When your patient reminds you of your own son!

It was a usual clinic day when the next patient entered the room. 

A young couple carried their 6 year old boy, in the fetal position and placed him on my examining table. He looked scared as most children do when they come to my office. Seeing a surgeon is scary ordeal for a child and he had reason to be scared as this was his fourth visit to a so called “surgeon.” 

When I asked what was wrong, the parents immediately uncovered the abdomen of their malnourished son. Protruding from his lower abdomen was fungating, friable tumor larger than the size of a softball. It had the stench of urine and necrotic tissue as urine leaked from around its base. He laid frozen in the fetal position perhaps from fear or perhaps due to pain. He had not walked in some months. 

As I looked at him, I was reminded that he was the same age as my own son.

The parents explained that they had spent most of their money trying to get this tumor treated. Upon further questioning, I discovered it was neither treated properly nor adequately. Tragically, this is not unusual. 

It is cases like this that break my heart. The family admitted they didn’t have much money left (having spent it on the prior treatments, none of which was a biopsy, nor a definitive operation) and they inquired how much it would cost. I knew it would be beyond their capacity, so I encouraged them to let us treat him and we would discuss payment later.

Edmond was admitted to hospital and started on a malnutrition protocol. He was anemic and required multiple blood transfusions before we could consider taking him to the operating room. His body was in a state of just trying to survive the perpetual attack of urinary infections from this resource sucking tumor that had plagued him for several months. The tumor, which engulfed his entire bladder and a significant portion of his abdominal wall, would need to be excised in its entirety, leaving him without a bladder. He would need a urinary stoma (meaning he passes urine from a small hole in his abdomen into bag) at least till we could get him better nourished to do something more definitive. 

He underwent a several-hour surgery where we delicately removed the tumor, which engulfed his entire bladder, and reconstructed his abdominal wall to fill the large hole. He was then admitted to our new ICU for post-operative care. 

Our new ICU has been a game-changer for patients like this. Our visiting anesthetist and ICU doctor (Dr. Joel you rock!) was able to give him an epidural for pain and he did awesome post-operatively.

In most mission hospitals, each patient must have a 24hour care provider who is responsible for patient laundry, food and waste disposal. Most mission hospitals do not have the resources to provide this, and it is all done by the caregiver, usually a family member. His mother, his caregiver, stayed at his bedside during his recovery.

Three weeks after his operation, he came smiling AND WALKING into my clinic. He gave me our traditional fist pump. His incision is almost healed his family is learning out how to live with a urinary stoma without running water & electricity. This is no small feat.

Though our surgery may cure him, the lack of available chemotherapy and his delayed presentation makes his prognosis guarded….but for now he has new lease of life. 

Mark 6:13 When the Lord saw her, his heart went out to "him" and he said, "Don't cry." 

I totally get this verse!! Unfortunately, I can't heal by just a simple touch as in the subsequent verses of Mark 6 but... 

We are so grateful to those who financially support our surgical ministry to help care for families and patients like Edmond.

#WithoutWater Campaign - VIDEO

Please help us share the need for water in our neighborhood.  

We are partnering with the Madagascar Water Project and Engineering Ministries International to dig some wells and bring hope in this desperate season. This will not only help the hospital to run, but we hope to also get water for the local community. 

Join us in our goal to raise $40,000 towards this fundamental provision. 

The Thiessens

WITHOUT WATER - Fundraising Campaign

No showers. No washing machines. No flushing the toilet.

Imagine your life without running water.

Imagine a surgical ward or hospital laundry service without running water. 

Now, imagine performing surgery and treating patients without running water. 

The Good News Hospital is a 60 bed hospital in Mandritsara, Madagascar and provides the only surgical services in the region. 

Every year, it operates with ONE HOUR of running water per day for months a time.

Help us change this with our Thiessens2Africa:

Over the next couple of weeks, in partnership with the Madagascar Water Project (MWP) and Engineering Ministries International (EMI), we will be drilling new wells and working to provide a safe & reliable source of year-round water for the Good News Hospital. 

Help us reach our goal of $40,000 

to bring water from half a km away. 

* SHARE this blog post or FORWARD the e-mail

* DIVE IN to transform a hospital and community

* FOLLOW us on Facebook and see for yourself what's happening as we dig in and start drilling

Want to take the plunge and join us to bring fresh water?

Donate HERE 

As I coordinate with our Guesthouse staff to put on a Thanksgiving meal for 50 team mates and visitors, I can scarcely believe we arrived back just 2 weeks ago. After an unusually eventful trip, I might add, which included standing at the gate to our flight in Paris and being told we are too late, while the plane proceeded to sit there for 45 minutes removing all of our 18 suitcases.

Moral support as we got
back to the airport.
Merci, Paris!

What's more, our friends meeting us in Paris sat on that plane telling them we were there, but to no avail.

After 7 hours in the airport and many meandering trips (Charles de Gaulle is not for the faint of heart!), we stayed overnight and repeated the flight the next morning.   

All of our bags did arrive in Madagascar,
and after a whirlwind shop in the capital,
we got everything on the small plane to our town.
Barely.
We had a 1074kg of weight limit on the plane,
and our totals including us and everything we had on us,
came to 1072kg!

Yes, we MAY have even packed some
special cheese and meat from Canada...
call me crazy!

Back with friends!

But I digress...we made it, and stepping into our home after 4 months away (and changing beds 18 times) was a surreal experience for our family. When we left Canada 5 years ago, we had visions of setting up a long-term home in Africa. As it happens, this was the first time in all those years where we actually came back to a pre-existing home. 

No new community. 

No new home to set up.

No new team and culture and environment to learn.

For the first time, we came "back". 

Even my very limited Malagasy (language) has begun to return!

As we set the suitcases on the shelf, we realized that more than just having a physical residence, it is also the sense of belonging that hits home. Somehow in a season of dust and dryness, we have found a place where our roots are sinking in. It feeds our soul to have this precious sense of connection after we have "wandered" for so many years.

Don't be fooled,
these pies are COMPLETELY 
out of my comfort zone!
Even my love for a good challenge
was on the edge
after 7 of these...

As we gather our team of nationals, westerners, and visitors tomorrow to share a celebration from our passport country, I am both humbled and grateful at where God has brought us. The journey has been bumpy (like Malagasy road-style bumpy!), but the evidence of His provision is far beyond my imagination. 

Thinking of our people near and far, as everyone gathers to enjoy their precious relationships, while marvelling at God's goodness in our lives. 

"Rejoice always, pray continuously, give thanks in all circumstances..."

"Taste and see that the Lord is good..."

By Julie 

What is Home Assignment Anyway?

So I still don’t totally know what other missionaries do on their home assignments. Home assignment or “furlough” as it is sometimes called is this strange time where you get to return home from the mission field. My Malagasy colleagues frequently ask how my “holiday” is going? I feel like I need to correct them because it really feels like anything but a holiday most days.

I thought it would be a time to get refreshed, recharged and maybe get a book or two read.

Julie and I strategically (or not) have supporters, friends and family spanning the entirety of Canada (over 5000km). Having driven across Canada twice on our last home assignment, we decided to fly across Canada this time and visit 2 provinces instead of 5. But despite the immense generosity of many people, we still have had to move close to 8 times. It will be closer to 12 by the time we are done. What this means, is I have lost any motivation to put my clothes in anything but my suitcase. I think this feeling is also shared by my kids as well. Julie is in a perpetual state of planning meals while adapting this to whatever housing situation we are in. 

Thankfully, Julie and I have an almost perfect marriage and almost perfect children so we don’t EVER have disagreements... haha... this makes it easy to live with others:-)

Getting around to see people and visit various churches and organizations is always easier with a vehicle. We were thankful to have my mom’s vehicle for half of our stay. For the other half, I spent a week just shopping to buy for our current minivan which I will need to sell not even two months later. Lots of work, but financially better than renting even for a short time.

Along with sharing about our work and lives, Julie is planning and stockpiling school materials for the next two years. We are replacing our electronics which are on the verge of dying or outdated and we also need to get everyone into a dentist with some of us needing multiple appointments due to the unavailability of a reliable dentist where we live and work.

I am also ordering surgical supplies and equipment mostly from around the world to bring back with me. This involves lots of research to ensure the equipment will fit our existing OR and will do what we need it to do. 

Then there is the reverse culture shock of coming back to the land of everything. There is ensuring our kids don’t feel homeless and managing the emotions associated with continuous hellos and good-byes all the while, trying to reconnect in brief meetings with friends and family after being away for two years and knowing you won't see them for another two. 

And yet while Julie and I look at each other some days and ask how do we make this life happen, we see God’s provision over and over again. Like the houses, basements, cottages & boats we have been offered so Julie and I can enjoy incredible views and our kids can fish and swim and enjoy nature. Like friends who come to us with food and who drive to where we are at so we don’t have to. Like the the generosity of people who continue to support our mission and work. 

Sometimes reflecting on all this, I ask myself who does this life?

This month, I travelled to North Carolina to speak to 11 physicians including 7 surgeons and their spouses preparing to serve long-term in mission hospitals around the world with the World Medical Mission Post Residency Program. For them, it will be the same path Julie and I took almost 5 years ago. I was so encouraged by these young doctors because after so much studying and sacrifice, they are willing to give of their time and talents to serve the world’s poor and to provide compassionate and quality medical and surgical care and doing so because of the hope we all share.

What isn't going on?

It’s amazing how busy life can get even when you are in the middle of remote Madagascar. Life is just busy whether it be homeschooling, work or just life. 

The launch of the new Pan-African Academy of Christian Surgeons (PAACS) surgical training program has been a major success! 

I am so unbelievably excited to see surgical care improving by leaps and bounds. There is nothing like seeing our trainees become independent in doing C-sections or become more proficient treating critically ill patients. Praise God! Our two trainees are busy studying for their first set of  exams in June (which must be done in english). Both have had to learn english to be in this program. So, we communicate amongst ourselves in english, but we need to speak to our nurses in french as most of them don’t know english and then to patients in 1 of 2 dialects of Malagasy (as they generally don’t know french or english). It can be a word salad some days. I should also mention that when “we” speak in english it may be a Canadian, British, Irish or Australian accent. I should also add American because my Malagasy surgical colleague was trained by Americans and he has adopted some of their accent! We are definitely a salad of international staff!

I am overwhelmed and humbled by the FAIR "Out of the Waiting Room" appeal to raise money for our surgical education program here in Madagascar. 

Our original goal was $145,000 CAD. To date, over $230,000 CAD has been raised! Thank you, thank you and Praise God!

Our new ICU and recovery unit headed by a critical care nurse from Ireland has saved at least 3 patients’ lives and I suspect many others since opening in March 2022. Prior to this, patients had really no option but to go to the surgery ward which was not equipped to deal with sick patients. We now have a dedicated team of Malagasy ICU nurses. Another major step forward. The Malagasy writing on the wall is Psalm 121.

We recently had Engineering Ministries International (EMI) remotely assess our hospital infrastructure for water and electricity as we felt we were outgrowing it. Our suspicion was correct and their report indicated much of our electrical and water infrastructure needs upgrading. We will be hosting 3 EMI engineers from South Africa later this month as they come to provide detailed plans for some major upgrades in these areas. Our hope is that this will greatly address current needs but also provide for future expansion. 

With detailed engineered drawings, we can better cost out the upgrades and begin working on what needs to be done and we have the financial means to do. If I think I only want to operate as my job and not work to improve infrastructure, I find myself thinking again because performing surgery can’t happen when electricity is poor or there isn’t enough of it. The same goes for water.

But all these big picture projects are really intended to make a real difference in people's lives. This week I saw a smiling 18yo mother in follow-up in my clinic. She has a young child. Someone tried to kill her with a machete several months ago and she arrived in a terrible state while I was on call. She sustained unimaginable injuries including two large open skull fractures. I honestly didn't think she would make it. I spent 4 hours trying to reconstruct one of her hands with 9 tendon repairs, a wrist fracture and a nerve repair while my resident worked on some of her other injuries. In clinic, she can move her fingers and hand more and more each day. She has no pain. She now comes to my office with a huge smile. She tells me how her young child is doing and I remind her how sorry I am for having to cut her long braided hair to fix her. She laughs and says "tsy maninona" which means no problem. She is neurologically normal. Praise God!

It seems like a lot on the plate some days…and it is, but this is what it looks like to improve healthcare in a developing country. It means building systems that will last, training surgeons, nurses and departments, modelling compassion and trust, pooling and stewarding resources, and helping empower a community to care for its own. When the days are busy I often find myself looking to the hills and reminding myself where my hope comes from. JESH

Not a "Homeschool Mom"

A long time ago, in a land far away, I once said - "I will NEVER homeschool". 

Never say never, right? 

I have been eating these words for years. 

Sometimes, I have been solely responsible for their schooling, but most often have had the support of trained teachers. Never have I felt convicted, nor convinced, that I'm the best one for the job. 

And let's face it, I like having time and space in the day to be involved in things outside my home! 

However, Jesh and I have been certain that these kids are our primary ministry and responsibility right now. With the older two in Middle School years, and our primary teacher leaving, it's became clear that I need to step it up. A lot. 

With a sense of overwhelm and apprehension, I have begun digging into what it will look like to be their full-time "teacher" for the next couple of years. Yikes!  It feels like an incredible sense of responsibility, knowing I'll have to be prepared to follow through. Every. Single. Day. 

As I began really researching homeschooling options for middle school years, it only got more overwhelming. Did you know there are 7 basic methodologies for homeschooling? And all sorts of hybrids? And don't even get me started on curriculums.  

And then what about their spiritual formation? Special skills? Or Youth Group and extracurriculars? 

What if I blow it? And they hate school? 

Admittedly, I have had panicked, sleepless nights considering what they need and what I want to be able to provide, but having no clue how to confidently proceed.

How to make "mofo banana"
(fried bananas) 

But then I got thinking. If I really believe we are where we need to be in this season, then can't I also trust God will equip us with what the kids and I need? 

I have never felt like I'm the perfect one for the job. Not as a "missionary", and most certainly not as a "teacher".  You know what? It's just plain uncomfortable. And while I don't always want this role, it's also my privilege. Even my joy (who would have thought?!). 

Walking alongside my kids, being humbled, and learning what it means to raise up children to one day be contributing members of society. 

With help from my logical husband, we are sifting through the information overload. I'm mucking my way through our homeschool vision; goals, needs, values, resources and limitations. 

And you know what? I'm really AM excited. I have found myself thinking how wonderful it is to watch them learn and discover, and been surprised how much I can enjoy learning with them. 

Participating the rice harvest with our neighbors

_______________________________

Making clay flower pots at a local village

________________________________

Fabricating Aluminum cooking pots. 

Up-cycled from litter found around town, 
it was exciting to watch the aluminum get purified 
and turned into something lovely and useful. 

(imagine the analogies!)

As much as I don't feel like I'm the best one for the job, right now it's up to me (and online classes?!?). 

So I'm diving in, and praying for grace and patience. 

But hey, I'd happily "let" someone else help with their educational support, so do spread the word our team is still actively looking!

By Julie