On Sunday, our little family got a little bigger. The beautiful Neriah Grace Lowry came into the world at 7:30pm. Just like Joen, the journey to Neriah was hard work.

Once again, thanks to everyone who followed the blow-by-blow account on twitter – read it here - including at least two people over the age of 80. Who says social media is just for young people? Anyway, enough of that, on with the story…

I’m currently working in Lincoln, around 1-2 hours from our home in Boston, and in the month preceding labour, Katherine seemed to enjoy sending me texts containing phrases like “baby’s coming!”. I would frantically call her, where she would explain that she simply meant “at some point”, so she was tidying the house in preparation. By my estimate, I had at least 4 heart attacks in January because of communication like this.

On Friday, my parents-in-law came up to help look after Joen. I have successfully not thrown milk at either of them, which is a significant improvement over last time! It was brilliant to have them around so Joen could get used to them before we disappeared to the hospital.

Just like last time, we sailed past the due date (15th January), and ended up going into labour a few days before we were booked for induction. On Saturday at 4pm-ish, Katherine started to have her first sporadic contractions. By 7pm, they had become regular and painful.

12 hours later, there was very little progress. Lots of pain, but no progress.

At half 8, they were down to every 2 minutes, and rather intense. We rang the hospital, who advised us to come in. I was a little hesitant to do this, since last time she’d had similar symptoms for 10 hours+, but was only 3cm dilated when we made it in to hospital. However, deciding it was for the best, we threw everything into the car and scurried over to the labour ward.

As the tweet below shows, I was right not to be too keen:

From this point until 10:30am – about 12 hours later, there was very little progress. Lots of pain, but no progress. One midwife thought she was up to 4cm, but on re-examination 5 hours later, a different midwife felt that this couldn’t be the case.

They decided to break her waters at 11, which really kicked things off - she had 12 very painful contractions in the space of 30 minutes. She soon ran out of relief from the gas and air, and was given her first dose of morphine.

By 3, the morphine was wearing off, and Katherine decided she wanted an epidural. Unfortunately, the anaesthetists were busy in theatre, and I was going a little bit frantic in wanting to sort her pain. Given that I currently work in palliative care, where I am comfortable prescribing piles of opiates every day, it was so frustrating not being able to hurry up her analgesia.

They eventually gave her some more morphine at 5pm, just an hour and a half after I had suggested it, and she was finally able to settle down a little. The contractions had been going steadily for hours now, and she had dilated to 9.5cm!

It was at this point that a light of rage appeared in Katherine’s eyes.

At 5:50, 10cm was reached, and Katherine began to push. I will open myself up for criticism here and say that I don’t think was really pushing that hard at first. We hit an hour of pushing with no baby, and the Registrar doctor came in, and told us that she was going to have to use forceps as the pushing was going on for too long.

It was at this point that a light of rage appeared in Katherine’s eyes. Given a 15 minute reprieve, and spurred on by the midwife, “Come on Katherine, we don’t need forceps!”, Katherine began to push like a successful Sisyphus. After just 3 more contractions, there was a screaming head sticking out of my wife, and just one more later and our beautiful daughter was released into the world.

Although disappointed not to use her shiny tongs, the doctor seemed happy enough getting to play with needles and thread, sorting out the second degree perineal tear, and even found time to quiz me on the theory of Obstetrics – I will be working under this registrar in April!

We were both fairly oblivious to this, since there was a disgusting, blood covered angel dripping on us, and looking into our eyes. Glorious!

This is Neriah.

Full name: Neriah Grace Lowry (or “Nia” for short).
“Neriah” is Hebrew, and means “Light of God“. We pronounce it “Ner-ee-ah”.

She was born at 7:30pm on 20th January 2013. She weighed 7 pounds 9 ounces.

Her hobbies include avoiding accidental injury from her boisterous older brother, submitting to being sniffed suspiciously by dogs, and throughout remaining surprisingly content. We don’t know much else about her.

Last month, we took a big step as a family. We moved from our familiar, friendly home in Yorkshire over to the barren flatlands of Eastern Lincolnshire. In doing so, we said goodbye to 8 years of friends, and hello to convenient beaches, widespread obesity, and owning another house that needs every single room done up before we will be able to relax!

I’ll take you through some of our key moments with some photos:

This is our new home: Orchard Cottage, on Woodthorpe Avenue. It’s on the slightly nicer side of town, but needs quite a lot of work! The garden hasn’t been touched for about 2 years, so we are having rather a lot of pruning done at the end of the month, and some building work after that…

Joen has settled into things well, and both he and the dogs are loving the big new garden. As you can see, there are cat flaps everywhere, coupled with awful red carpet in the kitchen, and mammoth spiders in every room. Katherine hates all 3 of these things, especially the eight legged monsters.

One of the key aspects of our corner of Lincolnshire is that it is as flat as a pancake (In fact, if you read this study, its likely that its considerably flatter, since it would appear that pancakes are not terribly flat). The downside: its a bit boring. The plus side: we can cycle everywhere. Joen has decided to live on the edge though, since he has now worked out how to remove a cycle helmet, rendering it useless.

Alongside the uninteresting terrain, there is considerably more sky visible, so sunsets and dawns are rather beautiful to behold. Sadly, the road I take to work each morning is almost due East for large sections, meaning I can barely see beyond the brain melting glow of the sun. The unending flatness means that a 44 mile round trip is just about doable on bike, although I’m not achieving it every day.

I have begun my GP training, which involves hundreds of hours spent reflecting, signing sick notes and prescribing amoxicillin. Here you can see my office, with a photo of the family, and a coffee mug, recently filled on my most extravagant new purchase, a DeLonghi EC 152 Coffee Machine.

As mentioned above, we have several fantastic beaches, 20 miles or so down the road; and we have made the most of them already. Here you can see Joen swimming, playing and eating the sand on the beach at Chapel St Leonards.

Finally, the most important photo is that of our new child, around 50% ready now. Probably a she (the ultrasonagrapher wasn’t completely sure), we look forward to her arrival in January!

Thanks to everyone for your prayers, support and hot meals over the last month, especially Eagle, Sadie, Daniel, Tammie, Hannah, Helen, Micky & Rachel, and thanks for the unpaid manual labour of Nick & Jon!

I cycled today! 14 miles on my dad’s mountain bike. Excellent practice for a potential 26 mile cycle to Skegness on my next rotation. I decided that this exertion deserved a reward with a croissant, before the morning session began…

Caring for the carers

Mary Hopper has lived and worked in Rhodesia/Zimbabwe and South Africa for many years, and also runs a counselling and trauma workshop for those working in resource poor settings.

Elijah was afraid and ran for his life. When he came to Beersheba in Judah, he left his servant there, while he himself went a day’s journey into the wilderness.

He came to a broom bush, sat down under it and prayed that he might die. “I have had enough, Lord,” he said. “Take my life”.
1 Kings 19 

Following this, God strengthened Elijah, takes him to a quiet place, given a word of encouragement: and then gives him another difficult job to do.

The passage from Kings is a word to those who have grown wearing in well doing. Also a word to those who think that this will never happen to them. Huge list of people who have shown stress in history: Jeremiah, David, Charles Spurgeon, Martin Luther

Stress

Both acute and chronic stress have physiological effects. Its a common problem in the field of world mission. 20% have taken anti-depressants since becoming missionaries.

46% of missionaries suffer psychological problems (mainly depression) - their home organisations only knew of about 7.5%.

What can cause stress and burnout in resource poor settings?

• Frustration
• Feelings of inadequacy
• Busyness and tiredness
• Conflict within teams
• Cultural differences
• Language barriers
• Distance from local church – no fellowship
• Sad spouse, stuck at home
• Personal healthcare issues

Greenhouse effect: a plant in a greenhouse in the UK won’t grow out of control. Pop it into the Congo jungle, and it will grow out of control. Social conventions in the UK can reign back behaviours: drinking too much, driving, marriage problems. etc – without that control, it can worsen abroad.

Children especially can find returning home to the very civilised culture in the UK very difficult. No one at school will understand the freedom of running around barefoot under the sun. Studies show that children struggle with moves most, especially when they have to leave friends behind.

Single women can have problems: cultural expectations are often that must be prostitutes.

Further problems

• Questioning the meaning of life
• Loss of purpose
• Loss of hope
• Changes in beliefs
• Doubts
• Giving up faith
• Anger
• Feeling far from God

“I felt as if my life had ended; I just had to do things for other people; I couldn’t do enough for them.”

It is normal to feel low/disorientated when adjusting to a new culture. People who accept this is normal, and seek support, soon start to feel normal.

What is our theology of suffering and poverty?

When surrounded by dying and suffereing, how do you respond to “How can there be a God, if all this is happening?!”

“When working in a relief programme and witnessing a lot of death, poverty and suffering, I found my spiritual beliefs gave me a lot of comfort, and helped me “lay it all to rest” in my head.”

“Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you’ll recover your life. I’ll show you how to take a real rest. Walk with me and work with me—watch how I do it. Learn the unforced rhythms of grace. I won’t lay anything heavy or ill-fitting on you. Keep company with me and you’ll learn to live freely and lightly.”
Matthew 11:28-30

Helping yourself: Prevention

• Take a day off every week.
• The Sabbath principle
• Don’t overwork – do a Bible study on when Jesus said “no”, or didn’t meet needs”
• Do things you enjoy
• Have an attitude of gratitude

Savour the culture!

Mary has learnt far more from the people culturally in her area than she’s ever taught them. Coming home can be difficult because we have changed. She is no longer English – she is Shonglish: Shona and English. You come back, and you bring both cultures with you. One story she told us was very revealing:

“When I first went to Rhodesia, I still liked men to allow me to walk through doors first. There was one paramedic who seemed very rude – sometimes he would push me out of the way! One day, I confronted him, ‘Why are you so rude?’.

He explained, ‘In this land, I am the man, I must be first through the door. If I am first through the door, it is me who will be shot, it is me who will be blown up by the landmine.’

This rather turned my theology of manners upside down!”

Sabbath living

It is good to try to live out a Sabbath principle, even if we can’t necessarily have a set day each week.

God has called us to be a living sacrifice, so there will be times where we do have to work very hard, at the same time there are periods where he takes us behind still waters, times to get up on the mountain out of the crowds.

God has also called us to be members of a body – teamwork is an integral part of sharing a workload, jointly serving.

Managing teams across cultures

Standing barefoot in the sun for 20 minutes made me feel ready to sleep in the sun, but before that, we had Jane Bates heading up our final session for the weekend.

Cultural intelligence is a valuable skill, since our personal cultural situation so affecst the way we think, live and relate to one another. Jane shared some of the insight she has to this as a half Indian woman, raised in the UK by an English mother, and currently working in Malawi.

A simple model of different culture: our Prime Minister is the leader of our country, in Malawi, the President Joyce Banda is called the Mother of the Nation.

• How do people greet each other?
• How do people behave when they disagree with each other?
• How do people behave when they disagree with you?
• Do people publicly question/teach one another?

“A fish only discovers its need for water when it is no longer in it.”

We all have our own culture, but we may not recognise it until we are out of it.

Going beneath the surface

There are different layers of culture: “tip of the iceberg” culture is anything you can perceive with your five senses. Such as clothing, temperature, geography, smells. But its the deeper things that will affect your relationships more:

• opinions, viewpoints & attitudes
• philosophies & values
• convictions
• rules about relationships
• attitudes to time
• how the individual fits into society
• role of the family
• different role expectations
• fear of losing face
• attitudes to money & corruption

Case studies

What is your response, and what cultural issues may you need to consider?

You are part of a team of a team about to set out for a community visit and are waiting for team members to arrive. The last member of the team is over an hour late and gives no excuse on arrival.

• “Initially I found this very frustrating, but as time passed, I settled into their culture and became more late myself. Important meetings, I would tell them an hour earlier than I actually wanted them there.”

As team leader your office manager is one week overdue in submitting a report for donor funds. The donors are hassling you for the report.

• “Frustration”
• Cultural clash from donor expectation

The hospital you work at has run out of oral liquid morphine. Last week your staff went to the pharmacy to get distilled water, and you contacted the pharmacy warning them of this impending shortage.

• Frustration, understanding of problems with electricity.
• Increase your stocks – create buffers.
• Perhaps the pharmacist is not aware of pain being caused.

Overseas donors question why you have failed to extend the contacts of one of your staff members who they found ‘warm and personable’ on their recent visit.

• Everyone can have several different faces.
• Discussing problems, differences in living and working with people rather than seeing them on a visit.
• Important to have knowledge local labour laws and local contracts.

A visiting foreign doctor in the department of which you are head has one month left on his contract. He disappears and emails a week later saying that he has “decided to get some experience in accident and emergency before he leaves”.

• Considering his own advancement over his responsibilities. 
• Need to look at the contract.
• “?He is avoiding anyone losing face: if he came to me to ask for more experience, and I couldn’t provide it, then I’d be losing face”.

Your team refuse to go into the field unless you provide money a cold drink and a daily allowance.

• Assess the normal amounts and behaviour.
• Definitely provide a drink.
• Bargain 

Patient on the ward is the wife of one of your staff team. She has tested positive for HIV but only you are aware of this result.

You get back from two weeks leave to find that only two home visits have been done instead of the usual 8-10.

You are planning to do an HIV awareness campaign in a local community. Your staff workers return from their day’s visit saying they failed to do the activity as religious leaders “refused permission”.

Your staff team are regularly seeing and treating relatives of staff with general health issues regularly during time for your palliative care clinic.

Within your team, rumours have reached you (from a senior team member) that another staff member is having a sexual relationship with one of her immediate juniors. The junior staff member is about to come up for his appraisal.

Keys for managing a team:

Lead by example

Teach forward planning

Delegate

Transparent process of recruitment and selection

Train those starting work

Fixing salaraies and offering incentives

Seek opportunities for professional development

Team building get togethers

A few nights ago, we said goodbye to some great friends, Joe & Lois, on their way to live forever(ish) in Zimbabwe. This, on the same day that the senior partner at my practice retired, and my wife and I decided to move to Boston in 2 months.

I’ve been feeling a tremendous amount of emotion, as if something tangible has been torn from me; my brain is looking into the future, and feeling a loss that hasn’t even happened yet.

Why such a response? It’s strange, because I’m genuinely happy about all these changes!

I’m joyful that two friends are going to live in my favourite continent, under huge, romantic skies and terrifying political regimes, with a vast multitude of surprisingly friendly insects to keep them company.

I’m pleased that a fellow doctor is taking up a well earned retirement, with his health, his wife and the money to enjoy his days following his heart’s content.

I’m excited that my family and I are moving to Boston, a town I’d barely even heard of until Tuesday, and yet will soon be calling “home”.

So, if these are all such positive events, why am I so sad? I thought I’d look a little through the breadth of our literature and culture to find some consolation. In this, as with most emotions in life, Shakespeare has something apt to offer:

Parting is such sweet sorrow.

 

As one GCSE revision website explains this, the quote above puts my feelings in a different light: “It is therefore delightful that parting can hurt so much“. The sadness just reflects how much I love the Ovendens, how much I value my colleague, how much we treasure our Sheffield friends.

Tennyson made a similarly iconic statement (which is just as well, since that’s what famous poets are meant to do):

I hold it true, whate’er befall;
I feel it when I sorrow most;
‘Tis better to have loved and lost
Than never to have loved at all.

It is better to have loved and lost, than never to have loved at all. Whilst most people know that quote as used in a romantic context, it was actually a poem written by Tennyson about losing a good friend.

In realisation of this, I’m going to try and avoid being sad about this any more. In fact, the next two months needs to be a celebration of everything and everyone we love, value and respect in Sheffield. I want to laugh with you all – as The Jam said:

To be caught smiling is to acknowledge life.

 

Let’s really acknowledge life together, my friends. For a final verse (if cut in half), I leave you with Philippians 4:1:

So, brothers and sisters, I love you and miss you. You are my joy…

 

A New Market

Steve Jobs said, at the announcement of the iPad in January 2010, that it is only possible to make a successful new market by being “far better at some things” than neighbouring markets.

My experiences with the iPad 2 show an amazing, innovative, well thought out product. For people who buy coffee table books, or only browse the web at a very basic “let’s check facebook” level, it’s pretty ace.

However, it’s neighbouring markets are smartphones, and laptops. It’s too big to fulfill some of the key needs of a phone – if you have the capacity to carry a tablet, you probably have room for a laptop – and its not got the versatility of a full PC. So, for the average geek, it probably fails to fully displace these markets.

Appearance

The look of the iPad 2 is really, really good, and it fits into your hand beautifully – so slick and futuristic, you feel like someone out of Star Trek. Apple have put a lot of money into making it light and thin (so much so, at launch the iPad 2 was worth more than it’s weight in silver). The build is thin, which may excite some people, but the general size is still too big to easily carry around for long periods, which means you have to get a bag (may I recommend the Cool Bananas 24Seven).

But, as said, it does look very nice, and if that’s your thing, this is perfect. The build quality it top notch: solid, thin, light and sturdy – not a millimetre of bending if you lift it up from one corner. The only definite complaint is that the curved back forces the volume buttons and the cable socket round quite an awkward corner, and it’s hard to plug in the charger cable.

The screen looks great, with viewing angles as close to 180° as makes no difference, and the colours are solid. The gloss finish feels very nice, and the screen is bright enough to prevent the majority of glare. Videos looks amazing. The sound quality is surprisingly deep considering how thin the speakers have to be, and Jobs’s claim of a month of standby battery charge seems to be very accurate.

Software

The operating system is great and really is very intuitive, if restrictive. If you’re used to an iPhone or iPod touch, then this is no different, there are a few quirks which really could and should be ported to the smaller Apple devices (for example the brightness can be adjusted from the multitasking bar).

But for the most part, Apple’s control of both hardware and the software works really well in the mobile market. There’s very few times where it slows down noticeably, and there are enough well thought out tricks that Apple have put in to make using it a little easier.

In a recent update they allowed the keyboard to be split, meaning that if you are holding the device in two hands you can type fairly effectively with your thumbs. However, the keyboard can be moved up the screen which means that it can block whatever you’re typing into and having this happen sometimes seems to be the best compromise.

Sadly, I found that typing for any period of time really makes your hands ache – I’ve heard a lot of people mention that buying a bluetooth keyboard sorts out this problem. But with a tablet this expensive should you have to buy more kit to make it work…?

Cameras

The cameras are adequate, although the outward facing camera is higher quality than the one facing the the user. While this seems pretty understandable, the only time I used the camera was to take photos of myself, or to use Facetime, so it would be better if the user-facing camera was of a higher quality.

It’s also important to remember that you look like the idiot on the right (me) every time you take a photo. The lack of a flash also ruins a lot of perfectly good photos, unless you’re standing in bright sunlight.

Ultimately, with flash enabled camera phones producing such high quality pictures in comparison, there’s practically no point in using the iPad 2 for this purpose.

Useability

All the above is irrelevant without asking the question – how is it to use? The answer is that it’s really nice to use, initially. I would come home and plop on the sofa and pick up my iPad and check my facebook, load up some news websites, no problems.

But within a few minutes, I would get frustrated having to switch apps, tired of clunkily changing between sites. I inevitably ended up switching to my laptop after about 10 minutes.

The bottom line is that in no way can the iPad replace even a basic laptop or netbook. It makes a very good companion but it can’t compete. So… anyone want to buy an iPad?

Let worship be the fuel for mission’s flame
We’re going with a passion for Your name
We’re going for we care about Your praise
Send us out

Matt Redman

In the last 8 years, I have visited Harrismith, a small rural town, one of millions of tiny dots on the world map, six times. I’ve spent 24 weeks – nearly 6 months – of my adulthood in this place. Each time I return, I feel like I’ve been away for a few days: friendships pick up where we left off, as if no time has passed at all.

Back in England, I pounce on every accented black person I meet, eager to practice my Sotho, or my Zulu. It’s rare that a week passes where I don’t look up the weather in Harrismith, or hover ethereally over the town in Google Maps.

There’s a little something of Africa in my blood – hopefully not TB, bilharzia or malaria – its a passion. A passion to see the beautiful people of this beautiful country filled with joy, to learn from them the lessons of glory that they have learnt, and passing on to them the glimpses of the Kingdom we see in the west.

On this trip, we have worshipped in many ways: as a family in prayer; saying grace over meals with friends; playing guitar with the worship team; filling in charity paperwork; clapping and dancing in the township; buying Christmas presents for orphans; and sitting on the bonnet of my car, looking at the sky.

Through it all, so far, no bushes have burst into flame, no clouds have cracked open with a deep bass voice proclaiming how I must lead my family. Yet, when we tell people here that this might be our last trip, that we are waiting to hear from God on whether we should come to stay, not one person has given the faintest credence to the possibility that we might not return.

When we left England, there was a great deal of fear inside me, fear that I would not find out the answer to the question: what is His plan for us? That question remains, but the fear is gone. Just as 3 weeks ago, there was only a sliver of a moon in the night sky, tonight the moon is full, and so is the hope for our future.

Lord, send us out.