Week 25: Feb 1-8

"And a soul well-spent will be one who lives Best Yes answers.” – Lisa Terkeurst, The Best Yes

“’If you want people to use such great words to describe you, think about the decisions you are making. How are they leading people to describe you?’” – Lisa Terkeurst, The Best Yes

When I don’t know what to do to move my dreams down the road. I usually just try to figure out what the next step is and then do that…It seems like there must be more to it. But there isn’t. For most of us, the next step is as easy as picking up the phone, sending an e-mail, writing a letter, buying a plane ticket, or just showing up. After that, things start happening. “ - Bob Geoff, Love Does

“This world can make you think that love can be picked up at a garage sale or enveloped in a Hallmark card. But the kind of love that God created and demonstrated is a costly one because it involves sacrifice and presence. It’s a love that operates more like a sign language than being spoken outright. - Bob Geoff, Love Does

Heart – I got on the porch and drank tea and spent time with doggies every day. Chocolate too. Enjoyed Korean dramas (Extraordinary You) and used the heat pack. I loved baking cheesy crackers and carrot cupcakes, soup with grilled cheese, Café with Kiana, and Chai tea in the rain. I had baths twice and read a book in bath. I also got a hair cut, hair washing, and shopping for dishes. I like that.

Soul – Worship on Sunday night kept songs in my heart through the week. I loved being there with Greg in his yellow shirt and thinking how 15 years ago we sang the same hymns to guitar and I would worry that I thought too much about him, wonder if he would hold my hand. I prayed a bit in the monrnings, when stretching out of bed or starting on the porch sipping tea. Mrs. Msosa told me some heaviness and so we prayed together in my office on Tuesday and Thursday. I only read my Bible about half the days, I want to make that more of a first-thing in the morning kind of thing.

Strength- I ran four days this week. Twisted my ankle. Keeping up with Ishmael was tiring and exhilarating. I did ab workouts twice and stretched half the days. I drank water with my tea, and ate fruit most days. Woke up early a few days, so averaged 5:38 up. 10:34 to sleep because of Korean drama mostly, so 6:53 per night with 11 mins awake. Average steps 8,128 which is a bit down.

Mind – I read Best Yes. Working on a lot of things for work. Want to read more.

Neighbor – A delightful evening of tea, bread, and chocolate with Isa and Jacob. Visited Anna at her house on Tuesday for our meeting. Called Conk which was so much fun. Lunch with Helen. Had Msosa and Nyathipa’s daughters over for tea on Sunday, so much fun – they played with stickers and picked flowers afterward. We are working with chaplains to have a better way of helping people. Good time with Ishmael.

Husband – have discovered head massage and stepping on back and back massage while watching Korean drama. Fun sitting on porch together, eathing together. Really enjoying lunch breaks, taking a full hour.

Mentor – spent a lot of time with the Dundee girls. Their projects are fun and meaningful. I’m actually glad they didn’t get approval because I think they can do more this way. But exhausted working with Neil their supervisor. Excited about Selina, but Contra Costa annoys me, trying to find time to talk. Then the residents – Patrick’s wife is sick and Amos is not doing well on his rotations, we don’t know why. Excited for LLU kiddos to come.

Boundaries – Not always great at no work after-hours, especially disappointing on Saturday but Sunday wasn’t too bad. God lunch breaks 4/5 days and got home the other. Did not leave work on time except Monday but limited working hours two days. Total work hours logged: 53. Friday was particularly late talking to Salvador about leadership options. Wondering if re-defining my role will make things harder. Probably. But maybe more solidified authority will help me know my role and keep others accountable.

A Fresh Start: Greg and Christina Miller’s January Update

Patrick, Madhvi, and Lauren reported to me about their progress at Kasina Health Center. Malawian Family Medicine Resident, American Global Health Fellow, and Dutch Medical Student went together to the small health facility a few villages away. The health center was struggling to care for patients with high blood pressure, because the medical assistants who staffed the clinic did not feel like they had enough training or experience to manage newly arising or complicated cases. They asked if Dr. Patrick would visit often and help run a blood pressure clinic for them. But I had been mentoring my resident about boundaries, realistic expectations, and professionalism. So instead of committing to an ongoing partnership that would lead the health center toward dependency on him, Dr. Patrick decided to lead them toward a collaboration that would help them develop capacity far into the future. We had a plan to bring teaching for the clinicians and the patients, protocols and methods for referrals. Some of the work we had already completed at Diamphwe, another nearby health center, meant that many of these tools were already prepared, and soon we would have the forms ready for Kasina, with potential thereafter to replicate in over a dozen nearby health centers. Our residents had some of their first opportunities to become leaders in healthcare systems and advocates in their communities. Our visiting doctors and students were able to work together with the Malawian doctors in a way that broadened their vision of Global Health and led toward sustainable improvements in the future.

As for me and Greg, this new year is just bursting with opportunities. The hospital received funding to implement rigorous blood pressure screening and treatment interventions at Nkhoma and beyond, a program that I am passionate about and from which I have already started seeing benefits. The fledgling Nkhoma Research Ethics Committee has six research proposals to consider and move along, which should keep us busy for a long time to come. And we have an opportunity to be involved in starting Community Health Evangelism programs in a new and very under-served area. Greg is not only teaching Systematic Theology at NTCCA, but has started teaching a similar course at Josephat Mwale Theological Institute (NMTI) at Nkhoma. He has also been asked to preach to a large church this Sunday and teach an intensive course of course of study next weekend for working pastors who cannot attend school full-time.

We are sleeping and resting so much better now that we have moved to a different house. The space that has been a blessing to us has already started blessing our community as well as we host Bible studies, tea parties, mentorship time, and even an afternoon of painting on the back porch. The house is a bit older, so it is also keeping us busy as we work on water, plumbing, and electricity issues, but we are so happy for the space, peace, and potential for fellowship that we are happy for the few side projects.

This month, please join us in prayer: - Praising God for a restful holiday in Capetown, a fresh start this year, and a beautiful new home - For wisdom as we embrace new opportunities in community health and teaching, that we won’t commit to too much too soon - For a productive and balanced month in February as I have 3 visiting Family Medicine Residents from American helping me with sustainability and prevention projects

Thank you for your prayers and support, - Greg and Christina

Hope Breaks Through: December Update 2019

“It’s so refreshing to see the stretcher used for something other than trips to the mortuary.” Olivia, the volunteer nurse serving with us on medical ward, is no doubt thinking of cases seared in our collective memory: The man who stopped breathing on the way to his x-ray; the woman with a fungal infection in her brain; the man who lived in the hospital for months because he couldn’t breathe without an oxygen machine and there was nowhere else he could get one. Our team shared grieving with each of their families, but a special type of healing accompanied that last case. The family felt loved and cared for during their time with us. They grew so close to Olivia that they gifted her a chicken. A chicken, it turns out, that outlived the patient. But when Olivia presented his widow with a photo of the patient, nurse, wife, and chicken, her grieving tears mixed with tears of joy and appreciation. We couldn’t heal his body, but wholeness of heart and relationships grew during his time with us.

Even as we reflect on the past weeks, today is a day of rejoicing. It is December 21st, the lightest and longest day of the year. The stretcher is filled with gifts for patients. Our charge nurse, Mrs. Msosa, has raised funds and collected donations for months preparing for this day. It’s a program she has carried on for over a decade, but the celebration is fresh for us. Empty medication boxes are filled with gifts of sugar and rice and oil and tea. The head chaplain appears dressed as St. Nicholas. The assistant chaplain with whom we’ve spent the morning discussing community health is bellowing the good news to a crowd of patients and family members on the steps outside the ward. The nursing student who splashed in the lake with us last weekend is stomping her feet, dancing, and leading the group in a song celebrating God’s goodness this season.

We parade through the hospital. Into the maternity ward where our lone provider collapsed from fatigue in the operating room last month. Things were difficult as she took some much-needed time off, but an incredible, recently-hired Malawian doctor helped pick up the slack, and now a second Malawian doctor has arrived to help run the ward. Today, the mothers are smiling and showing off their little ones as they take a bag of clothes and food. We tiptoe into the neonatal ward, past the incubators encasing premature babies in locally-made wooden crates under the lights. Two weeks ago, the clinician caring for them got sick, and with nobody checking in on them, five babies died in five days. That was another crisis amazingly handled by my Malawian colleagues. The newly-hired clinical officer who is now helping in that ward keeps coming back to medical ward for our weekly tea parties and team meetings; he’ll keep being a part of our team no matter which ward he’s helping in. “Tea inspires staff retention.” Mrs. Msosa told me. “Everyone wants to stay on Medical Ward now.”

We play Christmas music as we step onto the pediatric ward. Some children cry and hide from Santa. Only about half the beds are filled right now, but we know that we will have to use an overflow room during the peak of malaria season. We didn’t have funds to spray the surrounding villages to control mosquitos this year, but we’re doing what we can on a community level. A visiting nursing student is working tirelessly to ensure that at least all admitted children can sleep under a mosquito net.

We’ve been through a lot together this year, the Malawian staff, visiting volunteers, patients and I. We’ve had our times of grieving, and there will be more difficult times ahead, but today is a day of celebration and joy. “The people walking in darkness have seen a great light…For to us a Child is Born.”

Have a Merry Christmas and a Happy New Year,

Christina and Greg