My Soul Glorifies the Lord

This time of year, we spend a lot of time talking about Mary – a very young woman, pregnant out of wedlock, giving birth in a stable. We talk a lot about the joy she must have felt – the joy of being a mother, the joy of knowing that God was using her to bring his son into the world. Lately, though, I've started to wonder about the things Mary feared. She had been promised wonderful things, but she was also promised pain: “And a sword will pierce your own soul too" (Luke 2:35).

If there's one thing basically every mother I've ever met has in common, it's that they worry. And the worries of a mother in the developing world are on a whole different scale from those of many of the mothers I know. Did these things bother Mary, too? Mary's first response to the angel was, after all, to be "greatly troubled" (Luke 1:29).

I wonder if Mary worried about practical things. In Bolivia, I’ve met mothers who have little to nothing to feed their children, and I wonder if Mary, Joseph, and Jesus ever lacked food. On the journey to Bethlehem and when they fled to Egypt, did they ever wonder where their next meal would come from? They were a poor family, after all. Did Mary ever go without food so that her little boy could eat?

Did Mary worry about the dangers of childbearing? I have no idea what the maternal mortality rate was in the Roman Empire back then, but I imagine it wasn't very good. Did Mary ever worry about if she would survive to see her son grow up, to realize the promises the angel had made? As far as we know, the promises she received included nothing about what would happen to her.

Mary must have had at least moments of doubt and fear, of wondering how this was all going to work out and if she was doing what it was that God had picked her to do. Yet, in all of this, she sang,

My soul glorifies the Lord
and my spirit rejoices in God my Savior,
for he has been mindful
of the humble state of his servant.
From now on all generations will call me blessed,
for the Mighty One has done great things for me—
holy is his name.
His mercy extends to those who fear him,
from generation to generation.
He has performed mighty deeds with his arm;
he has scattered those who are proud in their inmost thoughts.
He has brought down rulers from their thrones
but has lifted up the humble.
He has filled the hungry with good things
but has sent the rich away empty.
He has helped his servant Israel,
remembering to be merciful
to Abraham and his descendants forever,
even as he said to our fathers.
Luke 1:46-55

This Christmas, I’m praying for a bit more of Mary’s courage, and for all of the mothers around the world who share some of her fears. And I am praising the God who “has filled the hungry with good things” – who sent his Son to become fully human, to share in our sufferings, our hopes, and our joys.

A Confession

I had been in Bolivia for a week and a half when I saw her. It was past dusk, and she sat on the side of the road, weaving on a small hand-held loom. She couldn’t have been more than ten years old.

I walked past. I’d seen this before, in Guatemala, in Mexico, in Bolivia. I knew she would probably sleep on the street, but so would a lot of other kids. There wasn’t anything I could do.

It wasn’t until later that it hit me. I’d become calloused. Things that used to shock me no longer shocked me. I prayed for forgiveness, and I prayed that God would protect her.

It’s hard, when you see things like this on a regular basis, to continue to care. We get used to suffering. To protect ourselves, to be able to keep living our normal lives, we stop letting it bother us.

I decided that night that I never want to become calloused again. I never want to let other people’s pain stop bothering me. With Bob Pierce, the founder of World Vision, I pray, “Let my heart be broken by the things that break the heart of God.”

We have a God who did not just walk past when he saw us alone, sitting in our brokenness and pain. We have a God who came to us in our poverty and need, who made himself one of us in order to save us. I am so glad that he did not just walk on by.

Please Help Me

“Please help me,” she begged. Kneeling before me, tears running down her face, she asked again, “Please help me.”

It was three days before I would leave Bolivia, and I was visiting the home of one of our patients. After welcoming me into the one room where she and her six children slept, she had offered me a glass of juice and begun telling me her story.

She told me of past trauma, of secrets that she had only before revealed to her priest, of the predatory lender for whom she slaved. “Please, just give me the money to pay off my debt,” she asked. “I won’t ask for anything else; just give me the money to pay my debt.”

I didn’t know what to do. Her debt was $1,000, and she was asking me to pay it. I don’t have a thousand dollars just lying around. And, more than that, how was I to know if her story was true? How could I trust that she wasn’t simply trying to manipulate me, a (relatively) wealthy American?

I asked if I could pray for her, and she agreed. As I prayed I couldn’t stop thinking of James 2:15-16, which says, “Suppose a brother or sister is without clothes and daily food. If one of you says to him, ‘Go, I wish you well; keep warm and well fed,’ but does nothing about his physical needs, what good is it?” This question kept echoing in my head. What good was it for me to pray for her, if I did nothing to help her?

I gave her everything I had in my pockets, just reserving enough change for bus fare home. It wouldn’t do much for her and her family, but, if her story of her children going hungry were true, it would at least purchase food for a day or two.

As I left, I promised to pray and to talk to some people and to see what I could do for her. I couldn’t promise to give her a thousand dollars, but I promised to help if I could.

When I got home, exhausted from the effort of listening, praying, and trying to decide what to do, I called my friend Javier, a lawyer. I told him her story, of the 20% per month interest the lender was charging. I hoped Javier would help, as he’d told me before about his interest in providing legal assistance to the poor. I couldn’t think of a better case to start with.

When he heard about the exorbitant interest, Javier confirmed my suspicions. “That’s illegal,” he told me. “5 or 6% is okay, but 20% is not.” He promised me to help her, that he would start the legal proceedings necessary to free her.

I left the following Monday, praying that Javier would be able to help, that, if her story were true, he would be able to take on her opponent and win.

I don’t know what will happen to this woman and her family. Will they lose their home, as they fear? Will she give into the despair that has tempted her to take her own life and that of her youngest children? I pray that the answer to these questions is no. I pray that God will take up her cause, that he will bring justice and set her free. I pray for Javier, that he will be able to pursue this case and win it.

I think that I made the right decision in this case. I think that I have done what I could for this woman and her family, even though it isn’t what she asked me to do. But these are questions I may never know the answer to.

I wish I knew, but I don’t. All I know is that I have entrusted them to my Heavenly Father, and that He loves them and has the power to save them. In that, I put my hope.

Things We Are Thankful For

This Thanksgiving, we'd like to take a minute to stop and reflect on the ways God has blessed our ministry. Here's a brief list of things that Hospitals of Hope is thankful for:

• Our Heavenly Father, whose mercies are new every morning
• The opportunity we have to share his love through this ministry
• The chance we have had over this last year to expand our ministry though Clinics in a Can – and the way this aspect of our ministry continues to grow
• Our partnerships in Liberia, which are growing and bearing fruit
• The gifts of good health, plenty of food, and clean water
• Our amazing international volunteers, who give of their time, their talents, their energy, and their compassion.
• For the way God is working all over the world – bringing us volunteers from all over the US and from as far away as Australia, New Zealand, and Scotland
• Our local volunteers, who have done an amazing job organizing our warehouse, helping build Clinics in a Can, and keeping our office running
• Our interns over the past year – Andrew, Savanna, and Amanda – who have been a huge help and done great work
• Our donors – those who have supported us faithfully for years and those we have just met
• Our local partners in Wichita, like Wesley Medical Center, who has been a huge supporter of our work in Haiti
• Our US staff members, who give so much of themselves to our work
• Our Bolivia staff members, who work hard to serve the community surrounding our hospital
• Guillermo and Claudia, our new guest house hosts, who are going to do a fabulous job
• YOU! Thank you for all that you do to support our ministry!

The Art of Sterility

Check out this blog post by Letitia Juday, one of our volunteers in Bolivia:

On Thursday, November 4, 2010, my life here in Bolivia, and my responsibilities at the hospital, changed suddenly and drastically. Having just left morning rounds to take Conta (one of the two Scottish volunteers helping out for two weeks) in to see a reconstructive surgery on a woman’s humerus, I dressed myself in my little booties and cap and mask like usual and entered the quirofano. I looked at the x-rays on the wall and saw where the woman’s bone was broken in two places close to the elbow, and I watched as the surgeon spread povidona over the woman’s arm to clean it.

That’s when it happened. Nelly, the woman in charge of the quirofano and the first surgical assistant, said something to the doctor about me helping him. Then she began speaking at me, but it’s very difficult for me to understand Spanish which is spoken from under a mask. She motioned for me to remove my ring. At that point I thought she was asking me to put on non-sterile gloves and help clean the woman’s arm. So I reached for the gloves.

“No, no, no!” She shook her head and gestured for me to enter the outer room…where the sinks are! I could not believe what was happening: I was being instructed to wash my hands up to my elbows, be sprayed with iodine, dry my hands with a sterile cloth, be dressed in a sterile gown and gloves, and be the second surgical assistant!

I had seen this done many times. The interns were always the ones who assisted Nelly and the surgeons, but of course, the interns have been gone for more than a week now. There are two interns left, our friends Anghelo and Vladimir, but their expertise is better utilized in the ER or with internalized patients, and they are not always there. I realized as I stood with my hands folded in front of me in all of my sterility, that I was the obvious choice because I speak Spanish and they wouldn’t have to pay me.

I pulled aside ligaments and other tissues with a separator tool (Nelly told me today what it’s called, but I’ve forgotten) and used the aspirator to suck up excess body fluids. I also was in charge of cutting stitches.

I’ve always wondered how, if I get tired of being on my feet long enough to watch most of the surgeries, the surgeons and assistants stand in their gowns under those bright lights for so long without getting tired. And I thought that I would never be able to do because the first time I watched, I passed out. And all the other times, I’ve gotten very tired. But I suppose I have become accustomed to being in that room. Although I was aware of feeling tired and hot, I did not come close to overheating or passing out. I had a job to do, and I fully enjoyed doing it.

The doctors temporarily clamped the bones together and then used screws and a long, narrow plate to permanently fix it. And her bone was fixed.

I wondered if this dream-like experience was a one-time opportunity, or if I would get to assist again. Friday came and went with no surgeries. We had a lovely weekend visiting some Incan ruins, going to the movies, and going to church. But I stayed up late Sunday night and woke up Monday feeling slightly under the weather. So I decided to stay home from rounds and not go over to the hospital until Tuesday. But at 9:00 AM, the Scots came running in, and I heard four beautiful words, “You’re needed in surgery.”

I forgot all about how tired I was and ran to my room to put on my scrubs. Then I ran over to the hospital and went straight to the sink to wash my hands. When I went into the quirofano with my arms dripping iodine, there was Nelly smiling at me (well, her eyes were, anyway- it’s hard to smile at people with a mask on) and holding the sterile towel for me. The surgeons greeted me cheerfully, trying to pronounce my name, which they had learned Thursday, in English. That day I used separators and braced a man’s ankle in various positions as the doctors fixed both the talus and fibula. I learned how to properly trade places with a surgeon (back-to-back) and how to properly hold the scissors and cut stitches. Once again, I was fascinated.

On Monday, I asked the surgeons and Nelly if they wanted me to buy a cell phone so that they could call me at any hour of the day or night to help, and they said “Absolutely.” So Tuesday I bought a pre-paid phone at La Cancha (a large, market district of the city). Tuesday passed with no surgeries, but this morning I was eating breakfast, about to go over to the hospital for rounds when our house phone rang. Leta answered and then turned to me and said the beautiful words, “Tisha, you’re needed in surgery.”

Today, it was a C-Section! I went over long before the surgery started, so Nelly and I got sterile before the surgeons arrived, and she taught me my first thorough lesson in the art of sterility. She told me how to dress myself, how to put sterile gloves on the doctors, how to put the sterile cloths on the table and arrange the gauze and bowls. She taught me the names of instruments as she pull them out and she taught me where each belonged on the table. She taught me about the various types of sutures, and how to open the kit and grab the curved needle with the forceps to get it ready. Then she taught me how to cover the patient with sterile cloths and prepare the electro and the aspirador.

It’s difficult to learn from people who speak Spanish behind masks, but I tried to follow instructions when I understood them and not move if I didn’t. The other obstetrician arrived, we began the surgery, the baby came out, Nelly and I handed it in a sterile cloth to the pediatrician, the placenta came out, and the doctors stitched up uterus, the peritoneal lining, and the muscle and fat layers. Then Nelly was left to do the final skin sutures. After she began, she handed me the tools and told me to do dentrodermico sutures. But I said, “Okay. Teach me how.”

“You mean you don’t already know?”

“No. I can do simple stitches, but that’s all.”

“Oh, well, then give them back. You just watch this time.”

So I watched very closely. At the rate Nelly is rushing me into things, I might be doing sutures before long. But I’m in no hurry; and if I do end up doing them, it will only be under Nelly’s close supervision.

I feel like Nelly’s young padawan, and she is my master. So far, I have been gaining confidence in the art of being sterile. Next, I hope to learn the names of instruments, anticipate surgeon’s needs, and learn to suture. I am so thankful that Nelly fully intends to teach me everything I need to know to be a competent second surgical assistant, and she now has my cell phone number, so tonight, for the first time, I am on call. If there is ever an emergency surgery, I will receive a call and have to go straight over to the hospital. I’m not wishing for bad things to happen, but hopefully my cell phone will be necessary someday soon.

I never expected this glorious responsibility. I never expected to hear so often, “You’re needed in surgery.” I hope I learn as much as I possibly can as I enjoy a front-row seat to these fascinating operations.

Read more about Letitia's experiences on her blog: http://pakasqa.wordpress.com/

Jungle Clinic

The elderly Quechua man hobbled into our clinic supported by two canes. He wore a "Franklin L. Williams Middle School, Class of 2007" shirt, doubtless a donation from the US which obviously did not suit his 98 years. Although walking was a struggle for him, he slowly made his way around the room, greeting all of the volunteers and waiting patients personally. He spoke only Quechua, and his hearing was very poor, so our communication was mediated by a translator shouting into his ear.

This man was one of the 30 patients we treated at our clinic on Saturday in the Chapare, the Bolivian jungle 6 hours from Cochabamba and a major center of cocaine production. Patients began showing up an hour before the clinic was to start, having walked for miles from their homes in the countryside to see the doctor.

Some of these patients had waited too long for medical care. One girl came in with an infection in her foot from a thorn that had punctured her big toe over a month before. Because the infection was so severe, our doctor could only give her antibiotics and a referral to a surgeon in a nearby city. Many came in with vitamin deficiencies, and we gave out shots of vitamin B12 like candy. A few came in with chronic headaches, and, while we gave them pain medication, we also gave them an anti-parasitic drug and instructed them to visit a nearby hospital for neuroimaging. In that part of the country, neurocysticercosis (brain lesions from a parasitic infection) are very common.

The treatments we could offer in a one-day clinic were limited, but we did what we could. It's hard to see so much need and only be able to meet a small part of it. Even in cases where we were able to offer a complete solution to the medical problems presented, we knew we could not even begin to address the poverty we saw all around us.

As we drove home that night, we passed by wooden shacks with light pouring through the cracks between the boards. No light escaped from others, probably because they didn't have electricity.

Despite this, our volunteers were struck by the joy they saw on the faces of those we treated and in the pastor we stayed with and his family. The pastor explained to us that things used to be much worse in the Chapare, in the years past when the drug trade was at its height. Despite the money circulating through the region, the area was less developed, and there was less hope. God has been working there, he explained to us, and he participates in this work every day by broadcasting the gospel in Spanish and Quechua on his radio station. He has opened his home for volunteer teams, like ours, who are able to alleviate, to a certain extent, the physical needs of many there.

Although what we are doing seems very little, it is part of the light breaking into the darkness in Chapare. Like the homes we saw spreading light into the jungle, we are spreading rays of our Father's love. Right now, the light seems dim, but we know that one day, the night will shine like the day.

New Creations

This morning started out slow at the hospital coffee shop, so I stood in the back of the waiting room for awhile and listened to Nestor Hugo preaching to the patients. He had a CD of worship music, and he'd play a song and sing along and then talk to the people about the message. He had one song on repeat for awhile, one about how in Christ we are new creations, that we are no longer what we were. God is the one who heals, Nestor Hugo explained; he alone can make us new. I listened for awhile while he preached in Spanish; when he switched to Quechua I came back to the cafe and waited for customers.

The rest of the morning I stayed busy at the cafe, before returning to the guest house for lunch with the volunteers. Two of them are working on preparing a lesson for the girls at an orphanage that we visit frequently. Most of these girls have experienced abuse, which makes the lesson the volunteers are preparing -- about God's plan for sex -- particularly sensitive.

The volunteers are focusing on education, making sure the girls understand the way sex affects people, physically and emotionally. It's something God created, they will explain, but many have abused this gift.

They especially want the girls to know that they are not responsible for what has been done to them, but that they have a choice, from now on, about what they do with their bodies.

These girls, who have no choice about their past, have a choice about their future. They have been treated as if they were cheap, but they are so precious that our God died to make them new.

2 Corinthians tells us that "if anyone is in Christ, he is a new creature; the old things passed away; behold new things have come." I often forget that this verse is followed by this next sentence: "Now all these things are from God, who reconciled us to Himself through Christ and gave us the ministry of reconciliation, namely, that God was in Christ reconciling the world to Himself, not counting their trespasses against them, and He has committed to us the word of reconciliation" (2 Cor. 5:17-19).

The message Nestor Hugo was expressing this morning, is the same as the message we're trying to bring. It is the message that has been entrusted to us -- the message of reconciliation, of hope, of the opportunity to be made new.