Merry Christmas 2017

        Merry Christmas from the Cahill family! We hope that you all have a joyous day celebrating the birth of our Lord and Savior Jesus Christ! We also want to take the time to say thank you to all of you who have so graciously supported us this year. You have blessed us with your financial support and prayers for our family and the people of Ghana.  Many of you have given abundantly through time, hospitality, and meals while we were in the U.S. Our families have sacrificed seeing grandchildren/nieces/cousins as we miss all the family gatherings. We also love hearing from you about your families and your notes of encouragement that remind us that we are not forgotten. We could never be here without the love and support from you. What a blessing to have each of you in our lives. Thank you! We pray that God will bless you and your families much more than we are able.

                         Merry Christmas from the Cahills (Tim, Lori, Rebekah, Abigail, and Hannah)

New baby, family visit, and more!

So we thought it might be time to post another blog...:) After all, we have a new baby! (As most people have probably already seen on Facebook). Hannah Elizabeth Cahill was born two months ago on August 24, 2017 by God's grace via a normal delivery. She had been breech (bottom down), stubbornly so, up until about 36-37 weeks of pregnancy. She then flipped to head down about 5 minutes before we were about to do an ECV (external cephalic version- or manually flipping the baby to head down from the outside)- praise the Lord! Lori then developed high blood pressure about a week or so later, so we had to induce her labor. She delivered a healthy baby girl at 38 weeks and 4 days (which is the exact day of gestation that our other two daughters were born- crazy!). After a bout with neonatal sepsis and IV antibiotics for a week, bad reflux with feeding, and bowel movement difficulties (one time going up to 7.5 days between BMs- associated with increasing fussiness), Hannah is now doing better (although still having reflux). By God's grace, despite all that was happening with her, she has continued to gain weight appropriately.

First day of life after first bath

Day 3 of life with her two big sisters

Almost 2 months old!

We were also blessed with a visit from Lori's parents and her oldest niece, Rachel. They arrived the week after Hannah was born and stayed for a couple of weeks. Lori's mom and Rachel assisted Lori with the cooking, laundry, and keeping up with the home, which was a blessing since Lori had her hands full with keeping Hannah well-fed. Rachel also helped out some with homeschooling our older girls. Lori's dad helped to fix several things around the house, including some plumbing issues and a broken gutter. We also enjoyed learning some new games and playing some old ones (like NERTS!). It was nice to finally be able to host some of our family at our home in Ghana!

On a walk to the nearby river with Lori's family

Also while Lori's family was here, we harvested our corn (not spectacular, but better than previous years!), the rest of our green beans, and some of our cucumbers. We also held a baby-naming ceremony for Hannah at our church, Fulbe Baptist. Traditionally, babies are given an English name and a Mampruli name here in our region, and both names are introduced to the public at the baby-naming ceremony. Oftentimes, the ceremony is held around the eighth day of life, but because of Hannah's infection and some other issues, we had to postpone it until about 2.5 weeks of life. Her Mampruli name is Wulim Albarika (essentially "beloved blessing"), and because our pastor is Fulani, he gave Hannah a Fulani name as well, which is Jede (meaning "God's gift").

Whole family just before baby-naming ceremony

Hannah's baby-naming ceremony with Pastor Alex and his wife

 A final noteworthy event happened on the day that Lori's mom and Rachel left Nalerigu: Rebekah lost her first tooth! She received a 20 pesewa coin (kinda like 20 cents) on her nightstand that night, and she was able to buy some of her favorite gum in town a few days later. She then said later that she planned on buying some fabric and making a dress with the money that she gets from losing more teeth. It may be awhile though because fabric to make a dress costs more than 50 cedis (kinda like 50 dollars) :)

Momma and the girls (and dada!) are crazy about Hannah!

Back to a New Normal

I was about to leave the hospital on a Saturday afternoon after doing surgery for an ectopic pregnancy, when I received a call from Lori. There was a certain urgency that I immediately noticed in her voice, and it reminded me of the phone call she had made to me back in December when a grassfire was coming close to our house. Instead of a fire this time, though, our house was flooding! The ironic thing is that we were still in the dry season. It was not flooding because of a heavy rainstorm…it was flooding because our toilet had broken. Back in the US, we are used to toilets that are all one piece. Here, many toilets are two-pieces, the tank that holds the water and the toilet bowl, connected by a curved piece of PVC pipe. Our younger daughter is still working on potty-training, and she had just finished going to the toilet and was flushing the toilet when everything happened. The toilet tank fell off the wall and broke the water inflow pipe in the process. What made matters worse was that we did not have an indoor emergency stop valve to the toilet, and we did not know where the outside stop valve was for our house. When I arrived home from the hospital a few minutes after Lori had called, I could hear a waterfall flowing inside. Our whole bathroom and parts of our hallway and master bedroom were flooded already. Lori had fortunately been able to redirect the flow of water so that it shot across the bathroom into the bathtub, so as to decrease the amount of flooding in the house. She was also working frantically to soak up the water with clothes, towels, and a mop, to keep it from spreading to other parts of the house. I then made a careful search around the outside of the house (along with one of our neighbors, Francis, who is the hospital volunteer coordinator), and we eventually found the stop-valve and were able to mostly turn off the water to the house. The plumber then came and cut out our bad pipe, put in an indoor water stop-valve to the toilet, and installed a new toilet tank for us. We were very grateful for the quick response and help by both Francis and the plumber.

Lori at ~24 wks

New nursery

Rebekah pretending to be Helen Keller after reading about her in homeschool. *Notice her spoon* :)

                After arriving back in Nalerigu at the beginning of April, we have been busy with many things around the house, trying to get back to a new normal. I say a “new” normal for several reasons: we are starting to homeschool Rebekah, preparing for a new baby in the late summer, taking Mampruli lessons, Tim taking a specific day off from work every week, etc…all things that we did not do or think about during our previous times in Ghana. Since we now plan on staying here for several more years, there have been a handful of projects that we have undertaken or are in the process of doing. I painted the room that we will eventually make into our nursery for the new baby; we learned that the old floor tiles in a couple of our rooms contained asbestos, and we are eager to have them replaced (reinforced by damage from the flooding); I cleaned out several trash bags full of leaves, dirt, and squirrel/lizard poop from our attic (that was weighing down the ceiling tiles and frequently finding its way into the rooms below); Lori is experimenting with a wicking garden (using local resources); and we had our hallway painted by someone else (because of lots of peeling paint).

We are also excited to announce that we have been accepted to MedSend. For those of you who don’t know about this organization, they help medical missionaries pay their monthly loan payments while serving on the mission field. It was definitely an answer to prayer, as medical school loans can be quite daunting to think about in the face of a missionary salary. As always though, God is faithful in how He provides. If not through MedSend, we trust that He would have provided for us by some other means. However, we are grateful for the ministry of MedSend and how God has used them to bless us in this area.

I started back to work at the hospital during the last week of April, and I have already had several new experiences and discoveries. The hospital, Baptist Medical Centre, has morning devotions every day at 7AM for the hospital staff (and whatever other patients may be sitting in the waiting room at the time). I did not know about these devotions until a little over a year after first arriving in Ghana in 2014. By that time, however, I was utterly exhausted from the workload and was finding it hard to even get up there by 7:30 or 8AM for rounds. I only went to a handful of the morning devotions from June 2015 until Dec 2016. I decided to make it a point this time around to make the hospital devotions a priority in my weekly routine. It is an encouraging time to sing some songs, listen to a sermon, and interact with some hospital workers in a slightly different context than usual. I learned a little later that these devotions used to be required of all hospital staff in the years before we came to Ghana, but now it seems to be optional (as there are usually only about 10-20 workers present each day). Being a regular attender of these devotions has also opened the door for me to give some of the sermons. One of the hospital pastors asked me a couple weeks ago if I would be willing to lead the morning devotions, preferably once per week. I am not naturally a public speaker, so I was a little hesitant. However, as I described in our last blog post, God did give us several opportunities to speak in front of groups during our last trip to the US. I believe that He was growing and preparing me for this opportunity. I have lead two morning devotions so far, focusing on the topic of worship, and I have thoroughly enjoyed preparing for and giving the sermons. Please pray that there would be a revival among the workers of the hospital to represent Christ well in how they live their lives, both inside and outside the hospital, and how they treat patients in the hospital.

 

Shingles

Lastly, since we are medical missionaries, I think that it is necessary that I talk about some of the interesting cases in the hospital and how God has worked in different patients’ lives. Some interesting cases I have seen so far include:  herpes zoster (or shingles) on the face; polycystic kidneys; a horseshoe pelvic kidney; two women with ovarian masses (one with bilateral ovarian teratomas- masses on both ovaries; another with a unilateral massive tumor- mass on one ovary, found to have metastases (or spreading of cancer) all over the inside of her abdomen); a pregnant woman with a teratoma (ovarian tumor); a pregnant woman with a large jaw abscess from a tooth infection; a young boy with leukemia; a young girl with an acute subdural hematoma (I thought she had a brain tumor based on physical exam findings and no history of trauma, so I transferred her to a bigger hospital for a CT scan of the head and to see the neurosurgeon; it turns out that she had a brain bleed, they operated on her, and she is supposedly doing better—praise the Lord!); a baby with suspected tracheo-esophageal fistula (transferred down to Kumasi with a charity program we have at our hospital à baby WAS diagnosed with a TE fistula and reportedly underwent surgery – again, thank you Lord!); lady with a ruptured ectopic pregnancy; lady with a molar pregnancy; and a young girl who presented for first time with diabetic ketoacidosis (a severe complication of diabetes).

Akee fruit seed (these red bugs love it!)

To expound on the last patient: She had presented with two weeks of abdominal pain and then began vomiting profusely the night before she came to the hospital. Her abdomen was mild to moderately tender, mostly in the upper part, and she had a little bit of blood in her vomit. She then began having difficulty breathing and became less responsive. I used an ultrasound to look at her abdomen and saw that her stomach was massively dilated with a thick substance, and her bladder was also enlarged. I ordered that an NGT (nasogastric tube- tube that goes from the nose to the stomach, used to either evacuate the contents of the stomach or to feed a patient) and a urinary catheter be placed. The contents in the NGT bag were dark brown, and it was at this time that the family admitted to using local medicines/herbs that were that color in order to try and treat her abdominal pain. The color reminded me of a local fruit, the Akee fruit, that we have here in West Africa, (and that I had just read about online a few days prior) that, if not prepared properly, can cause severe hypoglycemia (low blood sugar). I asked the nurses to check the blood sugar, and the reading was >33.3 mmol/L (or >600mg/dL for those of you in the US- which is extremely high). I did not believe it, so I asked them to check it again…and it read the same number. She had diabetic ketoacidosis (DKA) (she had no previous history of diabetes), so we started treating her with IV fluids, IV insulin (best we could here with limited blood glucose strips and no infusion pumps to regulate an IV insulin infusion), serial urinalysis to check for ketones, and prayer. Her DKA resolved a few days later and she was feeling well for a few days. However, in the last several days, she has started showing signs of several cranial nerve palsies (possibly due to cerebral edema, which is a common complication when treating DKA in children) and has continued to spike high fevers, despite having been treated for malaria and with multiple antibiotics. She may have tuberculosis, as it can present in this way sometimes. It is the weekend now, so we cannot start TB meds until Monday.  This morning she became suddenly worse with hypoglycemia and breathing difficulties again, requiring oxygen. Please pray for healing for this girl and comfort and perseverance for her two caretakers (the father and grandmother). Also, please pray that Christ would be glorified, whatever the final outcome.

Return to Ghana 2017

  **Disclaimer: So keeping up on blogging is not necessarily our forte :) Both of us had a science major in college, and neither one of us particularly thrived at writing. However, we would like to communicate with our friends, family, and supporters about what we are doing in Ghana and elsewhere. We apologize for the long hiatus since our last blog post, and we hope to do better in the future.**


   We would like to first start by saying thank you to all our friends and family that housed us and fed us during our US travels the past 3 months! It was such a huge blessing! Thank you also to those who took time out of their busy schedules to come meet up with us and catch up a little. Apologies to those friends and family who we were not able to see this time, but know that we think about you and pray for you regularly. Lastly, thank you to the auto ministry in Memphis for supplying us with a vehicle during our entire US visit. We traveled by road between Texas, Tennessee, Georgia, and North Carolina, and this was made financially feasible by the auto ministry.

   We arrived safely back in Ghana last week, and we returned to our home in Nalerigu (Northern Region of Ghana) last Saturday. Our plan is to stay for at least another several years, serving the Lord at Baptist Medical Centre. We were fortunate enough to get to move back into the same house we have been residing in during the past 2.5 years. In fact, we were able to leave most of our stuff in Ghana when we came to visit the US. We are now just getting settled back in before going back to work.


   God has been good to us, even in the "little" things. I enjoy teaching, and during our time in the US, God gave me several opportunities to give lectures at residency programs about practicing medicine in Ghana. Both of us also were blessed with the opportunity to speak in front of a few different groups (some at churches and some not), as well as run a booth at a large missions conference, telling people about our ministry in Ghana. We were humbled by the number of people who came up to us to tell us that they had already been faithfully praying for us, and that they would continue to pray for us. We are also grateful for those who have chosen to help support us financially. It is through your prayers and support that we are able to serve here in Ghana.

   One of the reasons we came back to the US after such a short period of time (6 months) since our last visit was to attend the orientation of the long-term sending agency to which we were transferring. We received approval to renew our work permit in Ghana back in November, and we desired to come back long-term. We had previously heard about Christian Health Service Corps, a long-term medical mission sending agency, during our orientation with Samaritan's Purse Post-Residency Program back in 2013, so we contacted them right away after getting approval to return to Baptist Medical Centre. Thankfully, they still had room in their January orientation group (they only have orientation in January and July each year) for us to attend, so we moved around our flights a little in order to make it.

   I also wanted to recount a few ways that God blessed us during our US visit and other travels. We had been hoping to show our girls some snow during our visit since neither one of them had been old enough to remember the last time we saw it. We thought for sure being in the US during winter, especially spending a few days in the Appalachians, that we would see some snow. However, it was an unusually mild winter in all the places we traveled. We did see some patches of snow in Nashville on our way through to Knoxville, but not enough to make a snowman. Then, on March 13th, a couple weeks before we returned to Ghana, we were in Knoxville and had heard that there would be some light snow nearby, but it wasn't supposed to affect my parents' house where we were. That didn't stop us from praying for snow that morning though! It ended up snowing 1-2 inches later that day, which was enough to make a snowman, throw some snowballs, make snow angels, and do some modified sledding :) (aka pull the girls around the yard on a boogie board) Funny thing was, there was no accumulation of snow about 5 minutes down the road. We considered that God's answer to prayer.

    Another way that God was looking out for us on our travels was when we were about to board our plane in Dubai. The people at the gate were weighing all of the carry-on bags of the people in front of us in line. This was the first time we had seen this done by this airline. We remembered seeing that the weight limit for each carry-on was 7kg (or 15lbs). We had forgotten to weigh ours, but we were pretty sure that some of our bags exceeded that limit. We started to get a little worried because this airline supposedly makes you pay for and check any bag that exceeds this limit. However, in God's grace, when we reached the front of the line, they did not ask us to weigh any of our bags, but instead just pointed us through the gate.


   Lastly, we would like to ask you for your prayers and accountability on the following:
1) Wisdom and patience as we begin to officially homeschool Rebekah.
2) Language learning. We are planning on taking one day a week to have someone formally teach us the local language, Mampruli.
3) Healthy pregnancy for Lori, uncomplicated delivery, and healthy baby. Lori is 19 weeks pregnant.
4) Readjustment back to life here in rural Africa.
5) Patience and wisdom as we try to get Abigail potty-trained.
6) Lori possibly working more hours at the hospital (if she is accepted by a certain program that helps to pay off school loans for medical missionaries). If this does happen, then favor in obtaining a medical license here, as well as wisdom on childcare, food preparation, and schedules.