Thursday, December 15, 2016

Celebrating Christmas in a country that doesn't celebrate Christmas

Our first Christmas in our new little country.  It is an interesting time indeed.  It will be the first Christmas of Madison's life we won't be sharing it with her.  She came for the summer, and therefore we don't have the funds to get her here twice in one year.  So - she will be spending the time with her grandparents and her Aunt and Uncle in California. They have great plans for her, and I know she will be well cared for.

But here I sit, in a country that doesn't celebrate Christmas, and it's my favorite time of the year.  I'm not sure what to do with that yet.  Because we sold everything before we came, all of my Christmas decorations were sold right along with everything else.  I didn't realize that that was going to be a problem, thinking I would just pick up new stuff when I arrived in country.  However, we found out that the country doesn't celebrate it.  What do I mean by that?  Well - it's two-fold.  The first, the primary African culture here doesn't celebrate it, so there's that.  And secondly, the church does not celebrate it.  I've talked with a lot of pastors  since I've been here in respect to that, and have received varying reasons behind that.  The primary reason is that they believe celebrating a day that is not really Christ's birthday, along with all the peripheral decorations, etc. is offensive.  There are a few exceptions - and the little Baptist church we attend is one of them.  But, for 95% of the churches here, December 25th is just another day.

I love Christmas.  I love everything about it.  I love people getting together, I love Christmas parties, I love candle light worship services, I love hearing Christmas music in the mall, drinking hot cocoa in the cold, sitting in front of a fire place, decorating my house, seeing lights around the neighborhood, hearing Christmas music on the radio, every store decked out in lights, cutting down a Christmas tree, and just living in the season as we read our daily Advent and prepare our hearts for the coming of our Lord and Savior Jesus Christ.  For me, all the things around Christmas all help lead my heart to that incredible celebration of the birth of the most important person to ever have lived.  That may sound superficial and materialistic to many.  I don't apologize for it - every time I see a Christmas display, I think of Jesus.  Every time I hear a Christmas song while out and about, I think of Jesus.  Every time I see lights and decorations, I think of Jesus.  For me, it's a time to say a prayer, and give glory to Him who is the Highest.

Even in Honduras, where Christmas is a huge event, although I was typically sweating on the day, there still were people all over who decorated for Christmas, Christmas programs at the schools, the mall was decked out to the max, they had bands playing music at the mall, and lights and displays around town.  Here?  Almost nothing.  So, in my attempts to make it feel a little like Christmas, I did the best I could with what I had.  Anyone who has come over to my house during Christmas would look around my house now and know how bare it looks.

I am making my cookies, and going to a gathering this weekend, and am trying to enjoy this season through the sweat of 95 degree days.  With no Christmas tree, no presents to unwrap, and no kid here to celebrate with, Christmas day is going to be a quiet event at the Pettengill house - just the two of us, with a city closed down, the streets empty, and no one around us celebrating.  A strange thing indeed.

Friday, December 9, 2016

First seminary class done - HIV/AIDS and The Responsibility of the Church

My awesome class
Think back to the 1980's, when HIV, unfortunately, became the new deadly disease.  Rumors flew about how it was transmitted, who was at risk, and was essentially a death sentence.  We've since come a long way.  Now, at least in the majority of first world countries, HIV has been placed into the category of "chronic" diseases - and is no longer (for the most part) a death sentence.  Here, in Africa however, it continues to run it's deadly rampage and remains as the #1 cause of death in a large majority of African countries.

As I am concluding teaching my first seminary level class on the subject it has become more and more apparent as to why this is the case.  I will only speak of the country I am living in, because that is as far as my personal knowledge goes.  I have read more books over the last few months about the subject, so have become a lot more educated about HIV/AIDS in Africa, but my personal experience with it only covers this little country.

My first day of class I wanted to explore what the myths surrounding HIV were in this country.  So I made up "sticky" notes that had a combination of true and false statements, and asked the students to place them up on the board under each category so I could get a feel for what my students thought.  This is the list I came up with, and their responses next to each statement (I have put the actual answer next to it)

o - in Africa, more men are infected with HIV than women   - their answer: true; reality: this is false
o - in Africa, more women are infected with HIV than men - their answer: false; reality: this is true
o - You can look at a person and know they have HIV/AIDS - their answer: true; reality: false
o - The number one way HIV in transmitted is at the barber or manicurist - their answer:  true; reality: there is no documented case of HIV being transmitted via manicurist instruments (other diseases, yes, but not HIV)
o - Witch doctors can curse you with HIV - their answer:  true
o - You can have HIV and your test can come up negative (window of infection) -their answer: false; reality:  true
o - HIV/AIDS is the same thing - their answer:  yes; reality: no (HIV is the virus that causes AIDS)
o - mosquitoes can infect you with HIV - their answer:  yes; reality: no
o - there is a cure for HIV - their answer:  yes; reality: no

Some of my students diligently working on an in-class assignment
In addition, no one in the class believed that HIV/AIDS was the number one cause of death in their country - they all believed that malaria is the number 1 cause of death (it's actually #3).

This was a great way to start the class, because I could immediately counter the myths, teach them the realities of the disease, and educate them on prevention and methods of transmission.  I can't say this went over easy - it was a much heated conversation, and took a lot of convincing, showing of evidence, and showing statistics before people started to come around and believe it.

I was, however, still worried about the overwhelming statistics of HIV/AIDS related deaths in a country where testing and medication is free.  And I found out the reasons why.  1 - sex education is considered a taboo in this country.  It simply isn't discussed in the home, in church, or anywhere for that matter.  2 - the huge stigma that continues to be attached to this disease, people are ashamed, and don't want to be seen going to the hospital to get their medication. 3 - polygamy is an accepted cultural norm.

The thing I continued to discuss when my students were getting frustrated was that this was not something that could be changed in a day, in a few months, or even a few years.  These were cultural norms that were going to take a generation to change, but that did not alleviate the necessity that we start NOW, and start with THEM in THEIR churches.  That it was our job to break the cycle and to be part of the solution.  So, I challenged each of my students to talk to their children, to start programs in their churches, and to be active and vocal in their communities.

We, as North Americans, as people of a completely different culture, and shake our heads in wonder as to why people believe what they believe.  But I ask you to step back, and consider your surroundings, your resources, and remember where we came from in the early stages of this disease.  It took a lot of public health education to help everyone have a better understanding of this disease, and here, in Africa, we still have a long way to go.

One of the final activities I had my students do was to give a bible study on key verses that I provided them with.  They were required to tie in the biblical truths with HIV/AIDS outreach, and as a church body.  The results were incredible!  As the last student gave their bible study, I stood up in front of the class and said, "Remember how, on day one of this class you couldn't 'see' how HIV/AIDS was in the bible?!  Do you see now?!"  To which I received a resounding YES, accompanied with applause, hooting and hollering, and grins all around the class.
Jonas giving a bible lesson and incorporating HIV/AIDS into it
I have challenged the class to now take action.  To not just take this information in, but to apply it to their everyday lives - start ministries in their churches, do outreach into their communities, and to serve those who are infected, and strive for prevention through education.  Only time will tell - but to me this is the best solution of all - Nationals serving Nationals.  When one of the students told me that I needed to go to every church in the country and give out this information - I told them that I will go as often as I am asked, but the "answer" was that THEY were the ones to now go forward and to make things happen.  THEY are the answer for THEIR country -I'm just a small part to play for how ever long I am here, but the country will only be changed if each take on accountability and responsibility to make that change.

Wednesday, November 23, 2016

I stared at the face of death on my patient's face today...and cried...

My ministry revolves around hosting medical clinics and teaching HIV/AIDS classes.  Each clinic I can typically see about 25 patients in that time frame - this allows me to do patient education, which is what my heart loves.

Today I was able to tell a diabetic the way to change their diet which will change their life.  My patient, who has been a diabetic his whole life (needs insulin), had never received any type of this information before.  In a country where the primary item on every dish is cups and cups of rice - this was hard information to process, but he listened intently, asked some great questions, and we both felt good about it as he left.

Image result for african woman with aidsAbout half way through my day a young 22 year old young mom with her 4 month old baby came to see me with "constant fever."  Each patient here is responsible for their own medical information.  They carry around with them their "cuaderno" - or their notebook - where the doctors write down their visits, exam results, and the prescriptions they give them.  The hospital does not keep medical records on the majority of their patients - this is the responsibility of each person.  Upon reading her cuaderno, it became evident that both she and her 4 month old baby were HIV positive.  So I had to ask the next question - Are you taking your meds?  To which she replied with a quavering voice, tears in her eyes, and without eye contact - No.

I took a deep breath - not because I was frustrated, not because I was angry, but because as I looked at her, I saw the look of death across her face.  I saw hopelessness.  I saw a young woman in her prime taken down by this disease, and my eyes wandered down to her baby as well.  I took the deep breath because I needed time to think through this and figure out a way to help her, give me time to process.

So I talked about how beautiful she was, and how much life had to offer her.  I told her that her baby needed his mother, and she needed to see her son grow up.  I held her hand and made her look into my face as my own eyes welled up with unshed tears. I told her I wanted to see her live!  To not look death in the face - to let the medication do it's job and how she could live for many decades more.  But...she said...she could "sneak" her baby in to get his meds at the hospital, and no one knew, but when she want to "that place" everyone knew why she was there, and she just couldn't bare that.  She knew what people were thinking about her, and how ashamed she was.  She "knew" it was HER fault (her words). She knew the inevitability of her death, I could see it in her face...I could see the hopelessness and the helplessness.  I could see that she knew it was only a matter of time - her face told me this with her single look of despair.

I told her that this is when she needed to be courageous - if not for her, then for her baby.

She gently nodded her head, with her head bent deep, staring absently into the folds of her skirt.

I softly lifted her chin with my shaking hands, so her eyes were looking at mine.  And I said to her - "You need to not just say need to make me a promise."  She looked back, and didn't say anything...her eyes were darting back and forth to my eyes - trying to understand what I was asking, and her mind was trying to decide what to do.  She finally looked at me...."yes...I promise."  "You promise what?" I whispered in response to her comment.  "I promise to you that I will go to the hospital and start taking my meds."

It was all I could do.  I kissed her cheeks, she stood up, with her baby in tow, and I bent my head, and the unshed tears came streaming down my cheeks.  To feel so hopeless, helpless, rejected, and unloved - her lack of her own self-worth radiated from her as he walked away. She arrived alone, just she and her baby, and was leaving alone.  Abandoned and uncared for.   And I was burdened.  My heart ached...I felt it in my bones!  If I could have done anything else I would have...but what I had done that day was give her a hand to hold, a kiss on the cheek, and tears to help share her burden, if just a little, and to tell her as much as I could that she WAS worth something...that she DID matter...that she was a child of God and had so much left to give. And she made me a promise...

I pray it was enough.

Monday, November 21, 2016

When you are the "expert"

I found when I was in Honduras, that the title of "nurse" just didn't cut it.  No matter HOW many times I told people I was a nurse, my patients would refuse to call me that, and always referred to me as "Doctora Teresa" (my middle name I've always used).  Ultimately I gave up, and just responded to how people addressed me.  I think it really was more an acknowledgement of how much I know.  I have done my utmost to educated myself well beyond what I learned in Nursing school, and my 13 years working in a hospital.  I've gone to week long trainings, seminars, read more books than I care to acknowledge, been to medical symposiums, break-out sessions on topics that are "hot" in my area, and am only a few months away from getting my Masters degree in Public Health.

However, even with all that, I can't help but feel the burden of being the "expert" in a field.  I have taught on HIV/AIDS, will have a 30-hour class on the topic, will be doing another church-wide event on the topic, and have bi-monthly medical clinics where I am heavily involved in patient education.  I do NOT profess to be an expert in pretty much anything...but I'm highly educated on a LOT of "stuff".  Because of that, that means I am typically the most educated around (in health care issues, that is).  My class that started out as 9 students, has morphed into 25 students.  I have a student handbook that I created, have a text book we are using, and I'm having the students devise an HIV/AIDS outreach program within their church as their "final project" for my class.

We have, once again, found ourselves figuring out things on our own.  Our team mates returned to the U.S. only 2 months after we arrived, so we were left to figure out things for ourselves - but our time in Honduras prepped us to be able to do just that.  We arrived in Honduras by ourselves, and left with a HUGE team taking over.  So - God prepared and equipped us to be able to do that.

However, I won't deny the stress and burden that that brings with it.  I have people knocking on our door almost on a daily basis asking for medical help - organizations looking how I can help out - churches asking for classes and health education - the list is endless, and honestly, my days would be filled with just that if I let it.

However, I must find a balance.  I do work for free, after all.  Regardless of how much work I do or don't do.  When a missionary goes on the field, they go as a "unit".  That  means that one person is paid.  Typically that means that the spouse (wife) is primarily involved in the hugely important job of caring for the family on the mission field, but they typically have only a small involvement in the ministry.  For me, that's always meant something else.  I've always been a mom, a wife, a nurse, and 10 other hats.  And my full-time job means working for free.  On the mission field that looks like a full-time ministry partner.  This is a unique place, and not one that many other "units" experience.  Don't get me wrong - there are certainly other missionary units that have working spouses, but this is the exception, not the norm.  But the bottom line is - if I wanted to make money, I would not be a missionary - I'm not here because I am looking to make money - I am here for a different reason entirely - to be obedient for what God has for me here, in this place, at this time.

And so...I guess I will be the "expert" in my field, and do my darndest to pass that information on to others.  To educate others on how to change their life, their diet, and reduce their risks of becoming infected with HIV - the number 1 cause of death in this little country.  With the average life expectancy is 57, where your odds of dying before 5 are one of the highest in the world, where your odds of becoming infected with HIV and dying from AIDS are the 14th highest in the world...yeah...I guess me becoming an "expert" in the field is important after all.

Friday, November 4, 2016

My quest to save one life at a time

When I went into missions I had this grand idea about what that would look like.  I envisioned transforming communities with clean water, deworming all the kids, vitamins to the malnourished, malaria meds to one and all, and everyone eating a good/balanced diet.  Yeah...that was through the eyes of a naive / new missionary.  Within a year of me being in Honduras I realized the futility of that.  So I changed my vision and changed my heart and looked past what I wanted to what was needed.  Yeah...I know....good plan, right?!

It was then that I realized - I'm NOT going to change the world.  I'm NOT going to change a community, but I CAN change one person at a time.  I can make a difference in ONE life - and that became my new goal - my new passion.  I would still serve everyone who came to my door...everyone who came to my clinic...and I would treat no one differently than another.

But it is frustrating.  I have to admit it!  When I see the same people coming for the same reasons, and if they could but make a few life changes, they could turn things around.  My LEAST favorite section in nursing school was Public Health. I admit it!  I didn't buy into it...but I was young, and didn't see the value for what it is.  But now I am pursuing a Masters Degree in Public Health, Population Medicine, and will have completed this in less than 6 months time after almost 4 years (a class at a time) of pursuing it.  And public health is my passion.  Look how far I've come :-)

So I teach.  I educate.  I inform.  And if someone chooses to implement these changes or not - at least they do it with the information I've given them, and they have made a conscious decision to do it or not.  But it still surprises me.  After 9 years on the mission field, and doing medical missions for that long, when someone does do what I tell them.  And it's a moment to rejoice!!!

Case in point.  One of the pastors we work with, a board member of the seminary where Mike and I teach, and the first clinic we put on here, came to me at the end of the clinic and asked to have his blood pressure taken.  He is 48 years old.  My age.  Let me put that in perspective.  The life expectancy in the U.S. is about 80 years old, in Honduras it's about 75, but here...where we live...,it is 58 years old.  That means in 10 years, he will most likely be dead.  We long to have a good/robust life - to see our children grow up and experience lives with our grandchildren.  For the majority of the people here, that is not even a reality.  I contribute it to genetics, diet, and just the stress of living.

So this sweet man came to me, and I took his blood pressure - and it was through the roof.  So I started my inquiry into his life.  His diet, his home life, etc. I came up with a plan, and the education started.  For about the next 30 minutes I gave him practical every-day advice on how to adjust his diet, reduce his stress, and started him on some base-line meds.  I told him he must return every week for me to follow-up with his blood pressure.  I told him this, knowing the probability of him returning was slim to none.  I've been here before.  A LOT of times.  I've had the SAME conversation over and over and over with so many people, I can't even count.  But it doesn't stop me.  I'll keep saying the same thing - and keep giving people the same information in the hopes that one day - maybe - someone will actually listen!

So...I waited.  And I got a knock at my door the following week.  It was the pastor.  Come to get his blood pressure checked.  And I took it -it was better...but still not great.  So we talked about his life - his diet - what things looked like.  And we poked and prodded until we came up with a slight revision in the plan.  And I told him to come back the following week.

So...I waited.  And I got a knock at my door the following week.  I sat him down, and we talked for a bit.  Then I took his blood pressure...and the delight that came across me I couldn't contain!  It was all but "normal."  He KNOWS I am not a heart doctor, nor a specialist of any kind - just a well educated nurse trying to make a difference.  But he has so few options, and I was his "best" hope.   We looked at each other -and the joy couldn't be contained.  I lifted my hand for a High-Five, because I couldn't help myself - then the joy spread to him.  He beamed from ear to ear, and we sat in silence, and yet shared this moment of least for now...This sweet man just had his 10th child, and I long for him to be able to experience life with them - to not suffer from the primary cause of death not associated with disease in this country.  To live long after the "normal life expectancy."   And that maybe, just maybe, I can help save a at a time...just one more...just one more!  Until my time here is done, I will continue in this pursuit.  And how I LONG to hear...

Well done, my good and faithful servant!

Tuesday, October 25, 2016

Just do the best you can

and Learn Something New Every Day, and Make Do With What You've Got - three phrases from my grandmother, who passed away almost 2 decades ago were phrases I heard growing up, and that I've passed on to my own girl.  And sometimes, that's about the only thing that keeps me going, because otherwise I look at what I have and can give in to discouragement.

Clinic today - saw 25 patients, and at least 24 of them I was able to help, in some capacity.  But the one that I ended up thinking about was the one that got me thinking about where I am, what I'm doing, and what has happened to get me here.

I found myself in a community with well water access only (contaminated at that), torn up dirt roads, shack homes, and many many naked children running around - I don't know what it is about sweet little African naked babies - but their innocence and joy for life in the midst of what we would consider a slum, lifts my spirit.

Here I found myself, serving this community, and a little 2 year old boy comes to my clinic in severe respiratory distress.  He was barely moving, offered no concern when I started assessing him, and his eyes were a bit too wide for my liking.  I barely needed my stethoscope to hear his lungs, as the noise coming from his lungs was SO loud.  I knew we were in some immediate need for this little guy, and FAST.  I don't have a nebulizer here, have asked every doctor, nurse and pharmacy where I can buy one and they all tell me the same thing - no where in country.  Okay...well...this little guy was in trouble.  So, I pulled out my "tools" I had learned in Honduras and fashioned a way to get meds to this kiddo.  Cutting the bottom off of a water bottle,  covering that end with gauze (so it's not sharp), and putting my own (unused) personal inhaler on the "mouth" piece of the water bottle - seal it up with tape - and there you have it.  I used this to give my little guy two "breathing treatments."

As I sat there, talking to this mom, and asked her about what her resources were for her kiddo, if he had been hospitalized in the past for his condition, and what was available to her, my heart sank.  Little to no options, and she had never been told about using an inhaler at home, she had NO access to a nebulizer.  So...she got my inhaler, of course.  And I looked at her holding tight to that plastic-rigged/gauze protected "spacer" with taped on-inhaler, and I thought - what is happening here?  I was up against a LOT in Honduras, but at LEAST I could purchase equipment for people who were in desperate need - and here I was - "all" I had to offer was a plastic taped just made me sad...I won't deny it.  This kiddo has a LOT of things he is going to have to combat just to make it to 5 (where 95 out of every 1,000 kids dies before the age of 5), I wasn't very hopeful/optimistic.
My awesome volunteer helpers.  Two Guinean nurses, and a church member.  I LOVE having nationals help nationals!

But...then I was reminded....yes, the words of my grandmother came back to me, "Just do the best that you can."  And so I was, and so I did.  They came with nothing, and were leaving with a kiddo who could actually breath, meds for home, some to buy, but with at least a chance...

And so I will continue on...just doing the best that I can.

Sunday, October 16, 2016


I have done on-line bible studies (OBS) since going on the field more than 10 years ago.  I always loved being involved in bible studies with my home church, or attending Bible Study Fellowship.  However, on the field, it's a bit more challenging.  So, I supplement my daily devotions with an on-line bible study.  Some have been great, some have been challenging, others haven't really "fit" with me, and some have been just down-right perfect.  The one I just completed with Proverbs 31 Ministries was called Uninvited, and was written by Lysa TerKeurst.

The subtitle of the book is Living Loved When You Feel Less Than, Left Out, and Lonely.  On her dedication page, the author writes this:

"And to anyone who has felt the sting of rejection, grieved the deep loss of a relationship that was there one day and gone the next or questioned whether God has any good plans for you at all...I understand.  God made sure to get these words of hope to you.  He loves you and so do I."

This last season of my life has been one of the most challenging in my adult life.

Uninvited:  the last few years have been one of being uninvited from events, uninvited from participating in activities, and outright excluded.

Less Than:  The rejection I have received recently was...difficult...when people you call friends outright reject you, it is an affront that goes deep.

Left Out: (see Uninvited)

Lonely:  When you are kind of out there on your own, even in the midst of a lot of people, it really is a lonely place to be.  Gratefully, my husband and I have grown together as a couple more and more as the years have gone by, and I am so very grateful that he has chosen this path for us to follow.  I maintain contact with some amazing friends back in the States - but electronic mechanisms of reaching out can only reach so far...the comfort of hanging out on the couch of your BFF and chatting the night away seems so long ago...

So, this book came at a great time.  Some things I highlighted in the book:

1.  "Rejection steals the best of who I am by reinforcing the worst of what's been said to me."

"God is good.
God is good to me.
God is good at being God.
And today is yet another page in our great love story."

2. "Sometimes the equation is make a friend, try your best with that friend, and things go cold.  Really cold.  People who care more about being right than ending right prove just how wrong they were all along."

"God's love isn't based on me.  It's simply placed on me.  And it's the place from which I should live...loved."

3.  "If their absence was caused by death, you would grieve their loss.  But when their absence is caused by rejection, you not only grieve their loss but you also have to wrestle through the fact that they wanted this.  They chose to cut themselves out."

"Relationships don't come in packages of perfection, relationships come in packages of potential."

4.  "Rejection isn't just an emotional feeling.  It's a message that alters what you believe about yourself.  And the minute you sense that happening is the minute you must stop the run-away thinking with truth."

"You aren't set aside.  You are set apart."

5.  "Remember:  like a lion is drawn to a food source, Satan rushes in where he smells emptiness, deprivation, and rejection."

"Truth is the perfect tranquilizer.  The enemy's power is rendered powerless in the presence of God's promises."

So...there are so many great things in this book, and I pray it can be a blessing to you as well.  And if not to you, that you may glean some truth from it to help others out.  Something I've always told my daughter - that I might not like the way that God brought me to this place in my life, but I can't help but see the wisdom in it.  I certainly would have chosen a very different path to get me here,  but then, I wouldn't be the same person that I am today.  I am a sum of my parts - I am God's creation that he has pounded me, molded me and created in me the person I am today...and I like that person :-)  I like that God uses me in all my circumstances, and that because of my past I am able to help others.

So my OBS is done, and I'm getting ready to start another study...we shall see what I glean from this one :-)

Blessings to you all - and LIVE LOVED!