Paul and Becca

OK, in the previous post I intended to give a report about some of the outcomes from this last year in Ethiopia and brag on God a little. However, I got to thinking about life and God and joy and the amazing peace I have at Jesus’ cross and, well, I couldn’t stop smiling and typing. It got a little long winded so I figured I would just write a second post.

As you probably know, we came here to teach Christian surgery residents through the Pan-African Academy of Christian Surgeons (PAACS). God decided to show once again how great He is by starting us off in the hole. Only He could dig us out. I was informed after we arrived that our program would probably be put on probation and, indeed, it happened officially a few months later. There were several problems but the two main areas were poor resident operative experience and bad test scores. We wouldn’t receive any more new residents until it improved and, if it continued to be a problem, we might lose the program.

The residents were getting plenty of time in the operating room but they just weren’t doing the cases. They were simply assisting. In order to get off probation the residents needed to be doing much more of the operations. Many prayers were raised, meetings were held, attitudes began to shift and the “culture” of the residency began to change. God has done great work! All of the residents have turned in their final reports for the year and the numbers are encouraging. Etuh, our third year resident, over doubled his number of cases as the primary surgeon (i.e. he did them) compared to last year; up from 173 to 415. Tewodros, one of our second year residents, over quadrupled his number of cases as the primary surgeon; up from 82 to 379! Daniel, our first year resident, has logged 186 cases as the primary surgeon in his first nine months, putting him on track for about 250 in his first year. Prior to this, the highest number of cases ever recorded by a first year resident at Soddo was 86. It’s really exciting to see what God has done!

Last year’s results of the yearly PAACS exam were not good. Five out of five residents failed it on the first attempt, although they did better on the retake exam. We took this year’s PAACS exam about two weeks ago. Five out of six residents passed! The one who failed did so by only 1%. Furthermore, one of our residents achieved the second highest raw score in all the PAACS residents across Africa (I think there are around 28).

I am very pleased to announce that our probation has been lifted and we have been approved to accept two new residents. Praise Christ, for this is completely of God! I’m extremely happy for the guys and we had a celebratory dinner a few days ago. It is exciting to see the changes and see the growing confidence and pride in the residents regarding their training and abilities. Thank you all for your prayers and support of us while we are here. You mean the world to us and we rejoice with you. I can’t wait to see you again.

Solomon, Arega, me, Haile, Etuh (missing: Daniel - on call, Tewodros - in Addis Ababa)

There is now less than one week remaining of my time at Soddo before I start the journey to the US. Though the work has remained busy, I’ve had some time in the last few weeks to reflect and try to prepare myself for coming back to the West for a while. I’m definitely excited about being reunited with my family and look forward to the break, but there is a sense of uncertainty about stepping back into my old culture. Given I’ve only been here for one year, I can only imagine how people might feel after coming back after four or five years away.

As I reflect on it, I think the sense I’m trying to convey is one of homelessness. But I’m thankful for it because it is a sense of homelessness that is, in fact, more proper than the comfortable familiarity I felt before. Peter writes in the Bible that Christians are “strangers and aliens.” The writer of Hebrews says that people who have put their faith in God have “confessed that they were strangers and exiles on the earth. For those who say such things make it clear that they are seeking a country of their own. And indeed if they had been thinking of that country from which they went out, they would have had opportunity to return. But as it is, they desire a better country, that is, a heavenly one. Therefore God is not ashamed to be called their God; for He has prepared a city for them.”

These words of scripture are not new to me but this last year has taught me a new level of experiential understanding of them. God led my family and me to a foreign land and He’s been stripping away stuff that separates us from Him. If you’re curious to know how hard you are clinging on to something try either letting go or, better yet, having Someone rip it out of your hands. It hurts but, in the end, gives freedom. This time has brought me closer to my Father and I feel more keenly than ever that no place will truly feel like home until I’m with Him.

I’ve written and communicated to friends that one of the challenges of coming here was the sense of “This is it? This is what I was working towards?” For thirty-two years I was on the conveyor belt of education. One step led to the next… high school, college, medical school, residency and preparing for the mission field. All along the way there has been a nagging hunger, an itch I couldn’t scratch or a sense of missing something. I’ve always suppressed that feeling, though, because there was always a hope that it would finally click once I “arrived.” Well, I finally arrived but the warm fuzzies of deep, abiding contentment stood me up! It was quite a punch in the gut.

As is often the case when God leads and disciplines His children, the pain and confusion drove me closer to Him. I’ve spent a lot of time this past year contemplating what is really valuable and important in life. For me, the list has become shorter but much deeper. Walk deeply and intimately with God through the Holy Spirit in Jesus. Eat and drink with friends with a cheerful and thankful heart. Work hard and, whatever your hands find to do, do it with all your might. Enjoy life with the woman whom you love all the days of your fleeting life which He has given you under the sun.

I still feel the hunger. I still feel the itch. I still know that something is missing. But now when I feel it, I rejoice in Christ because He has set me free. The thing for which I hunger is coming, just as surely as Jesus is on the throne of heaven. I will never know satisfaction until He comes back, but then I’ll know it forever. America isn’t my home any more than Ethiopia is. My home is coming and, each night when I lay my head down and pray to my Father, I’ll smile and know I’m one day closer.

Ascaris lumbricoides

We were nearing the end of an operation on a man for an intestinal perforation when we were rinsing out the abdomen with saline. Suddenly, from the loops of intestine near the top of the abdomen, this little guy starts rising up like a cobra dancing to the tune of a snake charmer. I was quite pleased when all the Africans jumped much higher than me. I was further pleased when I was the only one with the guts to pick it up (I did have gloves on…). Meet Ascaris lumbricoides. I find his life cycle to be particularly interesting. According to the books, you pick this thing up when you eat food contaminated with infected feces containing the eggs. The eggs hatch and the larvae make their way through the blood system to your liver and, from there, on up to the lungs. In the lungs, they work themselves into the air sacs, called alveoli, where you cough them up and swallow them right back down. Once they get back to the small intestines, they grow into the adult worm (see above). Then the female produces “innumerable eggs that are fertilised and thereafter excreted in the stool to perpetuate the life cylce.” Yummy. And to think we Americans get all worked up over E. coli. Please, E. coli’s a chump

(This is Becca) It has been a great past few weeks.  I have been visiting friends in Dallas and now I am passing through Austin and staying with some college friends.  Nathan has encountered more kids in the past few weeks than the rest of his life combined.  It has been so fun to watch him with others and I can see a difference in his sharing skills from the first of the trip until now.  (I really wanted to post some pictures, but I can’t figure out how to get the pics from the camera I am borrowing over here.)

I have been so encouraged by everyone I have seen.  It has been a good refresher to help me reflect on our time in Ethiopia.  You – our friends, family, and even those of you we haven’t met – have been such an encouragment and have truly kept us going.  We truly feel that this is your ministry in Ethiopia just as much as ours.  We have been sustained by you in so many ways.  (I cannot stress the last two sentences enough, you could just read them again to get the full effect…)

Of course, Nathan and I have been longing for Paul.  We chatted with him today and it was good to catch up on everyday activities.  He also received our father’s day package filled with chocolate, baby girl clothes and a card with Nathan talking on it.  I am overwhelmed by missing him so much.  A piece of Nathan and I is definitely missing.  We can’t wait to have him back in 3 weeks.  It makes me think of how we should long for heaven.  We long to be back together as a family, but we should desire even more eternity with our Savior.

2 Corinthians 5:  Our Heavenly Dwelling

 ¹Now we know that if the earthly tent we live in is destroyed, we have a building from God, an eternal house in heaven, not built by human hands. ²Meanwhile we groan, longing to be clothed with our heavenly dwelling, ³because when we are clothed, we will not be found naked. ⁴For while we are in this tent, we groan and are burdened, because we do not wish to be unclothed but to be clothed with our heavenly dwelling, so that what is mortal may be swallowed up by life. ⁵Now it is God who has made us for this very purpose and has given us the Spirit as a deposit, guaranteeing what is to come.