Looking back at 2015

I’ve started to write this on December 30th, sitting on a train in Lincolnshire at 7:30am, on my way to work. It’s still completely dark outside, and half the country is still on holiday. I feel slightly jarred, like the alarm clock went off, but no one else has had to get up.

Feeling disjointed is somewhat appropriate – it aids my reflections on the last 12 months.

2015 has been a year of experiences. We’ve lived in three continents; I’ve had an epiphany in healthy living, exercise & weight loss; my medical skills, for the first time, feel formed; and, as a family, we’ve started to have some clarity about how we want to live.

Home

This year has shaken my understanding of home. In many ways, “home” still means “Epping” to me. My parents live there, I grew up there – the streets feel familiar, comfortable and safe.

“Home” is any place that has touched your heart.
Leaving doesn’t stop that.

But in a much more practical way, our lovely house on Woodthorpe Avenue in Boston is home. It’s the place we can best exhale. We can kick off our shoes, settle comfortably onto a high chair on the breakfast bar, and watch the chickens, dogs and children flap around in the garden.

YEditedGroupPhotoet Restore Church, full of our friends, is also home. We seek the heavenly realms together, we drink moderately bad cups of tea together and we laugh about the projector turning everything purple again. This whole year has been a mess of realising that “Home” is any place that has touched your heart. Leaving doesn’t stop that.

If you’ve read Harry Potter, there’s a concept where Voldemort tears apart his soul and stores it into objects that have emotional value to him. That’s not quite how I’m feeling – home is not a horcrux – but there’s no doubt that putting roots down involves investing a part of oneself.

Now I’m coming home
I’m coming home to you again
I hope things haven’t changed
New Found Glory

Many homes

This year, “home” has been Mseleni hospital in South Africa. It’s been Sea Point in Cape Town. Jackson in Missisippi. Alterna community and Koinonia Farm in Georgia. QC Family Tree in North Carolina. Grace & Main in Virginia. The Simple Way and Inner Change in Philadelphia. A little bit of us still lives in the homeless shelters of the Catholic Worker movement in New York City

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Returning to the UK has brought us face to face with the contradiction of “home”: it means a state that is temporary and yet, somehow, extraordinarily enduring.

Our idea of home is shaped by the setting and society we live in. This year it’s meant our children sitting naked, in dusty mud, next to the road. It’s meant seeing giraffes on the drive to the shops. Getting excited about a visit to the town café that pretty much only sells chips. Friends who have never had – and will never have – the life opportunities that I take for granted. Patients who have never slept in a bed, and thus don’t know how to sleep when they are admitted to hospital. Evenings without a TV, without electricity, without water, spent cooking pizza on a wood fire, and laughing. So much laughing.

John M PerkinsAnd it’s meant eating sweet potato wedges with John M Perkins. Jugs and jugs of sweet tea. Contemplative silence in LaGrange, and board games late into the night. Cooking pizza for the entire residency of Koinonia farm. Shaving heads and eating chocolate.

In Charlotte, it meant reincarnation through recycling, through gardening, through relationship, through reimagining an unloved locality. And a little girl doing a poo in a public water fountain. It’s meant permaculture, community gardens, ultra thick milkshakes and sitting on porches in Danville. In Philadelphia it meant pizza (home == pizza), and gunshots, and an understanding that all of us need our home to be sustainable. New York meant $1 pizza slices, enjoying glorious mess surrounded by healing people, and my first ever visit to a board game cafe!

Returning to the UK has brought us face to face with the contradiction of “home”: it means a state that is temporary and yet, somehow, extraordinarily enduring. In common with many others who have crossed cultures, there will always be a discomfort in us, even in situations that have been familiar to us for years.

wp-1451644198031.pngHealth

Alongside learning more about the mental framework we use to fit into the world, I’ve also come to terms with my physical existence here.

For the first time, I can say I genuinely love exercise. I even hate running a bit less!

Sure, 2013 was the year I decided to start losing weight. And 2014 was the year that I realised healthy eating is going to be a life long commitment. But 2015 was the year I started to understand the link between health and happiness.

For the first time, I can say I genuinely love exercise – I even hate running a bit less! I’m more aware than ever how rubbish I feel after an episode of gluttony – Ben & Jerry’s, I’m talking to you here – and I’m starting to have the self control to just not go down that path.

I’ve hammered out a few personal milestones, such as my first Triathlon, my first sub 25 minute 5k, and consistently dropping below 70kg. I’ve also managed sustained periods of exercise, accountablity and weight management – see my blog series: six kilos in six weeks.

Medicine

babychris-800x817Working in South Africa was a privilege – a scary one at points. Having a baby named after me was a highlight, as was being signed off as competent to perform caesarian sections without supervision. It was also the first time I’ve ever worked with a degree of autonomy, and the only time I’ve been at a grass-roots level in the midst of the community I live. Being a doctor… at home.

When I was 17, I made a decision to apply to medical school. I’m now 29.

As I look towards the end of my training, I know that the only way I’m going to be able to sustain the enthusiasm and purpose I need is for my career to have integrity. When I was 17, I made a decision to apply to medical school. I’m now 29. It’s only at the end of this year that I will no longer be on a training scheme. I’ll actually be an adult, able to apply for a job where I get told in advance where I’ll be working, what hours I’ll do and how much I’ll be paid! I’ll be able to raise concerns and suggestions for improvement without putting my entire career at risk! Brill.

In 8 months, I’ll be able to choose my hours, select my workplace and start to explore my sense of vocational calling. Medicine needs to line up with our life goals, my heart and my sense of home. Who knows exactly what shape that will take, but its an exciting prospect.

Next

The bible is full of phrases like this:

“And calling the crowd to him with his disciples, he said to them, “If anyone would come after me, let him deny himself and take up his cross and follow me. For whoever would save his life will lose it, but whoever loses his life for my sake and the gospel’s will save it.”
Mark 8:34-35

When I read a passage like that, I think: “I’m not really doing that”. I’m not saying that I believe God calls us all to martyrdom; but I do believe a luke-warm 50% lifestyle simply doesn’t cut the mustard.

SAM_0952I’ve become certain of one thing this year: we desire to live out the gospel. Really live it. Not half live it, tacking on a bit of grace and love to a plastic Western lifestyle, but LIVE it. Our hope is to explore, sacrifice, pray and practice until “The Kingdom of Heaven is near” starts to resonate with us.

“Home” this year has meant common threads: friends, community, adoption, Jesus, vegetarianism, pizza, board games, fitness, laughter… shared values in others that reflect the hope we have for this life.

One of our mentors, Colin, recently said to us “You need to find your tribe“. As we continue to explore what and where “home” is for us, I think God will make it clear to us who our tribe is. Maybe it’ll be through pulling on some of those common threads, and more importantly, following back to the heart behind them, one that says “My God; my neighbour; our life together.”

Thanks for reading this, and thank you to everyone who has been part of home for us this year. Have a great 2016!

PS. I leave you with a song that is very much on the same page as us…

Avocado Cookies

AvocadoSo, Avocados are a thing you can get much more cheaply in Africa that you can in Lincolnshire. They also taste much better too. If you’ve never seen one, I’ve included a picture on the right.

They are also much healthier for you than butter, apparently full of “good fat”. Always up for a challenge, I decided to try and make some cookies, using avo instead of butter.

Given that maize is a local staple too, I chucked some of that in, which made this an even more South Africany treat.

Disclaimer: I am a proud member of the chuck-it-in-it’ll-be-fine school of cooking. I firmly believe a happy cook just throws stuff in a pan, rather than measuring 18g of this and 3.5 medium egg yolks of that; so take my measurements with a pinch of salt, so to speak. This recipe makes around 15 cookies. Ish.

Ingredients:

  • 2 or 3 medium avos – as ripe as possible.
  • 1 cup sugar – I literally used a coffee mug, rather than any kind of accurate measuring thing.
  • 1 cup chocolate powder (I used cheap stuff that’s full of sugar. If you use cocoa powder, you are going to want to add more sugar, around another 1/3 of a cup.)
  • A big spoon baking soda
  • 1 egg
  • Half a cup ACE chocolate maize (If you haven’t got this, just replace with flour).
  • 1.5 cups white flour
  • 1 cup chocolate chips. Or chocolate chunks. Or just eat the chocolate chunks, and have plain cookies. Mmmm, chocolate chunks!

Avocado CookieRecipe

  1. Mush the avos. I used a fork. If you have a blender, that would be easier, but you have less excuse to lick avo off your hands…
  2. Put all the powders in a bowl: flour, sugar, chocolate powder, baking sofa, maize, etc, and mix thoroughly.
  3. Now add the egg and avo mush, and mix thoroughly. It should be about as thick as butter thats been out of the fridge for half an hour. Add a little water to thin it, or more flour to thicken it, as needed.
  4. Put 1 inch balls onto an oven tray (greased with more avo!).
  5. Cook at about 180 degrees celcius for 12ish minutes. Peer at them through the door.
  6. At 10 minutes, quickly flatten them with a spatula – the avo doesn’t melt like butter, so they don’t go flat without extra help.
  7. Remove when browned, and allow to cool.
  8. Eat a cookie. Feel proud. Feel ashamed about eating all the chocolate chunks earlier. Get over it, eat another cookie.

Low Cost Holidays – unbelievably bad customer service

lowcostholidaysA few years ago, me and Katherine went on holiday with a low cost company that managed to pretty much ruin our holiday.

They are called Low Cost Holidays. I think a more apt name is Low Quality Holidays, with terrible customer service thrown in

A bad start

Our apartment had:

I contacted the company after our third night with no sleep, after my wife started crying because of how little fun she was having. The representative I spoke to was friendly and understanding: “Go find some other accommodation, keep the receipt, and we will fully refund you on your return”.

That got worse

Our next week of holiday, in a self catering flat next to the beach, was great. My experience with Low Cost Holidays, on returning back to England, was less good.

They flat out denied my request for compensation. Repeatedly.

They denied that their customer service representative had spoken to me, or authorised me to stay in alternative accomodation. Even when I provided them with itemised phone records showing the exact time, date and duration of my 35 minute call to their number, on my mobile from the Canary Islands, they denied that the offer had taken place. They were uninterested in the photos documenting the poor quality of the hotel, nor my hotel stamped initial complaint letter.

Eventual success

Over the course of a year, I wrote 6 letters, and spent around 10 hours of my time on the matter. Eventually, after threatening to take them to the small claims court, they finally agreed to pay the £300 they owed my for the accommodation- but refused the £300+ that I was claiming for my time and expenses (such as filing small claims, lost time doing freelance work).

I decided that it was no longer worth my time fighting any more, and laid the matter to rest until…

A ridiculous request

In September, I received an email threatening legal action from the formerly mentioned untrustworthy holiday company. In the email they said:

Links from your site have been identified to us as malicious or spam content and we request the immediate removal of any links directed to lowcostholidays.com

We request immediate action or our legal team will seek removal. Please notify us with an email once action has been taken.

I explained that the link was probably in a post complaining about the terrible service I received. I asked they simply pay the money I was still owed, and links would be removed.

Making things worse

A month later they went to my excellent, high quality hosting company, and tried to get the links removed. In this email they lied and said “we haven’t managed to find the correct contact details for the site owner“, and asked them to remove the links.

In going over my head, and lying about previously contacting me, they clearly broke the law, as well as proved themselves to be the scumbag, disreputable company they had already proven themselves to be.

And then even worse…

They then offered my hosting company money to remove the links without my permission! Pretty sure that’s totally illegal, and definitely immoral regardless. They offered £25 per link. At this point, I was a bit angry. I think you can understand why.

However. I am currently volunteering in Africa, and I could do with the money, so here is my response:

Dear Low Cost,

In the above post, you can clearly see that your behaviour has been, at best, shady, and at worst, actually illegal. You still owe me around £350 for my time spent chasing your company after you broke your word.

That said, My family and I are currently volunteering in South Africa to help some of the poorest people in the world with healthcare. I don’t officially have a job yet, so I could do with a little extra income.

You offered my hosting company £25 per link. There are currently 14 links = £350. You already owe me £350 anyway, in case that wasn’t clear. Pay me that which you owe me, and I’ll remove all the links to your company, and, beyond an acknowledgement of your gracious behaviour, never publicly comment on the matter again.

How does that sound? Pay up, and I may even consider going on holiday with you again…

Regards,
Dr Chris Lowry

Take some Pudding home…

Thanks for all the friendly offers of a home for our dog. Pudding has been given a home over the next year, so please – no more offers, its heartbreaking having to keep saying no!

This is a heartfelt plea to see if anyone would be able to provide a home for our dog Pudding over the next year.

Myself, Katherine and our children are all off to South Africa from the end of August until July, working in a hospital, and trying to avoid being eaten by hippos.

Unfortunately, its too difficult and expensive to take our two lovely dogs with us for this period. Hezebelle, our 8 year old collie, has a temporary home with a friend for 11 months, so we just need somebody who would like to support our work over this year… by looking after a slightly annoying Labrador.

IMGP1455Pudding is 6. She is half collie, half Labrador, and 75% moron.

She plays well with children, and other dogs – there might be a settling in period for a day or two with dogs – she loves to be with people and animals.

She is a scaredycat – we have chickens, its funny to watch her run away from them round the garden. If you don’t have a chicken, we can lend you one. She will bark at your front door, but she shuts up pretty quickly, and there’s no aggression in her, she’s just saying “OH NO, THERE’S SOMEONE AT THE DOOR?!”.

She is fully housetrained. That said, she is still an animal, and she is known to eat ridiculous things like sticks and frogs, so I can’t guarantee that you won’t have one or two accidents in 11 months – but it shouldn’t be more than that.

She is a food lover. She will eat anything you offer her – and the occasional poorly guarded thing that you don’t – but she is reasonably well behaved. For example, if you put cake on a table and said “Pudding, do not eat that cake!”, you can be pretty sure the cake is fine. If you put a tub of butter on a chair, and just wander away… there’s a reason she is called Pudding. We will pay for her food whilst we are away.

She is lazy. She is happy with 5 walks a day, but she also manages with 2 a week. Half the time we have to call 3 times to wake her up in the morning to go out. She will likely not even notice if you leave her alone for the majority of the day at work, and has been threatening to become wider than she is tall ever since we got her.

She is a much loved part of our family, and I’m confident that she would settle into yours too. If you think this is something you would be able to take on, please give us a call, an email, or whatever. In looking after her, you’d be supporting a young family as they go on mission to help those in need in Africa.

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Snakebites and sad goodbyes

dhThese notes are about the CMF Developing Health Course 2014.

The focus of today is Dermatology. I made notes on the whole course in 2012 – you can read about this day here.

Each day I’m just going to write about things that impacted me, and things I need to read later…

A final morning chapel followed our joyful late night escapades last night, with a combination of Amazing Grace and We Are Marching to get a bit of the African clapping vibe working. The photo below is from earlier in the week, but since its the last day today, it seems appropriate to share it…

Beautiful_photo_DHC_2014

Dermatology

Clare Fuller showed us lots of very interesting graphs. Dermatology complaints are known to under present, be poorly treated and lead to people avoiding healthcare for other important issues.

In some studies, more than 60% of Dermatological prescriptions were inappropriate in a Developing world setting.

Also, distance effects health seeking behaviour in Dermatology more than other conditions: if there is a clinic within 1km, people attend with their fever, their pain, their rashes. If the clinic is 10km away, they will only go with their fever or pain, according to one study.

Apparently 10-20% of children with scabies will still have haematuria 10 years later! That’s terrifying, and only something that’s recently coming to light.

Skin lightening products

Using topical steroids for skin lightening leads to low birth weight and vaginal bleeding in pregnancy.

Generally dangerous

Cutaneous bacterial infections

Very common in the tropics, can be difficult to identify which one in particular.

Treating cutaneous bacterial infections

  1. Wash skin – clean water, disinfectants
  2. Remove crusts, debris, necrotic tissue
  3. Topical anti-inflammatory/anti-biotics, honey, etc.
  4. Oral antibiotics

Eczema

Acqeous cream should not be left on the skin – can inhibit barrier function.

Otherwise the greasier the better.

Snakebites

Approach will vary depending what snakes you have in your area.

I saw a snake on my balcony, and was concerned, so asked a colleague what to do.

Their response, “Have you tried the exposure test?

“What is that?“, she replied.

Let it bite you, and see what happens

Fond goodbyes

I was feeling desperately sad by the end of the day, but it was time to say goodbye to everyone. I got bullied into starting a Developing Health 2014 facebook group, so feel free to join if you came along – it’d be great to stay in touch.

Thanks to everyone who came along, everyone who donated their time to teach, and the course organisers: I’ll be processing everything I’ve learnt for months…

Ladies, feet washing and goodbye curry

dhThese notes are about the CMF Developing Health Course 2014.

The focus of today is More Women’s Health. I made notes on the whole course in 2012 – you can read about this day here.

Each day I’m just going to write about things that impacted me, and things I need to read later…

Cross Cultural Care

Mary Hopper delivered a talk that usually marks part of a 30 hour course over 6 weeks. In 55 minutes.

Your race is a constant.
Your culture constantly changes.

She recommended reading a book called “Desert Flower”, by Waris Dirie.

She mentioned that simple things like Dermatology books rarely have pigmented skin, making medicine itself culturally inaccessible, but then Marli emailed me an African Skin Guide, which is not added to my ridiculous pile of things I need to read…

Labour and Obstetrics

A maternity dashboard sounds like an excellent way of keeping track of statistics and aiming to improve them across a whole hospital.

We had lots of very useful workshops, which included resolving a shoulder dystocia, and delivering a breach. I also had some great one-on-one tuition from Julie-Rachel, a midwife working in Zambia, who invited all of us to stay out there – she has ridden on an elephant! I definitely want to ride on an elephant, so now I just need to persuade Katherine that the experience is worth 20 hours or so of travelling…

Final evening

jesus-washing-disciples-feet-by-taklaIt being the last evening before the end of the course, there was a goodbye service in the chapel, where Ian spoke about Ephesians 1 again, and talked about the big transformation present in so many biblical lessons: imagining a U shape, starting high, dropping low, coming high. Jesus is Lord, coming down to mankind, dying an ignoble death, then rising up again.

He ended with John 13:

Jesus knew that the Father had put all things under his power, and that he had come from God and was returning to God; so he got up from the meal, took off his outer clothing, and wrapped a towel around his waist. After that, he poured water into a basin and began to wash his disciples’ feet, drying them with the towel that was wrapped around him.

He came to Simon Peter, who said to him, “Lord, are you going to wash my feet?”

Jesus replied, “You do not realize now what I am doing, but later you will understand.

No,” said Peter, “you shall never wash my feet.

Jesus answered, “Unless I wash you, you have no part with me.

Then, Lord,” Simon Peter replied, “not just my feet but my hands and my head as well!

Jesus answered, “Those who have had a bath need only to wash their feet; their whole body is clean. And you are clean, though not every one of you.” For he knew who was going to betray him, and that was why he said not every one was clean.

When he had finished washing their feet, he put on his clothes and returned to his place. “Do you understand what I have done for you?” he asked them. “You call me ‘Teacher’ and ‘Lord,’ and rightly so, for that is what I am. Now that I, your Lord and Teacher, have washed your feet, you also should wash one another’s feet. I have set you an example that you should do as I have done for you. Very truly I tell you, no servant is greater than his master, nor is a messenger greater than the one who sent him. Now that you know these things, you will be blessed if you do them.”

John 13:3-17

Last time I was on the course, I felt a calling to wash everyone’s feet. This time we did it again, myself, Marli and Jayde. As always, it was an intimate, humbling experience – an honour for all of us.

CURRY!

Several of us had wanted to go out for an evening meal, but Vicky was sad about people leaving on the very last night: we compromised with an Indian takeaway. In the largest order I’ve ever made, we ordered £120 of curries, rice, poppadums and naan breads. We pulled together 3 tables, and sat round them, laughing, sharing, and trying not to think about saying goodbye.

After the food was finished, we spent some good old fashioned time singing Irish songs, National Anthems of every country round the table (we didn’t do all 11 verses of the Norwegian one), reading out poetry and spoken word, and telling jokes.

Worship in the dark

By around 10, a small group of us – Me, Jayde, Marli, Jakob, Ingvlid, Richard (until his wife summoned him away) – headed to the chapel, where we started playing worship songs. We turned off the lights, with just a small torch lighting up the music on the piano, and stayed together for hours.

It was a peaceful end to the course, and an honour to share with friends who were strangers to me 2 weeks ago. Around 1am, we prayed for each other, and headed for bed.

I stupidly also chose this time to pack, but because I’m a disorganised man, it only took me about 5 minutes to shove everything randomly into bags

The Ladies are Dying

dhThese notes are about the CMF Developing Health Course 2014.

The focus of today is Women’s Health. I made notes on the whole course in 2012 – you can read about this day here.

Each day I’m just going to write about things that impacted me, and things I need to read later…

why are  women dying?Maternal death

Afghanistan – “One of the worst places in the world in which to be pregnant”
UNICEF

Has a Maternal Mortality Rate of 6,500 per 100,000. Which is the highest ever recorded, anywhere in the world.

Reducing those MMR stats is simple: we know the answers…

  1. Improve access
  2. Ensure skilled staff at deliveries
  3. Increase Utilization
  4. Education and Family Planning

Female Genital Mutilation

Studies have shown that it is not really a religious tradition but a cultural one. It is barbaric – and the pictures and case studies just confirmed that. I’m pretty proud of our country that they have made it illegal for UK nationals or residents to perform FGM anywhere in the world. Maximum sentence 14 years!

There were some interesting discussions about this though: if you deliver a baby, and the mother gets a tear, relating to her FGM, you breach the law if you repair it to how it was previously, rather than trying to reverse the FGM – regardless of the patient’s choice!

Women, depression and domestic violence

There is a big correlation between depression and suicide in women in the developing world – in the UK, men are about 3 times more likely to be successful in suicide. In Bangladesh, there is no statistic distinction between the two.

Being poor, worrying about family, about health, about money, about social insecurity, domestic violence: all these things are stressful.

In some studies, 20-36% of women in Asia suffer from post-natal depression.

Group work

We had a range of group workshops, where we talked through loads of case studies. Very informative, very useful. Just like yesterday, where I ended up teaching a group how to perform a spinal anaesthetic, today I realised that I actually have something to contribute, based on my professional experience. Last time, I knew very little about gynaecology, but this year I had 4 months on experience, and was able to participate actively in the discussion.