“Shall we accept good from God, and not trouble?”

The bright African sun beat down from its perch in the cloudless blue sky as the usual haze of red dust circulated about my feet and clung to my shoes and scrub pants. I smiled as I pondered the irony that every day I was blessed to walk in 90 degree weather on a rocky, dusty path through the African bush to get to clinicals, while my American counterparts were driving their cars through the chilly Indiana rain. Despite the many difficulties of living life and participating in health care here in rural Africa, it is a huge, huge privilege for us to be in Zambia. 

On our first day of clinicals in Macha over three weeks ago, I was doing rounds with the doctor in the morning and we came to a young patient who the doctor explained was 24 weeks pregnant and diagnosed with an “inevitable abortion” (miscarriage). He then asked me, “What is an abortion?” I replied that in Zambia, the word “abortion” was generally used to refer to either the unintentional death of the baby (miscarriage) or the intentional termination of an unborn baby. (Only recently legal in Zambia). The doctor rather indignantly replied, “why do you keep saying ‘baby’?? At 24 weeks it is a fetus. You can’t keep calling it ‘baby’—only after 28 weeks can you say ‘baby’. This is just a fetus. What do you think?”  It took me a second to realize what he was saying. I was a bit shocked at his forwardness about this topic, but firmly replied “No, I disagree – I believe this is a baby from day one. On day one there are living, human cells, and I believe that they are always babies from the moment of conception.” Laughing at me, the doctor moved on to examine the next patient. 

Later that night, a nurse walked into the Maternity ward that I had rotated to for the evening, carrying a tiny little baby that wasn’t breathing. The baby turned out to be that very same 24-week-old “fetus” that I discussed with the doctor earlier that day. The nurse placed him on the scale to weigh him and kept standing there. His tiny lifeless form was quite blue, and I asked her several times if he was breathing. She did not really respond, and eventually stepped aside. Immediately I checked his heart rate—and his little heard was beating hard and fast—he was still alive! I put him on the warmer and Jamie and Marguax helped as we began to try to stimulate his tiny body and get him to start breathing. I kept getting a bunch of meconium-stained fluid out of his airway (basically poopy, amniotic fluid). We ambu-bagged him (emergency resuscitation), prayed and prayed, stimulated, suctioned, ambu-bagged, put in a bit of oxygen, and kept repeating the cycle. Finally, I will never forget the moment that he gave a tiny gasp, his skin retracted against his tiny rib cage, and he took a breath! What a miracle! Preemie babies do not have a big chance at life here in Zambia, but life is definitely gift from God. God gives and He takes away. Blessed be His name. I am thankful that even for just a little while we could give this baby life. Almost this exact situation happened to 2 girls of our team just a few weeks ago and so it was an unreal situation to walk through, and difficult to process and sort out in my heart and head.            

 I hope that the doctor came around the next morning and saw the living, precious little human life. Over the next several days,  we checked in on the baby, rejoicing at the miracle of this little life. One day I went in, and he was no longer in the warmer. I searched every room, and he was gone. We asked the nurse and she said that he had “expired.” Originally I had my hopes up that he would make it, but knew his chances were slim. His internal organs were so underdeveloped and no sophisticated machines exist over here to help keep him alive. The father never showed up to name the baby before he passed away, so, (at least for my own sake) I named him Chipego, which means “gift” in Tonga. God graciously gave Chipo a few days of life, and in His wisdom decided to let Chipego’s human body die. I have been encouraged by reminders from Isaiah, recognizing that God’s ways are higher and far above what I often think would be best, and I have been challenged by Job’s assertion, “Shall we accept good from God, and not trouble?” God is good, always. 

On another evening shift later that week, we had an incident where the victims of a car crash were brought in to the hospital, several already dead and one lady in a critical condition… she ended up coding and a Zambian doctor and Haley, Kristin, and Abby rotated doing CPR on her, but she passed away. A week ago, while pushing a patient to Surgery, a procession of women, wailing loudly, wheeled the covered body of a small child out to the morgue. I have seen more death here than in my entire life combined. In the West, death is viewed as the ultimate enemy, and we do everything we can (especially in the medical world) to fight it, avoid it, and delay it. For the people here in Zambia, the idea and concept of death is so much nearer and tangibly real—people are almost fatalistic about it all. I struggle to reconcile these differing cultural views, remembering the fact that we live life in a broken world, and yet simultaneously clinging to the truth that Jesus won victory over sin, suffering, and death through His perfect sacrifice—and that as believers we have ultimate hope beyond the grave. 

One of my friends in the States put it well—“nursing itself is hard enough [emotionally], let alone doing nursing IN Africa.” I have never seen so much physical suffering in my life. As a team we covet your prayers that God would help us to process through things well, and that lessons and themes would emerge out of the weeks and months that we have been through so far. Every day is so full of so many new experiences it is so hard to sort things out and make sense of all of the pain and suffering we witness. I have been so encouraged by 1 John 3:20: “For God is greater than our hearts, and He knows everything.” When my heart flails for answers and I can’t figure things out or make sense of them, I can rest assured in the understanding that GOD knows everything. HE is in control, and He has reasons and purposes.

Please also pray that, as we wrap up our final 15 days left in Africa, that we would still be present and make the most of our days, hours, and opportunities while we are still here.

love,

~Elisabeth