Kalukembe Staff Housing

Are you looking for an early Holiday present? We are! Some of our staff at Kalukembe live in these crumbling adobe homes, often without latrines or cooking spaces. We are looking to raise $90,000 for repair of 18 homes, latrines, and kitchen structures. If you would like to join us in celebrating early, you can support by going to this: Kalukembe Housing Project  ! Please write HOUSING PROJECT

Fall 2019 Letter

Coping with loss, living with hope.

We gain lots of things coming here, including the experience of loss. Eliel, just days before his 6th birthday, had fallen in love with his sweet Bunny. He tenderly cared for him, hunted for green leaves even in dry season, and would share stories and draw pictures of his friend every day. Suddenly Bunny took ill, and in a matter of hours we watched Bunny die, helpless and disbelieving. After local fashion, we buried him on the same day, surrounded by friends, there to help carry Elie's grief. It's been several weeks now, and Eliel still talks about Bunny, his memories. Death, very real to us, continues to be ever present. But today, as I sit here listening to the deafening pounding of first rains and the shouts of joyful children, I'm hopeful. We are thirsty: He is the Living Water.

Our neighbors and neighborhood.

 Gentlemen waiting outside their brother's room on men's ward. We love meeting our neighbors!

Sunset at Rio Kukala (our local creek). 

Biology, bigotry and the blood of Jesus.

 Last week we walked to church through the woods, passing a small cemetery covered by the graves of all the new borns who die at our hospital… and lastnight I wrote a review for a government epidemiologist of the 7 maternal deaths the hospital had in the first 6 months of the calendar year.When asked what our “numbers” for neonatal mortality, I reply grimly “I don’t know, a couple a week, I’ll have to go count.” Daniel is at the hospital right now preparing for a cesarian delivery and rationing out our magnesium sulfate to another eclamptic lady, this one just arrived from an outside hospital and has been seizing for 3 days.

Home deliveries gone awry, septic infants, premature babies, anemic, febrile, infected. Mothers seizing from eclampsia or malaria, febrile from disseminated TB or schistosomiasis, hemorrhaging from placenta previa or abruption, septic from their uterine rupture or concomitant typhoid perforation… this happens all the time. 

But it's not all heavy. We have fun moments where our odd homeschooling strategies and patient care sometimes work out well together! Let me tell you about one such case: 

Last week Monday I was carrying for a lady with a septic abortion who was anemic, with a Hgb < 4. We treated the infection, removed the retained placenta… but she still needed blood. I left family with the task of finding someone to donate blood, and went home, praying. Tuesday morning is a school day for me (meaning I magically become a kindergarten and 2nd grade teacher) but at breakfast I got the distressing news that the young woman, whose family is from “the bush,” only had elderly ladies with her and were unable to donate. So after our math assignment, I told the kids we were doing our science experiment early. We we walked over together (along with our dear friend Luis, who does school with us) to “Hemoterapia” (our “Blood Therapy” ward) where I donated blood. We then walked over together to maternity… everyone taking turns carrying the bag of fresh warm blood. The boys were interested; Naomi, seriously worried. “Are you going to die? How can Philadelphia blood mix with Kalukembe blood? Are you strong enough right now?” She scowled watching the blood being given to our young lady, worried for a bit, that this life-giving blood was going to take my life. But in the end I laughed, picked her up, and we skipped out of maternity together. On our walk home we all had a sweet talk about biology (how amazing our bodies are!), bigotry (how we are all the same inside), and the blood of Jesus.

And guess what? Just like that she got better! I showed the kids her smiling face on the day of discharge and we all celebrated, even Naomi. This week we also re-double our efforts to prevent maternal and infant mortality. We restarted our ultrasound outreach (funded by Hope for our Sisters), where we invite ladies to come for a free prenatal ultrasound (usually costs a day laborer a week’s wage). It is sweet to give surprise notices of twins… but it is also a time to counsel risks. In three days we did 47 ultrasounds… a small step, but worth celebrating too. 

II Corinthians 5:14-15

For Christ’s love compels us, because we are convinced that one died for all, and therefore all died. And he died for all, that those who live should no longer live for themselves but for him who died for them and was raised again.

Scenario 1

Update from Kalukembe! We have been here for a month and a half; Priscila continues with multiple tasks including homeschooling, caring for guests, caring for patients including reinitiating care for women with vesicovaginal fistulae, thinking up new ideas for projects for the family and hospital and home. I continue in my moral support with occasional skeptical commentary. 

Imagine this coming out of the liquid that bathes your brain and spinal cord. I can't. The 9 year-old boy that I drew this fluid out of had been sick for roughly a month, getting various treatments, including an assortment of antibiotics (though none likely were properly prescribed or taken), traditional medicines and then in the last week, his condition worsened. Pus drained out of his ear, he mounted persistent high fevers, and his neck grew stiff. His father took him to the municipal hospital across town but they told him they could do nothing and sent the boy to us. That day when his father brought the boy to our hospital, he no longer could talk and could only moan, eyes wandering in separate directions. His father was clearly concerned, but it was already too late for us to save the child. Even with the right antibiotics, antimalarials and judicious IV fluids--for a malaria rapid test positive, smear negative result (and this LP test was just done out of curiosity how the lab would interpret the liquid), the boy died 2 days later in our ICU.
The story's like this boy's played out for at least 6 other babies and children this past week. . . treatments at home or in some nurse's clinic that don't show improvement and then the parents bring their child unconscious to our hospital. After expending their time, money and efforts elsewhere, I feel heartbroken to see the children succumb to intervenable and preventable diseases.
Government officials recently visited our hospital to look through the charts of malaria deaths recorded here year-to-date (almost 90). Apparently, only 2 deaths were recorded due to malaria last year--clearly something off with our statistics. It overall seemed to be a good learning experience, for the hospital to be reminded to maintain better records of what happened to patients and improve diagnostic clarity. We all have much to learn in caring for our sick. I should be the first to admit I miss the mark to be compassionate and competent with each and every patient. I pray God will give me and my colleagues the desire for whole healing of our patients and families. It's for His goodness sake we seek healing.

Return to Kalukembe 2019

We are back home in Kalukembe and are so glad to be here as a family, caring for our neighbors, sharing our animals, cleaning up our house, and learning through so many venues God provides.

Animal Assisted Therapy: bringing our rabbits to the pediatrics ward!

Students from our most recent seminar, "Where there is no doctor" that Dr. Nick Comninellis taught. The course was very well received and the nurses from our remote clinics benefited most from this continuing medical education. We hope that another seminar can be arranged in December. If you have interest in teaching nurse clinicians, let us know!

Our kids and friends climbing the banks of our local creek with our friend Dr. Steve Collins visiting

We've re-started our Fistula Program... some ladies have been waiting patiently all year, others have come recently. 

Family and friends: kids are starting back in school, also joined by our dear friend Luis

Preparation and anticipation

Beautiful dolls prepared by a knitting circle in Waterdown, Ontario. They gave us almost 200 dolls to take back to our patients in Kalukembe! These dolls were so fun for our patients before. Such a great and creative idea; we are so glad to be a vehicle for these gifts

It's been a while since we put anything on here, but plenty has been happening this last year in the States! No, no baby announcement, but we are anticipating returning soon to Kalukembe. We have had some delays in applying for visas, but we hope to have everything in tomorrow. And next we hope it will just take a few weeks for our applications to be reviewed and approved. No hard and fast dates yet, but watch this space!

After Daniel finished working in Delaware in April, we went on a trip through western PA, Ohio, Michigan, Ontario and western New York to visit supporters, friends and family (and all three-in-one). Then we visited our organization's headquarters for a few days and Priscila's sister's family a few more days in Texas, returning a week ago. In all the travels, we've still had time to make special connections with people, go hiking as a family and even celebrate Zeke's birthday on the road multiple times. Thank you to everyone we saw, and we are sorry we missed others of you who's places we went through or were close to. We would love to see you, too! Hopefully next time.

We are eager to return to Angola. We hear a little from our colleagues there, but it's hard to picture how things are moving on the ground. . . are there enough medicines for the patients? How are our friends and colleagues doing? Anyways, we have heard of some changes but don't know what kind of impact those have had until we get back. Please remember Kalukembe and us in prayer as we anticipate a return soon!

Priscila between Tia Malita and Tio John Vanderkruk in Ontario, Canada.  

With friends, the Sytsmas and Theules, in Grand Rapids, MI. Our kids are the normal looking ones. Ha ha. 

The two lovely ladies of the Cummings family enjoying an intimate story together in Texas (spoiler: most likely one about princesses, horses or unicorns)

Kids hiking in Pennypack park, Philadelphia. Beautiful forest!

L to R: Eliel, Zeke and cousin Han: displaying their treasure haul from upstream. Funny, in Kalukembe we worry about diseases like schistosomiasis and amebas around the water; in Philadelphia, we worry about fish hooks, broken bottles and sharp objects inflicting injury in the water. There is no risk-free place, I guess, and each place also carries much joy and wonder for our kids.

Jiichan (Grandpa) Cummings cutting up the watermelon our kids and cousins broke up in "suica-wari" (a Japanese game using the watermelon like a piñata) on Memorial Day.

Digging for fossils with Bella and Uncle Matt in Texas.

Remember our maternity!

Fall 2018 letter!

Travels that bring us back

It's nearing the end of April and we have already been back in the USA for 2 weeks. We began our travels saying good-bye to our Kalukembe family in March and embarked on a journey that took us through 3 weeks; 7 airports; both sets of parents and one pair of grandparents; innumerably inspiring colleagues in medical missions; 3 bottles of lice shampoo (for our 2 youngest--not easy to find time and place for a haircut--be careful with your airplane seats!); and delivered some travel-weary but sturdy children to a new home in Wilmington, DE.

We finished our time in Angola with encouraging farewells and hopes for returns. Then we passed 2 weeks in Greece, first at a medical missions conference and then a long weekend with Daniel's parents sightseeing Athens. The conference drew missionaries in the medical profession from all around the world, mostly Africa, the Middle East and Central Asia. . . quite inspiring and encouraging to hear others share their experiences and what they've learned in their service. Greece's ancient and rich history enthralled our family, and we had the privilege to see the beauty of the Adriatic Sea (though not quite warm to swim in beyond a few seconds; i write that, but we did see an elderly man taking a leisurely swim for what must have been an hour!). And in Holland, we spent few days with Priscila's parents and sister, who made a cozy cottage warm with many Dutch delicacies. Zeke loved going to a pancake restaurant with his great-grandparents and swimming in an indoor pool. . . Pri's Opa and Oma are an inspiration--they just returned from a return trip to Brazil for 5 weeks and Opa's 90 year-old eyes lit up as he told us about the many times he was able to preach and share the Word in his "native" Portuguese.

And we are now in a big house in Wilmington, where we are settling in to stay for the upcoming months. Daniel is preparing for a return to work in the emergency departments of hospitals in the Christiana system. Priscila is homeschooling Zeke and managing Eliel and Naomi's energies with mushroom hunts in the backyard and dissections at the dinner table. What a fascinating world we live in!
We would love to hear from you while we are back in the States and with fast internet connection! We hope to settle in to a routine here soon, figure out our travel plans, etc, though most of our travels won't occur till next spring around the time we hope to return to Angola. Please keep remembering and praying for Kalukembe, the workers who carry on and the patients who continue to need care and healing.

The day before we left Angola, an ambulance arrived from the government as a donation to the hospital. The hospital had been struggling with an old vehicle that was used for carrying water, construction materials, and transporting on call staff and had no longer been reliable to transfer patients to Lubango for more complex care. Though not equipped with what a standard American ambulance would carry (which would cover 1-2 pages in supply stock alone), it did at least come with a stretcher!

Our home church, Belem, is in the middle of the patient villa. Walking to and from church, Naomi would enjoy seeing how peoples' meal preparations were progressing. Most food is prepared over charcoal fires as seen in the foreground. Most church members come from this neighborhood. In their farewell song, they sang that we are all journeying to the New Jerusalem. We look forward to reunite with our brothers and sisters either there or back in Kalukembe!

Our miracle premie who's mom arrived at 27weeks gestation with ruptured membranes and delivered at 28weeks at 1.2kg. She was tenderly loved, fought for and kept vigilantly in kangaroo care (since we have no functional incubator anymore - the hospital has 5 broken ones) for 2 months. Every morning the first thing I'd ask was "How is our baby" and even with the 20 others on the floor, the nurses knew who I meant. She was always the last patient and I loved doing my "you've-gained-dance" on the good days.  We finally sent her home a "fat" smiling baby and mom grinning ear-to-ear. We all did our celebratory dance that day.   

Naomi at church, happily sitting by a little "ne-ne". 

Zeke and Eliel, swimming at the waterhole with their friends this rainy season.

The 3 matrons of "cuida de mulhere": Priscila (chief of everything OB and GYN) with Tia Julia (chief of maternity) and Marta (chief of women's ward). What a privilege to work with these beautiful, intelligent hearts and hands--Priscila, too!