“I believe most people are good..”

It’s already been two weeks back in my other home, which seems impossible! My friends at Blessings had been reporting accurately about how busy they’d been in the weeks I was gone. We literally hit the ground running on my first Monday back and we’ve barely stopped since! Dr. Chimkonda asked me at the end of the first day how the first day back was and I said “fun!” and it’s true, it was so fun to jump right back in at full-speed. And being reuinted with this team and jumping back in with them, has by far been my favorite part of being back!

Saturday evenings in the theatre 🙂

So many great things have happened while I was away. Many many new babies started their lives within our walls, the building itself has been in the midst of a major renovation and is progressing beautifully, the team transformed our guardian shelter to accommodate an increasing number of cholera patients amidst a nationwide outbreak, all of this while continuing to maintain our high standard of care in all other areas during the beginning of our busiest time of year. I had joked with some of my colleagues before I left not to let anything exciting happen while I was away because I would have FOMO…it seems they did not agree to that request!

Currently, the biggest stress on our system and the hospital systems of Malawi is without question the cholera outbreak the country is facing. There are many articles out there you can read to hear about how bad things are, but I’d like to highlight the beauty in the storm. Every time there is a tragedy or crisis anywhere, someone in the social media world will share a quote or story about ‘look for those running to the problem.’ Every time you see a photo or a video of a tragedy or crisis you see so many running away in fear – as is human nature – but always there is a beautiful story to be heard and seen when you look for and watch those who run toward the situation to find a way to help. I also feel like every time I have been witness to a crisis or tragedy of any kind, the beauty of humanity gets put on display. That point was highlighted a lot as our country watched, rallied, and prayed for a young NFL player whose life hung in the balance after a bizarre hit. In the midst of tragedy and crisis, most of our superficial disagreements and opinions fade into the background.

So back to cholera…in addition to IV fluids, one of the most life saving elements of cholera treatment is a drink mix called ORS (oral rehydration solution). During treatment the patient and their guardian are provided with small packages or sachets of ORS to mix with 1 liter of clean water and are given a goal of how much to drink within a set period of time. Often adult patients are given 4 of these sachets to drink within a set period of time. This little powder is so vital because it contains a specially formulated amount of essential electrolytes and glucose to help rehydrate you without diluting these important components, and to help replace all of the essential things lost when you have large volume losses through diarrhea and vomiting…the hallmark of a cholera infection.

Now that you’ve attended a brief in-service on how ORS can save your life 🙂 There’s a sweet story that goes along with it.

Often when patients are brought to the hospital for cholera admission they have come in a hurry because their patient is sick and the family hasn’t yet gathered the usual supplies for a hospital admission. So finding bottles to hold the ORS can be a problem. Well, while I was having a lunch meeting with a colleague the waiter came to collect our water bottles. I asked if we could keep them and my colleague explained we wanted to use them for ORS for our patients. A few minutes later, he came back with a shopping bag full of empty bottles. Such a simple thing, but it warmed my heart to be reminded of the goodness that is at the core of us all, even on our very worst days. It got Luke Bryan’s “Most People are Good” stuck in my head for a long time!

Our team is stretched thin, they’re getting tired, and they’re exposed to the illness each and every day. But the care I watch us provide in our isolation center continues to warm my heart and remind me of the goodness in us all. Our staff is attentive, they are kind, and they are showing up to take care of the people in our community. They’re living out the greatest call of healthcare workers and are literally a light on a hill here in Lumbadzi. I am grateful and so proud of the work they are doing.

There are a lot of hard, painful, and tragic elements to focus on in the midst of such a difficult time for so many; and there is undoubtedly so much pain and grief overwhelming the many who have lost loved ones during these last months. It can be easy to become overwhelmed by the darkness. I’m trying instead to set my gaze on those nurses, clinicians, doctors, HSAs, public health officers, attendants, and security guards who are moving toward the darkness to bring light. I’m trying instead to notice the revealing of the goodness in humanity as so many are touched by the suffering of others.

Please consider praying for the country of Malawi, for its healthcare workers, and for its leaders as they all try to join hands to overcome the enemy and win the battle at hand.

Much love,

Ash

The One Where I Turn 40…

Woah – 40 years. What a blessing, what a gift.

Looking back all I see is the hand of His blessing on my life. As I look forward, I have been faced with a choice.

A. Grieve the perceived loss of youth and allow a sorrow of “the best days are behind” become my narrative. (Yes, I realize when I turn 60 I will laugh that these were thoughts at 40, but alas..they are a negative outlook that has knocked on my door and begged to be chosen.)

B. Stand on the firm foundation of a 40 year testimony of the beauty of life and the truth of His faithful presence with me to excite me for what the next season, the next decade, will hold.

If we rewind to January of 2012, on the precipice of 30, choice A was the loudest narrative in my mind. I joked as my 30’s went along, that at 35, 36, 38 I was still trying to cope with having turned 30!

I was tempted to be deceived again by the lie that what has been is the best there could be, and surely something as good can’t lie ahead. I’ve been reminded that during literally every season of change I have encountered, I have held so tightly to the romanticized perfection of the season I was leaving behind convinced that nothing that lay ahead could compare. That is, until the next season of change came and I realized that what I was now living was the best it had ever been.

If you’re exhausted from reading that borderline irrational loop of life outlook, I understand…I have been exhausted living it! 🙂

Last year a dear friend of mine turned 40 and I found myself only seeing the blessing of growing older. Yes I know to anticipate the eventual failure of my body, the new aches and pains that are more nearly in my future than ever before (actually already started, I sneezed the day I left Malawi for the US and got an intense muscle spasm in my neck…I literally thought, “ok, it starts now” haha)…but what about allllll of the beauty I’ve been blessed to experience? I’ve noticed that beauty in the frequency I already get to say “I have a story about that…” Every time I tell a story from this fascinating journey of my life, it’s a reminder of the blessing of so many years walking on this Earth.

The amazing thing about retrospect is the beautiful way it paints a picture. Somehow retrospect often allows us to see the painful moments, not on their own, but their dark and hard colors weaved into the whole picture giving it a depth and contrast that it wouldn’t have without those colors, without those moments. Some pain is so deep, even retrospect can’t make it beautiful it’s true – but I do believe that from the standpoint of eternity we will be surprised how beautifully all of the beauty and pain weave together – it’s the hope that I stand on when I look at the pain face to face.

SO – 40’s, I welcome you. I welcome the depth, contrast, color, and expanse you will add to the painting of this life of mine. I don’t welcome you naively, I know you will also bring with you pain and loss, that may challenge all I say here and all I hold true – but I know the 40 years that came before you have prepared me to endure and to see the beauty in eventual retrospect.

By now, you know how much music speaks to my soul. It’s been long enough ago now, I’m not sure when I first heard this song, but my gut says circa 2019ish. “Seasons” by Hillsong Worship. While the world was being moved by “So Will I” (also me, it still gives me goosebumps today)…Seasons rocked my world.

If there was a way to microwave my sanctification, to wake up tomorrow as my perfected self, to no longer be plagued my humanity – particularly my temper, my selfishness, my anxiety, my worry, my poor self confidence, I’m afraid I’d be willing to do almost anything to receive it. Over the last several years our gentle and faithful Creator has whispered to my soul – process.

Insert eye roll emoji here…process. What about instantaneous? Turns out, He’s not about that. Turns out, He’s a God of process. Turns out, no living thing that I have been able to think of enters into life in it’s final form. Turns out, there’s also beauty in the process. There’s strengthening in the process. There’s permanence in the process. What I have observed so far in this life journey, the things that happen instantly tend to be fleeting. The things that endure a process, eh they become a kind of beautiful that can’t come instantly.

So back to “Seasons”.

“If all I know of harvest is that it’s worth my patience,
Then if You’re not done working,
God I’m not done waiting,
You can see my promise,
Even in the winter,
Cause You’re the God of greatness,
Even in a manger,
For all I know of seasons,
Is that You take your time,
You could have saved us in a second,
Instead you sent a Child..

Like a seed You were sown,
For the sake of us all,
From Bethlehem’s soil,
Grew Calvary’s sequoia”

Check out the YouTube link below to hear the song and see all of the lyrics, I promise you won’t regret it.

“You could have saved us in a second, instead You sent a child.”
“If You’re not done working, God I’m not done waiting”

This song came to me in the midst of grieving my slow progress in changing some things about myself that I wasn’t pleased with. Every time I didn’t live out the change perfectly I was defeated and despondent. He sent me this song.

Then later on He sent me this picture.

Not a sequoia, but a Baobab. A massive tree commonly found in Southeast Africa, you know, the region of the world where He has been doing a major work on me.

So, for 40, I put it on my body. A reminder that life is a process, that droughts force our roots deeper, heavy winds make our trunks stronger, bright sun and light cause our branches to stretch higher…and all we have to do is be. Baobabs execute no extra effort to become bigger and taller, but time, the course of nature, and the creative plan of our Maker direct it’s growth to a majestic height that points only to His glory, His beauty, and His faithfulness. (please note my tshirt, it was the part of my 40th birthday I was most excited about 🙂

For all of you reading this, you’ve added varying degrees of colors and lines to the picture of my life over 40 years and I’m thankful for each and every one of them. I’m especially thankful for the role you have played in allowing me experience God in the unique way I have in my season of life in Malawi, for all I have learned about myself, the world, and Him by living in another culture, and alllll of the beauty my Malawian family, friends, and colleagues continue to reveal to me, teach me, and remind me of daily. Thank you.

It takes baobab’s hundreds of years to reach majestic size, so I’ll try not to be disappointed in what feels like a lack of process in 40…instead today I focus on gratitude. Looking forward I pray to more intentionally look for beauty, choose a joyful and positive filter and outlook for life, and looking at this tree to remind me that life is a process, He’s not done working, I’m not done waiting, and I’m excited to see what my 50 year old soul looks like 🙂

Thanks for enduring the length of this post and its entirely self-centered nature 🙂

Soon to come, updates about Blessings and all of the amazing things happening there!

As I leave you, I point you towards Ecclesiastes. That author knew a little something about seasons too ❤

“There is a time for everything,
And a season for every activity under the Heavens…”(3:1..but keep reading because 2-8 are pretty powerful too!)

“He has made everything beautiful in its time. He has also set eternity in the human heart; yet no one can fathom what God has done from beginning to end” 3:11

Much love,

Ash

Proof of Life, Some Updates, and A Lot of Gratitude

I am alive, well, and still in Malawi 🙂

When I notice I’m answering those questions more frequently via text message I know it’s probably been too long since I’ve been here!

I apologize for the prolonged silence! I have been taking a break from social media and had the intention to use this place for updates, but suddenly it’s the end of November and I’m not sure how that happened.

Like the rest of the world, news headlines and updates can lead you to believe that things in Malawi are in dire straights. While the country is facing challenges are various fronts, I’m happy to report the view from my favorite coffee spot is as beautiful as ever; we had a beautiful rain storm one week ago whose smells and cool temps ignited hope that the beauty of rainy season is just around the corner; I’m learning so much at work right now which makes every day exciting and I love going to work more than I ever have; in short…I’m grateful for much these days 🙂

We wrapped up a successful team season in October. This was the first year we have managed to conduct 3 surgery teams and it was an exciting time. Across the three teams nearly 100 procedures were done, both the American and Malawian teams learned so much from one another, and the ripples continue to be seen every time we enter our ORs for any type of procedure.

Our new staff have been with us for a full year now! It’s hard to believe that just one year ago we more than doubled our family and now they’re all an integral part of the family and the work we do every day.

Looking ahead we’re excited for hospital renovations, possible new radiology equipment, and the most exciting news we have to report is our long awaited partnership with the Ministry of Health to enable us to provide free maternity and neonatal services to those in our community is nearing completion! We’re looking forward to being able to expand our exceptional maternity care to our immediate community in the new year. Stay tuned for some ways you can partner with us to make sure our labor ward is ready to an exceptional standard and our nurses and clinicians have the tools they need in hand to deliver exceptional care.

I continue to be profoundly grateful for all of the ways you support me and my time here in Malawi. Zikomo ❤

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Beautiful Chaos…

Ya’ll … things are a little crazy right now…but in the most beautiful and amazing ways.

Another element to this CHAM news I recently shared is that the MOH has created what are called Staff Establishments for the different sizes of healthcare facilities. Based on the size of our catchment area and the services we currently offer, they have deemed Blessings Hospital to be a Community Hospital. Therefore, the MOH has an established and standard number and types of staff that they have decided are necessary to run a Community Hospital appropriately, and these are the type and number of positions they will pay the salaries for. Currently Blessings has around 45 employees and the staff establishment for a community hospital has allocation for significantly more staff than that.

We had been thinking that when approval came we would have a few months to strategize the who’s, when’s, and how many’s of hiring and recruiting. However, things are a little different than we expected and we learned last weekend that our window for recruitment is actually only until the end of this month! Woah!

Don’t worry though, the Blessings management team is full of rockstars who all came for a meeting after work on Monday night and spent a few hours discussing which of these positions are critical for hiring now and how to balance meeting our needs without out growing ourselves too quickly. What resulted was a list of almost 70 positions! So on Tuesday, Harold (our administrator) worked quickly to get our vacancies drafted, posted, and submitted to the newspaper. Within minutes of posting the vacancies on the hospital wall we started receiving emails…and they haven’t stopped since! We’re getting emails and hand delivered applications around the clock – which is a beautiful ‘problem’ to have.

Confession: I always want to be the kind of person who’s diamond is revealed when she’s put under pressure, but more often than not I find that what gets squeezed out is a shorter fuse, a sharper tongue, and maybe even some quicker tears. I don’t love when God lets things be bigger than I can keep under my control, and it’s showing this week 🙂

HOWEVER – the beautiful part it, wow is He doing a work on and in me! I recognize that this season for Blessings Hospital has not been curated specifically for my personal growth…but…I can see God’s hand allll over these last few years and how He has been teaching and transforming me in the waiting. Even though this version of Ashley hasn’t perfected grace under pressure, thanks to His faithful work and grace she’s much further along than the Ashley of 2018.

I’m a little scared at the speed at which we’re moving, but God is reminding me in the quiet parts of my spirit – and in so many faithful friends and encouragers – that He is not surprised by this timeline, He is not surprised by the magnitude of the task, and He always knew it was gonna be just like it is right now. He even already knows exactly who is going to fill every vacant position. So instead of letting the enemy comandeer this beautifully answered prayer with lies of impossibility, I’m trying to remind myself that every application, every interview, every moment of stress right now is a beautiful answered prayer and a reminder of His continued faithfulness to provide Blessings Hospital with exactly what it needs when it needs it.

There is no other explanation than He loves this place even more than I do, and He’s gonna continue this good work He started in it.

The purpose of this update is twofold..

1. The update itself 🙂 for those of you who have been on this long journey with us.
2. Plea for Prayer!

Please pray:

• Our Blessings Hospital managers – we continue to actively and intentionally pray the prayer of Solomon for wisdom to lead His people well. I work with some incredible humans on this management team, and I know every one of their hearts desires the best for the hospital and their colleagues, so please cover us all in prayer for wisdom and discernment to continue to see the best ways forward.
• That He would put the right people in the right positions and that those He has raised up for critical positions in leadership would be the clear choice. Please pray that every hire makes our family better, stronger, and more equipped to give excellent healthcare and love to our patients.
• Please pray for me. I want to still choose and see joy, blessing, and beauty even when I feel like timelines are impossible and tasks are too big. I want to trust that the beauty of this current season is that it is too big for me to manage and that means I have to ask Him in where I “might” …ok..would…have just run with it in my own strength. Please pray that my fuse would be long and flame resistant, that my tongue would only pour out kindness, grace, and encouragement, and that the tears of an overwhelmed heart and mind would come only in appropriate times and places 🙂

Ya’ll we’ve walked this loooong road together so far and He has been with us every step. He is actively answering our prayers and it truly is beautiful. I hope you are all feeling as joyful and victorious as we are, because the victory is ours. A lot of people have congratulated me as an individual, and I appreciate the encouragement, but I know there are a lot of you out there who have been praying over this as long as I have – and some of you even more faithful and consistently than I have. He has given this victory to US, so let’s celebrate every beautiful – crazy, chaotic, and messy – step forward into the frontier 🙂

Much Love,

Ash 🙂

Beautiful CHAM Update…

This post has been a long time coming! So many of you have been praying over this process for actual years…and now I get to tell you that the ball is really truly rolling…and it’s rolling fast!

A little background for those new to the CHAM party 🙂 Because if you don’t know the background, the rest of this update will not make any sense at all!

Here’s the rundown…

Within Malawian healthcare there are two sectors – public/government and private. Probably evident by the name, but for clarity sake – government run hospitals offer free services to all Malawian citizens. Private hospitals offer services that are paid for by the patient. The prices of private hospitals vary widely depending on their purpose. Some private hospitals are businesses and charge higher prices to be able to sustain themselves and to offer services other facilities cannot. Some private hospitals (like Blessings) are more mission focused, have some support from outside donors, and therefore offer services at a cost, but one that the facility tries to keep in line with the resource availability of their patients.

Now…CHAM. CHAM stands for Christian Health Association of Malawi. This organization serves as a bridge between the government and Christian healthcare facilities. CHAM as an organization provides so much support for the MOH that I could not do justice in a brief blog post. For the sake of this update, here’s what you need to know: CHAM and the Ministy of Health (MOH) within Malawi have a partnership that allows many staff at CHAM facilities to receive their salary through the MOH, along with a variety of other great benefits and support. We’re going to focus on the salary support segment though because it’s been our primary hope and need through CHAM membership for many years.

In November of 2018 we were accepted into CHAM as one of its member facilities, but until about 2 weeks ago we have been waiting…some of us patiently (myself not included)…some of us not so patiently (I was found in this party :)) since that time, until about 2 weeks ago when we received official communication from CHAM and the MOH that we have been approved to start receiving salary support through the MOH as soon as NOVEMBER 2021. Yes…that’s next month…in like 2.5 weeks!

This means a few things..

1. Once all of the migration and transition processes have taken place, most of our staff will begin receiving their salary from the MOH.
2. We have been given a green light to recruit additional staff that fall within the “staff establishment” assigned to our level of hospital by the MOH. Basically, the MOH has a blueprint for the number and type of positions needed to safely and effectively run various levels of healthcare facilities. The staff establishment for our level of hospital has significantly more positions than what we currently have and what our budget allows.
3. Summary – we will hopefully be able to have the number and types of staff required to deliver the level of excellent healthcare our entire team desires and hopefully require less funding from Chikondi Health Foundation to cover the cost of those employees…meaning the CHF funds and budget can be more effectively used to grow our infrastructure, facility, and resources to also move us ever closer to our goal of delivering excellent healthcare to our community.

Standing here today, I have zero doubt that God was using every. single. second. of this waiting period of nearly four years to grow us, to prepare us, and to remind us that HE is our primary provider. I was convicted a few months ago by the awareness that I had started to put more faith in this man-made government system to save Blessings for the future than I had in the God who has kept its doors open and salaries paid from the get go. Now as we walk forward into a beautifully unknown new frontier, we can know and believe that He will continue to provide for us as we navigate this uncertain new terrain.

I beg you to continue your faithful praying over Blessings Hospital and Chikondi Health Foundation as the leadership of both organizations seeks to find the most prudent, responsible, and also visionary minded steps forward. We have a lot of work to do in a very short amount of time, but His faithfulness in the desert of these last 4 years gives me a solid rock of hope and trust to stand on. We’re excited. But honestly, I’m also nervous and a bit overwhelmed by the task ahead of us. Please pray over our leaders:

Harold Banda – Hospital Administrator

Lazarus Kabzoko – Accountant

Jones Mkomba – Lab Manager

Jonathan Chimkonda – Medical Officer

Chifundo Kuleza Banda – Nurse Matron

Jennipher Kamanga – Nurse In Charge

Becca Bennie – CHF Executive Director

Wes Gunn – CHF President

All of Chikondi Health Foundation

and…myself 🙂

Please pray that God’s wisdom, courage, and discernment would cover every leader and decision maker in the coming days. Please pray that we would be bold and full of faith, trust, and hope in what big and amazing things our God can do, has done, and will do at Blessings. Please pray that He would be raising up the right people for our vacant positions – that they would be honest, trustworthy, bold, visionary leaders with a heart and passion for Jesus.

We are cresting a mountain we’ve been climbing and camping on for many years, I can’t see over the top, I have no idea what lies ahead, the timing doesn’t feel awesome in my personal calendar, but I’m certain God is not surprised by one thing that is happening right now and He will faithfully carry us into this new land if only we seek His way and not ours.

Thank you as always for your prayers, your encouragement, and your support.

Let’s go! 🙂

Much Love,

ash

Beautiful COVID Things..

First and foremost, please know that I know of and have seen with my eyes the devastation that COVID has caused so so many people around the world. I do not seek to be insensitive to the tragic and painful loss that too many people have endured. In keeping with the theme from my previous post I only seek to intentionally look for the beauty that exists even within the bleakest circumstances. I can say without a doubt, within each difficult wave of COVID in Malawi there have also been some beautiful moments of team growth, individual growth, deepening of faith, and renewing of passion for serving others.

In recent days our isolation ward has remained empty, the carousel of exchanging oxygen cylinders has come to a stop, our face shields are hanging idle, and our energy has been restored. In these blessed quiet days between the storm of COVID and the upcoming Malaria season, I’ve been able to reflect on the mixture of loss and beauty that blew through our lives during July and August.

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South Africa has become a bit of our forecasting focal point. As COVID things in South Africa start heating up, we’re learning that our numbers will start to pick up as well a couple of months down the line. So even while things in Malawi were still quiet and many of us were hopeful that maybe we had finished with the worst COVID was going to offer us, our medical officer was invited to participate in a training conducted by the Africa WHO.

We were especially excited about this training because many COVID informational materials tend to provide guidance based on resources not readily available in our setting. This training, we knew would be focused more on how we could best care for our patients within the resource context of our setting both at Blessings and within Malawi. We were invited to this training by a contact I had made through our Lilongwe medical worker journal club. This physician knew we were trying to improve our practices and remembered us when his facility was chosen to host the training. *Beauty*

Dr. Chimkonda then came back and prepared an excellent presentation to update our staff on new guidelines and best practices. Through his training and under his guidance we were able to modify and adapt many of our procedures and practices to continue to grow in our ability to stabilize and care for COVID patients. *Beauty*

The main piece of the puzzle still missing from our processes and procedures was testing. In previous waves, and early on in this wave, we were at the mercy of over burdened government testing teams to help us get admitted suspects tested. Because their teams were over run with work, sometimes patients would recover and be discharged home before they were able to be tested and confirm if they did or did not have COVID.

In a great coordinated effort between Mr. Banda (our hospital administrator), Dr. Chimkonda, Chifundo James (Environmental Health Officer), and spear headed by Jones Mkomba (lab manager) we were able to finally get coordinated with the Distrtict Health Office in a way that allowed us our own rapid testing kits…and this my friends, was a game changer. From that time on we have been able to test patients and make more efficient and appropriate clinical decisions for their care. *Beauty*

^{Dr. Chimkonda leading COVID-19 training in early July 2021}

It just so happened that this wave of COVID decided to pick up steam at about the same time I started picking up visitors for our first surgery team since pre-COVID at the airport. The wave stayed with us through the surgery team and the two week engineering team visit. While there were a few hectic moments, all in all, everything fell into place and both teams experienced great success in their work, supported us as we pushed through the heaviest moments of this season, and managed to also all remain COVID free and were able to keep their travel schedules without any major issues! *Beauty*

To me, the most beautiful thing about any tragic or difficult season is the way people pull together. So often a difficult or tragic season bonds a group of people in a way that smooth sailing never could. This proved true again at Blessings Hospital in July and August of 2021. We survived and maybe even thrived on some days because we all carried the burden together. *B-E-A-U-T-Y*

The way our system currently works is that once a patient is found to be COVID positive and is stick enough to be admitted and need oxygen support, we initiate a referral to a government treatment center. This is because those treatment centers are well staffed and have access to resources we currently don’t because of COVID specific funding from various international organizations that supports the Ministry of Health’s fight against COVID.

George Chikwakwa – one of our ambulance drivers, is our designated COVID transport driver because he is young, healthy, has survived COVID already, and is fully vaccinated. In order to protect one of our most treasured hospital family members, ambulance driver Mr. Chibwe, whose age puts him at a higher risk for complication – George has selflessly volunteered to drive all COVID and COVID suspect referrals. Often the referring clinician is different. Often the transporting nurse is different. But the driver was always George…sometimes twice in the same day. George was an MVP during these crazy times and we are so very grateful for his willing heart and his big smile! *Beauty*

^{George and I returning from a referral to the central hospital treatment center}

Much like other parts of the world, there is a lot of information about COVID circulating throughout Malawi – some true, some not. There are also a many false stories about what happens to patients inside of treatment centers which has created some hesitancy among the general population to accept referral to treatment centers for themselves or their patients. Our nursing and clinical teams did a beautiful job taking time to counsel patients and their families on their COVID diagnosis, prognosis, and referral plan. In many cases they were able to bring some comfort and peace while working to restore trust in the government health system.

Speaking of the government health system. What an amazing job they’re doing. Often the government healthcare system in Malawi is villainized as being neglectful and even harmful. However, our experience has been that though the system has its flaws and shortcomings (as most large systems do), most of the people within the system carrying out the work day by day, are really doing the best they can.

Just like at Blessings, the government treatment center processes and procedures have improved with each and every wave and I can honestly say that I felt confident every time I walked away from a patient within the walls of the treatment centers – they were going to be well cared for, and in a way we are not currently able to provide at Blessings. Every time we brought a patient we were received with willing hands, and smiles behind N95 masks. The beds were full, but so were the oxygen cylinders, and so were the nurses stations with and abundance of staff very actively caring for their over full wards. We felt a great camaraderie with our government brothers and sisters in arms during this time, and it was beautiful.

Even our electrician, Latiel Mwale, who was a hero of Blessings long before COVID, and will continue to be a critical spoke in our wheel long after – joined the party and searched high and low for tiny little o-rings to keep our oxygen cylinders working when we thought we were out of options. We started one day believing we had no oxygen cylinders functional because of these broken o-rings and in God’s provision we had no patients requiring that level of oxygen on that day and Latiel managed to find replacements at a random hardware stall in a market I’ve never been to. Before the close of business that day we had not only replacements, but back ups of functional o-rings. *Beauty*

^{La_{tiel and I with the coveted o-rings!}}

I cannot give a clear picture of the teamwork that kept us up and running throughout the entirety of this wave without mentioning our awesome cleaning staff. We have a great crew of women who keep the inside of the isolation ward clean and ready, they decontaminate areas after patient discharges, they keep our isolation gowns and scrub caps cleaned and ready for us when we need them…and frankly, we just couldn’t do it without their dedicated help.

Before I wrap up this long-winded COVID Wave 3 summary, I cannot be remiss to testify to God’s protection because during this entire wave, we had zero…count them zero known COVID infections amongst our entire Blessings family. ZERO. *BEAUTY*

We are a tighter knit family today than we were in June.

We share war stories, heart breaks, victories, and beautiful glimpses of God’s goodness from our time in these trenches and we thank God that through the dark nights – His sun always breaks through, and morning always comes.

For those of you healthcare workers now in the thick of your battles around the world, we rally with you in prayer and on this side of this wave we beg you to keep fighting for beauty, keep looking for goodness, to trust and remember there is a morning on the other side of even this night. Don’t give up on the goodness of our God or the goodness of our fellow man, it will endure and that goodness will stand victorious in the end if we keep carrying its banner.

Much love,

Ash 🙂

Beautiful Complexities

I have recently been working my way through a new book titled “Soundtracks” in the two week blocks it becomes available on the library app. I think it’s been God’s grace that I’ve had to work my way through it in chunks and not try to gulp in down at once. The slower pace is allowing me time and opportunity to more intentionally try to put some the ideas presented into practice. Most recently, the author suggests a practice of “gathering evidence” to support the new soundtracks you are trying to learn. His method involved a short phrase he repeated to himself when he encountered things in his life that aligned with the new soundtracks. Somewhere in my soul I heard a whisper of “That’s Beautiful” and that’s the phrase I’ve been practicing saying when I notice things around me that are beautiful.

These days it feels like I’m waking up more and more to how complex life is and how messy, hard, and chaotic co-exist so seamlessly with beauty, joy, and sweet sweet moments. The complexities of how the hard and the beautiful are interwoven in the same story, and how often one gives birth to the other feel like they are setting me free to practice taking life as it comes and letting all things be beautifully complex.

That was a long lead in to the real heart of this post…these days at Blessings Hospital and my life in Malawi there are so so many opportunities to say “that’s beautiful.” Friends, it’s been a bit of a chaotic, messy, sometimes hard, sometimes amazing, and so so so often beautiful and sweet season here.

As I started a list of things I wanted to update you on in this post, the list got a little out of hand…so I’m going to break them up into a few smaller (and fingers crossed – more frequent) posts so you too have more time to enjoy the beauty of them!

New Faces

In the post I made after my visit home in May, I wrote these words:

“Please be in prayer as our new team members join us and begin to learn our culture, and please pray boldly that their presence and fresh perspectives would stretch our minds and help us continue to grow and improve in our pursuit of excellent healthcare!
We are also currently in the hiring process for a few nurses and a clinical officer so we also appreciate your prayers for God’s provision in applicants, and wisdom for our selection committee in the coming days and weeks.”

Well…ya’ll did some praying, because what a blessing these new faces have been!!

We have welcomed quite a few of the new faces mentioned above over the last few months! It’s been a season of grieving the transition to new chapters and work places for some of our beloved family members, but God’s faithful provision has brought some amazing new family members that have been a lot of fun to welcome into the family and get to know.

In May, we welcomed the new medical officer I spoke about in my last post. Dr. Jonathan Chimkonda joined us on 4 May and has been a blessing to us from the word go. Our entire team has been so impressed with him from day one. Dr. Chimkonda brings with him a passion for his work, a passion for teaching, gentleness and patience with his patients, and a leadership style that inspires every member of our Blessings Hospital team. We’re very much enjoying getting to know him and his family as they settle into our Blessings family.

We have also welcomed four new nurses to our family, two of which had worked with us on a part-time locum basis for a long time. A new clinical officer and a pharmacy technician intern (who has just recently passed her national licensing exams!) have also joined the team in the last few months. All of these new faces have brought a lot of exciting energy, eagerness, and light to our staff and we’re so thankful for the ways they’re already all making us a better hospital.

Visitors Return!

In October of 2019 when I dropped our surgery team off at the airport with dates for three surgery teams in 2020 I had no idea it would be July of 2021 before I made another trip to the airport to pick up a team again! We were so excited to have some old friends back and make some new ones as the team performed around 24 operations.

Throughout the week so much teaching and learning happened for both the visiting American team members and the Blessings Staff. Many of the team members came with open hands to help and spirits to learn and it was truly beautiful to watch the partnership that naturally emerged as the days rolled by. It may go down as one of my favorite trips because of the two way learning and teaching that took place throughout the week.

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On the same day of the surgery team’s departure we welcomed back some visitors from Lipscomb University’s Engineering School, and what a blessing they are!! This was our second time hosting teams from Lipscomb’s engineering program and both times were such a blessing. Much like the first team, this team of engineering students arrived with such a generous and flexible spirit.

The engineering team is also personally so fun for me because they are such intelligent humans in a world I know nothing about, so I spend most of their time here amazed at their seemingly superhuman ability to solve problems. Their team leader, Dr. Elrod, also models such a hard working, adaptable, and gentle spirit for his teams that they have been a real pleasure to spend time with on both occasions!

In their two weeks with us this team managed to expand our solar back up system by 18 panels and 16 batteries!! They also installed some float switches in our water tanks and since their departure we have only had ONE water outage and we no longer have to remember to turn the water pump on and off throughout the day – an invaluable development for our staff and patients.

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Personal Update..

Hairstyle and Photo Credit to: Boston

Personally I continue to also be a really sweet season of hope and growth. It has felt as though the Father has been revealing to me that though the answers don’t look like I expected and aren’t on the timeline I desire…He is faithfully and purposefully answering some of my longest standing and most desperate prayers, this peeling back of the veil has infused me with a hope for the future and a freedom in the now that I don’t think I have experienced in any of my 38 years of life.

That’s not to say that every day I walk on clouds…many days are still covered in mess (often of my own making), many moments are still hard, many times I still feel like I’m failing at many things…but right now, those feelings of shortfall and defeat aren’t defining me – but learning to trust the faithfulness of my Father is become a firmer and firmer foundation every day…and that…well, that’s beautiful ❤

Stay tuned…more to come on COVID and other beautiful things 🙂

HAPPY NURSES DAY!

“Every nurse was drawn to nursing because of a desire to care, to serve, or to help.” Christina Feist-Heilmeier

In my brief time in this beautiful profession I have met very very few exceptions to this statement. Sometimes the initial calling gets buried under the weight they carry, but it only takes one moment with one patient at the right moment in time to re-ignite the flame that we were all initially drawn to.

To:

Chifundo
Jenipher
Stella
Tiya
Jacque
Alfred
Rosaline
Alitta
Devotion

And to so many more nurses who have graced the halls of Blessings Hospital, who I have encountered at various hospitals across the country, and who and blessed my life since 2017…I see you and I thank you.

I see you stay behind ward rounds and make sure a patient or their guardian understands what was just discussed…

I hear you advocate for your patients by taking new and nuanced information you gleaned in conversation while providing care to your patients that help the doctors and clinicians have a broader picture…

I see you share the night duty staff meal with patients and guardians who weren’t able to bring food with them to the hospital…

I see your tears of joy after a scary moment with a good outcome and your tears of grief when we say goodbye..

I’ve seen you on your way to the funeral of a patient on your own accord because you developed a deep connection and relationship with the patient and their family while they were in our care…

I’ve seen you visit patients at their homes to check on and support them..

I’ve seen you rally around your sisters or brothers in arms when their family is sick or they welcome a new child into their family…

I’ve seen you run the halls to collect supplies in emergencies…

I’ve heard you ask about patients days after you cared for them because their well being is still on your mind and heart…

I’ve seen you overcome adversity and bond together stronger as a team..
I’ve heard you ask questions and seek to know more so you can be a better care giver for your patients…

I’ve seen you seek out opportunities to learn something new…

I’ve seen become some of the best wound care nurses this country has to offer…

I’ve seen you reading textbooks looking for more knowledge and skills to grow as a nurse…

I’ve been forever changed by the way you all nurse, by the way you adapt, by the way you care, by the way you advocate, by the way you love through your work. I am a better nurse today than I was yesterday; a better nurse this year than last year; and a better person all around because I get to work alongside you each and every day.

I work with some really incredible humans at Blessings Hospital. Every position, across the board, has forever made a mark on who I am and who I am still becoming. There is something uniquely special though, in the camaraderie of a shared profession. We may have gone to different nursing schools and had different types of clinical training, but there seems to be a universal truth at the heart of our profession, a nurse is a nurse. Across cultures and continents we share a common experience of love, joy, sacrifice, pain, grief and an unspoken understanding of the world as seen through a nurses’ eyes that forges a unique connection, a connection that defies articulation and rings true around the world.

It is a privilege and an honor to nurse alongside these sisters and brothers of mine. I hope you feel appreciated, loved, and honored on this day set aside to recognize all you give to Blessings Hospital and your fellow man.

From our nursing team at Blessings Hospital to all of our nursing friends – thank you for what you do each and every day, we hope you feel honored and appreciated today 🙂

“Nurses see the world in its most raw, inexplicable, unfair form of reality, and somehow, by the grave of their inherent hope for humanity, and unmeasurable depth of courage, still love it.”

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For this thing I prayed…

It will come as no surprise to many who know me that I have experienced my fair share of COVID related anxiety during this prolonged season of global illness. A great deal of that anxiety has been rooted in the lack of control I had to protect my family, and the lack of ability I had to show up for them if they got sick. In December and January when COVID numbers peaked for both of our worlds, when the names of people who had suffered COVID changed from being names we knew of to names of people we knew, and when the things I was reading had me pretty convinced that if you stepped outside of your house in the US you were more likely to get COVID than not…my general prayer of protection changed to a specific prayer for reunion. I started praying specifically and frequently that God would allow the four of us to stand physically together in the same place again, healthy and safe. That prayer was answered last week.

Like many of the stories of modified plans and gatherings that I have heard, read, and seen in the last year and a half my short time at home looked a little different than I would have ordinarily planned and there are many people I wasn’t able to see. While I missed getting to see, hug, and catch up with many of you the silver lining was a beautiful and special time with these people – a time of answered prayer, and a time I will cherish forever. I look forward to continued freedom from the COVID cloud as vaccines and treatments continue to grow and evolve, but for now this answered prayer was a perfect reminder to me to choose thanksgiving and joy for the blessing of what was instead of staying in the sadness of what wasn’t. Our few days together were full, fun, and delicious 🙂

Leaving home has always been hard for me, even when the current place of my residence is a place I love and cherish; leaving home has never come easy. This time was no different, but my perspective was. This time, an answered prayer of reunion and present day health allowed me a new perspective of gratitude. There were still tears, there were still overwhelming moments of grief and sadness, there was a still a longing for more time – but this answered prayer gave me a new response to those things, a response that probably should have always been there but I hadn’t been able to grab ahold of in a real way before, the response was “thank you.”

Every time the tears welled up, every time my spirit felt heavy and dreaded departure day – my heart whispered “thank you.” Thank You, Father in Heaven for these days and moments for us to be together again and for our present health and safety. I know there are too many people in the world who don’t have that COVID story now, and many people who still may not when it’s all said and done, so thank you that today we do.

It’s easy to look back on this last year and focus on what we’ve lost in time, education, relationships, etc…and all of those losses are real and worthy of our grief. I hope many of you have some thank you moments too, and I hope those thank you moments anchor us all for what unknown still lies ahead in this thing called life, because COVID or no COVID hard times await us all and we need beautiful thank you moments to anchor us when the seas get rough.

With a welcome home crew like this…you can’t stay sad for long ❤

Ironically I landed in Malawi exactly 4 years to the day I arrived in 2017. A few things have changed in that time, one of which being my ability to tolerate and value change 🙂 My sweet roommate helped me celebrate the day with peanut butter cookies and our favorite sweet chili chicken for dinner!

Ya’ll have held on through this personal sappy Ashley stuff, so I want to also share with you a brief Blessings update 🙂 When I return to work on Tuesday (Monday is our labor day holiday in Malawi), I will be joined by our new medical officer and pharmacy technician! I am really excited about both of these people and I do believe God has answered our prayers for the right people for this time and season and Blessings. Please be in prayer as our new team members join us and begin to learn our culture, and please pray boldly that their presence and fresh perspectives would stretch our minds and help us continue to grow and improve in our pursuit of excellent healthcare!

We are also currently in the hiring process for a few nurses and a clinical officer so we also appreciate your prayers for God’s provision in applicants, and wisdom for our selection committee in the coming days and weeks.

Much love,

Ash 🙂

Katemera! (Vaccine)

Changing Seasons

"There is a time for everything, and a season for every activity under the heavens.." Ecclesiastes 3:1

The wisdom in Ecclesiastes has been profoundly helpful and guiding in this season of my life, so it’s not surprising to me that I thought of this verse as I sat down to write this month’s update to you. The weather is shifting in Malawi, as we enter our version of autumn the cool mornings and chilly evenings are exciting me for the cold weather to come.

I LOVE rainy season in Malawi, I would go so far as to say it’s my favorite. December to April are the most beautiful months in this country, watching life be restored after months of dusty dryness is such a beautiful and rhythmic reminder of God’s faithfulness and the nature of creation. I love anticipating the possibility of rain each day, and much like the snow of my Indiana winters past…it takes A LOT of rain for me to stop being excited every time I hear the first sounds of the trickles on our metal roofs. The green covering of the ground contrasted against the blue skies never ceases to grab my attention, the familiarity of the maize/corn growth keeps my heart warmed with thoughts of Indiana summers, and the warm sunny days are almost perfectly balanced with cool rains.

As we close out March and find ourselves in April I find myself a little apprehensive with each lighter and lighter shower…will this be the last one? BUT I also love the coming crisp cold air and the comfort of knowing I won’t be hot and sweaty again for MONTHS to come 🙂 Seasons. They change. They each have their beauty. They each have their own way of reminding us of God’s vast nature, never ending beauty, and His faithful love for us.

Blessings is in the midst of a changing of seasons too.

In early March Malawi received their first consignment of the AstraZeneca COVID vaccine through the global COVAX initiative to ensure all countries have access to COVID vaccines. Shortly thereafter both the president and vice president of Malawi publicly received the first doses of the vaccine to help improve trust and buy-in to the upcoming national vaccination efforts.

Admittedly, I expected it would take some time for Blessings to have their turn in the roll out. However, I was pleasantly surprised when we learned that not only were our staff going to have quick access but a vaccine team from the Ministry of Health was scheduled to visit us to administer the doses at Blessings as part of the initial roll out at various facilities!

After learning about our upcoming date, we were really proud of Chifundo James, our Environmental Health Officer, for taking time to hold afternoon sessions in the three days leading up to the teams scheduled arrival to provide information and answer questions from staff interested to learn more about the vaccine.

As with most of the world, there was a little bit of hesitation from some folks, especially because of the coinciding halt on AZ administration in various European countries. However I believe Chifundo’s time and effort did encourage and empower people to make a choice they were comfortable with based on current information. Some staff chose to wait and some chose to move forward and receive, all decisions were respected without pressure. I was really pleased with the efforts by Chifundo to make sure those decisions were made based on true and current information.

On 19 March 60+ people from Blessings, our campus, and the airport/immigration staff received their first dose of the vaccine in a very well run and well organized effort by the MOH team. The energy of the day was exciting and hopeful. Here are some photos from the day…

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Tionana (See You Later) Seasons…

This month we also said goodbye to two really incredible members of our team.

Our pharmacist: Thompson Matebule and Blessings Hospital’s very first medical officer: Gloria Zailani were both recently offered an opportunity to join the government healthcare system at Kamuzu Central Hospital, the largest referral hospital in the country.

Both of these individuals have made a tremendous and long lasting impact on Blessings Hospital. In their own unique ways both Gloria and Thompson have helped our entire leadership team see a new vision of the future. Blessings Hospital is a better hospital today because of their influence, leadership, and skills. While we are deeply saddened to lose them, we are thankful for all they have done for us, and we are excited for the ways they will influence Malawian healthcare on a larger scale.

At Chikondi Health Foundaiton and at Blessings Hospital, we desire to see growth and development and pursuit of excellence in healthcare in all sectors – not only within our walls. So while we wish we could keep these talented individuals in our family forever, we know they will continue to improve healthcare delivery in Malawi wherever they go.

As an individual I definitely had some days of worry after learning of these upcoming changes but the Spirit reminded me of God’s faithful provision for Blessings Hospital. For many years He has provided us with who we need when we need them, and we turn our trust and worries back to Him.

We plan to hold interviews for the replacement of these positions next week. If you would join us in prayer for wisdom and His continued provision of the right people at the right times, we would greatly welcome your prayers.

Thompson Matebule and Gloria Zailni

Thank you Thompson and Gloria for all of your great contributions to the mission and vision of Blessings Hospital. We pray great blessing and success over your next chapters!

As always – thank you for your faithful support, love, and encouragement!

Much Love,

ash 🙂