We hosted our first visitor! Dr. Scott, our beloved CMO from Hôpital Adventiste d’Haïti, came to visit us for a few days. It was SO nice to catch up, swap stories, receive much-needed advice, and spent precious time with a fellow missionary! This has been something we’ve really missed being here. We have made really good friends here, but there’s a special bond that is formed when serving as like-minded missionaries together, especially in a place like Haiti. We miss our whole HAH family…
Scott came at a perfect time. He has a gift for construction work and we are in the middle of renovating our imaging department. In just a few days, he was able to help us make some key decisions that will make a big difference in the future flow of the imaging department and beyond.
Though his visit was short, it was a big boost for our morale, our physical health (we went on a couple morning runs), and our spiritual health. It was a nice reminder of how we are not alone on this journey towards eternity. God has blessed us with the gift of companionship and we are so grateful for this taste of heaven on earth.
Over the last few months, we have been working with the administration here to come up with a building master plan for the hospital and we are starting the first part of Phase 1 which is the renovation of the current imaging center. By God’s grace, the hospital has received a number of very generous donations which cover a new CT scanner and a mammogram machine. These new machines alongside the current digital X-ray and ultrasound machine will allow for this imaging center to be among the best in the country and provide a much needed service for this community. This will be a huge boost for the hospital and begin to relieve years of financial struggle.
The proposed exterior view for Phase 1 shows the new aesthetic for an existing building which includes outpatient, imaging and administration, which will be done at a later time.
The images below show what we are proposing for the imaging center which is the first part of Phase
Our timeline for construction is very tight. We need to have most renovations complete before the CT machine arrives in about a month. Our budget for this renovation is $120,000. By God’s grace, we have raised $57,000 in donations to start the project, but we would need to raise the remaining $63,000 to complete the project. Any contributions would be immensely helpful in bringing this project to completion. Since we moved here to Belize we’ve witnessed how God has been generously providing for the needs of the hospital and we are excited to see how He will transform this hospital’s physical structure and beyond.
Donations can be made via Adventist Health International at https://ahiglobal.org/donate. When you donate online, click on the dropdown menu and select “Other (please specify project in special instructions)”, then on the next page, you can put “Belize Building Project” in the special instructions. After you make your donation, please send us an email at michellejeffcho@gmail.com and we will follow up with AHI to make sure it gets to the right place.
We are so grateful to those who have supported us in this project and others thus far. It is such an incredible experience getting to witness the amazing generosity of our family and friends – something we would never know firsthand if we weren’t here. Our hope and prayer is that this imaging center may be a blessing to our community and the people of Belize. And our ultimate goal is that this imaging center will be a center of influence that will point people to Christ and help us all get ready for His soon return!
I longed for Jesus to be in our Emergency Room this morning while we coded a 16 year old boy for over an hour. I know He was there because He promised that He would be (Matthew 28:20). But I wanted Him there physically, so death would flee from His Presence!
I was about to round on a patient when I heard honking and my patient said “You have an emergency, doc, go!” He knew what was happening before I did. Next thing I know, family members are dragging a limp body out of a car and carrying him into the hospital. He had a significant cardiac history – congenital heart disease diagnosed just a few years ago and he was on “the list” for surgery, but he was being medically managed for the time being. He had collapsed at home just minutes before and his family brought him to our hospital right away. He was completely unresponsive and didn’t have a pulse, so we started CPR in an empty patient room, then quickly relocated to the Emergency Room. We gave emergency medications and we put him on the monitor to see what his heart rhythm was. It showed a condition called “sinus bradycardia” which means that his heart rate was too slow. We gave multiple doses of atropine, but he did not respond. I looked around for the defibrillator. It was close by! Relieved, I studied the buttons to find the transcutaneous pacing option, which could potentially help us get his heart rate up by providing an electrical signal through the skin of his chest to his heart. But I couldn’t find it! Where was it? I asked if we had any other defibrillators. Yes, in the OR. Bring it! It was the exact same model we had in the ER. Any other defibrillators? None that we could find. The reality of practicing in a lower middle income country was starting to hit me. Up to this point, I had run into a lot of differences between practicing in the US and practicing in Belize, but not during such a critical moment. I called the private ambulance company – do they have a machine capable of transcutaneous pacing? No! They are hoping to have one soon, but not yet. The government hospitals don’t have one either. I was shocked. In my naiveté, I thought all defibrillators came with the ability to pace through the skin – but I was wrong. We moved on to the next option in the algorithm – dopamine drip. But after over an hour of trying to resuscitate the young man, we declared him deceased after all our efforts did not improve his condition. During the code, I was praying in my head – please, Lord, a miracle! Only You can save him! Resurrect him! He’s so young – he’s got his whole life ahead of him. It’s always hard to lose a patient, but especially when they are young. And even more so when things could have been different if they had been in a different country with a more advanced healthcare system.
Our current defibrillator
Life is fragile. We are not guaranteed tomorrow. Just the day before, this young man had been hanging out with his family and friends, just like normal. And then this morning, he was gone. This experience was a sobering reminder that we are living in a war – the Great Controversy – and we never know when our time will come. But by God’s grace, we can know the Resurrection and the Life and there is a time coming when “God will wipe away every tear from [our] eyes; there shall be no more death, nor sorrow, nor crying. There shall be no more pain, for the former things have passed away. (Revelation 21:4). I am looking forward to that day! I have recently started reading a book called “The Way” by Pastor Don MacLafferty and towards the beginning of the book, he wrote a section called “Discover how you can BE SURE of your salvation”. I encourage you to read it and hide these verses in your heart as you get to know Jesus, the Source of life.
This experience has also made me realize that the equipment we have available can make a life or death difference. I am not sure if a transcutaneous pacer would have saved this boy’s life, but I do not want to see another precious soul pass prematurely to the grave because we do not have this technology readily available. I am not sure when or how, but I am sure the Lord will provide a way!
One of the great privileges of being a missionary overseas is getting to witness the incredible generosity of our friends and family and see what kind of impact it has on the front lines. At this time, La Loma Luz Adventist Hospital is operating on miracles. Payday after payday comes and there is not enough money in the bank, but somehow our staff get paid. On one occasion, it was an overdue payment from the government. On another, a special arrangement with the bank. On another, an exceptionally productive day right before payday. One way or another, God works out a way for us to keep our doors open. He wants His light on the hill to keep shining.
One of my favorite things about serving at La Loma Luz Adventist Hospital is getting to pray with the leadership after staff worship Monday through Friday. It’s a precious time we get to come together, humble ourselves before God as a team and seek His will and blessing. We start by reading a short passage from “Medical Ministry” by Ellen White and then we enter the throne room of God together. It is here that I get to hear about many of the miracles that God is performing to keep this place going. After one of these prayer meetings, we were talking about our plans to upgrade our imaging department. At this point, it is impossible for us to do this on our own. We are entirely dependent on help from our brothers and sisters around the world to achieve this dream. And God has been pouring His blessings on our hospital already. A very generous donation was able to cover the cost of a portable digital X-ray machine from Giving Tree Medical. If any medical missionaries are reading this and you need an X-ray machine like this, I would be happy to connect you with Giving Tree. They are a Christ-centered organization dedicated to sourcing medical equipment that strike a good balance between quality and cost and can withstand the above average wear-and-tear often experienced at mission hospitals. One of the amazing things about this X-ray machine setup is that we were able to take back to Belize with us on the plane, so we were able to save on shipping costs and time. By God’s grace, we are not required to pay duty on it, but we still had to pay taxes, which were quite substantial and something we had not budgeted for. But while I was on my way to pick up the X-ray machine from the GHI office, I received a notification from another friend who said he and his wife had just made a donation to us that covered a bulk of the taxes we needed to pay! This was actually their second time donating to us while we were in Belize. Their other gift helped cover the bulk of a costly tractor repair that is essential for keeping our expansive hospital grounds looking beautiful.
Our current traditional X-ray machine
Our current film developer
Yet another blessing came from Loma Linda University Health (LLUH). The most profitable department of our hospital currently is our surgical department. However, we only have 1 working anesthesia machine. It is an old machine and if it breaks down, that would be catastrophic for our hospital in more ways than one. We received a quote for a machine for $9800, which was pricier than we had hoped. We reached out to GHI at Loma Linda who connected us with the anesthesia and biomedical services department at LLUH. Not only did they say they happened to have 3 good quality anesthesia machines that were being phased out, but they went the extra mile to include patient monitors and are trying to even include sevoflurane vaporizers with the machines so that we can give the safest anesthesia possible to our patients! We only have 2 OR’s, so the third machine will be heading to another mission hospital that needs it.
Our hospital’s only functioning anesthesia machine
The list of blessings goes on and on…we were able to remodel our house through an unparalleled show of support from AHI/GHI, made possible by a LLU School of Medicine Class of 1950 fund designated for DMA housing. Another couple of dear friends donated $20,000 to use for equipment and projects. Our families have been extremely supportive and we are especially grateful for Michelle’s parents who have gone above and beyond for us on too many occasions to count.
Back to our discussion after a morning prayer meeting – we were discussing the needs in our imaging department and there are two major pieces that are still missing: a CT scanner and a mammogram machine. We actually have both machines – previous donations, but the CT scanner has not been functional for many years and the mammogram has never worked. I believe this is actually the third donated mammogram that has not worked. We have gathered quotes for both: a CT scanner will cost ~$200,000 to be tested, crated, packed, shipped, and installed with a budget set aside for taxes and maintenance costs; and a mammogram machine will cost $40,000. A mission organization with close ties to the hospital has already pledged $100,000 for the CT scanner. But we are not sure where the rest of the funds will come from. We talked about applying for a loan to purchase equipment, but with all the blessings that I mentioned earlier in mind, I said, “I don’t think we need to take out a loan. I think we could get these through donations!” Then I heard our CFO say quietly, “…by God’s grace” and I was instantly reminded that these generous donations and the ones to come do not come to us by any merit of our own. We cannot take credit for them at all and there is no guarantee that they will continue to come. But by God’s grace and mercy, I…[unfinished post]
I wrote the above post yesterday, planning on posting on #GivingTuesday in hopes of raising funds for the CT scanner and mammogram. But I didn’t get around to finishing it. But today, we were informed that funds for BOTH machines have been pledged already by 2 different mission organizations!!! I am blown away by God’s grace. I am reminded of Psalm 81:10 “Open your mouth wide, and I will fill it” and that God owns the cattle on a thousand hills! I am overflowing with gratitude and filled with.a longing to get to know this God who sees the situation we’re in and is blessing exceedingly abundantly above what I ask or think! I knew He would take care of us, but I was prepared to make compromises on the specs of the machines we were considering. I did not expect to see this need filled so quickly and so abundantly! And I did nothing to raise these funds at all! It was all Him – working on the hearts and minds of people and organizations dedicated to furthering His healing ministry. To God be the glory!
My prayer now is that our imaging center, officially named the Sylvan N. Roberts, Jr. Memorial Imaging Centre, may help the light on this hill shine brighter than ever before. We have been blessed by so many marvelous gifts and we know that God blesses us to be a blessing, so I pray that this imaging center can serve this community in a mighty way and that God uses it to draw people to Him. God’s hand here is so evident and it is SO exciting to be a part of His work! If you would like to get involved in any way, please don’t hesitate to reach out – we would love to hear from you and explore how you could join us in this amazing journey!
Our family in front of La Loma Luz Adventist Hospital
As a missionary visiting or moving to an underserved country, you brace yourself for the physical discomforts and challenges. The heat, the humidity, the insects biting and crawling on you day and night, the mold, the makeshift construction and so on. That said, our home at La Loma Luz Hospital is in better shape than most mission accommodations that we’ve seen, but it takes a couple days to weeks to adjust to any new setting.
The past month and a half transition to Belize has been surprisingly more difficult than our transition to Haiti. In Haiti we had instant community with our fellow expat missionaries and we were spoiled with shared amenities that made the adjustment much smoother. This was not the case in Belize. Our challenges and frustrations of every day living wore down on us and seemed to be magnified with having two young children. We have been waiting for Jeff’s work permit to be processed so a sense of purpose toward the hospital hasn’t been realized yet. We have a lot of free time to spend as a family at home but without a car or reliable appliances our patience was tested. However, after a month and half, we’ve experienced an outpouring of blessings just within a few days.
On Monday, we got a microwave—secondhand and it works! It’s something small but a convenience we greatly appreciate. We were also introduced to a nice lady who could help us clean and cook a couple times a week. This has brought so much more order to our home and handmade tortillas!
On Tuesday, Selah started sleeping through the night again after a rough two week sleep regression. We are so grateful that everyone is sleeping well again.
On Wednesday, we were able to have a long anticipated meeting with the leaders of the Belize Union. The leaders also brought a sweet gift from a stateside loved one that warmed our hearts. Later that afternoon, we finally purchased a car! For a month we checked Facebook marketplace almost every day, we asked locals to take us to look at cars, and experienced multiple disappointments. When we surrendered our problem to the Lord, He provided a car that a hospital employee was selling. It’s been a big blessing and relief to have some independence again.
On Thursday, Jeff had his long awaited work permit interview, which is one of the finals steps before he is able to work in Belize. Later that day we replaced our second-hand washer and dryer that broke down on multiple occasions and flooded our room. We also replaced our fridge that wasn’t cold enough to freeze food or keep food from spoiling. The washer, dryer and refrigerator was kindly donated to us through a fund via Adventist Health International.
On Friday we settled in and enjoyed all our new blessings.
It’s been overwhelming witnessing how God provided so much for us within a week. We are grateful for His provision and His care for the little things. We are still reminded every night through our girl’s lullaby that God will take care of us.
No matter what may be the test, God will take care of you. Lean weary one upon His breast, God will take care of you…
And some updates through photos…
Digging a banana circlePlanting fruit treesEnjoying Belize’s Independence DayWater playHappy SelahEden holding a butterfly at a butterfly farm.Selah and EdenOur long awaited vehicleOur homeThe girls hammock every day together
“Jeff, get up!” I woke up with a start. I had just closed my eyes for a moment on the couch at around 1:30am. Our flight was scheduled to leave at LAX and we had a ride to the airport arranged to pick us up at 2am. I looked up to see Michelle and her mom looking at me from upstairs. I looked at my watch…2:30am. With a sinking feeling, I looked at my phone. and saw missed texts, calls, and voicemail from our driver. Oh no…I had inadvertently slept in. And there was so much to do! Michelle’s alarm unknowingly had been on silent. If it hadn’t been for Michelle’s mom, we would have missed our flight. We hurriedly packed the van waiting outside, installed carseats, transferred the sleeping girls, said our hasty goodbye’s and rushed to the airport. Thankfully, there was no traffic in the middle of the night and we made it in good time. We weren’t able to check in online completely due to traveling with a lap child and none of our seats were together. We also were bringing one extra bag. The United Airlines employee at the check in kiosk was super accommodating and helped us check in all our bags, somehow gave us a discount on our extra bag, and when we got to the gate, they were able to get all our seats together. One thing after another, we saw so many pieces of evidence that we were under the loving watchcare of our Father. Our flight was delayed for ~45 minutes. Our layover was only 47 minutes. But we made up the time in the air and were able to make it to our connecting flight. The girls napped well on the flight and on our second flight, Michelle and Selah had the row to herself so Eden and I were able to join them. Our flights had been booked less than a week prior, so we weren’t able to select adjoining seats. But despite that and arriving later than expected to the airport, we were able to travel together as a family – we didn’t take it for granted.
We arrived safely in Belize and we were picked up by the CEO of La Loma Luz Adventist Hospital. Despite all the twists and turns regarding my position in Belize, we were staying on the hospital campus while working on my medical licensure and work permit. The initial plan was for me to fly down by myself for the medical license interview, but after further discussions, it was decided that it would be better for us to move down with the whole family so I could be more available for any in person requirements that came up. We were given the green light to buy our flight tickets 5 days before our moving day, which is not the way I prefer to travel, but these days I am learning to be more flexible.
Arriving in Belize, I can’t help but compare it to our experience in Haiti. We weren’t crowded by people trying to help us with our bags in the airport. Instead, one man transferred our suitcases from our carts to his dolly and wheeled them outside before we were even cleared by customs. The ride from the airport to the hospital took a little less than 2 hours on a smoothly paved highway rather than a bumpy mountain road and I experienced less anxiety (except when passing other cars). I wasn’t worried about getting kidnapped or getting caught in gang crossfire. We have the luxury of roaming around town at relative ease. The house we are staying at is double the size of our 800 square foot home in Haiti. It has its quirks, but overall, it is pleasant: running water, hot water, relatively stable electricity, the potential for good internet access. There is no AC, which is hard to get used to, but it cools down in the evenings. But there are 2 things that I have been missing here: community and mission. In Haiti, we had an incredible expat family. I think of them often here and wish they could be here with us. I’m sure we’ll build relationships here as well over time, but during these initial days, I have found myself longing for familiarity. The same goes for mission. In Haiti, the intensity of need is on a different level and correspondingly, the sense of purpose was clearer. I know there is a mission here for us. We’re not sure exactly what it looks like, but the fact that we’ve made it here is evidence that the Lord has something for us to do here. I’m looking forward to seeing where God is working and joining Him with our family.
At Belize City airport making our way through customs Eden, loving on our neighbor’s kitten Visiting the Macal River, just 5 minutes away.
It has been almost a year since Michelle, Eden and Selah were last in Haiti. After deciding not to return to Haiti for the time being, I wasn’t sure what to do. We were able to find a 6-month housing lease, which gave us some breathing room to figure things out. I wasn’t ready to leave Haiti and I felt discouraged, confused, and lost. I was sure the God had led us to Haiti, so why were we back in Loma Linda? I felt like we were just getting started and momentum had been building – I loved being in Haiti despite the challenges. I wasn’t ready to let go. I wanted to go back. But because of the rising insecurity, Michelle and I did not believe that this was the right time for our family to return – so what should we do in the meantime? Should we stay in the US or serve at another mission hospital? Our fellow missionaries encouraged us to serve at another site overseas and as we started discussions about the potential options, the possibilities that kept popping up seemed endless: Trinidad, Liberia, Malawi, Nepal, England, Guam, Rwanda, Belize, Guyana, Chad – some options were more realistic than others, but I was getting overwhelmed by the number of choices that seemed to increase every week. Then it was proposed that we stay in the same Division as Haiti (the Inter-American Division – see map below), which would facilitate a quicker transfer and keep open the possibility of potentially transferring back to Haiti once the instability improved.
Staying in the IAD narrowed down the possibilities, but there were still several options on the table: Mexico, Curacao, Aruba, as well as Trinidad, Belize, and Guyana mentioned before. Should we just stay in the US and go back to Haiti? After several weeks of discussion, La Loma Luz Adventist Hospital, a 9-bed hospital in Belize, rose to the top of the list and we decided to visit at the end of February to check it out. The first few days of our 5-day trip to Belize, I found myself missing Haiti even more. Our experience in Belize was really nice – was it too nice? In Haiti, the needs were obvious – less so in Belize. Belize is a popular tourist destination and for good reason – the people are warm and friendly, the landscape is lush and beautiful, the opportunities for adventure and exploring are endless – was this the place that the Lord was leading us to serve? 4 days into our trip, Michelle and I weren’t sure. The day before we left, we had to get our COVID tests. The CEO of the hospital had been the one taking us everywhere during our trip, but since it was a Monday, he was very busy, so the maintenance manager offered to take us instead. We ended up spending the entire afternoon and evening together, checking out local stores, visiting his house and garden in the beautiful countryside, crossing a river on a hand crank ferry and we were able to learn more about the history of the hospital from someone who had been there for ~30 years and served under 7 different administrators. It was during this conversation that Michelle and I both felt that there was a mission here at La Loma Luz Adventist Hospital that God was calling us to be a part of.
The next morning, I asked the Lord for a sign confirming that this was the direction he was leading. I wanted confirmation from His Word that He wanted us to be at La Loma Luz, (“Light on the Hill” in Spanish). I was reading through Ellen White’s book, Patriarchs and Prophets, which is an incredible commentary of the Old Testament from Genesis to the end of King David’s reign. I was on chapter 32, entitled, “The Law and the Covenants”, which didn’t seem like a very promising chapter in terms of providing guidance for our present situation. But as I read, I came across the following paragraph:
La Loma Luz! It was clear enough for us. We let the hospital and our church know that we believed that the Lord was telling us to move forward and over the next few months, the transfer process took place.
But it was not a smooth road. One of the major issues we ran into was the lack of a budget. In order for us to serve at La Loma Luz, the hospital needed to be able to support my local salary, but unfortunately, this was not possible. The lack of a budget is usually a hard stop. But to my amazement, within a month, I was informed that the local salary was going to be taken care of, so that barrier evaporated before us.
Then in mid-May, 2 weeks before our 6-month housing lease was supposed to end, we were told that we were not able to go to La Loma Luz because of some administrative details that made it impossible to allocate a budget to the hospital. The following week, we were told that the administrative details were being taken care of by the Inter-American Division leadership – thank you Jesus! Then 2 weeks later, we were told that we couldn’t go after all despite their efforts. And the day after that, we were told that the door was not completely closed and that we should wait to hear back after the General Conference session June 6-11. So that’s where we are now. Waiting. I know God is trying to teach us something. I hope we learn it soon.
Through it all, we have had ample evidence of God’s loving care. Our lease was supposed to end May 31st. But our landlord graciously found a tenant that was willing to move in mid-July, which allowed us to extend our lease for an additional 6 weeks. And beyond that, we have had a couple of dear friends offer their places for us to stay while they are traveling. SACHS clinic has been very flexible in terms of my work schedule and has been able to accommodate me despite my constantly shifting end date. And of course, we are thankful to have this extra time to spend with our loved ones.
In the book, The Thrill of Living Within God’s Will, Carl Coffman discusses three ways in which the Lord reveals His will to us based on a passage in Ellen White’s Testimonies for the Churches Volume 5 512.1-2. The three ways are: 1. His Word as found in the Bible 2. Appeals of His Holy Spirit making impressions upon the heart 3. Providential workings God can use any or all of these methods. So far, God has given us numbers 1 and 2. If we are approved to go to La Loma Luz Adventist Hospital despite the seemingly impossible barriers, then we will move forward with full assurance of God’s leading. But if the door closes, then we must seek God’s will for our family even more intently. We do not want to be where God does not want us to be. One of the conditions for ascertaining God’s will is to be 100% committed to doing His revealed will, whatever it may be. We must surrender our will to Him. Being in this place of uncertainty is not comfortable, but we are being well taken care of. Nevertheless, it does cause me some anxiety, which is why I need to remind myself that He has our best interest in mind and He is in control:
God has a purpose in sending trial to His children. He never leads them otherwise than they would choose to be led if they could see the end from the beginning, and discern the glory of the purpose that they are fulfilling. All that He brings upon them in test and trial comes that they may be strong to do and to suffer for Him.
Prophets and Kings 578.1
And we know that all things work together for good to those who love God, to those who are the called according to His purpose.
Romans 8:28 (NKJV)
With this in mind, I am trying to pray this prayer day by day as we wait for His leading:
Take me, O Lord, as wholly Thine. I lay all my plans at Thy feet. Use me today in Thy service. Abide with me, and let all my work be wrought in Thee.”
Finally a break. A weekend in Miami was just what we needed. The isolation of compound life with a toddler and newborn was getting to me. I was ready to recharge stateside. The situation in Haiti was getting worse but thankfully our drive to the airport was uneventful. We were able to pass through the eerie gang territory safely as the shooting ceased for a couple hours.
After arriving to Miami, we got Selah’s 4 month vaccines, stocked up on groceries and Amazon purchases and took care of some business. Once again, we packed our suitcases full, ready for our trip back to Haiti when we received a message from our hospital driver, Mr. Michel, “Don’t come back tomorrow.” The roads were blocked due to gang violence and transport from the airport to our hospital was not possible. After hearing this news we decided to fly to Loma Linda to be with family while we waited for the situation to clear. After a couple weeks Jeff decided to go back to Haiti and planned for the girls and me to join him two weeks later. A few days before the girls and I were to return to Haiti we heard the news–the Haitian President had been assassinated. Jeff evacuated Haiti a few days later.
After Jeff returned to Loma Linda safely, we entered another period of waiting but also a great opportunity to spend time together as a family. We drove from Loma Linda to Mammoth to Yosemite to Vallejo to see Jeff’s family to Redwood National Park to Portland/Vancouver to Mt. Rainier, to Gig Harbor. Then the earthquake hit Haiti. Jeff and I were convicted that he needed to be at the hospital to help. A couple days later he was on his way back to Haiti. To say the least, it was an intense and exhausting 3 weeks for him and the team at Haiti Adventist Hospital, but God orchestrated the amazing work that happened during that time and many lives were touched and healed.
Jeff was able to share some of our experiences at our home church.
At 33:00, Jeff gives a mission update of Haiti Adventist Hospital after the recent earthquake.
When Jeff came back from Haiti we were so happy to be reunited again as a family. Now we packed our bags again and headed to Wildwood, Georgia for 4 weeks for their Lifestyle Medicine Observer Program. Those 4 weeks were such a blessing to us. Jeff was able to see firsthand the workings of a Lifestyle Center and I was able to meet and spend time with some amazing families. The first week we purchased a used, but well-maintained minivan so the girls and I had some freedom to run errands and explore the city. We visited the Great Smoky Mountains and enjoyed beauty of the area. At the end of our 4 weeks, we decided to drive our car back to California across the country. From Wildwood to Ouachita Hills, to Dallas, to the Great Sand Dunes, to Mesa Verde, to Moab, to Salt Lake City and then finally back to Loma Linda. Thankfully the girls did remarkably well and we had wonderful time visiting dear friends and family and seeing God’s beautiful creation.
By this time, I longed even more to get settled. When would we go back to Haiti? Is that even an option? How could we take our young daughters back? What about the Haitian people? What are we to do in the meantime? More unsettling news… 17 missionaries were kidnapped in Haiti. Among the 17 was an 8 month old and 3 year old just like our daughters. Our hearts were broken for the group and their families. During this time, we struggled and ultimately felt impressed that God was telling us not to return to Haiti. What now? Where now? We still don’t know. We don’t know what our future holds, but we know the One who hold us. When I feel unsettled, I’m reminded that this is not our home. The Promised Land is waiting for us. He is preparing a place for us. In the meantime we wait, and we stay close to Him. We listen when he says stay, and we listen when He says go. He has led us, protected us, and given us place to stay until he tells us to go again.
It’s been over 6 months since our weekend trip to Miami. Eden just turned 3 and Selah is 10 months old. We’ve settled in a house for the next 6 months and Jeff is working at Loma Linda. We are waiting to be reassigned and praying for God’s guidance. We are grateful for the endless support of our family and friends and thankful for this time to settle down for now.
He came to our Emergency Department gasping for air – the picture of respiratory distress. Each breath was labored and accompanied by a short groan. Our hospital had just posted a notice saying that we could not accept any more urgent respiratory cases because our isolation unit was at capacity and our oxygen supply was critically low. But it is much easier to write a notice that the hospital is on diversion than it is to deny entry to someone who is gasping for air in front of you. Our ED staff had done their best to redirect the patient to another facility where they could possibly get help (highly unlikely because most hospitals were in a similar situation). But when our internist, Dr. V, and I saw the patient, we made a decision to use our second-to-last bottle of oxygen to bring him some relief – it was 3/4 full. Our last half tank was being reserved in one of our operating rooms for emergency surgeries. We had more oxygen on the way. It was expected to arrive by the end of the day. We had sent a team to Les Cayes, a 4-hour drive to the south, to fill 17 bottles of life-sustaining oxygen. They had left early in the morning, but it was taking longer than expected to fill the bottles. We had to source our oxygen from Les Cayes because gang violence had blocked the roads between our hospital and all the local oxygen suppliers, which are based in downtown Port-au-Prince. We had waited for the roads to clear up, but day after day went by and the violence continued…all the while our oxygen supply was diminishing…at a rate of 34 liters/minute to be exact. There were two patients upstairs in our isolation ward who were really sick, requiring increasing concentrations of oxygen, and needed to be transferred out to a higher level of care. The COVID centers in Haiti were all saturated, so Dr. V and I were working with the families of these patients to transfer them to the US as soon as possible. I called the team in Les Cayes mid-late afternoon. They were not quite done filling all the tanks, but I urged them to come back right away because we needed the oxygen badly and I was concerned about them driving at night.
The last couple weeks had been busy and stressful due to the current COVID spike caused by the presence of the UK and Brazilian variants. Scott, our medical director, was out of the country so as the assistant medical director, I felt more of the weight of responsibility for the day-to-day decisions, including ensuring that our oxygen supply was sufficient to meet the needs of our patients. Due to the COVID spike, oxygen suppliers across the board were running low on oxygen and were only able to supply us with up to 10 tanks at a time so they had enough to distribute to the rest of their customers. To make matters worse, gangsters stole a truckful of oxygen tanks heading to Hôpital Universitaire de Mirebalais (HUM), the largest COVID center in the country, so oxygen suppliers were sending their oxygen tanks to HUM to make up for the loss. We explored all the options we could think of. Hôpital Albert Schweitzer, located 3 hours away, generously offered to supply us with oxygen, but when we attempted to go there, the roads were blocked by gangs in Martissant, one of the most problematic areas, which is uncomfortably close to our hospital. We asked the other hospitals in our area where they were getting oxygen – all of them got their oxygen from downtown, on the other side of Martissant. We asked an air ambulance service if they could help us, but they’re not able to transport more than one small oxygen tank and the cost would not be worth the trip. The mayor of Carrefour helped us arrange a last-minute transport via a Coast Guard boat, but our oxygen supplier said they were unable to reach the destination port because of insecurity surrounding that area as well. Land, air, sea – all blocked by insecurity. But the Lord provided a way for us – our CFO, who started working at our hospital ~6 months ago, used to work in Les Cayes and for some reason, he had connections to a company that could potentially supply us with oxygen. But it was 4 hours away and it would take 2 days for us to get the oxygen due to the filling time. And if there was an opening, even for just a few hours, that would allow us to go to town to pick up oxygen, the 2-day venture was not necessarily the best choice. But as the oxygen tanks were used up and the roads continued to be blocked, we made the call to go south.
“He’s out of oxygen.” It was around 7pm and I was walking through the ED when the ED doc informed me that the gasping man’s oxygen tank had run dry. Where was the team that went to Les Cayes? They should be pretty close by now. I gave them a call. They had decided to stay and fill all the tanks before heading back up and were still very close to Les Cayes. I remembered the tank in the operating room being reserved for emergency cases. We could use that one and hope that there were no emergency cases requiring oxygen for the next 4 hours. I went to the operating room with a security guard to help me get the tank. We were stopped by the nurse on duty that night who adamantly refused to let us take the tank. We explained that there was someone who had ran out and really needed it – it was an emergency. But she would not budge. “What if there was an emergency surgery?” she argued. “What it there was a C-section and a baby who needed oxygen?” I was irritated at the resistance from this nurse I had never met before, but the idea of a potential newborn baby gasping for breath convinced me to run upstairs quickly to double check that we didn’t have any other tanks or concentrators that we could use instead. I found one – there was an oxygen concentrator at the bedside of a 6 month old boy with cardiac issues who was being trialed off of oxygen for the night. The relatives of the baby boy were worried that he might need it, but I explained the situation and reassured them that we would have oxygen soon. They reluctantly agreed and I prayed with them for the baby boy. I went back downstairs to the ED, oxygen concentrator in hand, and I saw the ED doc opening the door pulling a dolly that was usually used for oxygen tanks. Had they found another tank somewhere? But the doctor’s face and body language told me something was wrong. It was also strangely silent in the ED – there was no more gasping. “He died?” I asked. “Yeah, he died,” he responded, shaking his head. We sat together briefly on a nearby bench, a mixture of emotions swirling inside my heart – frustration, sadness, anger, regret, helplessness.
I should have insisted on taking the tank from the operating room. I should have acted faster upstairs. I should have been more insistent that the team from Les Cayes return right away. I should have put my foot down and made things happen quickly to save this man’s life – relationships could be repaired later. On the other hand, maybe we shouldn’t have accepted the patient in the first place. I shouldn’t have undercut our ED staff and made them look like the bad guys when they were doing their best to do what they were told to do. We should have been consistent with the hospital notice and sent the patient away…but how could we? We would have sent him away to die. Our mission is to continue the healing ministry of Jesus Christ. Jesus never turned anyone away unhelped. But if we didn’t divert people, our hospitalized patients who needed oxygen could meet the same fate as the gasping man in the ED. But now, the gasping man had died anyways and we were short one 3/4 tank of oxygen. What was the right thing to do?
The security guard interrupts my thoughts and informs me that two of our patients upstairs had also run out of oxygen and one of them really needed it. I immediately headed into the operating room. I told the nurse that the man in the ED had died due to lack of oxygen and told her that I would be taking the spare tank for another patient who needed it upstairs. She didn’t protest this time. I prayed that there would be no emergency surgeries before the full tanks arrived later that night.
I head out of the ED back home. I see Tim taking out the trash, heading to the dumpster. He asks me how I’m doing and I tell him briefly what happened. He comes over, gives me hug and prays for me. While he prays, some of the stress from that day and the last couple weeks is released as tears run down my cheeks and a few beats of a cough-like sob rack my body.
Looking back, I see plenty of evidence that God is taking care of us in the midst of all the challenges we are facing. – There were no emergency surgeries that night. – Aside from that day, we have not run out of oxygen again, although there have been plenty of days when it has gotten close due to continued insecurity. We have had more patients die from respiratory failure, but not due to lack of access to oxygen. – When we were first realizing that our oxygen supply was going to be severely compromised, one of our volunteers, Annika, an ICU-nurse and nurse educator rallied the troops and pulled together the major stakeholders at our hospital to strategize how to both minimize our use as well as work on acquiring more oxygen. I’m so grateful for her leadership during this time of crisis. – On that day we met, God delivered two bottles of oxygen directly to our campus. A truck from a hospital in Leogane had somehow made it past the blocked roads with several tanks full of oxygen and they generously stopped by our hospital on their way back and sold us two of their bottles. Those two bottles were critical. By the time we were able to get our next refill of oxygen, we were down to the equivalent of 1.75 tanks split between 3 tanks. – Our two working oxygen concentrators have prevented us from running out of oxygen multiple times. – Our need for oxygen has correlated remarkably with our oxygen supply. When our oxygen supply was running low, our oxygen requirements also decreased. – Towards the beginning of this crisis, the oxygen supply lasted far longer than we predicted, reminding us of the story of Elijah and the widow of Zarephath whose jar of flour and jug of oil never ran out. – Ricardo, our CFO, knew the right people in Les Cayes to make sure we had priority at the oxygen filling station. One of the other hospitals gave us their place so that we could get oxygen sooner. Ricardo went down with the team on his wife’s birthday in order to make sure that they were able to successfully fulfill their mission. – Our driver, Janvier, and oxygen manager, Justin, have made multiple trips to Les Cayes and have driven in the dark, in the rain, for long hours without any serious accidents. Our vehicle broke down on one trip and had to be towed 4 hours back to the hospital, but they were unharmed. They have also made several trips into town and have been on the road during shootings between gangs and between the gangs and the police, but have been able to make it back safely. – I was a little worried that once I left campus for this short trip to the US that our oxygen supply might run out since I was not there to keep a close eye on our oxygen supply status, but despite continued and even worse road conditions, oxygen tanks have been delivered to our neighborhood depot so we have been able to keep up our supply more easily. During the 2 weeks I was there, oxygen tanks were only delivered once to the neighborhood depot. Our COO, Mackenson, has been doing an excellent job coordinating things in my absence.
I lift up my eyes to the mountains—where does my help come from? My help comes from the Lord, the Maker of heaven and earth. – Psalm 121:1-2
Oxygen bottles have never looked so beautiful to me before.Janvier, Justin, and Ricardo with our first batch of oxygen tanks filled in Les Cayes.
Leaving for Delimart in 30 mins. Normally our expat group goes to Delimart (the grocery store a quarter mile away) in the volunteer pickup truck, but this time we are going with Mr. Michel, our hospital’s most trusted ambulance driver. I grab my shopping bags, purse, put on my shoes and say I’ll be back to Jeff and the girls. Walking toward the gate I look down and realized I put on my Adidas sandals – not the best shoes for running away. Oh well.. wait, I forgot a mask too. Okay good, I’ll get a mask and change my shoes. We all hop into the ambulance and have an uneventful trip to Delimart. The roads are busy, not as many street vendors, but the store is pretty well stocked today. A good sign. Yay for almond milk and kale!
We have been taking precautions. The roads to town have been blocked for days due to gang warfare. It’s been a battle of territories for our neighboring gangs. Civilians are not targeted purposefully but many have been displaced. We gather clothing, towels, sheets, hygiene products and money to be distributed to the refugees.
We don’t feel threatened at the hospital and plan to stay put until we hear otherwise. We pray for God’s protection. With our human eyes we see suffering and destruction, but as God opened the eyes of Elisha and his servant to see the angelic army surrounding them, we too can be assured that His angels are surrounding us.
“The angel of the LORD encamps all around those who fear Him, And delivers them.”
Branch to Vine 