Highlights of 2011

Some of you received this via email, but I wanted to record it on my blog as well. 

At the beginning of 2011, I was just past the halfway point of my two years in Kenya. I was so thankful for God’s direction in leading me to join the McCropder team, but we didn’t know yet where we were going (though we hoped it was Burundi) or which mission agency we would partner with (though we hoped it was World Harvest). I had a one month old niece I’d never met and family I hadn’t seen in over a year. Our power supply was very erratic due to lack of rain and malfunctioning of the hydroelectric power plant. I wondered how much I should invest in the new Kenyan intern class knowing I wouldn’t be there to the end of their internship. I unavoidably realized anew my strong desire for others’ approval and acceptance rather than resting in the unconditional love of my Heavenly Father. But thankfully, amazingly, God continues to bring treasure out of jars of clay. Which leads me to:

Highlights of 2011

 

 Caring for the premature quadruplets as three of them miraculously recovered from necrotizing enterocolitis (without TPN) and went home to their happy parents at 4lb each.

 

 Being encouraged and refreshed through medical missions conferences and retreats with like-minded friends around the world (pictures above and below)

Growing through mentorship with the Sonship discipleship course and understanding more and more the beauty of the gospel in my everyday life. 

Visiting Burundi (East Central Africa) in May and experiencing the joy in teaching bright, enthusiastic medical students and caring for underserved patients in one of the least developed, poorest countries in the world. Understanding truly that this is the long term work God has for me and the McCropder team.

Witnessing the pediatric team at Tenwek praise God for healing Bab – the boy pictured who was admitted with severe meningitis (CSF WBC 1500) and uncontrollable seizures but who suffered no long term effects from his illness.

Mfangano Island medical mission trip in Lake Victoria – a trip I very reluctantly and apprehensively agreed to help lead in partnership with two churches from the U.S. But despite my hesitation, God demonstrated His power and love amazingly both to His children on those underserved Kenyan islands and to His children with different but no less significant needs on the team. 

Joining World Harvest Mission, an agency that emphasizes the centrality of the gospel and whose mission is “Laying down our lives to proclaim the Kingdom of Jesus Christ through preaching, healing and equipping” – exactly what our team feels called to do! Picture represents the East Africa WHM missionaries (Burundi, Kenya, Uganda, Sudan) at our retreat in August.

I’m so thankful for the joy of getting to know this amazing intern class through our Bible study (which they’ve continued) and through working together in the hospital. I miss them but am glad to get updates through Facebook and email!

Hanging out with friends, playing games, eating homemade pizza, and watching movies with the projector are some of my favorite memories of 2011 and of my time at Tenwek. This picture was from New Year’s Eve 2011.

Christmas with the Pfister pfamily all together again in Nashville. What a joy! 

As you’re making New Year’s resolutions, consider committing to monthly supporting my ministry in Burundi. I still need to raise $2830/month. Email me for more information: alyssapfister@hotmail.com.

Thanks so much for your continued prayers and support. Happy New Year!

My Tentative Schedule for 2012

January – hospitalist work in Birmingham

Feb, Mar – tropical medicine course in Peru

April – work and travels in Birmingham, Nashville, Boston

May, June – cross cultural and language acquisition training at Mission Training International in Colorado

June 23 – my sister’s wedding 

August – begin 10 months of French language school in Albertville, France

Summer 2013 – move to Burundi!

Christmas

What a joy to celebrate Christmas with all the Pfister pfamily traditions and with the whole family together for the first time in several years!

 

Lauren, Alyssa, Mom with Sam, Dad, Bud with Emma, Leslie

We did miss Lauren's fiance Wei Chi, but we enjoyed some pre-wedding fun with lunch and bridesmaid dress shopping with a few of Lauren's closest friends. Looking forward to the big event June 23! And so thankful I'm in the country for all the fun!

Isn't Emma adorable?! She's so much fun and quite the dare devil - loves being thrown up in the air and climbing the stairs whether anyone's spotting her or not.

Gigi (my mom) found so many fun activities for the grandkids like this cardboard castle. Isn't Christmas so much more fun when little ones are around?!

Christmas Eve enjoying the festivities at Opryland. (From Bill Bryson's book "Notes From a Big Country": "But what really sets Opryland apart is that it is a Total Indoor Environment...It is, in short, a flawless, aseptic, self-contained world, with a perfect unvarying climate and an absence of messy birds, annoying insects, rain, wind, or indeed any kind of reality.") It is a beautiful place, especially at Christmas-time, but I'm thankful I don't live there. The messiness and irregularity and annoyances of everyday life, and my response to them, are what remind me that I need a Savior. And I'm so thankful Jesus came to cleanse the incredible ugliness of my heart and to bring true beauty into this fallen world. 

Samuel blowing out his candle at the Christmas Eve service at West End Community Church. Samuel continues to love church and sits more quietly than I do through the service! 

Traditional Christmas morning breakfast - sausage and egg souffle

Dr. Samuel, gift from Auntie Alyssa! Maybe he'll join me in practice in Burundi someday!

Examining baby sister Emma

Enjoying laughter and conversation with special family friends, the Spillmans

I'm thankful for the peace and joy of the Christmas season, the reminders of the beauty of Christ and the gospel, fellowship with the body of Christ, and the giggles of small children. Merry Christmas!

Work

Last week I began working nights as a hospitalist (nocturnist, some would say - but that sounds like a possum or other night critter to me) here in Alabama. I must admit, the first couple nights I walked around a bit dazed by the wonders of modern technology. Thankfully things haven't changed too much since I finished residency in 2009, but wow, are things different from Kenya! A few examples (and I apologize for the medical lingo for my non-medical blog readers - it's a little hard to avoid in this post):

1) An intubated patient was transferred from the Emergency Department (I can't stop calling it Casualty in my head - the British term we used in Kenya) to the ICU via CT (certainly no CT scans available for inpatients during my years in Kenya). As the nurse gets her settled in the ICU, he reports to me, "I think her ETT may have dislodged a bit during the transfer, but she's still pulling good tidal volumes on the vent, so I don't think it's come out too far." An astute observation that likely would not have been noted in another setting. He orders an x ray. Within 10 minutes, I look up and see that not only has the xray been taken, but it's actually visible digitally right there on the portable x ray machine. The tech waits patiently while the nurse & I unsnap the ETT securing devise (no pulling off tape or unrolling gauze), push the ETT in a bit, and resecure it. Then she shoots another x ray and I verify the placement immediately - again, on the screen. I still listen for equal breath sounds with my stethoscope, but out of habit more than anything else. And then a radiologist actually calls me with an official read of the x ray in another 10 minutes. I'm completely astonished at the efficiency of it all!

2) Another ICU patient has both pulmonary and cardiology consultations complete within 5 hours of admission (which was after 5pm). I missed subspecialty consults greatly in Kenya! Though it does take some adjustment to remember when I should consult a specialist here.

3) I was paged to the bedside of a lady with advanced cancer who was developing respiratory distress. For better or worse, I certainly gained a lot of experience with end of life discussions in Kenya. There was a steep learning curve there, though, as so much of end of life care, expectations, and decisions are culturally derived. In Kenya, these discussions are traditionally had with family members, not with the patient. And no one wants to be the bearer of bad news, so they generally don't tell other family members who aren't present that a loved one has died but only ask them to come. Even the Kenyan nurses describe a dying patient as having "changed condition" as opposed to a more definitive assessment. Speaking to this lady in Alabama about her wishes was so simple - we spoke the same language, she understood the implications of what I was saying, & I knew she understood because we even spoke the same nonverbal language. And I knew the culturally appropriate ways to comfort her. I did feel significantly more pressure to document this discussion in the chart than I ever did in Kenya, though!

Of course I'm also amazed by almost immediate lab results, computerized records, and hand sanitizer everywhere among other things. But, though these conveniences and technology are a refreshing change of pace, the fact remains that another doctor would care for these patients if I wasn't here. My heart goes out to my overworked colleagues at the mission hospitals in Kenya right now. At Tenwek, a series of recent events (one being the loss of the five McCropder docs a couple months ago - a scheduled departure, but nonetheless challenging to find five docs to replace us) has left them significantly understaffed. And December is always a busy month with higher numbers of patients and lower numbers of hospital staff due to annual leave. But to make matters way worse, now the mission hospitals are essentially the only hospitals open in Kenya. The Kenyan doctors went on strike on Monday due to concerns of lack of drugs, equipment, and adequate pay. Click here to read an article about the strike. This means government hospitals are closing and mission hospitals are running over capacity. Click here to read a missionary colleague's blog about her experience at Kijabe mission hospital the last couple days (note interns are included in the strike).

Please pray for this situation in Kenya. And pray for compassion for all of us - for the members of parliament and the doctors in Kenya, for the exhausted and overwhelmed staff at the hospitals there, and for me as I seek to care for patients here in Alabama - patients perhaps not so physically needy, but just as much in need of the compassion and love of Christ as anyone else in the world.

Thoughts

I'm continually amazed by the interconnectedness of people around the world. I met a girl at church today in Nashville, TN who spent the summer in Kenya working in community development and microeconomics just 30 minutes away from Tenwek. I stay connected with friends around the world through email, blogs, & Facebook. Though I hadn't heard of Burundi two years ago and thus don't expect others to know it, I regularly run into people who have been there or who know Burundian refugees or who have read the book "Strength in What Remains" (the story of the Burundi genocide).

And yet somehow, despite all this interconnectedness, despite the fact that I talk about both Kenya and Burundi daily with friends and strangers as I share my story, sometimes it still seems surreal. I lived in Kenya for two years, and, though I missed aspects of life in the U.S. and certainly faced unique challenges, my daily life was very comfortable and even felt normal. I didn't notice the cows or donkeys on the dirt path on my way to work or the ladies selling local produce on the corner. I forgot that before living in Kenya I used to drink tap water and buy eggs and milk from the grocery store. I shook hands with everyone and greeted them in Swahili without thinking twice about it. I wore long skirts daily. I expected to treat patients with meningitis and malaria and HIV/AIDS on a daily basis and to take a break for chai at 10:30am. I visited with friends and neighbors every day because, with the exception of an occasional trip to Nairobi (3 hours away), most people, missionaries included, rarely traveled farther than walking distance from their house. It was not uncommon for me to not even ride in a vehicle for a month or two at a time.

Now that I'm back in the States, though, life here seems normal, too - decorating for Christmas, driving my car everywhere, going out to eat regularly, brushing my teeth with tap water, pumpkin in a can. And of course, the joy of all the Pfister pfamily Thanksgiving traditions:

Family Thanksgiving. Congratulations, Lauren and Wei Chi on your recent engagement!

Boulevard Bolt - 5 mile race my family runs every year on Thanksgiving morning

With a November 28th birthday, I always enjoy a family birthday celebration sometime during Thanksgiving weekend.

To give you a glimpse of some of the juxtaposition between worlds, though, I'd like to share with you some recent news and observations from here and there:

Many of my friend's 7th grade English students in South Sudan have not even held one book this entire year.

My mom's third grade students are blessed to be surrounded by hundreds of books on a daily basis. I loved getting to share with them my story and vision last week. They were so sweet to listen enthusiastically and even pray for me.

Other friends report that in Doro on the Sudan/South Sudan border, there are currently 8700 refugees. The United Nations has exhausted their food supplies at that site and people must wait in lines for 4-5 hours to obtain water from one of the three boreholes near the camp.Medical needs are already significant and climbing with problems of severe starvation and lack of sanitation.

I enjoyed the fireworks display at the Summit mall in Birmingham, AL a week ago - an impressive show to kick off the holiday shopping season.

Friends here and there around the world have suffered from significant disappointments and loss in the last month.

Recent news from Tenwek includes another man gored by an elephant and a lady with a completely dead uterus two weeks after a C section was done at a district hospital. Both patients miraculously survived.

Poignant story copied from the Myrhe's blog: "This is Tume, the severely malnourished 9-year-old girl who was transferred from NE Kenya with TB, a dislocated hip, sores where her fragile skin had broken down as she lay immobilized in bed, and allergic reaction to her drugs. Two weeks ago she was not moving or talking, let alone smiling. Now she's up with a walker, coloring pictures, and chatting. Progress. But something about the poignancy of her "Prom Queen" shirt tugged at my heart. Her mother is also HIV-positive. This girl's challenges include eventually being orphaned, and possibly being lame. A bit far removed from some other distant little girl whose cast-off shirt seems shallow and vain in this context. Yet I hope Tume feels beautiful too, and loved and admired in the same way the prom queens do."

               -------------------------------------------------------------------------------------
I found this definition of poverty from the book, "When Helping Hurts" (which I would definitely recommend):

"Poverty is the result of relationships that do not work, that are not just, that are not for life, that are not harmonious or enjoyable. Poverty is the absence of shalom in all its meanings."

 

While few of the people reading (or writing) this blog are materially poor, most of us suffer from some element of poverty - poverty of relationship with God, with self, with others, &/or with the rest of creation. 

I've been blessed with so much and yet, like this blog writer and fellow missionary, I don't truly live a life of gratitude. I complain. I judge. I don't demonstrate the compassion and love of Christ to family and friends in my heart or in my actions.Thankfully, God is transforming even me, slowly, into a new creation. Thankfully, He loves me and Tume and the refugees in Doro and the third graders in Nashville unconditionally. He created each of us in His image and through Jesus' life, death, and resurrection, He is calling us back to right relationships. We won't fully experience shalom (peace, wholeness) until the coming of the new heavens and the new earth, but we see glimpses more and more each day around the world.

 "For God was pleased to have all his fullness dwell in him [Jesus], and through him to reconcile to himself all things, whether things on earth or things in heaven, by making peace through his blood, shed on the cross." Colossians 1:19-20 (italics added)