Two Steps Forward!

January 2023


Dear Partners,
This past week our administrator here in Kamakwie, “BL” Bangura, spoke at the hospital chapel service of a man that had been found lying on the street the prior night and brought to the hospital. Estranged from his family for some time, he had tried to take his own life. Several members of the staff quickly joined in providing him appropriate care and counsel and today he is reunited with his family. His parents were so grateful that, unlike what they were used to, care was provided without any up-front demand for payment. God has so shown us grace and mercy every day and we want to overflow with it, thanking God for opportunities like this in both Haiti and Sierra Leone.
In Haiti, as the economy continues to worsen and food prices rise, there seems to be no end in sight at this point to the political upheaval and gang violence. So much discouragement! Pray for miracles! As we stay in touch with the medical team, we are encouraged that the hospital is doing good work, led by the skill and leadership of the three Haitian specialists that came back to La Gonave about the time we were asked to leave. Dr. Berley, our pediatrician, is expanding the neonatology services using his experience and advocating for improved equipment to be used in the care of premature infants. Our OB-Gyn, Dr. Annecie, provides high-risk obstetric care and surgeries like hysterectomies that previously could only be obtained on the mainland or when visiting teams would come. And Dr. Badio, our internist, is able to offer procedures and consultations for heart and lung conditions that also save patients trips to Port-au-Prince. Together these doctors are expanding the continuous-learning opportunities with regular pediatric and adult group rounds, journal club and weekly grand rounds to discuss interesting cases and have the doctors give their own presentations.
Dr. Berley Merilan, pediatrician (and all around really nice guy:-) with a child in the pediatric ward in Haiti. And a view of the neonatal care area that he has developed.
Personally, we continue to respond to requests for food aid and help some small businesses that provide training and employment when possible. As the La Gonave Action Team and the Friends of La Gonave group grows, this auxiliary group has been able to ship hospital supplies and is working on supplying medications that the hospital has difficulty procuring. While we pray and hope for an opportunity to visit the island soon to maintain our working relationship with and to encourage the staff, we also ask for wisdom about how to continue to engage effectively in the work and mission of the hospital from a distance.
In both Haiti and Sierra Leone the staffs celebrated Christmas together. We got pictures from Haiti, and we loved the parties here. Movies and card games for two can get a little old :-), so volleyball, "tug of peace", caroling through the town with the staff and watching them dance and sing was a joy.
In Sierra Leone, it's Two steps forward and One step back! But progress is undeniable—and so much of it thanks to your prayers and generosity! The fresh coat of paint inside and out at the hospital changes the atmosphere, as do dozens of new mattresses. A brand new generator is working well and fourteen oxygen concentrators have been repaired, so that we no longer have reports of deaths related to our being unable to offer oxygen therapy. This is so good!
The CHOs (the health officers that Bob is working with) have moved from attending a continuing education session once a week to presenting at them twice a week—at their own suggestion! We are proud of them! Bob has focused more on teaching ultrasound skills to Edwin, one of the surgical CHOs, who can now determine the baby’s sex—what everyone really wants to know :-). And we hear rumors on the street that the hospital is doing a good job—which means a lot. BL, our administrator, is great at encouraging the staff to do its best and has even entered the hospital in a competition among NGOs. Even more importantly, the relationship between the national church and the hospital has been working well.
Of course, the new white paint is already dirty from many hands, and we are still short on some basic equipment and supplies. But, with gifts from partners like you, BL has made numerous trips to the bigger cities to fill some of those gaps; he even has purchased some sheets for the beds—we could actually have sheets! :-) There is always much to be done yet--a wealth of opportunities!
We are praying about two fencing projects, one to provide much-needed security around the hospital and one that the national church has proposed to fence all the land that belongs to the church and school and hospital here in response to encroachment that threatens it. These are big projects, and prayer meetings and a planning committee have already been formed. We thank God for finances already available for the hospital fence and look forward to bringing in supplies and equipment to a more secure location. In a place where there is desperation, anything of value may disappear— a difficult part of life with poverty.
These little guys need healing. Setitgie had severely malformed legs, and we are excited to see how surgery in Liberia (lots of great provision there) will change his life. He is eight and has not been able to attend school. Ibrahim has been in the hospital for several weeks with multiple surgeries, and can't keep his tuberculosis medications down. Please pray for them.
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Thank you for remembering people in Haiti and here in Sierra Leone and praying for them. It means a lot to them and to us. Praying:
--For two doctors for Kamakwie. Dr Faso, who has given almost three years of service here, is probably going to stay in his home country of Nigeria. The financial sacrifices he made to work here and the distance from family are major factors in this decision. Even if he had returned, one doctor here is not enough.
—For peace and stability in Haiti, wisdom for Haitians who literally don’t know what to do. Wisdom for us as we plan and strategize about active involvement from a distance and any possible travel to Haiti.
—La Gonave and Kamakwie Hospitals to shine: care with compassion and excellence, staff to see their jobs as service to God and to know the rewards of living it.
—Growing relationships between administrative staff and church leaders, toward a partnership working together toward the same goals.
—Sustainability tools to finance the health services to succeed—the water project to gain customers and the garage and lab and housing for guests to be further developed and to thrive. These hospitals (like all) will always need partners, but they are trying to do more to cover their operating costs.
***** Thank God for wonderful relationships! Celebrate with us the progress made and the amazing people in both institutions. It is our privilege to know them! And you our partners! It’s an amazing life—not always easy, but amazing.
Love to you all,
Marcia and Bob
p.s. Due to moving around, (and no mail service here) we're having all mail sent to our permanent address in Michigan. If you haven't sent a Christmas/New Year letter/picture yet (hint) we'd love to replace the ones we have enjoyed having hanging on the walls here. 1830 Dairy Lane, Grand Haven, MI 49417
p.p.s. If you want to give financially to support the work or something specific that we've mentioned, just drop us an email and we'll let you know how to do that. Thanks SO SO much to all of you who give so faithfully and generously!
Cute babies inpatient and out, and a local craftsman with his wares.

I had no Idea!

Dear Partners,                                                                          November 23, 2022                                                                         
Haiti is in turmoil, gang wars and political corruption and dysfunction continue. Here in Sierra Leone the hospital building and its resources are in dismal condition.  The generator has been broken for over a month and after $1500 in repair work, a piece broke off and blew a hole in the engine block.  There has been no running water at the hospital or to the employee living spaces for a month.  The water filtration project, which is the one money-making project here, can’t run because the generator is needed to pump water to the building. The solar power system is old and inadequate and doesn't give electricity through the night or allow surgery air conditioners to operate reliably. There has been a history of friction between the church and the administration.  We have put off writing you all because we just didn't know where to start.  

 

If there was a dollar for every time we said, "We had no idea." it would be a nice little fund.  We've learned about things we really didn't want to know:  Did you know that a cobra can spit with a very accurate aim up to 9 feet into the eyes of a person?  We had no idea how many children still die of malaria.  We had no idea that we would see young men die from snake bites because there is no anti-venom here. We had no idea that almost every family has lost at least one child--it shows on the charts of the maternity patients in the number of pregnancies and the number of living children: almost never the same number. We had no idea of the difficulty and darkness in, not just crisis situations, but in daily everyday life.  We didn’t know (really know) how little some people eat.
 

 

Never has it been more clear to us that there is more to life than what is seen. And that “it takes more than bread (or rice) to stay alive. It takes a steady stream of words from God’s mouth.” (The Message, Matt 4:4)  In these situations we see people clinging to the unreasonable hope that God will come through and that instead of hopelessness, there is hope and even praise.  Seriously.  Hope comes from knowing that God is at work in the midst of this overwhelming mess of a world and his way is “love, joy, peace, patience, kindness, gentleness,  and self-control.”  Though we cannot keep everyone alive, we can treat them, every one of them, with dignity and respect.  We can bless and love well with all our ability.  Can you tell we are urging ourselves on?  It’s a daily discipline.
 
That’s our rant. (Only Marcia rants.) And it ends with incredible thanksgiving!--for hope and the generosity of partners.  This week great need is being responded to.  Food aid is being sent to the hospital on La Gonave.  Renovations with painting have begun in the hospital here in Kamakwie and Brima Bangura, the new administrator, is making lists to begin making some things better.  Equipment lists and repair lists and medication lists, and who needs to be better compensated for their work lists—they are long lists, but they are hope-filled and possible.  All things are possible, right? 

 

A Haitian proverb says, “Little by little the bird builds its nest.”  In Sierra Leone they simply say, “Small, Small.”  It’s how we hang on to hope.  We celebrate small things and big things, every thing we can celebrate.  We thank God for faithful employees who show up, for cleaning people who carry all the water that they and everyone else at the hospital uses, for a new administrator who seems pretty hard to discourage and who is focusing on sustainability (a new building is going up near the well to provide water for the water project), for clean white paint going on the walls, for a rumor that there may be new mattresses coming, for the timing of amazing financial gifts which came just after some good discussions with church leaders here promoting a working relationship and for all those who make the use of these gifts transparent and accountable. We give thanks for laughter in the hospital corridors and beauty in smiling faces and nature, staff that sing enthusiastically off key, and children who run to fist pump or hug us, for hard work with progress.  We celebrate a new blood transfusion policy and more regular staff inservices and department head meetings and monthly reports and plans for a staff Christmas celebration.   Good, small steps forward.
God is light.  In him there is no darkness at all.  To whom else do we turn?

 

 

So, with grateful hearts, we truly celebrate Thanksgiving and you, our partners, and the opportunity to be ambassadors here.  It’s good.  It’s challenging.  Morning by morning we bring our requests to God and wait in expectation!

Blessings!
Marcia and Bob

 

 

 

 

October 16, 2022

Haiti's Crisis is not just Looming.  It's happening Now.

Dear Partners,


This has been too long in coming and we admit to feeling somewhat helpless over the last few weeks as we've watched and searched media for news about the crisis in Haiti. We've prayed and consulted with coworkers and prayed some more about how to respond. We've watched as the international community (UN) struggled with how to help as well--whether to become involved or to let Haitians try to find their own solution. Gang wars have escalated in Port au Prince, and the movement of gasoline and food and supplies to much of the country blocked. This means that transportation on our island is minimal now with gas at $45 a gallon and food becoming scarce and very expensive. People who have often not eaten daily in good times are suffering, more children are malnourished, and some are starving.


Thanks to those of you who have given, we have been able to respond to some of the greatest needs by sending funds to the accounts of three trustworthy individuals in Anse a Galets. They then have been able to buy from local merchants and use a well developed system to distribute the food in small quantities as in the photo above.

Though we couldn't travel down with the medical supplies we had planned to bring, some were shipped to Missionary Aviation Fellowship and some of our Global Partners coworkers are planning a way to have several suitcases of supplies and payroll money brought in in the next week.


We have felt so strongly that we cannot just sit by in our plenty and watch while this happens. We know that many of you have felt this way too and are praying with us for the situation to change. In the meantime, we have worked with Global Partners Health Network to set up a simple way to give for those who want to help.


If you do you may use this link and specify for food relief on La Gonave.


We will keep you updated as we stay in touch.

Thank you so much for your continuing prayer.


Marcia and Bob

p.s. We have traveled to and settled in in Kamakwie and will send more news about that soon.

September 19, 2022

Abrupt Shift

Dear Partners,

Today again we mourn with our Haitian brothers and sisters and in an abrupt shift, we’re not on our way to Haiti. While we long to be back there, recent events have forced a delay.


Saturday night we were ready: tickets to Port-au-Prince, passports in hand (that’s a whole other story that some of you are privy to—thank you for your prayers!), the car packed with our four 50.4# suitcases stuffed with medical supplies and gifts for our Haitian friends (Dr. Ferdinand turned 74 years old Saturday!). But with the latest exacerbations in demonstrations over high fuel prices ($20-30/gallon on the black market), and soaring food costs (inflation over 30%) we sent out some last-minute messages to friends on the ground in Haiti to get their advice. Yesterday morning the replies from both North Americans and Haitians were in: Don’t come! Even though the island of La Gonave is calm and we might get there safely, tensions are high as people are hungry and there is no fuel on our island. Lord, have mercy. When will it end for these our friends, our colleagues, our brothers and sisters?


While we have been so privileged to spend the last weeks here in the Midwest with beautiful weather, fruitful gardens and orchards, great biking, and wonderful friends and family, we mourn that so much of the world reels with war and floods and prejudice and injustice. Everywhere is brokenness, loss of relationship with God and with each other. God, while we enjoy your gifts, teach us, your people, how to bring shalom, true flourishing!


If we don’t feel we can safely travel to Haiti very soon we will postpone our travel there and make plans for returning to Sierra Leone. Bob’s Sierra Leone visa needs some work that can hopefully happen quickly so that we might work at Kamakwie Wesleyan Hospital until we can go back to Haiti.


That’s what we know for now. We’ll fill you in with details as we know more. In the meantime, please continue praying for Haiti. Friends in Port-au-Prince and St. Marc report this morning that they are staying in their homes to avoid the violence in the streets. Dr. Ferdinand says that fewer people are coming to hospital because they can’t afford to do so. Pray for our brothers and sisters there, for their safety and that they might “shine like stars in the sky as they hold firmly to the word of life” (Philippians 2:15-16) during a dark time. Pray for the United Nations (the General Assembly meets this week with Haiti apparently early on the agenda), the United States and other invested countries to have wisdom on how to respond. There are no easy answers and we’re sure that any proposed solutions will have lots of pros and cons that will make them difficult to accept and to implement.


To those of you who so faithfully support this ministry with prayer and emails and money and ideas, thank you again and again and again! For those of you who want to support the work or respond in new or different ways to the need, below is an updated giving sheet that explains many ways for you to support the work at La Gonave Wesleyan Hospital and Kamakwie Wesleyan Hospitals and their communities. To address the immediate need that many have for food on La Gonave and to support the hospital there in a time of economic downturn we would suggest the best ways to give at this time would be to our personally directed distribution via our PayPal or Venmo accounts or to Global Partners Health Network Click here and scroll down for giving options.


Waiting, praying and working toward the next steps,

Bob and Marcia

July, 2022

Home, Jetlagged and Excited!

Dear Partners,


At the end of June, when we left Sierra Leone, we experienced one of the most difficult goodbyes we have had to say. Leaving Haiti was hard but necessarily quick. Leaving the Kamakwie staff was slow and hard. Such an appreciative group of people, eager for our (our and your) continued involvement in their work! It means a lot to them to know that people care.


Returning to the US, there have been Global Partners’ meetings and a retreat, family time, and a reunion with our kids near Paul and Claire’s place in Germany to celebrate our anniversary, jet lag X2, and some great discussions about vision and roles.


As we wait for Bob’s passport to be renewed—even expedited is 6-8 weeks--we are praying and recounting God’s incredible care and leading in the past year: healing for Paul and return to family life and the Air Force in Germany for Paul and Claire and Jonah (little Jude is due in September), the prayer and other support of friends and family, the privilege and opportunity of working alongside amazing people in Sierra Leone and Haiti both, and even the gift of pondering uncertainty, wrestling with what loving well (representing you) in two places could look like.


Bob continues to consult in Kamakwie via WhatsApp with Mary, nurse in Pediatrics, and to hold conversations with Edwin in surgery and the National Superintendent of the Sierra Leonean Wesleyan Church, who is the chairman of the hospital board. We again are impressed with the importance and urgency of the care given by these hospitals, in Haiti and in SL, both far from other inpatient medical facilities.


Thanks to many of you, we have been able to continue to send assistance to a few people on La Gonave as we have received requests for help with food insecurity or medical or educational needs. We were also able to share $6000 of gifts with Kamakwie Hospital and a women’s development project in a nearby village. The hospital gratefully sent an accounting of their planned use of it, and we received photos of the women who are attending meetings to organize an initiative for them to increase skills in tailoring and business:

The SL hospital administration sent these plans (which we have encouraged them to proceed with):


A. Renovation:

  1. We plan to replace all twelve wooden windows and four doors with metal materials and glass work on both women's ward rooms.
  2. Fix the damaged ceiling of one of the wards
  3. Repair and replace wall tiles in the ward
  4. Paint the entire interior of the women's wards.

B. Drugs and Medical Supplies

  1. Procure 500 X-RayFilms and 1000 suture materials
  2. Procure drugs.
  3. Procure Lab Reagents

C. Budget Estimates

  1. Replace wooden windows and doors and glass works......NLe13,500 ($975)
  2. Replace ceilings, tiles and interior painting.........NLe12,500 ($900)
  3. Procure 1000 Films and 100 sutures..................NLe16,000 ($1150)
  4. Procure Drugs....................................................NLe 23,000 ($1650)

So, THANK YOU ALL! For caring about our/your Haitian and SL family! And for your prayers. We’re staking our plans on a God who guides.


Gang warfare and violence continue in Port au Prince, but La Gonave and the route to the island remains calm. If this holds, we hope to return there in September for at least a few weeks with a plan for assisting the doctors with their mission and providing connection and support (education, supplies???) in the future.


In October our hope will be to return to SL. Please pray with us for a clearer vision for our role, and a new, on site, skilled hospital administrator. Also for plans for a possible medical team visit in November/connections with specialists with hearts for service in the developing world and teaching medical professionals. If you know some, send them our way!


In both Haiti and SL we pray for a sustainable, ongoing way to support and encourage brothers and sisters, to love them well.

We are here for the next several weeks and would love to see you and get your reaction to our plans! Please call the church for our contact information.


Love,

Marcia and Bob

May 23, 2022

Fayn fayn! Ad ad!

In Krio, one of the many languages spoken here in Kamakwie, one way to add emphasis is to repeat the word.  
 
Fayn Fayn!  Ad ad!  Very beautiful and very hard is how we would describe our time here in this community  and at the Kamakwie Wesleyan Hospital.  We have been surprised at how quickly we have come to love people we work with, and at how critically needed and difficult their work is.  We have learned many things we did not know about peaceful and supportive relationships between Muslims and Christians, and about how many children die of malaria every day.  We have been impressed with the passion and excellence with which many do their jobs and their desire to learn, and dismayed at the meager salaries, staffing and administration problems, and the physical condition of the hospital buildings here.  
 
We knew when we came that three months would not be long enough. Three months is too short a time to understand all the dynamics and certainly too short a time to give much advice.  As in Haiti, our goal has been to come alongside and encourage.  We hoped to grow in understanding enough to connect those with great need with those who have compassion for the poor in a place with few material resources.  So, we’ve prayed and wrestled—in another great place for wrestling with God about our response to a world that groans with illness and death and need.  Kamakwie Hospital has given us heavy hearts, but with great hope for God’s way to come, for things to be made better, for Christ in us to help make all things new!
 
We certainly have been made aware of and have been approached with many needs.  Opportunities for charity/love are everywhere, and so we ask how we can love well.  What is our role in the future here and in Haiti?  How do we look to the needs of others and not only to ourselves?  We can’t tell you how important your support, encouragement and prayers are to us and to our coworkers here and in Haiti.  Knowing you are not alone and that someone is praying is huge.  Every day they literally come to work with the resolve to make a difference and a sense of the importance of the work with little material reward.

 

We have five weeks left here.  When we return to the US, we plan to meet with Global Partners to talk about options for returning to Haiti and/or for returning here.  Feeling a draw to both places now, we are praying and trusting that the way forward will be clear.  We look forward to talking with many of you for you impressions of what we have passed along to you as our partners. 

 

Several of you have asked how you can help the hospital and people here in Sierra Leone, and we would love to be part of an active love project, done in a way that will encourage.  When we’ve asked about their greatest needs, here’s what they’ve said: (Warning: It’s an overwhelming list of pretty basic things!)

  • Fuel for the generator (Repair of the solar system could help.)  We've had no electricity at times and been unable to give oxygen.
  • Funds for medications  Having money for basic medications is an issue monthly.
  • Mattresses and covers for 120 beds including the pediatric ward.  Many that they have are falling apart and unable to be cleaned well, stained with...well, we don't need to go there :-).
  • Lab equipment—Digital Xray machine  This would be a game changer for good X-rays.  (We've asked the government health system to help with this and are waiting a response, but we're not holding our breath.)
  • 4 Computers --for the Finance department, Pharmacy, Lab and Director of Nursing   
  • Repairs for the KVA generator
  • Bulbs for the Operating Room
  • Fencing for the Hospital Compound—300 meter perimeter wall.  With so little control over people and things crossing back and forth from the hospital to the street, this seems like it could be a major help.
  • Training for 10 more staff
  • Solar Battery replacement  (24) within 1½ years
  • Increased funds for the Indigent Fund through Global Partners  (click the link to give)
  • (our addition) a paint job for the whole place!


And, constant prayer for the administration and staff.  For example, Chaplain Michael (pastor of a new local church) is functioning as the temporary administrator, working very hard in a job he's not trained for while continuing in the daily chapels to encourage the staff, both Christian and Muslim, to follow Jesus Christ. And for all of us, discernment about how to come alongside the poor with compassion and respect.

Please let us know if you are feeling nudged to help in any of these things. We're working on specific ways to give financially for these items, but in the meantime you can give support through the link above or giving via our Paypal account (mbvermaire@gmail.com), just like many of you have been doing for Haiti) and letting us know what the gift is for.


And Haiti
We continue to receive news from Haiti about the violence and warfare of the gangs and continued kidnappings in Port au Prince.  Two ministries (we know of) have had their work disrupted and found the people in their areas endangered.  La Gonave remains calm, but there is an ongoing need for food assistance as prices rise and hunger increases.  Please pray for God's mercy!  Meanwhile, the plans and fundraising for renovating and improving the medical work there, spearheaded by World Hope (click the link to give), are pressing on and the actual projects should begin very soon.  Please pray for this to succeed and to be done well.

 

Your faithfulness in Partnership is amazing to us and spurs us on.
Thanking God for you!
Marcia and Bob