today with Dr. Rick

Hi from Dr. Rick.... sorry to have been so scarce since January.

I spent the day today at the hospital. Arrived around 8:40, after a few urgent emails this morning at home. I’m so excited about the new ultrasound machine that Dr. David McLaughlin got the Sonosite company to donate (and he also contributed several probes to make it operational). Dr. Ben Kanwee, one of my Liberian colleagues, did all the ultrasounds today but called me in a couple times to “consult”... mainly OB patients, a few gyn cases, one lady who probably has cancer in the uterus (but looks like it may be cured by surgery).

Dr. McLaughlin helped me in the office today, so after seeing a few outpatients, Sis Bee Mason from the Counseling Dept (the folks who take care of our PLWAs.... people living with AIDS) came by to let me know about a patient she wanted me to see. The lady had been getting sick over the last few years, off and on, and had been diagnosed with HIV infection at another clinic. But she decided to come to ELWA to get her long-term treatment. She had just started taking ARVs (Anti-Retrovirals—the “real” AIDS drugs that, if taken properly, can suppress the virus and restore the immune system) about a week ago. Over the last few days she had increasing rashes on her body and itching, and now for the last day she’d developed red, itchy eyes. She was reacting to one of the ARV drugs—a reaction that could have become life-threatening if she hadn’t come and reported it right away. The road to recovery and health for someone with AIDS isn’t easy, and requires lots of interactions to deal with side effects, drug reactions, and other infections like TB or diarrhea. After talking a while about her medications and what our plan would be for dealing with this drug reaction, I asked her a couple questions about her family and home situation. Unfortunately, she had informed a couple family members she is living with about her status, and they are thinking of moving out.... just when she needs their support! She started to choke up. Fear and Stigma are very real here, and our counselors have to work very hard with clients, helping them figure out who to inform about their disease, and how and when. I gave her some words of encouragement and told her to come back in 5 days for another visit.

I reviewed the statistics for the first couple months of this year—last year we diagnosed 222 new cases of HIV infection, including 20 children. So far in January and February, we have diagnosed 50 new cases ( if this 35% higher rate keeps up, we’ll diagnose over 300 cases in ’07). In addition, around New Year’s we started offering testing to the pregnant women in prenatal care, and we had 10 cases of HIV infection out of about 225 women tested. So this is quite sobering. We have 200 patients on ARVs now, up from 90 when we got back in June of 2005.

Seeing our PLWAs get the care they need, including real human touch, love, and support, is a big part of what motivates me to be here... thank God for such a great group of Liberian believers to work with on this ministry!

Just a nice boat going by at the end of the day to share with you a picture of the end of the day here in Liberia.......................................

Welcome to Liberia!

I spent the last ten days working to get housing ready for a short term nurse, Grace, and a new family, Tom and Melanie Goodnow. My shoulders still ache from scrubbing walls and hanging curtains, but with a little help from my friends (thanks, Janna, Frieda, Bill, Sis Bindu, Morris, Eric and of course, Rick!) we had the places in pretty good shape – clean and well, almost everything, working…..we did our best.

The Goodnows are here for 5 months, and Tom will be in the OR, as a nurse anesthetist, also training ELWA Hospital’s OR assistants in anesthesia. They have 4 boys, one of whom (Joel) is Caleb’s age, so the two of them are now tethered to one another. The others are Tim (17), Nathan (4) and Daniel (2). Goto http://www.goodnows2go.com to see a picture. Please pray for all of us as we get the Goodnows settled in, because it is not a small thing to make such a big shift. They came from California, so they are still trying to get on schedule, and little kids just can’t force it the way we adults can. And then there is the whole deal of learning to cook with different foods, and coping without a washing machine (ours went down at Christmas and we won’t have new ones till the container comes, probably in April), and the heat and humidity, and the Liberian English, etc, etc. It’s just not easy. Seeing the reality again reminds me that we need to pace ourselves as we accept new missionaries and rebuild our team.

In addition to the Goodnows, we have Dr. Dave McLaughlin and Dr. Gene Birdsong (who came through Northwest Medical Teams) helping out at the hospital giving the docs a little relief from the workload; Hanna Cho and a friend, medical students from Korea; Grace Heister, Dr. Dave’s niece who is a nurse, and Cork Loken, a former ELWA Radio missionary here helping out the technicians! This is a big team (for now- they’ll all be gone by March 11)! It is certainly challenging our “small-time” methods of hosting and orienting people, and I am feeling a little guilty, like we are not really serving them like we should – having them for meals, touching base with them to see how their day was and what they are working on, what their questions and frustrations are, etc. I bet this is a lot like a pastor feels as his church gets bigger. But it is also an opportunity I guess, to let God be their guide, to let our national partners connect with our missionaries more directly, and to let our other teammates mentor and encourage the new folks as well.

Well, that’s all for now. I did actually go to the beach today, which means something like I am having a breather. It won't last for long - since we have more people coming next month and it's right around the corner!

It's a small world after all!

I know you are going to hate me for titling this entry after THAT cliche song that drives you crazy once it's going around in your head, but sometimes you just have to say it.

About the time Trina left, a med student from U. Nebraska arrived. Her name is Beth Larson, and she is Korean, but she was adopted by an American family when she was about 18 months old. In addition, some Korean missionaries in town, who have been here for 20+ years, came by in January to ask if their med student (in Korea) daughter could come and do a month long rotation at ELWA. Their daughter Hanna grew up here, and went to Houghton College in NY State (near Cuba NY, Rick's mom's hometown), so she speaks perfectly good English. Hanna's family had us over for dinner one evening - always a treat because the Korean food is so great - and she and Beth started comparing notes (a very Korean thing to do -when were you born? when did you graduate from high school? etc) Before long, they realized that they were born in the SAME YEAR, in the SAME MONTH (probably, Beth's birthdate may be an estimate the orphanage made) and get this - the SAME CITY in Korea (not Seoul, a smaller one)!!!! Very likely the same hospital. So here they are, in AFRICA, finding one another! Weird, huh? Their time at ELWA Hospital is overlapping by a couple weeks, so they are enjoying each other's company.

Rick is off to Senegal on Sunday for the West Africa Leadership Retreat with our new Deputy International Director, Joshua Bogunjoko. A few weeks ago, I realized that there was too much happening here for me to go along, and it turns out the we will have the Goodnow family of 6 plus a short term doc and nurse all arriving on the 18th due to delays and flight schedules. So it would have been rather difficult to be ready for them if I was out of town the week before.
Rick will get to see Max's new digs in the dorm at D.A. (like that alliteration?) and arrive home just in time to welcome the new folks.

So that's the news from this side. Next week would be a nice week to get a few extra hellos from out there since Rick will be gone....

So Long Trina!

This is Trina Schmitt (the white one) with her friends Famatta (the girl) and Charlie(the boy). Trina has been here for about a year and she's leaving at the end of the week. (boo hoo!) Trina came to do youth and children's ministry. She led a girls' Bible Study, organized a teen sport time on Friday afternoons, helped a local church launch their children's Sunday School and Junior Church programs, spent time in a village helping the pastor and his wife in their kindergarten school and sharing the word of God with people, and lots of fun stuff too. We went to her church today for their good-bye program and it was pretty teary. But as several people said, it was also a celebration, because the purposes for assigning her to that church for the year were accomplished in wonderful ways. Just having someone there to help train teachers (even though she didn't feel she was equipped in that) stimulated the church to get a shelter built for the children's program. The youth group was going through a transition in leadership and she was able to encourage the new leader to be active and develop the program. In conjunction with her girls' Bible Study, she organized a retreat that the church is planning to continue holding. Though the church will miss her a lot, they are equipped, encouraged and completely able to carry on these ministries on their own.

ECF's first Children's Christmas Program

Trina's time here really illustrates for me the role that missionaries still have to play in the church in Liberia. Liberia's churches have many strong believers, who love the Lord and are willing to serve Him. Sometimes they need tools and skills. Sometimes they just need help getting something started because they feel inexperienced or inadequate. It's amazing what can happen in a year - how the ball can really get rolling.

So thanks, Trina for coming! We know you would give the Liberian answer: Thank God. And we do. We know He was the one who sent you and He kept his promise to complete the work that He began in you, and through you. Bon Voyage and a bientot (that means see you soon!)

I just can't resist saying it

The saying "the difference between men and boys.....is the size of their toys" seemed to come to life last week when Jim Molenhouse, from the Wheaton Bible Church team, spent much of his last 24 hours in Liberia getting this old dinosaur running. It's a road grader and it's about 50 years old. (only MACHINES this old are dinosaurs...) Here he is doing a little work at the end of the driveway next door which had a nasty divet that even our new jeep couldn't get over without a good jolt. He didn't get to do much grading because he needed some good "laterite" clay soil to spread around on the roads and there wasn't time to get it. But he still had fun with the few spots he could do, and the suspensions on our cars are grateful (I often apologize to my car when I can't avoid the most serious holes and ruts- ouch.)

Notice who just had to join Jim in the driver's seat.....it's Jared of course.

January Update

We sent this short update out last week. If you get it, sorry that you thought we had a new post and it's old news to you. If you don't get it, you can check here for monthly updates (about) or drop me an email to say you want to get it via email.

I'll write more soon.

Dear Friends –

Happy New Year! We’ve hit the ground running, with a construction team from Wheaton, Illinois, that arrived on January 3. They’ve already got most of the framing for the roof of the new Services Office Building in place (a couple of them arrived the 29th and got started with the Liberian carpenters the next day). In addition, we moved our SIM office to our new location on the ELWA compound this week. (Moved, but not really moved in- but it’s a step in the right direction.)

We enjoyed a great holiday with a nearly 2 week visit from Rick’s dad and his brother Doug and his family (wife Deidre, daughters Haley, Hannah and Maddi). There was lots of beach time, tours of Monrovia and ELWA and even a jaunt out of town (see our blog at http://iscripts.blogspot.com for proof!)

It’s a little scary to face this, but our schedule for 2007 is very quickly filling up. We have a steady stream of people coming over the next 6 months, for a variety of reasons. Medical students, short-term docs and nurses, radio consultants, teacher trainers, administrative consultants, and more. It’s even beginning to get tricky to be able to house everyone.

The logistics of getting all these people here and finding a place for them to sleep is a big enough task. But it looks like we will be really having to work a lot on our mentoring and support systems for all our new people, both short term and long term. We have been developing some materials for orientation, but they still need more refinement and some kind of structure to be a real “program” that will help get our new missionaries plugged in to their ministries and the Liberian culture. We want everyone to have a positive experience here but we’ve pretty much been flying by the seat of our pants during the lean years. Admittedly, we haven’t always been successful at that, and we’ll be even less so as we start receiving more people, unless we get more systematic about it.

We do love interacting with newly arrived missionaries -- we enjoy their enthusiasm and zeal for ministry and are happy to help them understand more about the people of Liberia and their way of life. But you can imagine that it is also a challenge to be involved with people as they get through the ups and downs of culture stress and adjustment, finding their niche in ministry and sometimes just growing in the Lord and as a person. Our prayer request this month is for the power of the Holy Spirit to uphold us and flow through in this role – to have love, and joy, and grace, and patience that really come from the heart of God towards our new missionaries and not to be relying our own strength.

These folks are expected in January and early February:
Frieda Schmidt – dental therapist, new SIM member from Canada (arrived 1/5)
Beth Larson – medical student, 5 weeks.
Hannah Cho and Eun Yung Ahn - medical students from Korea, 4 weeks
Tom and Melanie Goodnow, plus 4 – nurse anesthetist, 6 months
Gary and Tammy Dunseath, plus 3 – pastor’s training, new SIM members from USA

Pray for them and for us!
His Kingdom Come, Debbie Sacra

Happy Birthday Caleb!

Today is Caleb's birthday - he is 10 years old! That's it - all of them are now in double digits. His birthday often gets overlooked, being right after Christmas, so I really wanted to make an effort for him this year, even though when I first asked he didn't really sound like he cared. After a little pressing, he decided he wanted to have a dinner party - Italian food. So we decided on lasagna (no small feat since I have to make the ricotta myself; at least I don't have to make the noodles) - and he adds "with olives on the side, for those who like them..." So I asked, "do you like olives?" and he replies "no, of course not, but someone might." He often cracks us up with such funnies. I know I should write more of them down, but I suspect they will keep coming. (Yes, I did serve olives) Caleb is our people-person - he prefers to be with someone, and actually it doesn't really matter what they are doing- he's flexible on that. He sat in "jail" this evening while playing capture the flag with a high school guy from the construction team that is visiting without much angst - Joel said Caleb said that when they get released they should run out in triumph. Where does he get these images? Actually, I suspect that much of it comes from Calvin and Hobbes.

We love you Caleb! Happy Birthday and God Bless You!