Summertime

One thing Kris often talks about is how hard it is to mark the passage of time in our lives in Kapsowar. As non-farmers, we often feel that the seasons are very similar here - pleasant, slightly warmer than pleasant, slightly cooler than pleasant (although Kris would NEVER admit that there is such as thing as slightly cooler than pleasant here). Sometimes it is shocking to read about weather phenomena in North America and realize that the mid-west is in tornado season again, or that flights are grounded by winter storms, or there's another severe heat wave. Here in Kapsowar, I mark time very differently - by the visitors, both medical and non-medical, who come to visit us, or by the trips we make to visit others.

Over the past five years, we've had some really special visits with family! 

This (North American) summer, we'll be sad to miss many family get-togethers and special occasions. It makes us so grateful to be living overseas in the era of video calls! At least we can say hello instead of writing a letter and receiving a reply months later! And even when the weather is cool here, we like to celebrate "summer" with some traditional picnic or barbeque food, and weekend campfires if it's not raining. Enjoy your summer, stay safe, and eat an extra hot dog or s'more for us!

A reflection on motherhood

Every year around Mother's Day, I find myself caught in two main reflections. First and foremost, of course, is gratitude for my own mother, and the growing appreciation I have for her as I realize how difficult it is to be a mother, especially of an independent and strong-willed child!

The second reflection is about my patients. As an OB/Gyn, so much of my work circles around the idea of motherhood. Women who aren't pregnant and want to be. Women who want help with family planning methods so that they can time their next pregnancy when their family is ready for another child. Women who have been pregnant, sometimes over and over, but have never brought a child home with them due to what is know here as "Bad Obstetric History."

A few weeks before Mother's Day, I got a call from one of our visiting physicians. "I have your patient Faith here" (name changed, of course). The patient's name was an incredibly common one, and I wasn't sure who he meant. I waited for more information. "She's had two stillbirths at term; this is her third pregnancy."

As an general OB/Gyn, I'm fully trained to see routine pregnancies and manage some high-risk conditions in pregnancy as well. A general OB/Gyn in the US might very reasonably see a patient in his/her clinic with a history of one prior stillbirth. However, to have a patient with two prior stillbirths would be quite uncommon, and most likely a general OB/Gyn would at least get a consultation from a high-risk Obstetrics physician (we call them "Maternal Fetal Medicine" trained OB/Gyns).

What made this conversation stick out in my mind was not the fact that this woman had two prior stillbirths. It was that even after receiving her name and history from the visiting physician - I still couldn't recall who this patient was. Not because I'm a heartless provider, or I have a terrible memory - but because we have so many patients with a similar story. Being a referral center for high-risk pregnancies, of course, we have much higher rates of "Bad Obstetric History" than most antenatal clinics would see. But still, the number of patients we see with potentially avoidable pregnancy losses is at times heartbreaking, and it is staggering to think that Kenya is much much better at maternal-child health than other countries in the world.

Some people tell me that the women in Kenya are so strong, to be able to deal with these pregnancy losses and still carry on. I can tell you on the one hand - yes, they are incredibly strong. And on the other hand - many have no option but to carry on. Others aren't able to. I've met women in my practice who have lost their marriages, families, and communities due to their difficulty conceiving or carrying a pregnancy. I've met women with suicidal thoughts and profound grief, depression, or anxiety due to the loss of a current or past pregnancy. The fact that these women may have a sister, mother, or friend who has also lost a baby "normalizes" the experience a little, but it doesn't make the loss any easier for any particular mother. 

I'd love to end this post with some profound insight or great plan of how we're going to end "Bad Obstetric History" in Kapsowar, or a moving call to action. I guess I'm clean out of pithy summaries. Maybe as you reflect on motherhood in your culture or context, think about the women and mothers who might be struggling within your sphere of influence, and send them a kind or encouraging word to let them know that they are valued, no matter what they have been through. 

A Shameless Plug - Kapsowar School of Theology

Kris has not been teaching during the first term of 2025, due to traveling and several projects around our house and station that required his supervision. He's also been working on setting up the first ever Kapsowar School of Theology website. It's literally a site - a single page - targeted toward men and women interested in attending the school. Check it out here!

Books

Three years ago, as we were preparing to head back to the US for a prolonged period (to "graduate" from the Post-Residency Program to Serge, and for my US oral board exams), we were facing what felt like a difficult problem. Dominic was a little bit interested in reading, but mostly just comic books, and mostly just superficially. As an "early" reader myself, I was SO ready for him to start reading chapter books independently! My memories of most school vacations are reading books in various locations - the lake, Grandma and Grandpa's house, campgrounds...

We shamelessly bribed Dominic to read by letting him choose a brand-new book from a series at our local bookstore in Seattle - he chose Dragon Masters, and a Minecraft instruction book. And it worked! By the time we left Seattle, he had read every Dragon Masters book at the local library, and was looking for more! Soon he discovered reading e-Books from the library, and we were off and running!

Now, we're facing another challenge - finding books and series that are engaging, appropriate for his age and reading level, and that are good literature. Sure, he loves Captain Underpants...but you can only eat so much junk food, and in my opinion a 10-year-old mind should only take in so much junk reading (sorry, Captain Underpants fans). I wish I had time to pre-read every book that Dominic is interested in reading, but unfortunately I do have a job - and he's starting to read pretty fast. Common Sense Media seems to rely primarily on parent and kid reviews, and the presence or absence of scary situations, references to drugs/alcohol/sex, or bad language. However, the present/absence of those things doesn't necessarily make a book good literature! 

I recently discovered the Redeemed Reader website. So far I've been impressed with their recommendations and the depth of (most of) their reviews. It's a good starting point, and they have a lot of book lists and recommendations for various reading and maturity levels. I keep trying to get Dominic to throw in some classics, but it's helpful to be able to toss in a new book (or better yet, a series) that someone else has already reviewed!

Since 2022, Dominic has read and enjoyed:

- The Chronicles of Narnia (we've read them through twice together, and he's read them all by himself as well except The Last Battle)

- The Hobbit (read aloud)

- All the Dragon Masters books that he can get his hands on 

- Wings of Fire Graphic Novels through #6 (that's where we decided to stop)

- The Rangers Apprentice Books 1-3, not because we stopped there but because that's all we have

- Warriors (it's about tribal violence between groups of cats. Not my favorite theme on a number of levels)

-Jack Zulu and the Waylander's Key

- The Green Ember and other books in that series (only on audio)

- I'll admit it: Captain Underpants, Dog Man books, countless Garfield, Far Side, and Calvin and Hobbes cartoons - although I know Kris would not want me to classify Calvin and Hobbes as junk reading

- The Redwall Series (audiobook only)

- The Wingfeather Saga (read aloud)

- The Incorrigible Children of Ashton Place (I read this series ahead of him and really enjoyed it)

We're looking forward to starting Harry Potter in just under a year (Age 11 feels like the correct time to start that series, especially for a slightly more sensitive reader)! Until then, I'm sure we'll need a lot more book recommendations, so feel free to leave a comment or sent me an email or text with your favorites! 

Photo Dump!

We've been busy traveling and training and just trying to get things done. So, here are some pictures since the beginning of January!

Traveling to Asia for a medical conference in February

There were topiary dinosaurs...

Interesting architecture...

And Starbucks!

Riding elephants at an Elephant Sanctuary...

And more coffee!

Touring town in a horse-drawn carriage

Biking

And lots of interesting plants

On our return:

Avian flu has apparently NOT hit Kenyan chickens

We came home with a picture of elephants painted by an elephant

Life is changing! My first day back to work - thanks to having a full time OB/Gyn partner, I was home in time to play a game with Dominic before dinner!

There have been a lot of challenges on returning to Kenya, primarily centered around the hospital and difficulties with funding as well as supply chains. Most of that is a national, not international, problem, but for those of you who are curious about the effects of the defunding (or at least, freeze on funding without an end-date) of USAID on hospitals in Kenya, our colleague Matthew Loftus wrote this article for Christianity Today.

Matthew and his family live and work at another mission hospital in Kenya - our family visited with them last year. What I love about this article is that he emphasizes that many of the affected patients in sub-Saharan Africa are Christians living with these infectious diseases (HIV and TB). It's easy to depersonalize these defunding decisions, but I think Matthew's point is this - Christians globally have an obligation to care for our brothers and sisters who are less economically blessed than we are. It's a challenge to think about whether you would support someone in your own congregation with one of these diseases who couldn't afford their medication. I hope you would support them, and we pray that the church in the US will be the voice for their Christian brothers and sisters all over the world. Feel free to contact me if you have questions!