Mongolia, September 2009

Last week, 35 Americans, including Kirk and myself, traveled to Ulaanbaatar, Mongolia for our sixth Mending the Broken Hearts week there.  Many of you know it is my tradition to write the updates of our trips on the plane home.  I myself find this a fascinating process because I often have no idea what I’m going to write about it.  Our surgical trips are usually so busy that there is not a lot of time to process what I feel the Lord is teaching me until I get quiet on the plane flying home.  This week I have actually been intentional in asking the Lord “what are you trying teach me/us through this week?”

I have felt called to praise the role of our dear friend Ed Morrow.  He’s a humble man, so he wouldn’t want me to do this, but too bad (he also has a sense of humor, thankfully!).  He is the Director of Samaritan’s Purse’s World Medical Mission.  Since For Hearts and Souls has partnered with Samaritan’s Purse to do now our sixth pediatric heart surgery trip to Mongolia (and first to Kosovo this past summer) since 2005, I cannot overstate the level of administrative, personal, and spiritual support he is given to our Mending the Broken Hearts team.  Despite his own aggressive travel schedule, he commits to being with us in Mongolia and serving as our chaplain.  He conducts our daily morning devotions.  He mans our hospitality room, making sure we are all fed and watered.  He delights us with his sense of humor and endless stories of his family’s years on the mission field in Congo.  He serves as counselor to many.  And, most importantly and most dear to me and Kirk, he is our faithful prayer warrior.  He delights in praying for the children prior to their having their procedures and we know he is consistently praying for us throughout the days and nights as we conduct our week.  There are new members to our team each year, but the most frequent question most veterans ask is:  “Is Ed coming?”  I doubt he’ll know this side of heaven the impact he has had on the faith of many individual members of our team.

This year Ed’s travel schedule prevented him from being in Mongolia during the Mending the Broken Hearts week.  However, as a little gift to me and Kirk, his travel schedule did allow him to be in Mongolia for Samaritan’s Purse business the week prior.  Kirk and I; Brandon Phillips, another pediatric cardiologist; Kayleen Lundstrom, our scrub tech; John Souto and Todd Poor, our biomedical engineers; and Bart Hensler, our perfusionist, actually arrived several days prior to the rest of the team in the hopes of conducting one surgery on Friday for a young man, Batulzii, who had his first heart surgery in San Antonio, is now over 18 and ineligible for the Children’s Heart Project, and needs a follow-up surgery.  The schedule of Dr. John Kupferschmid, our pediatric heart surgeon, unfortunately did not allow him to be there as planned (it turned out that Batulzii was sick and couldn’t have had surgery anyway….God knows!).  Our being there early gave us extra time for getting organized for the week ahead and for screening more children for heart disease…and for spending time with Ed!

One morning after we all had met for breakfast the rest of the team had left the table and Ed told Kirk and me that he had something to tell us.  It’s like the old E.F. Hutton commercial:  when Ed talks, people listen!  He told us that he had been awakened in the middle of the night and felt like the Lord was telling him we had a hard week ahead.  He clarified that he’s not a dramatic person and this is not a usual occurrence for him (he said it had only happened to him one other time in his life), but that it had actually frightened him.  If you’ve followed these updates, you know we’ve had some hard times.  In 2006, we lost Undermaa after her surgery.  In 2007, we lost Bogi.  This past summer, our team in Kosovo was involved in a bus accident where three out of the four young men in the car that hit us lost their lives.  We believe in a loving, sovereign, all-powerful God, but I would be lying if I told you that most of us who have been through this don’t have some post-traumatic stress from having gone through all of this.  We took his words as a call to prayer.  This was our sixth surgical trip to Mongolia.  The care and conditions there have actually improved dramatically enough that our concern is that we will start to rest on our ability and our strength and not rest on the power of God that works through us:  “unless the Lord builds the house, they labor in vain who build it (Psalm 127:1).”  Before he left on Sunday morning, he met with the team on Saturday night for a devotion and told us about his experience and his concerns.  He called us to prayer.  And he brought a cross for us to write down and tape to it whatever it was that was distracting and entangling us from our work.  He also called us to be loving and patient with one another as team members.  Although we missed his daily devotions throughout the rest of the week, Tom Mangham, the Mongolian country director for Samaritan’s Purse, filled in more than ably and blessed us with his devotions each morning.  Ed’s devotion also carried us.  Team members including myself talked throughout the week about more things we needed to put on the cross.  That imagery lasted throughout the week.  And, though we had our failures, I think I saw the most progress in us truly living up to Ed’s admonition to love and support each other as team members throughout the week.

I in no way desire to be arrogant, but I think it’s important to understand that what we do is very, very hard.  Pediatric heart surgery in the United States is very, very hard.  Take that to a third world country and it’s exponentially hard.  I can say without hesitation that our international surgical weeks are the hardest and most exhausting of my year.  Add to that a team of highly skilled and, by necessity, highly controlling individuals who have a touch of post-traumatic stress disorder and it can be explosive!  I confess that sometimes it’s not pretty!  Ed reminded us of that and rightfully cautioned us at the week’s outset.

On Sunday morning, we went to church and immediately saw Bogi’s mom.  This year is the second anniversary of Bogi’s death.  On the morning after Bogi’s death two years ago, her parents met each team member with a book mark handwritten with the following Scriptures: “I thank my God always on your behalf, for the grace of God which is given you by Jesus Christ (1 Corinthians 1:4)“ and “Therefore, my beloved brethren, be ye steadfast, unmoveable, always abounding in the work of the Lord, forasmuch as ye know that your labour is not in vain in the Lord (1 Corinthians 15:58)“.  This year Bogi’s mom told us that September is her favorite time of the year because she knows families are being helped.  During the service, she prayed powerfully for the children and families who were going to receive care.  Seeing her there, I replayed in my mind pictures and images of that last week with beautiful Bogi.  As we were singing praise songs, I couldn’t stop crying and asking God to please not let us hurt anyone this year.  I think that is the simple prayer of many of our hearts on the team:  “oh please, Lord, just let there be no death this year.”

On Monday, our usual caution of “expect the unexpected” in Mongolia occurred and we were unable to do any cases in the cath lab.  We did, however, do two cases in the O.R. and it went well.  On Tuesday, we did three cases in the cath lab and two cases in the O.R. and that all went well.  I started having theological discussions with myself:  “Well, maybe Ed warned us and we prayed and it’s all going to be fine.”  Then Wednesday came.  We did four cases in the cath lab.  The fourth was supposed to be the easiest and quickest and it was the longest and hardest and the news wasn’t good.  The lovely young girl we were taking care of has an inoperable condition and there was nothing more we could do for her.  We did two cases in the O.R. and they were long and challenging.  We finished late.  Everyone was tired.  And the first surgical case of the day, Anuujin, was not doing well.  I think most of the team left for the hotel sometime after 8 p.m. and, in addition to our regular ICU team who stays all night, a number of us stayed until well past 11 p.m. putting our heads together and trying to figure out what was best for her.  As it was all transpiring, I knew Wednesday was what Ed had been warning us about.  Team members were short with each other.  And many of us were somewhat fearful and thinking “please!  Not again!”  Kirk always tells the team that God will put is in the position during the week to drive us to our knees and to depend on Him.  This year, it was Wednesday.

On Thursday morning, we were relieved to see that Anuujin had held her ground through the night.  She slowly got better throughout the day and by Friday she was literally miraculously better.  We thought we were going to have to transport her across town to the Children’s Hospital on Friday for continued care in their pediatric ICU as our team was preparing to leave the country, but this turned out to be unnecessary.  We did two more surgeries and three caths on Thursday and two caths on Friday.  In total, we did eight surgeries and twelve caths and, by God’s grace, all children are doing well.

Kirk did the devotions on Friday.  He reflected on all that had transpired through the week.  And he asked us to individually ask for forgiveness for those we had been short with and to thank those who had blessed us by their service.  I love these teams and the people on them.  Many of us count each other among our dearest friends.  We look forward to reuniting and serving in Mongolia together.  But it blessed me to see an extra measure of team love and unity than I think I had witnessed before.  To those other people on the team reading this, forgive me for any way in which I fell short or caused offense this week.  And thank you for your loving and sacrificial service.  Thank you, Ed, for reminding us that they will know we are Christians by our love, one for another (John 13:35).  On that last morning, Caley Johns and Deanna Smith, our two child life specialists, shared about some family members and patients they had led to the Lord during the week.  These Mongolians had testified that our love and care and concern for them, their children, and each other demonstrated to them that we were in some way different…and this testimony allowed Caley and Deanna to share the only thing different about us is Jesus.  Our ministry name is For Hearts and Souls. “For what does it profit a man to gain the whole world, and forfeit his soul?  (Mark 8:36)  What will it profit these children and their families if we fix their hearts and do nothing for their souls?  We are all like these children.  We have broken hearts that need fixing and that fixing comes by a free gift.  Jesus died that we might live and all we need to do is accept that free gift (John 3:16).  That is why we do what we do:  all because of Jesus.

As I fly home, Kirk, 26 other Americans, and 16 Mongolians are in western Mongolia for the Searching for the Broken Hearts week.  They will screen hundreds of children for congenital heart disease, and share the gospel with them and their families.  We felt the prayers of those of you at home during the Mending week.  Continue to pray for the Searching team and for all they come in contact with.

Since Kirk separated from the Air Force in June in order to devote himself to full-time ministry, his travel schedule has been and will continue to be aggressive.  Prior to this trip, since July, he had been in Malawi, Zambia, Iraq, Mongolia, and Kosovo.  After the Searching week, he will join friends of ours on a team from Calvary Chapel Maui in Nepal.  They will trek three days to minister to a nomadic tribe that follows monkeys.  He will return to the U.S. on October 23, be home for about three days, and head to Honduras.  He heads back to Iraq in November.  Please keep him in your prayers as he travels.

Thank you, as always, for your love, encouragement, support, and prayers.  Soli Deo Gloria.

Kim

Kosova July 2009

“But Mary treasured up all these things and pondered them in her heart.” Matthew 1:19

We’re flying home from a week in Kosova. We went there to do our first pediatric cardiac surgical mission trip there as a joint project between For Hearts and Souls and Samaritan’s Purse Children’s Heart Project (CHP). This was Kirk’s eighth trip there since 2001. Like Mongolia, he has traveled there to screen children for heart disease and train local pediatric cardiologists. And also like Mongolia, Kosova is a country from which CHP sends children with heart disease to the U.S. and Canada for surgical repair. It was my second trip to Kosova. Five of us had traveled to the capital, Prishtina, in 2006 to conduct a symposium on how to establish a pediatric cardiac surgical program there. There are so many children to be treated that many of them die in these countries while waiting on a list to be accepted by a U.S. or Canadian hospital. Our hope is that more children can be treated successfully if we help these countries develop their own cardiac surgical programs. It was our sixth such trip, the first five being to Mongolia. These trips are always filled with joy and sorrow, successes and frustrations. This week was no different.

Our week actually started with tragedy of a kind we’d never experienced before. The majority of our American team of twelve (Kirk, peds cardiologist; me, anesthesiolgist; Dr. Minnette Son, peds intensive care physician; Beth Huskamp, RN and CHP staff; Mike Andersen, pharmacist; Dr. Cathy Woodward, peds nurse practitioner (PNP); Nelia Doenges, PNP; Lisa Matasovsky, PNP; and Molly King, RN (PNP in training)) had arrived in Prishtina on Friday. We joined five of Samaritan Purse’s wonderful in-country Kosova staff, headed by Country Director Val Kroeker, there, as well as four sweet, serving translators who helped us for the whole week. We arrived early so that we would have the weekend to examine the children we were planning to take care of, screen more children, and attempt to get set up for the week of surgeries ahead. Dr. John Kupferschmid, pediatric cardiac surgeon, his wife Elizabeth, and Dr. Mary Porisch, peds cardiologist, arrived on Sunday afternoon. While Val went to retrieve these three from the airport, the rest of the team had planned a relaxing outing to the coutryside with some of the local Kosovar medical staff and their families in order to get to know each other better before our week of work together began.

As we were driving through a local village, our bus was hit by a car. I did not see it happen. Given the frankly wild driving we’ve witnessed in Kosova and other countries we’ve traveled in, we’ve been thankful in retrospect to piece together that our bus driver was on the right side of the road and not traveling at excessive speed. Some of our team in the front of the bus saw it happen. An Audi traveling toward us at a high rate of speed had gone off the shoulder, tried to correct, lost control, and fish-tailed into us. Their right side hit the front of our bus and spun so they ended up resting with the right side of the car against the front left of our bus. None of our team were hurt. I heard the screech of tires and felt the impact. From the force of the impact we felt, most of us just thought someone had pulled out in front of us and it was nothing more than a fender-bender. Someone on our team yelled that the four teenage male occupants of the car were not moving and all of us with medical training piled out. The scene was actually indescribably horrific. The occupants were not wearing seat belts, nor did they have air bags (they’re often removed from these cars to be sold). Despite our best attempts, two died at the scene while we were attending to them. We got one into a private vehicle (the emergency response system is nothing like the U.S. and we could not count on an ambulance to arrive in a timely fashion), but he is brain dead. Our team did help stabilize the fourth, least injured victim and an ambulance did arrive for him. Praise the Lord, his injuries were not life threatening and he will survive.

I hesitate to take up a lot of this update with this event. However, as you can imagine, it was incredibly significant for all of us who experienced it. We’ve had a week to “ponder it in our hearts, “ talk about it, cry about it, and pray about it…and most of us can see the loving, sovereign hand of the Lord all over this tragedy. My first reaction was “what did we do wrong?” What did we do wrong that the car hit us and that three occupants did not survive? That’s why it’s been so important to most of us to realize our bus driver was absolutely driving responsibly. I’ve come to realize that the car was out of control and was going to hit someone, either pedestrians or another car or cars. The fact that it hit us, who could absorb its high-speed impact without us being hurt, prevented even further tragedy. One of the Kosovar peds cardiologists had wanted to drive ahead of us in his private car with his wife and two sons. He fully realizes he could have been the vehicle hit and is so thankful Kirk talked him into riding with us. Evidently it is cultural when an event like this happens to find someone at fault and administer instant justice. We were immediately surrounded by a riotous crowd as we attended to the victims at the side of the road. It actually occurred to many of us that although we survived the crash, we may not survive the crowd! I remember praying for protection and keeping to my task. As quickly as the thought came into my head that we were in trouble, the crowds calmed. It turns out two European Union (EU) police officers were returning from the airport and had come upon the scene and immediately, with the help of Kosovar police and some of our Kosovar team mates, established crowd control. One of these men was trying to coordinate an emergency response, including the ambulance. He had even tried to get us a helicopter. The Kosovars tell us the fact that police and ambulance arrived as quickly as they did was actually miraculous for this country.

The hardest part of this event for all of us was to have so much medical training and expertise…and to feel completely impotent to prevent these three deaths. I really do console myself that their head injuries were so bad that even in the U.S. all three would have died. We would have had the illusion of intervention, but the outcome would have been the same. I prayed for our witness as we cared for these victims. I cannot overstate how Americans are absolutely revered by Kosovars. I kept hearing one of the Kosovar doctors telling the crowd we were American doctors. I confess I worried that we had come to their country to help their children and their confidence in us would be damaged by the fact that we could not save these three. The word of mouth that we have received is that most who observed us were thankful and touched to see us try so hard and realize we did everything we could. It turns out that the victims were gypsies, who are highly discriminated against in Kosova. It broke my heart to learn that some in the crowd actually said we shouldn’t try to help them because of their ethnicity. I praise God that we were able to demonstrate that every single human life has value. The EU police officers came to visit with us at our hotel for several hours over dinner Thursday night. They are still reeling from witnessing this event and were actually leaving for Germany the next day to undergo post-traumatic stress counseling. I praise God that we were able to share with them the hope that is within us, what we felt we had learned from the experience, and how we could have peace in the sovereignity of a loving God in the midst of this tragedy.

I think one of the most powerful lessons was trying to take care of patients without the appropriate supplies or equipment. We experienced this for maybe one hour and it was heart wrenching. After working with them for one week, I now know that this is what the Kosovar physicians experience every single day. We were amused with how the doctors and nurses would respond to us in English when we asked them for a particular supply or medicine. They would say “we haven’t.” It became one of our team’s comic relief catch phrases for the week. “We haven’t.” However, it is actually their tragic reality. They have the desire to care for their countrymen. We were impressed by their level of medical education and training. But when it comes to what they need to do their jobs, “they haven’t.” It was important for us to feel what that is like, if even for one hour.

After the week’s hard start, in terms of taking care of the children, the week actually went miraculously well. We were supposed to start surgeries on Monday, but Dr. John’s luggage did not arrive until Monday and he had checked some donated surgical equipment that we needed. I am thankful for one additional day of organization. They don’t currently do pediatric heart surgery in Kosova, so what we accomplished was historic. There were lots of logistical false starts as we tried to sort out who and what we needed from the Kosovars to pull this off, but the Lord was faithful. There were lots of things we thought they had that we found “they haven’t,” but I can testify, like on every surgical trip we’ve been on, we may not have had everything we wanted, but we had everything we needed. We do not want to reduce our standard of care to do these surgeries internationally and we in no way want to compromise the safety of these children. We were able to accomplish this successfully.

We chose to do “simpler” surgeries that did not require the heart-lung bypass machine, as they are not currently performing these surgeries in Kosova, even on adults. We did one patent ductus arteriosus (a remnant vessel from fetal circulation that usually closes on its own) ligation, four coarcation of the aorta (narrowing of the large artery that feeds the body) repairs, and one diagnostic heart catheterization. The heart cath was also historic in that they had never done a pediatric cath, let alone general anesthesia in the cath lab. Dr. Mary had actually wanted to do an intervention on this child to hopefully enlarge her narrowed aorta (she’s already had one repair and a stent placed), but decided the conditions were not safe to do so. Although this was extremely hard on her not to do what she had wanted to do for this child, it ended up being a powerful lesson in us not being willing to do procedures we consider unsafe. She will likely go to the U.S. again for repair or we will take care of her on a subsequent trip if we can be more assured of the right conditions.

The end result is we were able to be the hands and feet of Jesus to six children and their families and there are six healthy children to show for it at the end of the week. There is no greater joy. The needs continue to be great. We pray for workers for the harvest field, more medical professionals who are willing to do these trips. We pray for the children we took care of, the additional children we diagnosed, and their families. We pray for comfort for our bus driver and for the families that are grieving, and we pray for healing and comfort for the young man who survived.

Our desire is to glorify the Lord in all that we do. I pray that in all circumstances this week, both good and bad, that our desire was accomplished. Soli deo Gloria.

Mongolia April 2009

          We’re en route home from Mongolia and, as is tradition, I’m writing an update.  We usually do a big trip to Mongolia every Fall with a Searching for the Broken Hearts week, a Mending the Broken Hearts week, and a team of at least 50 people.  This was a short trip with a small team:  Kirk (peds cardiologist and team leader), Mary Porisch (peds cardiologist), John Kupferschmid (pediatric heart surgeon), Bart Hensler (perfusionist—runs the cardiac bypass pump during heart surgeries), and me (anesthesiologist).  We were missing one team member, Minette Son (pediatric intensive care doctor), who sadly couldn’t join us at the last minute.  We were only in the country from Friday night to Wednesday morning.  We performed three heart surgeries and three cardiac catheterizations.  We went on this quick trip to fulfill some promises.

            Instead of children, we actually operated on adults this time.  All three had congenital cardiac defects, meaning they had heart defects they were born with.  They just weren’t diagnosed until later in life.  We had a smaller team this time because we had promised to come help the Mongolian doctors operate on these patients.  In the four years we’ve been doing these surgical trips, we’ve been doing lots of training and have watched the Mongolian doctors and nurses come a long way in their proficiency.  We usually duplicate each and every member of the team required in the U.S. to take care of heart surgery patients, which results in us having up to thirty people on our surgical team.  On this trip, the Mongolian medical team took the lead, with us just offering assistance.  It was so gratifying to see how far they’ve come, from doing surgeries without cardiac bypass and with an approximately fifty percent mortality rate four years ago to becoming proficient enough to have done almost fifty bypass cases in the last six months with a less than five percent mortality rate.

            There a great stories regarding all three adults and how we came to be involved in their surgeries.  The first was the father of a girl, Anujin, who we operated on two years ago.  We met her three years ago when Kirk diagnosed her mother with inoperable congenital heart disease.  She asked Kirk to examine her daughter and he found she had a hole between the collecting chambers of her heart (ASD or atrial septal defect).  He promised her then that we would operate on her the following year and she was our first surgical patient two years ago.  She came back last year for follow-up and her father mentioned some concerns about his heart.  Kirk examined him and found that he had the same defect his daughter had had.  Our promise to operate on him was the reason we planned this trip.  The second patient was the niece of one of the Mongolian operating room nurses that we have worked with over the last four years.  She also was diagnosed with an ASD by our team last year and we promised to help with her surgery too when we came to take care of Anujin’s father.  The last patient’s story is a little more involved.

            Shinebayer was diagnosed with heart disease by the Mongolian doctors two years ago.  Her family had the means for her to go to Hong Kong to get an echocardiogram (ultrasound of the heart) to confirm her diagnosis, also an ASD.  Her family then began seeking help from various NGOs (non-governmental organizations) for her care.  They had even found a hospital in Utah willing to perform her surgery, but she was unable to get a U.S. visa.  One of the organizations they had written to was Samaritan’s Purse.  Kirk was able to see her last year and confirm her diagnosis.  She had proceeded to look for ways to have her heart surgery outside Mongolia.  She had just been accepted by a hospital in Korea and was going to be able to travel there by herself, without any family members accompanying her, if she could cover her own travel expenses.  She was debating this option until just last week when a member of our team called her and offered our help.  Shinebayer’s sister-in-law speaks excellent English.  She took us out to dinner as a thank you and it was wonderful to hear firsthand all the details of this story and the tremendous gratitude of Shinebayer and her family.  They truly saw the hand of God in all the circumstances of her story.

            We operated on all three adults on Monday.  Each trip we seem to get blessed in being part of something historic in Mongolia.  This day was historic because it was the first time they had ever performed three cardiac bypass cases in one day there.  This would be a strenuous schedule even by U.S. standards.  All three patients did well.  They were able to have their breathing tubes removed in the operating room so did not require any time on a ventilator in the ICU.  It was wonderful to see all three of them sitting up in bed first thing Tuesday morning and walking around the ICU by Tuesday afternoon.

            There are always lessons on every trip we take.  As I said, we arrived Friday night.  We went to the hospital on Saturday morning to meet with the three patients for Monday.  Then we spent Saturday afternoon screening more children for heart disease.  This is a regular part of what Kirk and the other pediatric cardiologists do on every trip to Mongolia and the main focus of our annual Searching for the Broken Hearts trips.  I, however, am not usually involved.  As the anesthesiologist, I’m usually involved when it is already decided what children need procedures.  Now, I have been involved in the past and, of course, I’m married to the primary screener, so I’m not ignorant of the process.  It’s just easier to escape the emotional burden by not being primarily involved.  I was already thinking on Saturday afternoon how good it was to be there and how slow I am to learn the lessons that the Lord must teach me over and over again.  I know how good we have it in the U.S. and how incredibly blessed we are, but I have to stare the alternative in the face again and again and again to be reminded.

            On Saturday afternoon alone we saw at least three babies with severe enough heart disease that they are likely to die soon without intervention.  There are not more of these babies born in Mongolia than in the U.S.  They are just diagnosed and treated in the U.S. in a timely fashion.  Many children in Mongolia go a long time without diagnosis or have few treatment options if they are diagnosed.  I have already told you they have come a long way in Mongolia, but they are still able to perform surgeries on the simplest of cases and on patients usually above about forty pounds.  There are not a lot of options for the littlest and most complex cases.  I know this.  I know it goes on there, and a lot of other places in the world, all the time.  But I don’t have to see these beautiful baby faces and the tear-filled eyes of their parents who so apparently love them.  Kirk does and, once again, it gives me so much appreciation for what he goes through as our team leader.

            These situations introduce a horrible dilemma for us who are there as team members.  We have the overwhelming desire to “do something.”  With the five of us who were there, it is easy to consider taking these children to the operating room or to the cardiac catheterization laboratory.  But a simple procedure is such a small part of the process.  We went on this trip planning to do three adult ASD cases.  That is what we had the supplies and personnel to do safely.  We did not have the medicines, supplies, personnel, or even time in the country to take care of all these babies safely.  A surgery or a cath is one thing, but it is often the post-operative care in the ICU that determines whether these children live or die.  We had no ICU doctors or nurses with us to ensure these babies would be well taken care of post-operatively and we were leaving the country on Wednesday morning.  Please know we do not take these decisions lightly.  We considered all kinds of options.  Do we cancel the adults to take care of the babies?  But that would be breaking a promise to the adults.  Do we try to take care of the babies knowing the great risk involved?  One of the considerations is how long do we think they will live.  Would we be potentially hastening their deaths?  And do we think we can get them to the U.S. soon for repair?  Are there hospitals that will accept them?

            We ended up taking one of the babies to the catheterization laboratory on Tuesday.  She was the smallest baby we’ve ever taken care of in Mongolia, another historical moment.  From our U.S. standards, it did not go smoothly given all the glitches in the system and the fact that we were charting new territory.  But we left a living, breathing, smiling, cooing infant in her parents’ arms when we left…and we think we did her some good.  She will need more procedures.  We hope and pray we will see her again in Mongolia when we return in September and we’ll complete her repair. 

            We left two other sets of parents heartbroken.  We pray we can get them to the U.S. for repair.  The clock is ticking.  Samaritan’s Purse Children’s Heart Project will get them to the U.S. or Canada, if we can get a hospital to accept them.  The economic downturn is affecting hospitals as well and limiting the amount of money available for charity care.  The complexity of these cases also limits the hospitals that will accept them.  There is a chance we can negotiate with a hospital in San Antonio to take them for a flat fee.

            So, as always, pray.  Pray for the healing of the five patients we took care of (the last two patients I didn’t explain were a 16-year-old who had a diagnostic cath and needs to come to the U.S. for repair and another teenager who has already come to the U.S. for repair who had a diagnostic cath to confirm all is well).  Pray for the continued care of pediatric heart patients in Mongolia, for the ones that they are able to take care of and, most of all, for the ones that they are unable to take care off.  Pray in specific that we’d find a way to get these two we met taken care of.  And pray for the many more that we haven’t met there and all over the world. 

            In church on Sunday, they sang in Mongolian one of my favorite worship songs:  “Blessed Be Your Name.”  I love this song and always pray that it would be true for me:  “Every blessing You pour out I’ll turn back to praise.  When the darkness closes in, Lord, still I will say ‘blessed be your name’.”  When I sat in that room, sad for those babies and their parents, the only thing I could rest in is that the Lord is good and He is sovereign.  “The Lord giveth and the Lord taketh away.  Blessed be the name of the Lord.”  Job 1:21b

            We have witnessed so many victories in Mongolia and for that we rejoice.  We are so blessed to be a part of this work the Lord has called us to do.  We always feel we get more than we give on every single trip.  The gratitude of the patients and their families is humbling.  We pray they see in us the love of Jesus, the reason we do what we do.  To Him be the glory, great things He has done…and will continue to do!