Posted by on May 26, 2017 in Blog, Uncategorized | 6 comments

It’s been months, if not going on years, since I’ve actually written in this space.  My heart aches to write and too often I push this desire aside to complete the unending list of tasks and self-imposed deadlines.

Alas I’m putting it off no longer… there’s too much to say, too much to share, too much that I want to invite others into to better understand what full-time life and ministry in Madagascar is really like.  The truth is, it’s hard.  Life is heavy.  Ministry is exhausting.  Darkness sometimes feels pervasive.  There’s doubts.  There’s regrets.

Saturday, May 13th was the four-year anniversary of the opening of the Sarobidy Maternity Center.  It was joyous to look back and see all that the Lord has allowed to happen, all the growth, the miracles in our midst, the provision, the walking with women.  It was also the eve of Mother’s Day.  As I was looking through old photos to find the opening day pictures of the maternity center, I quickly lost focus as I saw hundreds of images of our own sweet babes.  At the time, Isabella was seven, Eliana had just turned five and Gavin was not yet three.  The kids hopped up next to us and we opened the folders of their births, the first tender days and weeks of their lives, their silly expressions, their sweet naked bottoms sticking out of aprons as they stood on chairs to help me bake, standing inside the open refrigerator looking for food, images of snuggling and giggles. The memories flooded my mind, my heart swelled and tears fiercely rolled down my face.  So much joy and yet at the same time, so much sadness for moments lost because of the busyness of raising a young family, fundraising, both of us working, midwifery school, seminary, preparing to move a family of five to the other side of the globe.  And then… transition, language study, a move across the island, more midwifery training, more seminary and the launching of the maternity center and the growth of Eden Projects.  And in the midst of all of this, some of our darkest relational moments with others.  The depth of the sadness was overwhelming. We continued through the pictures, the kids and Jamie laughing hysterically and myself joining in through the tears.

Had we stayed in the USA, I imagine that the same would be true and my heart would grieve the fact that the years have passed so quickly even when the days sometimes feel like an eternity.  However I also believe that these emotions are magnified because of the demands, stress, and the heaviness of life and ministry are intense.

Last week…

We received heartbreaking news on Monday morning at the start of our prenatal program day at the Sarobidy Maternity Center that the older sister of our long-time neighbors, died in childbirth here in our city.  The family grew up on the property directly adjacent to Jamie’s childhood home which is now the maternity center. Jamie’s mom used to buy mangoes from the girls each mango season.  Three of the sisters are employed by Eden Reforestation Projects with the dry deciduous work based out of the center.  Two of the sisters have been through our program at the maternity center and one of the sisters, Mamitiana, was the first planned delivery at the maternity center in August 2016.  Their older sister never applied to our program because she lived on the other side of town.  She was a mother of three children ranging in age from 15 years to 3 years old.  It’s hard to know all the details but we do know that when she went into labor she went to a community clinic for the delivery.  It’s said that her blood pressure was elevated and she was passing out between pushing.  The clinic released her and she and her unborn baby died in a taxi on the way to the hospital.  She left behind a husband, three children, seven sisters and a greater family and community that loved her.

Marie Estella, is one of the ladies in our prenatal program… she was amongst the first 5 women when our program started in May 2013 at which time she delivered a baby boy.  While they still lived close to us, her oldest daughter Jaz and our youngest, Gavin loved playing together and were really two peas in a pod.

Marie Estella is currently pregnant with her third baby and due next month.  She’s also one of our artisans with Sarobidy Creations.  She came on Monday to prenatal day with a towel covering her right hand.  When asked about it, she revealed a massive second degree burn on her hand and forearm as a result of mixing hot wax with kerosene over an open fire two days prior.  We started dressings changes, prophylactic antibiotics and pain medication.

Her biggest concern… that she couldn’t work with Sarobidy Creations for several weeks while the burn is healing.  She and her family were counting on the income prior to the birth of her little one knowing that she would be on maternity leave thereafter.

That same afternoon we came home to the unwelcome job of hours of picking lice and nits out of our daughter’s hair.  The term nit-picky is for a very real and unpleasant reason.  Our daughter told us that the girl who sits next to her in school knowingly rubs her lice-ridden head against our daughters head.  This isn’t the first time this has happened to one of our kids.  Ugh.  The night before, we killed a poisonous centipede in our bathroom and continued to wage the war against rats in our attack and garage.  To date, Jamie has easily killed 17 0r more in the last few weeks.  This would be common place for our Malagasy friends with the exception that they wouldn’t have the rat traps nor the means to purchase the essential oils and medication to treat the lice infestation.

One of our midwives, Rozhes, lost her mom last week.  Her mom was 84– quite the old age considering the average life expectancy of a woman in Madagascar is just 67 years old.  Nevertheless, death and final separation is hard no matter the age.  As is customary here, people pay their respects to the family by visiting, offering a small gift of money to “help with the burial cloths” and offer our prayers.  The staff of the maternity center and administration team along with a representative of Eden Projects visited Rozhes and her family to grieve with them and stand beside them in this time of mourning.  This was the second such visit last week with the first being the family of the young mom that died in childbirth.

A first-time mom with joyful expectation of delivering a healthy baby boy had been struggling with the results of her 20-week ultrasound that showed her baby had short legs.  Unbelieving of the news, she received a second opinion and was told from a different physician that her baby was totally healthy.  However the repeat ultrasound once again with our back-up physician again confirmed the short legs.  She was in denial for half her pregnancy.  At 39+ weeks the baby was transverse and it was decided to send her to our back-up hospital for a consultation with the physician there.  Three days later, a baby boy was delivered by scheduled c-section due to his malposition.  We spoke with this young mom just hours after she was out of surgery.  She asked us to come visit that day.  We arrived at the hospital and knew immediately there was something far more than just short legs.

In a crowded maternity ward with 8 other beds, moms, newborns and family members, we asked if we could take the baby to another room to examine him thoroughly and out of the sight of curious onlookers.  This little guy indeed has several malformations including short legs, arms, a robust heart murmur, a super high palate and a cranial abnormality.

We sent pictures and the history to a pediatric genetic specialist in Canada that Dr. Rachel knows and he suggested several tests.  We’re waiting for these results, albeit a bit with bated breath.  Even in the best of circumstances in the best of hospitals with specialists, therapists and a multi-disciplinary approach, this would be a hard journey for this little one and his family.  This family lives in quite the opposite of circumstances– a small one-room, 10′ x 10′ tin house in a crowded community, without running water, just a single light bulb hanging from the ceiling and a mattress directly on the floor.  The only furniture are two small rickety tables and a bench– all made of scraps of wood.  Noise abounds all around… the neighborhood mosque calling for ritual prayers, kids playing, the clanging of hammers banging against recycled metal as the immediate neighbors make hundreds of fatoperas each day– small one-pot charcoal stove tops.

Shocking to all of us, baby is nursing like a champ and is gaining weight.  Despite mom not wanting to see the full body of her baby that first day at the hospital, she is now bonding intensely to her sweet little guy for which we’re so incredibly thankful!  We’re still waiting for the father to come back into town and we’re praying that he indeed does.  During her pregnancy, mom was fearful that her husband would leave her if the baby was born with short legs… which brings even greater concern to us now.

This past Monday a young single mom who has a not-so-distant (and perhaps even current) history of prostitution asked if we could give her medicine to abort her baby.  She’s currently 32 weeks pregnant, completely unengaged with this pregnancy and doesn’t want the baby growing in her womb.  Her first child who is 3 years old lives with and is raised by his grandmother.  We sat and listened trying to make sense of the stories that just don’t quite make sense nor add up, we asked hard questions, we listened more, we addressed the massive risks of attempted abortion (and of course didn’t give her anything!!), we encouraged, we prayed with her.

We currently have three new midwives at the maternity center… the third still in her “trial” period before we decide whether or not to offer her full-time employment. All three are new graduates and as expected there’s a learning curve that comes with the territory of new graduates regardless of whether it’s in the USA or in Madagascar.  I speak from first-hand experience as I’ve been a new graduate nurse, nurse practitioner and midwife.  And yet, the learning curve is at times TOO STEEP… bordering on insurmountable for those of us trying to train the midwives in our midst even in the most basic of skills and knowledge.  And yet, we know that training– breaking down the current rogue memorization of education that is found here and re-educating while teaching critical thinking skills and evidence-based practice care is what will ultimately make a difference in the care of mothers and babies in Madagascar.

There’s no easy answers, no easy solutions, there’s also no looking back.  We know too much about the reality of life and death and poverty and struggle here.  The work is heavy, sometimes it feels as though we’re literally pulled down by the enormity and gravity of it all.  At times I grieve the loss of a life in the USA… a life a bit lighter at times.

A few weeks ago, Isabella who is now 11 and I were talking.  She’s quite perceptive this one of ours and loves to have good conversations.  I don’t recall what we were even talking about at the time that led to this comment of hers, but she said, “I can see now that it’s hard work to live here, because of the poverty, and the difficult situations and the sick babies. I used to not think that when I was younger but I see it more as I get older.”  Yes, dear one.  Yes.  She sees and I pray that she will always have the eyes to see these things in the world around her.

A few nights later, while sitting around the dinner table we opened the “key jar” and this question came out…  “What’s something that you love about our family?”
Isabella… “that we live and work in Madagascar” 
Eliana… “that we do lots of fun things together” 
Gavin… “that we love each other” 

Even in the midst of my grieving the losses of younger years, banging my head over the mounting frustrations, weeping about the injustices our friends experience all too often, there’s a deep joy in the responses of our sweet children as well as an ability to sit with the heaviness as we continue to hand it over to the One who can bear it all.



  1. So glad you shared this with all of us Alissa. My heart is with you. So glad to know how to pray for these beautiful people by name. Sending so much love and prayer and big hugs as well. xoxox

  2. so good to read this in spite of the heartbreak. So easy to get complacent in our soft safe American lifestyle. I don’t have words to express how I felt reading this but there is a lot of awe, respect and love for you guys. God is doing a work in all of us but it does get tough. love you guys. Aunt Jan

  3. Thank you for sharing these beautiful, real and very hard stories! You are gifted by God!

  4. Oh, Alissa. So hard. And I’m so sorry. It is an honor to read what you have shared and try to do our small part over here on the other side of the world to bear each other burdens through prayer and work and sharing. Thank you for being honest. Your family is such a gift. Carrying HOPE on your behalf…

  5. Tough blog, thanks for posting this reality of ministry! Praying even more than before.

  6. Oh, dear Alissa, I love you and am so grateful for you–for your heart, your thoughtful writing, your faith, your courage, your commitment to following God’s call on your life.. It has been and continues to be one of my life’s most precious gifts to spend this year here living alongside you and your family. Thank you for sharing these intimate stories and the gorgeous photographs.

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