I didn’t even know this was a puzzle

We often talk about how God puts all the pieces of a puzzle together. Well sometimes He’s so awesome I don’t even know there is a puzzle.

I first met David about 9 years ago, right when we moved to Prescott. He was visiting his hometown with his lovely Filipino wife, Lorna. They were taking a small hiatus from the mission field. They met smuggling Bibles into Hong Kong and David told his buddy “I’m gonna marry that girl” when he first laid eyes on Lorna.

Stacy and I have been together since the day we met. Love at first sight can be a real thing.

David’s story is simply amazing and I encourage you to purchase his book, “The Space Between Memories.” He grew up in Prescott Valley and as he viewed pictures of China in a National Geographic magazine, he told his mom at age 3: “I’m going to take bread to the people of China.” She probably thought he meant physical bread. Little did she know he would spend twenty plus years on the mission field of southwestern China going to the far reaches of the Earth spreading the love of Jesus. His ministry, Within Reach Global, focuses on unreached people groups.

David started noticing his vision going bad a few years ago. He’d stop by the office when he was in town every couple years and we’d get him some glasses to get by. However, it started to become apparent this was more than just an eyeglasses or contact lens problem. Further testing revealed he had kerataconus. Rather than scouring google for info on kerataconus: just take 17 minutes and watch this Ted talk.

One evening 3-4 years ago I was walking through the grocery store when my phone started making a weird noise. “Skype call from David Joannes.” What in the world? “Uh. Hello?” “Hey Jon-it’s David Joannes.” “Aren’t you in China or Thailand.” “Yeah northern Thailand.” I realize just a few short years later this doesn’t sound so exciting but at the time it was unheard of to make calls over the internet. “My eyes are killing me and I’m really worried.” The pain, blurriness, and double vision were making it nearly impossible to read and work.

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kerataconus simulation

Professionally I felt completely useless. There’s no fixing this. I counseled him that he would not go blind which was a great relief. Worst case scenario he’d need a cornea transplant (donor tissue from a cadaver). That’s not a fun procedure but it’s there if needed. For someone who supplements his missionary income by writing and doing web design, having poor vision is even more daunting. Add a growing family to that income burden and it starts to get real.

Fast forward a few years. David contacted me again with more problems. I told him “let me know what days you’re available and I’ll fly you back to the States. I’ve been having great success fitting patients with kerataconus into scleral lenses.” It was hilarious. He flew over 24 hours, drove up to Prescott from Phoenix and we spent a couple hours putting big pieces of plastic in his eyes. He was a bit tired 🙂

We only had enough time for the initial fitting and one follow up due to the customized nature of the lens manufacturing process. It turned out OK…….well actually he did not do as well as any of my other patients.

I was distraught.

Looking back, I think I wanted to be the hero too much. I love what I do for a living. This was going to be an amazing story.

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I was the one who was able to help one of my true heroes. A true Superman moment.

I literally lost sleep over David’s eyes for nearly two years. Stacy would tell me not to worry about it (“there’s nothing more to be done”) but I just couldn’t let it go. God was still in control but I sure didn’t like how He was driving this train. He had a plan…..and it was far better than I could have dreamed up myself.

Around that time the FDA started fooling around with finally approving Cornea Collagen Crosslinking aka “CXL” in the United States. This procedure is designed to strengthen the cornea so it will stop bulging out. Doctors in Europe have been doing it for decades.

Then Nick showed up to our office. He sees me for scleral lenses…..and does well with them. Nick had “Holcomb C-3R” performed by some doctor in Beverly Hills for his kerataconus 10 years ago. The Holcomb procedure is named after the late great Steve Holcomb who piloted the USA bobsled team to olympic gold. His career was saved from kerataconus by this doctor in Beverly Hills.

Then Jed came to see me a year later. 16 year old who couldn’t see the chalkboard any more. First eye exam and I tell him and his parents he has kerataconus, but fortunately it is mild and we caught it early. A year later it’s not mild and has advanced significantly in just a year. “Can I still go to med school if I can’t see well?” “Uhh….well…..” Then his mom stopped me in my tracks: “Dr. Bundy-what would you do if this were your child?”

I always counsel patients to ask that question when they see other doctors: “Dr.-what would you do if this were your__________(daughter, father, wife)?”

Back to Jed’s mom. I said, “I don’t know who does it and I’m not sure if it is FDA approved yet, but I’d find some way to get crosslinking done.” So I wrote down all the big words on a business card and gave it to her so she could google away. A crappy way to pass the buck for sure.

She emailed me the next day and said, “Have you ever heard of a Dr. Brian Boxer Wachler in Beverly Hills? He does something called ‘Holcomb C-3R’ which apparently is like crosslinking.” I spent hours that night researching Dr. Brian. Let me pause here and say I can’t tell you how many patients have told me that their previous doctor invented contact lenses, or invented LASIK or invented modern cataract surgery. It’s frankly amazing.

Yet here was a doctor who really did develop a procedure. A much needed procedure. A procedure rooted in research and backed by years of study. I’m a cynic at heart but this was the real deal.

I called Jed’s mom and said, “I’d be in Beverly Hills tomorrow.” He had the procedure done within a few months and is stable 18 months later.

My talk with kerataconus patients had changed immediately. Now I tell them: I can get you seeing as good as possible with scleral lenses but I highly recommend Holcomb C-3R for stabilization.

Well time flew by and eventually we got to spend a week with David in Thailand working in Karen refugee camps along the border of Burma.

 

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It didn’t take long for me to notice him squinting, moving his phone and computer around trying to find a clear distance, and working to not rub his eyes. I decided to type up some emails before we even left Thailand and got in touch with Dr. Brian’s office.

Things moved fast. I called Dr. Brian’s office manager, Marie, from LAX airport on our way home. “I thought you were in Thailand.” “Yeah we were 16 hours ago.” Scheduling became very difficult as David needed to fly in from Thailand, but just yesterday he had his procedure completed.

I flew over so I could shake Dr. Brian’s hand and tell him thank you. That Ted talk I told you to watch: he’s the one giving it.

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A day after David’s procedure, the vision in his worse eye had actually improved. We don’t expect that or promise it, but it is not unheard of. He’ll fly back to Thailand tomorrow to rejoin his wife and daughter. A few months down the road we’ll work on his scleral lenses but for now he can rest more easy knowing his kerataconus should be stable.

The Prescott Sunrise Lions and Prescott Cornerstone Church helped fund David’s travels for his care. For that we are forever grateful.

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Fasting Log

This is boring stuff meant for me personally to be able to review down the road.

7pm my last food. Stacy is going to start the Keto diet next week so I made a coconut cream chocolate “ice cream” type deal. Tons of fat to help my blood sugar not spike tonight into tomorrow. Also tried to eat few carbs for dinner for same reason. Already given myself a headache worrying 🙂

6:30am woke up and man this thing has me psyched out. What if I get a migraine? What if my hands start shaking and I can’t perform delicate procedures in the microscope? Whatev have a little faith. 1 tablespoon of MCT oil and a cup of black coffee.

7am brisk 2 mile walk in the rain. What rejuvenation! The sights, the smells, the quiet. Thank you Lord!

10:15am stomach growling but no hangry irritability or real hunger pangs. So much fun to read this email from one of my buddies:

·         I feel my soul being cleansed. It’s amazing what the toxins will do to your body. Not only physically, but spiritually

·         An intense renewed desire for God.. to the point of almost being in tears (so amazing and I didn’t expect this at all!)

·         Clarity and ability to hear God speaking to me directly

·         Satisfaction. Being filled with the spirit is so much more that satisfying than food

11am 1 tablespoon MCT oil. I may have licked the spoon a hundred times to get every last drop. Mostly I’m hungry when I have a few minutes of free time for my mind to wander.

12pm Ok not fun. Everyone is heating up their lunch and the smell is wafting through the office. Time for some prayer and Word.

5pm 1 tablespoon MCT oil. This is going way better than I expected. Basically I get bored and want to go eat something. Otherwise I’m just fine. I ordered some keto test strips which just arrived in the mail. I’m all the way into full blown ketosis already.

8pm day one pretty much in the books. Evening is tough because I’m hungry but mostly due to the fact that I have free time in which to think about food. Fun night taking the kiddos out to ride their bikes and the mental clarity is top notch. Easy to be present and focus.

DAY 2

6:30am woke up mildly dizzy and borderline nauseous. Cup of black coffee and tablespoon of MCT oil. Brisk 2 mile walk and now I’m back to feeling really good. Walking and praying is such an incredible physical, mental and spiritual boost.

12pm 1 tablespoon MCT oil. Still going better than I expected. Slightly weak but nothing major; definitely not enough to interfere with work. Maybe I can do 3 days instead of 2?

2pm scratch that last idea. Had a piece of gum before afternoon patients (tasted like heaven) and my body apparently thought food was coming. 10 minutes later: headache, hungry and low energy.

5pm Blood glucose? 55. So for those who think they can’t do this because they have hypoglycemia I say “fooey.”

8pm day 2 almost in the books. Just kinda low energy. Small bout of “GI distress” but no major problems. Another email from one of the guys: Started asking questions, and at once knew God is at work.  God is opening my eyes about several things.  That God is sovereign in all things no matter what, and you can see him at work even in bad situations.  Looking forward to talking to you guys about this.  God is revealing to me things I never knew about marriage.  God is teaching me things about leadership.  Hang in there guys and enjoy.  This is good stuff!”

What’s fun about these emails are they are from fellas who I would not classify as “spiritual.” Meaning they love Jesus with all their heart but don’t constantly talk about “leaning into Him, finding refuse in His embrace” nor do they sing Hillsong United choruses on repeat for 15 minutes straight.

DAY 3

6am up early to take Lilly to her field trip. No nausea or dizzy but once again just kinda low energy. TIME TO EAT! Oh my goodness it’s heaven. 4 pieces of bacon, 4 eggs with cheddar cheese. Tons of fat to keep me in keto. A short 20 minute trunk workout went surprisingly well. Mild “GI distress” but nothing major.

I can’t recommend this enough. I plan on making it a habit.

Cultivating Discomfort

I don’t like being uncomfortable but I love having been uncomfortable.” J. Bundy

Stacy has known for nearly 17 years that I’m not all right upstairs; I’m alright but not all right. My parents and brothers have known for 36; my buddies are learning more by the day.

My newest idea? Tomorrow my buddies and I start a 48 hour fast. Why? Why not?

I’ve written before about fasting. This one will be the toughest yet. Here’s the rules: water only plus up to 3 tablespoons of MCT oil per day. The oil appears to help physically get you into ketosis and prevent muscle wasting. I’m all for suffering but not shutting down kidneys and losing muscle. So what happens if you give up? They said no to tattoos or nipple piercings as punishment; you can ask one of the fellas what we wound up with but suffice it to say they’re motivated to stick with it.

Aside from the physical challenge, we’re going to spend our normal eating/preparing food time praying and reading God’s word. Hopefully the headaches, nausea and overall hangry will turn our attention to God. Hopefully.

“Suffer a little regularly and you often cease to suffer.” T. Ferriss

Hiking Rim2Rim in the Grand Canyon in one day was uncomfortable but I love having done it.

I feel better right now because I felt like my legs were going to fall off during this morning’s wall balls and sprints combo. After years of this I know I’ll pass out long before I’ll die.

Sitting in a cramped van for 9 hours with a dozen folks who don’t speak my language and smell like a farmyard? Uncomfortable.

But none of those things are really painful. None of that is permanent.

I started taking cold showers after our last trip to Cambodia. The gals’ water heater wasn’t working so it was a fun forced introduction to the practice. There’s lots of info out there about cold immersion but mostly I like the everyday “this is gonna suck but it won’t kill me.” And yeah the water coming out of our faucet is in the 40s so it’s cold. Not as cold as the snow-melt Hassayampa river I talked Allan into jumping into with me a few months ago, but it’s cold.

So here goes nothin’

“And when you fast, don’t make it obvious, as the hypocrites do, for they try to look miserable and disheveled so people will admire them for their fasting….” Matthew 6:16

…nothing in there about Facebook or blogging so this post is OK

Recap

We don’t focus on numbers as we simply try to do what is asked of us. For some missionaries that means seeing 60 people in the middle of nowhere where it takes most of the day to get there. For others it means seeing over 200 people while sitting still all day. However I’d be remiss not to mention that we saw 1203 patients on this trip. Yowsers!

The best part is many more will be seen as a result of the trip. After a few trips now working with me, Socheat (school nurse at AIM) really understands how to use the flippers, has a solid stock of eyeglasses and is getting better and better at triaging eye disease. General Jane, the exhibitionist, took to the eye care more quickly than anyone I’ve ever met. Her knowledge of eyes and optics far surpasses any general care practitioner I’ve ever met. We left her plenty of glasses and medications along with a set of flippers so she is off and running.

It’s always tough when we get back and folks immediately ask us, “how was your trip?” Well for the first few days it was something along the lines of, “we’ve taken turns being in the bathroom all day and taken turns losing 6-7 pounds.” Not exactly tweet worthy.

The other part is these trips make my brain feel like it’s been put in a clothes dryer and set to tumble. The first day on the ground we went to the Killing Fields

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It’s not like we want or need some kind of emotional self flagellation but these kind of truths help us understand the enormity of the situation.

Each day is a crazy roller coaster of emotion. We spent one morning helping young ladies who have been rescued out of hell on earth. That night we enjoyed dinner with friends and celebrated a life altering eye surgery made possible in part by my local Lions club. Most days I’m just plain exhausted.

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Someone snapped this at lunch one day

During clinic times I have zero idea what is going on around me. If you’ve never been the end of the line for over 200 people it’s quite flattering but mostly intimidating. What if I get sick? What if I get frustrated? How do I give patient #208 the same attention and care as patient #6? Those answers come from so many other lessons in life but mostly come back to living in the moment and having faith as a mustard seed.

No posts about travel woes? Everything went smooth? Sure. Relatively so 🙂 We checked in for our flights from Phnom Penh to Chiang Mai and the agent said I paid for baggage from Bangkok to Chiang Mai but not from Phnom Penh to Bangkok. How that is even possible I still have no idea. Mind you this was one ticket, not some kind of goofy mixed segment fancy ticketing. Long story short is $122 later my bag with all our glasses made it. Upon landing in Chiang Mai we convinced the customs agent that she did not need to charge us for bringing in hundreds and hundreds of pairs of glasses. I didn’t bother to tell her about the medications worth more than $10k. And I was flattered my seat mate wanted to touch me for the entire flight, but after 90 minutes of moving, shifting and trying everything to get away, I just sucked it up and decided to be thankful to return to the idea of personal space when we landed back in the States.

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Just a random elephant helping out with road work in western Thailand. Wish I had a video of the dude on top riding bareback like a boss.

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Can’t read “Green Life” on the brim

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We’re all still laughing about these beds. I literally got a bruise on my knee from the springs simply from climbing into bed.

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Just commuting in to work for clinic.

Our last day we went to an elephant camp. On the way there Allan said, “Hey this is pretty cool. We’re going to do something just for fun.”

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That little fella sure loved Alison

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You can watch elephants painting on YouTube but it is nothing short of magical to see it in person.

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“Hey Jon wanna L sit on that escalator?” “Of course.”

This trip was an excellent reminder of how much I love my wife. She’s my best friend, my soul mate, the best gift I’ve ever received. Once again, we get home after two weeks of 23.5 hours per day together and as soon as I’m away from her for an hour I miss her like crazy. When she steps away from clinic for a few minutes, it immediately bogs down. She can read my mind most of the time and is already in the process of handing me something when I turn around to ask for it. When I’m hangry and turning in to Betty White, she knows just what to say. Below is a photo of me rubbing her feet in our hotel lobby while we sit and enjoy a live trio playing some jazz.

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For those who make these trips possible I cannot thank you enough. Thanks so much Grammy and Papa for watching Lilly and Berto. Thanks to those who donate financially. Thanks to those prayer warriors who truly pray for us without ceasing. And big thanks to Matt and Tracy for running the office so well that we can leave for two weeks.

Where we go from here, I have no idea.

Finishin’ Up

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The gang at night playing games, chatting and eating chocolate.

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Some of the boxes of rice that Feed My Starving Children provides. I can’t share my photos of Karen refugees carrying these over the border into Burma. For those of you, like me, who wonder what in the world we are doing helping, or partnering with, something illegal, it’s difficult to put into words. After a great discussion in the van today I’ve reconciled this with Jesus healing on the Sabbath….and no I am not drawing a direct comparison between myself and Jesus. Is it better to follow the rules of the land and let children literally starve (we aren’t talking hungry; we are talking chronic malnutrition with evident physical characteristics) or better to help? 

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Always fun to see what grows on the other side of the planet.

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#LifeGoals

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Stacy’s life motto

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Not my favorite part of the day. See patients for 5 hours straight with one 3 minute potty break; jump in van for 7 hour carnival ride; make PB&J on the road. Need more stopping to smell the roses.

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Iced “cooffee” makes it better.

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“Everybody’s got a water buffalo”

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It’s just impossible to capture the curviness of these roads.

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Hours and hours of this. Honestly after only an hour we stopped and I got out of the van and walked crooked. Felt like I was playing that stupid game where you put your head on a baseball bat, spin around, then try and run.

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Dinner of champions. We shared. Just couldn’t do the gas station reheated “food.”

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This gentleman is a Karen refugee. He made an illegal border crossing today to come see an eye doctor for the first time in his life. He is simply trying to survive. Unfortunately he requires cataract surgery. Out of nearly 500 refugees that we saw in the past 4 days, only 8 require surgery. That’s a very small number and means a surgical short term missions team is not fiscally responsible here. It makes no sense to send 500 patients further into Thailand for basic care, and it makes no sense to spend tens of thousands of dollars to bring a surgical team. This patient can apply for a visa that will allow him a few days in country to receive the care he needs. What does make sense is spend less than $100 per patient (mostly travel and food) to coordinate transportation with local missionaries who can take these patients to get care here in Thailand. Want to help? www.eyes4life.org

 

Into Burma

So we’ve been working along the Thai/Myanmar border for the last two days and today we ventured into Myanmar. Granted we didn’t get our passports stamped but I think we can officially say we’ve been. We waded halfway across the Moei river which is the border. I planned to cross to the other side to say I’ve stepped foot in Myanmar but we heard a vehicle start up on the other side about the time we made it halfway. We never saw anyone (granted it’s a total jungle around here) but I thought I’d throw a rock to the other bank and call it good. Sometimes I make good decisions. After playing in the water for a half hour we made it back to the Thai side….and heard that vehicle motor start up again and leave 🙂 That was a new one for us. Hi mom 🙂

At lunch I got to shake hands with one of generals in the Karen army. Turns out he is the number two guy. One of our hosts, Roslyn <not her real name>, who has over 20 children’s refugee homes is a champion for the Karen people so she knows everyone and everyone knows her. Sitting with her at dinner and listening to her story was unbelievable. That’s the wrong word: it is believable. I just wish it wasn’t. It is her story so it is not my place to share but I think the first minute of the trailer from Rambo 4 would be a pretty good place to start for those interested.

The general was hoping we could come over to their base and take care of their soldiers. Roslyn and Jane didn’t have time to work out getting permission from the Thai border police to make it happen. They have offered it as an option in the future if we want. We would travel with an armed escort. I told Stacy no…..I think I’d like it too much.

We had some time at lunch to sit around and chat. I was having a tough time figuring out this Thailand/Myanmar/Burma/Karen conflict. Well it’s been going on for 60 years so I’m not the only one. I think the closest similarity would be the US government wiping out Native Americans a few hundred years ago. Now it is the majority Burmese wiping out the minority Karen, Wa, Kachin, Shan, and other peoples.

On the positive front, God is moving mightily here. The Gospel has been with the Karen people for a few generations so Christians like Roslyn truly understand the idea of temporal suffering and eternal glory.

Kiddos at today’s refugee camp were in better shape than yesterday’s. Much less fungal skin infections, lice and obvious malnutrition. We saw somewhere around 145 patients across two camps. One little girl will be getting a new pair of glasses…..in a few months. She has a super unique prescription that can’t be made locally so we’ll make them back home, get them to David, he’ll fly them to Chiang Mai, transfer them to Jane at church, then Jane will get them to one of her coworkers who comes back here more often. Maybe we’ll send two pair as a replacement may be a bit troublesome 🙂

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Classroom at the “nice” refugee camp.

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Not my normal Tuesday commute

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Start em young

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Allan pondering how to climb that jungle mountain.

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Have clinic will travel

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Tetanus check! Stacy’s heel found a rusty safety pin. Dr. Jane cleaned her up and patched her up…with some duct tape of course.

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After realizing we are being watched, I figured maybe throwing a rock into Burma was a better idea than stepping foot on shore.

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Not a view many people have experienced.

No clue where to start

I love that these trips have been happening on Super Bowl Sunday. There’s just something about the dichotomy of the utmost in commercialization vs. true third world conditions  that really resonates with me. Internet in southeast Asia is amazing. David has had 4G nearly the entire time and is able to work on projects as we drive through the windiest of mountain roads. Today it meant he gave us the halftime score and final score. During game time we saw some of the most incredible views of fog filled valleys, drove through multiple police checkpoints and discussed things that can’t be forgotten. For a taste, take a minute to watch this.

Dr. Jane is far from fantastical and has zero flair for the dramatic. We love her. I may nickname her “General Jane” except she’s way more B.A. than Mad Dog Mattis. When she says, “I need you all to turn off any location services on any electronic device in this car” it took me a few minutes to do the mental gymnastics about what she was really getting at. I understand no tagging our location on Facebook but when it is “no photos as they often contain an embedded GPS tag and that can threaten these folk’s lives” my brain just has trouble processing that. I think I simply don’t want to process such things. Refugees, IDPs or “internally displaced peoples,” camps, and genocide are terms I much prefer to not think about. I should have told Stacy “no” when she asked, “want to hear the worst story I heard today?” You can ask either of us in person if you really want to hear.

Western Thailand and eastern Burma are unbelievably beautiful. I’m gonna keep calling it Burma (vs. Myanmar) as the Karen people we are helping prefer that term. The majority Burmese decided to change the name a few years ago as part of the process in wiping out minority peoples. The Karen have a few choices in life: stay in Burma and face severe persecution, flee to a Thailand U.N. camp and give up all individuality and ability to earn a living, or flee Burma and live illegally in Thailand supporting themselves. We are helping the latter. All those police checkpoints we keep driving through are set up to stop illegal trafficking.

There’s always talk of poverty and access to health care. It’s important to remember absolute poverty (refugee in Thailand struggling to eat today) vs. relative poverty (homeless in America but not starving to death). There’s real value in working to alleviate both. I’m a big fan of working in both realms. In Cambodia we have been consistently exposed to significant absolute poverty and huge barriers to access. However we have amazing missionaries like Kreg and Kevin who are willing to drive a patient needing cataract surgery the 8 hours to Phnom Penh, feed and house them while there, and then get them back home. Simply amazing servants. Today I asked Jane “hey what can be done if we uncover problems that I can’t fix?” “We’d have to smuggle the patient through all those checkpoints and drive them 7 hours into the city….then take them back.” I’ll complain a lot less the next time I have to drive 13 minutes to the dentist.

The eye care went great. Most of the kids were normal and healthy. One young girl in kindergarten was +8 in one eye and +1.5 in the other so we are going to try and patch the good eye to strengthen the other one. That’s tough back home, let alone in a refugee camp, but the missionary team is up for the challenge. Fortunately most of the folks looked relatively healthy. Many simply needed eyeglasses and no one required significant care that we couldn’t provide. Could some of them use cataract surgery? Sure. Absolutely necessary? Nope. I’ve found that’s typical with people who may spend lots of time outside but spend lots of time under a tree canopy which protects their eyes from the sun.

On the health front, we’re all doing well. This morning was another 3 or 4 hour drive on windy roads. For the Arizona folks, think road to Jerome. For North Carolina folks, think Mt. Mitchell. But continuous windy. Over and over. And over.

If you want to see more photos, or watch a few videos, come over to our home when we get back. We can show them, just not post them online.

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Allan’s hiding behind us in the back seat 🙂

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Educational blog this is

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YOLO!

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Our fearless driver Simon.

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East meets west. You can’t make out the “Starbucks” writing on the canopies.

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Sunrise over Mae Sariang. We saw/met a unicorn at our guesthouse this morning: a big boy from Alabama…who doesn’t care about SEC football!

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I really hate confusing bathroom signs but I guess with so many guests from so many countries speaking so many languages a picture (or 3D diagram in this case) is worth a thousand words.

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Did I mention the road was windy?

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One of many police checkpoints.

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I made it over a week without a southeast Asian rest stop photo. Looks like I’m spying on David but this is simply the view from the road.

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Unbelievable views. All day.

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Thailand here. Burma there. Crappy photo but this one’s from the road so we’re ok to post it.