is always on call for OB for the next week or so. I think the midwife that is normally here will be back around then, so then they will share it. It is so nice for both of that everything immediately felt familiar from our last trip. And we have loved seeing missionaries and Togolese hospital staff again that we got to know last time - even more now since we know them already! Yesterday and today I have spent a lot of time unpacking, getting settled in, and giving lots of attention to Evelyn to try to give her as much a sense of normalcy as possible. We did go down to the hospital for a little while today and “talked” to some moms and babies (ok, so our talking consisted of me greeting them in French and thereby exhausting my French vocabulary, and me talking and cooing in English to their baby strapped to their backs, while they talked and cooed in French or Ewe to my baby strapped on my back, and Evelyn ecstatically pointing her pudgy little finger at their baby and screeching “Beebee!!!” at the top of her lungs). We handed out some stickers too, but most of the kids around right now were toddlers or babies and rather scared of the strange white lady trying to hand them something weird =-) On Monday I am hoping to be able to start going down regularly in the mornings and spending more time with the moms and babies, which will hopefully make us less scary.

Ok, sorry for being so scattered and superficial… I will write more in a few days. I think Stephen is going to try to update soon too. Tomorrow we will try to go to a local Togolese church, which I’m (mostly) looking forward to =-)

We are here!

We have arrived safely =-) Evelyn did TERRIFIC (not perfect, but soooo much better than it could have been!). Our only major travel issue is that we are minus one bag. Sadly, it is the one with most of Stephen's clothes and a lot of mine... Anyway, I will write more soon when we can. Thank you so much for your prayers!

Ready yet?

No =-) I've been asked that a lot of times in the last week or two. In fact, a few people looked at me aghast today when I told them I hadn't even started packing yet! But really there's so much packing you just can't do until the end anyway, that it just makes me feel disorganized to be half packed. Don't worry though - I have a monstrous and very detailed packing list, and I think I have just about everything purchased and ready to go.

We do have a lot to get through in the next few days though, and packing is fairly low on the list really (Stephen says that will take 2-3 hrs... but I always at least double his time estimates ;-). There are just a lot of home and life related things that have to be tied up before we leave. And I was "ordered" today to make sure my husband sleeps before we go...

We leave Wed., Jan 23 at 5:40pm EST. We'll fly to New York first, and from there we have an overnight flight to Accra, Ghana. A driver from the hospital will pick us up and drive us to the hospital in Tsiko, Togo (Hospitale Baptiste Biblique, or HBB), which should take about 6 hours. My best guess is that we will arrive there around 1pm EST on Thurs, Jan. 24. We will try to write a quick update that evening just to let you all know when we arrive safely.

Here are a few things you can be praying for us in the next few days and as we travel:

- that we will be able to get things tied up around here that need to be - including...but not limited to...some home repairs (basement waterproofing issues, long story), and a final signing of Stephen's post-residency job contract
- that we will remember (brains are getting old over here!) to do everything we need to do, and to pack everything that we need to pack - and of course, that it will all fit =-p
- for Stephen and I to work together to get ready in a unified way, with patience and without misunderstanding
- no flight delays and smooth connections 
- sleep for Evelyn, our 17m old daughter, on the overnight flight (and maybe a little for us too!)
- for all of us to stay healthy before and during our travel time
- that we will have no problem connecting with our driver ("Johnny") picking us up in Ghana
- for all of our baggage to arrive with us and go through customs easily (we are transporting some things for the hospital)
- for a safe drive from the airport to the hospital in Tsiko, Togo (over very bumpy pot-holed mountainous roads!)
- for a quick transition to Togo time (5 hours ahead of EST), especially for Stephen as he will likely be jumping right in to his work at the hospital
- that we will be patient with each other and flexible in responding to any unexpected and 'un-fun' situations that may come up as we travel
- uh, did I mention SLEEP for Evelyn?

Thank you all for remembering us before our Heavenly Father. We are completely convinced that apart from His working in us, through us, and around us - we could do nothing of eternal value (here or there). Please follow along with us on this blog, feel free to comment and encourage us, but most of all - PRAY! It is a privilege to be used by God to participated in His mission of spreading the gospel to all the peoples of the earth, specifically right now in Togo. Through your prayers, you can participate in that too!