I didn't know they were hungry...

Where do we draw the line between "When Helping Hurts" and Christ's mandate to give all to the poor?

I find myself pondering this question a lot these past few days.  The new shift in missions is towards accountability, to being met halfway by the people we are serving and icks-naying free hand outs.  

For the most part.

I agree with this ideology.  We (people in general) have unintentionally ruined relationships by giving of our own volition creating a hazardous dependency in which once we (the provider) have been removed from a situation the receiver fails to stand on their own two feet.

The new mission model has created a beautiful partnership.  And, as someone who uses this model daily, it works.  My patients have dignity and our relationships have freedom without the weight of dependence.

But.  Then I was confronted with a new situation.

Last week, I went to visit a patient whom I see weekly.  We always arrive at her house in the afternoons, after meal time.  I knew her family was poor.  I knew 6 of them lived in one small room.  I knew her husband hasn't had work for 5 months.  But, I guess I didn't understand how that translated into their day to day living.

This family is hungry. 

They are not eating daily.  And when I ask, they already feel like I've done so much for them, and so they lie.  

This brought to fore front my previous question.  In the New Testament Christ makes it obvious that we are to give to the poor.  Most notably in Luke 12:33 

"Sell your possessions and give to the poor."

But how much?  I could feasibly drop off food every week and help them with gas and electricity....they are used to living on such a low standard of living I'm sure they could survive on $100/month.  And I could probably cut back on my own lifestyle and afford to help them, but would that be healthy?  Probably not on either side.  But they are hungry and are more than just faces to me, they are friends.  And so of course I want to help.  

But how much giving is too much?  Not enough?  Where do we as Christians find that healthy, Christ-mandated balance?

In this circumstance, Fernando and I have begun looking and praying for a job for the husband.  Of course in many circumstances in an impoverished country work is the key to many financial hardships.  But what if that doesn't happen?  In the DR, unemployment rates are high.  Especially for Haitians.  Will dropping off a bag of rice and beans every week damage our friendship?  Or do I let my friends go hungry?

Please join me in praying for this ethical dilemma.  I trust "what would Jesus do" to help guide me....so help me find....what would He do?

Dr. Fernando reviewing anatomy with our medical assistant
Caroly in our clinic in Angosto

Bienvenidos, little one!

I have the most incredible job.

We're still waiting to find out her name!

I wasn't really looking forward to this weekend.  I had no plans except church on Sunday.  Which makes for the fourth weekend in a row without a concrete activity.  Since returning to the DR I have found I crave this chill time...but this weekend I was finally ready to resume my faster pace of living.

And so, I wasn't disappointed when I received a call at 6:30 am from Dr. Fernando at the local clinic that my dear sister/patient/friend Rosne was in labor and therefore we would be performing her c-section unexpectedly early.

So that is how I spent my mañana...

Praying with my dear Rosne as she was prepped for her ceserea.  I held her hand in the OR as the anesthesiologist gave her an epidural.  I cringed as I saw that her blood pressure was high (160/110) despite my more than weekly visits to her house and provision of Methyldopa.  I thanked the Lord that we decided to have her deliver at the private clinic where she would get good care as opposed to the public hospital where my dear friend would be treated as a number and her high blood pressure not as closely monitored.  I heard the cry of her newborn daughter as she was brought into this world.  I watched the expert hands of Fernando perform a tubal ligation and suture her abdomen closed.

And this afternoon...I rejoiced with Rosne as she finally had her baby girl.  And I now have a sweet Haitian god daughter.

Me and my goddaughter :)

So from the bottom of my heart, and Rosne's (she made me to promise to share with you), thank you. For your prayers.  Your concern. And your love.

Caroly (my assistant), Rosne and her baby!

Imperfection?

I passed.  In so many ways I feel as light as a butterfly.  I don't need to worry about medical tests or boards for 10 years.

But through my studying and preparations I saw how ugly my heart can be.  As PAs we have more than one opportunity to take our boards...I think it may be something like five times.  But, due to my incredibly public life, taking my exam didn't just slip under the radar like other PAs.  No I had to apply for a leave from my international job, fly home, study and take the test.  Without any board preparation.

And yet, my greatest concern wasn't that I pass for myself or my patients, but that I wouldn't have to admit to seemingly the entire world that I failed.  My supporters who believe in my skills and my patients who are receptors of my knowledge.

I also realized how much of my identity is in grades and doing well in things.  Ugly.  I was so confronted with this reality that I was almost positive that I would fail so that I needed to admit to the world imperfection.

But then, that is not the God we serve.  We serve a God who honors His call on our lives.  And provides us with the resources needed to do that.  For me, my license.

And so, I thank Him.  For carrying me when I was tired.  For helping information to permeate into my brain and then allowing me to retrieve it when needed.  And for continuing to shape my flaws.  My ugliness.  And any part of my identity that fails to be focused on Him alone.

Once again....I am always learning....

buh bye 20s

I do not want to turn 30.  I am kicking and screaming each day that is leading to September 8.  And yet despite my search for the fountain of youth the days keep coming.

Why am I so resistant?

Anyone who knows me knows how much I usually love birthdays.  Each year growing up, my poor mom had the difficult task of trying to live up to my unrealistic birthday expectations.  I have always thought life deserved to be celebrated, and greatly.

When I moved to the DR at age 27 I thought of how I would be turning 30 during my time abroad and what that would look like.

As I have been incredibly challenged this summer, I have found my thoughts drifting negatively to 30 and to what I am lacking.  Instead of thanking The Lord for the incredible gifts and opportunities I have been given; I have focused on exhaustion, heat & humidity and missing the comforts found in America.

I am ashamed that in my trials; struggles have been whispered into my ears and taken root in my thoughts.  Lies of inadequacy, of the sacrifices of following Christ, of no longer fitting into my home culture, of if I would ever fit into America again, of what good am I really doing in the DR.

My thoughts have focused on the abundance of engagements, weddings and pregnancies that continue to bless my dear friends and yet I continue to serve The Lord solo.

I don't share this for a pity party.  I share this as a reality of the struggles of being tired and on the mission field.

This past month as I have been cramming for my boards, I have had more time alone than in years.  And that is when 30 has even more become this horrifying age of what society tells me I should have but so clearly lack.

I don't have a high paying job.  I don't own a house.  I don't have a husband.  I don't have children.

As my laments became stronger and stronger this month, I had the opportunity to go away for a weekend.  To celebrate my roommate as she moves back to the states.  To be in air conditioning away from the heat.  To eat a variety of vegetarian foods (I was even becoming sick of rice and beans....the tragedy!!!).  To sleep.

And to spend time alone with The Lord.  When am I going to learn that is always what is needed? Always (see missionaries are far from having anything figured out).

When I was living in NYC 5 years ago; I had money, I dated a lot and had a prestigious job.  I was living our societal ideation of success.

But I lacked purpose.  Fulfillment.  Meaning.

I lacked Christ.

During my time alone with Jesus at the beach, he lead me to 2 Corinthians 16-18 which reads:

"Therefore we do not lose heart.  Though outwardly we are wasting away, yet inwardly we are being renewed day by day.  For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all.  So we fix our eyes not on what is seen, but on what is unseen.  For what is seen is temporary, but what is unseen is eternal."

As I pondered these verses, I reflected...

I may not have societal successes but...

I have CHRIST!!! In a post-modern world I have a relationship with the creator of the university and He has chosen me to follow HIM!

I have an adventurous life in the DR.  I have an incredible Christian community who sharpens and grows my faith on the regular.  I have countless friends all over the world.  I have the privilege of paving the way in medical missions, teaching nursing students, tackling the tropical disease Chikungunya and sharing the love of Christ.  I am living my passion.  All the time.

So, Rachel, what is 30?  What does it matter the earthly things we are lacking when we as Christians are looking toward our eternity.

I still struggle with turning 30.  I know age may always be difficult as the future continues to close in.

But, I am so grateful to be reminded of the choice to be thankful.  Just like we daily choose to follow Christ, I can also daily choose to look at the incredible path that has been paved for me.  That hopefully glorifies God and forever impacts those I work with.

My life is so full.

What is a number anyways?

Disciple to Multiply

I am like a proud Momma duckling.  Ok, that's a little tacky and extreme.  But nothing is more fulfilling than watching someone you love and have poured yourself into attempt to walk upright in the Lord, take control of her life, achieve yet again straight A's in school and share her passion with others.

In case you didn't know, I speak of Caroly.

Yesterday, we welcomed another graduate of the Women's Volleyball Program into our site.  It is my dream that when my two nurses come on staff they have a Caroly (read clearly, not Caroly, A Caroly....haha).  And yesterday we began that training process.

As we sat in Angosto and I watched Caroly teach Shakira how to assess vital signs, I sat in disbelief.  How far Caroly has come in a year.  She has taken ownership of her life, her future, her passions.  And now she is sharing that with her peers.

Multiply.  We disciple to multiply.

And so, I may be getting a little ahead of myself since we just began day one, but I give thanks.  For the lives of these young girls who are beating the odds, becoming educated and have incredibly bright futures in front of them.  THEY are the future of the DR.

Jeremiah 29:11

Tomorrow begins a new season without teams.  An autumn filled with "normal" clinics as just Fernando, Caroly and I will head out to communities alone for several months.  Then in October we will be joined by three nursing students from Bethel College until Christmas.

This morning I sit rocking on my porch, eating a sweet mango, reading through the gospels and reflecting on the last three months of intense ministry.  Some times I find myself wondering whether reflection is truly a healthy thing.  It is good to learn from our choices but in the same regard it can be oh so painful to see our down falls.

Recently, I wrote an email to a dear friend and mentor and was finally able to identify the sour taste I had in my mouth about this summer.  My plate was so full (all with things I am incredibly passionate about) that I wasn't able to give my best and do an incredible job, in fact, in anything.  I shamefully admit, I just barely got by.

I've shared about the illness we had with students...when at one point I had more than 40 sick participants over a weekend.  I myself was sick with an amoeba.  I have been trying to study for my boards (Sept 11).  My roommate and I led the intern bible study and mentored three more intensely.  I had a two week eye clinic in which we saw more than 600 patients.  And I began a new branch to my ministry working with the shoe shine and street guys in town.  I was the director of a dear friend (and fellow missionary's wedding) and we hosted past interns through all the wedding festivities.  All this while continuing my regular clinics.

I hate feeling like a failure.  But, as the summer wrapped up and I said goodbye to the interns, thought about the 18 participants who served in my site and realized how tired I continue to be, I can't help but pray that God's sovereignty shone through all my inadequacies.

Last summer, my site was new, missionaries in town didn't know I existed, my patient load was low and interns were an added bonus to my ministry.  This summer, my clinics have become so busy I never seem to have quite enough time to pour into the students and patients that I once did.  Let alone adequately disciple interns in the way I felt they deserved.  Thankfully, God is sending me two nurses and hopefully a volunteer in 2015 that will allow us to give both the participants and students the attention they deserve.  Because, I am truly here for both.

This summer I have also found that God has ignited a new passion in my heart through Marcos and has given me the opportunity to work with some of the street boys in town.  It started with one but is growing as Jim (missionary starting a site for the shoe shine boys) and I realize what an incredible conduit medicine can be and how many physical ailments those living on the streets suffer.  In the fall I hope to devote more time to them and will add a clinic day for them to my schedule.

I'm proud to say my site currently serves Dominicans, Haitians, street kids, those with physical and mental disabilities and missionaries in 7 different communities and a special needs school.

And on July 27th I celebrated my two year anniversary of living in country.  Amazing.  Baby steps to get to where I am.  Perhaps reflection isn't awful and maybe God's sovereignty has shown through all my inadequacies after all?  As more participants work with Fernando and I and discover their passions.  As patients are healed through the gospel and physical ailments have become controlled.  And I see past nursing students begin to make their mark on this world.

The front of my journal is inscribed with the famous words God spoke to the prophet Jeremiah.

"For I know the plans I have for you," declares the Lord, "Plans to prosper and not to harm you, plans to give you hope and a future."  Jeremiah 29:11

Yes, I can say in the short term (the past 3 months) I don't feel as if I was as successful as I hoped.  But thank the Lord success in heaven is not the same as our human standards.

And so, perhaps instead of thinking of how stretched I felt this summer, I will think of the doors God has opened over the past two years and the way that hopefully His glory has shown through all of my shortcomings.

And I will embrace the newness of autumn and the fresh opportunities it will bring.

Amoebas, Pink Pandemic and Chikun-what??

Well, to call this the summer of illness would be an understatement.  Ready for some medical talk?  Haha, I am a medical missionary...

As I shared before, I ended June with an amoeba.  Then around the same time Chikungunya hit the island…which has become a bit of an epidemic.

Chikungunya is a mosquito born illness that creates intense and uncontrollable joint pain, high fevers, headaches, body aches and occasional GI distress.  This virus has ravaged our island and quickly depleted our supplies of acetaminophen (Tylenol).  

I have been spared at this point but each community I visit seem to have more and more patients contracting the illness along with several of our missionaries.  It typically lasts about a week with residual fatigue.  Those at highest danger are the young, old, pregnant and immuno-compromised (as with most diseases).

This week we welcomed our second to last team for the summer…it’s hard to believe we’ve been going straight since May!  And with them my long awaited optometrist.  At this point we have already fitted about 180 people for glasses.  What a blessing!

On Thursday things got a little complicated when at 2am I received a call that students were having severe diarrhea and vomiting.  By Friday afternoon 37 of 75 people living at our base had contracted a viral GI illness with fever, diarrhea, vomiting, nausea and back pain.

I knew my hands were full when they literally could not keep any medicine I fired at them down…including orally disintegrating Zofran!

As Fernando (my doc) also was sick this past week and unable to assist me, I was so grateful for the past couple of weeks of rest.  Early July began an intense period of time when I began to understand self preservation, and so I was ready for what we’ve deemed the “Pink Pandemic (ok…it’s not quite a pandemic or pink but pepto bismol has just been a necessity).” I put together my task force of interns and together we tackled vital signs and evaluating each patient to ensure they hadn't become dehydrated.

This morning, I once again marveled at God’s timing when I stayed healthy through the night and was good enough to evaluate patients this morning.  I am so grateful that this virus lasts only about 24 hours.  Not just for my patients, but because once most of them were in the clear I realized I am not immune and have found myself also developing symptoms.

And so, I ask you to pray with all of us.  It’s hard to understand why so many students would be incapacitated when they are here to serve, but it just continues to remind us of the weakness and frailty of our human bodies.

I am praying for strength, recovery and no further spread of Chikungunya or this gastrointestinal bug.  Please join me!  I have big plans for this next week of eye clinics!

Gracias!