We would like to introduce the latest family member to join the Gray’s in Ethiopia. Last week, we finalized the purchase of a used Mitsubishi pick-up truck in Addis Ababa. It’s a studly, turbo diesel four-wheel drive. After getting everything checked out, it was time to put my new driver’s license to work and we made the inaugural drive down to Soddo. (OK, maybe it’s not that studly and, though it’s really nothing to write home about, we’re going to write home about it.)

Ah, so many things to communicate… Where do I start?

Let’s start with thanksgiving. God has provided this vehicle through the generosity of our supporters and we are extremely grateful to Him and to you. This is a huge answer to prayer. Though we have been thankful the available transportation via the hospital van, this is a much better option due to the flexibility and reliability it offers. It can often be difficult to work around the scheduling of the van and, especially with a family, it is nice to be able to get away every now and then. We have never felt in any danger here and have been thankful for the peaceful politics and culture of Ethiopia, but it is also nice to have reliable 4-wheel drive transportation should the need ever arise to leave Soddo. Thank you all so much.

Buying a vehicle in Addis

Sometimes you have to cast yourself completely on the mercy of another. Buying a used vehicle as a ferangi (foreigner) in Addis Ababa is one of those times. I was extremely blessed to have a knowledgeable guide for this amazing process. First of all, you need to forget the notion you may be used to, especially if you live in the US. When we sold Becca’s car in Texas, we met a guy beside the car. We signed the back of the deed and wrote the buyer’s name, who also signed the back of the deed. He gave us a money order… bam… done. We mailed in a form to make sure the authorities knew we had sold the car.

Not so here. There a countless unwritten rules and procedures. If you’re thinking, “Hey, what’s the big deal, just look it up online,” the Millennium Generation has a phrase for that: ROFL (stands for ‘roll on floor laughing’). To give just one example, it seems that you need black ink for filling in bank forms and blue ink for government forms.

After agreeing on the price, our mission agency wired the funds to our bank in Soddo. I got a certified check and we left for Addis. In Addis, our guide led us around like a blind man through a mine field. We visited around fifteen desks in three or four buildings, all in the perfect order. He would give commands and I complied. “Sign here.” I smiled, nodded my head and signed. “I need 100 birr.” I smiled, nodded my head and paid. “Give me your driver’s license and resident permit.” I smiled, nodded my head and handed over the documents. “Remember the document from three desks ago? I need that.” I smiled, nodded my head and complied. I was a helpless babe, but I was in good hands. I’m still amazed at how complicated the process was and how smoothly it actually went. The guy was fantastic. I can’t imagine how painful it would have been without him.

The whole process took about six hours but it was finally completed. The most surreal part involved the actual transfer of funds. Coming from the land of electronic money, I realize it’s difficult to imagine a place that functions so heavily on cash. But even after being here a year, I assumed that the sale of a vehicle couldn’t possibly involve any actual cash. Guess again. It seems that the certified check I had obtained could not be used to deposit directly into the seller’s account. Therefore about thirty pounds worth of bills that completely filled my backpack were delivered at the bank and were eventually transferred to, I kid you not, shopping bags for delivery to the seller’s bank. Amazing. Part of me wished it would have involved an aluminum brief case handcuffed to my wrist. Oh, well, maybe next time.

As we drove home, I kept imagining what it would be like for my family back in the States to be sitting in the car with me. The rules and norms here are definitely different. Basically, it doesn’t matter the circumstances, if you hit it, it’s your fault as the driver. Therefore, while driving, if you hit a cart, person, cow, donkey, goat, sheep, chicken or dog, it’s your fault. The upside is that drivers are generally fairly careful. The downside is that pedestrians are fearless. I’ve had to just chuck my usual American notion of what driving is like and get along with the local system. For the most part, as a motorized vehicle, I’m a guest on the road and I might as well relax and just wait on the twelve donkeys trotting down the center of the road. That’s how it is here. Thankfully everything went smoothly and we had an uneventful trip!

Well, should any of you come to visit us, you may be spending a little time in Ol’ Blue. I look forward to it!

we try and balance out the blog between hospital and home…we try and do the same with our time.  of course both often demand more than that.  good thing there are two of us to tackle it together!  don’t worry i will leave the surgery part to Paul.

speaking of time, when i was home this summer spending time with my mom and sister, i acquired a new nickname.  growing up i was “becca-boo”  and my sister was “jessie-bell”, but this summer i was reanmed FOTS.  I was known as the “Fun-Organizing-Time-Sucker”.  I think most of the tasks that my mother was accustomed to went out the window as I was always planning events…trips to the beach, to Sonic, to Moody gardens, to the mall, to see others.  And my sister and her husband were dragged into it too, even during there last few weeks before they left the country, i was encouraging them to join in FOTS activities….I loved it!  Hey, I was just glad I wasn’t renamed the “Time-Organizing-Fun-Sucker”!

Some of the FOTS activities my dad got sucked into was cooking for the many family and friends who were visiting and taking pictures….here are a few of the pics.i feel like this picture shows their personalities already.  nathan with his silly, independent nature and loud Hawaiian shirt.   lydia raising her hand saying “pick me” and decked out in her fancy clothes.  she is already such a social butterfly.  she will start to whine a tiny bit and we will just talk to her and she quiets down.  or nathan will sing her a song, he will sing “baby-ah, baby-ah, baby-ah” instead of baby lydia he combines the two words into baby-ah!

i love this “action-shot” because it shows how much fun nathan had with his daddy this summer.  what a special time to have him home for 2 months.

the latest family shot

and sweet baby lydia

It’s been an emotionally draining week at the hospital. So many people are suffering with cancers.

“12 cm high-grade sarcoma”

To most people this probably doesn’t mean a whole lot, but to those who have experience, it makes your heart drop. With her biopsy result back, we had to tell a 19-year old woman that the big mass involving her left cheek was this deadly cancer. I still don’t know a good way to do that and I don’t think there is one. It’s horrible.

The books say there isn’t supposed to be a lot of cancers of the colon or rectum in Africa, but we have seen quite a bit. Last week, we operated on two people with cancers of their rectum that required an operation called an abdominoperineal resection. It means removing the last part of the colon, the rectum and the anus to get the tumor out. It involves a permanent colostomy. It’s not an easy operation and I’ve only been involved in a couple during my training so it’s been a challenge. But at least it’s from the same field in which I trained… have to be thankful for something.

Yesterday, we operated on a heart-breaking young boy. He is twelve years old and came in with difficulty having bowel movements for the last several months. He has been passing blood from his bottom in addition. To look at him, you might think he came out of a concentration camp; he was so malnourished and sick. On rectal exam, there was a round bulge the size of his fist in his rectum. After resuscitating him a bit, we took him to the operating room with the presumptive diagnosis of chronic intussusception, a condition where the bowel telescopes in on itself, kind of like pulling a long-sleeve shirt inside out. We opened him up and indeed found an intussusception with his entire colon pulled in on itself and extending down into the rectum. Usually when this happens, there is something that acts as a “lead point” to start the process of pulling in. In his case, he has some kind of bad cancer that started it out. There was tumor throughout his abdomen. I don’t know how long he will live, but unless God performs a miracle, it won’t be long. Again, it’s horrible.

Well, sorry for the downbeat post but I hope it helps illustrate some of the difficulties here.

While we were home this summer we shared stories and pictures of our life in Ethiopia with many of you.  Some of those pictures and stories included Etagainu, our house help and friend.  We have been honored to pour into her life as she has poured herself into ours.

 Last year, she expressed her concern for her son’s education.  They live in a small town up on a hill about a 45 minute walk from Soddo and her 8 year old son, Bekolu, was attending a school there.  She told me that she found out he was not learning, but mostly playing outside all day due to the lack of direction in the school.  Within Soddo, there are some private schools who offer an education with an intentional curriculum, however, these schools are expensive and often cost about half of a monthly wage for a child’s fee. 

I wanted to share with you that Bekolu is now attending a private school in Soddo called the American International Academy.  He is in K2 (the second year of kindergarten).  Nathan and I had a chance to visit the school and meet some of the teachers.  It is a very nice school and does some of the teaching in English and most of their school activities and books are in English.  The students are still learning Amharic in school and most of them grew up learning their local language, so most will soon know 3 languages.  It was great to visit and see the opportunity here in Soddo for the children. 

So, I am writing to see if there is someone out there who would like to help Bekolu attend school.  I think this is a neat opportunity for a family with children to help from afar.  In the process of helping Bekolu your own children will learn about people in other parts of the world.  The cost is 15 USD per month for Bekolu to attend school, but I imagine the rewards will be much greater.  What an amazing opportunity for some children from the states to be able to communicate with Bekolu and write letters and color pictures back and forth. 

Again this is not a pity story, we could help him attend school and we will continue to develop our relationship with Etagainu and her family.  But I wanted to offer up this opportunity to some of you who cannot physically come, but desire to help in a personal way.  If you and your family would like to get to know Bekolu, please email me at paulandbecca@gmail.com

My plan and hope this year is to do a better job keeping up with the blog. We’ll see how it goes .

We’ve been back in Soddo for about a week and life seems to have taken off at a sprint. As Becca wrote, our trip to Addis, while long, went well and passed uneventfully. God’s provision and grace through it all was amazing. The kids did great and we passed through all the airports with no difficulties. As we stood outside the airport waiting for our ride to arrive, it was a cool evening in Addis and the airport was bustling with people from the international flights that arrive and leave each evening. The sights, sounds and smells, while so different from the US, were familiar to me and it kind of felt like home. It definitely felt more like home than I thought it would. We stayed at the familiar SIM guesthouse and left for Soddo the next day.

We arrived in Soddo late last Sunday afternoon and it was good to be home. We were all tired but the reunions were great. We enjoyed seeing the familiar families again: Duane and Jackie Anderson, Ruth Droppers and the Bowers (Harry, Stephne, Ben and Karmyn). We also enjoyed seeing the Aarsland’s again (Asle and Kari). Asle is an anesthesiologist and they’ll be with us for a year. Finally, it was great to sleep in my own bed again! Man, I’m definitely a homebody when it comes to beds… I’ve been missing that bed.

We spent Monday getting unpacked and resettled. That was all the time off I was allotted, though. I was called by the on-call resident that evening with two emergencies. There was a young woman with possible appendicitis and a man with a bowel obstruction. The reintroduction to medicine in Ethiopia was representative: weird and tragic. The young woman’s story was not really typical for appendicitis and it looked like she might have an ovarian torsion (where the ovary spins on itself and strangles itself). Either way, though, she clearly needed an operation. The man with a bowel obstruction looked bad. He had been in severe pain for three days and his vital signs were worrisome. He was very dehydrated and needed to be resuscitated some more before going to the operating room. So, we started pouring fluid into the man and took the young woman to the operating room.

In the OR, after she was asleep and her abdominal muscles were no longer tightly contracted, it was evident she had a tennis ball-sized mass in her abdomen. We opened her up and found a large, abnormal ovary that was very black and very dead. It had indeed twisted on its blood supply and died. We removed it and looked at the other ovary. It too was clearly abnormal and large. It was a tumor called a teratoma which has multiple types of tissue growing in it in a disorganized fashion. The hair growing in it gave it away. Unfortunately it meant removing that ovary as well. It left a 19-year old woman with immediate menopause and no chance of ever having children. Horrible.

I left the OR to check on the man with the obstruction and found that he had died during the first operation. The second punch in the gut. I suspect his problem was similar in that his bowel had likely twisted on itself and killed itself. That is a deadly condition to have.

The suffering in Ethiopia continues, just as it is happening in every other country in the world. The only way anyone can’t see that this is a fallen and horribly broken world is if they have no understanding of what it is supposed to be like. The Bible teaches that the world as we know it is an aberration, a fractured and broken world of conflict, both interpersonal and spiritual, that is not going to last forever. It teaches that the world as we know it is clearly set between two historical bookends: the rebellion of mankind at the fall and the return of Jesus at His second coming. The hope that Jesus has given me of the world to come helps keep me going; it helps keep it all in perspective.

The difficult truth is that, while mankind is suffering, mankind brought this on itself. Romans 1:20-21 says, “For since the creation of the world His invisible attributes, His eternal power and divine nature, have been clearly seen, being understood through what has been made, so that they are without excuse. For even though they knew God, they did not honor Him as God or give thanks, but they became futile in their speculations, and their foolish heart was darkened.” It goes on to describe how men exchanged God for the worship of created things and how we have spiraled out of control. It ends with this: “and although they know the ordinance of God, that those who practice such things are worthy of death, they not only do the same but also give hearty approval to those who practice them.”

It’s a miserable truth and my pride makes it hard to swallow, but God in His love did not leave us there. One of my favorite verses in the Bible is in Ephesians. It’s the amazing rescue. After again describing the woeful state of mankind, Ephesians 2:4-5 says, “But God, being rich in mercy, because of His great love with which He loved us, even when we were dead in our transgressions, made us alive together with Christ.” He made us alive together with Christ by killing Jesus in our stead. Jesus died the death of which we are worthy. That’s the great Truth I have the privilege of proclaiming here in Ethiopia.

The man who died last Monday is going to live forever. We talked with him before operating on the girl and we told him there was a chance he might die that night. We asked him if he was prepared to stand before God and he smiled and said ‘yes’. He was already depending on Jesus for his life. He believed that Jesus has died for his sins and that he had received forgiveness by that death. I wish that we could have helped him that night because life is still precious. However, for that man, the death of his body was only temporary. When Jesus comes back (and He will, make no mistake), I believe I’ll see that man alive again and we’ll enjoy eternity together.

Please pray for us as we share this Truth. God has given me the opportunities to talk to many people this week who do not know or recognize Jesus. As far as I know, none of them were receptive. But then again, no man ever saved a soul. As the apostle Paul says, some plant and others water but God brings the growth. I believe God can draw those men and women to Himself. This world will end someday but until it does, may God bring home all those that He desires.

Well, since everyone else out there has been posting pictures of their kiddos in the pumpkin patch we thought we would join in.  When we arrived back in Soddo, I discovered that our 2 pumpkin plants (planted about 6 months ago) were completely taking over our side yard.  I said to our neighbors…”have you seen our pumpkin patch?”  They were all unimpressed because they hadn’t seen any pumpkins actually in the patch.  The next day when Tomesgen, our gardener, arrived he showed me all of the pumpkins he had in our storage shed.  We had 22 pumpkins so far! 

I told him about Halloween and how in the fall in America, lots of children line up to take pictures in big patches of bright orange pumpkins (our pumpkins are green, but orange inside)…and how the leaves change from green to red when the weather gets cooler(our leaves stay green but fall off when it the rain stops).  He was very intrigued (and thought this was slightly silly)…but he humored us and made us our very own pumpkin patch and Benjamin and Karmyn came over to join in the festivities (Lydia is the white hat that Karmyn is holding)….

………………………RECIPE.……………………

The best roasted Pumpkin Seeds

I discovered the trick to tolerably chewy pumpkin seeds is to boil them first for about 5 minutes before roasting…

Clean seeds from pumpkin

Rinse with water

Boil 5 minutes

Dry on towel 5 minutes

Spread on cookie sheet

Sprinkle with worcestershire sauce, cayenne, seasoning salt (or your own variation of spices)

Stir

Bake at 350 F for about 15 minutes (some may pop in the oven, no, not like popcorn)

Enjoy

After making 6 trips between Ethiopia and America with Nathan we are thankful that this past flight was the most tolerable.  Nathan did great.  The first trick to flying with a walker and a talker is buying them a seat.  Even though Nathan isn’t quite 2 we bought him his own seat.  The problem when Nathan and I were coming back from Ethiopia in June was that the seat did not contain him.  He was always climbing all over the place and asking to “go” and get “down”.  Before our flight back I did some research (of course research for me these days does not include long forms to fill out on numerous patients…but is essentially…googling).  And what I found is you don’t have let a squirming kid sit in an airplane seat with a lap belt you can bring a……

Car Seat!

 Well, that is it.  The Car seat was the perfect solution for Nathan.  Most American kids are used to spending hours in a car seat in the car and are somewhat comfortable there.  And for the most part they know they cannot get down.  This was definitely true for Nathan.  He was not always asking to get down because he was securely fastened with movies playing in front of him, but where he couldn’t reach it.  And it was easier for him to fall asleep in his seat than in our arms or the floor.  (That is another trick to long flights…let your child sleep on the floor as long as the fastened seat belt sign isn’t on :)

One trick…that we haven’t found the answer to…is apparently there are only certain car seats that are allowed on planes, they say something about being FAA approved.  I could not find this sticker anywhere.  And further more we had to buy a no frills seat to get it to fit into the airplane seat…something to keep in mind.  We were able to bring ours on (we bought an extra one that would fit for 45 bucks at Wal-Mart…because it was the only one narrow enough.)

Hope this helps some of you out there.  It will be interesting to see how many hits we get from searching “flying with a toddler.”  We still get about 10 hits a day from people searching “tumor” and they get Paul’s post about his crazy day.

We made it home on Sunday afternoon.  The kids did great on the plane (more on the secret to happy flying toddlers later…mom’s be in suspense because it worked like a charm. I am just way to tired to write much more).  Nathan and Lydia have even been sleeping better at night than Paul and I.  We enjoyed a quiet day at home today unpacking and settling in.  Paul even showed terrific restraint by not going to the hospital….that is until about 30 minutes ago (7pm our time).  One of the residents called the house with 2 big cases that have to be done tonight.  But the restful day was nice, I just feel bad that I get to go to sleep early after fighting jet lag and he will be in the O.R.