"I have but one candle of life to burn, and I would rather burn it out in a land filled with darkness than in a land flooded with light." --- JK Falconer

Tuesday, June 23, 2009

Cari's First Entry

Hello friends and family!
Andy's been getting on my case about doing one of these, but I don't think he understands how hard it is to concentrate long enough to write coherently when I have a two year old who is finding all sorts of cool things in the game closet behind where the computer is! But I finally figured out that I could get an email in after the boys are in bed if I do it before 10 (after that, the ants and cockroaches come out to play in the computer area which really kind of grosses me out). So I have a little peace now...

How are we doing - the boys and myself? (I think Andy does a good job of showing you his life) Well - we are doing very well. As Andy has mentioned, the boys have already made friends - both human and animal. It turns out our friends Jeremie and Elise (from our last trip) are living nearby in Tsiko, so their boy, Jean, and their nephew, Papi, come over nearly every day for about 2 hours of fun. Papi speaks great French which really helps me and the boys all seem to understand each other well enough to play. So far the food has been great and neither boy has trouble getting enough to eat. Drew is sleeping well, but Tony is struggling a bit. I would like for him to get more than 8 hours of sleep at night - and have it be good sleep (he tends to wake up crying several times a night) We are working on a few adjustments hoping it will help him to be well rested.

I have not been working with the teachers in training this year, which is a little difficult for me. I really enjoyed that last time, but having Tony is even more important, so I have been looking for ways I can help even with a 2 year old. It turns out that one of the Missionary Kids (MK) here is in a British Literature home school course. Since it is not his mother's forte, I have most readily jumped in. I have also been helping with the kids' club every Monday, Wednesday, and Friday. It is a real challenge since I mostly work with the younger ones who only speak Ewe - not French. But they enjoy the attention and we sing lots of songs and play games. Drew and Tony look forward to kids' club, as well. Otherwise, I have been doing what I would deem "servant"tasks - cleaning, organizing, babysitting. Those things that can be done behind the scenes, and can also end up meaning a lot. So I feel good about what God has given me so far.

Thank you for your prayers. We certainly appreciate it! And if you could, please add a hospital worker to your list who was poked by an HIV contaminated needle today and will have to take some fairly intensive preventative drugs for the next four weeks. I cannot imagine the stress of it on him or his family.

I will end with my Ewe greeting which means "Have a nice day

ngkeke nyuie yowo

Andy's Fourth Medical Journal Entry

22.Jun.2009 -- Day 12

Egbebedo! Dog-be. Yo-lo.

“Unless the Lord builds the house, the workers labor in vain.”

Sorry it’s been so long between emails. Four calls in 7 days, several deaths, lots of heartache, some joy, and not quite enough sleep. (Although I did get one of the brownies Cari made for me for Father’s Day!) Life has picked up here in the last couple days. The new short term surgeon, Dr. Harris, is here, which will be a good relief for Dr. Briggs, the Family Doctor who’s been covering call. Dr. Harris’ wife, Hillary, is also an anesthesiologist – they jumped in on a case just a few hours after arrival. They are from Cape Town South Africa, although Hillary grew up in Zimbabwe (travel was only two planes and 8 hours for them). They have two boys, ages 12 and 11 so the place is loaded with kids now. (Harris - 12 and 11, Briggs - 21, 17 and 15, Ebersole – 19 and 17, a family from Mango – 14 and 13, Jade a 21 year-old college student, and Taylor – a 20 year-old college student). The Harris’s are also thinking about and planning for long term missions. The teachers arrived over the weekend and started their training today. Cari hasn’t been able to help teach yet this year but she’s contributed with some of the prep work.

John Briggs invited me to play tennis on Tuesday and all the teens were on the court for street hockey on Thursday. Drew, Tony, and Cari finally were able to use the pool this week. Cari’s been to market in Adeta. Andy’s been attacked by army ants a couple times and Cari’s been attacked by mosquitoes (no snake stories yet). We’re not too happy about the rooster crowing at 3 or 4 in the morning, but the boys enjoy helping ATsuTse (aChooChe) feed the chickens and collect the eggs. We’ve learned that a couple chickens outside the coop happens a lot and is no big deal so for the moment no more exciting “farm-Cari to the rescue” stories. Andy has been mostly working or sleeping but we have managed to squeeze in some Carcassone and Settlers. Cari says she has plans to write an email at some point but can’t get her nose out of her Jane Austen books (maybe when she’s read through them all once?).

The medicine has been a bit rough. Stayed up almost all night with an unconscious man who had seizures and then stopped breathing – turns out he had taken WAY too much insulin (10x his dose) and gone into hypoglycemic coma, took us a bit to figure that out and almost lost him, but after about four hours and tons of glucose IV he suddenly woke up and started pulling out his various tubes! Insulin is hard to explain here, even if you have a fridge to keep it cold. He had long-acting and short acting which usually are given together to optimize sugar control. He had been using his short acting vial first and then when it was gone he was going to start using the second vial (long-acting)!!! I had two kids die on the same day – one of renal failure after toxic epidermal necrolysis (very bad…and two weeks after taking medicines we gave her here at HBB) and one newborn baby. Then Russ had two more die in the next 16 hours – one was a six year old whose twin brother had passed away less than a day earlier (Witchcraft is common here, and the Togolese nurses asked about it. Apparently there is another family in the village with long standing animosity against our patient’s family – so some suspect a curse was put on them. Our other working hypothesis was cashews, some of which can be very poisonous, although mom had also eaten the cashew meal and was fine. Of course, we will never know….). We’ve also sent home several patients to die including an elderly lady with pneumonia and a 5 year old with renal failure from nephrotic syndrome. We currently have seven babies in isolettes (31 week and 32 weeks premies doing great, 32 week premie not feeding well, 28 week premie born today, 2 week old recovering well from sepsis, 3 day old with seizures, and 3 day old with heart failure and probable seizures). One of the things we could really use is IV nutrition (TPN) – we joke about how much sugar kids in the States get but some of our babies are alive because of sugar IVs! The 5 year old MVA has awakened from his coma and is drinking a tiny bit but hasn’t talked yet and doesn’t really follow commands. He’s got a long road. The caustic ingestion kiddo is doing well (hide your bleaches!!!!!!).

It’s been a rough week. Tiring, and I’ve made a few mistakes (several with adults, even a few with kids). A reminder that God is the one doing the work here (Ps 127:1, Is 31:1 and Zech 4:6) not me. And my job is to be obedient and humble, to find my identity in Him (Luke 3:16), not my profession. Thank goodness we have a God of power and forgiveness, might and mercy. More rests to come this week. Maybe even a chance to join the kids in the pool.

We hope all of you are well. Happy Father’s Day Tom and David and all you other fathers. Everyone give your kids a big hug and thank God for another day with them! May God be the source of your strength and your song.

In the Shadow of the Almighty.

CADT (The Robertsons)

Andy's Third Medical Journal Entry

17.Jun.2009 -- Day 7

Aphematoh! Oh doe! Yo-lo!

We greet you in the name of our LORD!

Today is Wednesday, the second of four calls in 7 days. Our short-term surgeon, Dr. Bruce Dekinga from Northern Michigan, is leaving today. The next volunteer surgeon comes in on Sunday. So for the next 5 days it’s three of us (the pediatrician Dr. Russ Ebersole, and Dr. John Briggs, a family doc who also does surgery. Interestingly, they are brothers-in law! John married Russ’ sister Susan). Not much happened yesterday. Andy was post-call and slept the afternoon away.

We’ve already had one answer to prayer – friends for the boys. Several of the boys who played soccer with Drew last time have visited. Drew and Tony love the company. They have been playing soccer, baseball, and riding bikes. It’s been a lot of fun for them to have someone other than mom or dad to play with! Drew also had his first over-the-handlebars wipe out. Fortunately he fell into grass so injuries were fairly limited.

Today was kids club at the Ebersoles. They host 60-80 Togolese children every M-W-F, with games M-F and lesson time on Wednesday. Cari jumped in and helped teach the lesson today! Pretty typical VBS type lesson, except she taught in French. Melody did give Cari an interpreter so at least she wouldn’t have to teach in Ewe. : ) She said it didn’t go very well, but I’ve heard otherwise. It’s pretty neat to hear the laughter and yelling of that many kids running around the compound.

The medicine here is just as complicated and sad as I remember. Monday call was long and tiring. We have several patients in the four bed SI unit (our “ICU”) who are very sick.
SI-1 is a 70 year old lady with pneumonia who hasn’t gotten better despite 3 days of antibiotics. Her sugars are high (bad) and her white count had been coming down but now is going back up (50,000, also bad). I am worried she will die soon.
SI-3 is a 30 year old lady who became unresponsive after losing her sixth pregnancy. Her glucose was off the scale (diabetes). I spent most of the night getting it into measureable range. On morning rounds it was 550 and Bruce (the surgeon) said “Üh-oh, that’s high.” I responded, “Oh no, that’s wonderful, I’m just glad the machine is finally giving us an actual number!” (I’m thinking it could have easily been over 1000 when she came in) She is doing much better, alert and talking to us. Unfortunately, almost no one has refrigeration so controlling her diabetes with insulin is a near impossibility. So now we have to explain that she probably has miscarried 6 times because she has diabetes, and continuing to get pregnant with this condition may end up killing her. But the emotional burden of being barren may be just as devastating so she likely will continue to try.
SI-4 is a 12 year old boy in liver failure. His liver and spleen are huge, his direct bilirubin is 10 (normal is less than 0.3), he can’t breathe well, and we haven’t been able to make him better either. I’m afraid at some point we will need to discharge him because there is nothing else to do. His liver will continue to fail, and then he will die.
We have 3 preemies all less than 33 weeks but they seem to be doing well. A 10 year old girl with nephritic syndrome (kidney failure) who also has high blood pressure, blood in her urine, and high creatinine (bad) – there is one type of nephritic syndrome that responds great to steroids and kids do fine but unfortunately she doesn’t have that kind. The 5 year old MVA is still in a coma, its been a week now, I feel so bad for the mom. Every morning during rounds I imagine myself in her shoes – if that was Drew in a coma, sitting at the bedside, wondering if he would ever wake up so I could play games with him again -- and it’s a crushing thought. Malnutrition, typhoid, malaria, hernias……… Yesterday, Russ had a worst of the worst come in, a child that drank lye (used to make soap) causing burns covering his mouth and esophagus, he likely will have permanent scarring. Neuro-ICU, CCU, PICU, OB/GYN, dialysis, orthopedics, NICU -- Andy gets pretty tired from the mental exercise.

I guess it’s just a reminder that our surgeries and medicines are just temporary reprieves, everyone we treat will eventually still die, and that ultimately we are powerless over death. How great it is to know that we have a God who is both personal and powerful. He loves each one of us enough to die for us, and he has overcome death for us.

Drew says his favorite things about being in Africa are “playing with the kids, feeding the monkey bananas, and playing his new computer games.”
Tony says his favorite thing about being in Africa is also feeding the monkey bananas (accompanied by monkey noises).
Cari says her favorite things about being in Africa are “the much slower pace of life and buying things at the outdoor market in Adeta.”
Andy says his favorite thing about being in Africa is “being back in Africa.”

In the Shadow of the Almighty.

CADT (The Robertsons)

Andy's Second Medical Journal Entry

14.Jun.2009 -- Day 4

Aphematoh! Oh doe! Yo-lo!

“Whoever loses his life for my sake and the gospel’s will save it” (Mark 8:35).

“Don’t waste your life”.” – John Piper
(I like what he says in the forward: “This is not a book about how to avoid a wounded life, but how to avoid a wasted life. Some of you will die in the service of Christ. That will not be a tragedy. Treasuring life above Christ is a tragedy.” So youth group teens, since school is out now and some of you are probably already sitting around bored and restless – why not put it on your reading list?)

Can’t believe we’ve been here four days already. (I guess Thursday doesn’t really count). Andy’s call on Friday was long (oh well) but he’s been off since Saturday noon and we’ve had some good family times. Yesterday was “game day” – we played some baseball in the DeKrygers back yard. Tony is much improved – he’s even hitting the occasional ball back up the middle. He still runs in random circles, laughing the whole time, sometimes asking to get tagged so he can fall in the grass, but we did work on jumping on third base so that’s a small improvement. Drew is maturing steadily – he has mastered the art of “imaginary runners” and can play a whole game by himself if necessary (this worked out GREAT during our 12 hour layover in Casablanca!). Except I have not figured out how to get his imaginary runners out, yet. They always seem to be safe, for some reason. Then we broke out the new game – “Carcassone”! (Thanks Tina, Dave, Eve, Philip, Susannah, and Alexander!). Fun game, we played twice – Drew won both games.

We have met several of the missionary families now. We really appreciate Melody Ebersole (the pediatrician’s wife). She’s the one who brought cookies and juice to the airport for the boys because she knew we’d be tired and hungry from travel. Yesterday she stopped by on her way to town (Adeta – just down the road a bit) to see if Cari wanted to join her, to meet the seamstress, pick up emergency supplies, and just get away from the kids for a moment. It was very thoughtful (and Cari was quick to take her up on it!) She also stopped to pick us up on the way to church today. Small acts of kindness that have meant a lot as we reacclimate to life here.

Today (Sunday) about fifteen people were baptized in the river after church. The whole congregation, led by the praise team (bugles, trombones, and snare drum), marched down to the river (except a few who rode their motos), everyone kept singing and it was just a fun, joy-filled time. We continue to catch up with old friends, seeing several at the church service.

The DeKrygers now have chickens which they keep penned up right across the road. They wake us up every morning (although I’m starting to block out the noise). Yesterday Cari played farmwife and rescued two that had gotten out, chasing one and scooping up the other (in her BARE hands), returning them inside the fence (Andy’s rescue attempts were feeble and unproductive, despite loud encouragement from the boys, and he quickly gave up and cried out for help). Today Atsotse (“Achoo-che”), the man who watches the house and the chickens while the DeKrygers are gone, let the boys help feed them which they thoroughly enjoyed. Did I mention I had forgotten how many ants there were here in Togo…….

In the Shadow of the Almighty.

CADT (The Robertsons)

Andy's First Medical Journal Entry

Caution: Andy likes to share medical details that some may find a little too detailed!

Peace to you, our brothers and sisters. I wish for you the perfect peace that only comes from keeping our minds steadfast on Him.

Well….our morning devotions were about the peace of Christ. With it came a gentle but firm reminder from Jesus himself that his promise of peace does not preclude trouble. If fact, he assures us that there will be trouble in this world, and knowing this we should not despair, but rather “take heart!” Yes, the NIV even includes the exclamation point. Odd….

There were several families for whom I prayed for peace today:
1) A 7 year old with 6 months of chronic illness, cough, and fatigue. His dad was a nurse at the government hospital 30 minutes to the south. Turns out his mom had died when he was six months of some type of prolonged illness and Russ (the other pediatrician) was more frustrated than surprised that no one had done an HIV test yet (positive). He had large palpable lymph nodes in the neck (not good) and his chest x-ray showed more nodes and pneumonia in the chest (even worse). But a cute kid. Russ and Gaglo (the physician’s assistant/local pastor/person who trained me in Togo medicine 2 years ago) took the dad and grandma aside to explain the diagnosis (HIV with complicating pneumonia, highly likely to be TB) while I played catch and soccer with him in the hallway. The whole time I kept thinking about Drew wondering how many more days of catch we might have before someone took me aside and gave me awful news. After wallowing in self-pity for a wee bit, I figured it would probably be better (and more spiritually appropriate) to be thankful for the wonderful years we’ve had together and appreciate each new day for what it really is, a gift of grace from our loving Father. I was glad I could kick the ball around a bit with the boy, and pleased as punch to be able to come home and hug the family.
2) A 6 month old wasting away with chronic skin abcesses all over (yeah, Tina….a pus story!). I held while the surgeon drained another one, meanwhile the mom’s HIV test came back positive. Although the baby’s HIV test was initially negative, in light of the illness and mom’s test, we’re sure the baby has it, too. Bummer……… There is some hope in the government AIDS program with access to some medicines, but…….bummer…..
3) The 13 year old with a week of abdominal pain and a positive “Ebersole-Williams sign” (pressing on the umbilicus elicits pain with perforated typhoid enterocolitis). The surgeon was hesitant at first but when we took him to surgery……..(well, you know the rest…….). First time I’ve seen a perforation up close (other than Bob Cropsey’s pictures). I’ve seen air under the diaphragm (not good) twice, both times here in Togo. Thank God for surgeons.
4) We currently have three premature babies on the peds ward! (30, 32, and 32 weeks)
5) A five year old still comatose from an MVA 3 days ago.

I’m on call right now. So far, so good. The boys are adjusting well. Melody Ebersole hosts a children’s ministry on the grounds Monday and Friday so Drew and Tony met 50 Togolese kids and watched the excitement this afternoon. Our good friend Elise and her children (Jean, and a baby girl) stopped by to visit with Cari so that was neat. Her husband Jeremy was away. We squeezed in a couple games of Yahtzee after dinner. It’s only 2100 and I’m ready for bed!

Take heart! He has overcome the world. Praise God.
In the Shadow of the Almighty.

CADT (The Robertsons)

Arrival in Togo!

Hey mom and everyone!

We are here safe. All in all it was a fairly routine 54 hours of traveling. We got off fine to Charlotte...the only setback was when Andy went back for sunglasses he thought he had left but were actually packed just fine. The flight to Charlotte was delayed 30 minutes because of a storm passing over New York but that didn't affect us because of our 4 hour layover there. The Royal Air Moroc flight to Casablanca was smooth...they put us up in a gorgeous hotel with two free meals...we squeezed in a train ride downtown..then caught the evening connection to Lome. Customs in Lome went smooth, all 7 bags arrived which was a blessing (minus one wheel), we met our hosts at the door (Russ and Melody Ebersole) just like planned, and they whisked us off to a wonderful guest house with air conditioning and chocolates. Andy even remembered to tell the porter "no taxi, no taxi....mon ami.....NO TAXI" this time. We slept, we awoke, we ate something that tasted really good, the Ebersoles took us shopping (cereal and ketchup for the boys) then out to lunch by the ocean, then a three hour drive to Adeta. As we drove through the gate Drew started remembering things from before which was neat.

Russ shared that most of the staff we met two years ago are still here, including nurses, PAs, and guest house staff. Florence met us as we drove up. Really, the main difference is that none of the docs we worked with are here right now! The boys immediately spread their toys over the living room rug, Cari and Andy set our "pan de chocolate" (bread with chocolate? -- a real treat here) and cookies on the counter and were quickly reminded by the ants why you don't do that in Togo, we ate a delicious dinner of tacos and chocolate chip cookies thanks to Florence (in case you were wondering .... Drew did ask why they eat the same food in Togo as we do back in the United States :) And now we are off to early bed (Cari and Andy at least, the boys will undoubtedly be up forever). The two docs are a bit overworked so they asked if Andy wouldn't mind taking call Friday (tomorrow) so please pray no adults are seriously ill that day.

Thank you for your prayers. Togo is much as we remember, and we are looking forward to a wonderful summer.

We thank our God each time we remember you. Delight yourself in the law of the LORD, meditate on it day and night, so He can give you the desires of your heart!

CADT (The Robertsons)

Friday, June 5, 2009

A word from Cari

Well - here goes, my first post! Hard to believe we are almost headed across the ocean again to see our family in Africa. I find that the more we do this, the easier it is to forget to pray. So PLEASE, everyone, pray for us and if you see me or talk to me, remind me to pray, too! I know full well, that all of our trips rely on God's care and sovereignty. And with two boys now instead of only one, it is even clearer to me. I am excited to be returning to a place we have served at before - it is nice knowing what to expect and how to pack, etc. But at the same time, it is good for me to remember that two years have gone by and many things there have changed just as we have changed. So I am looking forward to new experiences. It is hard to be leaving friends and family here, but we also know that August 26th will be here before we know it, and we will again be doing the American thing. Thank you to everyone who has given to our support and who has served us through any number of ways. We truly feel blessed in those God has placed around us. And we look forward to using this blog to keep y'all updated! I have added some links that might give you more info about the ministries we partner with for all our trips.

In His Care,


Monday, June 1, 2009

We're off to Togo in ...... 8 DAYS!!!

Thank you to everyone who is praying for us. This is a picture of Andy receiving eggs (right hand - in the bag) from a patient who recovered from severe croup. One of many stories from our last stay there, his croup was so loud Andy could hear it from the house across the mission compound when the nurse called to give report!

Please keep us in your prayers:
- that we would finish tasks so we are ready to go
- for our dear friend Marley who has agreed to stay in the house and take care of Roka this summer
- for safety in travel (I heard today that an Air France plane went down over the Atlantic - we flew Air France two years ago)
- for a heart like Christ as we serve others
- that the boys would adjust well to new food, smells, languages, and friends

For those who have asked about supporting us, the address is:
World Medical Mission; PO Box 3000; Boone, NC; 28607. Insert our Project Account number (#003351) in the subject line.

Speaking of giving .... Remember to give generously to your needy brothers and sisters (and without a grudging heart!) Deut 15:10

In the Shadow of the Almighty, Andrew, Cari, Drew, Tony