A Year in Review: Arriving

“One does not surrender a life in an instant. That which is lifelong can only be surrendered in a lifetime.” 

~Jim Elliot

I was sixteen years old when God called me to be a missionary doctor, although I’m certain that He has been in the process of preparing me for this work my whole life. I don’t think I ever doubted that this is what the Lord created me to do. Through college, medical school and surgery residency, I had this singular purpose in mind as God continued to give form to my vision and fuel my passion.  I graduated from residency, passed the American Board of Surgery exams to become board certified, and completed training with both Samaritan’s Purse and SIM. One year ago, after a lifetime of education, months of preparation, weeks of packing and goodbyes, and about 30 hours of traveling, I arrived in Zambia.  It’s hard to believe a year has gone by already!  So I thought I would take the next few posts to reflect on what the past year has brought, to recount the things I have learned and the ways I have grown, and to remember what the Lord has done.

Some say that the first year on the mission field is the most difficult year in the life of a missionary. I suppose this is true, although having spent only one year here, I don’t have much basis for comparison J.  It has been a good year. I have learned so much in the way of surgery and medicine in rural Zambia. I’ve taken care of hundreds of patients and have witnessed God at work in healing bodies and hearts and minds. I have become part of a community of missionaries who have been faithfully serving the Lord here in Zambia, some for as long as 40 years! I have made friends with several of the Zambian hospital staff and am slowly learning the culture and language of the Kaonde people. I’ve given lectures at the nursing school, spoken in chapel services, and have overseen visiting medical students doing elective rotations at Mukinge. In the relaxed pace of life here, I have found plenty of time to read, to rest, to go on walks and to sometimes just sit on the porch and watch the rain. I have grown in my walk with God and have gotten to know Jesus more deeply and fully than before. It has been a good year.

It has been a hard year too.  Hard in ways that I expected, but also in ways that I didn’t know how to expect.

The first few days and weeks in Zambia were a whirlwind of activity and excitement – taking the Zambian medical licensing exam, shopping for groceries, making the short mission flight from Lusaka to Mukinge, meeting the missionaries, moving in and unpacking, seeing Mukinge Hospital for the first time, walking through the wards, and getting acquainted with the operating room. It was thrilling and overwhelming and terrifying all at once. Here I was, finally a missionary doctor, finally in Africa, finally realizing my lifelong dream.  

It’s difficult to describe what it felt like (and still feels like) to have finally arrived at the goal toward which I had been working so hard for so long and to discover that even greater challenges were before me. Maybe like reaching the top of a high mountain, only to find a great chain of mountains waiting on the other side. Not that I was naïve to the challenges I would encounter once I arrived, but how does one really and truly prepare to move to a new country, learn a new culture and a new language, live a new community, start a new job, join a new church and engage in an entirely new way of life?  I was taken out of my comfort zone in nearly every facet of daily life. I knew that no one expected me to have it all figured out or to feel at ease right away. I didn’t really expect me to have it all figured out either. But I was not accustomed to not having all the pieces of my life fit together neatly and comfortably. This confident, independent, driven, and – let’s face it – proud young surgeon felt something she wasn’t used to feeling. I felt lost.

On Friday nights, the missionaries get together for potluck and a movie. My first Friday night at Mukinge, it was pouring rain and pitch black outside as I tried to navigate my way along unfamiliar paths carrying a flashlight, an umbrella, and a hot casserole dish. I kept a keen eye out for snakes as I walked through tall grass and slippery mud, up and down wrong roads until I finally found the house where potluck was being held.

That experience seemed to exemplify how I was feeling on the inside – I thought I knew where I was supposed to be going, and I thought I had all the right tools to get there. But once I actually stepped out alone into the dark and rainy night, all of a sudden the way didn’t seem clear at all. As I slogged through grass and mud, the hot dish burning my hands through thin potholders, and unseen deadly snakes lurking in the shadows just waiting to strike, I wasn’t sure how I would make it to potluck. Going home wasn’t really an option.  I knew that turning around and trying to find my way back to my house would be equally as treacherous.

The devil is well known for using these times of uncertainty and change to attempt to sow fear and doubt into the hearts of men. Just like his encounter with Eve in the Garden of Eden, he sneaks up in the darkness and whispers, “did God really say…?” (Genesis 3:1).  And so it was, in this time of feeling lost and uncertain that for the first time since I first heard Him say to me, “This is it Sarah. This is what I want you to do,” I questioned God’s calling.

Was it possible that I had been wrong, that I had heard God incorrectly or that I had made this whole thing up in my head?  Did He have any idea just how overwhelmed I was by the high mountains before me or how completely inadequate I felt? These questions and insecurities brought me to my knees before the Lord. He was gracious to answer, and slowly my heart was at peace.

When you pass through the waters, I will be with you;

and when you pass through the rivers, they will not sweep over you.

When you walk through the fire, you will not be burned; the flames will not set you ablaze.

~Isaiah 43:2

The short answer is that, no, I had not heard God incorrectly all those years ago when He first called me to be a missionary doctor, and yes, He knew exactly how I felt. In those first weeks and months at Mukinge, He confirmed and reaffirmed the same call I had heard as a teenager. This is what I was created to do. The Lord had guided me through many intense years of studying and training. He had given me the skills and the knowledge that I needed and the resources to learn how to care for the diseases and ailments I would encounter in Zambia. Most of all, He had given me a great passion in my heart for every person to know this great news that they are created and loved by God, that He sent Jesus to pay the penalty for their sins, and that He offers the free gift of salvation to any and all who will choose to receive it. He had never promised that it would be easy or that I would see the whole way clearly before me. But He did promise that He would be with me.

It’s been a good year. And if it's true that the first year is the hardest, I’ll say it’s nice to have that one under my belt. I am grateful for what the Lord has taught me and the ways in which He has shaped my character through the challenges of being a brand new missionary.

Lord, you have assigned me my portion and my cup;

you have made my lot secure.

The boundary lines have fallen for me in pleasant places;

surely I have a delightful inheritance

I will praise the Lord who counsels me;

even at night, my heart instructs me.

I have set the Lord always before me.

Because he is at my right hand, I will not be shaken.

~Psalm 16:5-8

Atotwe

On Sundays after church, we usually meet for pancake lunch. This particular Sunday I was running a few minutes late. As I stood in my kitchen peeling and slicing bananas to take along, I heard crying coming from my backyard. I ran outside and found a little boy standing in the middle of my lettuce patch. He was all alone and was obviously very scared. I scooped him up, ran inside to put on shoes and grab my keys. Then he and I set out in search of his mother. He didn’t speak any English, and I sadly don’t even speak Kaonde well enough to converse with a four year-old. Just enough to learn that his name was Atotwe.

We went to the Kilata – the area behind the hospital where family members of patients stay. I walked up and down the rows of hostels, asking if anyone was Baina Atotwe – mother of Atotwe. With open palms raised toward the sky to demonstrate empty hands, the only reply I got was, “Kafwaako.” No one here.  As we walked along, I chattered away cheerfully at him in English, telling him about my family and my cats and how I hoped we'd find his mother soon.  He didn't say much in reply, but just clinged to my arm while we continued our search. We went to the house where pancake lunch was being held to see if anyone there knew who his parents might be. Kafwaako. I found some folks whose Kaonde was much better than mine to see if we could get any more information.

“Atotwe, jizhina Bainanji?”  Atotwe, what is your mother’s name?”

“Bamama.” Mama.

“Bagipi?” Where is she?

“Ku nzubo.” At home.

“Mwikala pi?” Where do you live? 

“Ku nzubo.”

We went to the hospital and walked through the wards to see if anyone recognized him. Kafwaako.  “Nasaka kuya ku nzubo.” “I want to go home.” I wanted him to be able to go home too!  After walking around for over an hour, the poor little guy was exhausted and fell asleep in my arms. I was exhausted too and feeling a tad discouraged. We headed toward a few of the hospital staff houses next to the hospital to see if anyone knew him, and we decided that if we still couldn’t find his mama, we’d take a break for some pancakes and water and then regroup.

As we walked up the road away from the hospital, a frantic looking woman saw us and came running and crying in our direction. Baina Atotwe! Not far behind her was Atotwe’s Nkambo – his grandmother – in an equal state of duress. Apparently Atotwe had wandered away from junior church and had traveled over a kilometer down the road all by himself before he ended up crying in the middle of my lettuce patch.  Atotwe was passed over to his mother as many joyful tears were shed and hugs were shared. A happy ending to my mid-day adventure.

Healing Rains

Be glad, people of Zion,
rejoice in the Lord your God,
for he has given you the autumn rain
because he is faithful.
He sends you abundant showers,
both autumn and spring rains, as before.
~Joel 2:23

Last month I made a quick trip home for Grammy’s wedding. I spent two wonderful weeks with dear family and friends both in Indianapolis and in Charlotte. The Lord used my time at home to refresh and encourage me – as if each encounter with friends and loved ones was like God pouring into my soul from a pitcher.

Pretty much as soon as I returned to Mukinge, the rainy season started, and we have had heavy rain most days! The corn in my garden was only knee-high when I left. It is now taller than I am and ready for picking! The rains seem to have refreshed the ground, the plants, and the people alike. Everything around me mirrors how I feel inside after such a great time at home in the States. Thank you to all of you who helped make my time there so wonderful. And for all those who I missed while I was home, I look forward to seeing you the next time!

Sweet corn in my garden

For my Zambian friends and neighbors, the rains have softened the ground and made it ready for planting. Zambian farmers are busy cultivating their fields and gardens, planting the seeds that will produce the crops they depend on for their survival. Please pray that the Lord will continue to send the rain needed to make these plants grow in order to provide the food and income that will sustain each family in the coming year.

Watching the rains on the porch with Lloyd and Ned

Lloyd working hard to stay dry during the torrential rains!

Wedding Bells!

In case you hadn’t heard the news, Grammy got married! Yes, it’s true – my dear, sweet Grammy and her “gentleman friend” Jack tied the knot last weekend. I was able to make the long journey home to stand beside her as her maid of honor. What a great time of celebration with Grammy and Jack! I am so grateful for the opportunity to be at home with my family for this exciting day!

!Man & Wife

 !Cousins

My beautiful mama

The Lantz family

Paul

First attempt at wearing the prosthetic arm

This is Paul. Nearly two months ago, Paul and his father were in a terrible car accident. Paul’s dad had just a few minor cuts and bruises, but’s Paul’s injuries were much more severe. He had multiple cuts on his face and scalp, an open fracture of his right ankle (broken bones and joints were exposed, skin and muscle shredded over the fracture), and a rather gruesome traumatic amputation of his left arm just below his elbow. When Paul arrived at Mukinge in the middle of the night, he was immediately taken to the operating room (theatre) where we worked to place IV’s, assessed him for injuries to his internal organs, sewed up the cuts on his face and scalp, washed the dirt and grass from the open wounds on his leg and arm, and completed the amputation of his left arm. Since that time, Paul has been a patient on our pediatric ward.  He has made multiple trips to the operating room to have his ankle cleaned out and placed in a stabilizing device called an external fixator, to have a skin graft placed over the open wound on his ankle, and to have the external fixator removed and a plaster cast placed.

Proper prostheses are available only in the capital city of Lusaka. The cost of accommodations and travel to and from Lusaka, not to mention the cost of the prosthesis makes it all but impossible for most of our patients to go there.  We aren’t even sure if there’s anyone there who makes arm prostheses – especially for children!  One of our physiotherapists has been working with Paul to make a prosthetic arm using materials that have all been purchased locally. What he has come up with is pretty incredible! Over the past week, Paul has been working on strengthening his shoulder and learning to use his brand new arm! Only a few more modifications are left to be made, and then Paul will be ready to be discharged home.

Paul trying on his cosmetic hand

A double hook attachment that enables Paul to grab and hold!

Paul and his parents

Paul’s parents have remained faithfully by his side. The three of them have remained joyful and enthusiastic throughout his stay. Paul is a bright kid who has taken a special interest not only in his own care, but also in the care of the many children who have come and gone from the ward since his arrival. He has worked hard to learn how to get around using one crutch and his one good leg. He sings with the nursing staff in the mornings before rounds and plays with the other kids on the ward. In September, we helped Paul celebrate his 9^th birthday.

Seeing Paul is my favorite part of each day. He is a remarkable kid. The other day I asked Paul what he thought he might want to be when he grows up – a teacher, a businessman, a doctor? He’s not sure yet, but there’s no doubt that he could probably be just about anything he chooses.

We know that we treat, but Jesus is the one who heals.  We are so grateful to God for sparing Paul’s life, for healing his body, and for allowing all of us to get to know his family through this ordeal. Thank you for praying for us here at Mukinge and for patients like Paul.

Shepherdless

Jesus went through all the towns and villages, teaching in their synagogues, preaching the good news of the kingdom and healing every disease and sickness. When he saw the crowds, he had compassion on them, because they were harassed and helpless, like sheep without a shepherd.  

~Matthew 9:35-36

Not long ago I admitted a child to our pediatric ward. Although she was nearly a year and a half old, she weighed only 5.1 kg (11.2 pounds). She was horribly malnourished and was close to death. As I examined the baby and got the history from her mother, my heart felt so conflicted. Part of me was grieved by the sight of this little girl, by the disease that wracked her body, by her helpless, listless frame. Another part of me was upset, almost angry at the child’s mother. Why did she wait so long? How could she not realize how sick her baby was? Didn’t she see that her little girl was dying?

As Jesus encountered the throngs of people – the lost, the hurting, the broken, the sick -- he saw that they were like sheep without a shepherd.  A shepherdless sheep is a sheep in serious trouble – vulnerable to predators and the elements, lost, and hopeless. The bible does not say that Jesus felt cynical toward them or that he was angry and bitter at the depth of their depravity, but rather that when he saw them, he had compassion on them. The Greek word used here for compassion is splanchonai. The splanchnic nerve is the nerve that innervates the gut and causes the intestines to move.  When Jesus saw the crowds and saw that they were like sheep without a shepherd, he felt literal gut-wrenching love and compassion toward them.

A few days after she was admitted with malnutrition, vomiting, and diarrhea, the little girl died. As we grieved with her family, the Lord did some work on my heart. Instead of seeing the child’s mother as incompetent and uncaring, God helped me to see her as He has seen her – harassed and helpless, like sheep without a shepherd. I was reminded that in the same way, Jesus has seen me as a shepherdless sheep.  He is deeply moved with compassion for a lost world. I have received his love and compassion, demonstrated most fully in his death on the cross to pay the penalty for my sins. He loves each of my patients and their families with the same gut-wrenching compassion shown to me, and he has called me to show this love in return.

Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God. Consider him who endured such opposition from sinful men, so that you will not grow weary and lose heart.  ~Hebrews 12:2-3