Archive for March, 2007

Spring 2007

March 31, 2007

“For our struggle is not against flesh and blood, but against the rulers, against the powers, against the world forces of this darkness, against the spiritual forces of wickedness in the heavenly places.”  Ephesians 6:12

What a strange way to start a For Hearts and Souls’ trip update.  Sounds like a “downer”.  And these trips are so not “downers.”  They are some of the most amazing experiences of our lives.  But I realize I have been on three trips now without writing about them.  What is that about?  I believe it’s about Ephesians 6:12.  But, I digress.  I am truly a chronological story teller.  So, probably for my sake more than anyone else’s, let me tell the story in order.

We were in Mongolia the last two weeks in September.  The statistics from that trip are impressive.  There were around fifty team members over the course of the two weeks.  The first week was the Mending the Broken Hearts week, where we performed eleven surgeries and fourteen heart catheterizations.  The second week was the Searching for the Broken Hearts week, where almost eighteen-hundred children were screened for congenital heart disease.  But, we had a death:  beautiful 5-year-old Undarmaa.  Hers was the most complicated operation we had undertaken there.  Medically speaking, she did not act “right” from the moment I put her to sleep.  She required a lot of pharmacologic support to keep her blood pressure up in the operating room and in the twenty-fours she lived after her operation.  She had us all scratching our heads.  Even her death was a surprise.  She had had her breathing tube removed.  She had been speaking and interacting with her family.  Then she had a sudden cardiac arrest.  Our ICU team was incredible.  I cannot praise them enough.  They did everything right.  Sure, hindsight is 20:20.  And when something like this happens, we all wonder what we could have done differently.  We wonder if she would have lived if she had had her surgery in the United States.  We’re not sure.  But, we’ll never know.  The Lord knows though.  He is good and He is sovereign.  I rest in that.

I don’t know how to describe a scene like that though.  It is truly terrible.  The wail of a mother who has lost her child is unforgettable.  My dear husband Kirk always counsels physicians he is training to never, ever forget that wail so that we always remember the sacred trust granted us when we take care of people’s children.  I confess that the night she died everything went black for me.  The Mending week in Mongolia is thoroughly and utterly exhausting.  As the team leader’s wife, I confess I worried that it would ruin everything.  People travel at their own expense and work really, really hard.  Would they be too discouraged to go on?  Would they ever want to come back?  Would the Mongolians continue to trust us?  Would Samaritan’s Purse, who has so graciously and abundantly supported and partnered with us, continue to trust us?  She died late Wednesday night.  Not everyone on the team knew she had died until morning.  We met for breakfast in the hotel when most everyone found out.  We had this precious cook who made to-order eggs for us every day.  He found out what happened and tried to reassure our team members “Everything will be all right.  You are here and you serve the children.  I am here and I serve you…eggs.”  What a sweet man we all have come to love as he has made us breakfast over the last two years. 

After breakfast, we gathered at the hospital for our usual team devotions before starting our work.  Kirk put the question to the team “are you willing to continue?”  The answer was a resounding “yes!”  I don’t know that I remember the specifics of that devotional time, but I knew we cried, we prayed, we sang…and we continued to trust a loving and “faithful Creator in doing what is right” (1 Peter 4:19).  This was my first lesson in Ephesians 6:12.  There really is an enemy, Satan, who wants us to get discouraged and lose heart.  The team acknowledged this reality and refused to give him the victory.  I was so blessed by their faith and their resolve.  The rest of the week went very well.  Twenty-four lives changed.  The number currently escapes me how many children are brought to the U.S. and Canada out of Mongolia per year for cardiac care, but it’s about the same.  That’s a year’s worth of impact in one week. 

However, I didn’t learn the lesson of Ephesians 6:12 well enough to be courageous enough to sit down and write an update about it.  It’s so much easier to write an update when all goes well.  I in no way want to come across as defensive or as minimizing the loss.  The loss is tragic.  But I believe that beautiful little girl is in heaven.  And her family is continuing to be ministered to by members Samaritan’s Purse Children’s Heart Project in Mongolia.  And we will not know until we get to heaven how many learned about and began to trust Jesus because of what happened.  “For what does it profit a man to gain the whole world, and forfeit his soul” (Mark 8:36)?  That is why our organization is called For Hearts AND Souls.  What does it profit those we serve if we simply medically fix their hearts and do nothing for their souls?  In our human thinking, a medical mission trip is successful is we have no deaths or complications.  But “‘My thoughts are not your thoughts, neither are your ways My ways’, declares the Lord.  ‘For as the heavens are higher than the earth, so are My ways higher than your ways, and My thoughts than your thoughts” (Isaiah 55:8-9).  In God’s economy, there is victory in human death, if it is exchanged for eternal life with Him.

Continuing with the chronology, over Martin Luther King Jr. weekend in January, thirteen of us went to the Mayan Riveria, near Cancun, Mexico, to screen several hundred Mayan children for congenital heart disease.  Part of my writing these updates is, I confess, an opportunity for me to process personally what the Lord taught me in each trip.  You who read them have to somewhat suffer from my “thinking (or, more appropriately, typing) out loud.”  In keeping with what I believe the Lord is teaching me about spiritual warfare, the only thing I can think about that trip in that vein is that I didn’t write about it.  It was a great trip.  The Lord put together an absolutely wonderful team.  Our accommodations the first night were really quite sub-optimal, but they willingly endured it without a single complaint.  As team leaders, I cannot tell you what a blessing that is!  We were rewarded the following nights with truly beautiful (and cheap!) accommodations.  This was supposed to be the first trip that I was supposed to lead without Kirk, as he was supposed to be headed to Iraq.  His departure to Iraq got delayed and he got to go down to Mexico on Thursday night with the team.  He left Mexico on Saturday morning to head back to the U.S. and then on to Iraq, but it was such a huge blessing to have him there at the beginning!  And I am truly grateful for how the team loved and supported me through my grieving his departure and for how they provided for spiritual and medical leadership in his absence.  OK, I did get stuck for 48 hours trying to get home due to the freezing weather that hit Texas.  I think the spiritual warfare there is trying to convince me it’s just too difficult to get the time to get away and do these trips.  My absence affects my partner greatly in terms of workload…and I feel awful when I’m gone too long because I so appreciate her willingness to support what we do by bearing the brunt of the work and call when I am gone.

So, I just returned from Zambia this week.  A team of ten of us went there to conduct a pastor’s conference and to minister to the thirty-six orphans collectively being taken care of by what we call For Hearts and Souls Children’s Village.  In terms of spiritual warfare, this was what I began to call a “Satan Attack Fest”!  The four of us who left San Antonio together were delayed from the start.  Our flight out of San Antonio into Chicago was delayed due to weather, causing us to miss our connection and ultimately delaying our arrival by twenty-four hours and our luggage’s arrival an additional three days!  Due to a collision of circumstances, three of us did not get to the airport on time to depart Zambia, thus delaying our return home another twenty-four hours.  My partner, tragically, is getting way too used to these delays!  There were numerous other little frustrations during the week that are not even worth recounting.  But, call me crazy, it was still a fantastic trip.  The delays allowed for some wonderful quality time with the people I was traveling with.  And not having my luggage really taught me what I really need to have, versus what I would like to have.  The Lord may have taught me more on this trip than ever…and I truly felt closer to Him than I have ever felt.

This is the first time I’ve led a trip without Kirk.  I confess this caused me a lot of anxiety, as did the fact that the trip did not seem to be working out in keeping with the vision we had for it when we started planning it over a year ago.  Joshua 3 relates the story of the Israelites crossing the Jordan River into the Promised Land.  The river only parted AFTER those carrying the ark stepped into it.  Sometimes the Lord’s plans only become evident and accomplished AFTER we take the initial step of faith.  I went to Zambia not really knowing what exactly we were supposed to accomplish there and the Lord made it perfectly evident as the week went on.  We thought we would take a team of doctors and do medical outreach.  Only two doctors went:  me and my loyal friend Audrey, who decided to come at basically the last minute because I told her, on so many levels, that I needed her.  (I have to give credit to my friends Tae and Richard who did the exact same thing for the Mexico trip.  I am blessed beyond words by our many wonderful and supportive friends.)  The two of us only had the capacity to examine the thirty-six orphans, but this was exactly what was necessary.  Other outreach would have distracted from the quality time we needed to spend with them.  We thought we would take dentists to do dental outreach.  No dentists came.  We thought we would do building.  There were two couples that came for the pastors’ conference.  The other six of us were women.  Not exactly a strong building team.  But a strong team for simply loving on the orphans, which again was exactly what was necessary.  And, sorry men, it was such an incredible bonding, ministering time among these six women, I can now see why the Lord didn’t call other men to come.  All that being said, we would love it if doctors, dentists, and builders felt called to come with us same time next year!  And if you want to come just to love on orphans, as they say in Africa, you are welcome!

We did partner for the first time with Shepherds’ Support (www.shepherdssupport.org) to conduct a pastors’ and wives’ conference in Kitwe, Zambia.  Shepherds’ Support is the international ministry of my former Pastor Steve Troxel and his wife Connie that they stepped down from over thirty years of pastoring our church to start.  They did a three-day conference for around one-thousand pastors and wives that was wildly successful.  This was the fulfillment of a dream for Pastor Edward Mwansa, who oversees the orphanage work in Kitwe.  He, like Steve, has a heart to minister to and teach pastors, so it was a beautiful fit. 

What has been accomplished in Zambia since we first met Pastor Edward and his wife Barbra there in 2001 and since For Hearts and Souls Childrens’ Village (FHASCV) opened in 2003 is truly miraculous.  FHASCV started in a rental home.  You may remember last year we went to open Mimi’s House, a home FHASCV owns on land it owns.  There are now twenty-eight AIDS orphans living there.  A foundation has been laid to build a home of equivalent size on the same site.  A house has been rented for Betsey’s House, which is a home for eight teen girls who have been rescued from a life of drug abuse and prostitution on the streets.  Land has been purchased to make their home permanent as well.  There are twenty orphans in the capitol, Lusaka, who are going to school because of FHAS.  Another ministry has donated land to build a home for teen boys and building is going on there.  Meanwhile, Pastor Edward and his church members are ministering to the street boys once a week there with food, showers, clothes washing, and Bible study.  Barbra’s crisis pregnancy ministry, Silent Voices, continues to grow and counts over three-thousand babies alive because of it.  They’ve recently had an ultrasound machine donated to them.  We are praying for a doctor or ultrasound technician to go spend a significant amount of time with them to train them how to use it.  Pastor Edward’s Church on the Rock has been lavishly supported by Solid Rock Church in Portland, Oregon and they have purchased land to build their own building.  Someone else is assisting Pastor Edward and Barbra to build a guest house that will be so helpful for people going over there to minister. 

There is so much need there, it can easily become overwhelming.  Without being guilty of being satisfied and thinking it is enough, I do marvel and praise the Lord for what He has already done there.  A favorite song the Zambians love to sing when we’re there is “Come and see what the Lord has done.”  He has done so much…and it is so important for me personally to “come and see” it.  There are thirty-six children with names and personalities that have woven themselves into my heart because I’ve gotten to see and touch and hold and hug and interact with them.  Team members took their pictures and wrote down their stories.  We’re going to try to get them on our website so people can specifically pray for them.  And we continue to pray for how the Lord keeps expanding the vision.  We’d still love a farm for the orphans to move to once they get older, where they can learn skills they can use to support themselves.  There’s now a pre-school at Mimi’s House.  We’d love to have a school for all the orphans at FHASCV who now go to public school and for the orphans in town who may have family to live with but no money to go to school.

There is a spiritual “high” in going on these trips that is indescribable.  I honestly wasn’t tired the entire week I was there, which is miraculous because, ask my husband, I’m an expert at being tired!  I think it has to do with this:  “pure and undefiled religion in the sight of our God and Father [is] to visit orphans and widows in their distress and to keep oneself unstained by the world” (James 1:27).  There is simply a blessing in taking care of orphans that is palpable.  In contrast, I’ve been exhausted all week since I’ve been home.  This is probably the hardest time I’ve ever had writing an update.  It’s weighed on me all week.  And, like I said, it’s the first update I’ve written in three trips, despite the fact that people have told me they’ve missed them.  I finally realized it’s all about Ephesians 6:12.  The Lord is doing amazing things in the world through those of you who go with us, pray for us, and support us.  I named some names in this update, but there are so many names I’ve left out.  Please know that we are blessed by every single one of you.  What we are doing makes Satan mad.  And I consider it an honor.  If he weren’t mad, I’d question the effectiveness of what we’re up to.  The good news is we know who wins.  We are children of the King.  Through faith in Him we are able to “extinguish all the flaming missiles of the evil one” (Ephesians 6:16).  “In all these things we overwhelmingly conquer through Him who loved us” (Romans 8:37).  For me, the lesson is not to be discouraged by, but simply to be aware of, the spiritual battle.  I will continue to “be strong in the Lord, and in the strength of His might” (Ephesians 6:10).  And I will continue to be thankful for all of you who make the ministry of For Hearts and Souls possible.

Dr. Kim Milhoan, President, For Hearts and Souls

As a footnote, praise the Lord that Kirk’s time in Iraq is over half over.  The last time he was there he got to screen around sixty children for congenital heart disease, many of whom have traveled throughout the world to have treatment.  He’s praying for a similar opportunity this time.  In February, he did have the opportunity to travel to Yemen in an official capacity as an Air Force physician to screen children for congenital heart disease there.  He’s been invited back and is praying he’ll get to go on his way home from Iraq.  Stay tuned for a potential FHAS trip to Yemen.  Kirk never goes anywhere without getting the vision for more ministry!  Meanwhile, Lord willing, our upcoming schedule consists of Mending and Searching weeks in Mongolia in September, a Searching week in Mexico again in January, and a trip to Zambia again next March.  Is the Lord calling you to come with us?

Kosovo 2006

March 31, 2007

We are again enroute home from yet another trip where I am awed and humbled by what I have experienced.  Kirk and I are traveling home from Pristina, Kosova.  We were accompanied there by our good friends, Dr. John Kupferschmid (pediatric heart surgeon) and his wife Elizabeth and Dr. Minette Son (pediatric intensive care unit doctor).  John has been to Mongolia with Kirk three times now and Minette twice.  This was Kirk’s fourth trip Kosova since 2001 and it was the first trip for the rest of us.

We went to fulfill part of the dream of Dr. Ramush Bejequi, a pediatric cardiologist that Kirk first met in 2001.  He and Kirk have become good friends over the years.  Dr. Ramush has an incredible heart for the children of Kosova.  They have even less access to corrective heart surgery than the children of Mongolia.  Samaritan’s Purse Children’s Heart Project has brought over 100 children out of Kosova since 1999 for corrective heart surgery.  However, in the same time period, over 70 children have died either because they have had heart defects that could not be easily repaired or because they were waiting for acceptance for care at an international hospital.  There is absolutely no pediatric heart surgery in Kosova.  So, Dr. Ramush and his colleagues must day after day diagnose conditions they can do little about.  Dr. Ramush has a dream of bringing pediatric heart surgery to Kosova and he is dogged in pursuing it. 

The first step in Dr. Ramush’s dream was the organization of a symposium on pediatric heart surgery in Kosova.  The four of us went to speak at this symposium.  Dr. Ramush is not a Christian.  Most Kosovars are nominal Muslims, meaning they are Muslim by culture but not by practice.  A woman that works for Samaritan’s Purse in Kosova says that Dr. Ramush’s heart has been changed by this Dr. Kirk Milhoan who keeps coming back to Kosova and who was willing to fulfill his promise.  Kirk promised Dr. Ramush that he would one day help him to organize this symposium.  He kept his promise.  I was blown away by the joy and excitement with which he first greeted Kirk, “his friend,” when we arrived. 

I was also blown away by the lengths he went to in organizing this conference.  His goal was to have 500 people attend.  We all thought if 20 to 30 people attended, that would be impressive.  Pediatric heart surgery is such a specific, specialized topic, it’s hard to get many people together in the U.S. to discuss it.  He filled a downtown theater in Kosova with over 150 people.  We were impressed.  Dr. Ramush said it was not enough.  Like I said, he is incredibly dogged in his determination.

He published pamphlets and flyers and banners.  He had a Kosovar drug company provide sponsorship, with materials and briefcases for the participants.  He had businessmen donate funds so that he could cover the travel and lodging expenses for physicians from Albania and Macedonia, and so that he could feed the participants lavishly.  I was humbled to learn that the participants paid 20 Euros (about 27 U.S. dollars) to come to the conference.  However, I was relieved to learn that at least included breakfast, lunch, and a “gala” dinner.  Gala it was, lasting until past 1 in the morning and including traditional Kosovar dancing.  I particularly enjoyed the dancing part.  I did not particularly enjoy the getting up at 4:30 in the morning to get to the airport this morning after going to bed at 2.  Actually, it was well worth it.  I was so touched by these people and their desire to do something for their children. 

Part of the reason Dr. Ramush could get 150 people together, many of them to hear about a topic they know little to nothing about, is because we are Americans.  Sounds arrogant, but there is no other way to say it.  We were told over and over and over again by many different people how much the Kosovars love Americans.  They see us as their saviors.  Conversations consistently include the phrases “before the war” and “after the war.”  About one in twenty Kosovars died in the war with Serbia.  Most everyone lost someone. 

One of the people we met with was one of the former translators for Samaritan’s Purse, a young man named Hilke.  He says his brother was killed in the war.  He spent six months in his house, never leaving because young men were rounded up to be either killed or sent to prison camps.  After the war, his uncle, who had fled to Finland, started writing him and sending him tapes about his newfound faith in Christ.  Hilke said, despite the social cost of accepting Christ, he was overwhelmed by His truth and could not deny it.  Despite the fact that his family is only culturally Muslim, this still had tremendous personal cost to Hilke.  His uncle was funding his education in dentistry.  He disowned him and he had to quit school.  His father asked him at least three times to denounce Christ.  He said that first conversation with his father was the hardest of his life.  His father also disowned him and kicked him out of his house.  His father sent his uncles and cousins to change his mind, sometimes physically beating him.  They ended up telling his father that his faith was real and Hilke was winning all their debates with him.  His father did not talk to him for 4 years.  Hilke was allowed to go visit his mother during this time, but his father would never speak to him.  Finally, his father got deathly ill and Hilke went and took care of him, physically and financially.  They now have a relationship again. Hilke says a lot of his cousins have now accepted Christ.  Hilke is back in dental school and getting married next Spring, to a Christian woman his father has even accepted.  Hilke desires to go to Turkey to do missionary dentistry. 

Kosovars say they experienced atrocities in the war you’d never want to imagine.  One said “if you were watching it on a movie, you’d turn the movie off.”  And, as they see it, the U.S. came to their rescue.  We were told time and again that they would love to volunteer to help the U.S. forces in Iraq.  They watch the news with great interest and grieve when an American soldier dies.  Dr. Ramush’s partner, Dr. Ragijb, said he prayed for Kirk every day when he was in Iraq and that if Kirk had to go back, he wanted to go with him.  I cannot tell you how much they insisted on this point that they love the U.S.  The hotel we stayed in was “Hotel Victory,” with a replica of the Statue of Liberty on the roof.  There were American flags and symbols and names (including Boulevard Bill Clinton) everywhere.  It was truly, truly humbling.

Kosova is currently in limbo status.  They are not yet a country.  They are a disputed land, under U.N. management and NATO police protection.  Kosovars can travel fairly freely to Albania, Macedonia, Bulgaria, and Greece.  However, it is almost impossible to get a passport to travel anywhere else.  They told us, because we are Americans, that we were the “most favored of men.”  We have freedom to travel and are very welcome in their country and most countries in their region.  They so desire to be their own country.  We saw many signs that said, in Albanian, “We do not want to negotiate.  We want to be free.”  They desire to establish their own government and begin addressing some of the problems in their country.

They say that life out from under socialism is in some ways better and in some ways worse.  At least then everyone had jobs.  Now the unemployment rate is 70 percent.  Physicians only make about 240 Euros ($320) per month.  Dr. Ramush works full time at the public hospital and every evening and weekend (7 a.m. to 9 p.m., 7 days per week) in a private clinic so that he can make ends meet.  U.N. management has resulted in a two-tiered society where those with U.N. jobs make 1000 Euros ($1333) per month, while the rest of the population makes far less.  They say the cost of living is so much higher then their income, but somehow they survive.  Families do a very good job of taking care of one another.  Dr. Ramush’s two nephews, both of whom have college degrees but are unemployed, did a lot of helping with the conference.  I assume their family is helped by Dr. Ramush in return. 

Dr. Ramush desired to organize this conference to inspire the Kosovar doctors, medical administrators, and local government and businessmen to try to bring pediatric heart surgery to Kosova.  The U.S. ambassador to Kosova did visit the hospital and take a tour with us the day before the conference.  Dr. Ramush did invite the local Minister of Health to attend the conference.  He did not.  This was a source of great frustration to Dr. Ramush and many of the other doctors at the conference.  Two surgeons came up to us after the conference was over.  They had been trained in surgeries of the chest and lungs, but had not received any training in cardiac surgery, although they had very much desired to receive this training and perform these surgeries.  They said, though, that they have no support from local officials, such as the Minister of Health, for training and resources.  They said “please help us, however you can.”

We did meet an official from a foundation named for Mother Teresa that attended all of conference festivities.  He came to us at the “gala” dinner and said he wanted to raise a lot of money to bring pediatric heart surgery to Kosova.  Hallelujah!  Kirk saw 21  heart patients on the day before the conference, screening them for potential inclusion in the Children’s Heart Project and surgery in the U.S. or Canada.  He had to tell the parents of three of these children that there was nothing we could do.  We all fought tears as he did this.  What amazes me is the Kosovar pediatric cardiologists have to do this day in and day out.  That is what drives Dr. Ramush’s dogged determination.  We pray that the Lord helps him realize his dream.

 

Dr. Kim Milhoan, President, For Hearts and Souls

Zambia 2006

March 31, 2007

I am writing this as Kirk and I are on a plane back from a “quick” trip to Zambia. Upon our return, we will only have been gone from San Antonio six days. However, it takes well over 24 hours of flying just to get to or from Zambia. We were blessed with four fulfilling days there though. We were also blessed with four friends who traveled with us: two pastors from a church in Oregon who wanted to see how there church might become involved and some of our best friends, another doctor couple from our home group in San Antonio who’ve now moved to Okinawa.

This was my second trip to Zambia and Kirk’s fifth. We first went there in July 2001 when we were asked by the crisis pregnancy center that we were on the board of to visit a center that they supported inKitwe, Zambia. It was then that we met Pastor and Mrs. Edward and Barbra Mwansa and were touched by their heart to serve the Lord in ministering to the people of Zambia. One-and-a-half years later, Kirk, who was inspired by the orphanage work of the late George Mueller (who took care of as many as 2,100 orphans without ever asking man for money but by faithfully seeking God for provision) and the overwhelming number of AIDS orphans in Zambia, felt that God was leading us to help start an orphanage in Zambia. He wrote an e-mail to Pastor Edward asking him to pray about it. Just six months later, through a series of miraculous events, Kirk was there to witness the opening of For Hearts and Souls Children’s Village (FHASCV) in a rented home in Kitwe in July 2003. On a subsequent trip to Zambia in January 2004, Kirk inquired of the “mothers” who so faithfully take care of the orphans what they thought the orphanage needed and their common response was: a home of their own. FHAS was subsequently able to acquire land and Kirk returned in September 2004 with some other volunteers from the U.S. to help pour the foundation for the new building. This trip was to witness the opening of that new building.

The “opening ceremony” was Sunday afternoon. The worship team from Pastor Edward’s church sang a song at the ceremony that easily expressed the theme for the trip: “Come and See What the Lord Has Done.” The miraculous hand of God is so indescribably evident in the fact that despite obstacles too numerous to quickly summarize, this building was erected in such a short amount of time. The original rented FHASCV was meant to house ten orphans. At the time of the new house opening, eighteen children were being taken care of by FHASCV. The new house will likely accommodate up to thirty children.

Prior to taking this trip, I admit questioning whether it was a wise use of time and resources. It was going to be so short and relatively expensive. I was convicted over and over on the trip though how important it was that I was there, not for anything I could contribute, but for everything that the experience had to teach me. As I struggle to write this, I realize how words are so inadequate to explain what I was able to “come and see.” One of the most inspiring things to see was the orphans themselves. It’s one thing to talk about caring for orphans. It’s another to see them, to hold them, to play with them, to see them smile and laugh and cry, to put faces to names. There were eighteen of them, all with incredible stories. All are orphans of AIDS. Seven are HIV-positive. The youngest is two months. Most are toddlers. We laughed at this sea of little people we saw moving around, all about the same height. The oldest is twelve. They are thankfully surrounded by love. There are eight “mothers” who take care of them full time. Pastor Edward’s church members are heavily involved in volunteering there. They called most of us adults “mommy” or “daddy.” They loved to be held and played with and talked to and read to. I say there were eighteen of them, because as of today there are only seventeen. The littlest one, Peter, died this morning, right before we left. He had HIV. We noticed he looked sickly when we first met him on Saturday. By Sunday, he was in the hospital. By this morning, he had died. He’s the sixth child that has died since the orphanage opened and the second this month alone. He’ll be buried tomorrow in a baby graveyard that is very full and very busy. There were four of us physicians on the trip. We were all struck by, despite all our combined skills and training, because of his disease and because of the scarcity of resources, there was so little we could do for him.

That was the other important thing to see: the magnitude of the need. I cannot adequately communicate the passion and heart of Edward and Barbra for the people of Zambia. Theirs is an incredible ministry, that includes a church, the crisis pregnancy center, and the orphanage, that God in His providence has led them to in order to meet many needs. Barbra has an incredible ability to put their experiences into words. One night, as we were visiting in their very nice house by Zambian standards, she told me that “you know, you sit in this house in Zambia and everything looks fine. But something is terribly wrong in this country. Our people are dying.” She talked about the life expectancy of males in Zambia now being around 33. One in four, to maybe even one in three, Zambians are HIV-positive. There is an extremely high rate of HIV positivity in the teenage population. She said “we’re about to lose an entire generation.” She has an incredible passion to talk to teens about abstinence, the only foolproof method of protection against HIV. She says she talks to them about their hopes and their dreams and how best to protect themselves so they can live out those hopes and dreams. And on days when babies die, she says she wants everyone to be able to witness that experience. I believe it was God-ordained that we did.

We’ve had four days of seeing how much the Lord has accomplished in this ministry and how much more He is calling us to. We’ve got big dreams and visions: more room for more orphans, outreach to orphans who live with extended family, a school for orphans, a home for teenage girls that would save them from a life of prostituting themselves for food on the street and teach them skills to get a job, a farm where possibly teenage boys could live and raise chickens and crops, a medical clinic that would increase the medical resources and standard of care for the community. They’re God-sized dreams. But He’s already shown us what He can do. Meanwhile, FHASCV will keep loving orphans. And since we’ve chosen to minister to AIDS orphans, many more will probably die. But, as Kirk says, they’ll be loved into heaven. And when they get there, they won’t be surprised by the love of Jesus, because they saw it lived out in those who took care of them on earth.

 Dr. Kim Milhoan, President, For Hearts and Souls 

Mongolia 2005

March 31, 2007

For the long update on the trip, I decided to just give you the play-by-play I typed to my family while I was there….

Date: Wednesday, October 26, 2005
Subject: Woohoo from Mongolia!!!

I am typing in a state of exhaustion and relief. We did the first pediatric cardiac bypass case in Mongolian history today!!! And the child is doing very, very well!! Praise the Lord! I cannot even come near to explaining how this week has gone. Our container of supplies, including the anesthesia machine and cardiac bypass machine and LOTS of other important stuff, did NOT arrive!!! We now see this has been totally in God’s providence. Our goal was to do 10 ASD (atrial septal defect–hole between the 2 collecting chambers of the heart) cases starting on Monday. Well, given that we didn’t have our equipment, the Mongolian physicians invited us to observe them doing two of their hypothermic cardiac arrest cases on Monday. This is when they literally wrap the child in ice, wait for the child to cool, stop the heart, and operate as fast as they can. I think all of us were completely nauseous watching the whole thing. It was a completely heartwrenching, frightening experience!!! One case, a 27-year-old, survived. The other, a 3-year-old, did not. That’s about their mortality rate: 50%.

Meanwhile, in the screening, Kirk had been coming across a lot of other kids who we could really help with different types of surgeries. So, we went back to the drawing board figuring out what we could do with their supplies and what we brought along with us. For the cases we watched on Monday, they used an antiquated Russian anesthesia machine with ether anesthesia. I’ve only read about ether anesthesia historicallly. It is no longer on our boards!! So, after we watched these horrible cases, their surgeon’s were really pushing us to do some other cases. Plus, we were considering some other cases we really wanted to do. We want to do cases where the benefit outweighs the risk, meaning they are likely to die if we don’t do the surgery…or they’ll die if the Mongolians do their version…or we can’t get them on the Children’s Heart Project list to get them accepted in the U.S. I admit I was completely freaked out Monday afternoon and thought there was no way I could safely proceed!!! I needed a little alone time and some good debrief and prayer time with some of the wonderful people on the team, including, of course, my wonderful husband. I figured out how I thought I could safely do things my way. I was so freaked out because I thought there was no way I could safely do things their way!!

So, we did two non-bypass cases on Tuesday. I told the team I would go set everything up and see what I had and would not proceed if I did not feel it was safe. I cannot tell you how nervous I was starting that first case!!!! Lots of prayer and tears (I kept getting all this amazing confirmation that all would be OK that made me cry) getting there!! But, hallelujah, both kids did really well. I was able to extubate (remove the breathing tube) both of them in the OR, which is a victory. So, I was feeling a lot of relief going into today. But, today we did our first bypass case. Our perfusionist (who runs the bypass machine) was feeling the stress I was feeling yesterday. He had the same criteria. He’d set it up and if he didn’t feel safe he would not proceed. Well…we did it!! And that child was extubated within a half-hour of arriving in the ICU…another victory. I cannot even tell you the relief!!!!! Kirk told the team way back in Feb. that we would plan and the Lord would likely blow all our plans and make us totally rely on Him. Well, that is what has happened!!!The director of Samaritan Purse’s World Medical Mission is here and his morning devotion before we did the first cases yesterday was about the Lord being personal, a provider (ohmygosh has He provided just exactly what we need…and no more!), a protector (He would keep us out of trouble), and powerful. From what I have witnessed in the past 2 days, I cannot tell you how true this is!!!

Date: Friday, October 28, 2005

The Lord continues to miraculously intervene. We successfully did 2 pump cases and one non-pump case yesterday. All 3 kids were extubated within an hour of arrival in the ICU. More woohoo! I think everybody sees it and feels it. Kirk said I feel like it’s a failure when they wake up crying (because I want them to be comfortable and not in pain!), but everyone else is so excited to hear them crying! Especially their parents. You should see their tears of joy and relief!

Today is a big day. We are going to do a baby that will absolutely die if we don’t do surgery…but who is so sick he might not survive the surgery. His father has been driving us around the whole time we have been here because he has wanted to serve us for what we are doing. He and his wife understand the risk of the surgery…but they understand the absolute risk if we don’t do it and want us to proceed. Please, please pray! Another child is 13. He is the son of the man who owns the 2 vehicles that they have been using to drive us around. He is at risk of sudden death if he doesn’t have surgery. The last is a little baby. Littler patient, bigger risk. Only one case is a pump case. We had just enough equipment to set up one more pump case and no more. It is truly amazing to see God direct our steps. We feel like it’s like the widow’s flour and oil…it lasted just as long as the famine lasted and then dried up. We keep opening suitcases and finding what we need. And I bet when we’re done, the supplies will be gone.

The Mongolian surgeons were going to do another hypothermic circulatory arrest case today. Kirk and Dave (Kirk’s partner) saw the patient…and said he doesn’t even need surgery!! Thankfully, they cancelled the case. That is another prayer of ours. The risk of their surgery is so, so great. It’s even more heartbreaking to think they are putting kids at risk who don’t even need it. Kirk and Dave and John (our surgeon) have been working valiantly to try to help them improve their diagnostic skills and figure out who really needs surgery. Kirk and John are meeting with the Minister of Health for Mongolia today to try to get them to start funding the supplies for the pumps for the children who need heart surgery in Mongolia. That’s the whole problem. They have pumps but no appropriate supplies for doing peds pump cases. And the doctors and hospital only get $5 per case. I honestly think they don’t want to hurt these kids. They’re doing the best they can with extremely limited resources. So, prayerfully, I’ll have a good report tonight!

Date: Saturday, October 29, 2005

Today’s is a mixed report. Bottom line is we did 8 successful surgeries this week and have 8 kids doing very well and 8 very happy families. I don’t know if I’ve ever been so tired! The director of the hospital and the surgeons hosted us for a nice dinner last night. I was so, so tired I had a hard time rallying to get there, but I’m glad I did. We were showered with presents from them…and 2 of the families of the kids we treated showed up with more presents. Truly, truly humbling. I came home and slept like the dead. First night since we got here that I didn’t wake up in the middle of the night thinking about what was before me. It’s a really good tired though. I get tears in my eyes just writing and thinking about it.

We’ve staffed the ICU every night this week. Kirk’s partner Dave and one of the nurses were there last night. So, Kirk, another nurse, and John the surgeon got up this a.m. to go relieve them…and hopefully send the kids from yesterday out of the ICU to the floor. They were both extubated early after surgery too and all the rest of the kids have been able to go to the floor post-op day 1. Then the surgeons want to take us to the countryside. So, its a nice day to relax a little and reflect before we get on the plane tomorrow.

I said it was a mixed report…we didn’t get to do the child who will most definitely die without the surgery. It has a lot to do with politics and circumstances that are not worth getting into, but what an incredibly hard decision! It’s a chance for a lot of us to see what Kirk has been seeing for 5 years. He’s had to tell countless families there’s nothing we can do. Sounds strange, but I’m happy for him that there are many more of us who are experiencing it and can share the emotional burden with him.So, anyway, much progress made. Much more to be made. Kirk said the meeting with the Minister of Health was just ceremony. No real progress on policy there. But, after 9 trips, it was at least a meeting with the Minister of Health. It’s easy to get discouraged with how far there is to go…but we’re trying to keep focused on how far we’ve come. There’s that parable in the Bible about the shepherd leaving the 99 sheep for the one. We came halfway around the world for eight. That’s pretty remarkable.

To God be the glory. Great things He has done.

Oh, yea, the container arrived today. I think that was God’s humorous exclamation point on the week. He wanted us to do all in His strength, not our own. Another oh yea: I can’t tell you how many things we used the last of on the last case! On the last case, the blood warmer on the pump failed. We were able to get the patient just barely warm enough. After he was off pump, the oxygen line to the pump broke. Truly amazing! We did so many creative things to get this all accomplished, I think my skills must have grown exponentially. I will be so appreciative to do my job in the U.S. now!!!

Thank you so much for praying and supporting us!

Dr. Kim Milhoan, President, For Hearts and Souls

Fall 2005

March 24, 2007

Once again I am writing from high above ground as I start a journey to Mongolia. But, first allow me to thank all those who have been faithfully supporting this ministry through your prayers and generous giving. Next, I would like to apologize for the delay in “Updates”. Please know that the lack of updates is not because nothing is happening but rather that I spent the last 4 months in Iraq.  (If interested in my writings about my time there, please go to www.brokenmasterpieces.com and click on “Thoughts from the Cradle.”)  Please allow me to share with you what God has been doing while For Hearts and Souls has been in the neighborhood.

For Hearts and Souls Children’s Village, Kitwe, Zambia, a ministry to AIDS orphans

The orphanage in Zambia continues to bless and be blessed. Since opening in July 2003 we have seen the faithfulness of a loving God who cares for the fatherless. The new home we are building is almost finished. I am planning on traveling for the opening in January 2006, Lord willing. We currently have approximately (numbers can change daily) 14 orphans, including a 16 y/o orphan Cecelia and her two children. She was a street child until a year ago when she came to us. Shortly after arriving she was noted to be pregnant from before. She has since given birth to her second child and has become a real help around the house. Cecelia has opened our eyes widely to the problem of young girls living on the street. As the new home opens, I would like to keep the rental home and have it become a home for young girls who currently live on the street. We want to care for their physical, emotional, and spiritual needs. The new home will be primarily for young children. All of these children are AIDS orphans and about one-third have HIV/AIDS. I would also like to purchase a 20-acre farm for food for the orphans as well as an on-the-job training facility for our older orphans. I would like to share some of the financial blessings that God has poured down on the orphanage. I list these not to solicit, but to give glory to God for His faithfulness. The monthly budget to care for 14 orphans and employ 8 staff is $1640 a month. God has been faithful to provide. We continue to seek only our God for financial help and He has directed many to share with this ministry. The cost of the farm will be between 2000 and 4000 dollars. We trust that if it His will for us to buy the farm then the money will be available in His perfect timing. Please continue to pray for the work in Zambia as the need continues to grow larger. But our God is even larger.


Searching for the Broken Hearts, Playa Del Carmen, March 2005

In March, I had the pleasure of traveling to Mexico. I saw 48 patients and 16 of those children had significant heart disease that needed either surgery, cardiac catheterization, or medication. The other patients did not have any heart disease and were very relieved to know that their heart was OK. I am happy to report that, as of Oct 13 2005, eight of these children have traveled to the U.S and undergone care, either with catheterization or surgery or both. One nine-year-old child’s family, after she underwent further diagnostic evaluation in the catheterization laboratory, elected for her not to have surgery as the risk of surgery for her would have been very great. One 3-year-old boy with Down syndrome had been turned down for care multiple times in his life, both in the U.S. and Mexico. What a gift to see the tears of joy in his father’s eyes when he was told his son could have surgery. Another three of these children have undergone surgery in Mexico, performed by the
U.S. pediatric cardiothoracic surgeon who traveled there with me in March.

Searching for the Broken Hearts, Mongolia 2005

There are 18 team members who are currently traveling to Mongolia. This is our third large scale medical mission to Mongolia to search for children with heart problems. We plan to see 1500-2000 children in 4 ½ days. All children will receive toys and a gospel bracelet. Children who are thought to have a heart problem will receive an echocardiogram at no charge to the family. Children who are diagnosed with a lesion that requires surgery will either be treated by the Mongolian physicians, be treated by our team, be treated by a Japanese team, or become a part of the Children’s Heart Project, a Ministry of Samaritan’s Purse. Please pray that the children and their families are able to clearly see Jesus through our lives, actions, and words. We will be screening children from October 17-21.

Mending the Broken Hearts, Mongolia 2005

In 2001, I had asked God to show me children with heart disease that I may be able to help. Shortly after that prayer I was in Kenya and I saw many children who needed heart surgery but I had no way to help them. As I sent one child home to die, I walked to lunch with tears in my eyes, pleading with God that now that he has shown me all of the need that he would allow me to do something to directly help the children and teach the local physicians. Over four years later a door has been opened for us to bring pediatric cardiac surgery to Mongolia. The Mending the Broken Hearts team has 12 members: pediatric cardiac surgeon, pediatric cardiac anesthesiologist (my wife Kim!), 2 pediatric cardiologists (including myself), pediatric intensivist, pediatric cardiac perfusionist, and 5 nurses who specialize in caring for children with heart problems. We will be working with the local physicians and nurses in Mongolia to train them on the equipment that has been donated for the project. Our plan currently is to do two open heart surgeries a day for 5 days. We hope this is will start a collaboration where we can come and help them bring up the standard of pediatric cardiac care in Mongolia, so eventually no more children will need to leave to receive the life saving surgery they need. We are doing the project in conjunction with Samaritan’s Purse, who has been very generous with gathering the donated medical equipment as well as purchasing items that were not donated. They also have provided for the shipment of a 20-foot container. This is where we need your prayers. The container’s arrival is still in some question due to some unforeseen problems. Please pray that the container will arrive and be released from customs so we will have the equipment so desperately needed. We trust that God’s perfect will will be done. Please pray that God would be glorified by the works of our hands and that the children and the families would sense God’s love through His son Jesus Christ in a very real way.


Iraq

Many of you know I was deployed as an Air Force Flight Surgeon to Iraq for four months over the summer. One of the highlights of my time there was when I was able to go to Baghdad and screen 57 children with significant heart disease for eligibility for surgery. 27 of the children need surgery and do not need any further evaluation. 20 children need further study with a catheterization prior to a decision being made on surgery. 7 children were not operable and 3 did not need surgery. There are 4 organizations that are interested in helping these children find places where they can receive surgical repair. One of the most interesting is Shevet.org. They are a Christian Jewish organization that has brought 50 children out of Iraq so far. Some of these children have been treated in Israel. What a testimony to the work of Christ: Christians bringing Muslims to Israel for healing. Please pray for this work.

Future trips


         Zambia: I plan to go to January 2006 for the opening of the new orphanage.

Mexico: We will continue to help children in Mexico at Playa Del Carmen. I already mentioned that the pediatric cardiothoracic surgeon that traveled with me in March has been back to perform surgery. Our next trip will be in early Spring.

 

What I ask of you is to pray. Pray that we are worthy to serve the people God puts in our path and that our service brings glory and honor to our Lord and Savior Jesus Christ.

 

Soli Deo Gloria

 

Dr. Kirk Milhoan, Medical Director, For Hearts and Souls