Jarretts Ministry

March 24, 2002

Dear Friends and Family:

I wanted to give you a brief update of answers to your prayers. Thank you so much for interceding on behalf of God’s work here at Tenwek. Our visitors, Rachel and Leah, arrived safely and are joining our girls in ministry. They taught Children’s Church this morning.

Patient Updates

I have been so encouraged by the progress of our cancer patients with the Methotrexate treatment. Decla and Grace were both here this week; each has completed three rounds of therapy. Not only do they feel well and look well; their pregnancy tests have turned negative. The pregnancy hormone is the tumor marker we follow to see that the cancer has been eliminated. Now we have the reagents to run the more sensitive blood test, the Beta HCG, and we should have enough patients’ blood samples to run a batch of between 9 and 11 tests, which is what the kits contain. The cost for the tests will be about $8 instead of $30 if it were sent out to the reference lab at another hospital. Peris looks very good as well; she has had no bleeding since beginning treatment. Her pregnancy test is still positive and the metastasis in her lung still causes pain; she will begin her 3rd round of treatment this week. Picoty, the 17-year-old, has not returned for follow-up since her first round was prescribed. Pray that she will return soon. Betty is starting her second round, but her ovarian cysts are shrinking [that's another marker of how well we're doing in fighting the tumor]. Esther is another patient who has the placental cancer [we learned this six weeks after her D&C]. Fortunately, her pregnancy test is negative and she’s had no further bleeding. We hope she will return for the close follow up with the Beta HCGs that are required monthly for a year. Elisabeth recovered from her pneumonia and left the hospital. We will hope to see her in consultation in two weeks. Please pray for the laboratory personnel who must learn to do the new test accurately.

The hysterectomy for Agnes went extremely well. I was able to get around the cancer with a wide margin without injuring a ureter. No visible spread to surrounding tissue from the large cervical cancer was seen. I also had a “routine” hysterectomy on Bornes for pre-cancer of the lining of the uterus. That surgery went well. I have scheduled several major cases for the next few weeks before we leave for the mission wide retreat April 5-9 at Brackenhurst near Nairobi.

In church this morning, Sam Powdrill mentioned a tragic case of a 7-year-old child who had contracted measles. She is the 9th of 10 children of a woman and an alcoholic father. The measles caused such severe inflammation of her eyes that both of her corneas ruptured. She will be blind for the rest of her life, barring a miracle. Measles is a disease that many American doctors have never seen. It is entirely preventable by immunization that nearly every American child receives. In populations where vaccination programs are incomplete, the disease periodically breaks out; most children are moderately sick and have the rash. But some children have pneumonia and other side effects that either kill them or maim them for life. This child lives a good distance from the hospital, but we will try to assist in the situation as much as possible. In the States, a cornea transplant would likely restore vision, but such an operation is too expensive and unavailable in Kenya. I thought it was ironic that we sang a Fanny Crosby song just before Sam told of the young child’s blindness. God can still work in her life and we can only pray for His intervention.

Occasionally there are instances with patients that remind us of why we’re serving here at Tenwek. Last week one of the male patients was found lying on the floor unconscious and without a pulse. The staff began resuscitative efforts immediately. He was brought back to life with their efforts by the power and will of God. He was taken to the ICU where he was able to converse with the staff. He prayed to receive Christ as his Savior. Only he and the Lord know what he experienced during his time “out of this world”, because he died later in the night and couldn’t be revived. Not many people get a second chance at salvation. That’s why someone shouldn’t postpone a decision for Christ. 2 Corinthians 6:2 For he says, “In the time of my favor I heard you, and in the day of salvation I helped you.” I tell you, now is the time of God’s favor, now is the day of salvation. (NIV)

Our trip to Nairobi

We started out shortly after six in the morning to reach Kijabe for the 10AM dental appointment. It had rained heavily the night before, so the chuckholes were difficult to gauge for depth. Sometimes, it really isn’t a question of dodging a chuckhole. It’s more a question of which one do you prefer to hit, and which one do you really want to miss. When they’re full of water, it’s a toss-up. So we jolted and weaved our way along until the sun had evaporated the water. One part of the road was under construction; and they had formed a new “deviation” which is what they call a detour. The surface had not been improved yet, so the “black cotton” soil was as slippery as ice. A bus was off into a ditch and the passengers milling about near the road. We prayed to keep control as we glided by and that we wouldn’t hit one of them, the bus, or a nearby utility pole.

We made the appointment in time and went on to the Mennonite Guesthouse afterwards for lunch. To our great surprise, we met our friends, Howard and Marilyn Johnson. They left Tenwek two weeks ago and had toured Mombassa and Samburu [of Survivor fame]. They were going to fly back to the States on Saturday. So we got to have several meals and shopping time with them having missed saying our good-byes at Tenwek.

“Mama Mary” swung into action at the Masai market on Friday and the dukas on Saturday. The man she mentioned in her last letter was there and prayed to receive Christ with her. Thank you for praying for him. She passed out three dozen Bibles and some tracts and received many more requests for materials. Laura was addressed as “Becki”(who was there the previous week) by three different people and received the usual number of marriage proposals. The vendors not only remember your name but also what you were looking at the week before, or often from many months before.

Friday night I drove to the airport with Amy and Laura to pick up Rachel and Leah. Driving on the roads at night in Nairobi is an experience not to be missed. No street lights or lane markers for a three-lane high-speed road with no less than six roundabouts in a driving rain was a bit of an adrenaline rush for a tired driver. I got honked at and yelled at more than a few times for going so slow and for allegedly encroaching on the other lanes.

The girls’ flight was 30 minutes early, so they came out of customs immediately on our arrival at the terminal. The rain was still coming down but the traffic a little lighter on the way back to the Guesthouse. I managed to get our newly acquired vehicle back and forth without any dents or scrapes. I slept well that night.

On Saturday morning, I picked up another visitor, Allison (a nurse from Oregon), who had come in earlier than expected. No transportation to Tenwek was arranged for her at this time, so we were asked if we could bring her back. Her luggage was added to the girls and ours, but the large roof rack accommodated all this as well as our groceries without difficulty. I just missed getting smashed by a big truck on the way back from picking her up. He had the right-of-way from an unusual angle on a road that I hadn’t been on for a year, and it took me by complete surprise. He was too shocked to even blow his horn after jamming on his brakes. I missed my turn onto the road I wanted and ended up on some downtown streets where I hadn’t been before. I did find my way back and another non-working stoplight as well. [That makes 4 stoplights I've found in this city of 4 million people.] They work only intermittently; and most people just ignore them anyway. My driver’s license is still being looked for in various government offices after being requested and paid for two years ago. I hope I never need it.

We completed our shopping, lunch, and packing later than I wanted to, knowing that it would be dark on the far end of the journey. I hustled everyone along as best I could. I picked up the meat and cheese order while Marty did the fresh vegetables. I ordered a kilo [2.2 pounds] of Mozzarella but found out when we got home that the clerk gave me cheddar instead [same color here]. Guess the pizzas will taste different this month. We made it back at dusk and found dinner waiting at the Chupp’s house thanks to Pam and our Becki who spent their day making dinner for all of us. Then we got to watch a video that our visitors brought starring our grandchildren. That was just enough to keep me awake until bedtime.

Pricilla Carpenter

It is my great good fortune to have this experienced missionary on my service for the next three months. I will be training her to do hysterectomies and other gynecologic surgeries. She has already been doing cesarean sections at the 35-bed hospital in Pakistan where she has served for seven years. She is trained as an internal medicine specialist, but at this woman and children’s hospital she is doing more Pediatric and OB-BYN work.

Today in church, she shared her work and the difficulty of ministry in Pakistan. The population is 97% Muslim, 2% Hindu, and 1% Christian. Very few converts have been won in the 30 years her mission has been there; although in the past two years, some results are being seen. The church that was attacked last week in Islamabad is where they often worship. The grenades that were thrown into the service hurt several people; the toll would have been higher, but the children had left the room for their Sunday school. It’s unclear whether the church was attacked because of Christianity or because Americans are there in large numbers. Either is a possibility. Please pray for God’s work in this part of the world and for the persecuted Church of Jesus Christ here and in other areas of Muslim domination. Christian missionaries remain in the area in spite of great persecution to show the love and forgiveness of Jesus Christ.

Prayer Requests

1. Marty says this will be another busy week for her with the usual ministry, a safari on Thursday and Friday, and preparation of Easter dinner with some other mission families.

2. Susan Carter is improving, but still is having relapses of her symptoms.

3. Paul Mazur is improved with his hepatitis.

4. Ernie and Sue Steury flew home to the States. It is felt that his time on earth is limited and he is ready to go to his real home.

5. Pray for effective ministry for our family and visitors.

6. Prayer for our family and parents at home.

Thank you for standing with us in prayer for the work here. We are blessed and encouraged to be in an area where fruit is being harvested. Others work at sowing seed in areas where they never or rarely see the harvest. While he was here, Steve Hawthorne shared a story with me of a missionary woman who served for 50 years in Bolivia among the Quechua Indians, losing her health and her husband in the process. She never saw a convert during her time on the field. She died alone and in poverty back in the US, but he and other workers today are reaping the harvest of the seeds she had sown. Luke 10:2 He told them, “The harvest is plentiful, but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into his harvest field. (NIV)

Serving Jesus with you,

Paul for all the Jarretts in Kenya

March 17, 2002

Dear Friends and Family:

Marty has authored the majority of this letter.

Thankful for You

It is with a grateful heart for your prayers and for God’s faithfulness that I share with you how the Lord has been working in the girls’ and my life at Tenwek. One can daily sense God’s presence anywhere on the compound – not just at the hospital. Phil 1:3-4a “I thank my God every time I remember you. In all my prayers for all of you” (NIV)

Guesthouse Hostess

My first two months were filled with monumental administrative duties for the Guesthouse along with the more pleasant expected job of hostess – greeting visitors. In light of my weaknesses in the area of management [firing, hiring, training, rewriting a job description manual], the many challenges gave me wonderful opportunities to seek and trust the Lord. At the beginning of each day, I could confidently put the job in God’s all-sufficient hands; and then praise His faithfulness each evening as I was reminded daily that the Lord truly equips and enables us to do all that He calls us to accomplish for Him. 1Peter 4:11b. If anyone serves, he should do it with the strength God provides, so that in all things God may be praised through Jesus Christ.

Two weeks ago, I had asked for your specific prayers for interviews, hiring, and training a new guesthouse cleaner. I went to that meeting with three other committee members feeling totally inadequate [which is good – then God can totally guide.] I also sensed that I needed to surrender my personal choice of the four candidates and desire God’s choice. I still marvel at God’s perfect leading in the hearts of all the committee members. Confusion and many silent prayers for the Lord’s direction surrounded the first three ladies’ interviews [including my previous choice]. And then it happened: from the minute Helen entered the room [as a shining star] and shared her testimony, God began to confirm in each of our hearts that this young woman was His perfect plan for the Guesthouse. What she lacked in cleaning experience was obviously overshadowed by her heart for the Lord, eagerness to serve, and willingness to be instructed and corrected. The whole experience reminds me of Samuel interviewing David’s brothers and then God directing him to anoint David as the next king of Israel. [A cleaner may not hold the same prestige as a king, but she is definitely as valuable!]

Well, that is not the end of answers to your prayers for me. The following day I was faced with the task of informing Helen and “reminding” Livingston [long-time Kenyan cook and manager of Guesthouse under my authority] of their duties and personal character guidelines. My concern was presenting all these “newly enforced” rules and regulations in a manner that would be pleasing to the Lord and conducive to Livingston’s cooperation and willingness to work together with Helen and me. In Kenyan culture, most women are regarded in a very low position and not treated as having much value; nor is their opinion particularly valued. I definitely needed God’s provision to enable me to handle this authority position He had given me. As I was preparing their job folders the evening before and praying for God’s help, He brought to mind a passage of scripture in Matt 25:35-40, where Jesus tells His followers that whatever they do for the least of His, they are doing for Him. The Lord also gave me the picture of 5 concentric circles with God at the center to represent authority, accountability, and working together. God’s center circle was surrounded by Geoffrey Langat [my hospital administration authority, as the guesthouse is under his direction], my name, Livingston’s, and finally Helen’s name under the authority of each of us; ultimately, we all answer to God. I wrote the word “visitors” outside the circles, and I shared that we were all serving God by working together to serve the visitors. The Lord has answered our prayers “exceedingly and abundantly” as there has been great cooperation from both employees, the guesthouse looks so clean, and there are big smiles on both Livingston and Helen as they work together. [The situation for the past six years has been very trying for Livingston to say the least, without going into the “gory” details.] Whew! I praise the Lord that I can now focus on the part of the hostess job I love – welcoming the visitors to Tenwek. Eph 3:20 Now unto him that is able to do exceeding abundantly above all that we ask or think, according to the power that worketh in us, (KJV)

I can hear a few of you saying, “Wait a minute! With 10 children you certainly should be able to manage relationships, handle confrontation, and train in cleanliness.” Well, to that I will respond “Yes, but I could spank them, send them to their rooms to read and write God’s Word, and withhold privileges – and for awhile I was bigger!” (>: In addition, I didn’t feel very successful with the “cleanliness” bit if judged by some of the kids’ rooms. One son hid his dirty clothes in his pillowcase and another grew “slimy green stuff” in glasses and “advanced stages of mold” on plates under his bed. [I won't mention any names (>:] I guess the boys did learn something about cleanliness even though they didn’t practice it in their bedrooms because all three now have strict rules in place when we visit their new homes.

Bible Study with Househelpers

The Lord also answered prayers for my burden to study the Bible with Jennifer and Caroline [2 of our family's favorite househelpers]. In January, I approached both young women about this possibility. I was confused about Caroline’s lack of enthusiasm and apparent hesitation. As I prayed about this for a few weeks, God brought to mind that she might be embarrassed by her limited abilities to read and understand English. Studying an English Bible with me might be intimidating. Then the Lord impressed on me that I could use all the wonderful children’s visuals that we also use at the primary school and for Children’s Church. [We are so thankful for all the Bible teaching materials given to us from home.] Sure enough, as I spoke to Caroline about her hesitation, this was exactly her concern. As I explained the plan God had shown me, she became excited about the opportunity to study the Bible. The three of us are immensely enjoying our time together looking at God’s Word during “chai break”. [All househelpers get a 10 AM rest for 30 minutes to drink their milk and sugar-laced tea.] God is so faithful!

Mogogosiek Baby Orphanage

The girls and I thoroughly enjoy visiting these precious children [infant through three years of age] that are being cared for by loving Christian nannies. The workers consistently give hugs and discipline and teach the little ones Christian songs and Bible verses. We were treated to an impromptu program as the children shared songs and verses with us. There were three little girls who were natural born song leaders – body language and all in the Kenyan style of leading worship. One particular baby that attracted my attention was a beautiful three-month old girl who had been found last month in the dump in the nearby town of Kericho. God certainly had His Hand on her as she was rescued and brought to such a godly home for orphans.

Expecting the Unexpected at Tenwek

No, not a new baby Jarrett (>:, although Becki and I would love to adopt one of those precious Kenyan orphaned babies. I want to give you a glimpse of the unusual and sometimes humorous events that are likely to happen daily around this compound. The girls and I were reading some history books together for our school time. When the phone rang, I picked it up to hear the breathless, concerned voice of Rachel Powdrill [our neighbor]. Realizing she was distressed, I asked her if there was a problem. She was anxiously looking for a 9-volt battery and hoped we had some. Rachel was assisting her husband who was in the middle of an eye surgery when the battery wore out on the instrument he was using. Needless to say, they were urgently searching for someone who could come to the rescue of their waiting patient! We were thrilled to be able to provide the two necessary 9-volt batteries as one of the girls ran up the hill to facilitate the surgery. Life on a mission compound is never dull. We are thankful for God’s perfect provision – even to equip the equipment (>: Hebrews 13:20-21 “May the God of peace, who through the blood of the eternal covenant brought back from the dead our Lord Jesus, that great Shepherd of the sheep, equip you with everything good for doing his will, and may he work in us what is pleasing to him, through Jesus Christ, to whom be glory for ever and ever. Amen.” (NIV)

Books, Books, Books, Everywhere

Becki, Debbye, and Alicia have been cataloging books for the Nursing School Library for two months. The girls thought they were about out of a job with only two boxes of books left, but their work is safely secured now with the arrival of 1000 books waiting for their attention. The shipment from the United States had been held in the seaport of Mombassa for several months as the officials were afraid to open it for inspection fearing the container would be full of anthrax. A representative from Tenwek finally traveled to the eastern coast [12 hours journey] to assure the port officials that not everything from the U.S. contains anthrax so the cargo could safely be released into his custody. Those books [along with their many other ministry opportunities] should keep them busy until they go home at the end of May.

Unlimited Ministry Opportunities

Each term we return, the girls are immediately involved with Community Health [preparing medicine packets for villages], leading Sunday worship with music, teaching Children’s Church, entertaining visitors and other missionaries [dinner, games, and music], babysitting [welcome relief for mothers], cutting hair [Nairobi salon is 4 hours away], teaching at a local Kenyan primary school, and entertaining children in the pediatric ward [songs, bubbles, puppets, books, play dough and coloring books]. When we visit the hospital, responsive smiles light up the faces of those precious children who are victims of burns [firepits in the huts are the source for cooking and heat], life threatening diseases [malaria, etc.], malnutrition, rabies, road accidents, and wild animal attacks in addition to the “usual” childhood diseases [measles particularly] and other problems. What a joy to bring some laugher into their lives. Proverbs 17:22 A cheerful heart is good medicine, but a crushed spirit dries up the bones. (NIV)

This year the girls have been a tremendous help to me as they run countless errands associated with Guesthouse Hostess. It is exciting and encouraging to see how God chooses to use willing hearts to accomplish His purposes. In addition to Paul’s valuable assistance at the hospital dealing with daily life and death matters, God has graciously allowed all of us to be a part of His work here in Kenya – what a humbling experience! Eph 2:10 For we are God’s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do. (NIV)

Primary School Joy and Sadness

Eager, friendly faces and attentive, obedient attitudes greet Becki, Alicia, and me each Tuesday as we visit our 2 classes of first graders to teach Bible lessons and songs. The highlight for them has been making the five-color beaded bracelets to represent and further impress on their hearts the Gospel as we shared it using the wordless book materials. [gold: Heaven, God's love; black: sin, darkness of our hearts separating us from God; red: blood of Jesus Christ to redeem us; white: hearts washed clean; green: grow in Jesus]

Last week’s visit to the class was bittersweet as we noticed 16 of the 36 students were missing. They had been sent home that morning due to lack of school fees for the month. With the needs of so many being so great in this country, our family is deeply grateful for God’s leading in establishing a Scholarship Fund for Orphans and Children of Widows. Even though we are not able to help every deprived child, we can trust the Lord’s hand to direct us to those He sovereignly chooses to be educated for His purposes. We are now prayerfully exploring ways for the local churches to be involved with the housing and loving care needed for the orphans. It is exciting to walk up the hill to the school and see the children out in the field playing soccer with the balls that two Castleview families donated. You are such a special part of this ministry.

Nairobi Adventures

As I am compiling my notes for this letter, our family is returning from our three days of business and pleasure in Nairobi. We are so thankful for God’s incredible provision of a car through the generosity of some special friends, David and Amy Brown. The bumpy roads make my writing almost illegible. However, Paul is used to deciphering his own “physician’s handwriting”, so he does very well decoding such penmanship as he types out my scribbling for you. He is a blessing!

We just passed the “usual” animals along the road – giraffe, ostrich, zebra, and gazelles. I guess we are becoming truly Kenyan because these sights don’t hold quite the excitement they once did, although I could never tire of seeing the African animals. We even went to the Giraffe Park in Nairobi this time for Alicia to experience feeding and “kissing” the giraffe. Becki still says that familiarity with giraffes is not for her. I agree!

The business agenda included grocery shopping and photo shoots for all of us to either renew passports or get alien registration cards. When the photographer called out “first alien, please” I scurried to the bench. God does say His children are aliens passing through this earth as their journey takes them to their eternal home with Him. 1Peter 2: 9-12.

Many of you are familiar with Paul’s statement concerning my shopping ministry [“Marty has the gift of shopping in tongues.”] Well, in truth, God has graciously given me many opportunities to share Christ or encourage Christians who are my “selling friends”. I was excited about my assignment to take Alicia to both of my favorite “hot shopping spots” – Masai Market and the Zebra Dukas where souvenirs can be purchased at bargain rates in the midst of some very meaningful [life-changing] conversations. The girls and I ran out of gospel tracts at the Masai Market as curious sellers surround us seeking this good news about Jesus. As I handed a booklet to a man selling Rachel some sandals, I asked him if he personally knew Jesus as his Lord and Savior. He openly replied that he knows who Jesus is but did not know Him as his own Savior. I shared that we are all sinners. After denying several other possible commissions of sin he finally admitted that he had once disobeyed his mother. As I pointed out to him that he might be taken from this earth at any moment [many daily possibilities: my most frequently expressed example being a matatu [overloaded bus] accident, I urged him to consider God’s truths and not delay a decision to trust Him. He eagerly took the tract to read and asked me to pray for him. I will talk to him again next Friday as Paul, Amy, Laura, and I return to Nairobi [gluttons for punishment from the roads] to pick up our two visitors from College Park Baptist Church.

When Amy, Alicia, Becki, and I ventured into the maze of alleyways in the Zebra Dukas [as if we hadn't seen enough souvenirs at Masai Market], I was greeted with numerous “Hello, Mary” calls from every direction. I truly love these people and had come loaded down with two bags of Bibles, Daily Walk devotionals and Bible teaching messages on cassettes to be passed around to my friends. As always, I make new friends each visit and have a long list of requests for next Saturday. It really stirred my heart when one of these friends said “Mary, we are so happy when you come to see us. Thank you for bringing God’s Word to so many of our fellow workers so they, too, can know Jesus.” “Wow! Thank you, Lord, for allowing me to be your instrument.

Prayer Requests

Again, thank you for your “powerful and effective” prayers for us. [James 5:16 a]

1. There are some serious health needs right now. Susan Carter [missionary friend] may have contracted typhoid fever during a dedication visit to a village. She has had some response to medication, but accurate diagnosis is always difficult here.

2. Paul Mazur [visiting doctor] has hepatitis and left for home in Rhode Island as his time was completed. A flu bug visited many on the compound [Becki, Laura, Amy, and Alicia included], but seemingly it was not as severe as the Indiana variety we have heard about recently.

3. Please continue to pray that Rachel will be spared from more of the grand mal seizures [two were more than enough!]. Unfortunately, the medicine we resumed using for her [Neurontin] which helps prevent seizures, also seems to make her rather rude, unkind, and generally disagreeable – definitely not a good side effect. Please pray for wisdom concerning her medicine for her autistic condition.

4. I would appreciate your continued prayers for my hostess duties, and wisdom in balancing those with family responsibilities.

5. Please pray for the travel and ministry involvement for our two visitors, Rachel and Leah.

Wow! This will probably be my one and only ministry account as it has taken more than enough of your time.

Finally, I want to encourage you with the remedy for discouragement [which we all face] by reminding you to look to God’s steadfast character and living, active Word [His promises are always true] instead of looking at our circumstances or ourselves. As we “look unto the hills’ for the guidance of Christ, our perspective changes from self and temporal to a godly perspective. Psalm 121:1-2 becomes such a literal picture of God’s truth as I look up at the mountains surrounding Tenwek. “I lift up my eyes to the hills– where does my help come from? My help comes from the LORD, the Maker of heaven and earth. (NIV) God’s majesty is so evident in the handiwork of His creation all around us. Thank you for standing in the gap with us.

Serving the Lord together with you,

Marty for all the Jarretts in Kenya

PS from Paul:

Please pray for Agnes, a patient for surgery on Tuesday, March 19. She has a large stage 2 cervical cancer which I believe I can get around with careful dissection particularly of the left ureter. The tumor doesn’t seem to have invaded the bowel or bladder. The surgery will likely not be curative, but should extend her life the remainder of which would otherwise be characterized by heavy bleeding from the primary tumor.

Elisabeth, the patient with a hysterectomy for a hydatidiform mole, is still in the hospital after developing pneumonia a few days after surgery. We also have a patient, Sawe, who could use your prayers. She has an abscess after a cesarean section where her wound completely came apart.

Also, please pray for Chelangat. You may remember the 10-year-old girl who had a large ovarian tumor. She was back to see us in clinic and looked quite well. But the tumor was malignant, a dysgerminoma; this is a tumor originating in the cells which would later become eggs. It is sensitive to a chemotherapy agent which we don’t have, but is available in Nairobi. Unfortunately, the family doesn’t have the resources to go. We talked with her mother, Marcella. She is not a Christian, but listened to the presentation of the gospel and took a tract. Please pray for their salvation and for healing for Chelangat.

And thanks to those of you who prayed for me this morning not even knowing what to pray but the Lord did—- for my rescue from the hospital bathroom where I was trapped by a defective lock. The men from the “Industrial” department released me after 10 minutes. Fortunately, no patients were neglected during my temporary imprisonment.

March 9, 2002

Dear Family and Friends:

We are thankful to all of you who have been praying and writing to us. Correspondence with e-mail has been fairly reliable the past few weeks, so for those of you who have held back from writing, please be encouraged to give it a try. The power supply has been inconsistent this week as the river is low, but the spring rains seem to have started. Lots of missionaries have been taking cold showers, however, as only some of the houses have solar panels for hot water. We are blessed to have a solar panel, but lots of people share the limited supply.

Laura has moved a lot faster this week as the soreness from her fall has diminished. Marty’s back continues to improve, but still lets her know when she has done too much. Rachel has had no further difficulties with seizures. Becki scared us with some fever and weakness last week, but her malaria test was negative. She seemed to make a complete recovery from what was most likely a flu bug. Amy had a day of the same symptoms. Symptoms that one would pass over fairly easily back home assume heightened importance in the kingdom of the mosquito. Debbye, Alicia, and I are doing fine. My hearing aid shorted out, so I’m back to using the uncomfortable one until I can get it returned to the States for repair.

Thanks for your prayers for the patients with choriocarcinoma [placenta cancer]. Decla, Peris, and Grace were all here last week having completed two rounds of chemotherapy. They all seemed to be doing well, and Decla even had a negative pregnancy test indicating the tumor has regressed considerably. I will send off a blood sample for a more accurate test next week. Betty returned for a visit and her ovaries were still swollen and her pregnancy test positive. I was concerned enough that her mole was persistent and started her on Methotrexate as well.

Choriocarcinoma and hydatidiform mole are both abnormalities of the placenta; they are also collectively known as gestational trophoblastic disease. “Moles” are considered benign, but can persist after removal; they can burrow into the uterus and secrete the pregnancy hormone which gives a positive pregnancy test and causes the large cysts in the ovaries. They can also give rise to choriocarcinoma, the malignant form of the disease. The incidence of molar pregnancy is 1 in 2000 pregnancies in the US and Europe, but higher in other areas of the world. It certainly seems abnormally high in the Tenwek area.

I have two other patients with the disease now to pray for. Picoty has had 2 D&Cs after her first pregnancy at age 17. The pathology report showed a mole from the first D&C, but she’s continued to bleed and have the ovarian cysts for two months afterwards. Today, I started her on the Methotrexate as well. Elisabeth is a 43-year-old mother of 11 who presented on Thursday with symptoms of toxemia of pregnancy at only 3 months. She had high blood pressure, swelling, protein in the urine, and enlargement of the uterus to 5 months size. The ultrasound confirmed that this was not a normal pregnancy, but a molar pregnancy. We recommended a hysterectomy since a patient of this age has a 37% chance of developing the cancer and the major surgery is a much more likely cure than the D&C.

Elisabeth’s surgery went fairly well yesterday, although we are out of the suture that we normally would use for this kind of major surgery. We did have some suture material without needles attached, so we used reusable needles that were threaded with the suture for each use. Never had to do that before, but you get tired of my saying that. We are so dependent on donations of suture from visiting staff; if visitors come without supplies, it aggravates the chronic shortage.

Some Animal Encounters of the Worst Kind

Last month we had two patients with unusual injuries from local animals. One weekend while I was operating in one room, I saw the surgery team operating on a 10-year-old boy in the next room. He had a large wound on his arm from a hyena bite. The surgeons were working hard to save the arm. The story was that he had been bitten and dragged off by the hyena. His mother heard his screams and found him bleeding profusely from the wound. She put a tourniquet around the arm and arranged transportation to Tenwek, although this had taken many hours. The surgeons were relieved to see the arm survive although he required some more minor surgeries in the weeks ahead. As he was nearing release from the hospital, we learned the rest of the story.

The mother had rushed out in the darkness, found the boy, and headed for Tenwek. What she didn’t realize is that an older brother had heard the screams before she did. He had beaten off the hyena only to have it turn on him. It grabbed him by the neck and dragged him into the brush. The mother hadn’t missed that son in the confusion; and the father found the dead boy in the morning light. He came to Tenwek the following week, but didn’t inform the mother or the young boy initially of the brother’s death. The young boy did keep asking about his brother, and when the father told the mother what had happened, it affected her severely. At night as she slept by the boy’s bed, she had nightmares and would scream and cry without awakening.

Another patient had trouble with a domestic animal. Martha was about 24 weeks pregnant when she was kicked in the abdomen by a cow. She came in on a Saturday when Caleb was on OB call. Her symptoms were fairly minimal the first day, but her abdominal pain worsened after 24 hours. I came through the ward on Sunday giving a tour to a visiting obstetrician who was here for two weeks. Caleb stopped us and introduced us to Martha. Her uterus didn’t seem to be injured, despite being the most vulnerable part for injury from “blunt trauma”. We took the old ultrasound machine and went over her abdomen with it. The baby was playing contentedly in the uterus; it seemed to be jumping all around. But outside the uterus we could see a lot of fluid and something wiggling around in the fluid. This was a mystery. Was it just transmission of waves from the baby’s activity into some blood that was free in the abdomen? It looked like worms, but what would they be doing free in the abdominal cavity? Martha was anemic, but what could have been torn to cause her to be so pale?

Finally, the mystery was solved when the surgeon and Caleb took Martha to surgery. Her bowel had been ruptured by the cow’s kick; there were worms from the intestinal tract now wiggling around loose in the abdomen. Unfortunately, she delivered a premature baby the day after surgery. It didn’t survive. Now a month later, Martha is nearly ready to go home. She has had lots of trouble from infection that developed from the ruptured bowel.

Strange Cases

We saw some more unusual situations develop this week. I guess you could describe our OB service as semi-organized chaos. In the middle of the afternoon on Thursday, a woman was rushed from the outpatient clinic into the delivery room having just delivered the placenta. That wouldn’t be so unusual, except the baby hadn’t delivered yet. And there was still a heartbeat, which made no sense at all, since the placenta and umbilical cord are the baby’s lifeline that must remain attached to the mother for the baby to receive oxygen. I solved the mystery by suggesting that this was a set of twins; one was dead but the other still alive. The placenta had been lying low in the uterus and was sheared off and delivered ahead of the presenting twin. The cervix wasn’t dilated enough to allow the dead baby to deliver, and the remaining twin seemed to be in distress. We did an immediate cesarean section and saved one of the small twins; it’s fighting for life in the nursery.

Another mother came in and delivered a very premature baby that lived only a few minutes. But what was strange was the condition of her cervix. I had never seen a mother deliver through a large cancer of the cervix, but that’s what appeared to have happened. I took off a piece of it and sent it to Kijabe Hospital where all our pathology specimens are taken. They sent back a report more quickly than usual that this indeed was cervical cancer. I hope to get the patient back to do a hysterectomy, although it’s likely that the cancer has already spread from the cervix. But removing the primary cancer usually extends the patient’s life somewhat as it stops her from bleeding to death from the cancer. A patient may die in kidney failure later from the spread of the disease blocking the ureters or from interference with some other organ system.

And we’ve had some cases that are just too gross to describe in a letter. I don’t even share these with the family. The lack of medical care, poor diet, and transportation difficulties are just a few of the ingredients that make these strange cases regular occurrences here. We’re thankful to have something to offer the patient besides life-saving surgeries and medications. Each week we see patients come to salvation as they are presented the gospel. And we’re able to share the love of God with fellow brother and sisters in Christ who come here for help and others who work here. If I come early to the ward before the normal time for rounds, I hear the staff praying or singing a Christian hymn. Patient’s can’t help but see and hear the Gospel in the lives of those who work here.

Thanks for praying for Marty this week. She was very pleased that the hiring interview went so well. The committee of four was unanimous in its selection of a young woman to work at the guesthouse. And the cook couldn’t contain his satisfaction with the work of the new employee. He was so happy with the new helper, since a fairly unsatisfactory situation had existed for quite a while.

Please pray for a visiting doctor, Paul, who seems to have come down with hepatitis. Serving at a mission hospital has its hazards, including food-born illness as well as patient and mosquito-born disease. An accidental needle stick, a cough from a tuberculous patient, or a splash from infected water or other body fluid can have dangerous consequences.

Our missionary friends, the Renbargers, from Rigdon, IN [between Elwood and Marion] are returning home for five or six months for a family wedding and birth of their first grandchild. Pray for them as they travel. Dr. Marty and Holly Graber are also returning home soon after a long career in Kenya. They certainly could use prayer during this transition. The Chupp family will leave Kenya for furlough after the annual retreat in April. Anna Tsusada RN will go home to Japan for furlough as well. Four medical students have left and new ones have arrived. It’s as though there is a revolving door at the hospital sometimes.

Equipping others

I had good help for two weeks from Dr. Steve Hawthorne, a family practice missionary doctor with SIM serving the past 13 years in Bolivia. He was here learning some techniques for cesarean section. He serves in a remote hospital in a mountainous area where it has been necessary to transport a mother needing a c-section to another facility over 3 hours away by car. He hopes to be able to do the procedure at his facility. His technique was just fine; training staff to assist and make the operation safe in his setting will be the challenge.

I’ve also had a family practice resident from Oklahoma, Dr. Dorothea Yee, this week. She’ll be here through the end of March. She’s getting experience doing c-sections as well as missionary medicine. My Kenyan intern, James, is making progress in his obstetrical training as well. And I will have a fourth year medical student from Oregon this month, Becky, and next month Mitzi, from Kansas. Another missionary serving in Pakistan, Priscilla Carpenter, will be here for four months learning to do hysterectomies and other gynecologic surgeries. The lectures I gave on anatomy and pathology for the Chaplain staff seemed to go well. I have two lectures on March 25 with the nursing staff on fetal monitoring. So I’m very heavily involved with training others. Hopefully, I’m setting an example of sharing the love of Christ with patients as well as surgical and obstetric techniques.

Visitors coming

We are expecting two visitors from the College Park Baptist Church later this month. Rachel Redmond and Leah Standridge are two mid-teens who are interested in missionary medicine. They leave on Thursday, March 21 and arrive here the night of the 22nd. We hope to pick them up in Nairobi. They’ll stay with us for two weeks. Please pray for their travel and visit.

We’ve had difficulty getting an appointment with the dentist for Amy and Laura to have adjustments to their braces. Please pray that the dental office will find an opening in the schedule when we can take them in to Kijabe [near Nairobi]. We hope for either the 15th or 22nd. We will travel to Nairobi both weekends.

Other Family Matters

Last week I was shocked to get an outside phone call from our daughter Beth. [First time I've had a call from family since 1999]. Fortunately, it was good news instead of bad. She was offered a job with the Montreal Expos organization and is now headed for spring training in Jupiter, FL. She’ll have the rookie team in Melbourne during the spring and summer seasons. This will be her sixth year as a professional baseball athletic trainer, but her first year to be affiliated with Major League Baseball. We’re confident that she will do well, but please pray for her as she makes the transition.

Our parents report that they are doing well, but please continue to pray for them. Lisa reports that grandchild number 10 is growing just fine and should arrive in August. The other 9 are reportedly doing just fine as well. Jon is recovering from laser eye surgery so please pray for him.

We have requested ticket changes for our return to Indianapolis. Alicia will stay through the 21st of May and return with the other girls minus Laura. She will stay with me through the 4th of July. God has led her to stay on with Dad, who will be glad for the company and help. I had visions of pink underwear, which I haven’t worn since I was in college. My laundry skills are even more limited than my cooking skills.

Thank you for your continual prayers and encouragement in this ministry God has planned for our family in Kenya. You are essential partners with us as we share the love of Christ with people living in darkness.

Romans 15:13 May the God of hope fill you with all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit.

Serving Jesus with you,

Paul for the Jarretts in Africa

March 2, 2002

Dear Friends and Family:

It’s been two weeks since I wrote last and no one has yet complained of withdrawal symptoms for lack of a letter, but I thought it best to write to you about some of the events of the last two weeks. Actually, there was plenty to write about last week but no time to do so.

There was an answer to prayer last week with the arrival of a supply of Methotrexate from the regular supplier, so the crisis seems to have passed. I currently have three cancer patients who have had two courses of the medicine. Peris is much improved with the therapy. She has had no further bleeding, but it’s much too soon to claim victory. One of the clinical officers here saw Decla last week with some complications that made him concerned about Typhoid fever. Unfortunately, I was in surgery when he was seeing her, and he didn’t talk with me before releasing her. Grace did not return for an appointment after her second course, so I will need to talk with the surgical staff member who lives in her village in order to find out what the problem is. Since he’s off duty this week, he is probably out in the village.

The automobile question seems to have been answered affirmatively. We can accept the donation of our friends’ vehicle to World Gospel Mission. It will be designated for our use. We will be responsible for upkeep and mileage [or does one call it kilometerage here?], but it is available anytime we need it. The car is a 1992 Mitsubishi Pajero 4-wheel drive with a 4-cylinder engine. This is similar to the Montero model sold in the states. It seats 5 people with two “rumble” seats in the back. It will be a bit crowded for all of us at the present time, but next year when Debbye and Becki stay home to start college, it will be perfect.

More Travels in Kenya

Our trip to Lake Naivasha was eventful to say the least. This is a large freshwater lake between Nairobi and Nakuru in the Great Rift Valley. It is surrounded by mountains, but the surrounding area [except around the lake] is really arid and desert-like. There is a national park called Hell’s Gate nearby which gets its name from the steam vents that arise from the canyons. The volcanic activity in the area has long since ceased, but the geothermal energy from the steam is being harnessed for electricity production. There are numerous game animals roaming the park, but the roads are pretty primitive and dangerous. We were thankful for the 4-wheel drive on several occasions as we drove through the park sliding down hills on the sand-covered roads. We distributed gospel tracts to the guards as we encountered them at various points in the park. Each was thankful to receive a tract in his native language. We have not yet experienced someone refusing to take a tract. In fact, many people ask for more copies for friends.

There are several “resorts” around the lake, some of which are very expensive. We had been told about the Fish Eagle Inn by friends who stayed there last year. This modest facility has motel type rooms, a dormitory for groups, and a tent camping area. The meals in the restaurant are ala Carte. The resident rates at this in were more favorable for a missionary’s budget. We arrived on a Thursday at lunchtime. After the meal as we sat around the table, Rachel had another seizure. This time the girls recognized it in time to catch her as she fell off the chair, so she didn’t hit her head. It scared the waiter as well as us, but she seemed to recover uneventfully this time after an afternoon of sleep. We’ve now decided to stop her Larium malaria prophylaxis and started an anticonvulsant medicine that she’s used before for learning disabilities. The supplies of this medicine [Neurontin] are limited, so we hope to have some sent over. The rest of the day was spent lounging around the pool [green water that didn't look that inviting]. We later found out that the “ring around the tub” was left as a result of the British Army that had invaded the pool the day before our arrival. The girls were disappointed about missing the Army.

There were many species of birds around the lake, including Maribou storks and egrets. The lake is edged by a carpet of water hyacinths and one uniquely designed bird scurried across the lily pads with his huge feet that kept him from falling into the water. At the pool I saw a Lilac-breasted Roller. It’s hard to imagine a bird with so many different colors. His head and back is golden brown, the throat is lilac, and the chest is blue; the back of his head is green, and the wings are a bright blue. I was sorry that he didn’t stay long enough for me to get my camera.

There was a family of black and white Colobus monkeys living in the trees of the fence line that separated us from the resort next door. They could raid either property from the home base of their lofty perch. The monkey has a luxurious coat of black and white fur with a long, white, fluffy tail. Their beauty has been their downfall as they have been hunted for their pelts until they were designated as a protected species. The parents stayed high in the tree while the children played like kittens in the lower branches quite oblivious to our presence a few feet away.

The next day we arranged to go horseback riding. The hotel recommended the “Century” farm. We followed the directions and found the Sanctuary Farm. Even though we’d all heard the name three times, we still didn’t hear it right. That’s the difference between Kenyan and American English. You just think you understand what’s being said.

The Sanctuary Farm is a working farm with cattle, horses, and many crops. It has many hundreds of acres and adjoins the lake as well as the main road nearly a mile away. The grounds used to include a polo field, but it has been turned into a field of maize [corn]. Apparently the sport has died off in this country with the waning of British influence. They also raise racehorses for the one active track in Nairobi. An elderly Brit owns the farm, and his son greeted us on our arrival. He explained that he is trying to develop Kenyan managers who can run the place in his absence. The father’s health is in serious decline.

The only similarities to a horse stable in the States seemed to be the manure and the waiver form that he had us sign. The saddles were either an English saddle or one used for polo or racing. The horses varied considerable in temperament and vivacity. We told them that Alicia and Rachel were not accomplished riders, but the rest of us were experienced riders. [Minus Marty – she stayed in the car.]

They gave me a horse that obviously thought he was the leader as he always wanted to be in front of the others. That was fine with me, as I wanted to take pictures of the girls and keep an eye on them. I asked the horse manager if the horse neck reined or bit reined and he said “yes”. I found that actually either did seem to work. Laura started on “Royal Prancer” and found him a bit too prancy for her fancy. Becki took over on that horse. Debbye, Amy, and Laura’s horses were also fairly spirited. Rachel and Alicia had horses in the moribund category. Their only instructions were to check the horse’s pulse periodically to be sure the heart was still beating.

We were accompanied on our ride around the farm by 6 groomsmen on foot. They kept the reigns for Alicia and Rachel; Debbye had to talk long and hard to get them to release her. She also commented on the groom’s lack of personal grooming; being upwind was definitely preferable to downwind. The girls desired to go at a faster clip than a walk, so it was necessary to separate themselves from the plodders who might take a notion to also pick up the pace and keep up with the crowd.

We rode along the rows of crops which were thriving with the irrigation from the lake. Then we entered an acacia forest that was a beautiful contrast to the clear, blue sky. The acacia tree has a bright yellow-brown trunk and green leaves fanning out like an umbrella. Giraffes were busy keeping the trees trimmed while antelope and zebra grazed nearby. I didn’t mind the slower pace. The horses were a little skittery around the wild animals. My horse jumped sideways two feet when we came around a tree within 10 yards of a giraffe.

As we came in view of the lake, the girls asked if they could trot the horses ahead. That seemed safe enough, although my horse wanted to catch up and lead. It soon became apparent that my horse had two gaits: walk and dead run. I guess there’s no need for a racehorse to trot. I got him stopped as Becki was prancing around in circles trying to gain control of her horse. Laura and Debbye were gone in a flash. Laura’s horse jumped a 3-foot shallow ditch sending her helmet flying off. Debbye gained control slowly. Laura was running out of real estate as she approached the lake when suddenly a herd of Masai cattle came up the bank. This startled Laura’s horse who put on the brakes from his top running speed. Laura then illustrated one of the laws of thermodynamics which states that an object that is in motion tends to stay in motion. She landed on the ground with a thud that was actually unobserved by the rest of us except Debbye as we tried to control our mounts. As we rode up to the lake, we saw Laura sitting on the ground surrounded by the cows and being looked upon curiously by the herdsmen. She was bruised and shaken but able to move around, so it seemed that nothing was broken.

We rode out into the lake allowing the horses to drink. Laura gingerly remounted for the ride back to the stable. Nobody else asked about trotting on the way back. A horse heading for the barn is even more difficult to rein in. After the long walk back, Laura’s back and hips began to stiffen, so it was hard for her to dismount. Her next 24 hours were spent in the room in bed on Aleve and Tylenol. A week later, she still has numerous scrapes and scratches and a gimpy walk but seems likely to survive.

Crime and Punishment

The first of our weekend encounters with robbers was at the Fish Eagle Inn. Our room steward, John, was almost too accommodating. He was always in and out of the rooms with soap, towels, sweeping, fresh linens. We know to keep valuables with us, but Alicia had some money in an envelope which she put in the bottom of a full book bag of Marty’s. It wasn’t too long before she noticed it was missing. John had some assistants, so we reported it to him. The manager [owner] wasn’t around that day for us to talk to him. John was very sorry to hear that $40 US and 3,000 KSh [about $40] were missing. He promised to look into the matter. As we were leaving on Saturday, we met the manager. He was furious that a theft had occurred and felt that John was likely responsible. The manager gave us 3,000 KSh from his own pocket. He said the matter would be investigated and if solved, he would forward the rest to us.

Theft is deemed very serious in Kenya. The punishment is worse than for manslaughter according to information given to a fellow missionary. The logic is that if you steal a man’s sack of sugar, his whole family may starve. It doesn’t deter people from stealing however. This case will likely be turned over to the police, and they do not require a search warrant to go to your house. John may well lose his job, but we’ve heard nothing since. We had given John a gospel tract, so we hope he will have a chance to read it before he’s put in jail or beaten.

We traveled on to Nairobi to stay Saturday night at Mennonite Guest House. The day was spent grocery shopping at the Sarit Center. Some of the girls went to see The Lord of the Rings, while Marty, Becki, and Alicia went to the “Zebra Dukas”. This is the craft shop area where Marty was greeted like a long lost friend by the vendors that she visits each term. She left many tracts and purchased some of the crafts for friends back home.

That evening at the guesthouse we learned that they had experienced an armed robbery the week before. Every business in Nairobi has a fence around it with a guard whose job is to keep the gate closed until a customer comes. The guesthouse is in a busy neighborhood not far from the Sarit Center. At 8pm on Feb. 14, eight armed men came to the guesthouse and put a gun to the head of the guard, instructing him to open the gate and keep quiet. Allegedly, a passerby saw this and notified police.

They then came into the office and demanded money. The desk clerk told them he had only a little money, but the robbers weren’t satisfied with that. The clerk and the guests in the adjoining television/library room were told to lie on the floor. Then they ripped out the phone and tore apart the office until they found the safe. This was hauled away from the property and has not been found. The safe contained about 200,000 KSh [just under $3,000]. The clerk then went to another phone and called police. They were at the scene within three minutes. Perhaps it is better that they didn’t arrive sooner. Gunfights with robbers and police often result in injuries to bystanders. That’s why in the old westerns, the good townsfolk always scattered when the bad guy and the sheriff faced off.

When we arrived home Sunday evening, we discovered a window was broken out and the latch broken off. Nothing was missing as the would be intruder couldn’t get past the inner window frame after he opened the window. He would have needed a small child accomplice to go through the small opening and then open the kitchen door in order to gain entry. Consequently, we found nothing missing.

Your continued prayers are appreciated

We appreciate your prayers for our safety and effectiveness in ministry. Without going into details, I’ve faced discouragement at the hospital with some staff people. Please pray for God to work in this situation. We praise God that He is always sovereign and uses all things for good. Whenever God’s Kingdom is being enlarged, the enemy desires to interfere. The Spiritual battle is great, but we thank the Lord for His promise in 2 Chronicles 20:17 “You will not have to fight this battle. Take up your positions; stand firm and see the deliverance the Lord will give you… Do not be afraid; do not be discouraged. Go out to face them tomorrow, and the Lord will be with you.”

Our good friend, Dr. Howard Johnson, is leaving this week with no plans to return. We will all miss him very much. Please pray for he and his family as they return to Oregon. We continue to have challenging cases [not so many details this time]. Not much new to report on the widows and orphans project, but I expect by next letter there will be. Please remember the Steury family as Ernie continues to weaken. He is with his family at Kijabe.

Serving Jesus with you,

Paul for the Jarretts in Kenya

P.S. from Marty

I promise to write a letter sometime, but for now I will continue to edit and revise Paul’s letters. The girls and I have a very heavy load of responsibilities this term which is an exciting challenge to completely trust the Lord’s provision. By the end of each fulfilling day God gives me to serve Him, I have “worn many different hats” [wife, mother, teacher, hostess for meals, and Guesthouse Hostess]. My brain seems a little too weary come nighttime to add the “hat” of writer.

Please pray for my new duties as Guesthouse Hostess. I really enjoy greeting the many visitors to Tenwek and showing them around the compound. I must admit that I feel totally inadequate to handle the unexpected administrative and management details that became evident as I took over this work. I am so thankful that I can give this job to the Lord each morning and be assured of His faithfulness to enable me. This certainly is an opportunity for God to be glorified as only He can accomplish these tasks through me in spite of my weakness. I would appreciate your prayers especially for Tuesday March 5 at 9 AM (1 AM your time) as I am involved in the interview process for a new Kenyan housecleaner for the Guesthouse. [The previous one had to be fired two weeks ago.] Thank you for standing firm with us to see God’s deliverance.

2 Cor 12:9-10 But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong. (NIV)