31.7.13

Big Rig Send-Off

By John Cropsey
The McCropders have finished packing a forty foot, metal clad box with what remains of their earthly possessions mingled together with "essentials" for their work and ministry . . .  generators, welders, motorcycles, drill presses, axes, six foot steel pry bars, sledge hammers, indestructible Kevlar soccer balls . . .  OK, we even let the girls put a few things on too.  However, given the shear amount of testosterone contained with in this shipping container, it was only fitting that her sendoff be performed by two beastly wreckers and a maxed-out big rig chassis.  Feast your eyes on the video below of nearly 40,000 pounds being dead-lifted off the ground and onto a semi chassis as my son Micah and I revel in the music of big diesel.


(click this link if you have trouble playing the video above)
Credits: background music "Green" by Kissinger.


The McCropder men take our hats off to the ladies of the team who have been willing to say "au revoir" to homes, goods and the financial security of a higher tax bracket.  Instead, they risk losing that which remains to the bottom of the high seas or into the hands of brigands by land as our metal box journeys from the shores of the USA to the landlocked interior of Africa.  As we bid "a Dieu" to our container and its contents, we rest knowing that our Heavenly Father knows exactly what we do and do not need to minister His Good News most effectively in Burundi.  If these mere earthly things would hinder us or our brothers and sisters in fruitfulness, may they come to rest at the bottom of Davie Jone's locker.  

30.7.13

Prayer for Planting

The long-awaited date is getting close.  In less than two weeks, our team will have relocated to Burundi.  It's been almost two years of active preparation, and almost three years since Rachel and I took the first scouting trip there.

Pray for us.  There is travel and logistics.  There are the throes of transition, especially for the kids, with or without jet-lag.  There are first impressions, and the first moments of relationships that will likely last a long time.  Pray for us.

Another prayer request:  Pray for us as we plant.

Explanation:  For each adult on our team, it has been the same thing.  Since leaving home at the end of high school, we have moved often, and we have always known that this place has a definite time limit.  For the doctors, college was four years, and we knew med school was coming.  Of course, that wouldn't last, and residency would follow, which was always (thanks to the grace of God) limited as well.  Then we moved to Kenya, and we knew that was for two years.  We headed back to the States, but that was temporary, as was language school.  And then, after 15 years or more... We arrive.

I'll draw a distinction here.  The Faders signed on for six years in Ann Arbor.  I lived there for seven (though I thought it would be shorter).  It was a decently long time, and we invested in the communities around us.  Even in Kenya for two years, we were always trying to act in ways that made sense beyond our own tenure, trying to avoid solutions that rang of "well, I won't be here then, so whatever."

However, there was always a next thing.  And, in two weeks, in a very real sense, there will be no next thing.

What does that mean for us?  Of course, it means that there are a lot of unavoidable expectations.  More than that?  Who knows?  This is uncharted territory for us vagabonds, and that is precisely the point.

We have been striving to approach this vision from a long-term perspective.  Why else do all the language-learning time and effort?  And we are thankful for all of you who have shared this perspective with us.  This is our goal.  What will it feel like?  We wouldn't know.  

Some of you readers would.  You have been through this.

So, pray for us as we plant.  When Jesus talked about planting (which he did frequently), the images abounded.  It's like the seed dying, so that it can be born again, and better.  The seed is sown, but then there is mystery.  We don't know exactly how growth happens after planting.  We have to trust.  Plant where you will, but you can never be sure who your neighbors will be.  Thorns?  Weeds?  But the planting is a beginning.  And at the end:  Harvest.  And that is in the sure hands of our Lord.

26.7.13

COTW: HIV and lung disease

(from Eric)

We have a 40 year old Maasai lady on the female medical ward currently, named Janeth.  As I've been pinch-hitting on Rachel's off days from the hospital, I've seen her twice this week.  She is infected with HIV, and the infection has progressed to AIDS.  She came in with severe difficulty in breathing, very low oxygen levels, and an X-ray of her chest which just shows some vague opacities on both sides.

I have seen this case dozens of times.  It is the nondescript "HIV and lung disease" case, where they are very sick, and you're not sure what the cause is.  The primary offenders of concern are a wicked "normal" pneumonia, pulmonary tuberculosis (which is more common and severe in AIDS), and PCP pneumonia (which is reserved for patients with bad immune systems).  There are a slew of other possibilities:  MAC pneumonia, CMV pneumonia, pulmonary embolism, pulmonary Kaposi's sarcoma... but we have little in the way of diagnostic or therapeutic help for these, so we stick with the Big 3.

Part of me always wishes we could just choose one, or start with one and add other therapy if it doesn't work.  That's nice and clean medicine, like what I was taught in the US.  But it is a luxury that we give up.  This lady, and others like her, are too sick.  We cannot wait.  We will just be grateful if they make it out the other side of this illness, in time to get started on HIV meds, and maybe start their lives again.

A similar triad exists in Pediatrics.  The "Comatose kid already treated elsewhere who was referred here due to lack of improvement".  The triad is Bacterial Meningitis, TB Meningitis, and Cerebral Malaria.  Initially, in a desire to avoid unnecessarily committing a kid to more than 6 months of TB meds, I would hold off to see if they improved with therapy for the other two.  I changed my mind.  They are too sick.  I will always be happy if they survive.

This is, in fact, a general paradigm shift for medicine here.  My training tells me to do things for reasons of finding a sure diagnosis, reassurance, or piece of mind.  Here, we are often shooting in the dark, and I don't mind using a shotgun, if it means I hit the mark nonetheless.

So, 2 antibiotics for pneumonia, 4 meds to cover tuberculosis, horse doses of Bactrim to cover for PCP, and steroids to help the Bactrim, given how bad her PCP is.  As much oxygen as we can blow.  Prayers for her and her family.  Last night, she stopped breathing.  The intern was called, and when she came to write the death certificate, she was found to be breathing again (? I'm only reporting what I was told).  Now she is conscious again, able to talk a little, but looks terrible, and her oxygen level is 65%, several marks lower than what we would consider compatible with consciousness.

Pray for her.  We will continue to do what we can.  Outlook is poor.  But, on the other side, it will be her survival that will determine the quality of our style of medicine, and it's a bit surprising how I have grown accustomed to that.

24.7.13

A Song For Albertville

As perhaps a final salute to our time in France, I made a rough recording of a song I wrote to try and capture something of our little alpine town.  There are obvious images which, for those of us who lived there, recall various everyday sights and sounds, and for those who haven't, hopefully share something of the world around us, like a little musical scrapbook.

Beyond that, the song is trying to describe something of the ambiguity of "post-Christian" Europe.  Beautiful scenery, walking to the bakeries, narrow streets.  On the other hand, things that are just a bit off, maybe more than a bit tragic:  Empty churches, war memorials that bespeak of not-too-distant loss. And yet, even there, where perhaps the masses have decided to abandon God, his grace falls like the rain, and his goodness abounds.  It's a mixed goodness, like all that we would experience on this Earth, but, in the words of Buechner: "What's lost is nothing to what's found.  And all the death that ever was, if you set it next to life, would barely fill a cup."  

It's a fact to be learned anywhere in this wide world.

(sorry, the web music player I was using is not working currently.  So, the only way to listen is to follow the link and download.  I swear it's a clean file, having placed it there myself.  Web gurus: feel free to suggest a solution to this problem.)



In the autumn, we'll go walking
all through this valley town
Across the railroads, and down to the river
where the alpine peaks look down

And when we turn into a narrow passage
where the wind is brisker
and it scatters all the leaves and all the halves of chestnut shells
up above, under the eaves, where the sun in shining
all the ivy's afire with the red and bronze
that's ringing like a bell

And the bell's ringing on the hillside
at the church of Conflan's tower
though there's never anyone on the inside
and it always rings eight minutes past the hour

though there's much in what's been lost
it's as yet nothing to what's found
there's beauty and there's tragedy
like there is sky and ground
and this is where we live
where the alpine peaks look down

When the fall passes to winter
the snow will hike the downward trail
from the rocky peak of Belle Etoile
to every hollow of the vale

and our boots will trudge the unplowed walk
four times a day to the school
to take our kids across the street into the warmth of the bakery
coming home, they're running in the snow
as we pass by a pillar
topped with a stone eagle with its eyes full of bravery

it's the monument with all the names there
of all the sons of the town
felled amidst the two world wars all those years ago
that their memories would go on

----

When the peaks are green again
then it won't be very long
until it's our turn at the station
for the train to take us on

We'll have glanced up against the story
the mark is small, but indelibly made
and that's fine, for the story's held by ancient hands
they work mysteries, but never have they strayed

22.7.13

RVA and Africa

Last week, Rift Valley Academy held its annual graduation ceremonies.  For those of you who have never heard of RVA, it's a boarding school outside of Nairobi, primarily for missionary kids living in Africa.  I think it's a K-12 school, although most kids don't board there until they are in high school.  Sarah taught there for three years before joining our team, and Jason is one of its (most illustrious) alumni.  If our kids were to someday need to go to boarding school, this is where they would go.  I don't know what the future holds for our kids' education, especially secondary education.  And the thought of sending my kids several countries away to go to school is tough (even though it's really another 10 years away).  BUT I can't say that a little part of me isn't really excited that my kids would get to go to such an awesome place for high school, and be a part of a school choir that sings this song every year for graduation:

19.7.13

Another Day of African Rounds

(from Eric)

We are back in Kenya at Tenwek for a few weeks.  Our family's goal was to get Rachel back into clinical work, with my priority being supporting our kids through this crazy careening transition known as our life.  But yesterday, Rachel was at home, and the Pediatrics team was just one visitor, so I thought I would go up and help out for rounds.  Like Rachel wrote recently, it felt like our hiatus could have been just a few months, and it was shocking how much information came suddenly flying back to the dusty synapses of my brain.  

I have no white coat, no reference books, no stethoscope.  No ID badge either, but everyone knows me, so I just kind of went around with the visitor.  We saw the two ICU kids, then a kid in the ER ("Casualty" in Kenya).  Then we met the team for a chai break, and rounded with the interns.  

At lunch, Rachel asked me what kind of things I had seen.  I gave her a little rundown:
  • More HIV than normal, several of them really malnourished.
  • One of them has a recurrent nosebleed with platelets of 6, probably chronic ITP from her HIV
  • Another was a new diagnosis at age 11, which was kind of weird, but is now really wasted with lymph nodes in his belly that are hopefully TB and not cancer.
  • There were also a lot of heart failure kids, one of whom is terribly palliative, but several were getting somewhat better.
  • Diarrhea, pneumonia, bronchiolitis, that kind of thing.
  • A few bacterial meningitis kids who are getting better, but
  • the kid in the ICU came in with presumed meningitis with an asymmetric pupil.  She's been stable, but mostly comatose for nine days, so we actually decided to recommended getting a head CT.  First head CT I've ever ordered at Tenwek.
  • There was a kid in the ER with a big swollen face, probably nephrotic syndrome, was good enough to go home, and lives nearby, so that will make their follow-up easier....
After a little pause, Rachel asked me if I enjoyed being back, because it sounds like kind of a depressing set of patients.

I thought for a moment, then told her, a tad bit sheepishly, that I really enjoyed it.

Why?

After years of preparation and spending most of our time thinking about language learning, administration, and strategic 20-year plans for a hospital, it was such a refreshing opportunity to remember that, at the end of the day, there are just sick people who need help.  And through the gift of grace that is medicine, I can fix some of them.  Others I can't, but I can at least be with them, and usually help them in one way or another.  And to have that reminder here at Tenwek, where I already know the system, and can capably teach the interns from my experience, was truly enjoyable to me.





16.7.13

Coming Home

by Rachel

I have heard that the least favorite question a missionary kid can get asked is one of the American standards: "Where are you from?"  Um, do you want the 2 second answer or the 10 minute answer?  Where do I live right now?  Where was I born?  Where did I live most recently before right now?  Where does my family (i.e. parents) live?  We McLaughlins have a hard time with that question, too.  And at any point in time, the answer could be Michigan, Nashville, Phoenix, or France, until recently.  Now I am wondering if it's ok to say, Africa.  We're not really FROM Africa, but I think that in some ways, we are from here.  Eric and the kids and I arrived in Kenya on July 8.  Other than 3 pieces of missing luggage (now found), it was awesome.  The sights, the smells, the experiences.  I didn't even mind the exhaust fumes (I'm sure that won't last long).  Staying at Mennonite Guest House...the breakfast bell, the Imperial Leather soap, the giant tree swing.  ABC Place...the 2 well dressed Indian men at Gilani's Butchery, the cheap bill at Zucchini's, the ginger lemonade at Java House.  The drive to Tenwek...escarpment views, baboons by the side of the road, the Kenol station bathroom stop.  I turned to Eric at one point and said, "It's like we're returning after three months instead of two years."  I can't even explain all the emotions inside me right now, but they are mostly those of joy.  It's like we're coming home.
Family of 3 early in 2010 in front of our building
2 children on the porch of the same building - summer 2011
The joy continues at Tenwek.  Everywhere we turn, there are familiar faces.  Kenyans, missionaries.  Hospital staff, house helpers, passers-by. Some faces are missing, but most are still here.  Hugs, greetings, exclamations about how the kids have grown.  Some things have changed, but most are familiar.  The buildings, the trees, the dogs and turtles and chameleons.  I worked in the hospital 2 days last week, after two years away from clinical medicine.  It's like I stepped back in time, like no time has passed.  Rounds are the same problems with the same treatments.  Scrubbing in to a C-section (or four) required no extra thought...my hands slipped into the gloves, draped the patient, held the needle drivers,  tied the knots.  Four beautiful, healthy babies born, a grace from God.

Rachel with baby Ben in front of the Tenwek waterfall - 2011
family of 5 in front of the same waterfall, July 2013

I know that life at Tenwek was not and is not all joy.  There is tragedy and sadness and frustration.  But for now, for this time, I am so blessed to be here.  I feel like it's a perfect stopping point before diving back into the new and unknown, a chance to communicate and feel my gifts at work before going back into a situation with new languages and cultures.  So I look forward to these next weeks, and I pray they would continue to be a blessing to my family, as we hope to be a blessing back to Tenwek.

10.7.13

Harder Than We Dreamed

by Rachel

I'm staring at an absolutely gorgeous French Alpine mountain out my dining room window as I type this.  When our team first decided to come to language school in Albertville, the responses were pretty expected.  Yes, it's in the Alps. Yeah, I'm sure it's going to be beautiful.  Good skiing, I've heard that!  Mmm hmm, we're pretty lucky.  You're jealous?  Well, come visit some time.

And Albertville was all those things.  Every day (sans the really cloudy or foggy ones) we were confronted by the majesty of God's creation through our windows.  We are so grateful for our time here, for this beautiful place.  For the Bible verses about lifting our eyes to the mountains, from whence our help comes.  And yet...

I'm reminded of an Andrew Peterson song this year, a different type of reference to the mountains.
This is not another song about the mountains
Except about how hard they are to move
Have you ever stood before them,
Like a mustard seed who's waiting for some proof?

I say faith is a burden, a weight to bear
It's brave and bittersweet
And hope is hard to hold to
Lord, I believe!  Only help my unbelief...  (No More Faith, A. Peterson)

I want to preface this blog by saying there were many wonderful things about this year, and we McCropders want to thank everyone who made it possible.  But I would be lying if I didn't say it was one of the hardest years of my life (a sentiment shared by most of my teammates as well).  I came in to this year expecting French learning to be hard.  I was unprepared for how the process would challenge my identity and make me doubt my gifts and calling.  I didn't anticipate how the constant discouragement and despair would affect my psyche.  And I certainly didn't expect the extra team challenges of interacting day by day with other people struggling with significant issues, both related to language study and beyond.

God called me to missionary medicine when I was 16 years old.  When I was 32, he orchestrated a time for me of two years without practicing medicine.  Last year in the States, we stayed busy traveling around, meeting with people, and caring for our 2 little kids.  It somehow seemed easier, a welcome break from a busy year at Tenwek where I tried to work and be a mom at the same.  And I was looking forward to a year in France as a stable environment and a stepping stone to better prepare me for Burundi.  But I realized just how much value I place on my own competency.  I enjoy being a doctor, and after putting 12 years of my life into OB-GYN training, I enjoy some level of proficiency...being able to care for women with a particular set of gifts that I have received and worked to cultivate.  Now, in France, all my abilities and past accomplishments were taken away.  I couldn't communicate with anyone on the street without extreme amounts of difficulty--from the bread store guy to Maggie's teacher to the nice lady who greeted me at the front door of the church every week.  We say that it was like communicating as kindergarteners, but it was worse.  It was like communicating as an 18 month old.  And I haven't been this bad at anything for...well, maybe in my entire life.  Every day in class I would struggle with a new concept.  Every day I would have my feeble attempts at speech corrected.  Every paper, every test turned in would be returned bleeding red ink.  I am a smart person.  At least, I used to be.  Maybe I'm not any more.  Why can't I get this?  Why would God call me to do something that I can't do?  Why can't He make this easier for me?  If I'm following the will of God, why is it so hard?  Can I just have the gift of tongues, please? :)

I am part of an incredibly gifted team.  And yet even those of us who soaked up the French language and can speak it quite well struggled this year.  We were confronted with our own pride, selfishness, control issues, and lack of faith in a loving God.  We watched our teammates and classmates go through dark valleys.  And by the grace of God we have emerged on the other side of this year, perhaps more aware of the fact that we are broken people more than ever.  And we minister to the people of Burundi not through our strengths but through our weaknesses.   I will present myself through the broken French of a 5 year old, not the polished French of a distinguished professor.  I will remain powerless to fix "the big issues", and my abilities as an OB-GYN will be inadequate time and time again.  But God has called us to this, and His strength is made perfect in our weaknesses.

Our time in Spain helped really crystalize a lot of this year.  Josiah Bancroft, our Director of Missions had some powerful and thought provoking insights for us on suffering and the Gospel.  Notably, it was reassuring to hear that God will work His purposes in our lives whether or not we understand what He is doing.  We can wander confused or engage Him in faith, but He will not stop.  He will not "wait for us to figure it out."  He will keep working.  Also, we can find JOY in our sufferings, not just because He is with us, but because our sufferings serve to advance the Gospel.  And what else is there?  So I don't know why this year had to be so hard for us.  But I do know that God was working His purposes.

I stole my blog post title from another Andrew Peterson song.  "It was harder than we dreamed but I believe that's what the promise is for" (Dancing in the Minefields)  The promise?  I will never leave you nor forsake you.  I will complete the good work I began in you.  I am with you always...

6.7.13

Leaving Albertville

by Rachel

And now we come to the end of all things here in Albertville.  The tests have come and gone and (praise God) been passed.  There was a graduation ceremony.  We have been slowly saying goodbye to our favorite things (Beaufort cheese, warm bread from the bakery, Conflans, the twisty park...)  And our teammates have started fleeing the country.  What a year it's been!

The last few weeks our teammates have enjoyed parapenting (jumping off a mountain strapped to a guide and a parachute...fabulous views), hiking, field trips to Mount Blanc (the kiddos), and the inevitable good and bad parts of saying goodbyes.






So you know, here's the upcoming schedule:
(June 22: Sarah left for teacher conference in US)
July 3: Jason left for Kenya
July 6: Heather and girls leave for US; Carlan leaves for a month of European travels with his parents
July 8: McLaughlins leave for Kenya
July 9: Cropseys and Alyssa leave for US
August 5: McLaughlins and Jason arrive in Burundi
August 6: Carlan arrives Burundi
August 7: Rest of team arrives in Burundi
August 12: Start Kirundi language study in Banga, Burundi (more on this to come in future posts)

We are looking forward to the big reunion in one month and FINALLY our arrival in Burundi!  Please be praying for all our upcoming transitions and travels!

1.7.13

World Travel 202: How to Use Your Credit Card

(from Eric)

Accessing and Spending Money when you live abroad are big topics.  Suffice to say that, if you've never gone through it, it's more complicated than you would think.  A few sample conundrums:

  • I don't need US cash, right?  What?  You want me to purchase my long-stay visas for your country in US cash?  How do I get US cash, when I live in Africa?
  • My US cash isn't good enough?  You need bills in mint condition, issued after 2006 at the latest?
  • Which bank could I use to minimize international withdrawal fees?
  • My card is expiring.  How do I get the new one into my hands, when the permanent address they have on file is thousands of miles away.
  • Yay, an ATM in country!  Now I don't have to get my local cash by getting my Pakistani grocer friend to cash my personal checks!  But which ATMs can I trust? (real scenario)
However, in times of preparation for travel (like us currently...again), one of the most important steps is to alert your bank(s) of your travel plans, so that your cards won't be held the first time you try to use them in another country.  Always be sure to give them a call and notify them at least several days ahead of time.  A few tips:
  1. Take each card separately.  Obviously different banks require different calls.  But we have a credit card and a debit card with the same bank, but they never talk to each other, including on this issue.  So, generally speaking, one card = one call.
  2. Be prepared for utter failure.  We have done this several times, and roughly half the time, one of our cards will be blocked the first time we use it in the new country.  Call again (internationally this time).  "Yes, we blocked it because someone tried to use it in Albertville, France!... Oh, that was you?... Oh, yeah, I do see that note here.  Sorry about that."
  3. If you want, try and notify them about your erratic spending patterns.  I doubt this will help, but our friends in Kenya would get blocked almost every trip to get groceries in Nairobi.  No card activity for 6 weeks, then a veritable spending spree (a.k.a. stocking up) in a weekend.  Hold!
  4. Be prepared to give additional information.  Today, I called the lady, and told her our plans.  Her follow-up question?  "Could you spell Burundi for me?"  Absolutely, I can.  (Really, I don't blame her, so if you can't spell it either, don't feel bad.)
  5. Take a deep breath and be thankful they care.  We have had several rounds of identity theft, including a huge theft spree last fall from Kenya.  So, I wish the system worked more efficiently, but the alternative would be much more problematic.