Dead man.

Earlier this year, a man trembled up our gangway in desperate need of medical attention. The hardworking volunteer crew onboard the Africa Mercy went straight to work to help him – and it didn’t take long to realize that Sambany was changing our lives while we were changing his.

 

 

 

 

Read the rest of the story and watch the video narrated by Sambany himself here: www.mercyships.org/sambany

Unconditional Acceptance.

I have some exciting news!

This letter came this week:

Dear Kristin,

Congratulations!  We are delighted to confirm your unconditional acceptance to the Masters of Public Health programme with the University of Liverpool.

Cheers! 

First of all if you are American you might be thinking two things: Is that really a place and don't they know how to spell 'program'? 

Yes it's a city in England where the first US Consul in history was appointed to and the city where the Titanic was registered.  Find out more completely random facts here: Wikipedia Liverpool UK.

They also have a really good university that has a great online MPH program. (I'm not leaving Mercy Ships!) And that's how they spell program there.  It's not wrong, it's just different. (wink wink)

Why? I love what I do and I really want to be able to do it better.  The things I will get to study - like epidemiology, qualitative methods in health research, and health promotion, will help me to understand to a greater depth the global issues that affect health and barriers to implementing change, and will help us develop the most effective programs possible to see transformation in the health systems of our host nations.  And I really love learning, especially when I know I can use what I learn in a very practical sense. 

Do you have time? It will be a stretch.  My job takes up a lot of time, however, I don't have to do things here that I would have to do at home, like grocery shop or cook or commute, so finding time in amongst other things, while it isn't easy, it is certainly possible. Other crew members have done it and it takes determination and focus and I will have to give up quite a bit of my personal time. But I am willing. We're trying to maximize my work team and time next year as well and hopefully will be able to find some hours in the week to study!

Can you afford it? Nope, I can't. It's not nearly as expensive as an in-person mph program based in the United States.  (for reference, Johns Hopkins MPH is about $75k)  It is, however, still expensive and as someone who is entirely reliant on donations to survive and keep pursuing my calling with Mercy Ships, this is where I need to ask you for help.  I know that if I am supposed to pursue this that somehow the funding will be made available. I have enough in savings to pay my application and placement fees; after that I'm looking at about $26,000 for the three-year program including fees and books.  

So here is my ask:

1. Would you consider funding a part of my graduate education? This will be on top of my regular Mercy Ships fundraising needs. I plan to pay by the year, so my current need is just under $9k before I start this summer. Tax-deductible donations can be made via my Mercy Ships account and it would help if you sent me an email indicating it's intent so I can keep it separate from other funding.

2. Would you help me to find other funding opportunities? I've not found much as far as scholarships and other help for graduate studies (for a non-minority student... grr), but you are a wealth of knowledge that I do not have, so I am asking if you have a foundation or a trust or a church or some other kind of organization that likes to support education, would you contact me?

Please don't hesitate to email me with questions, or make a comment on this blog post. I'm really excited about this next chapter!! 

 

Happy.

Happy International Day of Happiness!

If you didn't know this was a thing, don't feel bad. Neither did I.  Until I read this: Today story

And I have a few thoughts. (As usual. Smile.)

My first thought: Happiness is a cheap imitation of joy. And it's fleeting.  I've written about this before, here. and here. and probably several other times. I'm kind of a big fan of joy.

However. That doesn't mean I don't love being happy!   And I want happiness!  Who doesn't?  It's just that I want JOY more. and in JOY I can find myself quite happy.  :)

So with that being said, I think the list that Today put out of the ways to be happy is pretty good, actually.  But I'd like to expand on a few of them.

1. Relationships are crucial. Yes and amen. I just had this amazing conversation the other day with some incredible women I am privileged to do life with - and the question was something along the lines of if God is supposed to be enough then where does community fit in.  And the answer is that yes, God can be enough, but it's the fullness of JOY that can be found in relationship.  We aren't meant to do this alone, and true depth of relationship is one of those things that isn't always happy, as true friends really can point out the yuck in us... but in that we can pursue freedom and joy and that is worth every breath and hug and word and prayer.

2. Be around happy people.  Yes and amen.  "If you want to make a sad person happy, start by planting them in a community of optimists." ~Donald Miller.  We are truly a reflection of the people we spend our time with - good or bad.  I've picked up a myriad of non-American phrases simply because I hang out with an international bunch.  When I'm around people who want to pursue more of Jesus with every breath I find myself wanting the same thing. On the flip side, when I hang out with people who complain a lot or are constantly offended, I find the same things coming out of my mouth, or can be guilty of getting offended on their behalf as well.  There are people in my life that spending time with causes me to want to be a better person; reach higher, further, deeper, and more fully into joy.  Who we spend time with is critical.

3. Happiness can be genetically determined.  meh. I tend towards the 'nurture' side versus 'nature' side of psychological development - in short, I think we blame too much on our genetics and don't take enough responsibility for ourselves. However, knowing that there is some basis in genetics is okay - it means we can recognize things in ourselves that we just need to work a little harder to change. This makes 1 and 2 so much more critical.

4. Focus on being Happier rather than Happy.  I don't think we should try to be more happy. or happier. I think we should try to be truly the person God created us to be - because that is the most happy, most beautiful, most joy filled and most powerful person we can be.

5. Money isn't everything, but....  The happiest person I know is the one that is not a slave to money.  Period.  Money isn't bad.  It just controls far too many people.

6. Experiences are better than possessions, but... Hands down, experiences are better than possessions.  If something you possess is actually used for an experience, then great.  Other stuff? just weighs us down and costs a whole lot of money. See number 5.

7. Small things can make you happy. seems to go with 8. Things that will make you happy often don't.  Small things do make me happy. Like a post-it note on my door from a friend. Or an encouraging word. Or when the croissants are still warm when I get to them. Or when just the right song comes on at the right time.  Sometimes I think junk food will make me happy and it just makes me sick. But sometimes just the right bit of chocolate shared with a friend? Pure joy. And I really like the colored staples in my stapler. 

9. Happiness increases with age.  Yes... I am happier now than I once was, but even more important is that I am walking in a level of freedom and a depth of joy that I never realized was possible.  I have found my species, my heart friends (see #1), and come to realize that all these things above are true.  And that naturally does come with age.

10. Know yourself.  I don't have a huge capacity for a giant social network.  I'm not quite rational after 8pm and coffee is a requirement for daily life.  I love good chocolate shared with a friend and running makes me a kinder person to be around.   Knowing these things comes with age (see #9) and embracing them as reality instead of fighting against them is wisdom.  I know I don't have a huge capacity for a large social life, but a more insecure me might try to fight against that and go out and be social all the time, and then wonder why I am a disaster. 

This became a much longer, rambling post than I intended. So if you made it to the bottom, well done friend.  Much love to all --Krissy

Transformation: Primary Trauma Care

This week I have the privilege of hosting the Primary Trauma Care team!

Primary Trauma Care is a system for training the front-line staff in hospital trauma management; aimed at preventing death and disability in seriously injured patients.  It is based on straightforward clinical practice and does not require the physician or practitioner to have access to high-tech equipment or facilities.  This type of training is critically needed here in Madagascar as well as the entire Mercy Ships target region of sub-Saharan Africa, where motor vehicle accidents and other trauma cases are one of the largest causes of death.  Many of these deaths can be prevented with a good working knowledge of the ABC's of trauma response.

A = Airway.  It's necessary to make sure the airway is clear and air is able to pass through into the lungs. We can only last a few minutes without oxygen!

B = Breathing. If the airway is clear then we need to make sure the patient is actually breathing. If they can't breathe on their own, that's when we need to use a bag mask or even mouth-to-mouth.

C = Circulation.  Assessing whether there is adequate blood flow, diagnosis of shock, and stopping major hemorrhage is the next critical step.

D = Disability.  If the patient is breathing and has adequate blood flow, we can move to the secondary neurological assessment (disability)

E = Exposure.  This is where we take a look at the rest of the body and evaluate major injury such as a broken leg.

The course is two full day sessions.  The third day, select participants are invited to return to participate in a train-the-trainer day session, where they learn the basics of running their own course; how to set it up, equipment that is needed, and how to teach the different skills stations and lectures. Then the last two days of the week, today and Friday, are a second course, with our new trainers teaching with assistance from our team as needed.

The participants learn how to insert a chest drain using a goat thorax. 

The participants are eager to learn and the new trainers are great!  It's been such a pleasure working with all of them and our hope is that this type of trauma response training will continue on here in Madagascar long after our departure.

--Krissy

Assorted bits, and the hardest thing.

One of the most common questions I get asked is how long do you think you'll do this?  My usual answer:

I will do this until one of two things happens. 

One, I run out of funding.  I am entirely dependent on the generosity of friends and family and if the funding ever dries up... well, that's it for me.  (so if you want to keep reading a blog about this crazy life I lead, donate by the link to the right.  Otherwise you might have to start reading a blog full of me whining about how corporate America is sucking out my soul.  Not to be dramatic or anything.)

Two, something better comes along.   Now really, can you imagine such a thing? What could possibly be better than exploring new cultures and serving in love and moving to a new country every year without ever even having to pack?? and my community and friends come along with me??  It's awesome.  I love my job and it has turned on a passion in me that I never knew existed.  I say "something better" may come along because I hold my future loosely, and never want to put God in a box by deciding now what my life will look like in three years' time.  Three years ago I would never have guessed I'd be championing safer surgery in Madagascar, but here I am.  Right where I belong.

~~~

Across the harbor there was a ship docked for almost a week called "wisdom lines".  Wouldn't it be awesome if you could just call them up and order a 40foot container full of wisdom whenever you needed it? 

~~~

So I've had this sore thumb/wrist problem for awhile.  Like, a month.  Or maybe two.

Ok, you have to know two things about me as I continue this story: one, I have an extremely high pain tolerance.  and two, I ignore injury.  I'm the girl that will look down on a random day and see a welt the size of a grapefruit on my shin of various shades of red and purple and yellow and say "oh, wonder where that came from".  I can't possibly be bothered to stop what I am doing and give any recognition to any type of pain that might be registering. especially if I am playing a competitive sport (ultimate Frisbee) or on a mission of some kind (trip and fall up the stairs on my way to a meeting).  I'm the girl that lived with a 90% tear of my rotator cuff for six months before seeing a surgeon... who promptly said "what the heck were you thinking?".

So one of my doctor friends told me she thought it might be fractured. and I said nah, whatever.  it's fine.  She said no really.  I said nah, really not.  Then she said if you put it off and you could die.  And I said okay I'll go get xrays. Because of all the ways to go, a wrist fracture would be rather anticlimactic.

So I saw the crew physician and got xrays and it's not fractured but I have other issues and then I got referred down to our incredible physio team which happens to have a hand specialist here right now. 

I don't know for sure, its been a long time since I lived in America and had to pay for medical care. But I'm guessing a visit to the doc, several xrays, and a referral to a hand specialist, where I get braces and exams and exercises and any variety of other lovely healing-type things I need... I'm thinking that is not cheap. Or easy.  And all of this is within about a hundred steps of my cabin or office.  In Madagascar.  Except physio, that's aaaaallll the way down on the dock. Sometimes I get stuck in commuter traffic on my way down the gangway and it might take me all of four minutes.

I am so blessed. And so grateful.

~~~

Someone asked me yesterday what I like to do in my spare time.

I said well, last Tuesday night I decided not to work late and I went to play with the kids in the local hospital pediatric ward.  Then I told him about all the other cool stuff we get to do, like love on babies in an orphanage and show the elderly how to make silly crafts and smile and share the joy of just doing life together.

Then I told him but my most favorite thing is making and serving coffee to the AFM crew on Sunday mornings with my freaking awesome friend Dianna, and I get to meet such amazing people that I wouldn't have the opportunity to know any other way, and the community that gathers and caffeinates together is a special place that I love.

He said, "....so, you're a volunteer... and in your spare time, you volunteer?"

yeah. is that weird? 

~~~

Someone asked what is the hardest thing for you doing what you do?  My answer was a fresh one.

The hardest thing about doing this thing that I do is not being a long way from home, although that is hard. it's not relying on generosity of others, although that too is hard. It's not the lack of freedom, the cultural difficulties, the language barriers, or the lack of familiarity, though those things are hard too. 

The hardest thing is seeing the reality of life here... and not allowing hopelessness to creep in.

I had a Malagasy friend call me yesterday from Tana where he is with his gravely ill father.  He has worked with me and Mercy Ships for several months and knows what good medical care looks like. He knows that a hospital can be a place of hope and healing and not a place of death and disease.  He knows how healing love and joy can be.  And he's in a hospital in Tana where his father is getting none of those things.  His heart wrenching words of "Krissy, they don't care about him here." brought me to tears.  That is what we are trying to change, fighting tooth and nail to break down the barriers and the practices to speak and show life and love and joy to those desperate for it, to bring hope and healing.  And it's phone calls like that that make me wonder how on earth my little band of educators could really make a difference.  It seems so inadequate; a drop in the bucket.  And if I'm not careful, the sinister whisper of darkness can creep in and hiss it isn't worth it. you can't really make a difference.

Crush that slithering voice right out.  It IS worth it.  I do believe it when I say one transformed person can transform a hospital which can transform a nation. It doesn't happen overnight and that's where we come in, persevering and pushing and hoping and praying for the individuals and the masses; not allowing the size of the bucket to deter us from the scientific fact that enough drops will eventually fill it.

And as a friend reminded me yesterday as I fought to contain the tears; any day you go for a run you are lapping the guy sitting on the couch.  At least we are doing something and something can be used a whole lot more by God and by a nation than sitting on the couch eating nachos, watching what is happening but doing nothing.

So I'm gonna keep on doing something and hoping it turns into some kind of great thing - for His glory.

It takes an army.

I was reflecting the other day on all the people it takes for me, just one person, to be able to do this crazy thing I do.   I had trouble keeping the list in my head, it got so long. So I started writing them down.

I can't do this alone. This isn't about me. It takes financial support, yes, and that is critical. But it takes so much more than that, so much love and support and there are practical needs to be filled and emotional needs to be met.  This amazing work that I get to do is a conglomeration of a zillion pieces that all come together beautifully so that I can be a part of transforming the healthcare providers and hospitals of Madagascar.

That's crazy.

And it takes an army, y'all. 

I am so grateful for... in no particular order....

--Incredible, amazing people I work with who encourage me to reach higher and further and just.keep.running.

--My accountant who I completely trust to sort out all those numbers and letters and tax laws.

--My friend Mel and her sweet words of encouragement and honey cinnamon lattes.

--The awesome family that lets me keep my "permanent residence" in Washington

--My mom, writing me a letter every.single.week. for nearly six years now.

--Bethel music for writing the current soundtrack of this season (we will not be shaken)

--Beth at Raptim Travel for finding me the best deal on airfare.

--My siblings and siblings-in-law posting photos and videos of the littles on Facebook.

--Michelle's parents welcome to their home in London

--People who listen.  People who speak truth and life and light.

--The beautiful smiles I get when I make coffee with a heart on top on Sunday mornings.

--My friend Brenda who sends the worlds best care packages - Treats from Trader Joes, and just the right post-it notes and pencils for this neurotic writer.

--Kirstie sending me funny imessages during the day

--incredibly faithful donors every month, that I don't adequately thank but completely rely on. thank you, treasured ones.

--various churches that let me share my passion through a microphone to a crowd.

--various other organizations that let me share my passion through a microphone to a crowd.

--media and communications professionals, here and there, that help me to get the story out.

--people who let me borrow their car when I'm in the states.

--more gracious invites and places to stay

--People who ask tough, or potentially tough questions, out of love.

--loving encouragement that comes from all corners of the globe.

--Donovan seeing beyond my dishwashing abilities all those months ago and encouraging me to serve long-term with Mercy Ships.  And his continued leadership and pursuit of excellence for this organization and everyone in it.

--Emotional support from the ends of the earth; people who don't hear from me for months who still encourage me and hold my heart when I'm upset.

--People willing to set up speaking engagements and fundraising efforts for me.

--The bestie.

--My sister for taking care of my chacos, sending them in for repair and getting them back to me!

--Random people who give random unexpected gifts - money, or care packages, or treasured words of hope and love.

--People who are willing to come fetch me at the airport.

--roommates who are gracious when I make too much noise in the morning.

--cute children who are fun for awhile but then remind me why I am grateful I don't have my own

--People who don't mind it when I'm especially needy.

I wish I could do this. My coffee has hearts on the top made of caramel drizzled on the foam.
But even though it's less fancy, it's still full of love.

Run faster.

Back a few years ago when I started running more regularly, I decided I wanted to train for a half marathon.  Not just any half marathon would do; I ran the Disneyland half marathon and played in the park for nearly a week as my inner child exploded all over the place… about a week before joining Mercy Ships fulltime.

But this post is not about Disneyland, it’s about running.  Sort of.

Training to run long distances is really hard.   Actually… all running is hard if you have never done it before.  But what I struggled with most in my training was that 10 mile mark.  (a half marathon is 13.1 miles…)  That’s about when I would start getting bored.  And tired.  And sore.  And think I’d much rather be doing just about anything than running right now.  And the battle was just about as much mental as it was physical, maybe more so…

But what I remember most clearly is what another running friend said to me about that time.  She said when you get to that point where everything hurts, and you think you can’t possibly go on… run faster.  It’s still going to hurt but at least you’ll be done sooner.

Very wise words indeed… but for oh, so much more than running.

It’s really the motto by which I choose to pursue God… or whatever God is calling me to.

I have a very dear friend who, when I first told her this, she didn’t believe me.  But now she knows it’s true. I had the (painful) privilege of practicing what I preach this week. So let’s just say, it’s fresh.

When God begins to stir something up in you… When something that isn’t right is pointed out, either by someone else or just by your conscience… When you realize you have become someone you don’t want to be or you said something that isn’t an accurate representation of who you serve or the pressures of life or love or faith bring out unsavory characteristics or desires or failures…  Don’t dawdle. Don’t try to ignore it or squish it up really small and hide it in the recesses of your heart or soul or life.  Don’t try to forget about it or focus on something else.  Run faster. Towards truth. Towards Jesus.

Because the process of restoration, or redemption, or refining… it isn’t comfortable, to say it gently.  Reality is it's usually incredibly painful; disrupting sleeping and eating and focus and emotional stability.  And really? It’s always going to be that way. And it will get worse, I promise, the longer you put it off, or try to hide it, or ignore it.

So run faster.  Because it’s still going to hurt, but at least you’ll be done sooner.

And what is at the end of the race? A medal, a celebration, carbs, and a hot tub.  That’s pretty great. Probably worth fighting through and finishing for.

What’s at the end of redemption?  Freedom. Joy. Peace.  That’s even better.   And absolutely worth fighting for, no matter what the cost. No matter how painful or deep or shameful or dark… Freedom is worth fighting for.

So run faster. Go.

Ever be.

These words have absolutely captured me this week. It's a poem, it's a love song, it's a stunning picture of what true love does to us - love from our Father God. Beauty from ashes. Oh, that it would be so! 

Your love is devoted
like a ring of solid gold
Like a vow that is tested
like a covenant of old

Your love is enduring
through the winter rain
And beyond the horizon
with mercy for today

Faithful You have been
and faithful you will be
You pledge yourself to me
and it's why I sing

Your praise will ever be on my lips,
ever be on my lips
Your praise will ever be on my lips,
ever be on my lips (2X)

You Father the orphan
Your kindness makes us whole
You shoulder our weakness
And Your strength becomes our own

You're making me like you
Clothing me in white
Bringing beauty from ashes
For You will have Your bride

Free of all her guilt
and rid of all her shame
And known by her true name
and it's why I sing

Your praise will ever be on my lips,
ever be on my lips
Your praise will ever be on my lips,
ever be on my lips (2X)

You will be praised You will be praised
With angels and saints we sing worthy are You Lord
You will be praised You will be praised
With angels and saints we sing worthy are You Lord

and it's why I sing

Your praise will ever be on my lips,
ever be on my lips
Your praise will ever be on my lips,
ever be on my lips (2X)

Bethel Music - Ever Be

Transformation: Safer Surgery.

I spent last week across the country, teaching the Checklist.

It was awesome. And it was really hard.  And hopefully, it was successful.

There were many, many really good moments.  The moment we realized one doctor went from completely against to completely for the checklist in a few hours time.  The excitement and laughter from the nurses as Jen taught them how to count instruments and swabs - such an empowering and life-saving skill that they are so excited to learn.  The laughter as one male participant volunteered as a patient for a cesarean simulation.  The gratefulness expressed in the words and eyes and hearts of the participants, that we would come and bless them and encourage them to keep on doing good for those in need.

There were hard moments, too.   At one point in the week, the entire team was really discouraged.  And this is what I wrote that afternoon:

We aren't fighting to save a life on the operating table today... we're fighting to save thousands, through changed behaviors... changing habits that were instilled long before the bullet entered the body....  It's significantly less bloody, but seemingly just as painful.

It really felt like we were fighting though as if it were a long, arduous surgery.  There were things in the way that had to be removed; habits, behaviors, and attitudes.  Words had to be presented and then re-presented in a different way, and sometimes one more time, just to get a point across.  But perseverance paid off and by the end of our time there I really believe we left them in a better place than when we arrived.  One can hope the safety of their surgical practice has been impacted, and we'll find out in a few months time when we go back for a follow-up visit.

It just reminds me that this is hard. No one really knows how to do it, there isn't a foolproof way to teach or to change behaviors or to see implementation.  But the important thing is that we are out there, trying, seeking transformation, and not letting a little discouragement stop us.   Thanks to the team for working hard, for getting out there, for trying, and for your passion for safer surgery for all.  

What's next?  Well, the coming months are full to the brim of mentoring programs, courses, follow-up trips, and various other projects including plans for our next field service here in Madagascar.  I just shake my head and wonder, how is this my life?  Two years ago I wouldn't have had a guess to a response if you asked me how to make surgery safer. Now, it's my passion.  Thanks so much for your support!!

An effective, safe surgery can save a life. An effective, safe surgical education program can save thousands.

Encouragement

Author George M. Adams is quoted as saying, "Encouragement is oxygen to the soul."  

Encouragement doesn't only make us feel good for a moment; it's actually required to maintain life and focus and the pursuit of the greatness we have all been called to achieve.

Yesterday our little team of educators stopped at Moramanga District Hospital, about 2.5 hours east of Antananarivo, to offer them Lifebox pulse oximeter training.  The Madagascar Assessment team visited this hospital before ship arrival; we found an extremely welcoming group of physicians and nurses who were committed to the wellbeing of their patients even through a profound lack of working equipment and medical supplies.  I told them then that we hoped to return; yesterday I made good on that statement, and the training went extremely well.  They were eager to learn and very grateful to receive the pulse oximeters we offered; however that is not what they were most grateful for.

"The fact that you came back; that you came to visit us, the encouragement you offer and that you care about us and our patients, that is what we are so grateful for."  The chief physician expressed to us that this visit, as well as the hope that we will return again in the coming months, will get them through for a long time... more so than any physical supplies or materials we could offer.

Never underestimate the power of encouragement!