Saturday, February 16, 2013


My faith is grounded in a person who cares passionately for women and children. This faith led me to become a missionary and move across the world to care for women and children in East Africa. My ministry draws me into daily encounters with hurting people, and sometimes their pain overwhelms me. I then turn to the one person who knows their pain better than I ever could—and who understands, loves and forgives in the midst of our human sorrow.

Abortion and its awful consequences is one such sad and heartrending circumstance that I am encountering almost daily now. * When I came to Tenwek Hospital as a missionary doctor, I thought I would be able to distance myself from the abortion debate that I struggled over in my work in America.  I am a follower of Jesus. In my mission hospital, I practice in accordance with my Christian worldview—and am privileged to work with other doctors who share my worldview and my belief that abortion takes a person’s life.

But I am discovering that the practice of medicine in Africa is less about debates with clean lines and predictable consequences; rather, it is about the realities of caring for people whose lives are often broken in ways that are difficult for someone like me to understand:  lives who have always been lived in poverty, helplessness and at the margins.  And these realities are often so brutal that it takes my breath away. I am discovering that here in rural Kenya, abortion is widely practiced in back rooms and alleys—and it continues to take lives—but here it is destroying the lives of both the baby and the mother. And it is breaking my heart.

She is a teenager and in high school. She is home for break from boarding school. She has a secret that she is terrified will get out: she is pregnant, and although her loose clothing and has allowed her to cover it up until now, people are going to find out. The baby is moving around a lot and she can no longer deny it. Soon everyone will know. Why did this have to happen to her? She cries when she thinks of herself just last year—a top student, full of dreams, waiting for that special boy who would talk to her parents, negotiate cows for her dowry, and marry her. Perhaps they would move to Nairobi. She could go to college. She could get a job. They would live in a pretty apartment and have a big family. Her mother and sisters would be so proud of the eldest girl.

 Then she met him. He was older and married. He drew her in, complimented her, gave her gifts. She wanted to please him. She never thought it would end with her becoming pregnant and him moving back to Nairobi.

Alone. That was what she was. And so afraid.

Day #1. The abortion really hurt. She had contacted an older woman outside of Bomet whose name she had been given by another girl at her school. She went to the woman’s house, and had special green sticks pushed up into her uterus while she lay in a dirty little bed. She went back to her home and lay in her own bed. She did not feel well. Her baby was really moving around. She cried herself to sleep.

Day#2. She awoke in wetness. She had broken her water. She started to cramp severely. She waited.

Day#3.  Just pain. The baby was no longer moving. She felt hot and sick.

Day #4. Blood, and a really bad odor.

Day #5. A lot of blood. She was weak and vomiting. She could not stop shaking. Her mother had figured it out. She spoke to the relatives. They would help with the hospital fees. They piled into the car and drove to Tenwek.

Once in Casualty, she felt calmer—she would get some help. She got an IV and an ultrasound. The baby was dead. She was infected. The doctors and nurses questioned her—she told them it had happened on its own. She had wanted this baby. Would they believe her? She was taken to the operating theatre. The baby delivered, and it was macerated and infected. The baby came out with a long green stick. Now everyone would know.

Something was wrong. Other people came into the room. She felt a large amount of wetness between her legs. She heard the word for hemorrhage. The anesthetist told her she would have to go to sleep now.

Day #6/POD #1 D&C/TAH.** She is in a special unit for very sick people. She has a line in her neck with blood going into it. Another IV with medicine is in her arm. She hurts. She asks the nurse what happened, and is told something about losing her uterus. Her uterus? No man will ever have her now.

A new doctor comes in. Two new doctors come in. She does not feel right. She can’t catch her breath. She thinks she is bleeding again. Her arm hurts when they draw blood. Why is her skin bleeding?

Three doctors are standing beside her now. They talk to her about Jesus. She remembers Him. They ask her to take Him into her heart—to accept him as her Savior. Yes—yes—she wants Him. She prays and asks Jesus to save her. She asks Him to save her life too—here on this earth. She has so many dreams. She misses her mama. It occurs to her that she is falling away. She wants to sleep.

The story of this young girl ends here. She was buried along with her baby. I stood with her as she accepted Christ. She was awake and cognizant only for about 10 minutes after this. We pumped in whole blood and fluid and antibiotics. She was septic and in DIC.*** My post call intern gave her his freshly donated blood to try and turn the process of DIC around (we do not have blood components here—just whole blood and sometimes fresh blood—which has all of our clotting factors). She was intubated. The family arrived. They gave blood too—wanting to help her, and if this were not possible, perhaps some other patient.  In the end, her young heart just stopped. And we could not bring her back.

I hesitated to publish this essay because I know about the gut level response that abortion creates.  I have many respected colleagues who will read this and respond with one kind of anger, directed at laws and worldviews that do not support abortion. I have also sat with other respected colleagues who respond with anger directed toward the providers of the abortions and sometimes, at the women who attempt to procure them.

I only remember this girl. She was not a debate. She was not a consequence. She was not a criminal. She was a beautiful person, made in the image of God, who  felt trapped and hopeless and made decisions that eventually led to death. I believe both she and her child are with Jesus now. And He has wiped away every tear from their eyes.

*Abortion is illegal in Kenya and in most countries in Africa. Attempts to procure abortions illegally contribute to the overall high maternal mortality rate in the developing world. 

**Post-Operative Day #1; Total Abdominal Hysterectomy

***Disseminated Intravascular Coagulation