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This morning, as I read the news, I came across the image of millionaire Tom Brady with his millionaire model wife Gisele Bundchen in his arms at a luxury resort in Costa Rica, the lush landscape and further out, the ocean, behind them. What image comes to mind when I explain to our LoveAIDS donors and prayer partners that we are continuing our work in Costa Rica? Are luxurious retreats and lavish beaches what come to mind when I explain that we are continuing our work with HIV and AIDS patients? I try to explain that LoveAIDS works inland, far away from the beaches. I try to explain that, far away from the limited number of fancy tourist locations in this developing-world country, I work in developing-world conditions, not first-world conditions, That we work with socioeconomically disadvantaged individuals who have seen extreme suffering and that we work at facilities that are extremely resource-limited. I try to explain that every dollar for us counts and that I live on a very frugal budget. I try to explain that the impact of our work with our AIDS patients is felt tangibly at that AIDS facility I serve at. This is a question I ask myself often, as I ask myself, “Am I effectively communicating the nature of our work, so that what we are accomplishing and our financial needs are understood? Am I communicating clearly so that you, our friends who support us, understand the impact of what your sacrificial and generous dollars are accomplishing? Here, again, is our story, of Loving AIDS Patients, Loving Jesus.  One of the roads leading up to the AIDS facility in Paso Ancho, San Jose, Costa Rica. This is a dangerous area of town, so I do not bring anything of value with me. Immediately upon returning to Costa Rica, I find myself confronted by the cultural differences between this mountainous Latino country, a tiny drop of sunshine of only 4.8 million people, and the populous behemoth of the United States, with its equally-mammoth-sized population of 325 million. Both countries are bordered by both the Atlantic and Pacific oceans and boast of magnificent landscapes and captivating biodiversity, and can even boast about the diversity of its human populations. But the cultural differences I find myself engulfed by again are colossal. Those who have lived for significant periods of time in other countries and who have also spoken the local language and thus able to immerse themselves into the local culture to a significant degree know that each country might as well be its own planet. Immersing myself again in the Costa Rican culture, I experience again that things in Costa Rica are simply different, and even many of the simplest things have a different interpretation from the meaning they carry in the United States: Relationships are handled differently; conflict is handled differently; trust is built differently; decisions are made differently; and family and community have a different meaning than in the United States. To ignore this reality is to eventually harshly offend the Costa Rican people and become culturally and relationally ineffective, although the Costa Rican people will not inform you themselves, and find that you can only relate with other ex-patriots. I learned from my own mistakes made when I was new to the country years prior. I am eager to minimize any cultural mistakes I make this time around, move forward and get to work. I have little time to reflect once I arrive. I try to rush to purchase basic things needed for living, such as clothes hangers, a clothes iron, a laundry hamper, a hair drier, as I had forgotten mine back in Seattle, an electronic surge protector to protect our organization laptop, some basic kitchen utensils…. But my attempts to hurry this process are met with the sarcastic laughter of the diabolical Costa Rican traffic and the harsh reality – or perhaps the privileged reality – that I have to use – or am at least allowed to use – the public bus system: time-consuming (3.5 - 4 hours to get to work & back home minimum, daily,) inefficient…but it is, at least, transportation. My first days at the facility characterize themselves by a need for me to shadow the nurses and assess what the needs are. It is a more involved, lengthier process than I originally estimate. Because the Paso Ancho facility has fewer resources than the previous facility LoveAIDS partnered with, each staff member, with the exception of perhaps the staff psychologist, wears extra hats on a daily operating basis. The administrator and the two nurses also function as unofficial residence directors for our patients. One of the nurses helps produce financial and administrative reports. One of our directors, who served a Catholic priest in his younger years, and who holds, along with his theological studies, undergraduate and graduate degrees in sociology, carries out numerous training sessions alongside his wife and co-director, who uses her specialization in business management to help run the facility. Nurse Wendy tells me my first day there, in Spanish, of course, that, “Every day is a different day here. No day looks the same.” She also confesses privately “I have so much to do every day, I don’t know where to start.” I realize after a few days that she faces multiple urgent priorities daily, and, because of limited resources, still ends each day with many left undone.  The front gates at the AIDS facility in Paso Ancho, San Jose, Costa Rica I quickly observe that a number of the residents need physical therapy care to regain mobility. For the many who are not familiar with the health care system in Costa Rica, the country has a private hospital system (which the wealthy use and pay out of pocket or use private insurance to access) and a public health care system (funded by taxpayer dollars, or, to be more accurate, Costa Rican colones.) This public health system is set up so that HIV-positive individuals receive free medical care, in a preventative attempt to reduce HIV transfer to others. However fantastic this sounds, a structural problem exists which limits HIV patients’ access to this care: this health care system is structured for highly-functioning individuals who 1) have access to resources that afford them the transportation costs to regularly attend appointments, 2) have the internal discipline and structure to consistently make it to appointments and 3) have the corresponding mental health to empower them to make it to their appointments. But if a patient can’t afford the cost of a bus ride, or simply has not developed the internal discipline of keeping a calendar system to make it to appointments, or is too depressed or overcome with anxiety to have the strength to attend a medical appointment by themselves, they won’t make it to the appointment. And socioeconomically disadvantaged HIV & AIDS patients often fall into this second demographic. THESE are our patients. Mental health and internal self-discipline are “resources” that empower individuals to have a higher level of functioning and thus be more successful in even the basic things of living. For some reading this, this may appear a novel idea. Or it might simply strike one as common sense but they may not realize they lack an accurate understanding of the profound and painful implications of this truth. It is an every-day reality for our patients. Global health researchers, medical anthropologists, missionaries and medical workers around the globe witness this daily in their work and write about it. I face this daily in my work with these patients, and I am trying to write about it. I struggle personally with how to communicate this painful reality to those who, for many innocent reasons, may not be able to comprehend how severe the suffering of the socioeconomically disadvantaged really is. The suffering far exceeds not having enough food to eat daily, access to health care, a job, a high school education or a stable, secure home to live in, although these are realities for almost all of our patients. It extends into a poverty of a lack of a healthy family system to grow up in, in which a high level of personal discipline and functioning and emotional and mental health are taught and developed. Without having developed an inner personal discipline and functioning and a significant of emotional and mental health, these socioeconomically disadvantaged individuals struggle greatly with the basics of living. Their lack of sufficient education (often not even having completed high school) and difficulty in affording basic food and housing only deepens the suffering they feel as they strain daily to live life. As the days and weeks go by, I learn that more than a handful of the patients at our facility have needs for physical therapy and range of motion exercises. By building relationships slowly with each patient and asking questions carefully, I learn from their personal stories that they failed to receive the treatment they needed because they have difficulty getting to their physical therapy appointments. Hiding in the silence between the answers they do provide are the hard realities they don’t share, struggles of addiction, depression, lack of finances for transportation, lack of social and emotional support in their support system, lack of an internal discipline that they are too ashamed to confess and too hurt to admit they never developed. These are stories that require significant maturity and discernment in knowing how to respond. I find myself praying often in these moments, seeking wisdom from a loving God whose wisdom does not fail. After the initial weeks of shadowing the nurses and assisting wherever there is a need as each day progresses, I begin helping our patients with range of motion exercises as well as providing them the emotional and spiritual support in conversation to empower them to restart the lengthy process to receive physical therapy. This process requires them to meet with multiple doctors before they are allowed to meet with a physical therapist. This means that for the first appointment, they show up at their neighborhood health clinic at 5 AM to wait all day in a long line and hopefully get a few minutes with the community health doctor before the clinic closes at night. They receive a referral from this community health doctor, which is usually assigned a few weeks or months out. Then they need to ride the bus to their assigned hospital to meet with another generalist, before they can be referred to a specialist, before they can be referred to a physical therapist. This process takes months. My offer to attend the appointments with them motivates them, and they are eager to have me join them. Having someone who cares about them and who is willing and able to join them provides them an external structure and emotional support for something they want to do but do not feel that they have enough strength internally to do by themselves. Some of my patients have lived with their AIDS-induced loss of mobility for over fifteen years because they did not have the emotional support and resources needed to get treatment. They have given up hope. But hope starts to grow in their hearts again as I encourage them and show them by showing up again and again at the facility that they will have the emotional and structural support to move forward. It is in these capacities that I wear two hats, serving as a traditional nursing assistant and also that of a mental health technician, something that, with my licensure and formal studies I am equipped to do. I join a group bi-weekly for training provided by the director of the facility in the harm prevention model that is implemented here. (I do also help provide basic nursing care, changing briefs and bedsheets, helping dress patients, and so on, but it is not my focus to write about in this blog post.)  This plaque hangs on the wall in Director Orlando Navarro Rojas' office. Don Orlando opened the first home for AIDS patients in Costa Rica in 1992, when both men and women with AIDS had nowhere to go and, abandoned, rejected, and stigmatized by their families, they were dying of AIDS on the streets with no food, water, or medicines and in their illness unable to fend for themselves. In a strong shame-based culture, the suffering was intense and society's rejection mercurial. President Clinton praised Don Orlando for his commitment to provide for AIDS patients and to showing compassion and minimizing their suffering in their last days. At LoveAIDS we say, "Jesus loves the AIDS patient. They need to know they are deeply loved."  Nurse Mario and I in the administrative office The third hat that I wear is that of a ministry worker, or, more simply put, someone who loves Jesus. My job is to love wisely. This is where I need great discernment and much compassion. I ask God to help me with this every day. Every one of our patients in our facility has experienced significant abuse, whether it be from what was done to them or from addictions or struggles they somehow became involved in. An overwhelming most, if not all, have experienced emotional and relational abandonment. They come to our AIDS facility from living in the streets, because in their abandonment they had nowhere to go. In this loss, with this abandonment, there is trauma, often deep trauma. And with that trauma, abuse, and abandonment, they have had their personal boundaries crossed or violated, often deeply violated. They arrive at the facility needing to know that they are safe, that they can start over. It is in this context that I show love and serve and give them a listening ear. And it is in this context that my patients walk up to me when I arrive at the AIDS facility and ask me if I will be working with them that day. And I respond with a big smile and a firm handshake or a hug, and show them that I care.
I also encourage our patients spiritually by encouraging them to trust God for their recovery. Many of our patients have a faith in God and find strength drawing strength from Him. "Let's see how much mobility we can regain," I suggest with a big smile. "Your life is worth is, isn't it? Let us have a little hope in God, and put our faith in Him, and see what can happen." So many of our patients feel they need permission to be able to hope again. It is in being the hands and feet of Jesus, serving them quietly, day after day, that I see their hope being to light a flame again and grow. I remember something one of my psychology professors said years ago, something I never forgot and that is relevant to my work here in Costa Rica, I was studying counseling in graduate school, and what she said transformed my worldview. I didn’t like to admit it, but I had been trained to highly value the academic and clinical specialists and discreetly overlook the individuals whom I perceived as having less prestigious training or “qualifications.” “Research shows,” she explained, “that being able to spend time regularly and at least weekly, with someone who genuinely cares and is committed to that individual’s well-being – whether that person is a mentor, a friend, a counselor, a ministry worker, it doesn’t matter – is more transformative in the life of that individual who is trying to grow or make changes or is going through a difficult time in their life than meeting with a therapist or social worker who communicates a neutral concern for the individual” (paraphrased.) It would be years later, as I was serving as a nursing assistant in my previous work with AIDS patients here in Costa Rica, where I was recognized only as the (lowly) “nursing assistant volunteer,” -- not the "smart" premedical student or the "accomplished" young lady who has already been to college and graduate school, or the director of a young organization who leaves the AIDS facility daily and still puts in more hours doing administrative work once at home -- where I would understand far more profoundly the impact an individual who truly cares makes. I never forgot each of my patients -- poor, lacking high school educations, coming from the streets, ex-prostitutes, ex-drug addicts, often not even speaking proper Spanish -- who told me, “Thank you for coming. It is because of you that I can ____.” They each start to have a hope and a future.... My prayer for you is that you will also profoundly and tangibly understand the impact an individual who truly cares makes. May I encourage you in your walk with Christ not to underestimate the good you can personally bring to others as you go through your day today. I cherish your prayers and support as I continue to work with our patients. God bless you. Together, Loving AIDS Patients, Loving Jesus. Ingrid Anne Sometimes, out of fear, we don’t do what God calls us to do. Seventeen months ago, January 2016, I felt the Lord prodding me to move forward into raising full-time wage support for LoveAIDS. (I was still in Costa Rica at the time.) But I was too scared. “What if all the financial support does not come in?” “Lord, I want to go to medical school!! “But this is NOT THE PLAN I HAVE FOR MY LIFE!!!” Do you ever do that? Do you have an area of your life where you keep hearing the prodding of the Holy Spirit saying, “I need you to do this,” or “I want you to do this,” and you resist?  After much prayer, I accept I need to take the risk of moving forward in obedience and faith so that 1) both the operations side and the hands-on ministry side of our work can get done and 2) so that I can get my financial needs met as I serve the Lord. (1 Timothy 5:18)  (Now retired) AIDS facility director Terecita, Nurse Olga, and Anne I was working in Costa Rica with our AIDS and HIV patients, serving the facility out there in Cartago and carrying out the care plan the physical therapist weekly laid out for our patients. I did not have a salary, but our non-profit’s expenses were covered by donations that many had sacrificially made so that I could be there doing the work. When I was not at the AIDS facility, I was often sitting at the table in my kitchen handling receipts. Preparing financial reports. Handling our website. Handling correspondence with one or more of our ministry partners back in the United States. Preparing for meetings in the United States. Scheduling for our summer trip to receive our first volunteer. Working through paperwork from the IRS or Washington state. Setting up direct billing with organizations we partner with so we can do our work. Spending hours upon hours trying to write a new blog post… Most who do not specialize in administration do not realize this, but for as many hours were spent with patients, I had as many hours I needed to put in with operational matters. My kitchen table incidentally doubled as my desk for my LoveAIDS work as my kitchen incidentally also doubled as my LoveAIDS office.) And I easily could put in 60-80 hours in a work week, with always more work to do…. When I needed to purchase shampoo, when I hoped to take the bus to the beach and back in a $20 same-day trip, when I wanted to register for a half marathon (which, only costs about $40 in Costa Rica,) I was required to Skype call my father back in the United States and ask for help. My father, who had had cancer, and who was not in the same financial condition to be helping his daughter with any financial needs as he had been in previously. Because I did not have a car and could not afford a car, it was very slow getting around town. Mind you, traffic is not good anyway in San Jose, Costa Rica, and I think it would be fair to compare it to Los Angeles traffic. But my limited funds made it very difficult to get around town to develop friendships and get my needs for fellowship met. And the Lord was telling me, “I need you to start raising full-time support so that you can receive a living wage.” Oh, the fear…the fear that I felt…. Together as a LoveAIDS team of donors and fieldworkers, we got good work done. Many HIV/AIDS patients improved and were able to walk again and to have increased mobility. A number of our patients died, and I was able to provide palliative care and a spiritual hope to them. The nature of health care is that some stories can be shared, but personally identifying information cannot be released, or I would share differently and more. But what I saw was that the work was there, needing to be done, the need was there, needing to be filled, and that workers were needed. I intended to obey God’s leading by continuing the work with LoveAIDS. It was not the full obedience that I sensed Him calling me to, of raising full-time support, but in my mind, I rationalized that I was still moving forward in obedience. When I arrived back to the United States, I faced a number of delays. I lost my housing a ministry supporter had previously offered to me (her father was diagnosed with a terminal diagnosis and as a result her priorities were forced to change.) This caused me not to have a home for a number of months and slowed down how quickly I could help LoveAIDS move into this next season. A troublemaker targeted our organization as a vessel through which she could accomplish her desires, desires that were contradictory to our mission statement and which could not be justified to IRS authorities. And, although from the outside it seems simple to deal with, I spent a couple months handling that situation. The blessing is that I learned how to deal with similar situations for the future; however, it came at a price of using my precious volunteer hours, when I had so much to get done. My third delay was the utter instability of the job market as a Certified Nursing Assistant. I confess this was the loving Father’s chastening tool. Because I had a few good employers previously, I had not realized how unprotected nursing assistants are in their jobs, at the bottom of the totem pole in health care. I want to use professional discretion and think it is wise not to share more about my personal experience other than share that it is practically impossible to prove peer-to-peer bullying and to stop it. (Due to the sensitive nature, I kindly ask that the topic of bullying not be made the center of attention in any feedback on my blog post.) After three jobs in which I was the victim of relentless bullying, 1) I was more than filled with compassion for all the immigrant peoples who hold most of these jobs who, because of a lack of other options, tolerate daily behavior from their peers out of fear of losing their jobs, and 2) I was more than ready to say, “Okay, Lord, I am fully decided to obey. This scares me, but I will trust you. My way is not working. Your will be done. I will step out to raise full-time support with LoveAIDS and take this work forward which you are leading me into.” So here I am, finally saying something that is overdue, that I needed to have done almost seventeen months ago. “Yes, Lord, I will follow You all the way. All the way. I will move forward into raising full-time wage support with LoveAIDS. I will move forward in faith, trusting that you will provide.” And please know that LoveAIDS already has financial partners who have been partnering financially with us for a while with the commitment to providing me a living wage. Yes, this step of faith and of obedience for me was overdue for some time. I need to apologize to you, our faithful partners, financial supporters, prayer warriors. It may be that the Lord prodded you forward to partner financially with us in this new season, but I had never taken that step of obedience, so you, in your heart before the Lord, were left hanging. Please forgive me. In our obedience, or lack of obedience, to the Lord, we all affect each other. We are part of each other’s walk, though at times we realize it or not. Well, I have decided to trust and obey the Lord now. I am moving forward. I treasure your faithful prayers and financial partnership, in whatever way the Lord asks you to walk with Him. Thank you so much for accompanying LoveAIDS and me on this journey. “For the love of Christ compels us….” (2nd Corinthians 5:14) [Just a “disclaimer:” I do not know that I will (or will not) be moving forward towards medical school. Medical school is still on my heart and showing up in my long-term “plans.” I just think it is more important at this time to trust and obey, to truly walk in surrender with our Lord.]  Anne Stavrica, together with two dental student volunteers who were serving alongside our regular volunteer dentist and professor Dr. Silvia Feel led to partner with us?
Please Click Here  At the AIDS facility What qualities make for a good fit for doing international fieldwork with LoveAIDS? Some of the qualities one might be able to pick out right away – a genuine appreciation for other cultures, licensure/formal education in the medical field…. But other qualities might not be so readily obvious…. My mind travels back to a conversation I was part of in the past 9 months: “I’m American, so if I come work with you in this country, I want to have an American experience when in this country,” my ears heard, causing my jaw to drop. Big, beautiful eyes gazed out at me across the room with a sincere, servant’s heart innocence. “But if you come to work with us in Costa Rica, you are not [going to be] in the United States,” I responded, shocked. “Costa Rica is not the United States.” “But I’m American, and if I’m in Costa Rica, I expect you to provide an American experience for me,” was the inexperienced reply back. “Uh….” was the first verbal response I could gather as I sought frantically in the flabbergasted crevices of my mind for an intelligent answer back…. As you can imagine, it goes to say that it was during this moment I realized that this particular candidate, who was extremely qualified in other ways, was probably not the best fit to send out to the field in Costa Rica (I sought further to find if this candidate was flexible at all in their expectations of what they thought their experience should be in the field, and, unfortunately, they were not.)  Waiting for the bus in San Jose, Costa Rica In the past nine months, I have spoken with a number of candidates in looking to receive our first short-term workers this year, some demonstrating greater preparedness for international global health work and others demonstrating less. Out of that I realized the importance of highlighting just a few important qualities of what makes for a good fit for doing international fieldwork with LoveAIDS: 1) Appropriate Cultural Humility I admit, for some U.S. Americans, this may be a no-brainer. For those who come to work with LoveAIDS from countries other than the United States, this may also seem as a no-brainer. But for many U.S. Americans, this may be a harder one to understand at first. This might be a little bit more difficult for many otherwise very qualified potential fieldworkers, if they are U.S. Americans, because so many, in the United States unknowingly, innocently, see the United States as the center of, if not everything, most things, and possibly the best place on earth. Admittedly, the United States does have many wonderful things going for it and is a leader in many areas, yes. Of course. And it is a beautiful country with beautiful people who stand for human rights and who, in very many ways, are extremely generous with many of the world’s countries and bring much good to these countries through their hard work and generosity. If you are U.S. American and want to feel proud of your country, just do a Google search on nonprofit work done by U.S. American organizations on an international level. It will make your heart smile. But the United States is not the only country on earth. Because this specific topic covers countless areas, I will focus on one area, for starters, that can help at least slightly adjust one’s perspective of how one views the rest of the world (that is, the world outside of the United States.) “I’m American…” spoke the eager candidate in that informative conversation. Who is “American?” I asked myself afterwards. The answer rushed to my mind quickly. Argentinians are Americans. Costa Ricans are Americans. Chileans are Americans. Peruvians are Americans. Bolivians are Americans. Brazilians are Americans. Panamanians are Americans. Guatemalans are Americans. Uruguayans are Americans. U.S. Americans are also Americans. Speak with a Costa Rican or a Chilean or an Argentinian, and they will tell you that they are Americans. I’ve actually been asked numbers of times by Costa Ricans with a confused look on their faces, “Why do U.S. Americans call themselves “Americans” as if only people from the U.S. are Americans?’ Yes, those were slightly awkward conversations…. It is true that not only U.S. Americans are Americans. America includes South, Central, and North America. All are part of America. In seeking to be effective in working alongside Americans (aka other peoples from the Americas) as those of us who are U.S. Americans work in other countries, remembering this can be something that helps us walk in cultural humility.  With Costa Rican friends in the early morning as they do their job as professional fishermen 2) A Readiness to Work Within the Boundary Lines of the Experiences LoveAIDS, as a Global Health Organization, Can Provide. “I want to have an American experience,” the eager candidate told me, causing me to temporarily blank out and lose my train of thought. I admit, that was the last thing I expected to hear. It was then that I was confronted point blank with the reality that eager candidates bring memories of and expectations from previous experiences of international “mission trips” with them when they think about serving with LoveAIDS. Each person’s past undoubtedly shapes their expectations and imaginations when they consider doing international work for a first time and when considering doing international work again. And many a candidate’s international “mission trip” experience has been shaped by them serving with a wonderful charity organization that is not a hospital organization public charity. But what defines an “American experience” when one is volunteering internationally with a hospital organization public charity? Or more specifically, what can that “experience” be when the organization one is serving with is a hospital organization public charity? It is exotic to travel. It is exotic to see tourist destinations. It is a nice to have some work-related report & reflect retreat time away from a work site…. But as a professional organization, LoveAIDS is defined by specific boundaries in the experiences it can provide. LoveAIDS is a hospital organization public charity with the IRS. This means donated funds must be used with the documentable cause-and-effect of providing medical care: the sending of workers to the field, paying for worker’s provisions, paying for needed supplies, the provision of an operations person to oversee administrative functions which allows the fieldwork to continue, and so on. Some “medical mission” organizations have a model of fieldwork where workers travel to a region of a country which has a complete lack of medical care available and where for a specific period of time the volunteers provide a blast of medical treatment (i.e. diagnosis, surgery, prescriptions,) and then return home to their countries. Sometimes these organizations have a schedule, which is very rigid with long hours, customized specifically to do as much work as possible in as little time. Other times, the medical or dental workers are pampered a little, do not work regular-length shifts, and are afforded a significant amount of luxuries the local people to not have access to, since the goal is specifically to provide medical or dental attention, not to enter into, understand, and integrate into the culture. As a global health organization, LoveAIDS focuses on being the hands and feet of Christ by bringing our resources to strengthen already existing in-country systems. We come alongside. This model is more sustainable for the target countries we partner with and allows patients to receive more consistent, longer-term treatment. This means that LoveAIDS short-term workers come and work alongside long-term workers in the pre-existing schedule that has been arranged with the facilities we partner with. This allows for many opportunities, including further developing pre-existing relationships with a long-term relationship in mind. As a hospital organization public charity, LoveAIDS is required to demonstrate through the volume of medical care hours worked that providing medical care is our objective. This is easily accomplished because we work professional hours in providing medical care to our target population. Not excessive hours nor minimal hours. We work professional work shifts in the field. And we value the professional and personal maturity of our short-term workers in working professional hours alongside our long-term workers. This allows LoveAIDS to use wise stewardship with the generous donations of our donors as well as to provide dependable, professional service to the facilities we partner with. Before I specifically address the “American” in “I want to have an American experience,” let me take a quick detour with important qualities #3:  A local fruit stand in Costa Rica 3) A Professional Maturity and Ability to Work Well on a Team Some things, one thinks, shouldn’t need to be said. LoveAIDS should just quietly screen for these qualities when doing reference checks, and that should be all that is necessary. But this is one that needs to be talked about. Some wonderful people, beautiful people, people who may be otherwise well-spoken of, can come to the international field and demonstrate a side of them that seems out of character. Others, who might not strike you as an “exceptional” fit for doing international work but just “average,” arrive in the field and do beautifully. Although international work is never easy, you see a hidden side of them that comes out in the international context that just takes your breath away with how effective they are. How does this happen? Living and working internationally adds a stress level to one’s life that is unlike living in one’s home country. Unresolved family issues, unresolved personal issues can suddenly flare up, to the dismay of other team members or team leaders in the field. Important questions to ask are, “How does this candidate work and communicate with other team members? With team leaders?” Other important questions to ask are, “How does this person handle situations when things don’t go their way?” and “Can this candidate really handle it when the luxuries, comforts, and conveniences they are used to are taken away, and how do they live day-to-day in that context?” I have been on trips walking through red-light districts where pimps propositioned me to be “serviced” by their sex workers, where sex workers looked me in the face and I could see the misery unhidden in their faces, and I have also been to places where it could just be dangerous to be a U.S. American and where I, as a female, was not supposed to make eye contact with men. As of writing this, I have also worked in Costa Rica for a year and a half now. It is stressful. My experience is not that of beaches and Mai Tais but of seeing a lot of suffering and death and of dealing with the day-in and day-out stresses of living in another country. It’s not easy. The importance of stressing that interested LoveAIDS candidates need to have a professional maturity and be able to work well on a team cannot be overstated. Nor, do I believe, can one be too cautious and intentional in doing reference checks. Sometimes you ask a candidate to put down a professor or employer, and they put down a close friend instead of an objective reference. Sometimes when you ask for the phone number of a parent, they put down a work number of the parent that makes the parent very hard, if not impossible, to reach. Such behavior on the part of a candidate brings up questions of why is the candidate doing this and what concerns does it expose? A qualified candidate will confidently put down objective references and will do everything they can to make sure the phone numbers they provide allow their contacts to be reached by LoveAIDS as easily as possible. Again, what is important here is that LoveAIDS candidates have the professional maturity and the ability to work well on a team that is needed in the international field. An emotional maturity demonstrated by even how a candidate applies to our organization tells us important information about the readiness of that candidate to be in the field.  The courtyard at the AIDS facility in Costa Rica 4) Lastly, a Spiritual Maturity Demonstrated by an Ability to Live Among the Local People as a Local I think back again to the words I was told by that eager, big-eyed candidate, words which left me dumbfounded: “I want to have an American experience if I come serve with LoveAIDS….” It is easy to demand, “I want to have the U.S. American experience if I come work with LoveAIDS.” The exact comforts. The convenience. The experiences of a U.S. American traveler…. I mean, why not? I personally would like those comforts, conveniences, and experiences too, especially in a country of warm weather, palm and coconut trees, fresh fish, ceviche, mango smoothies, to put my feet up…. But contrary to the experience this eager candidate was asking for as they shared their expectations, the apostle Paul showed humility when talking about how he did international work. He expressed that when he worked among a people, he made himself like those people, and he lived side by side with them. “Like the Romans…” he wrote. Where did this motivation come from? Why did Paul do this? “The love of Christ compels us….” Paul writes in 2nd Corinthians 5:14. Or if we need more guidance on this, we can always look to Jesus. Jesus was born into a human body and lived on this planet the way we humans do, living amongst us, and out of love humbled Himself. “In your relationships with one another, have the same mindset as Christ Jesus,” Paul writes, “who, being in very nature God, did not consider equality with God something to be used to His own advantage; rather, He made Himself nothing, by taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, He humbled Himself….” (Philippians 2:5-8.) It is out of this model, first demonstrated by Jesus, then Paul, that LoveAIDS looks for a spiritual maturity in the lives of potential fieldwork candidates that proves itself by an ability to live among the local people we work with as a local. LoveAIDS leadership takes responsibility, to the extent is it reasonable as individuals still make their own decisions, for learning the customs and culture of each country and what is safe in each country and shares that information with our short-term workers. This frees LoveAIDS workers to be able to live and work comfortably in the ways the local people do. This means walking on the streets, using the bus system, using taxis when appropriate, eating local foods and at local restaurants that are recognized as safe. And just as other international aid and medical care organizations allow for a significant but discerning amount of freedom for its workers, so does LoveAIDS. By doing so, LoveAIDS lives out the commitment to not try to create a context in which short-term or long-term workers experience a mini-United States within another country but to allow instead for our workers to enter, understand, and to be integrated in the local culture as much as possible with the approach that the apostle Paul used. LoveAIDS leadership understands that the dynamics of intercultural relationships are such that pre-existing long-term relationships are further solidified and that the effectiveness of each short-term trip is further enhanced by short-term workers interacting with the country and the people of the country the way long-term workers do in seeking to enter, understand, and be integrated in the local culture as much as possible. Is that not what it means that "when one is in Rome, be like the Romans?” What was the motivation for all this again? "The love of Christ compels us," writes the apostle Paul....  The sky after sunset in Naranjo, a small town west of the capitol city in Costa Rica These four areas addressed here are important and just starting points regarding qualities that make for a good fit for doing international fieldwork with LoveAIDS. The gratefulness and appreciation LoveAIDS has for how short-term workers have sought to integrate and will seek to integrate into the countries in which we work cannot be overstated. We are immensely grateful for how our short-term fieldworkers have served and will serve in the future alongside our long-term fieldworkers as we seek to be the hands and feet of Christ. We cherish your prayers. I confess it is possible I might have learned these lessons in other ways, in other environments, in other situations, and that it is not that I had not learned these lessons yet at all. God had already been teaching me these things, in varying degrees. But it is here in Costa Rica where God has been solidifying these lessons and making them clear in my mind, lessons learned experientially, as I have put one foot forward in front of the other and said, "Today, Lord, I choose to trust in You." 1) Our willingness to follow the Lord wherever He leads us will take us farther than we imagined and will allow for experiences we never thought we'd have. Now, lest this seem cliche and "so obvious," let me assert here. It's not so obvious. Actually, I never would have predicted.... The story for me is still not completed yet, so I don't know for how long I will be here in Costa Rica or when (if) exactly I will return to pursue medical school, but for now I am in Costa Rica working with AIDS patients and speaking Spanish. Four years ago, I didn't even know Spanish, and if you told me a two years ago that God would allow for a 501(c)(3) hospital organization public charity to be put in place so that I could work with AIDS patients and have teams come out to serve, I would not have believed you. If you told me that I would be the one writing the 501(c)(3) application and that indeed we would be awarded the rigorous hospital organization public charity status, I wouldn't have believed you. If you told me that a faithful team of financial supporters and prayer partners would gather around me so we could work together to be the hands and feet of Christ to the AIDS patients we are serving, I would not have believed you. If you told me that this organization would be receiving teams of trained professionals in the field in Costa Rica so we could get even more done, I would not have believed you. But I here I am, being the hands and feet of Christ, and living a very different life from what I had foreseen even two years ago, and these things are happening.  Experiences that I did not know I would have - running on the virgin beach in Nicaragua, as I was a guest of a Costa Rican friend's family member for a a couple days. 2) Walking in obedience is harder than it looks. When Paul wrote, "I have become all things to all people...by all possible means...," what he wrote about isn't easy. When I come to the AIDS facility and spend 10 to 20 percent of my daily time with certain half of my patients just trying to track them down (because of behavioral reasons that I can not list here,) this "job" is not always fun. If I want to be effective, I will put my focus on leading by influence, even as I try to track these patients down, which consumes energy, because Costa Rican communication patterns are far more indirect than the direct style [we] U.S. Americans take so much for granted. How many times have I had to catch myself and say, "No, pull back, Anne. That's not the way to do it"? Sometimes, I find myself feeling incredibly incompetent. Or, switching to another example, would I be able to count how many times I have been treated as unintelligent or unintellectual because I didn't conjugate a [Spanish] verb correctly? Being treated as "unintelligent" doesn't feel very flattering, and after months and months of receiving this [very unoriginal] response (grrrr,) I can say, it's not my favorite part of the "job".... But that's when I am reminded again of what Paul says -- what does Paul say? "For the love of Christ compels us...." (2 Cor. 5:14.) It's not our love of other things that compels us (those who choose to do international work) to do what we do, To eat humble pie, To cross cultural communication barriers in ways that are not convenient for us and often leave us feeling incompetent.... But real love is never convenient....  Me with the Saprissa flag, one of the top soccer teams of Costa Rica. Being all things to all people means I choose to love and come to understand this people, instead of not being influenced by them and just living my U.S. American style of life among them.... 3) The very thing we dread is often the thing that is the best for us. Let me reassure you, I didn't learn this the easy way.... The atttrition rate for expatriots is 50% within TWO years. Now, in case when you read that number you think I must be mistaken, let me reassure you: I'm not. It's true: half of all expatriots, including international ministry workers, leave Costa Rica within two years. Costa Rica is not exactly an easy place to live. While many Costa Ricans like U.S. Americans, many, MANY other Costa Ricans do NOT like U.S. Americans for a wide variety of reasons too involved to list here. Many, many Costa Ricans are exceedlingly friendly and hospitable for tourist and business reasons, but when it comes to making a real Costa Rican friend, it can take years. In the meanwhile, the walk through the desert can feel very, very long and extremely dry. And, having a twin sister and having grown up with an automatic best friend, this "desert" was and is still not exactly my definition of a good time. However, God knows it is in the solitude, often in the forced solitude, that we learn to hear clearly from Him. Or learn to hear more clearly from Him. And what a gift it has turned into. There are other areas where I have learned that the thing that I have dreaded is the best thing for me. For example, Jesus said, "Whoever wants to save their life will lose it, but whoever loses their life for me and for the gospel will save it." (Mark 8:35) Well, I have walked with Jesus for quite a few years now, But my human nature still is not attracted to this idea of "losing" my life. Do I think Jesus was not saying the truth? (Quiet pause.) Why is it so often that I treat Jesus as if He was lying? Is it not in being dead to our flesh and walking with the Spirit that we overcome this world? Yet so often, I have thought that if I die to myself, to my agenda, to my goals, in a situation, that I will cease to exist, metaphorically speaking. Yet every day, in waking up and choosing to serve, choosing to give of myself, choosing to be the hands and feet of Christ by giving a part of my life, time, energy, heart, I have found that the essence of who I am has not shriveled and ceased to exist, But that the essence of who I am is thriving, at rest, upheld by joy, upheld by a divine peace that is far greater than our human minds can understand, Upheld by a divine love that is so wide and long and high and deep that it surpasses human knowledge, including mine.  With Costa Rican friends God has been providing lovingly. 4) There is a fourth lesson I have been learning here in Costa Rica, more tangibly, experientially, as I walk moment by moment into the future, as the future is becoming the present and then becomes the past, which shows itself in this passage: “For my thoughts are not your thoughts, Neither are your ways my ways,”declares the LORD. As the heavens are higher than the earth, So are my ways higher than your ways And my thoughts than your thoughts." (Isaiah 55:8-9) Sometimes I am confused, and I want to feel I have a sense of control over my daily situation here in Costa Rica. It can be easy to feel bewildered living and working in another country. Things can go wrong, and they often do during the day and week -- miscommunication across cultures, institutional corruption across structures which manifests itself differently here than in the United States, other things.... And then, sometimes, being a very goal-oriented person, I just wonder, wonder about my future. I want to make specific, concrete long-term decisions and goals, and I want to make them now. It has been good for me to remember to not be frustrated by what I see with my eyes at given moments, as I seek to move forward in obedience. It has also been good for me to remember, it is much better - and life-giving - for me to seek to walk step by step with His Spirit, listening for moment by moment guidance, than to absorb myself in making long-term goals through my own human efforts, using just my own human wisdom.... And God, who does know what He is doing and planning to do, behaves in ways and brings things to pass in ways which are completely different from my human nature would have planned or done. Oh, what comfort to sit in a place of humility and rest on this! And what do we read in the same passage, just a couple verses earlier? “Come, all you who are thirsty, Come to the waters; And you who have no money, Come, buy and eat! Come, buy wine and milk Without money and without cost. Why spend money on what is not bread, And your labor on what does not satisfy? Listen, listen to me, and eat what is good, And you will delight in the richest of fare." (Isaiah 55:1-2) God wants to give us that which is good, that which is better than we would give ourselves using our own guidance. In the "strangeness" of Costa Rica, in a culture that is completely different from that which I have been used to, In situations that are somewhat unpredictable and sometimes frustrating, And as the founder of a tiny, very young organization for which I carry legal responsibility in front of our United States government, Sometimes fearing "where the funds will come from" to enable me to continue doing my work as I hear the Lord saying He will provide, And still being a young adult with plans and visions and further dreams, I have learned it is okay for me to come to the waters and drink, to eat what is good, to trust in a God whose ways are not like my ways. I have learned it is okay to rest and trust God. And how about you, my friend, you who have taken the time, lovingly, to read this? How about you?  Image of a Nicaraguan virgin beach I captured when I was required to leave Costa Rica for three days because of my visa and was received by the family member of a Costa Rican friend Becoming All Things to All People.... Entering a Culture Is Not As Easy As One Might Think....1/14/2016
Good Morning...or Good Evening, wherever you are in your day right now, may the God of hope fill you with all joy and peace as you trust in Him. I would like to share a photo with you. This is an image I captured earlier this week on my daily bus ride out to the AIDS facility. When you absorb the intricate details, what do you notice?  Yes, a memorial park (some even apparently call a park like this "God's acre" or a "resting place") fills the forefront of the image. If you are a U.S. American, do you, as I do, find yourself shocked at how "white" this park is? Apparently, white granite and sometimes pearly tile covers the face of these sites, and this is a norm in Costa Rica, as well as other countries, such as Spain. Lacking are the green expanses, so common in the continental United States, which calm one's soul, replaced by this ocean of heavenly white which transports its visitor into an ethereal otherworld.... Let me share another image with you. I obtained it last week when a dear friend of mine took me graciously to a rural area of Guanacaste, the northwestern region of Costa Rica, for some rest. As your eyes soak it in, where do your thoughts linger?  It's beautiful, isn't it? Breathtaking in a inquisitive, intriguing sort of way.... It also dramatically differs, doesn't it, from what many of us who are U.S. Americans are used to? This picture represents a completely different way of life than many of us are accustomed to..... Here is another image I captured last December, in this case during a weekend run on the west side of the capital city (I live on the east side.) Again, what strikes you in this canvas?  Through these three landscape images, it is easy to sense immediately that life differs significantly in Costa Rica from the contintental United States, isn't it? Something about life in Costa Rica is just...different.... ...Everything about life in Costa Rica is just...different.... The longer I live here and work here among these people, or Ticos, as they call themselves, the more profoundly I come to comprehend that the Tico [Costa Rican] culture and people differ strategically and excessively from U.S. American culture and mannerisms. Take, for example, this quote I copied from one of my Tico friend's Facebook page. Posts with this type of message on the Facebook pages of Ticos are not rare, unfortunately. And this one reads, "Deceptions make you open your eyes and close your heart." Here is the image:  How do you feel or what do you find yourself pondering as you reflect on these words in this image? I find myself saddened...and bewildered. Because, again, these posts across Facebook here in Costa Rica are not a rarity. Often, I have listened, confused, as Ticos have confided in me, "Well, I did that and had that loss, so I am not go to take that risk [and opportunity to grow or for enjoyment] again." And the marketing.... In the past five days, my attention has been captivated by noticing with perhaps more acute observation than before the common use of the words, "Without Fear...." aka "You can do this without fear," "You can buy this...without fear," "If you use this, you will have no more fear...." The U.S. American culture of having a confident, expectant attitude in receiving positive results and having positive experiences that I, as an immigrant to the United States, have embraced as my own is not the culture within which I daily exist now. The one I daily exist within now, is one where theft, corruption, and lack of resources often shackle hardworking Ticos from a life and lifestyle I had come to believe was my "right" as I lived within the United States.... If I come with a confident, expectant attitude of positive results, not aware or sensitive to how close the possibility of loss feels to this population, I might unwillingly communicate arrogance, entitlement.... This is just one of many cultural differences I comprehend more daily. Am I willing to truly understand and adapt to the Costa Rican world I live in? I realize, again, and again, that: To love effectively and work effectively, there is much to actively learn and understand in another country, and there are many cultural bridges to continuously cross. What did the Apostle Paul write? "Though I am free and belong to no one, I have made myself a slave to everyone.... I have become all things to all people, so that by all possible means I might save some." "For the love of Christ compels us...." "Do not think of yourself more highly than you ought, but rather think of yourself with sober judgment, in accordance with the measure of faith God has given you...." "Do you not know that in a race all the runners run, but only one gets the prize? Run in such a way as to get the prize...." Will you rejoice with me and pray for me for the opportunity God has provided for me to serve and love this Costa Rican population and specifically the AIDS patients I work with? Below is an image of Costa Rica I captured when I was able to go on a morning run last week during my week of rest from the big city and hectic traffic. God graciously provided through a friend.  For those who would like to know more of some of the cultural differences, the article below touches on some of the areas I have been focusing on for effectively working and communicating God's love: 1) "Management hierarchy. In some cultures, there is an expectation that employees defer to managers." 2) "Different ideas about agreements and commitments. [U.S.] Americans tend to prefer clear, detailed agreements and expect commitments to be taken literally and seriously. But other cultures take a more flexible approach to agreements." 3) "Results versus profits. Some cultures value getting things done and aren’t sticklers for rules or protocol. Others emphasize protocol above all else." 4) "Attitudes toward appointments and deadlines. Whereas [U.S.] Americans expect strict adherence to deadlines, others are more flexible." 5) "Being "too direct." [U.S.] Americans are known for being direct and are generally not concerned with "saving face" or avoiding conflict, but these can be big hang-ups in other cultures." http://www.fastcompany.com/3054879/the-future-of-work/how-to-manage-cultural-differences-in-global-teams?utm_source=mailchimp&utm_medium=email&utm_campaign=colead-daily-newsletter&position=1&partner=newsletter&campaign_date=01122016 Again, I am very grateful for your prayers as I seek to work effectively and show love effectively among the Costa Rican population, the local health care team I partner with, and the AIDS patients I work with. "How beautiful are the feet...of this who bring good news!"  “How beautiful…are the feet of those who bring good news!”
Actually, the verse reads, “How beautiful upon the mountains are the feet of him who brings good news, who proclaims peace, who brings glad tidings of good things, who proclaims salvation, who says to Zion, ‘Your God reigns!’” (Isaiah 52:7) As I was looking at a pair of feet that tried to walk and struggled, I was lost in thought. For the story was, that a femur was broken…. A femur of a patient who was HIV positive, and certain orthopedic surgery was needed—yes, a slightly complicated operation—to help this patient walk again, to walk normally, that is. But the chief of the specific surgery department at a specific hospital in Costa Rica did not want to approve the surgery, because the patient was HIV positive. So this chief of surgery simply did not approve it. And this patient was left receiving minimal surgery but having lost the ability, hope, and motivation to walk. Hence it was that I met this patient. I was one of the individuals helping this patient to walk again. Actually, by asking a serious of questions of the medical doctor who now comes to the AIDS facility here in Costa Rica once a week, I was able to get both his attention and his analysis for him to assess x-rays taken of the injury. He then specifically analyzed the gait of the patient, and after further discussion, he provided me a list of specific exercises to strengthen specific muscles and told me, “These muscles are severely atrophied, but if this patient does the hard work, this patient will walk again.” My understanding is that this is the first time that this patient had been positively told by a knowledgeable physician, “”You will be able to walk again.” Maybe with a slightly limp, but this patient “would be able to walk.” Earlier in the day, this physician had told me, “But this patient does not want to practice walking. This patient does not want to do the work.” And I had told him, “But this patient does. This patient does this hard work with me. In fact, I provide MORE exercises for this patient, and this patient willingly does it…. Last summer, this patient didn’t want to do the work. But this summer that I am here working with them, they do.” He looked at me, surprised. He later quietly commented to me, in Spanish, “The most important thing in working with patients is love….” I couldn't have agreed more. “How beautiful…are the feet of those who bring good news!” “For the love of Christ compels us….” -2nd Corinthians 5:14 [Information has been slightly adapted to protect the identity of the patient.]  By Zach Dyer, in the Tico Times News, December 1, 2014
(Link to article at bottom) Nearly half of all HIV-positive people in Costa Rica are unemployed or not looking for work, according to a recent survey. The results were first published on Nov. 27 amid several events leading up to World AIDS Day on Monday. An HIV and AIDS awareness parade took place in San José on Saturday, and on Monday the Costa Rican Social Security System is hosting a free event in Parque Central from 8:30 a.m. to 1 p.m., where they will provide rapid results HIV tests, information about the virus, free condoms and health advice. Juan Carlos Zamora, director of the Costa Rican Demographic Association that carried out the study, told The Tico Times that the unemployment rate is one of several alarming results they discovered. Zamora said a constellation of factors contribute to the dire economic conditions in which many people with the immunodeficiency virus find themselves, from missed job opportunities to pressure to leave their neighborhoods or places of work, to health complications that could prevent them from working. For example:
These same anxieties spill over into respondents’ private lives, too:
More than 9,800 Costa Ricans over 15 years old have HIV as of 2013, according to estimates from ONUSIDA. The Costa Rican Social Security System, known as the Caja, reported that 6,218 people have HIV in Costa Rica. Public hospitals diagnosed 694 new cases in the last year, the agency reported Thursday. Men remain the group most affected by the virus in Costa Rica, representing 80 percent of the cases, according to the Health Ministry. Men who have sex with men are the group most at risk for infection. The rate of HIV infection has grown here between 2002 and 2013, from 8.6 to 14.6 per 100,000 inhabitants. http://www.ticotimes.net/2014/12/01/hiv-and-aids-patients-in-costa-rica-struggle-to-find-work-amid-discrimination "Oh Lord, please help my heart from getting hard...." Some prayers I find myself repeating over and over. "God, please help me to view this [incapacitated] patient as more than just a [physical] body...." "Lord, please help me never walk by a homeless person without showing kindness towards them...." "Jesus, help me never dialogue with a sex worker without feeling compassion for them, without showing Your love...." Prayers that I find myself repeating, because, when subjected to repeated suffering, the human psyche automatically wants to harden and not feel, because it hurts.... Because to "rejoice with those who rejoice, and weep with those who weep" costs us.... [Romans 12:15] Yes, it costs us.... Because the greater the other person's pain, the more it costs us to enter into that pain and sit there with them, even if only for a moment. But, alas, love can not be "fake." Love can not "gloss over." Love can not be "nice." "What good is it...if someone claims to have faith but does not have actions [to show that faith]?" James writes [James 2:14.] A person who is suffering recognizes real love. The deeper their suffering, the more they can see through "niceness" but also recognize real love.... (As I quickly learned working with AIDS patients on days I felt little energy to muster real "love," thinking I would just be nice...but I was read like a book, and their eyes quickly told me; oh, how I learned....) In Costa Rica, I come across harsh realities every day, where I find myself praying, "Oh, Lord, please help my heart from getting hard...."  Sex workers negotiating with potential clients in Costa Rica This image is taking from a guide on prostitution in Costa Rica written in English. A man who identifies himself as "Roger Fitzpatrick" writes in it: "You can find sex with almost anyone you want in Costa Rica, believe it or not. Simply offer any attractive person you see $10. If they smile, take their hand and lead them to your lair. You won't offend them; in this culture it is taken as a compliment, so feel free & the worst thing is they might just shake their head and walk away. What have you got to lose? My friend does this all the time & has some AMAZING stories." Is what "Roger Fitzpatrick" says true? Is such a thing truly a compliment? Most of the time, no. I walk the streets of Costa Rica and have good Tico (Costa Rican) friends, and I have yet to encounter this as a norm here. Nor do local Ticos see themselves as prostitutes welcoming solicitation. Which then opens a window for the unexposed into how dark the whole situation really is. These Gringos (U.S. citizens) and Western Europeans travel to poor countries, such as Costa Rica, because they will have opportunities to have sex with women of certain "caliber" who, if these same women were in wealthier countries and had access to more resources, would never prostitute themselves in the first place (that is actually what these "clients" think and how they "categorize" these sex workers, what these clients are told, and what they tell each other....) What these travelers do not know are how many of these sex workers are actually caught in sex trafficking (many of them.) And sadly, the United States is a huge supplier of "clients" feeding this sex trafficking industry; they do not travel to Costa Rica simply to go on guided fishing tours....  The Rostro de la Justicia [Face of Justice Ministries] van, with some of the teammates, preparing coffee and cookies for sex workers on the street in San Jose, Costa Rica. - LoveAIDS Christmas 2014 Trip. It is in this context of prostitution being "semi-legal" that HIV still has a horrific stigma. It is in this context that many medical doctors still do not want to treat HIV positive patients. It is in this context that I have watched slowly dying AIDS patients who never had regular support systems in place or experienced being well-loved by their families now often abandoned by those families, disowned. Even as I type these words, I can feel myself wanting to dissociate. I remember some of my patients faces.... I remember the depth of their suffering, and how it far exceeded what they tried to hide with their eyes.... Yes, It is in this concoction of many factors that the deep suffering of the HIV patient often brews.... It is in this context with the sex worker at night, with the AIDS patient during the day, that I find myself praying, "Oh, Lord, please help my heart from getting hard...."
What is the answer? We must move out in action. We must move out in humble obedience and faith. That is what Jesus did, so that He could offer a transforming reality of new life. What else did He do? He wept. "Rejoice with those who rejoice, and weep with those who weep." -Romans 12:15 "Jesus wept." -John 11:35 Lord, please help our hearts from getting hard. Soften our hearts, and help us move out in love.... [Below is the link to the Tico (Costa Rican) article I resourced from above; it reads in Spanish. http://www.teletica.com/Noticias/89765-Guia-de-prostitucion-en-Costa-Rica-se-vende-en-Internet-por-20000.note.aspx ] I have done something odd. I have returned from Costa Rica and left something behind.  Quiet countryside in Guanacaste, a Southwestern region of Costa Rica, during the Christmas 2014 LoveAIDS Trip My heart is missing, and though I have been loving my ICU job at the hospital and spending time with friends as I have been hurriedly working on the detailed, cumbersome, legal documentation for our 501c3 IRS status, learning a tremendous amount in the process, I have sensed its absence. It is as if a huge part of me is missing. I will tell you where my heart is. My heart is in Costa Rica. My heart is 4,200 miles away, in Costa Rica. With the HIV patient I spoke with who paid out of pocket at a private hospital to get treatment because the doctor at the public hospital was discriminating against him, under-diagnosing (mis-diagnosing) his health condition (insert in here what you will the motives you can conjecture as to why a competent medical professional might do that....) My heart is with the former sex worker who went to a infectious disease specialist hoping to get help and instead got ridiculed and talked about behind his back (I watched it happen) but didn't get the treatment he needed (again, your guess might be as good as mine here depending on why that happened.) My heart is with David [not his real name,] who, because of addiction had acquired AIDS and whose family rarely came to visit him, who perked up far more when Olga, our nurse, and I daily and hourly came in his room to care for him, before he died. (I am not disclosing publicly identifying information here; while I am thinking poignantly about a specific individual, there are, unfortunately, many who fit this profile.) He was a lonely man who in many ways was judged and condemned by his society and community in a country where HIV stigma is significant and who realized that we, as his care team, showed up every day for him because we WANTED to be there....  On the streets in San Jose at night with Rostro de la Justicia [Face of Justice Ministries,] an organization that works to reach those caught in sex trafficking, during the Christmas 2014 LoveAIDS Trip I wish I could introduce you to the many more people I have interacted with who have been the recipients of stigma because of their HIV/AIDS in this beautiful Latin country. (What a beautiful people; how easy it is for anyone to not realize what their actions are causing....) I am currently working with my Tica (Costa Rican) friend Veronica Vega on a project to start putting more comprehensive support systems in place for our AIDS/HIV patients in Costa Rica. I can't say more, because everything is new, and we will have our work cut out for us. But Veronica loves Jesus, and I love Jesus, and we believe that Jesus' heart is for these HIV/AIDS patients, and we want to show them God's love. I feel that there is so much to do. What can one girl from Seattle, Washington, and one girl from San Jose, Costa Rica, accomplish? I look at my upcoming support-raiser again to raise support for our Summer 2015 LoveAIDS trip, and the many relationships we need to build across the city of San Jose, and I gulp, speechless. (I forget that God has already been putting many relationships in place. I forget that LoveAIDS already has an open invite for Summer 2015 and are eagerly expected back to help further the work....) But then I look to my big God. "With God, everything is possible," said Jesus. (Matthew 19:26) With God, everything is possible. "The love of Christ compels us...." (2nd Corinthians 5:14) (Anne's next trip to Costa Rica is scheduled and less than 3 months away, for June 20th, 2015.)  Country roads in Guanacaste, Christmas 2014 LoveAIDS Trip LoveAIDS
Loving AIDS Patients, Loving Jesus: Caring for the Medical Needs of AIDS Patients & Sex Workers in Resource-Poor Countries  Dealing daily with suffering, death and dying in the face of limited resources was part of my regular work. This is phrase I have heard numerous times regarding my work in Costa Rica--my ten weeks spent there this summer, and my upcoming three and a half weeks for our Christmas trip. How does one respond? I wonder, when told that, if I should share about the gigantic brown cockroaches that would scuttle across my legs in the middle of the night. Or about the constant terrified wailing of the baby next door I could hear through the paper-thin walls for ten entire weeks and the harsh mother's voice next door raging constantly at the newborn who was just needing to be held. It was after this summer that I realized that yes, I can tell the difference between a baby just crying and the fearful, tormented sobbing of an infant who both longingly cries for its mother and is utterly scared of her. Recognizing this type of suffering in a baby for ten weeks can do strange things to your mind. Or how I was experienced hunger pangs daily, because my host mom could not afford to give me enough meat (or any milk) to satisfy my body's need for protein, and I learned a new definition of what it means to "go without." Or perhaps I might share that I only had two Saturdays off the entire summer, one of which was the only time I went to the beach. Because I was studying through countless academic research journal articles every Saturday...as a part of my summer's work. Or perhaps I should share about my 10-14 hour days I kept 5 days a week, every week. I WORKED. Do I share about how I gained weight, because it is very dangerous to run on the streets in Costa Rica, with a very high pedestrian fatality rate, due to drivers' disregard for those on foot, and so I couldn't go running? Do I share how I spent my Sundays at multiple church services...because I was working on building relationships with the local churches? No sleeping in for me, because I have to wake up early and it will take me an hour to take the bus to church.... Or do I share about how while my pre-medical and nursing student peers worked during the summer to make some kind of income, I gave my summer away, a poor pre-med student who really needs funds but gave my labor away? What is is people are jealous about? Please hear my heart. I do what I do out of love: "Christ's love compels us, because we are convinced that one died for all, and therefore, all died. And He died for all, that whose who live should no longer live for themselves but for Him who died for them and was raised again" (2 Corinthians 5:14.) Christ's love compels me. My prayer is that I would hear instead, "That is so awesome. I am praying for you." At the director of LoveAIDS, I am working very long hours and slowly, with my team members, building a vessel the Christ-loving church in the United States desperately needs: a vessel that Christian health care workers can utilize to travel globally to love the AIDS patient in Jesus' name. And I am stepping out to love and serve those neglected and stigmatized the most in countries where it is most needed: resource-poor countries. Costa Rica is only a gateway to further work in other, much poorer countries. That is my prayer. A coming-alongside of me with a "How may I join in?" and a "I am praying. I am praying for you."  My bed and shelves in my half of the bedroom where I lived all summer, in San Jose, Costa Rica. I had new experiences regarding what gigantic brown cockroaches on your legs at night and paper-thin walls--where you can understand everything your neighbors say in Spanish--are all about. |
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February 2018
CategoriesIngrid Anne StavricaDirector Patient ConfidentialityLoveAIDS would like to remind our partners & public that we are limited in both the stories and photos we can share do to needing to protect patient confidentiality, complying with patient privacy laws originating within both the U.S and the countries we work with.
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