Thursday, August 10, 2017

4 Questions to Ask When Choosing How and to Whom to Give


I recently had a family member ask my advice about how to choose an international organization that has children feeding programs. She felt convicted to set up regular giving, but didn’t know how to go about determining which organization was effective. She located one that provided rice to school children in a developing country. One thing I suggested to her is to ask the organization where they purchase the rice. The country where the school children live is a rice-producing country; if the rice is purchased and packaged in the US (possibly first grown in another country before being shipped for distrbution to the US) , then shipped for distribution to the children in the developing country, that may alleviate the child’s hunger, but what about the rice farmers in that child’s community? Is it wise to give away free rice in a country where families depend upon growing and selling it to feed their own families? In the long run, will that create more hungry children? Former President Bill Clinton learned this lesson, and in 2010, he made a public apology to Haitians for his trade policy of 1995 with Haiti. In an effort to help feed hungry people, he forced Haiti to drop tariffs on subsidized US rice, which ultimately put countless Haitian rice farmers out of business.  In his own words, "It may have been good for some of my farmers in Arkansas, but it has not worked. It was a mistake." 

This is just one example of the ways well-intentioned giving can go wrong, but just how does a compassionate person know which international organization to give their hard-earned donations?  Here are 4 questions to ask before partnering with an international aid organization:

1. Does the organization have an ongoing relationship with those “in the trenches”?  (And are the people in the trenches continuing to ask themselves the hard questions?) If significant funds are provided from the US, a high degree of accountability needs to be present. Is there frequent face-to-face contact between those representing the aid organization and those working on the project internationally? 

Example: Actually, this example has occurred in various forms more than once–the following is a hybrid of several conversations I have had. A US friend or acquaintance comes to me and says they have met a Haitian while visiting Haiti, and they have communicated since via phone (or Facebook, or email). The Haitian has a [fill in the blank: children’s home, medical clinic, school] that needs funding. “I feel like I should help them.  Should I send them money?“ they ask me.

There are opportunists and “ne’er-do-wells” all over the world, and Haiti is no exception. I would ask: have you seen the project? How much time have you spent there? Years? Weeks? Days? Hours?  How well do you know the individual in charge? What does the community around this person think of him/her? What is this person’s plan for long-term sustainability of the project? What are this person’s qualifications to run a project like this? If you can’t answer questions like these, it would be better to invest in a ministry run by someone else you know who can vouch for the project with answers to those questions.

2. Has the organization done its homework with the locals?  Before beginning a project, there is significant research to be done in the country to be served.

Example: Someone wants to build a medical clinic in Haiti. Sounds good, right? Have they asked the community if this is something they want? That is a good beginning, for sure. But many organizations stop there. If someone in my US neighborhood asked me if I would like an ice cream shop down the road, would I say yes? I do like ice cream! But what about the city planners? What about other ice cream stores in the area–would this put them out of business? In the medical clinic example, has the organization asked the local leaders? What about the governmental department dedicated to health issues (in Haiti, called MSPP)? Has the organization surveyed the area to determine what other medical services are provided nearby, so as not to duplicate? Are there indigenously-run clinics nearby that could use strengthening, rather than building a new one? We recently had another US organization visit our facility. They had funding and were on the verge of building a brand-new clinic, about 100 yards from ours! Unaware we existed, they began asking locals about nearby facilities. Once they visited ours, they decided to use those funds in another way, that building their clinic would be an unnecessary duplication of services. They did their due diligence.

3. Are the key players in the organization qualified for the project?  Effective international organizations understand that they need to partner with locals, because the underlying culture and specific challenges unique to that country are not readily understood by foreigners, even those foreigners living in that country for years on end. Add to that a foreign aid worker working outside of their scope? A recipe for disaster, for sure.  

Example:  Someone visits Haiti and falls in love with the country and loves the children. After several short-term visits, he/she decides to move to Haiti and open an orphanage, because they love children and want to help Haiti. My questions:  does this person have experience/education in the field of child development? Do they have experience with the business end of running an organization? Has this person become educated on best practices of orphan care? Gone to conferences, read books, met with experts? Have they had discussions with the child welfare department of the country’s government (in Haiti, called IBESR)? Have they asked the child welfare department in that country what their future goals are for orphan care? What uniquely qualifies this person to carry out this ministry appropriately?

Some might feel that questions like these take the “faith” part out of the equation. Having lived in Haiti for almost three years now, and working from afar for the 22 years prior, I can tell you that there is plenty more you will encounter living in a developing country that will test your faith! But developing sub-standards programs because you have not adequately prepared yourself is a disservice to those you intended to serve.

4. Is the organization investing in indigenous people and developing a long-term, sustainable plan?  Does the ministry provide training as needed, and have a plan over time to turn more and more over to locals? Does the mission continue in the absence of US players on the ground, or are the doors open only when there are foreigners present? Is the organization focused on empowerment or dependence? If the foreign aid workers could never return to that country, would the ministry continue or close its doors? 

These four questions are merely a starting point; different areas of ministry have their unique nuances, and answers to the questions above must be combined with knowledge of the particulars for that situation. And for sure, with God, all things are possible! Sometimes God calls us to do things that defy logic because He is in charge, and He knows way beyond what our minds can even comprehend. With each of these questions, as a Christian, we must bathe it all in prayer and look to our Maker for guidance!

Every day that we live in Haiti we learn new things. Every day. Many of the new things are culturally related; we could live the rest of our lives here and still learn new things about the culture each day. But we also learn new and better ways to appropriately and effectively serve God and the people of Haiti. If I had written this blog post 2 years ago, it would have looked different. If I write a similar blog post in another 2 years, I will have learned more, and have new insights. We are all on a journey of discovery, of learning who we are in God’s kingdom, and of how best to serve our Maker. This post is my best attempt to share, out of love, lessons we have learned thus far in our journey, about serving abroad in His name. I pray that as each of us learn more and more about how God wants to use us for His glory, that we give each other grace to learn and grow in Him.

Saturday, July 8, 2017

When You're Short on Jelly Beans


“When did you know you would just love living in Haiti?”  I get questions like this from time to time.  I am never sure how to answer.  Do I love living in Haiti?  The answer is more complicated than it would seem at first glance.  Knowing you are where God has called you is huge, and there is a feeling of dependence upon Him and closeness to Him that is unlike any other feeling.  And Haiti is truly a beautiful country, with oceans and mountains and pine forests, and is culturally rich.  And we have many close relationships here in Haiti, both with Haitians and foreigners living in Haiti.

But there are many challenges living here.  Every day, I deeply miss our family and friends in the US.  The depth of need here and our ability to address only a fraction of it often is overwhelming.  Navigating in another language and a foreign-to-me culture each day is often tiring.  So can I say I love living here?  I love parts of it, and other parts of it stretch me and grow me like nothing else can, which is good, and God is using that, but there are days that are difficult, to be sure.

Being stretched like this is not unique to living in Haiti, or living in other countries.  And even if you never leave the US, life throws so many things our way that challenge and grow our souls, things like chronic illnesses, caring for aging parents, broken relationships, and so many other things.  I had a delightful conversation with our daughter one time when she told me about a friend’s analogy when talking about emotional reserves.  She explained that each day, it’s like you start with a jar full of jelly beans.  As the day proceeds, there are events that take away jelly beans, such as being yelled at by your boss or getting a speeding ticket, and things that put jelly beans back in your jar, such as a compliment or a lunch with your best friend.  In seasons of life that are challenging, your jelly bean jar is only half-full to begin with each day. 

One night, when I couldn’t sleep (it was SO hot!), God and I had a little visit, and we came up with a checklist to give me extra jelly beans that I now consult each week.  It is crazy to me that at 56 years old, God is still teaching me so many things about myself!  I know that when the going gets tough, it is all the more important to draw close to the Lord, and spend time with Him and pray.  But there are other things I also need to make sure are in place to thrive in this new station of my life that can leave my emotional reserves shallow.  So here is my jelly bean list:

1.  Stay Connected in a heart-way
FaceTime with our granddaughter (isn't she cute?!)
Living in Haiti, it is often difficult to move about the country due to security issues, traffic, time constraints, etc.  I often work in our home by myself, as accounting (which is the work that requires the bulk of my time) is a one-man-show.  At the hospital, I enjoy deepening relationships with our Haitian staff, but developing new relationships requires much time, and add to that doing it in another language and culture, it can use a lot of jelly beans!  In any station in life, engaging regularly with those people who love you warts and all yields many jelly beans.  God has created us to be relational people!  You need time with those who already know and love you anyway, and can speak into your heart. Here are some ways to make sure you nurture the human relationship part of your soul:
  • Schedule time regularly when you can connect heart-to-heart with those who you are most deeply connected - a best friend, grown child, mother, etc to share your heart and to hear theirs.  For me, this takes place in the form of Sunday afternoon Facetime chats with my kids, or a face-to-face visit with an old friend who also lives in Haiti.  It is good and necessary to develop new relationships where you (for me, Haitians), but it also can be hard work, at least in the early stages of a relationship, especially if you are navigating in a different language, culture, economic background, or with those in your life who require more emotional energy – you also need times of low-stress/high-connection fellowship.
  • Reserve time for those on your “A list” first.  When I am back in the US, I reserve time with family and close friends before other commitments; any time I don’t have set aside often gets consumed by something else. 
  • Identify stumbling blocks to connectedness in your current situations, and make a plan to progress to more connections.  For me, living in another country, I make a concerted effort to continue to learn Haitian kreyòl and new things about Haitian culture, so developing deeper friendships with nationals becomes more natural and can move from jelly bean stealers to jelly bean contributors.  For you, it may be finding a sitter for the kids, developing that special friendship, or saying “no” to something to find time to say “yes” to a friend date.

 2.  Find Meaningful Work
Hearing screenings at a local school
Many missionaries end up doing all kinds of things they never anticipated, and many of those things are not necessarily what they feel competent doing or are very “glamourous” kinds of work.  This is true in so many areas of life, such as changing dirty diapers, grocery shopping, managing the checkbook of your aging parent.  So:
  •           Find time each week to engage in work you are passionate about and feel competent doing.  For me, that is speech therapy.  Even though I only do this a few hours a week, it energizes, renews my spirit, and puts jelly beans in my jar.
  •           For those necesssary tasks that are NOT so exciting and fulfilling, remind yourself to acknowledge the quality work you do.  For me, this is bookkeeping/accounting; for you, it could be the mundane parts of caring for a family member, or paperwork, or listening tirelessly to a friend in need, but give yourself credit for a job well done.
  •           When there is work that needs to be done that is beyond your scope, give yourself freedom to farm it out.  That could be hiring someone to do it, taking an acquaintance to lunch and glean from their experience, or finding a friend or family member to help.  For example, I am good at detail-level acounting, but setting up whole big-picture systems is not something I do well.  I need to call in backup for times like that.  Learn how God has gifted you and step into that role, and understand you need to rely on another part of the body of Christ.
  •           Remind yourself not to take on the stress of those areas God is not calling you to.  Acknowledge those assignments you can be responsible for, and those you cannot.  For example, my husband is on the management team at the hospital; I am not.  I need to remind myself that worrying about an upcoming issue the management team needs to solve will not help solve it – I can, however, pray about it and listen and encourage my husband as he plans for these things.

 3.  Allow for Rest and “Margin”
Afternoon of relaxin'
When your plate is full and it seems that there are always more demands, sometimes it feels like   There are times in our lives when we can “sprint” for a time, but on an ongoing basis, we need to acknowledge that life is a “marathon”, and we need times of rest and renewal to be able to continue doing the work the Lord has called us to.
working around the clock is the only solution.
  •            Begin the day with prayer, and let God help you order your day.  Soak in the Lord with Bible reading and prayer, and then ask the Lord which things He would have you do that day – it doesn’t all need to be done that day.  I have found a physical location to have devotions, not a place I normally work (there is one particular chair in our house with a view of trees and plants outside, or when at the clinic, I sneak away into a quiet and cool room).
  •            Have regular Sabbath time.  I used to get frustrated when older ladies in the church would talk about this when I was raising my young kids.  If I take a day off, who will take care of my kids?  What mother can have a whole Sabbath?  I think the important thing is to find regular time to rest.  This may be Sundays, it may be a different day of the week, it may be a quiet hour each night after the kids have gone to bed.  We found ourselves working 10-14 hour days, 6 ½ to 7 days a week.  Now, I try diligently to take off every Sunday whenever possible – I read the Bible, watch a movie, read a book, take a walk, talk to my special people on the phone, activities to re-fill my jelly bean jar.  We also set a time each evening to quit working.  Whatever we didn’t get to that evening can wait until the next day.  …and I have made a decision to actually take the vacation time alotted to us.  Jesus found times of rest, do I think I can do without if He needed it?
  •           During times of high demands, find a few moments to decompress.  When we host groups, I try to find a time to sneak away and have a phone call with a friend, have private devotions, or just have a few moments alone to decompress.  We enjoy hosting groups, but it also is a time when we are “on” every waking moment.  For anyone short on jelly beans, sneaking away even just for a moment to decompress can go a long way. 
  •            Cancel other obligations to have a “catch-up day” when necessary.  When I get behind, I try to cancel whatever necessary to make time to get caught up rather than staying behind for long periods of time.  For me, this is one of my biggest stressors – having a long list of tasks expected of me, and not being able to meet those expectations.
  •            When there are demands placed on you that you feel you can’t manage well, brainstorm solutions.  When I am faced with a difficult set of circumstances, I talk it out with a close friend or my husband and pray together to brainstorm ways to manage the situation.
  •            Exercise.  I know, I know, we all know this is good for us and good for managing stress, but some of us are better at being disciplined about this.  My husband is great at this; me, not so much.  So I try to exercise most days, even if it is just 15 minutes of stretching and light exercise.  Having a short time of exercise is better than none, and takes the pressure off of feeling a need for a long, organized workout.
  •            Listen to music to be inspired and worship, and dance J

 I don’t always adhere to these ideas as closely as I would like, and life often gets in the way and some things fall by the wayside.  But when I begin to feel my jelly bean jar getting close to the empty mark, I re-read my list, pray and regroup.  When I look at the way Jesus lived his days on this earth, I see evidence of Him staying connected to others important to Him, investing in meaningful work (obviously!), and allowing time for rest.  I understand that different seasons of life bring different challenges, and what may work in one season may not work in another.  Each person’s jelly bean jar will be filled in different ways, but I hope this can inspire you to find ways to fill your own jar!

Sunday, May 21, 2017

The Greatest Payment


Quite frequently, fellow missionaries here in Haiti send patients to us for consultation.  The problems can be anything from a severe rash to massive pathology to unexplained illnesses.  Sometimes we can offer help and other times, there is nothing that can be done in this country. 

Last week, another such patient was sent our way from the mountains about 6 hours away from our hospital.  The thin 63-year-old lady, whom we will call “Wislande” (not her real name), came with her daughter, and was holding a small handkerchief in one hand and a Bible in the other.  She had a slightly tattered blue dress, a head scarf , and dusty black, ill-fitting shoes.  “I am the one who Madam Gail sent,” she said in Kreyòl.  As I was busy doing about a thousand things, I rushed by and asked her to wait, to which she patiently obliged, and sat on a cement step. 

After about half an hour, I returned to her on the step outside the clinic and said “Ok, let’s take a look at what you have.”  She opened her mouth and revealed a mass covering her left jaw, a little smaller than a tennis ball. She stated that she was having problems eating and was losing weight.  I again asked her to wait as I wanted to get her inside to do a better exam, but was fully expecting not to be able to do much to help.  Wislande obediently waited and eventually I escorted her and her daughter into an exam area and discovered that maybe, just maybe, this could be something that could be removed somewhat uneventfully.  I explained the risks, and asked if she would like for me to attempt to remove this mass.  She kindly said that she was fine with that, probably because there were not really other choices.  So, I recruited my faithful assistant, Kathy, who squeamishly agreed to help, and we set up an OR. 

The entire time we set up the room, Wislande was praying for us and for healing, and would occasionally break into a soft song.  Finally we were set up, we all prayed together, and then began the surgery.  Thankfully all went well and after about an hour or so, we were finished.  At that point, we assisted her to sit up and with no prompting, she began to “pay us” for our help.  She gave both Kathy and I hugs.  Not the kind of hugs guys give to each other with a slight pat on the back, but the kind of hugs that let you know that you are having your very soul embraced.  She then began praising the Lord for His goodness and asked for blessings for us.  As if this was not enough, she reached in her pocket and gave us all that she had:  150 gde (about $2.30 US).  I told her to keep it but she insisted. “Please! Please!” she said.  So reluctantly, we took the money (which we gave to the hospital), and she and her daughter walked away, to catch a tap-tap back to the mountains, some 6 hours away. 

Over the years of practicing in the US and working in Haiti, some days just stand out and some patients just stand out.  This was one of them.  I have never been paid so much for any procedure as I was that day.  I left the hospital richer after seeing Wislande because I had been paid with a touch of Christ.  That day I saw Him in the form of a small, blue-dressed lady from the mountains who was a giant in spirit, who paid me far more than any procedure is worth. 

Saturday, April 15, 2017

The Family of God


It was the last day of February when we got the news from our friend, Wisnel, that his 18 year old son, Anderson, had been injured in an accident upon leaving church.  Immediately after the accident occurred, Pastor Jean Marie was nearby, and offered both his vehicle and all the money in his pockets to assure that Anderson was transported to a trauma center in Port au Prince.  After a few weeks in the ICU with Wisnel sleeping on the ground outside of the hospital at night, both the money and the ability to effectively treat Anderson were in question.  Wisnel approached me and asked if I would be willing to transport Anderson back to the family’s house in St Ard to see if he could recover.  I had so many questions.  Is he able to travel? How can he be cared for at home with no electricity, running water or 24 hour care? How can he be fed?  With Wisnel tearfully asking, I agreed to make the journey to the hospital to stuff Anderson in the back seat of our vehicle for what would certainly be his final journey home.  Wisnel assured me that he would arrange everything so that Anderson would be ready to go when I arrived at the hospital in Port au Prince. 

Mark visiting Anderson with Nurse Jen
I set out early the next morning, picking up Wisnel (armed with several pillows and blankets) and his cousin en route.  When we arrived at the hospital, I was allowed into the ICU and found Anderson on oxygen, with IV’s, a catheter, a tube from his mouth to his stomach for feeding, and a tube in his nose to assist with breathing if necessary.  Several medicines were being given to him through his tubes, as he remained unresponsive from (what I soon found out) his subarachnoid brain hemorrhage.  The ICU doctor was visiting from the University of Chicago and we began the conversation to turn Anderson over to our care.  The experienced US physician said that if I could ascertain that Anderson could survive on room air, then I could feel free to transport, as there really was not much else that could be done for him, other than to wait and see IF he might recover.  He gave me carte blanche to see what I could do.  As I weaned Anderson from his oxygen, checking his oxygen levels (O2 sat) he seemed to be maintaining well.  So after several hours, with all of his other “tubes and bags” in tow, we squished him and two others in my back seat to help hold his unconscious, limp body, while his dad and I manned the front seat.  Arriving at his house in St Ard after a couple of stops to help clear his airway, we were greeted by several members of the church, several extended family members and his siblings.  We carried him on a small mat, several yards down a dirt path, followed by several ladies from the church waving their arms and singing “What a Friend We Have in Jesus”.  We placed him on his bed, positioned his tubes, wrote a list of what was needed from our hospital to continue his care, had a rich prayer and petition time on Anderson’s behalf, and sent me on my way.

Family and friends frequently provide food
During the weeks following this scene, a family friend, who is an LPN equivalent, moved into the modest home and has rarely left Anderson’s side.  The church, his family and the community has provided meals, laundry, and an unbelievable amount of support for Anderson and his entire family.  The powerful prayers, songs and love shown to him, is only trumped by his mother telling me often how powerful Anderson’s testimony will be when he recovers.  At the writing of this blog, Anderson is still non-verbal, slowly gaining some responsiveness,  has no “tubes” and shows improved movement of all of his limbs.  His eyes flash open but do not react normally to light.  His arms and legs move uncoordinatedly.  He is still with us!!

I don’t know the final chapter to this story but I do know that these interim chapters have been incredible. To see the community respond at this level around a family in need is something that is rare in the US.  To see the hope that buoys the family given by the church has been incredibly touching.  To hear the songs, to feel the prayers, to know the love around Anderson has buoyed my soul as well.  As God continues to write the story of Anderson, I anxiously await what comes next.