Family reunited in Japan, children alive

Sounds like a news headline :)
Posting a few pictures from our family reunion in Japan August 14-20 (too short, so we stayed till the 24th; still too short, but Daniel had work. . . ). This was probably our last time all together in Japan. Bittersweet is the best english word i can think of right now. . . . We are thankful to especially to 'Jichan' and 'Bachan' Cummings and to everyone else in the family who came to Nojiri. We love you!

the Stout kids and Han at the tennis courts

Luke and Ema at amazing ramen-ya; Luke had a daily diet of ramen that week. And he lives in Japan! Not fair!

Once i mentioned literature was discouraged for young children, Caleb was the first to start reading aloud

Eli and Gabriel at the beach. Pri thinks this shows why he's confused as a girl. i think this reinforces his Brazilian skin comparison

More discouraged practice in action. This time, Jichan is with Zeke and Paul

the 'Balea' and Bachan with Zeke

The responsible pair for all this fun and mayhem

the Clan. Calvin, Edie and a whole passel of others

Family picture 2014

Communal living in Philadelphia

Zeke/Eli's other "sister and brother" Naya and Han

The boys now and before

 Zeke at ~ 6mo

Eliel at ~ 8mo

Winter 2013 letter

Praying for our other home.

This is Zeke's corner in our study. Being surrounded by pictures remind him (and the rest of us) to pray for Kalukembe and our return there, Lord willing. There are pics of Zeke with friends, landscape, patients, us working, etc. We want him to remember and become excited about going... we want to (as our friend Laura Rhodes said) to give our children the vision.

New prayer card!

Bemvindo Filho #2

We are very happy to welcome Eliel Johan Ribeiro into our little familia on September 7th, Brazilian independence day and Luke Cummings' birthday!

Doing what he mostly does. And he does it so superbly

Tia Ruth with the boys

Abby (who visited us in both Kenya and Zambia), caring for us again!

At home with his gentle, sweet cousin, Naya

Zeke finds use for any surface to drive his car

 "Actually it seems to me that one can hardly say anything either bad enough or good enough about life."
--C.S. Lewis

Summer 2013 Letter

Spring 2013 Letter

Fall/Winter 2012 Letter

Chegada (arrival)

We're now back in the USA, and it's Independence Day! Hooray! After two months at Kalukembe (more pictures to follow this post), we packed our bags, left a few belongings in our friends' container and boarded the plane out of country (and then 3 more to get to Philly). Zeke had a great time watching 'avião' after 'avião' take off and running down long terminal corridors.

Thanks for your prayers. We will be in Philadelphia after visiting family from this fall at least until the end of 2014. Priscila will be taking her oral boards, we will be looking for organizations to return with and, God willing, will be going back in 2015 to Kalukembe. Daniel will be working in Delaware at Christiana and hoping to take some cataract surgery training towards the end of our time in the US; Priscila will be working part-time at Esperanza health clinic in North Philadelphia as well. Zeke will be playing with his cousins, living with two who are in Japan right now. He's already on cloud 9 with so many planes flying over our south Philly home.

Priscila giving a talk on cancers affecting women to over 1200 women in Benguela

Zeke and his favorite lady friends, our neighbors Bety (r) and Avidé (l)

Since the water pump/tank was not working our entire time there, water was a daily struggle for the hospital. Here, they are filling the tank to be used for the operating room (but without a gravity feeding system, the staff would use the faucet at the bottom to cart the water into the OR).

Priscila, with the vesicovaginal fistula ladies she operated on during her last week of operations. She has gotten to know these ladies well over the course of time together with them. We miss them and pray for their social, physical, emotional and spiritual healing

Towards the end of our time in Kalukembe, one of Zeke's favorite things to do was to walk around the house, mimicking the local ladies carrying loads on their heads

But don't think we are immune to the draws of materialism! Zeke was amazed at how many cars were in just one store at the airport in Johannesburg. "Bue! (a ton!)"

On the move

We are on the move! We'll be moving to Kalukembe tomorrow (Priscila's birthday) to spend our last 2 months in Angola there. We have plans to return and work long term at Kalukembe as well. Our time at CEML is now finished.

Since our last post, we went back to Chiulo together for two more one week stints and Priscila had more in-depth vesicovaginal fistula (VVF) training at CEML. We've been packing up as Pri's been fitting in a number of gyn surgeries. And yesterday, we celebrated Zeke's 2nd birthday! Don't have the camera with me to upload those pictures yet, but lots of balloons and Zeke going wild over more trucks to play with. Other pictures below.

One of our favorite things about Chiulo are the abundance of baobab trees. Such fun-looking trees, we also love the "popsicles" that people make out of the fruit.

Malnourished 7 month-old twins, A and E. The mother's breasts had been severely burned months before and they were faring poorly on milk from other sources (no, she did not have money to buy formula). Chiulo has a consistent flow of children 'failing to thrive,' as we say in medicine. Unfortunately, even in the rainy season with fruits available, there are always on average 20 children in the malnutrition program. The pediatric census stuck overall around 80-90, most with malaria as the admitting diagnosis.

Before heading to Chiulo in March, we flew to Huambo for Priscila to give a talk with Dr. Steve Foster to the Women's Organization of Angola (google image search "oma angola" and several lines down, you'll see a picture of zeke from our blog :) R to L: The Most Beautiful Presenter holding the Rascal That Kept His Papa From Hearing the Presentation; the event organizer (sorry, forgot his name);  Steve Foster; Esther Chin, OBGYN resident extraordinaire from Ontario who came for 2 months; Matthew Chen, her fiancee and family practice doc who also came and helped with everything from pulling teeth to operatively delivering babies to accompanying me on interminable rounds at Chiulo; our master pilot, Brent Mudde

Zeke loved walking to school in the mornings with Dr. Laura Marin (lovely public health doctor with CUAMM at Chiulo) and her two daughters (and friend)

Ladies from Kalukembe (and a few of their spouses) who were flown to Lubango for their fistula repairs. Priscila was instructed by Steve Arrowsmith (see if you can spot the white urologist in the picture), who came for two weeks. Around twenty fistula repairs were done. . . i better ask Pri how many. i know she was operating every day, but i lost count.

Not every surgery during those 2 weeks were fistula repairs. This was a a stone i removed with Steve Arrowsmith from the bladder of one of the ladies who had a fistula in the past. Yes, i forgot to clip my fingernails for the picture.

Zeke, sporting his new favorite truck clothes and his favorite sapatos; gifts sent from our friend Julie Carter! Thank you, Julie!

Esther, Rob and a week at Chiulo

Rob and Esther Reich, sogros

It's amazing enough when family comes from far away to visit! Solomon wrote, “Like cold water to a weary soul is good news from a distant land.” But Rob and Esther Reich did not just come to visit us last month; they came to see Kalukembe and dream with us about possibilities of working, living and serving together there. In the short week we had together, we worked on the wards, performed operations, consulted on patients in clinic (Rob provided key HIV insights), attended the big annual IESA service (lots of church chutzpah, very little gospel speech), and passed our free time with long walks and talks.  We hope they had ample time to observe, question and process and then repeat that cycle again. 

Rob is a physician assistant and Esther a nurse, both who work at Esperanza health center in North Philadelphia. They already have much experience in community health and ministry; speak fluent Spanish (just a small jump from Portuguese); love the Lord and love caring for others; are simpatico; and are family (we'd more likely have an 'iron sharpening iron' experience; or, they'd just tell us when we're off the deep end). Looks great! Sign them up! . . . well, we know there are things to still ponder and pray about for them. God knows the desire of our hearts is to serve together with them at Kalukembe; but wherever they are and will be, we feel blessed to know them and to see their life stories be played out. Thanks again for coming, and a big thanks to Elias and Sammy for letting your parents come visit!

On a walk in Kalukembe.

Same, sad tune. Very few medications at Kalukembe.

On another subject, Daniel went back to Chiulo hospital for a week to fill the void of no physicians last week. Zach Rossfeld, a 4th year medical student from Ohio State University came along to help and posted a really thoughtful blog entry, which you can access by clicking here. 

Zach Rossfeld, in front of the HIV/AIDS outpatient clinic/container at Chiulo

This upcoming week, we have plans to go north to Huambo for Priscila to give a fistula talk and then back south to Chiulo with Dr.s Chan and Chen to keep helping out there until the new doctors are to arrive on the 19th. More to follow!