Phnom Penh Pals: Team Helm in Cambodia

"But the Lord said, 'You have been concerned about this vine, though you did not tend it or make it grow.  It sprang up overnight and died overnight.  But Ninevah has more than a hundred and twenty thousand people who cannot tell their right hand from their left, and many cattle as well.  Should I not be concerned about that great city?' " Jonah 4:10-11 This quote comes from the book of Jonah, which tells the story of a reluctant prophet sent to his hated enemy; he was sent to call them to repent and worship the only true God.  When his enemies repented, Jonah was upset, and for good reason.  Around one hundred years later, Assyria would capture Israel and take them into captivity.  Jonah was not only reluctant to go to his enemy, he was distraught when their repentance led to salvation.  In chapter 4, Jonah is demoralized, and he lies down in depression.  God asks him, "Do you have any right to be angry?"  Jonah then sits down to rest, and the Bible says

Perhaps surprisingly, garbage trucks don’t venture down our dirt road weekly here in Northwest Cameroon. Typically, garbage is dumped in a “pit” some distance from the house, and routinely burned. Our pit had been filled in at the request of our neighbors, who didn’t want to breathe in the diaper stench during the burning sessions (reasonable).  Fortunately, we don’t have a lot of garbage because most things we buy are not pre-packaged, and we have a large compost pile for fruit and vegetable wastes. Unfortunately, the new drop-off location for our garbage is half a mile up the hill at the hospital incinerator (every bit as scary as it sounds). So, our current sanitary disposal options are as follow. Plan A: our gardener, Keneth, brings the quarter-full, small garbage pail to the incinerator several times per week. As an aside, I am often amazed at how little garbage we produce here. In the US, I would bring out at least a large grocery sack full daily.  Unfortunately, today h

"Please Daddy, will you give mercy?" Our three-year-old squinted up at his Daddy, waiting for his response. The present report of his day's behavior, under most circumstances, would earn a relatively significant consequence. But that sweet, trusting voice. And such a sincere request. Ethan looked down at him. "I will give... no...mercy!" he declared as he began tickling Josiah, who collapsed into a pile of relieved giggles. *  *  * I sit here broken today, an American in Africa on Veterans' Day. Two days ago, the world witnessed a nearly exact split of votes in a U.S. presidential election that offered many of us two unsupportable options. Since we are geographically removed from the fray, it is hard to imagine the demonstrations of hatred that have erupted in our passport country this week. But we don't have to imagine them, because we can see them on Instagram, Twitter, and Facebook. We can see them, and feel the nausea that began during the pr

It’s not the endless armies of cockroaches or soldier ants storming our doors (and windows). Not the parasites extruding from the mango fly I killed near an enormous display of laundry drying inside -- for two days -- to avoid mango flies (washed this laundry again, because #firsttermmissionary). Not the incapacity to access the internet most of the time on most days. Not the months, and months, and months of deluge. Not the constant chorus of “white man!” and giggles whenever I take my kids out of the house. Not the complete lack of private space and quiet time in a culture whose hospitality I admire but do not fully understand. Each of these challenges to my privileged existence ran through my mind as I considered my friend’s question: what is the hardest part about living in Africa so far? Furthermore, it's not the extensive cooking process (starting with scrubbing and bleaching everything and ending with the inability to replace/repair broken kitchen items), nor complete

Thirty-three: the age Jesus was when He died. I have now achieved the age of the man who split history in half, brought God’s redemption to earth, and changed billions of lives (including mine). Reflecting on this milestone, I find myself  waxing philosophical on this surprisingly un-rainy day in West Africa. What does it mean to live a great life? Not just a good life. Not a culturally normative, politically correct, small town, little family, Hallmark cozy life. A great life. A great life is an arrow pointing to something greater. Even Jesus, whose life and teachings managed to challenge and revolutionize the sociopolitical and religious systems of the ancient and modern worlds, pointed to the Father. Is this the life I want? Am I really living to exalt the Great name of our God, or merely to satisfy the desires of my deceitfully inconstant heart? The past few days, the theme of God’s great faithfulness has been brought to my eyes and ears repeatedly. My aunt, who e-mailed

Some days, parenting is gripping tightly to the handle of a door you are afraid may incur serious damage from an epic temper tantrum. It is praying, in those moments, that your son will grow up to be a man with self-control, who can both experience and control his emotions.  Other days, parenting is looking up from a full sink in surprise as the same son clears your guest’s dishes without being asked. It’s thanking God for the privilege of raising His children. Most days, it’s both. How do we, as parents, live in (and appreciate) the already and not yet of our children as image bearers of God? The lists of parenting "must-do"s and "must-not-do" can be exceedingly exhausting. One simple way I’ve found to redirect a derailing day is to make eye contact. When I rush through a day, ticking “to-do”s off my never-ending-list, I miss out on experiencing my children as people rather than a summation of tasks. But if I consciously take a moment to look into their

Until this month, I had never met a Season I didn't like. Anything can be exciting, or romantic, or nostalgic for a few months. Except, apparently, Rainy Season. I was initially surprised when my Cameroonian friends had no concept of Winter, Spring, Summer, or Fall. Having lived through most of the two Seasons here, I can see why. In Dry Season, we are waiting for rain to bring down the Harmattan so we can breathe again. In Wet Season, we are waiting for a break from the rain to escape our muddy, moldy houses. Why bother with meaningless designations like Spring and Fall, which to Westerners conjure up images of baseball opening day and pumpkin spice everything -- images that similarly mean nothing in the non-Western world? Last week, a cough drop reminded me of Winter nights in New York. And I was sad. I started playing Christmas music (I know -- it's September; this is ridiculous). I put clove and orange essential oils in a dinky little infuser (in light of my sentiments

“Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.” - Psalm 23:4 Nobody said love was easy.  God loved the world so much that He gave His One and Only  Son (John 3:16).  He beckons us to love Him so much that we “take up our cross daily (Luke 9:23),” and die to ourselves in the same way (Romans 6:11).  My love for Jesus has brought me here.  Sometimes I feel encumbered by the weight of death.  Yet Jesus said, “My yoke is easy and my burden is light. (Matthew 11:30)” Sometimes, the burdens I carry do not feel light.  (The remainder of this paragraph may be hard to read for some, so feel free to skip it).  In the past month, as always, I have seen an immense amount of pathology including an 8 month old with biliary atresia (a fatal diagnosis), a newborn with trachesophageal fistula that developed an abscess in the lungs after surgery and died, a teenager with metastatic cancer located behi

Going through old pictures often makes me sad. Routinely, I look at faces that once knew my deepest secrets, and now seem like distant acquaintances. Of those I previously considered my closest friends, I interact regularly with only two or three. Occasionally, I've experimented with the "unfollow" button on Facebook to determine how well I am actually connecting with those I claim to love. During these times, I was more likely to initiate contact but still struggled to maintain connection. The major developments I missed in the process suggest my overall ability to maintain friendship is poor. Moving to another continent (with spotty internet) probably didn't help, but the distance was there long before we left Western New York. As suggested by my "unfollow" experiment, much of the problem stems from social media, which allows us to know what's going on in others' lives without doing any of the work of real relationship. It's like receiving al

Being invited into a home is an intimate and eye-opening privilege. Due to substantial distance and a large ocean, we cannot extend a dinner invitation to most of our loved ones. So, we wanted to invite you to virtually visit our home in the following pictures. You are welcome guests! Here is the view from our front door. Across the dirt road (the "main street" of Mbingo) is a 4-unit building where some of the hospital residents and physicians live. You will walk through the door into our living and dining room. Not pictured: a big window and another couch to the left. Past the bookshelf on the right is our hallway. If you turn to the right, you will enter our "guest room". Esther is not a guest, but she sleeps here because when the kids sleep together... none of us sleeps. Hopefully we will get Esther into Josiah's room before Auntie Coco comes to visit in October (otherwise they will be roommates: second generation!). Further down the h

Below is the content of a letter I was asked to write, responding to a friend's hesitancy towards vaccination. I am posting it here, because I have had similar discussions on multiple occasions and hope these thoughts will be helpful to anyone confused by the vaccine debate. "Greetings, friend! I am writing because I care about you, the health of your kids, and the wellbeing of the general public. I know you are an excellent husband and father, and believe you only want what's best for your children. As a mother, I understand the shades of gray that often seem to settle over parenting decisions like discipline techniques, educational approaches, and medical care. As a physician, I have committed the last 15 years of my life (nearly half!) to the study of evidence-based medicine. The field of medicine has evolved substantially over time, but the process by which therapeutic guidelines are created is more or less standard. Medical interventions (including vaccinations) are

In the daily grind of wiping bottoms and enforcing time outs, the big picture can get a little fuzzy. But every so often, I catch a glimpse of the goal in Christian parenting: raising people who love God and bless others. We were somewhere between time out five and six of maybe ten today when a neighbor boy stopped over to escape the rain. After devouring a peanut butter sandwich, he approached our tiny wooden train set with a huge grin on his face. As he played, I asked if he owned any books. No. I looked at our shelf, which looked quite bare by Western standards but still held more than 30 children's books. I asked him if he wanted a book. Yes. Did he want one for his brother? Yes. I picked out two paperbacks from the shelf. As I wrapped the books in a prized Ziplock bag, Josiah looked at me with his eyes wide. "I want to keep them," he said softly. "We've got so many books, buddy. He doesn't have any. It would be so nice if we shared with him. Can

This article  hits so much closer to home now than when I first read it a year ago.  As I scroll through my  Facebook newsfeed and celebrate all the beautiful baby bumps and newborn photos, I'm acutely aware of the millions for whom pregnancy and childbirth are nothing of gender reveal parties or newborn magazine shoots. Birth, in much of the world, is a matter of life and death. "The suddenness of this little girl’s death, so soon after her welcome to the world, made it seem particularly cruel. To the nurses, however, it was hardly unusual. Later I was told that Tanzanian mothers often do not name their babies until long after birth, trying to avoid emotional attachment in a place where neonatal, infant and child mortality rates are so high. I still don’t know what to make of the experience, except to pray for a woman and an innocent little soul and to realize that “neonatal mortality” is not something abstract. It happens in some room, on a table, under a heat lamp, wher

"But let all who take refuge in you be glad; let them ever sing for joy. Spread your protection over them, that those who love your name may rejoice in you." Psalm 5:11 The picture painted in scripture is that followers of Christ are refugees who belong to a glorious kingdom with a perfect King. Yet, we live in a world full of wrongdoing, suffering, and heartache. Our hope gives us reason for joy, for the One who is in us is lovely and kind. The place He has prepared for us has many glorious rooms. With this hope in view, followers of Christ have hope. As we chose to reside in His love and His unshakable Kingdom and His promise that "we have overcome" (1 John 5:4) we find the secret of being content (even joyous!) in every situation.

This is my fourth attempt to write this blog.  My previous attempts have been abandoned out of emotional exhaustion.  I have always been a crier.  I almost cried watching Beverly Hills Chihuahua (I was with twin 8-year old boys and had to pinch myself to prevent myself from tearing up.)  I am not ashamed.  Jesus wept (although probably not at Beverly Hills Chihuahua).   My first week here was particularly challenging:  six children died.   Towards the end of the week, I thought to myself, “Ethan, you have the worst job in the world. Your job is to bury children.”  Then the Holy Spirit opened my eyes to the reality that I do not worship a God who does not understand suffering, but instead, a God who chose to suffer on the cross for me.  He was perfect, innocent, and lovely, and he was tortured so I could be reconciled to God.   He has invited me to take part in His mission on Earth:  to help his beloved creation be restored to Him by proclaiming the Good News of Jesus Christ. He i

Each time, I glared at the tiny screw (or nail) on the floor in annoyance.  My 10-month-old daughter is adept enough at ingesting every inedible thing she finds, without the additional temptation of sharp, shiny objects.  Even the endoscopy-trained physicians at our hospital would be little match for her covert reconnaissance missions. As I picked up each offending piece of metal, I pondered where to put it.  The garbage?  No. Only "burnable" (plastic, paper) items could be taken to the incinerator. The compost? Obviously not. The ground? Burying it would be too much work. After exhausting this mental checklist, I had thrown a nail and two tiny screws into a little dish atop my dresser. Last week, the gardener needed a nail. I thought about how I had almost buried it as I gave it to him. Oops. Today, I was trying to cover an unpainted patch on the wall (in true avant-garde fashion, the layer of paint had been applied over a taped telephone cord in the middle of the room)

We were at Papa Palmer and Nana Nancy’s house when the phone rang.  We had just finished eating a delicious meal and were talking about M’Bingo and theology interchangeably.  After answering the call in the other room, the veteran missionary physician returned to report, “It’s a four-day-old.”  “You should go, Ethan,” Elizabeth said, voicing my thoughts.  So Dr. Palmer, an internist, escorted me to see my first patient, a baby girl in respiratory distress.  When we arrived, the baby was dusky, cyanotic (blue), and struggling to breathe despite high flow oxygen.  A resident presented the case.  The beautiful little girl was a 41-week-gestational-age infant whose mother had rupture of membranes (“broken water”) 48 hours prior to delivery, increasing both her and her baby’s risk for infection.  The delivery was notable for excessive meconium (fetal excrement). Extraction of the baby had been difficult.  All in all, not a good set-up for arrival in the world.  At the time of ou