2017 FHAS Summary Report

Dear Faithful Supporters of For Hearts and Souls,

I would like to thank you for your faithfulness. And I wanted to let you know what your
contributions supported in 2017:

Duhok, Kurdistan: 7 open heart surgeries & 22 cardiac catheterizations
Slemani, Kurdistan: 19 cardiac catheterizations

Kudjip, Papua New Guinea: screening for catheterization trip in 2018

Monrovia, Liberia: screening

Pristina, Kosovo: conference lectures on complex congenital cardiac anomalies and
medical ethics
Karbala, Iraq: screening and preparation for subsequent cath and surgical missions

Hilo, Kona, & Kahului, Hawaii: screening of athletes

Barcelona, Spain: World Congress of Pediatric Cardiology and Cardiac Surgery
Lusaka, Zambia: 9 cardiac catheterizations

Tel Aviv, Israel: meeting with cardiologists and cardiac surgeons at Sheba and Wolfsson
Hospitals to increase the number of children being accepted from Kurdistan
Duhok, Kurdistan: 13 cardiac catheterizations

Kathmandu, Nepal: lectures at international cardiac conference

We already started 2018 with a trip to Karbala, Iraq, where we performed 8 cardiac
catheterizations. They would like us to return for a combined surgical and catheterization
mission. We have plans to return to Kurdish Iraq in February. For the rest of this year, we have
invitations to three other locations in Arab Iraq, as well as invitations to return to Kosovo,
Mongolia, Nepal, Zambia, and Papua New Guinea, where we would conduct a first-ever
catheterization mission.

We have sought to be faithful with your prayer and financial support. Thank you for partnering
with us to make this work possible.

To God be all the glory,
Kirk A. Milhoan, MD, PhD, FACC, FAAP
Medical Director, For Hearts and Souls


I often tell people that my faith in Jesus Christ is like a rope hanging across the Grand Canyon
that I would in all trust hang over that chasm on, knowing it would hold me. I grasp that rope
this past week. Brace yourselves for a long saga. I do this because so many of you bless us by
being genuinely interested, so I might as well tell the whole story once in detail. Good thing I
have an 11-hour flight to pull this synopsis off. If you tire of all the detail, you can skip to the
end for my spiritual conclusions.
Kirk, interventional cardiologist Mary Porisch, and I spent the week in Karbala, Iraq, once again
taking care of children with congenital heart disease, providing screening and treatment
evaluations and performing cardiac catheterizations. Iraqi friends had recommended our team
to this institution and Kirk had traveled there, at their invitation, in May to meet some of the
doctors and evaluate the facility, as he always does before we take a cardiac cath or surgical
team anywhere. The hope is to do a cardiac surgical mission there, but we decided to do a cath
mission first as a sort of dress rehearsal for getting to know and work with one another.
In unique ways, the three of us agree that it may have been the hardest trip we have ever done.
In saying that, it is vitally important for me to clarify at the outset I mean zero disrespect to our
hosts. We have had open communication about how the week went and I in no way want to
cause them offense. We learn and move forward. Please bear that in mind in any comments
you make on this post.
We have been doing pediatric cardiac procedural trips with For Hearts and Souls since 2005, in
Mongolia, Kosovo, Zambia, Nepal, and Kurdish and Arab Iraq. We have been doing such trips to
Iraq since 2010, in four other locations: Sulaymaniyah, Duhok, Fallujah, and Tikrit. We realize it
was all training for this last trip.
Romans 5:3 says we “exult in our tribulations, knowing that tribulation brings about
perseverance; and perseverance, proven character; and proven character, hope; and hope does
not disappoint, because the love of God has been poured out within our hearts through the
Holy Spirit who was given to us.”
Almost every For Hearts and Souls trip is a tribulation of a sort. There’s jet lag, long hours,
exhaustion, and the heavy responsibility of taking care of very vulnerable children in unfamiliar
systems with different and limited resources. Our teams have joked for years that our motto is
“Be exhausted, get sick, pay your own way…come back anyway!” I now realize that each trip
has been training for a subsequent trip, clinically, physically, emotionally, and spiritually.
We stepped up our training when we started going to “unsafe” places, like Iraq. We started in
Kurdish Iraq, however, when Americans were generally well-received and when conditions
were relatively stable. We used our confidence in this training to go to Arab Iraq, to Fallujah
and Tikrit, before ISIS…and then back to Kurdish Iraq, after ISIS and a change in stability and
perception of Americans. It is Arab culture, however, to protect one’s guests. We have always
been exceptionally well treated and protected by our hosts everywhere we have gone in Iraq.

We had no illusions about our physical safety and reception in Karbala, home of the third
holiest site in Shia Islam, other than confidence in the reception granted by our medical
colleagues and Kirk’s experience there in May. Our team was small, bluntly because the
destination does challenge one’s resolve and because we were assured the medical conditions
were such that we would not clinically need a bigger team. Obtaining our visas was our
prayerful test of God’s will and we received them on Monday, before we left on Thursday.
We met Mary in Istanbul on Saturday night and, after 48 total hours of travel, arrived in Najaf,
Iraq at 7:30 a.m. on Sunday morning. It took five hours in the airport to process our visas. It
took another hour to get out of the airport, because we had to make a claim for our luggage
that did not arrive from Istanbul and we had to convince a cadre of customs officers that we
should be able to bring our medical equipment into the country. We were supposed to go to
the hospital to conduct screening for the week’s procedures but given that we arrived at the
hospital at 3:30 p.m., the screening was called off. We were graciously given a “sack lunch” and
driven to our guest house to rest. The plan was to meet our medical hosts for dinner that
When we arrived at the guest house that had only an attendant outside, I noted no cell phone
or Wi-Fi signals. We were so exhausted we collapsed into a three-hour nap and woke to a text
alerting us to a change in circumstances. The good news was there was a cell phone signal! The
bad news was the friend of the surgeon hosting us had died suddenly so he was appropriately
going to Baghdad to mourn with his family and friends. The pediatric cardiologists were unable
to meet us for dinner. We were in a guest house in a neighborhood with no restaurants or
stores close by that we could walk to, not that we really thought it safe to walk anywhere
anyway. They arranged to have dinner brought to us. I found Wi-Fi hardware, so we summoned
the attendant, who gave us access codes. It is no small thing to have cheap, reliable
communication with our family and friends so far away in the world. We discovered we had no
hot water but decided not to summon the attendant back at that late hour. We were thankful
to find a large selection of tea and a warming kettle (I don’t think I’m going too far in saying
caffeine is an utter necessity on these trips!). We were told a driver would take us to the
hospital in the morning and we would start with a breakfast meeting and then the delayed
Our home church, Calvary Chapel South Maui, participates in something called the NEST while
we are gone on these trips. Participants submit at least one e-mail prayer over the duration of
the trip, so that we receive one prayer per day per NEST team. We had three NEST teams this
time, so three prayers per day. In turn, we keep them updated and send them prayer requests.
Having people interceding for us in this way has palpably transformed our trips. We walk in
greater confidence. I cannot overstate how much I have come to believe in the power of prayer
through our experiences with the NEST. Being able to communicate with the NEST was one of
the primary reasons for wanting Wi-Fi. And as soon as we had it, I alerted the NEST to our
circumstances. They kept us buoyed and supported in prayer the rest of the trip, as I kept them
abreast of all that went on. They are just as much a part of our team as those of us who go.
Knowing they were praying, we went to sleep in peace.

We got up to still no hot water so no showers, but hot tea! And our friend Lori Tezak, who took
us to the airport, had felt prompted by the Holy Spirit to give us wipes as we left. Thank you,
Lori, for the lemon bodily refreshment!!
Kirk and Mary had received Viber messages overnight requesting us to take care of a two-day
old emergency patient first thing in the morning for a very challenging procedure. That’s a
whole mental change from breakfast and screening. We had not met or worked together. We
had no idea of their equipment, supplies, or capabilities. And this would be an incredibly
challenging and risky patient to take care of well. We do not like taking unnecessary risks and
jumping into this so quickly seemed to be doing just that.
The driver got us to the hospital late. We texted when we were arrived, and they responded by
asking if they could take the 2-day old to the cath lab! We were whisked to the pediatric
cardiologist’s office, where Dr. Ammar was actively screening patients and asked us to jump in.
We asked if we could have breakfast, in part to slow the train and have a chance to talk to one
another and plan. He took us to the cafeteria, put food in front of us, and told us he’d be back
in ten minutes. Then back to screening we went. Dr. Mohammad arrived and the same pressure
to start with the 2-day old ensued. Kirk and Mary did an ultrasound of little Karam’s heart and
were not sure he would benefit from the procedure or they could do what they were
proposing. We also learned that the anesthesiologist/ICU doctor who we thought would be
there to help me that week had taken vacation. They heard our concerns to do things
methodically and well…and to test the system by starting with an older, less risky patient. We
finished with the screening and planning for the week. We went to the drivers’ office to get our
medical supplies and found a driver had never gone for our bag that had arrived 24 hours late
from Istanbul. A driver was dispatched and got into a car accident. It was hours before we
learned he was ok. We did do a diagnostic cath on Monday afternoon and we were able to give
good news to our first patient, 23-year old Jenam, that she was still operable. Dr. Mohammad
did offer us dinner but we elected to take our exhausted selves back to the guest house to bed.
We still had no hot water or luggage, the Wi-Fi had quit working, and there was no cell signal
On Tuesday morning, the driver picked us up very late and then just dropped us off outside a
locked hospital door. Someone let us in, but we didn’t have a hospital Wi-Fi code to
communicate that we were there. We went to find breakfast at the cafeteria, but they were
done serving it. Dr. Mohammad found us and we communicated we were more than a little put
out. We soon had food and hospital Wi-Fi codes, the Wi-Fi and hot water were fixed at the
guest house, and our luggage was retrieved by the end of the day.
We were able to do a diagnostic cath on 19-year old Shahd, but sadly had to tell her she was
inoperable. We then undertook a relatively “simple” procedure (closure of a patent ductus
arteriosus or PDA, for those in the medical know) on 6-month old Mostafa. During this
procedure, a catheter punctured his heart, the sac around his heart filled with blood, and his
heart stopped. After CPR and a needle procedure to remove this blood and put in a drain, we
had many more hours of intensive care to stabilize him, make sure the bleeding had stopped,
and take him to the ICU. We cancelled the two other planned causes. We got Mostafa to the
ICU after 7 p.m. and then went to dinner with the director of the hospital (and the entire
medical staff!) and got in bed after 11 p.m. We closed the day with the same negotiation about
now 3-day old Karam and explained we had not had a good dress rehearsal to undertake that
case with confidence.
We had asked for the driver to come earlier on Wednesday so we could get there in time for
breakfast. We actually waited outside our guest house for 45 minutes. When we arrived, Dr.
Mohammed said he had been waiting at the door for 30 minutes and the driver told him he had
waited for us for 30 minutes outside our guest house. He believed us when we explained that
couldn’t be the case because we were standing outside.
We were able to take out Mostafa’s breathing tube that morning, which is a huge praise that
his CPR had gone well, and he was neurologically intact. He still needs healing and prayer. That
was no small thing he went through. We were about to bring our first already sedated patient
into the cath lab, when an adult was whisked into the lab without warning. It was not an
emergency and we protested. The adult was whisked out and we then did a successful PDA
closure on 20-month old Abass, who was the size of a 9-month old because of the cardiac
failure caused by his PDA. He had a cold and an abnormal airway and abnormal respiratory
mechanics, so, as I expected and planned for, he was not easy to take care of as he emerged
from anesthesia. We usually have nurses with us to take care of the patients post-operatively,
but the plan had been to recover these patients in the ICU with their very competent nurses.
When it was time to take Abass to the ICU, we were told there were no beds. We took the
patient to adult cath lab recovery and Kirk and I watched him while they did the adult cath case
we had prevented earlier. Abass still needed oxygen and to be monitored closely and we
thought we had someone responsible for that, so I went to set up for the next case. I came back
to find him blue, off oxygen, and not monitored. More vigorous conversations ensued. We were
starting to feel like things were spirally out of control, we were earning the disdain of the
medical staff and patients’ families, and, most importantly, we weren’t taking care of these
patients safely. We thought of stopping, but we had made promises to these families. Kirk and I
found ourselves alone in the cath lab, prayed, and carried on.
Nine-month old Miriam was next, and her PDA closure and recovery went very well. We then
did a diagnostic cath on nearly 3-year old Alaa. He is the victim of poor diagnosis and surgical
misadventure, which is unfortunately not an uncommon finding for us internationally, and will
need another surgery. His mother took this news especially hard.
We now had a full day of three cases that had gone well enough to give us the confidence to
take care of Karam. They asked us to do so at the end of the day but listened to our desire to
undertake this case first thing in the morning, when everyone was fresh and rested. By bedtime
that night, Kirk was very ill, and I was very worried. I alerted the NEST again and they started
praying. Two hours later, he was asleep but I could tell his fever had broken and our prayers
were being answered. I was able to go to sleep and he was well enough to carry on with
When we arrived Thursday morning, they told us they had five cases for us. We knew about
Karam and 3-year old Mesk. The other three were a surprise. We told them we’d take it one
case at a time and do what we could.
The NEST was on full alert and praying when we started 2.5 kg (about 5 ½ pounds), 5-day old
Karam. His case went well. We couldn’t do the procedure they proposed, but we did do a
procedure that helped him. (I have to stop and fill in the details for the medical people. He had
pulmonary atresia, tricuspid stenosis, and a restrictive atrial septum. We were able to do a
Rashkind but not a PDA stent. His PDA was actually too big for the stents the family were able
to acquire for us, as the hospital did not have any nor did we have any with us.) He has very
unstable physiology and doing the cath and the procedure did make him more unstable for
quite some time. This was not a surprise to us. We were in the cath lab for several hours after
the case just to get him stable enough for transport. When we told them to have the ICU staff
ready for receiving him, we were told he couldn’t go to the ICU, as we had been promised
before we agreed to do the case. The reason was there was no attending ICU doctor…because
he was on vacation. We explained that we were three doctors and we would take care of him,
all night if we had to. He went to the ICU. Their nurses were very capable and impressed us very
much. He was very stable by day’s end.

At 5 p.m. on that last day, we took care of 3-year old Mesk, the last case we had agreed to do at
the outset of the week (we cancelled the other three surprise cases). She is also the victim of a
surgical misadventure, will need another surgery, and her mother also took this very hard.
Please pray for all these patients and their families!
I was feeling discouraged at the end of the day Thursday. I felt like we had had so many fights
and I was concerned about all our relationships there. It just felt like the whole week had been
a battle. I haven’t even addressed in this long story how hard it is to be a female physician in
that culture, something I felt more acutely than ever. I don’t believe most American women
know how good they have it, which is a subject postponed for further musings. The week was
hard to wrap up in a neat little bow. We’ve endured challenges before with travel, illness,
luggage, supplies, equipment, exhaustion, personalities, cultural differences, car accidents,
choking (me, with Kirk having to do the Heimlech maneuver at our wrap-up team dinner), and
even patient deaths. Maybe it’s memories fading over time, but it’s seemed before we had
more clarity of purpose, what God was up to, and the victories that we could rejoice in despite
the pain. But then God started encouraging me.
We had warm and encouraging goodbyes with Drs. Mohammad and Ammar, many of the staff,
and many of the patients’ families. Mary and I even received handshakes, hugs, and kisses,
which I consider miraculous and tremendously respectful. Karam’s grandparents followed us
out to the parking lot to thank us as we were leaving.

You can imagine we were a little concerned about a driver getting us to the airport on time on
Friday morning. We were also concerned about getting our medical supplies out of the country.
This has never been easy and our airport experience earlier in the week gave us no confidence.
Dr. Mohammad communicated our concerns to our driver before he left us to go home to his
family in Baghdad Thursday night. The driver told us “Inshallah” which means “If God wills.”
That was a funny interaction when Kirk told him we needed an “OK” not an “Inshallah.” We
asked for his phone number. The NEST was praying. Our Kurdish doctor friend Fitoon was on
telephone standby to call the driver (or an alternate driver) and talk to airport personnel. Dr.
Mohammad had also written us a letter. The driver arrived early and proudly. Getting our
medical supplies out has never gone easier. The battle was over.
As we waited for our plane, the verses in James that I posted previously and the verses that I
opened with in Romans came to my mind. Mary, Kirk, and I all agreed that we could have in no
way endured with perseverance what we went through this week had we not been through
what we’ve been through before. We all see the hand of God training us to go deeper and
deeper in our faith with Him. And we have learned the absolute power of prayer enabling and
upholding us.
I chose to read Eric Metaxas’ biography of German pastor and martyr Dietrich Bonhoeffer on
this trip. What a great and timely choice. I cannot recommend it highly enough. I also watched
the movie “On Wings of Eagles” about Olympic runner Eric Liddell’s service and death as a
missionary in China. Just as I believe most Americans need to serve outside the U.S. to have
their eyes opened to how fortunate we are and all we take for granted, I believe we need to
read these challenging and inspiring stories of incredible people of faith. When I do, I learn the
sacrifices I have made are very small, as are the challenges I’ve endured.
Think on these reflections from Bonhoeffer, who was involved in the plot to assassinate Hitler
and paid with his life. Metaxas explains Bonhoeffer’s realization “that the idea that one could
go back to a time before troubles and death was false to begin with. The war was only showing
them a deeper reality that always existed.”
Just as time-lapse photography makes visible, in an ever more compressed and
penetrating form, movements that would otherwise not be thus grasped by our
vision, so the war makes manifest in particularly drastic and unshrouded form
that which for years has become ever more dreadfully clear to us as the essence
of the “world.” It is not war that first brings death, not war that first invents the
pains and torments of human bodies and souls, not war that first unleashes lies,
injustice, and violence. It is not war that first makes our existence so utterly
precarious and renders human beings powerless, forcing them to watch their
desires and plans being thwarted and destroyed by more “exalted powers.” But
war makes all of this, which existed already apart from it and before it, vast and
unavoidable to us who would gladly prefer to overlook it all.
Metaxas summarizes that “because of war, they could see things as they truly are. The
promise of Christ is therefore all the more real and desired.”

As the war did for Bonhoeffer, these trips help me “see things as they truly are.” Our illusion of
safety and security in the U.S. is just an illusion. And it’s an illusion that doesn’t help us. It
makes us selfish and self-protective. As I repeat so often, life is hard, but God is good. “For God
so loved the world that He sent His only begotten Son that whoever believes in Him should not
perish but have everlasting life” (John 3:16). Every one of us on this planet is a sinner in need of
a Savior. Jesus Christ is that Savior. Our belief in Him guarantees us an eternal life of the
security that we desire but will never attain on earth. And how will the world know unless we
are sent to tell them (Romans 10:14)?
More from Bonhoeffer, long but worth it:

We know, of course, that God and the devil are engaged in battle in the
world and that the devil also has a say in death. In the face of death we cannot
simply speak in some fatalistic way, “God wills it”; but we must juxtapose it with
the other reality, “God does not will it.” Death reveals that the world is not as it
should be but that it stands in need of redemption. Christ alone is the
conquering of death. Here the sharp antithesis between “God wills it” and “God
does not will it” comes to a head and also finds it resolution. God accedes to that
which God does not will, and from now on death itself must therefore serve God.
From now on, the “God wills it” encompasses even the “God does not will it.”
God wills the conquering of death through the death of Jesus Christ. Only in the
cross and resurrection of Jesus Christ has death been drawn into God’s power,
and it must now serve God’s own aims. It is not some fatalistic surrender but
rather a living faith in Jesus Christ, who died and rose for us, that is able to cope
profoundly with death.
In life with Jesus Christ, death as a general fate approaching us from
without is confronted by the death from within, one’s own death, the free death
of daily dying with Jesus Christ. Those who live with Christ die daily to their own
will. Christ in us gives us over to death so that he can live within us. Thus our
inner dying grows to meet that death from without. Christians receive their own
death in this way, and in this way our physical death very truly becomes not the
end but rather the fulfillment of our life with Jesus Christ. Here we enter into
community with the One who at his own death was able to say, “It is finished.”
As Metaxas says, “this was how Bonhoeffer saw what he was doing. He had theologically
redefined the Christian life as something active, not reactive. It had nothing to do with avoiding
sin or merely talking or teaching or believing theological notions or principles or rules or tenets.
It had everything to do with living one’s whole life in obedience to God’s call through action. It
did not merely require a mind, but a body too. It was God’s call to be fully human, to live as
human beings obedient to the one who had made us, which was the fulfillment of our destiny.
It was not a cramped, compromised, circumspect life, but a life lived in a kind of wild, joyful,
full-throated freedom—that was what it was to obey God.”

Amen. I could say it no better.
Do I believe it? I realize that rope over the Grand Canyon that represents my faith in Jesus
Christ is a zip line. And it turns out I’d ride it to the other side to share Him with others. It’s
God’s grace to give us joy in the journey. “Consider it all joy, my brethren, when you encounter
various trials, knowing that the testing of your faith produces endurance. And let endurance
have its perfect result, so that you may be perfect and complete, lacking in nothing” (James 1:2-
All praise, honor, and glory go to Him.

Kurdistan, Iraq :: JANUARY 2017

Kirk and I just traveled again to Iraq, but this time with the largest For Hearts and Souls’ team we’ve ever taken there, staying the longest we’ve ever stayed. Over the course of two weeks, 29 people undertook our usual pediatric heart work, as well attempted to serve the thousands of refugees found in camps there. In total, we had three pediatric cardiologists (Kirk, Allison Cabalka, and Mary Porisch), one pediatric heart surgeon (John Kupferschmid), two anesthesiologists (me and Mauri Garcia), one perfusionist (Bart Hensler), five nurses (Nelia Soares, Molly King, Amy Howson, Vanessa Dennis, Nancy Lopez), one child life specialist (Caley Johns), one EMT (Lori Hintz), one medical assistant (Bethany Hutsell), one premed student (Kyle Johnson), one balloonologist (Tim Sanken), and many other willing servants (Jeff Cabalka, Holly Folsom, Alline Goeke, Lisa Goeke, Kathy Hintz, Drew Milhoan, Trevor Owen, Dave Rich, Coleen Rishovd, Rachel Rishovd, Jacque Simon, and Ann Sugrue). Some came for part of the time, while some came for all of the time. Some only served on the medical team; some only served on the refugee team; and some were able to serve both.
My bosom friend (please note the “Anne of Green Gables” reference, in honor of the two nurses on our team from Prince Edward Island) Holly joined us from Maui. We met in 1999 when she was serving as a long-term missionary in Mexico. She’s also served long-term in Honduras and short-term in India and Nepal. She has known me well for the entire span of For Hearts and Souls’ existence and loves to pepper me with questions about everything I do. She kept exclaiming, “Now I understand why you have such a hard time explaining these trips. How do you even begin to put it into words?” Good question. Though I’ll start with the potentially long and dry narrative of what we actually did, I’ll finish with the more important spiritual lessons of the trip.
We, and most of the team, arrived in Erbil, the capital of autonomous Iraqi Kurdistan, at one in the morning on Saturday, January 21. We arrived at our hotel in Duhok at six in the morning, took a nap and a shower, ate breakfast, and arrived at the hospital by 10 a.m. Over the course of ten hours, we screened over 70 pediatric patients who have congenital heart disease and came up with a tentative schedule for a week of procedures at the Azadi Heart Center in Duhok. Screening means we verify the child’s diagnosis, usually by echocardiogram (ultrasound of the heart), and decide on a treatment plan. That plan can include continuing to follow, placing on medicines, recommending surgery either in or out of the country, or recommending diagnostic or interventional cardiac catheterization procedures. From Sunday through Thursday, we performed seven open-heart surgeries requiring cardiac bypass (closing holes or relieving obstructions to flow in the heart) and 22 heart catheterizations (done via the femoral vein and/or artery in the groin; either diagnostic or interventional, which means saving children from surgery by closing holes or vessels or opening obstructed valves). Almost every evening after our procedures were done, we screened more patients…and then were hosted at various dinners by the Heart Center, by the Minister of Health for Duhok, and in the homes of Dr. Kamal, one of the pediatric cardiologists we work closely with, and a patient’s family who had her heart surgery at Mayo Clinic in Minnesota. Team members stayed in the hospital to care for recovering patients on two overnights. And every day team members served in the refugee camps as well, distributing food, playing with children, hearing stories, being present, counseling, and praying. Estimates are hard to come by, but there are easily hundreds of thousands of refugees (Syrian, Arab, Kurdish, Yazidi, Christian, Muslim) in and around multiple camps of varying conditions. Many of our patients and their families are refugees as well.
On Friday, the only official workday off in Iraq, we stopped by the hospital to quickly round on our recovering patients before leaving Duhok. Kirk had been requested to screen a child whose family had been recently liberated from ISIS in Mosul. We met a team from Samaritan’s Purse (SP) and they took our doctors and nurses to their recently established surgical field hospital outside Mosul, so Kirk could ultimately give relatively good news to this family (he has a heart condition that is easily treated within the country and has a prognosis for a normal life span if he is treated by age 20). We were so grateful for the opportunity to witness the amazing work that SP is doing at this hospital. It is truly a top-notch, professional, highly secure set-up and we would encourage anyone with appropriate skills to volunteer. We then drove to Shoresh, to the Fountain of Love, a community center built by SP in a community established by widows and orphans from Saddam Hussein’s anfal (genocide) of the Kurds. We screened at this center when it first opened and we make every effort to return when we can. We screened nearly 30 patients in the afternoon and evening on Friday and then 60 more into the afternoon on Saturday. Allison had left Thursday night, so Mary arrived Saturday. She and Dr. Aso, the pediatric cardiologist we work with in Slemani, screened patients for us in Slemani simultaneously on Saturday and came up with the procedure schedule for our week there. Our remaining team drove from Shoresh to Slemani on Saturday evening.
From Sunday through Wednesday of our second week, we performed 19 catheterizations in Slemani. We screened more patients. Our refugee team served at more refugee camps and other ministries. We were generously hosted by Kurdistan Save the Children (KSC) during our time there and had dinners each night with Dr. Aso and representatives from KSC, the Heart Center, and the Slemani Minister of Health.
We chose to do our cases in Slemani in four days so we could use the fifth to go screen patients in Halabja, a town on the border with Iran on which Saddam Hussein used chemical weapons in 1988. We were there to screen children at the request of Sarko with SP in November 2013 and he has been requesting us to return ever since. It turned snowy and icy on Wednesday night and our in-country hosts begged us not to go, so we made the late night decision to cancel. The roads did not look so bad on Thursday morning and Sarko made a strong emotional appeal, so KSC arranged for a driver with snow tires and Kirk, Mary, Tim, and I made the trip to Halabja to screen probably around 65 patients. We returned in time to meet the team for dinner at Dr. Aso’s house and then we left for the airport at one in the morning. We are en route home as I write this.


Those are the facts. More important to me are the spiritual lessons, which I am largely directing to American Christians, including myself.
First lesson: go. Go because Jesus said so (Mark 16:15). Go because there are people suffering and hurting, who have been through things that you cannot imagine and living in conditions that you cannot imagine that need to know that God loves them and His people have not forgotten them. Go because you are a temple of the Holy Spirit (1 Corinthians 6:19) and your presence brings Him near. Go because you need to be reminded of how blessed you are living in (I say this unapologetically after lots of international service and travel), though not perfect, the greatest nation on God’s green earth. Go because politics and wars and presidential elections become real and not just something you debate on social media (I’ll write about this separately). Go because you get to witness the tears in your Kurdish colleague’s eyes when he hears from a friend that he had not heard from in two years who called to tell him he was safe in Mosul from ISIS. Go because you see miracles. At one of the camps, Ann was able to counsel and pray with a man who had literally not left his tent for two years. The next day he was found wandering around the camp, clear headed, and telling everyone he was healed because someone came to pray for him.
Second lesson: by the grace of God, you are capable of more than you think. These trips are grueling. Our in-country time started and ended at 1 a.m. and it seemed fairly non-stop in between. There is nothing in my nature that wants to endure this. I want rest, ease, and lots of sleep. Self-protection has infiltrated the U.S. church. We serve a loving, relational God who sent His Son to serve and suffer and die…and then conquer death by resurrecting and proving Himself as a person of the triune God…who sends His Holy Spirit, the third person of the Trinity, to enable us to follow our Master in love and service of His children, even if it means suffering and dying. We have no fear of death, so we are free to serve. And we are empowered by the Holy Spirit to do so. You cannot know what you are capable of through the power of the Holy Spirit unless you step out of your comfort zone and allow Him to enable you.
Third lesson: God answers prayer. For the past couple years, our church has organized NEST (Necessarily Encouraging, Spiritually Transforming) teams that agree to pray for us while we’re gone. Each team member submits a daily e-mail prayer that we got to read, and I know they spend time additional time praying (and even fasting) for us as well. We had two teams praying for us this time, so two prayers to read each day. I cannot tell you how these simply emotionally and spiritually encourage. They also amaze because you see the Holy Spirit directing people to pray for things we did not tell them we needed. It is a mystery that God is in control and His will is sovereign, but yet our prayers have power. We attribute our safety, our health, our logistics, our patient outcomes, everything we do on these trips to the power of people upholding us in prayer. That’s another lesson: if you cannot go, you can always pray…and you should never discount the magnitude of that contribution.
Fourth lesson: oh, the beauty of the Body of Christ. I’m slightly stealing his thunder because Jeff Cabalka wrote a beautiful devotional that he is going to deliver to his Community Bible Study in Minnesota about his first trip to Iraq. Like me, he is married to an energetic, somewhat fearless pediatric cardiologist who doesn’t mind going to serve in scary places. Like me, when his spouse asked him to join him on one of these trips, he had to face his fears, his true belief in his eternal security, and his misgivings about what he had to offer. He learned that God had designed him with unique gifts and personality that allowed him to serve in ways others couldn’t. These trips teach me this lesson so profoundly. We are each uniquely gifted and have unique personalities. We on the medical team believe our medical gifts open doors and give us access to people we would not otherwise have access to, but we are often so busy doing the medicine, we need others to do the more important relational, emotional, spiritual work that we cannot do. This trip also very much demonstrated how we come together as the larger body of Christ. There were so many people and ministries cooperating that were necessary and to whom we are grateful: Millennium Reach, Samaritan’s Purse, Joint Help for Kurdistan, Fountain of Love, Shevet Achim, and Kurdistan Save the Children.
Fifth lesson: never doubt the goodness of God. This was the subject of one of Kirk’s daily team devotionals. We who are stuck in time often question the goodness of God and fail to see how He is working His plans out over time and eternity. We got a glimpse in the story of Achmed. We met him years ago in Fallujah while serving there in conjunction with Preemptive Love Coalition (PLC) and Living Light International. He had a unique defect in his heart that needed a unique device to fix it. We had planned to return with that device and take care of him before ISIS intervened, prevented our return, and destroyed the cath lab we worked in there. Achmed’s family fled and currently lives in Kurdistan. His father has kept up with us and advocated for us to return and take care of his son. We were finally able to do just that on this trip. This enabled the father to see how God orchestrated events in answer to his prayers in order for his son to receive care. God’s ultimate desire is that we come to know Him and spend eternity with Him. Disruptive events on this earth may not make sense to us unless we see in them the hand of God bringing people to Himself.
Last lesson: overwhelming gratitude. I’m thankful for the loving God who sent His Son to save me and sends His Spirit to teach, comfort, and empower me. I’m thankful for His countless, overwhelming blessings that I do not deserve. I’m thankful He lets us see His power and His work. I’m thankful for everyone who gave, prayed, and served on this trip. And I’m thankful for the many who support us, encourage us, pray for us, and bother to read these updates. May God be glorified. Great things He has done.

Kurdistan, Iraq :: JUNE 2016

Kirk and I are heading home from our third trip to Kurdistan, Iraq in 2016 and our fourth trip in thirteen months. I wasn’t supposed to go on this one. Our last three trips were to Duhok. We hadn’t been to Sulaymaniyah since early 2015 and our friend and pediatric cardiology colleague Dr. Aso requested we come. Kirk and Mary Porisch always say “yes” if they can. I had plans. I was going to San Antonio to work for a week and I had a family reunion to attend. I started trying to recruit another anesthesiologist in my stead. When I started to realize this was going to be difficult because of the late timing, I prayed “ok, Lord, if we can’t find someone, I’ll go.” My role is a necessary one. We’ve seen bad outcomes when a true pediatric cardiac anesthesiologist has not been present. I knew I would be devastated if my not going caused a child to be hurt. I confess though that when we exhausted all our options, I was truly disappointed. I didn’t want to disappoint my colleagues in San Antonio or my family that I had made promises to. Then my Maui work schedule came out. I had originally been off one week, but someone had asked me to switch to another. In the confusion, my first week vacation request hadn’t been deleted and I found myself off for two weeks. I offered to work that first week and no one in Maui took me up on that offer. So I offered to go to San Antonio a week early. That allowed me to spend shortened but still lovely time at the family reunion. 

Seven of our team of ten (Kirk, Mary, Tim Sanken, Amy Burkett, Ann Sugrue, Chris Pruitt, and Jacob Cokely) arrived in Iraq 24 hours ahead of me. They screened over 100 children at the hospital in Sulay and then at Fountain of Love in Chamchamal on Sunday. I met our nurses for the week, niece Tara and her husband Roy Asejo, in Istanbul and we arrived at three in the morning on Monday. We went to our hotel and slept a couple hours and then got up to start the work week. We only did two procedures that first day. We were supposed to do four but, contrary to a previous promise, were told we had to stop after two. We screened well over forty children that afternoon and then were hosted for dinner by one of our generous hosts: Noaman from Kurdistan Save the Children. We filled him in on our early day. He came to the hospital with the Minister of Health (and some TV reporters) the next day and made sure we had complete freedom to do as many procedures as we could. We did four then on Tuesday (and screened at least 20 more patients), six on Wednesday, and four on Thursday. God was gracious. All 16 children did well. Pediatric cardiologist Dr. Kamal came from Duhok for two days, which was an encouraging collaboration with Dr. Aso. Our initial rough start and its subsequent resolution resulted in the healing of what had been a difficult relationship. 

The week was a powerful lesson for me in the joy of obedience. Faithful readers of these updates know how I struggle with exhaustion on these trips. For years I prayed for another anesthesiologist to join me. The Lord answered with my faithful friend Dr. Maria (Mauri) Garcia. Despite her enthusiastic willingness, she couldn’t go this time. If you read my update of our last trip, you read that I didn’t want to write yet another story of my struggling with lack of enthusiasm to serve…but being glad I did. I’m always glad I go. I was just getting weary of my own bad attitude. I had a couple epiphanies on the last trip. Mauri is a good listening ear while we work together. I was wondering aloud to her why everyone else on our teams seems so enthusiastic to go, but I’m just obedient. She suggested that the Lord sent her to let me know I was not alone in my anesthesia role and to give me relief from the exhaustion. She truly is a gift to me. Then Kirk realized that I spend all my time taking care of the patients in the procedures, so I miss all the prayers with the patients before (I’m getting ready) and interactions with the families after (I’m waking the patient up and getting the patient to the recovery room, only to go back to the cath lab to start again). When he said he realized that I get all this work with very little of the emotional benefit, it made me cry…because I realized he was right and I was relieved to think maybe I wasn’t so hard-hearted after all. 

My telling Kirk that I was going to go on this trip actually shocked him. I hadn’t told him about my prayer. I was hoping the Lord would provide another anesthesiologist. He didn’t, but I went with such a different attitude this time. I felt truly called to go. And the Lord was so gracious. I had surrendered time in San Antonio and time at my family reunion…and He had given those back to me. Instead of going with a sense of dread, I went with a sense of excitement. Having a short day that first day was another gift, allowing me to get some rest before continuing with some longer days. It was genuinely a fun week. Our team of ten was filled with loving, helpful, enthusiastic, faith-filled, fun, sacrificial servants. What a delight to serve with them.

I got a horrible cold and lost my voice to laryngitis at the end of the week. This is another lesson. There is nothing formulaic about faith. Sometimes you surrender a desire to the Lord and you get it back…and sometimes you don’t. Always there is a blessing to surrender and obedience, but it is not always easy or without difficulty. God’s grace was sufficient for me until my last procedure was done…and then I felt sick and exhausted. The lesson was not that He had left me, but that He had carried me as long as I needed to be carried. 

I keep reflecting on the fact that I lost my voice. How utterly frustrating. The Lord has been using it as a reminder for those we go to serve. I’m sure they often feel as they have no voice. Who will speak for them, serve them, help them, love them, defend them, rescue them? “Then I heard the voice of the Lord, saying, ‘Whom shall I send, and who will go for Us?’ Then I said, ‘Here am I. Send me!’ (Isaiah 6:8)” What a privilege to be sent and what a joy to obey.

Kurdistan, Iraq :: April 2016

Fourteen of us just spent a week in Dohuk, Kurdistan, Iraq. It is a city inundated with refugees from ISIS. It was our third trip there in a year. We screened well over 100 children for congenital heart disease. We performed diagnostic and therapeutic heart catheterizations on 20 children. We performed surgery on another five. I believe the majority of our patients were refugees. For the first time, we were able to bring team members with us who volunteered in some of the refugee camps. One camp alone had 60,000 occupants. There is a level of tragedy and evil that the people of this region have and continue to endure that is hard to comprehend or explain. It can easily become overwhelming.

With our first procedural trip to Dohuk last year, our church, Calvary Chapel South Maui, started supporting us with prayer teams called the NEST (Necessary Encouraging, Spiritually Transforming). Members are assigned one day to submit an email prayer on our behalf and, as much as possible, we share with them daily updates and prayer requests. This prayer support has transformed our trips. All of us involved have seen tangible evidence of the power of prayer. As Moses needed Aaron and Hur to uphold his arms so the Israelites would prevail against Amalek in Exodus 17, we have come to need and depend on their prayers to uphold us through these spiritually, emotionally, and physically exhausting weeks. We had four NEST teams supporting us this time. They were boldly praying for and believing in miracles this week. We commonly say on these trips that you don’t see a miracle unless you need a miracle. We need lots of miracles to do what we do with limited supplies under austere conditions and we see them all the time. The greatest miracle I could imagine, however, is for these patients and their families to actually see a vision of Jesus.

One of the local volunteers who helped us this week literally did. He came to faith and was fundamentally changed by this experience…and he could not be contained from talking about it. I wish I could explain the smile, the glow on his face, and the enthusiasm with which he shared his story and how it motivated everything he did. That was why he was there with us this week, tirelessly helping late into the evening as we screened child after child after our procedures were done, wanting to facilitate our taking care of these children, so we could share Jesus with them and their families.

It is a hard thing sharing our faith with the barriers of limited time and language. We do offer to pray with the families before the procedures. We explain that one of the names of Jesus is the Great Physician and that we rely on the Him to heal as we treat. Besides sharing our faith by our actions of lovingly taking care of these children, this is often the only way we get to verbally share why we are there. When we returned after an intervention trip to Iraq in 2010, one of our patient’s fathers said, “I cannot stop thinking of the God who heals.” He came to belief in Christ because of that simple prayer.

There is a painting I love of an operating room scene where Jesus is standing behind the surgeon, looking on. I love that vision of what Jesus told us in Matthew 18:20 to be true: “For where two or three have gathered together in my Name, I am there in their midst.” The bold prayers of our NEST team, the vision of Jesus our volunteer related, the power of a prayer bringing a father to Christ, and the vision of that painting with Jesus in the operating room inspired my prayers for the week. I envisioned Him in our midst and I prayed that those around us who don’t know Him yet would see Him.

I actually dreaded writing this update. I’ve recounted many times in these updates my struggles on these trips. I still struggle. If there is encouragement for you in knowing that I’m not brave and I get tired and cranky, yet I travel and serve anyway, please be encouraged. But I confess I’m a little tired of it in myself. I actually wondered and prayed all week “why am I that person?” Why aren’t I the person who is excited and energized and enthusiastic about this calling and this service? Why do I battle my flesh so greatly? There is a true and beautiful reward to obedience and I am always glad I went on a trip, but is that all I have to share…again? As I was praying about this on the last morning in Iraq, I heard the admonition “focus on Jesus.” I realized by how He had called me to pray that was what the Lord had been trying to get me to do all week.

It’s so easy to get our focus wrong. “The spirit is willing, but the flesh is weak” (Matthew 26:41). Focus on Jesus. There is true evil in this place. It is horrific and incredibly hard to understand or even to know about. Focus on Jesus. There is evil, but there is light in the darkness. There are people coming to love and serve. And in the midst of tragedy, people are coming to faith in Christ in the Middle East like never before. Focus on Jesus.

Kirk shared in a sermon on John 4 at church the week before we left how a royal official came to Jesus asking Him to come to his house and heal his son, who was at the point of death. Verse 50 says “Jesus said to him, ‘Go; your son lives.’ The man believed the word that Jesus spoke to him and started off.” He went home and found that at the very moment Jesus spoke, his son was healed…and he and his entire household came to believe in Jesus as the Christ. But, as Kirk pointed out, the man’s son had to become sick to the point of death in order for that father and his household to come to faith. “’For my thoughts are not your thoughts, nor are my ways your ways’, declares the Lord” (Isaiah 55:8). There is very little hope for the people suffering in the Middle East without the perspective that there is a God and He is good and we were made for eternity where He will make all things right:

‘Behold, the tabernacle of God is among men, and He will dwell among them, and they shall be His people, and God Himself will be among them, and He will wipe away every tear from their eyes; and there will no longer be any death; there will no longer be any mourning, or crying, or pain…I am the Alpha and the Omega, the beginning and the end. I will give to the one who thirsts from the spring of the water of life without cost. He who overcomes will inherit these things, and I will be his God and he will be My son. But for the cowardly and unbelievers and abominable and murderers and immoral persons and sorcerers and idolaters and all liars, their part will be in the lake that burns with fire and brimstone, which is the second death’ (Revelation 21:3-4, 6-8).

But the only way to the Father is through the Son (John 14:6) and how will they know unless they are told (Romans 10:14-15), or unless they see Him?

One of our NEST members encouraged us with Matthew 4:16: “The people who were sitting in darkness saw a great light, and those who were sitting in the land and shadow of death, upon them a light dawned.” She prayed that as our volunteers walked into these dark refugee camps, they would light it up! The Bible tells us in Matthew 5 that as followers of Jesus we “are the light of the world” and we should let our “light shine before men in such a way that they may see [our] good works, and glorify [our] Father who is in heaven.” We do not have to try to be light. We are light. And we are servants of the Light of the world (John 8:12). The world is evil. But we know the Light. Focus on Jesus…and wherever you are called to go in this dark world, light it up! 

Kurdistan, Iraq :: January 2016

As usual, I (Kim) am writing this as Kirk and I are en route home. A team of five of us (Kirk, me, Mary Porisch MD, Maria Garcia MD, and Anita Rich RN) went to Duhok, Kurdistan, Iraq to conduct thirteen pediatric heart catheterizations and screen well over 100 children for congenital heart disease. This is the message I most want to share: we are not heroes.


If you read these updates, you know that I’ve confessed before and will continue to confess my weaknesses. I like comfort. Kirk calls me a hobbit. I like to be warm, well rested, and well fed. I am not courageous. I wish I could tell you I am a willing servant. I can tell you I’m an obedient servant. These trips don’t excite me. They exhaust me. Our recurring team motto for For Hearts and Souls trips is “pay your own way, be exhausted, get sick…come back anyway.” It brings tears to my eyes to think how many people have done just that with us over the years, to places like Mongolia, Kosovo, and Iraq. They use their vacation, they pay their own way, they exhaust themselves, and they usually do get sick (although, praise God, maybe for the first time ever, no one got sick this time…I credit the many prayers on our behalf)…and they do it again and again and again. Our team this time was no exception. They were all veterans. 

Nelia Soares RN is one of our veterans who was supposed to go with us this time but was unable to because of personal circumstances. She was with us in spirit, though, faithfully praying for us and sending us encouraging messages. She wrote to us: 

During my past trips, there have been times I question why I am doing this to my body? I ask at the end of the week, with sleep deprivation, jet lag, pure exhaustion, not eating well, not having all the resources I am accustomed to, why do I keep coming back? What is it about hearing about another mission that ignites my inner passion? I am pretty sure all of you understand what I am talking about. If this is your first medical mission trip, this will make sense to you about day number 2 when you are looking for paper towels again to dry your hands:-)

Here is what I have come up with as one major reason I keep coming back: it makes me happy. Pure and simple. Maybe not the happiest while I am actually on the trip, but the reason it makes me happy is because it is hard work that not just anyone can do. It is physically taxing on my body, it is emotionally draining, sometimes frustrating, exhausting with jet lag and the list goes on. But it makes me happy. Why? Well, other than the obvious of helping children, being with my mission friends, impacting medical program development, and being an example of God’s love for others no matter where in the world, the happiness that follows from a difficult week brings intense joy that I do not feel by my “normal” every day happiness. It is a different type of intense joy that cannot be replaced ever.

For me, the joy is in the obedience. I don’t want that to sound like pride. I’m not proud that I obey. I obey and God, as good as He is, rewards me with joy. I think the older I get and the more trips I’ve gone on, the more I dread them. I know going in that I am going to be exhausted to the point of misery. But it is not long into every trip where I come to the realization, once again, that without a doubt I’m supposed to be there and it’s all part of the Lord’s process of continuing to teach and refine me. 

That realization came on arrival in Duhok. I had been on call the night before I left so only got short, interrupted sleep. Then we travelled for 48 hours with more short, interrupted sleep. We arrived at our hotel at 8 a.m. on Saturday morning and had 5 hours before we were going to start our week. I was longing for those 5 hours for a nap and a shower…and they started to be whittled away. The power went out in the first room they showed us to, as well as the second. As I waited in the cold second room while they decided on a third room, I turned on the water and it was cold. I understand there are people, like Kirk, who can observe they are tired and cold and not be excessively bothered by it. For me, it is physically painful. I hate it with every fiber of my being. As I saw my nap and shower evaporating by circumstances and delays, I saw the week stretching out ahead with no relief from the tiredness or the cold. And then I thought of the literally thousands of ISIS refugees literally miles from me living in the cold, with no warm showers, and no relief in sight….and, once again, I knew. I had to be there. 

We all have roles. Some are called to stay and support and pray. Some are called to go long-term. I thank the Lord for the many we know who now live and serve in Iraq. We couldn’t do what we do without them. And some are called to go short-term. I’m called to go because I need to learn again and again how to die to my fleshly desire for comfort. We did have a warm hotel room and hot showers. I suffered in cold for 10 minutes and nearly panicked. I need to learn again and again compassion and understanding for those who suffer not just for a week or 10 minutes but for extended periods, both at home and abroad. I’m called to go because I need to learn again and again how extraordinarily blessed I am. I have the freedom and the resources to go, and I have the freedom and the resources to leave again at the end of the week. I’m called to go because it encourages those I come in contact with. It encourages and helps the long-term missionaries (one of the things we are most thankful for on this trip is learning there is a long-term medical clinic being established based on relationships we have forged on our short-term trips) and, most importantly, it encourages the many I come in contact with who are enduring conditions most Americans cannot imagine. 

The central government is not reliably funding the budget for the Kurdish autonomous region in Iraq where we were. Kurdistan has oil it can use to raise revenue, but oil prices are down. The doctors and staff said conditions there are very hard. Most hadn’t been paid in months, but they continue to show up to work. The Ministry of Health used to have the funds to support international medical teams to come help deliver medical care, but they no longer do and the teams that don’t fund themselves like ours have stopped coming. On all our previous trips there, electricity has been reliable, but this time it wasn’t, going on and off numerous times a day. And the area has been inundated with refugees. One camp alone has 50,000 Yazidis. We kept note of where our patients were coming from and many were from one refugee camp or another. Everyone has a story. They have lost loved ones, homes, possessions, and livelihoods. Countless have endured unspeakable horrors. And we were there to give them “a cup of cold water” (Matthew 10:42), to let them know they have not been forgotten, and to share with them that their Father in heaven loves them.

Finally, I’m called to go because I’m supposed to tell you about it. I’m supposed to tell you that I’m weak and selfish and scared and not at all heroic…but that I serve an incredibly big God. We get a lot of very well meaning advice about what we should and should not do. “You shouldn’t go there. It’s not safe.” Four of us on this trip have grown children. One has young children. She would not want to be held up as a hero either, but I am impressed and humbled by that level of faith and obedience on her and her husband’s part. She felt called to go. She went. Even in America, we’re starting to come to the increasing realization that no place is safe. I am convinced that no place is safe except the exact center of the will of God. The very hairs on our head are numbered (Luke 12:7). Our days were numbered before there was even one of them (Psalm 139:16). Worrying cannot add a single day to our life (Matthew 6:27). If God calls me to Iraq, He has a plan. As He continues to demonstrate, He is abundantly capable of protecting me and bringing me home. But, even if He doesn’t, like Shadrach, Meshach, and Abednego (Daniel 3), I cannot bow to comfort or safety. Do I think so highly of myself that I cannot endure for one week what many endure for a lifetime?

The important question is “what are you called to?” It’s not “is it safe?” or any other distracting question. I cannot answer that question for you any more than you can answer that question for me. But if you seek the Lord, He’ll tell you (Jeremiah 29:13). And I recommend you obey, for it is there that you will find your joy.

MALAWI :: August 2015

Kirk and I (Kim) are heading home from Malawi. This was not a “heart” trip. It was an orphan trip. One of our favorite verses is James 1:27, which says “Pure and undefiled religion in the sight of our God and Father is this: to visit orphans and widows in their distress, and to keep oneself unstained by the world.”
Kirk and I got our international missions start as a married couple in 1998 when we went, with our son Drew, on a house-building trip to Tijuana, Mexico with our church youth group from Valley Evangelical Free Church in Vacaville CA. We knew we were moving to San Diego shortly thereafter and wanted to serve in Mexico. One of the couples that sponsored us on this trip knew about a mission orphanage in Mexico supported by Applegate Christian Fellowship, pastored by Jon Courson in Medford OR, and run by his brother Jimmy Courson. We wrote Jimmy a letter and the rest, as they say, is history. Everything in our ministry lives connects to this one event. Kirk’s assistant pastor at Calvary Chapel South Maui is David Courson, Jon and Jimmy’s brother.
During the three years we lived in San Diego, we visited the Mission Carmen Serdan one weekend per month and served as the primary care doctors to this group of disabled orphans. James 1:27 is the theme verse for this ministry. In addition to being introduced to the Courson family, we met Lloyd and Holly Folsom and their young sons Wesley and Riley. Lloyd and Holly served at what we lovingly call “the Mish” for ten years before moving back to Medford OR…and eventually to Maui. It was on a trip to visit the Folsom’s in Maui in 2013 that Kirk guest preached at Calvary Chapel South Maui, none of us ever dreaming or imagining Kirk would eventually be called to be the senior pastor there in 2014.
For Hearts and Souls was born during Kirk’s three year pediatric cardiology fellowship in San Diego. He was part of finding a Mexican girl named Eliphelet (interestingly the name of one of biblical King David’s children) and bringing her to San Diego for a life-changing heart procedure. We traveled as a family to Kenya and Zambia in the summer of 2001. As we served at Tenwek Hospital in Kenya, Kirk prayed to find more heart kids to help. What he found was heart kids with conditions so severe he had to send them home to die. We got the vision for international pediatric heart care…and I got the vision to become a pediatric cardiac anesthesiologist. We then traveled to Zambia and met Pastor Edward Mwansa. Learning while there of the incredible need to minister to orphans, For Hearts and Souls helped Edward start an orphanage there in 2003.
We moved to San Antonio in 2002. One of the first churches we visited was Wayside Chapel, pastored by Steve Troxel. This was such an incredibly missions minded church and Pastor Steve was such an effective Bible teacher, this quickly became our church home (and Steve’s family became our family. His daughter Kelli lives across the street from him with her husband Don Johnson and this is where I stay on my frequent trips from Maui to work in San Antonio. We love their four children Derek, Kelsi, Kyle, and Devon like they are our own.) Pastor Edward from Zambia was visiting us in San Antonio when Steve retired in 2006 in order to start, with his wife Connie, an international ministry called Shepherds’ Support that would conduct pastors and wives conferences throughout the world. Edward was so impressed with Steve at his retirement ceremony that he asked him to come to Zambia to put on such a conference. Steve, Connie, their granddaughter Kelsi, other team members, and I traveled to Zambia in 2007 for this conference and to serve the orphans at the orphanage that had been opened in 2003. Pastor Enock from Malawi heard about this conference and invited Steve, Connie and Shepherds’ Support to Malawi in 2008. Pastor Enock and his father Bishop Dimba have planted over 700 churches in Malawi and Mozambique. They also founded the Maoni Orphanage, which serves well over 200 orphans. Steve asked Kirk to join the team in Malawi in 2009 in order to medically screen all the orphans. He returned with them in 2011. In 2013, Holly and Lloyd’s pre-medical college student son Wesley spent the summer with us in San Antonio and joined Kirk on a trip to Kurdistan and on the trip to Malawi. Wesley met Steve’s granddaughter Kelsi in our home that summer (her siblings Kyle and Devon also went on the trip to Malawi). Kirk officiated at Wesley and Kelsi’s wedding in San Antonio in June 2014 and dedicated their baby Avelissa to the Lord in Maui last month. Wesley’s brother Riley just accompanied us on this year’s trip to Malawi.
There were fourteen of us on this year’s trip: Steve and Connie for their fifth time, Mike and Belinda McCartney from San San Antonio for probably their fourth time, Kirk for his fourth time, and me and eight others (Tim and Veralyn Dickson, their grandson Trevor Dickson, Riley Folsom, Amanda Hansen, Samantha Kinney, Andrea Reiley, and Nate Yadao) from Calvary Chapel South Maui (CCSM) for the first time. Steve and Connie do not know if their health will allow them to return to Malawi so they have asked Kirk and CCSM to take up the mantle of ministry there.
We started the week on Sunday by driving over two hours to a bush church. It takes Pastor Enock three years to make one Sunday visit to each of the churches he has planted. He has put well over 400,000 miles on his truck showing The Jesus film, planting churches, and visiting churches he has planted. We were met outside the church with singing; Steve, Mike, Kirk, and Tim all shared; most of the parishioners humbled us by their desire for us to pray for them individually; and we were bid farewell with singing. The opportunity to drive through the bush in one of the poorest countries in Africa, as well as worship in this little dirt-floored, brick-walled, thatch-roofed church may have been enough of a life-changing experience to have made the trip worthwhile.
The rest of the week we served on the grounds of the Maoni Orphanage. Tim contributed his 30+ years as a former pastor to join Steve, Connie, Mike, Belinda, and Kirk in teaching at the pastors and wives conference that had easily over 700 participants. These bush pastors were bused in from Malawi, Mozambique, Zambia, and Zimbabwe. They slept on the grounds. There were outdoor latrines, a stream for washing, and a well for drinking and laundering clothes that were dried on the ground. Meals for these hundreds, including the orphans, were cooked over outdoor charcoal fires. Breakfast was bread and tea. Lunch, and probably dinner, was nsima (a ground corn meal staple), a vegetable or pumpkin leaves “relish”, and, on most days, meat. Meat is an uncommon luxury. Chicken, goats, and a steer were all provided this week. Veralyn and the six young adults from CCSM taught a daily morning VBS to the over 200 children aged twelve and under from the orphanage and the village. Kirk and I taught a daily morning Purity Camp for the over 100 teenagers from the orphanage and the village. On the fourth day, one of the boys raised his hand and said “thank you for coming to teach us what we did not know.” While the older eight of us participated in the conference every afternoon, the young adults that I started calling the “fab 6” played endlessly and tirelessly with the kids all afternoon. The “fab 6” have all been part of a weekly young adult Bible study that we have held in our home in Maui over the past year studying “Experiencing God” and all six felt called to go on this trip. Seeing them experience their first trip to Africa and pour themselves out so lovingly was easily Kirk’s and my favorite part of the trip. Every day the number of the children coming to the orphanage from the village grew, I believe, because of the love shown by these young adults.
At the beginning of the week, Tim shared at our morning team devotional from the famous story of David and Goliath in 1 Samuel 17. In verse 17, Jesse directs his shepherd son David to go to the battle line to take provisions to his brothers there. This simple act of obedience to serve set in motion the series of events where David kills Goliath and eventually becomes the King of Israel. It was the perfect reflection for this week. Kirk and my simple act of obedience to go on a house building trip in Mexico in 1998 set up a series of events that has resulted in life changing friendships, the heart and orphan ministries of For Hearts and Souls, and our ministry at Calvary Chapel South Maui. Steve and Connie’s obedience has resulted in thousands of pastors and wives being ministered to all over the world in their decade long ministry with Shepherds’ Support. Mike and Belinda’s obedience in joining them in Malawi has resulted in a new boys’ home being built at the Maoni Orphanage and their starting a biblical mentorship ministry that they have conducted weekly over Skype for the past two years that is multiplying all over Malawi. The mentors they have trained were involved in training the 700 pastors and their wives in this technique this week. One of the mentors gave his testimony that this tool is one “worthy of dying for.” The simple act of obedience for our team from Calvary Chapel South Maui to go to Malawi this week resulted in one incredible week of ministry to hundreds. I know our lives are forever changed. I pray there are lives forever changed among those we ministered to. And I can’t wait to see the series of events that unfold from this week’s simple act of obedience to go serve.

Kurdistan, Iraq :: May 2015

I (Kim) got very sick this week in Iraq. Nine of us (Mary Porisch, Cathy Woodward, Molly King, Nelia Soares, Caley Johns, Tim Sanken, Becky Ernst, Kirk, and me) arrived on Saturday and immediately started a whirlwind week. That first day we screened 33 children for heart disease at the Fountain of Love in Shoresh for our partner organizations Kurdistan Save the Children and Shevet Achim and then drove to Dohuk, where we spent the next five days performing fourteen pediatric heart catheterization procedures and screening over a hundred more children. My illness on Tuesday, the exact middle of our week, was novel enough that even my team members suggested that it be included in the traditional update I write on the plane trip home.
I had woken up sick overnight, but felt good enough when the alarm went off to get up and get ready. By breakfast time, it was evident I should skip it, so I went back to bed briefly and then got up to go to the hospital with the team. Kirk suggested when we got there that I should get some IV fluids before starting the day to prevent me from being dehydrated and having to test putting anything in my stomach. I laid down in the area where the patients usually gather and he put in an IV, which I quickly pulled out by moving my hand too far too quickly. My pediatric-trained teammates thought this was hilarious, pediatric patient-type behavior and joked about needing to give me an arm board and to tie my hands. As they took pictures of Kirk lovingly putting in a second IV, they suggested the event had reached update-worthy status. The local hospital staff had arrived by then and, down to the housekeeper, blessed me with their concern, getting me clean pillows and covering me with blankets. I tried to nap, but when the crying baby that I was supposed to take care of arrived, I had to move out of that room. We had postponed the baby to give me a little more time to feel better enough to take care of her…and it was tortuous to me to hear her little hungry cry. I also figured it wouldn’t give the parents a whole lot of confidence to see one of their child’s doctors sick enough to need an IV. I moved into the crowded team room…and started to feel worse. Dr. Aras, one of the local anesthesiologists, came and moved me into their anesthesia call room. He agreed to handle the patient we had planned to do second first, while I took a nap. After I got to the call room, things went from bad to worse.
I became much sicker very quickly. But everyone had left me alone to sleep. I was on a different floor than my team and had no phone. My clothes had become unwearable so I was no longer decent or strong enough to get help on my own. I found something to wrap myself in and made it to the door, praying for someone who spoke English. My prayer was answered when one of the resident doctors who had been working with us all week was outside the door. I asked him to please get any member of my team, quickly. The first to arrive was Dr. Fitoon, a Kurdish surgery resident from Sulaymaniyah we’ve worked with before who took a week of vacation specifically to come and work with our team in Dohuk. Her sacrificial care for me was amazing. The scene was not pretty but she got me cleaned up and into bed. She started a third IV because the second was no longer useable. She secured appropriate medicines from the resident outside the door and starting administering them. Blissfully, one of the medicines was an anti-nausea medicine that allowed me to sleep for most of the rest of the day, between trips to the bathroom. I realized later that while she was watching me, she had cleaned that bathroom spotless. The rest of my teammates took turns checking on me all day long. I was distressed to keep getting updates on who else was feeling ill (by the end of the week only Cathy and Mary were unscathed). Thankfully no one else ever got as sick as I did, but that meant they all worked through their illnesses all day long, taking care of two very complex patients in the cath lab. I never was well enough to work that day, but was the next day, when that sweet baby named Bien finally got taken care of. The first thing her father asked me was “Dr. Kim, are you ok?”
The reason this entire episode became update-worthy for me is I don’t know when I’ve ever been so needy. Kirk observed that in almost eighteen years of marriage he had never seen me so sick. Everyone coming to my aid truly brought tears to my eyes and the words “thank you” seemed woefully inadequate. Similarly, the local Kurdish doctors and hospital staff could not seem to thank us enough this week for coming. They repeated the words over and over…and they treated us to dinner night after night, even when we were so tired we would rather have gone to bed. On our last day, Kirk talked about this overwhelming, cannot-do-enough gratitude in our morning team devotional. Often the life-changing question for the Christian is “do you believe Jesus loves you?” We can have a head-knowledge of God or of the story of Jesus dying on the cross for our sins, but when we finally get the depth of His love for us, we cannot say or do enough to express our gratitude. I believe the Lord allowed me to get that sick so I could fully understand this lesson. I was naked, filthy, needy, and longing for rescue…and that is the gospel. We are naked, filthy, and needy in our sins and God sent Jesus to rescue us, to clean us up, and to take care of us. The Lord allowed me to live that object lesson.
Going to Iraq this week for me was an act of obedience. No surprise if you follow along on these For Hearts and Souls updates. Kirk is the one who is fearless, motivated, called, and inspired to go anywhere. My other seven teammates obviously are too. I’m not. I’ve never been fearful on my numerous trips to Kurdish Iraq before and have even felt safely taken care of on three previous trips to Fallujah and Tikrit in Arab Iraq. That was all before ISIS…and the knowledge that ISIS-controlled territory was less than an hour’s drive from where we were in Dohuk. When Kirk suggested this trip, I was praying for a Spirit-led “out” that never came. I’ll admit to being fearful (before we left but never, actually, after we got there)…and to dreading the usual exhaustion that accompanies these trips. It seems impossible, but our team thinks we’ve never been more exhausted than we were on this trip. We arrived at two in the morning on Saturday and drove to Shoresh. We had about three hours to rest and then got to work. We worked about eight hours and then drove five more. By the time we went to bed Saturday night, none of us had been in one since Tuesday or Wednesday. We were at the hospital every day by 7 a.m. and maybe got more than five hours of sleep on only one night. We worked our last day, spent an hour at the hotel, were hosted at a lovely dinner, drove three hours to the airport, and left on a 3:45 a.m. flight. Most of us cannot remember the plane taking off out of Iraq.
But we left Iraq. We’re recovering. I’ve slept on two planes, in an airport lounge, and in a hotel, and am on my third flight. I’ve showered. I’ve eaten good food. And it all makes me cry as I type this. That is the good of obedience. The Lord says, “I want you to do something” because “I want to show you something.” I experienced true misery this week. And it was temporary. I had the choice to go to Iraq. And I had the choice to leave. My beautiful home in beautiful Maui is still intact. I still live in the greatest nation on the face of the earth, with the freedom to pursue my vocation and worship how I please. Most of the patients’ families we took care of this week have no such freedom or luxuries. They are refugees who’ve lost their homes, their possessions, their vocations, and who knows what else in the face of unspeakable evil. Kurdish Iraq is a haven of safety. We quizzed many on whether they felt safe so close to ISIS and they did. They trust the Kurdish military peshmerga to defend their borders. The Kurds still express gratitude to the U.S. for their survival starting with our military intervention in the 1990s. They have renewed gratitude for recent air support against ISIS. One of the doctors we worked with is from Mosul and his Muslim parents are stuck there under ISIS’ control. Another was from Syria and his mother and sister are stuck there. They see no hope in either situation. They are grateful to be in Kurdish Iraq, both expressing that all they want is to live a life of peace and safety and they see no other place in the Middle East where they can do that.
I cannot imagine the misery that many of the people I came into contact with this week have endured. But the Lord gave me a tiny little insight. And then He rescued me. He rescued me from illness. He rescued me from exhaustion. The contrast is so great that the LAX Westin, a meal, a shower, and an overnight of sleep seem like a foretaste of heaven. I have greater insight into the fact that all suffering in this world, no matter how short or long, is temporary in comparison to eternity with God. He showed me how much He loves me, and my words and actions of gratitude become inadequate. How can I not be obedient? How can I not go to a place in the world where people are suffering and let them know that the Creator of the Universe loves them and has not forgotten them? He convicted nine people to get on a plane and go serve and let them know there’s a Rescuer and His name is Jesus Christ. May He be glorified by our actions and may they come to a knowledge of Him.

Mongolia :: March 2015

Tradition holds. Kirk and I are en route home from Mongolia as I write this. We went with four others (interventional cardiologist Mary Porisch, anesthesia assistant Michael Schneider, and nurses Bobbi Odom and Sherwood DeJoie) to perform cardiac catheterization procedures on patients with congenital heart disease.
I have been convicted lately to pray more specifically and with more faith. Jesus taught us to pray “Thy will be done” in the Lord’s prayer (Matthew 6:10).  He also gave us a personal example when He prayed to the Father “not my will but Yours be done” (Mark 14:36). But I think I can easily use these examples as a copout to not pray with specificity and faith. Yes, I need to be submitted ultimately to the Lord’s will and, no, I don’t think He has to or will answer all my prayers…but it sure increases my faith when He does.
I was praying before we arrived in Mongolia for compassion that would outweigh my personal needs or desires. These trips exhaust me. But I wanted to care more about the patients the Lord had called us to serve than my tiredness. I also don’t want to hurt anyone. The sicker or smaller the patient, the more likely that is, especially internationally. Patients and procedures I would not dread in my job at home give me much angst on these trips. I find myself dreading those cases and hoping we aren’t called to do them. I prayed that I would not care about the week being easy, but just be concerned about helping, no matter what.
When we were en route to Mongolia, we found out about a 2-month-old infant with a critical coarctation (narrowing) of the aorta (large vessel that provides blood flow from the heart to the body). These babies are absolutely at risk of sudden death. Even though it is a case I dread internationally, I knew we had to do it. We screened easily at least 40 patients on Monday when we were planning our schedule for the week. We scheduled this baby for first thing Wednesday, purposefully giving us one day of older, less critical patients to “test the system.” During our screening, we found another baby with the same diagnosis, so scheduled her for first thing Thursday. I felt like the Lord was asking me with both babies “do you really mean what you are praying for?” With both of them, having more than my usual resolve to know we had to do these cases was an answer to prayer.
As we were leaving the hospital after a day of four successful and fairly smooth procedures on Tuesday, I walked past a Mongolian child being held by his father. He wasn’t one of our heart patients and he wasn’t in any distress. He was saying something over and over in Mongolian, but to me it sounded like “help me, help me, help me.” The need is so great in these places we go serve. I felt like that voice was just a reminder to me to keep caring and wanting to help regardless of what it costs me.
I woke up at 4 in the morning on Wednesday fretting about that first critical coarctation baby. I was praying about all the supplies I hadn’t found yet and my contingency plans. My bag full of anesthesia supplies had been confiscated by Mongolian customs on our arrival in the country and they had yet to give it back to me. They did allow me to take some supplies out of it, all of which turned out to be necessary (and they did finally give it back to me to take out of the country so at least I have it for my next trip). As much frustration as not having this bag caused me, it was actually a distraction that allowed Mary’s more important catheterization supply bag to pass through. If this bag had been confiscated, our week would have been nearly impossible. When I arrived at the hospital on Wednesday, I was able to find everything I prayed for. I had also prayed for every clinical step in the procedure and the Lord was gracious to answer those prayers. The case went smoothly and the outcome was incredibly successful. What a privilege to hand that gorgeous baby to her crying mom after the procedure was over.
When Mary went to tell the family that the procedure had gone well, the baby’s uncle told her that he had found Kirk online when his own son had a cardiac diagnosis. Kirk recalls this dad calling him the first time when we were actually in Kosovo. Kirk has regularly followed this boy on our return visits to Mongolia and he has not required any surgery or interventions. When his sister’s baby was diagnosed with this much more critical diagnosis, this man knew to tell her when we would be in the country. When the second baby that we took care of on Thursday presented to the children’s hospital and received the same diagnosis, they told that baby’s mother there was nothing they could do…but they should come find us. I was awed to witness the miraculous timing and divine appointments for both babies.
Our second patient on Wednesday was a 26-year-old woman with critical pulmonary stenosis. For those of you in the know, her right ventricle was one of the thickest I had ever seen and her right ventricular pressure was scarily high. She was also at risk for sudden death and her anesthetic and procedure were not for the faint of heart either. But God was gracious and her case went incredibly well also. We are so thankful for all of you who faithfully pray for us. Your prayers matter and we can feel them.
In all, we performed cardiac procedures of 17 patients this week and screened countless more. After our last procedure on Friday, there were more patients to screen before we left for the airport. The cries of “help me, help me, help me” are ever-present …and I pray for the continued compassion to answer them.

Nepal :: October 2014

Kirk and I are flying home from Nepal.  I have a favorite song from John and Anne Barbour called “For Such a Time as This” that this trip brings to mind.   I’m going to take the time to write out most of the words because they are so good:


I’ve built my house here alongside this mountain, 

this rugged mountain that stands so tall.

I’ve built a good life above the lowlands.

It’s more than I’d asked for…but less than I dreamed.

I’ve often heard a voice call down to me:

‘If you’d climb higher, you’d find wondrous things to see.’


But the way is steep…and a storm may come…


For such a time as this, isn’t it much too great a risk?

I’ve never flown from the edge of a cliff, never walked on the water.

But if I turn away, how will I know what I have missed?

Have I waited all of my life, for such a time as this?


I’ve been content to not ask those questions that stir the rivers and move the waves.

The windless waters are so much more peaceful.

They calm my spirit in silent song.

But I’ve often wondered what’s eluding me, 

The yearning meant to free me from complacency.


But the way is steep…and a storm may come…


For such a time as this, isn’t it much too great a risk?

I’ve never flown from the edge of a cliff, never walked on the water.

But if I turn away, how will I know what I have missed?

Have I waited all of my life, for such a time as this?


Sometimes the thrill of soaring has to begin with the fear of falling.


I’ve confessed in these updates before that I am not an adventurer.  I have an incredibly self-protective nature.  I hate to be tired, cold, or hungry.  And I very much like to be safe.  I had such an active imagination for all the ways I could possibly undergo death or serious injury in my childhood that my patient father spent many a countless night comforting me to sleep.  My Christian faith and belief in the reality of heaven has tempered these fears, but I still have an active imagination and pray for God’s grace and mercy in saving me from anything terrifying.  My fleshly nature could hang up this international missionary gig in an instant.

I went to Nepal for Kirk.  He is an adventurer.  He is not self-protective.  He will go anywhere to serve the Lord.  And he prefers his wife go with him.  In my mind I had a thousand excuses why I shouldn’t go on this trip this year.


But the way is steep…and a storm may come…


I couched my resistance in very practical, financial terms.   On his birthday we received a generous donation and I felt like, once again, the Lord was reminding me to trust Him with resources because He has always been incredibly faithful and generous with us on that score.  I told Kirk to book the trip.  He told me it was the best birthday present he received.

It was my third trip to Nepal and at least Kirk’s fifth.  Our good friends from Mayo Clinic Dr. Allison Cabalka, a pediatric cardiologist that specializes in catheter interventions, and Dr. Sheri Crow, a pediatric intensive care (PICU) specialist, have over many years developed a relationship with the pediatric cardiac program in Kathmandu.  They’ve recruited other specialists including surgeons, anesthesiologists, perfusionists (who are in charge of cardiac bypass during heart surgery), nurses, and child life specialists to join them on this annual trip with the goal of improving pediatric cardiac care in Nepal.  We spend time in the operating room, heart catheterization lab, and intensive care unit in two hospitals.  And over the last three years, we’ve all been honored to present at the Cardiac Society of Nepal conference.

On the first day of the conference, Kirk was honored with giving the keynote address on “when not to intervene.”  He feels it may have been the most important of his medical career.  In fifteen years of international medical mission work, we’ve witnessed the allure of “doing something,” when actually doing nothing in certain circumstances might result in longer life and greater health for the patients we are trying to help.  Kirk challenged us as physicians to examine our motives for intervening medically, to properly appraise our skill and the capacity of the systems we work in, and, as Hippocrates challenged us, to “first do no harm.”  It was challenging for even the Westerners in the room.  I’m completely biased but I was so proud it brought tears to my eyes.  On the second day, he gave a talk on echocardiography, ultrasound of the heart, his specialty.  A Nepali physician came up to him and said “yesterday you gave a very philosophical talk and I thought you were a philosopher.  Today you gave a very technical talk and I realized you were a scientist.  You are a very fascinating man.  I need to talk to you more.”  His keynote generated many thoughtful private discussions with many Nepali physicians.  One physician wrote him an e-mail and said “you asked and answered many questions that I was thinking about.  How did you know?  God must be in you and everywhere.”


I’ve been content to not ask those questions…


The time in Kathmandu is not hard duty.  Yes, it’s a long trip and, yes, we are jet lagged (meeting criteria for only one out of my three most hated things).  But that’s where the hardship ends.  The American team members love the reunion and fellowship of being together.  We love our quaint little Summit Hotel, where the staff remember us and treat us so incredibly well.  We enjoy the reunion with our Nepali colleagues and friends as well.  They are so gracious to us.  And of course it is gratifying to think we could maybe have some small part in helping them in their earnest goal to improve care for their patients.  And to see a glimpse into what the Lord is up to in hearts and minds as a result of something that we might have said or done is sufficient reward.  I think because the trip is so good is part of why I marvel at it.  It’s part of why we have such a hard time understanding grace.  The gospel teaches that our eternal salvation is the free gift of God gained solely by accepting Jesus’ death on the cross as payment for our sins.  We so badly want to DO something.  We feel we must earn it somehow.  I think I have a similar psychology when I serve internationally.  If it doesn’t require some grueling, dramatic self-sacrifice, I think I haven’t DONE anything.

I had such joy on this trip.  I kept thinking of Galatians 5:22: “the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, self-control.”  As Christians, we talk about and desire to exhibit these things as evidence for the hope that is within us.  But I really started to see them differently on this trip as gifts from God.  I take one tiny step and agree to go on a trip, knowing I was serving the Lord but mostly doing so to please my husband, and God blows my mind with the palpable experience of joy, peace, goodness, love.


‘If you’d climb higher, you’d find wondrous things to see.’


After three days in Kathmandu (one at the hospital and two at the conference), we flew west to Pokhara to conduct a two-day pediatric “heart camp” on behalf of the Jayanti Memorial Trust (a foundation named for a former Nepali princess that provides funding for medical care for needy Nepali’s).  Now we were getting into some territory where maybe I was DOING something.  The trip involves a flight on Buddha Air.  As a professional collector of tragic stories, I know the history of Nepali planes running into mountains.  I told Allison’s husband Jeff at the airport in Kathmandu that if I weren’t married to Kirk, I would not personally choose to be part of such adventures.  After a safe and beautiful flight demonstrating the grandeur of the Himalayas, we were transported to the Fish Tail Lodge, which is owned and run by the Trust as a means of support.  What a jaw-droppingly beautiful tropical (!) oasis in this Nepali town where countless tourists initiate their Himalayan trek.  C.S. Lewis has a book called “Surprised by Joy.”  I understand the sentiment.  I kept telling Kirk my mind was blown by the goodness of God.  We were able to screen a number of children.  We were able to give a lot of good news, which is such a pleasure and relief.  And we were able to find two children whose lives will be helped and changed by heart surgery.  And God blessed us with this wonderful experience that I would have missed if I had let my fears win.


Sometimes the thrill of soaring has to begin with the fear of falling.

On Saturday morning, we got to attend SD Church, a meeting of lepers and disabled believers in Kathmandu.  We had met the pastor and his family last year but hadn’t gotten to go to church because of our cardiac work.  I’m so thankful we got to go this time!  The pastor, who had been a member of a high caste family, had been paralyzed by falling out of a tree soon after he had gotten married and while his wife was pregnant with their son.  They were rejected by their families and the pregnant wife had to harvest her own rice simply to keep them fed.  He was taken care of in a mission hospital, where he became a Christian, and this incredible church was born.  I love worshipping internationally because it reminds me of the universal truth of the gospel, despite language and despite culture.  There was such unbridled joy amongst the “outcast” in this church that it moved me to tears numerous times.


I’ve often wondered what’s eluding me, the yearning meant to free me from complacency.


Another simple act of obedience to Jesus’ call in Mark 16:15 to “go into all the world.”  Another chance to be reminded how indescribably good I have it to be born and live in the U.S.  I did nothing to deserve this incredible gift.  I need to go elsewhere, regularly, to be reminded.  Another opportunity to see evidence of God at work.  He doesn’t need us to accomplish His purposes.  But He let’s us join Him.  Another privilege to experience the overwhelming goodness of God.  “Give, and it will be given to you.  They will pour into your lap a good measure—pressed down, shaken together, and running over (Luke 6:38).”


if I turn away, how will I know what I have missed?