Journal

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.

Stages of labour, clinical signs of progression, management of each. Studying stages and progression in some specific area of life always gives insight to the stages and progression of others. We are often a people who don’t want to have a course to take; we just want to arrive. But the birth of anything good takes time both for growth and development, and then to actually be born. Process. And the greater the value of the thing being brought forth, often the greater the personal cost for its arrival. We’ve all experienced “labouring” over something, even if not to birth a child. We’ve all felt the increase of intensity and pain, and how it can take over all of you. We’ve felt the transition points, where it’s so close, but not there yet; where we “can’t do it anymore” and need the encouragement and presence of others around us.  We’ve felt the complications of something-not-right that requires intervention (sometimes life-saving). We’ve felt the deep push; the unparalleled desire and uninhibited effort to bring forth this new type of life.

I think that as parents we continually labour over our children. New stages of life, new lessons they must learn, new battles we fight for them. Or sometimes it’s the same old ones coming ’round again because the intended outcomes were stillborn last time. But we can only progress. Nothing new comes forth without dlligent endurance and participation.

I have felt the gravid stretch of being the mother of teens. They’re uncomfortably large to stay “in the womb”. They’re kicking and stretching, anxious for freedom. They’re growing closer, closer, but still developing. Still unprepared for life independent. Everyone is a different individual, but the moment will come when it’s time for birth, and a great change takes place. Suddenly, outside the safe cover of inside-mum, there is perceived hunger, cold, dirty diaper, isolation -things never experienced before because they were provided without being realized. (One of the challenges of adoption is that there was a severely premature separation from the mother. All of these uncomfortable and even dangerous experiences of life suddenly took over a child unprepared. And while an orphanage may save a life from death, it is not adequately equipped to develop a child toward strong and healthy life. Perhaps this has been more like NICU. With Satan’s consistent aim to steal, kill, and destroy, and Jesus’s mission to bring abundant life (John 10:10), the NICU is always a war zone.)

– We learned ways to assist and comfort women in labour (positioning, breathing, etc). Makes me wish I’d taken Lamaze classes in my pregnancies! It is painful even to acknowledge the pain required to bring forth life. It’s part of the curse (Genesis 3), and can raise a big question as to “why”. I think it is more revelation, not punishment. Life was meant to be much easier. Not effortless (because it’s valuable, and the gift is in giving of ourselves), but always fulfilling. But it wasn’t supposed to be dreadfully painful, and certainly not at risk of death. God breathed His very life into us at creation, and does into each new creation He makes. By choosing not what God gave, by choosing to know both good and evil, by choosing independence and the right to decide for ourselves, the agony of death enters: separation from God. He is still God of Life, and still is Creator, and still is at work, but now life comes at great cost. Birth back into His family and eternal life came at greatest cost (the life of Jesus, as our substitute for the deadly separation and evil we chose). A life was never intended to cost a death, but now it does. That is the price of choice.

So we, as image-bearers of God, now experience the unintended and severe pain of offering life to another. It’s our small picture of what’s actually happened, our small price to pay alongside THE Creator, in effort to bring forth life on this earth. Praise God there is Isaiah 65:13, “They shall not labour in vain.” Our Creator is also now our Savior and Redeemer, and in Jesus’s resurrection, in each new child born, in each person who chooses to be reconciled, “born again”, to God through Jesus’s self-sacrifice, LIFE wins.

“‘Death is swallowed up in victory. O Death, where is your victory? O Death, where is your sting?’ The sting of death is sin, and the power of sin is the law; but thanks be to God, who gives us the victory through Jesus Christ our Lord. (Therefore, my beloved brethren, be steadfast, immovable, always abounding in the works of the Lord, knowing that your labour is not in vain in the Lord).” -1 Cor 15: 55-58

– We also learned paperwork and proper documentation on the partograph and in Indian charts.

We are completing the lecture phase of Birth Attendant School this week. In six days we’ll board a plane for Hyderabad, India, where we’ll spend our first seven weeks of outreach. Plane tickets and visas are in hand, luggage is strewn about the apartment, and we’re anticipating the sights, sounds, and smells of an entirely new culture. What an adventure!

Birth Attendant School has been serving and training in Hyderabad’s Government Maternity Hospital and Ghandi Hospital for 13 years. Mary will serve in the hospital antenatal clinics, labor ward, and recovery/neonatal units. All of us will do (home visit) delivery follow-ups, community health seminars and work in the HIV/AIDS clinic. BAS is established with several ministries in the city, and will undoubtedly have a variety of other activities.

PRAISE GOD WITH US

• despite the challenges of “community living”, it has been such a blessing to spend our every-day in the setting of a very extended family. We have felt so loved and supported, and have met so many people. Our family’s worldview and frame of reference continues to expand, and we are hungry for more! The global church is truly amazing to be a part of, and so worth knowing.
• our funds have come in to cover our trip to India, and then the Kimberley region of north Western Australia (outreach immediately following India)! The whole family is going, and we are so expectant of what God has to show us there.
• that God has historically and supernaturally revealed Himself to man, and we don’t have to wonder, doubt, or fear we’ve missed who God is, what life is about, or what’s worth spending it on. He is a good Creator and Father, a consistent God of holiness and love that wants to be known, and we are only more certain that He is worth pursuing. Living life by Jesus is Life.

PRAY WITH US

• for our final preparations and coming adjustments.
• for unity and good communication in the family, as we face the challenges of transition and the unfamiliar, together.
• that our family and our team would be bonded by intentional love at increasingly deep levels.
• for protection from all sorts of evil
• that our hearts and minds would be prepared to see India. We are so excited to experience together this place in the world, and all the beauty of it. But there is also suffering, and the pain of seeing suffering is intended to break our hearts as it breaks God’s. Pray that we would respond with honesty, courage, compassion, and love.

The whole world has been remembering Mother Teresa and the small, mighty gift she was to the world, and to India. As she so perseveringly reflected, “we do small things with great love.” Giving, out of the smallness of us and the greatness of God, is what brings Heaven on earth. This is what we’re after.

It’s hard to believe, but I’ve completed the first third of classroom training here in Birth Attendant School (BAS)! As the kids are continuing to find their niches and settling into the swing of homeschool, Bob is getting plugged into media ministry on base. I have been reviewing antenatal care, global health needs, infectious disease, risks in pregnancy in the developing world, and labor and delivery. Here are some impressive and sadly very real stats about the people we are here training to serve…

The BAS focuses on serving the poor, where 99% of these preventable deaths occur. We especially aim to serve in areas where women are frequently devalued and left literally to labor alone, with no one to watch for and respond to complications. We seek not only to bring good primary and obstetrical healthcare and education, but to reveal the nearness of God to them. There is high emphasis on loving presence with, and prayer over, the people we are serving: women who are largely forgotten, and the generation literally being delivered into our hands. We desire spiritual birth for them as well. 

This week our outreach itinerary was finalized and announced! We will begin our travels in late September, and divide our 8 months of clinical experience and service as follows:

Hyderabad, India

6 weeks in a public hospital BAS has been working in for years. The majority of our patients here are the very poor, and shown very little dignity or care. 

Derby, Australia

5 weeks in the Kimberley region of northwest Australia, in the Aboriginal communities where there is a very high rate of poverty, family breakdown, and rampant Fetal Alcohol Spectrum Disorder. We are pioneering a work in antenatal care here, alongside the primary health care schools establishing a presence in the community. We will be the first BAS to do a mobile antenatal clinic in the villages of the region.

Lusaka, Zambia

Late December we will head to Zambia for 4 months to work in a large educational hospital in Lusaka. BAS has served here repeatedly, and the hospital administrators have enthusiastically affirmed the mutual benefit to the labour wards of our training there alongside their medical and nursing students.

Malawi

Finally, we’ll bus across the border into Malawi for another BAS pioneering work, serving in a community where the primary health care clinics have been growing. We’ll do a lot of neonatal checks and early childhood wellness checks and interventions during this time.

PRAISE God for defining and opening this way before us, providing all our needs as we follow along. It is amazing to see His hand working in our daily needs… Nothing is too great or too small for an Almighty and loving Father.

PRAY that God will have His way in us as individuals, a family, and a team.

PRAY for unity in the Body of Christ, and that we will be known by our love for one another. That we would walk in abundant grace.

If you haven’t let us know that you’d like our regular prayer updates, please sign up at www.invitation633.com/newsletter. We are so dependent on your prayer, on God’s hand at work in and through us. It is so important to us to know who we have on our team, and that we can count on your support.

Newsletter

We would also like to make known our financial needs for outreaches. Ideally our family will be all traveling together. We are anticipating an estimated $46,000 to cover outreach expenses for all of us. While this looks like a large sum of money (and it is), we reiterate that nothing is difficult for our God. He has always provided our needs (according to His definition of them), and always will. If you would like to invest financially in this work among the poor through BAS and the Fichtingers, there are a couple of options.

You can donate online at www.ywamperth.org.au. This is electronic giving, and will be received as Australian dollars (conversion rate is around $0.78 US to $1 AU. To calculate US dollar equivalent, divide the amount you want to give by 0.78. The number will look higher, but the conversion rate will correct the amount of $US withdrawn from your funds). This gift would be directed specifically to us by name (select “student” in the drop down menu and type our name in the notes section). This is NOT a US tax-deductible route to give. We receive 100% of donations, but there will be an international credit card charge added on.

YWAM PERTH

We do also have a youcaring.com account through which you can give online. We receive 100% of all donations there. These donations would be in Australian Dollars as well, so calculate as above. This route also offers the convenience of electronic giving, but also DOES NOT provide a tax-deductible receipt.

You Caring

If you wish to receive a tax receipt, please mail a check (made out to Bethel Memorial Church) to:

Bethel Memorial Church
1520 S. Main St.
Princeton, IN 47648

Enclose a note stating it is for the Fichtinger’s outreach fund; please do not write our names on the check. They have graciously offered to maintain accounts for us; 100% of these donations  will go toward our outreaches. If this is your preferred route, please send the check asap; it takes a few weeks to process, and we need to purchase airline tickets in five weeks.

We praise God for His people; you are our family walking this road with us. We praise Him for the intricate diversity He has designed, and how we each play different roles in His awesome works on earth. We praise Him for the grace and adventure of walking by faith and interdependence on His Body. What a story, and what a joy!

We love you and thank you.

As His Kingdom comes,
the Fichtingers

Welcome to our new flat! We have been given this lovely little apartment with two bedrooms, a private bath, and a kitchenette. The kids get to share a room and perpetuate Shakamak camp-style living!

The place we’re in is a renovated Backpacker’s (like a hostel). It’s really quite nice, and has a huge yard out back (including a basketball court). We are so thankful for a little place to call our own as a family, yet surrounded by community living. Sharing dinner together in the cafeteria helps us get to know many new people, and the kids get to run around with other little ones before and after meals.

It’s winter here, and the building is a bit warehouse-style (no insulation). It’s chilly in the nighttime, so we’re thankful for a couple of space heaters and warm sleeping bags that can function later as mattress pads when we’re in hotter locations for outreach. It was tricky, packing for various seasons, cultures, and purposes, with limited space and weight!