Mary Fichtinger

Meanwhile, in the North…

December 8, 2016 By Mary Fichtinger

Our team and part of our hearts are in the Kimberley. Here are some snapshots BAS has sent us. They are the faces there on site. We’re thankful to be involved from a place of prayer support, but also miss being “part of the action”. And just look at that scenery!

Processed with VSCO with c6 preset — The three-day road trip to Derby, WA.

Sports are a big point of connection with the Aboriginal youth. This month BAS is doing pioneering work in a new community, so they are building relationships in a variety of ways.

The rainy season has just arrived in the north. God is refreshing the ground.

God is moving in the Kimberley region, and is opening doors for YWAM Perth to reach out and serve. Our Healthcare ministry and BAS are working on community health education to connect the Aboriginal people to their (quite good) government-supplied healthcare. There is a (historically valid) mistrust of whites, and a vast cultural disconnect between the way Western health services are offered and how Aboriginal communities will actually utilize them. Our team has been going out into more remote communities as well as building relationships within the town of Derby itself, aiming to build a consistent and trustworthy presence in the region.

I am in conversation to help in the development the new Aboriginal-focused health education resources (YWAM’s “Simple Healthcare Seminars”, as they are called, are already being run worldwide, but they want to develop a specifically Aboriginal-focused track). These will in the future be taken into communities to build trust of our healthcare teams and other medical professionals, build relationship as we grow in love for each other, and introduce the ways of God to them as we simultaneously fight the growing problems of diabetes, hypertension, and hyperlipidemia, as well as the current scourges of fetal alcohol spectrum disorder and loads of mental health and family breakdown issues.

Pray for the Kimberley region, and for forward progress in our avenues of service up there.

Gifts of Various Sorts

December 8, 2016 By Mary Fichtinger

When we arrived back in Perth, we landed amidst the largest October quarter YWAM Perth has ever had. There are nearly 600 students and staff on base right now. As our direction to stay back from the Kimberley was a bit late-in-the-game from human standpoint, and there were no empty beds on campus, our housing predicament was significant and urgent. Some friends delayed moving into their own new apartment on base so we could stay there a few nights. Then there was quite the scramble to find us a place that could or would immediately accommodate a family of 7 (somewhat abnormal for this area… okay, very abnormal), for a month, and not be obscenely expensive.

Our best option came up to be a hostel in city center. We went to visit it. It was a nice place, in terms of a hostel, and they would rearrange beds/rooms to keep us all together, and I believe we would have been safe and fine there. But it was not what I had interpreted “settle and rest as a family” to entail. Especially over Christmas….

Pregnancy hormones were not serving me well at the time, and as the tears flowed in the courtyard of that hostel, our friend who’d been searching diligently for housing options got a return call from a real estate agent. We were offered a holiday home of three bedrooms and two bathrooms, in a quiet community (walking distance to the train station into base, and the grocery, and a library, and a lovely park). It was immediately available, and we’d be given a discounted rate “because of the situation”… a rate even a bit cheaper than the hostel.

It’s only available until the 9th of December. Would we like it?

YES. And THANK YOU, Lord.

We have so enjoyed this little home and the comforts and conviences it offers. We’ve felt like a somewhat-normally functioning family again, just over the past two weeks. That kitchen has accommodated all of my pregnancy cravings (cinnamon rolls, biscuits and gravy, spaghetti with meaty sauce, pancakes, casseroles, hummus and veggie wraps, crunchy cereal and milk!, big colorful salads, and loads of fresh fruits). There’s also a barbecue on the front patio, next to the outdoor dining area, which Bob is loving. And you saw that bathtub, right? Oh, yes. A bathtub.

Whoever said “it’s the little things”…. they were largely right.

We have less than a week more here, now, but God has already opened a place for us to stay after that: a lovely townhouse on the other side of the city, just across the street from the famous King’s Park (go ahead and look it up and get a little jealous), and nearby to our only non-YWAM friends in Perth and their kids. Also at a reduced price, because of the kindness of strangers, the gift of God.

While I’m tearing up again at the generosity of God and His tenderness toward me in my most vulnerable states, toward us all in our fatigue and need for rest, would you just take this one little story -and it is only one of hundreds- and be encouraged to walk by faith? To trust that your Father is a good Father? That He really is God and not a sparrow falls without His notice… and we are much more valuable than they. That while we are wise and responsible and plan and prepare best we can, we don’t have to do all this worrying and all this depending on ourselves. I don’t know about you, my self has long run dry and I need Someone far more capable and with far greater supply to call the shots and direct the steps. He is faithful, friends. He is faithful.

OH… and… of all the places in the world we could be, we’re in a place that celebrates Christmas. Not just a community, but an entire culture. That’s a gift I don’t know that I’d counted until this time ’round. The co-op kids decorated one building on 1 December: the first day of Aussie summer. (There are “real”/artificial Christmas trees, too. We just didn’t put them up!)

Unexpected Life

November 4, 2016 By Mary Fichtinger

One morning during lecture phase back in Perth, I was reading Psalm 104 in quiet time. God highlighted v. 30-31 in a special way,

“When You send forth Your Spirit, they are created,
and You renew the face of the ground.
May the glory of the LORD endure forever;
may the LORD rejoice in His works.”

He spoke to me of His distinct intentionality in every new creation, the renewal and refreshing purpose He has when He breathes a new life into being. How this fresh life is always a reflection of His glory that will continue its expression on earth… And that He should be able to rejoice in His works. We can join Him in rejoicing in each of these works.

I knew this was to be a key verse, and an anchor verse for me to maintain strict alignment with. Sometimes, in the face of witnessing great injustice and suffering in the lives of infants and children, I’ve been subtly but shamefully deceived into wondering if it was “worth it”. It certainly challenges our perceptions and belief system to reconcile the kindness and goodness and sovereignty and righteousness of God with such earthly pain. But I believe we generally have big missing pieces in our near-sightedness. Life is always opportunity for hope and for purpose, always a gift of renewal.

This principle most certainly applies in the tragedies in the labour room, in the losses and the complications and the defects and the unexpected. It applies to the young mothers, child brides, with too-small pelvises and obstructed labours. It applies to the anencephalic little angel our team was able to observe and love and pray over during his miraculous three days of life outside the womb. There is always more hope than we see, always more purpose than we can conceive, always more promise than we could imagine. Let the glory of the LORD endure forever.

And then, in India, God re-gifted this verse to me in another very unexpected way.

I’m pregnant.

I’d been feeling poorly, but attributed it mostly to the setting and the change in food. I loved being in the hospital and the labour room, but was struggling to get through the shifts that were far shorter than I’m accustomed to. As symptoms progressed and I started to honestly ask God about it…. I knew. The next day two pregnancy tests lit right up, and we were blind-sided by life. (We thought we were already living the impossible and upside down by God’s gift of the crazy-hard-miraculous-good.) While the news shocked us and feels a bit ludicrous for our current setting, it is just a surprise gift planned in advance by God, His glorious offer to renew the face of the Fichtinger family.

I’ve always been a pretty sick pregnant woman (and this time around, remarkably emotionally affected). Just receiving the news and increasing in all the first-trimester experiences was a bit like being struck by a massive wave: a wave of the generosity of God, but in such an overwhelming way it’s taken a couple of weeks to find my bearings and try to re-adjust to the new-again normal. I’ve spent the last three weeks pretty much exclusively at home (smells, mobility, heat, dehydration, and emotional stress are a bit incapacitating right now, and the last thing the Labour Room needs is the midwife vomiting or passing out during a delivery). I’m resting as much as I can (between homeschool, housework, and our ongoing academic requirements), and Bob and the BAS girls hunt down the blandest food and coldest sodas they can find for me. (Besides being on outreach, what better setting than to be surrounded by sweet midwives who love me?)

This has given Bob and the kids (in turn) much more opportunity to get out and engage, which has been very consistent with God’s directing for our whole family to be here together, to be experiencing India and ministering in various capacities. I love the hospital and love the labour ward, so it’s been a challenging reassignment for me, but I’m at rest with this place.

(God’s extravagant gift to Fetya, who’s been asking for a baby sibling on every wish list for at least two years… We found out the day before her birthday, and so announced it in her little card.)

(God’s extravagant gift to me: a nausea-free day to go out with the family/group to the Hard Rock Cafe, and the capacity to eat -some- BEEF BURGER and ONION RINGS. I didn’t dream about food for days after that!)

Our littlest one is only 10 weeks gestation now: the size of a grape, with miniature organs all at work, eyes and ears, and a lot of growing yet to do. My due date is 11 June, 2017. We are still waiting for God to give us more specific direction in all our continuing plans. We are scheduled to return to Perth on 12 November, and leave 2 days later on a 3-day road trip to north Western Australia, to the Kimberley region. After 5 weeks we return to Perth for Christmas. BAS then heads out to Zambia and Malawi for 5 months (traveling back to Perth right at full-term for me)

We are okay with not knowing today what the plan for us is next year. We know God is working in and through our family, and that He is (again) not at all surprised by what surprises us. We want the fullness of His plan, so we are happy to wait on Him in this situation as well. We’ll keep you all posted for sure!
PRAISE GOD WITH US….
-that the God of LIFE is unhindered, and is always bringing hope and renewal.
-that except for minor illnesses we’ve all been so healthy
-for nearly 100 healthy deliveries, a dozen or more infant resuscitations, many interventions, healings, salvations, education, encouragement, sharing the Gospel, etc. Women are so open to hearing about a God who sees and loves them, and is able to hear and respond to their needs. At least 9 Muslim or Hindu women have put their trust in Jesus alone just this week!
-for peace that passes understanding, for grace to help us in our time of need, for wisdom when we ask.
-for the faithfulness of God, and that who He is doesn’t change. He’s our Rock.
-for God’s work in our family. He’s given specific things for us to pray for over each of our kids for this outreach time, and we are seeing Him work.

PRAY WITH US….
-for ongoing blessing over BAS and the work we’re doing here
-for specific opportunities for Bob and the kids, to really make the most of their time here
-for the salvation of more Muslim women (specifically on my heart)
-for clarity and direction for our family’s plans in the upcoming year.
-for ever deepening relationship with Jesus for each of our children (and ourselves, of course). He meets us in all our places.

Ministry Snapshots

October 28, 2016 By Mary Fichtinger

There have been some blogs on the BAS and our hospital work at www.invitation633.com. Check them out if you haven’t seen them yet!

Here are some snapshots of our more general outreach time:

Exploring the neighborhood on arrival; discovered the local mosque, church, schools, etc.

Prayer walking: orange flags are (anti-Christian) Hindu political party in power. The building with steeples on the front right is the local mosque.

Bob preaches our first Sunday.

Bob and the boys on the way to the hospital to visit postnatal ward, and give out chai and biscuits to the new mums (and balloons to siblings staying with mum in the hospital).

Boys make friends at church

Bob & girls head out to do a community clinic with medical DTS.

Distributing books and school supplies to the poor neighborhood children at the church.

Fetya finds babies at one clinic.

Nireekshana HIV/leprosy clinic

And…. More from the labour room….

Notes from BAS Weeks 9–10

October 27, 2016 By Mary Fichtinger

Week 9 -Beginnings

This week we spent studying the moments of transition between the womb and the world for a newborn. The miraculous changes that take place in minutes and hours at the time of birth; changes that allow a baby to go from total dependence on mum and placenta to breathing air, circulating blood independently, reflexively suckling, processing all its own waste, thermoregulation in the outside world. Amazing. We learned newborn exams, neuromuscular exams to estimate gestational age when we jut don’t know for lack of antenatal history and care. This was the week I finally began to feel equipped. By the grace of God I will be able to do this.

Week 10 – Nourishment and watchfulness

Every birth, just as every rebirth at the cross, levels humanity to reveal our inherent, utter dependency. We need a Life Giver even before we need a Life Savior.

We studied breastfeeding technique, tips, hinderances, problems, etc. Just as in pregnancy and delivery, breastfeeding (or any neonate feeding) begins us in a place of dependency on another. Except that someone has given extravagantly to each of us, we could not be. Breastfeeding makes me think of Isaiah 58:10, as we feed another from our own bodies: “If you pour yourself out for the hungry and satisfy the desire of the afflicted, then your light shall rise in the darkness and your gloom be as the noonday.” There is such a link, isn’t there, between the giving of your very self (not just something you have), and the depth of intimacy in a relationship? (Of course there are many things that can hinder breastfeeding, and that is a reality of life. There is always grace in our unique struggles. I’m speaking only of general created-order principle here.) Also, for any momma who’s breastfed or experienced engorgement, we can see how clearly we who have supply also deeply need “takers” to relieve us of our abundance. It’s too much for us to well manage without someone else to pour it into. As it turns out, there is always abundant desperate need for us to spill our abundant supply into. When we are the receiver of supply, we are sustained and alive. When we are the givers, we are relieved, so satisfied in the giving, and prepared to be filled again… To share again.

We also looked at neonatal death statistics. These, again, are shocking and incomprehensible to our western mindsets where every infant death is recognized as a great tragedy. 2.7 Million babies die in the first 30 days of life annually. They comprise 45% of all under-5 deaths. 2 million of these babies die in the first week of life. 1 million in the first DAY outside of the womb. Two infants less than 24 hours old die every minute. WHY? Not because of astounding levels of birth defects or impossible situations. Statistically speaking, 1 in 10 babies need basic resuscitation at birth as they transition into independent breathing and circulating. A few minutes of simple assistance at a critical moment will save their life; this can be performed by midwives at home if they are trained. Only 1 in 100 babies need any further intervention or higher level of care.

Even inside the hospital last week, our team encountered this precise situation. One of our students was faithfully monitoring a woman struggling with her labor. Just a couple of minutes before the delivery they lost the baby’s heartbeat. Hospital staff came to assist the mother in delivery, recognized the stillbirth of the infant, but in a busy labor room without monitors, were not attentive to the details of the situation or immediately receptive to the information given by our team. There was a substantial delay in resuscitation, but as the team pressed for intervention and we all cried out to God for this baby, resus attempt was finally made. They got a heartbeat back, and God gave this baby and its family the gift of another day. Due to effects of severe birth asphyxia, he died again the next day in the NICU.

We can’t help but wonder what would have happened if we’d been permitted to intervene immediately. If the 10 minutes were 2 minutes. How many babies die by the birth setting’s simple inability to attend, monitor, respond to emergent need? This is the place where minutes matter. As most of the world delivers without the luxury of computers and alarms and highly trained one-on-one care, clearly still many of these babies’ deaths are preventable. In our team of 14 here (including staff), there is one professionally trained nurse midwife, one nurse, and one PA minimally experienced in L&D. The rest began with “nothing” but the immeasurable grace of God, the passion to respond, and the diligence to persevere. This is not an impossible feat. In its 14 years of existence, BAS has delivered nearly 5,500 babies, assisted thousands more mothers, and resuscitated dozens of infants. One class, one year at a time, faithful.

The most devastating situations on earth simply need God’s people who are willing to say “yes” and do something by the grace and strength He gives abundantly. Be brave, trust Him to be the GOD He is. Ask Him what you can give, what you can do. It doesn’t have to look normal. It doesn’t have to look big. It doesn’t have to look sane. It won’t look the same as anyone else. But it matters. The power of GOD Himself He’s given freely to all of us who will follow Him, who will give Him our yes, is what changes the world. He is still the Creator and He is still the Savior. He’s still saving the world and speaking Light into the darkness. Love and life is who He is; goodness and justice is what He does. We are each invited.

Notes from BAS Weeks 6–8

October 26, 2016 By Mary Fichtinger

Week 6 – Complications

Even Hell is not a God-forsaken place” – Andy Gullahorn

This week we learned about complications in pregnancy and delivery. It’s a heavy week to study. With a medical background (particularly in Emergency Medicine), this is the stuff I’m more familiar with by experience. This is the stuff you don’t want to happen. But it does. Much of this I noted a previous post – much of it we’ve already seen in these first couple of weeks.

Week 7 – Spiritual Authority

This week in classes we focused on our spiritual position as midwives. We are welcomes, receivers, defenders of life. We receive and affirm the image, revelation, and kingdom of God. We are interveners, standing boldly against anything that attacks the image of God at it’s most vulnerable moments.

We reviewed the Biblical history of Satan’s attack on infants and children (strategic infanticide, worship of Molech, Amalekite war tactics).
We discussed the impact of frank idolatry on a culture and the fallout on the weak: if animals are gods, animalistic standards are acceptable (this is well reflected in the state of the hospitals we are working in, and in the poverty in the streets, the condition of many homes and shops, etc).
We considered the necessity of having both “dunamis” (power) and “exousia” (legal right) as we walk this earth as children of God. We must have the Word of God, and the power of His Spirit to back it up.
We were challenged as in Ezekiel 13:5, to be the people of God who listen to Him with specificity, and go “up to the breeches” where there is tremendous spiritual vulnerability, to stand for the ways of God in battle.
Refusing ground to the enemy: submitting to God and resisting anything not of Him in me, in my family, in my realm of influence. Proverbs 4:23-27 says “Keep your heart with all diligence, for from it flow the springs of life. Put away from you crooked speech, and put devious talk far from you. Let your eyes look directly forward, and your gaze be straight before you. Make level the path for your feet; then all your ways will be sure. Do not swerve to the right or to the left; turn your foot away from evil.”

**This is so imperitave. The heavy spiritual atmosphere here in India highlights the necessary-for-survival daily repentance, humbling, covering, cleansing. We are so in need of constant mercy and grace; we are in such desperate need of a living God who LOVES us. And what a wonder that this is who He is.

Week 8 – Primary Healthcare

We reviewed that the simplest primary healthcare and education interventions can solve 80% of the world’s health crises. The 8 pillars of global primary healthcare are: food & nutrition, water & sanitation, health education, mother & child health, community resources, disease control, essential drugs, and finally curative care.

To me, knowing that dehydration from diarrhea kills 1.6 million children annually (more than AIDS, malaria, and measles combined) reflects the reality of opportunity. Teaching mothers how to mix the proper ratios of sugar, salt, and clean water to save their childrens’ lives is something anyone can learn to do. Instructing in safe food prep and hand washing to prevent the spread of illnesses is something anyone can do. I see it: entering the world to save the lives of people God loves through the unlikely and smelly “stable” of pit latrines and cholera education. Are we but willing and available for when He says “go”?

So do not fear, for I am with you. Do not be dismayed, for I am your God. I will strengthen you and uphold you with my righteous right hand. ” Isaiah 41:10

Labour and Delivery: Outreach Phase

October 9, 2016 By Mary Fichtinger

We are two weeks into outreach in India, and we’ve spent five days in the labour wards of two different government hospitals here in Hyderabad. I’ve witnessed and assisted in my first deliveries since PA school (over 11 years ago for OB). I’ve seen rapid multiparous deliveries, several first-time mums being augmented through their labours and given huge episiotomies to expedite the delivery (as two or three other mums sat on mats on the floor waiting for a bed to open). I’ve assisted two women who ended in obstructed labors going to theatre for caesarean, a 30-week gestation premie who lived with minimal intervention, severe pre-eclampsia, macerated stillbirth, induced abortions, intrauterine demise leading to shock in one patient (where we were able to intervene), and death just prior to our arrival in another. I’ve seen breech delivery, direct posterior delivery, forceps delivery, and by-the-book normal deliveries. I’ve stimulated babies to breathe their first breaths of air, conducted newborn examinations, been the living monitor on infants in their first hours of life, instructed in first-time breastfeeding, prayed over many infants, mums, and families, and congratulated families with hearty welcomes for their baby girls (there is still significant desire for boy babies over girls in many cases). Thus ends week one.

My first day I encountered more death than life in the labour ward; it felt like a crazy ER shift and took some decompressing when I got home. Day 2 seemed “routine” enough for what I was expecting, and redeemed a bit of my anticipation for what these weeks will be like. Day 3 was bathed in a supernatural peace, and was a joy to experience and assist in the natural labours of several women. Day 4 was solid and steady. Day 5 was overload (7 deliveries in our 5-hour shift)!

I’m still amazed at the process of labour and delivery. I am still amazed at the profundity of these moments in life: here, fear of the unknown and witnessing of the appalling join unavoidable and inextinguishable pain. Moments where women feel they can’t go forward but nature says that they certainly can’t go back; where they know everything is at stake and there is nothing to do but proceed. These labour rooms and the local practice of obstetrical medicine in them are foreign feeling to me, but I am so thankful for these hospitals. I am so thankful for the students, interns, residents, nurses, and “aimas” who spend their days and nights there, who keep up and run the room in all its chaos. I can only imagine the millions of women labouring at home or in remote villages with uneducated birth attendants, no available interventions, and even higher risks to face (anemia, infection, obstruction, etc). So here we are, training, to be ready.

And still I am amazed at the relief of delivery and the abundance of new life. Mums’ faces turn from agony and desperation to peace and joy in a matter of moments. Their “No, please” groans become glowing “thank yous”, even as they have to wait hours sometimes to hold their newborns. They have lived, and so have their babies.

I’m more aware than ever of having had the privilege of experiencing pregnancy and birth where I did. The statistics are taking on faces for me: the 830 women who die daily due to complications in pregnancy or childbirth. They are deaths vastly preventable. They are deaths that fragment families, communities, and nations. This is a scourge that has taken me far too long to really recognize. I have no delusions of grandeur that I can save the world; it’s not my job, and is ridiculously far beyond my capabilities. While, as with engaging the orphan crisis in the world, I can feel so much like a miniscule drop in the ocean, I know I can do something, and God has allowed me to do it today. So I will.

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