Friday, January 22, 2016

Thoughts on Pleven (And a Pajama Party Wrap up)

First, thank you all for your support and prayers for Penny’s surgery for the stomach dissociation. Upon assessment the week prior to surgery a pulmonologist determined she does in fact have severe pulmonary issues and we elected to do a bronchoscopy before the surgery.  This in conjunction with a successful surgery should help to eliminate the reflux issues and reduce pulmonary issues (but may not eliminate them.)  She has had a very rough 15 years of life. Post-surgery healing is going well, and we just need time and patience as we watch her become healthy and growing again.


Do you want to know how big our God is, how He moves in the lives of those call Him father?


There is relevant quote from David Platt that I want to share:

Orphans are easier to ignore before you know their names. They are easier to ignore before you see their faces. It is easier to pretend they’re not real before you hold them in your arms. But once you do, everything changes.”


Oh how we are learning the truth of this. My arms almost physically ache to hold these children, no more innominate, again. To hug caregivers and thank them for feeding, caring for, and loving these little ones relegated to “least of these” status.


My trip to Bulgaria was very productive. We were able to maintain and improve the health of the little Victoria during the week before coming to the USA, and she was discharged in short order from the hospital in Oregon to be at home with her new family.  (Prayer request: Since I drafted this post, Victoria’s been readmitted & discharged again from the hospital. To date, the work up has not particularly conclusive.  Prayers for her healing, revelation regarding her health needs, and for peace & strength for her family are humbly requested and very appreciated.)


At the Pleven orphanage the director was overwhelmed that 150% of the requested PJs were provided, a total of 123 PJs. Amazingly, we had a single pair of cotton PJs donated; everything else we purchased or given was fleece, which was my focus for “winter jammies.” We packed them in anyway. Little did we know there was one little girl that cotton was the best material for her to wear and this one set of PJs ended up being her size, and they were a style that was ideal for dressing her (she has a very delicate skin condition.)  We also bought candies and treats in country for those children who could eat them. We had some extra funds that allowed for buying some crib toys from a local business in country for those children who were too little or unable to have sweets.   


The pastry/cookies platters for the staff were something they had no concept for, and seemed almost at a loss for how to respond to such a gesture, as it had never happened before.  In America, the nurses’ stations are inundated with food & treats at holidays; there never. I had to explain it was for the staff, not the children.  They asked which staff? I said all staff; those who clean the nurses, the leylas, administration; everyone. I suggested to them to find a place they could put them and have the staff come and get something from the trays during their shift.  It was a blessing to show appreciation to them in what proved to be a completely unexpected way.


I was able to see children on each of the six floors; an almost unheard of privilege.  I saw the full dynamic--from children growing as strong and healthy as an institutional environment could possibly allow for, as well as several children in some very rough medical conditions.  Yet absolutely all the children were clean, linens clean, and they generally seemed well cared for. Their fragile conditions due to the either the effect of previous neglect when under the old leadership or  the lack of medical intervention from the government agencies which dictate the permitted care, effectively leaving these children in this condition. The staff has essentially no support even though they are often providing palliative to hospice level care, and it was obvious that they were hurting as well.  My American naiveté was struck by this complete dearth of support-no chaplains, no resources, no protocols, and no debriefing-nothing. There’d been psychologist who under the direction of the Pleven Project had provided comprehensive case management and follow up. The name “psychologist” is somewhat disingenuous; their role was more consistent with a hybrid of Rehabilitation medicine, case management, care plan evaluation/accountability, and psychological assessment and support (including support for the staff.) There’s no further funding for this role.


The director & staff had such a concern for one tiny baby girl, “Dee” with significant medical issues that were declared untreatable/inoperable by those who make these decisions in country (this after a gross delay in care PRIOR to being admitted to the orphanage.) To not mince words, after delaying and providing no intervention, this child was left with essentially no treatment options, and was sent to the orphanage to die on their staff’s watch. I was permitted to gather information to specifically seek a consultation with medical professionals here. Caveat upon caveat-there would need to be a surgeon who would be willing and able to travel to Bulgaria to assess and potentially operate. I wasn’t convinced this was possible, but was certainly willing to “ask around.”  God clearly had a larger vision for this; and I was able to connect with several surgeons; one was able to facilitate connections with a Doctor’s Without Borders team currently in Bulgaria within a week of returning to the US. This team is being connected with the Pleven Director to consult the case.  That this connection can happen is a huge prayer request.  Realistically, it may be too late to intervene on this particular little one who inspired the efforts.  God has His hand over this too. Access to modern care in this specialty is simply unavailable; what is available is done in an outdated, frequently more harmful than helpful manner. I am prayerful that this connection will change that-If not for tiny Baby Dee, then for other children who have no current options for care, but who would BENEFIT from the care, were it to be available.


 This trip, made possible exclusively by God’s grace and God’s people rallying around us, has provided an opportunity to quickly and effectively respond to Pleven’s request for help.  He’s allowed us to provide abundantly more-than expected or imagined! I am hopeful this will build relationships which will grow and continue to benefit the children of the orphanage and the community at large.  Our God is good….all the time!


There are two pressing needs, an immediate need, and a long term need. Immediately, the role of the independent psychologists needs to be funded, as well as resupplying the Pleven medical fund (which has supplied additional care needs since 2012!)  A post dedicated to this role (explaining, outlining roles, responsibilities, costs, etc.) and the current state of the Pleven Project is shortly forthcoming. Long term, with the shift in focus to non-institutionalized care models, the need for outpatient care for children with special needs will become only more glaringly apparent.  Parents are routinely left without option except to relinquish custody of their medically fragile children because services simply do not exist within their communities. The director at Pleven shared with me a vision for capital improvements to the existing facility, including outpatient therapy clinics at the orphanage. Not a wish or amorphous dream, but a solid vision, complete with renovation construction plans and costs. The actual cost-approximately $40,000 USD, is actually not beyond reaching (nothing is with God.) Sadly, however, there are little to no other community supports (medical supplies, transportation, and equipment repair, etc.) yet in place for parents that want to keep their children with special needs in their home & communities. Both the needs must be met, for capital funding and for the needed community infrastructure supports. This lacking, far more than simple funding obstructs the progress. Prospective in trivia form: agencies and community supports for physical and mental disabilities (hard fought but achieved) in the US are decades old. The equivalent government agency in Bulgaria serving those with intellectual disabilities is barely two years old, formed in 2013.


So the challenge is set before us. Paul is currently assessing how the needed business structures that provide community supports to special needs children might be addressed- no small task. The only solution we have at this time prayer; serious prayer for the children and people of Bulgaria. Prayer that doors will be made open: for the government agencies that regulate business, suppliers, and supplies that are necessary for children to be raised by their parents will become available. Prayers for the others God will be calling to fulfill this because they will be the planners, consultants, funding sources, and hands and feet for these things to happen.  


 Pleven is better. Far, far better than just a few short years ago. The improvements are visible, and many children are thriving. There is a clear sense of pride you see on the faces of the staff as they show you what these (their) dear children are accomplishing.  And the pain on their faces as they tended sweet baby Dee and the handful of other children in similar condition was no put-on show for my benefit.  This is not an easy place, and the darkness would very much like to take it back-through fatigue, through discouragement, through the helpless feeling that you simply can’t make a difference. The battle is won, but dear friends do not kid yourselves for one minute-the war is not over.  Not until every child is given the standard of medical care.  Not until every staff member knows they are valued and doing incredible work-even in the soul wrenching work of caring for little ones being taken too soon.  Until no other family is ever forced to relinquish their child because they can’t have access to care-until this time, we are fighting.  God has this. He never plants things in people’s heart without His purpose already planned. We can see several foundational things happening (many already shared above), connections being made and other connections at the ready down the road for so many great things to come together for these little one in Pleven and hopefully other orphanages too.  Now is the time for obedience, much prayer, patience and diligent seeking Gods direction while taking intentional action since we already know His purpose for us……James 1:26-27.


~Paul and Maureen
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