From Death to Life: A Day in Togo

I woke up Saturday morning not sure what to expect. Since I've come to Togo, I've learned that nothing ever goes the way you think it will-- but that's not necessarily a bad thing. Life here is definitely exciting.
I am very happy to see we will be outside
under the trees.
That day, the plan was for me to go to a funeral with some of the other missionaries while Seth rounded on patients at the hospital. I wasn't sure what to expect at the funeral, or even if I wanted to go, but I had been promised it would be a "cultural experience," and I usually like "cultural experiences," so I went.

The funeral was for a woman known as "Mama" Gnoyi (pronounced “NO-ee”), and she was so honored and loved in the community that her family expected to have a very large funeral, so they held the service in the courtyard of the local school to make sure they had enough room.
As far as I could tell, deciding to have the funeral service outside was a very good idea. There were hundreds of people there. If you've spent any time in this part of Africa, you probably know that A.) outside in the shade is always the coolest place to be, B.) coolness is always the number one priority, and C.) there are very few buildings big enough to hold hundreds of people anyway.
The funeral ceremony was pretty elaborate. Soon after we arrived, a procession of people marched in from the brush and placed the casket, which they had been carrying on their shoulders, in a shady area under the trees. The women of Mama Gnoyi's family walked around the casket a few times, crying and saying their farewells. Everyone was seated in plastic chairs around the casket. Then the service began.
One of Mama Gnoyi's relatives mourns by the casket.

Those who had been close to Mama Gnoyi made no attempt to hide their sorrow. There were some women who threw their arms over their heads and wailed with grief. Others sat silently with tears streaming down their faces.
At the same time, the spirit of the ceremony was one of celebration. Mama Gnoyi had lived a long, full life.  She had six children and forty-two grandchildren.
Mama Gnoyi's son (the man standing to the right) speaks
in French about his mother's life. The man standing on the left
is his translator, translating his speech into Ewe.

Her son spoke of how she had started going to church as a middle-aged mother, walking there with her children, and how she had come to faith in Jesus and been baptized. Her family had been “fetishers,” which is the word they use here for people who worship their ancestors, idols, and the spirits of nature. Some of her family still belongs to this tribal religion, so when the pastor got up to speak, he preached forcefully of how only Jesus can save. “We know where Mama Gnoyi went,” he said. “She is with Jesus now. The question is, where are you going? This tree can’t save you. This rock can’t save you. Your ancestors can’t save you. Only Jesus can save you.”

When I get tired of listening to a thrice-translated sermon, I
spend my time watching the adorable baby in the row behind
me. This lucky missionary lady gets to hold her, but I only get
to take pictures.

Of course, he didn’t say those things in English. He was speaking in the local tribal language of Ewe (pronounced EH-vay). He had a translator who translated everything he said into French, for the sake of those there who didn’t speak Ewe. Thankfully, my knowledge of Portuguese helps me understand most of the French spoken here, but whenever I didn’t catch something, one of the other missionaries helpfully translated the French into English for me.

Here you are never to young to play a percussion instrument!

Part of the celebratory feel of the funeral came from the abundance of music. There were three separate church choirs present, each of which sang several songs. There was also a brass band that accompanied us when we sang hymns as a group. The hymns were all in Ewe, but the tunes were familiar, so I sang along, having no idea what I was saying.

This is a picture of one of the hymns we sang.
This is what Ewe looks like written out.

When the sermon and the hymn-singing and the choir performances were done, the funeral procession to the cemetery began. Several men carried the casket on their shoulders (as they had when they brought it to the funeral service), and the brass band played as we all walked up the road as a group to the cemetery.

The funeral procession to the cemetery.

There wasn’t much to mark the location of the cemetery. We basically walked up the road for a few minutes, and then through the brush to a clearing under some trees where someone had dug a hole in preparation. Two men jumped into the hole to help lower the casket in, and then jumped out.
This was the special meal given to missionaries and other
honored guests; steamed dumplings made of corn and rice flour,
with a meat sauce. The dumplings are called "ablo."
They are delicious.

The pastor prayed, and several people started to throw dirt into the grave. Then we all marched back to the school courtyard where the service had been, this time to eat lunch. It is tradition here that the family feeds everyone who comes to the funeral (even if this means feeding hundreds of people). As guests of honor, we were given seats inside the school-room, and special dishes made just for us. Most of the other guests were fed from huge communal bowls of rice, out under the trees.

As we rode home in the missionary van, I reflected that I had seen the commemoration of the end of a life here, and I wondered idly what it would be like to witness the beginning of a life here as well.

The mother is prepped for surgery.
Back at the hospital compound, I went to the guest house dining area, where Seth was eating lunch. As I sat describing the funeral to him, he got a call from the hospital. One of the other doctors wanted him to come and assist with a C-section.  Remembering my thoughts during the drive home, I asked him suddenly, “Do you think I could come and watch?”
“Sure, I don’t see why not,” he said.
That is how, mere hours after seeing someone buried, I found myself in a surgery room waiting to see someone born.
The mother, who was being prepped for surgery when we arrived, was quiet and calm. When her contractions came, she would click her tongue against her teeth rapidly, sometimes crying out quietly in pain, but her eyes were closed and her face was peaceful. She seemed to trust that she was in good hands, and indeed the doctors prayed before surgery that God would guide them, and I prayed for health for the mother and the baby.

Seth swaddles the baby boy.
In the room was a cart where they would place the baby after he or she was born. Seth’s job was to care for the baby while the other doctors performed the surgery. While I waited by the baby cart, I was surprised to see Seth wheel a second cart in. The mother was giving birth to twins!

Baby boy is very alert and wants to look around.
The surgery went well, and both babies emerged healthy and beautiful, first the boy, and then the girl. It was the first time I had witnessed a birth that was not one of my own children, and I can think of few things that have filled me with more joy. Seth and I were able to introduce the twins to their father and big brother. The pride and happiness in their faces was easy to understand, even though we didn’t speak the same language.

After the girl is born, I get to hold her and Seth holds the boy.

I didn’t know Mama Gnoyi or her family, and I didn’t know this young mother or her family, but in both cases they allowed me the great honor of sharing in their pain and in their rejoicing. In these brief but powerful moments I felt I saw a snapshot of the promises of Jesus. Whether in birth or in death, I saw the glory of God and the fullness of life.

Jesus said, "I have come that they may have life, and that they may have it more abundantly... I am the resurrection and the life. He who believes in Me, though he may die, he shall live. And whoever lives and believes in Me shall never die." (John 10:10 and John 11:25, NKJV)

Missionary Doctor – Day One in Review

They wasted no time in getting me involved in work at the hospital. I was on-call yesterday, my first day here. Initially, I wondered if that might mean “you’re on your own,” but thankfully it did not. I worked with a doctor who will soon finish his two-year commitment in Togo, just as I will start mine a little more than a year from now (after language school in France).

For the most part, nothing has come as a surprise. I have had some limited exposure to medical missions and have otherwise thought quite a lot about it over the past ten years. Resources are limited and out of date, the diseases are unfamiliar, and the organization skills of local medical staff are…different. All expected. I was also mentally prepared to see suffering and death out of proportion to what I see in practice back home. And yet, nothing can make it real as much as the experience itself. To some extent, I have already developed some ability to leave the emotion of each encounter when it’s time to move on to the next patient or to go home and be with family, and I have very often prayed over patients while I’m listening to the heart or working on the spine or when they are in surgery. I prayed a lot yesterday.

Being on call here is similar to what call is like at home. The on-call physician is responsible for a certain population of people who may need medical attention, he is called when needed, and makes rounds on his patients. There are no pagers here. If the doctor is not in the hospital, he needs to be available in one of a couple places where there is a phone. But then, why wouldn’t the doctor be in the hospital? Here rounds start early just as in most places, but we were covering the “intensive care unit” as well as men’s ward and women’s ward. The pediatrician is home for a few months, so we covered the pediatric ward as well. On top of that, the doctor I was working with is one of only a few who takes care of maternity/obstetrics, so of course we covered that too. Thank God, there is a short term family doctor who is helping with maternity and a surgeon who helped with C-sections. People come to this hospital from all over the country and from surrounding countries. This hospital has become the place to go if other western clinics and witch doctors have failed. This tends to mean that many of the patients are very sick.

We started with the patients in the intensive care unit. One with HIV and other related diseases, one with sickle cell crisis, another in heart failure, and the last with significant back pain. We work on each patient as a team which lends itself to excellent education for me as well as to a very lengthy process in general. The lady with back pain had fallen six months prior and was having difficulty with bowel movements since. I was able to spend some time practicing osteopathic medicine on her (for the medical people, aimed at lumbosacral and SI joint). She was in significant pain with the gentlest touch. Nothing I tried was able to get her muscles to relax. I started praying for her aloud despite her inability to understand me. That’s when her muscles began to relax. She no longer jumped in pain when I touched her back. Praise God! Hopefully her bowel function will improve. We went to the men’s ward and women’s ward and treated people with malaria, typhoid fever, and hepatitis C. We were not able to finish in the pediatric ward before being called to check on a woman trying to deliver a second twin. It was evident that the baby was not getting good oxygen, so the mother was taken to surgery for C-section. It took quite a while for the family doctor and surgeon to get the baby out as the baby was not in a good position (transverse). Three of us: the doctor I was working with, a short-term missionary physician assistant, and I received the baby after delivery. She was not breathing and her heart was only barely beating. Understand that this is not a typical part of my work at home in America. I was fervently praying for the life of this child as we tried to resuscitate her. Praise God! She began breathing on her own after 3-4 minutes (this is an eternity). A second C-section after lunch went much more smoothly. Praise God for that too!

The pediatric ward is seven beds in one small room with only two monitors for tracking vitals. It seems that these beds are always full of children, usually babies up through 2-3 years old. Most of them are being treated for anemia and malaria. Many have parasites or other infections on top of that. One little boy came in with a type of cancer called lymphoblastic lymphoma. He did not respond to treatment given in the past and is considered palliative/comfort care. He had a bloody nose and his right eye was swollen and protruding from his face. I am unsure if there is a tumor or bleeding.  Towards evening, two very small children came who both seemed to be having seizures and were neither of them breathing very well. Please keep breathing. My prayer for these beautiful children was the same I pray over my own children. That they would be healed. That they would be safe. That God would use them mightily in His kingdom. The little boy was doing much better this morning. The little girl is with Jesus now. I praise God for that too.

The hospital lives up to my expectations. The compound is very nice and the medical facility, although thoroughly substandard, is actually much better off than many other places in this part of the world. The doctors here truly do good work with what resources they have. However, medicine is not the reason we are here. It was never the reason for coming. It’s not why I even went through medical school. Christ is the reason we are here. His love is so great and big that we cannot keep it to ourselves. Medicine is only one of many ways to share his love and open avenues for sharing the gospel. This hospital is run as a ministry. We pray as a group over every patient in the hospital. The ministers work with patients just as the doctors do. I am excited to learn the language and be able to pray with these people in French and to build relationships with patients and the workers here. I can’t wait to share Christ with people. Many of the patients and their family members pray with us when we pray for them. There are Muslims and many of animistic religion. There are many who mix religions and still worship ancestors and fear magic. We know Christ is greater and that His perfect love casts out all fear.

I am optimistic about our trip here as well as for our two years here later on. I foresee a lot of work, fatigue, difficulty, and frustration, but that sounds like life anyway. Christ has called us here for this time. Pray that we would continue to have the hearts of true servants to the missionaries and people here. Pray for health and strength for us. Pray that we would be overcome by the love of Jesus and that our words and deeds would reflect his perfect love.  He is the one who changes hearts and minds beyond our understanding. May He be glorified.

“Love suffers long and is kind; love does not envy; love does not parade itself, is not puffed up; does not behave rudely, does not seek its own, is not provoked, thinks no evil; does not rejoice in iniquity, but rejoices in truth; bears all things, believes all things, hopes all things, endures all things. Love never fails.” (1 Corinthians 13:4-8)

Tomorrow I may get to work in the clinic after hospital rounds. Clinic is closed on Wednesdays and today (Thursday) was a national holiday in Togo. So far the greatest danger I have faced is falling mangos. Becca has been busy meeting other missionaries and helping them in their various ministries. I’m sure she will have an update. I do hope to get out and take some pictures soon. I’m unsure if I will be able to upload them, as the internet here is intermittent and cannot handle too much data. When you think to pray for us, pray for the other doctors and missionaries here as well. The lifestyle is interesting and exotic in many ways, but there are numerous challenges as with any ministry or mission.

Blessings to you all.
In Christ,

Dr. Seth

Ready, Set, Go!

Today is the day!
Seth and I are flying out from Detroit this evening, and we will arrive in Togo tomorrow evening. We are so excited!
The kids are staying at their Mallay grandparents' house. I already miss them, but they couldn't wait to go.
We have our sunglasses on! Can we go to Grandma's now?
We had a lovely drive up to Grandma's on Friday. Please pray that they will continue to enjoy their time with their extended family and that this will be a fun learning and bonding experience for them.

The drive to Grandma's house.
Yesterday and today, Seth and I have been cleaning up a little (so we don't have to come back to a dirty house) and packing all our things. We have enjoyed having time to work on these things together, just the two of us.
Please pray for us, that we will have a safe flight, and that our time in Togo will bring glory to Jesus. We want to be servants to the full-time missionaries who are there and testimonies to the Togolese people. We want people to see the love of God in everything we do. Please pray that we will be effective.
And, above all, praise and thank God for His love and provision! He has made this journey possible for us, and we are so very grateful.
In the last week, we have heard from many of you, saying that you are praying for us. We are so thankful for your prayers! Last Sunday we got to speak to some of you at our church, and we were so blessed by your response. Some of you have even been able to contribute to our trip financially, and we want you to know that we are grateful for and humbled by your support. May God bless all of you richly! We are so blessed to have you in our lives.
We are leaving soon, but we will keep updating while in Togo. If you would like to receive regular updates, please "like" our Facebook page, Mallays on a Mission, or e-mail us and ask to be added to our e-mail list.

"As the Father loved Me, I also have loved you; abide in My love... These things I have spoken to you, that My joy may remain in you, and that your joy may be full." ~Jesus (John 15:9,11)