October 2024 News

Often times, the days and months here seem to go by quite quickly.  This has been true for us the past few months.  The Lord continues to open doors for us to enter into the lives of people from many different backgrounds, cultures, and languages through their diverse medical needs.  Each of us has a story, that God is writing.  It really is a privilege to be trusted to walk with patients through some of the difficult times in their lives/stories and to be a part of how God is working in their lives.  It's also amazing to see healing through compassionate medical care, that allows them to change the focus of their life from these huge medical needs that have consumed significant amounts of time, money and worry.  Some of these needs we can treat, but others require a higher level of care not available at the Hospital of Hope or at other hospitals here in Togo.  However through relationships with other medical missionaries whose missions hospitals have greater resources, we have been able to get the medical care needed outside of Togo.  This is the case for the first two stories, we would like to share with you.

We mentioned a young female, Afi, in our last post who would be going to Kenya for resection of a large mandible tumor and facial reconstruction.  Her procedure was more complicated than Nafi, so she required a bit more time in Kenya than expected.  It's never a sure thing that a surgery will be successful, especially when there is a free flap which is dependent on blood supply coming from a small blood vessel that was sewn together.  We are very thankful for the ability to partner with the team at Kijabe Hospital to be able to help our patients access this level of care.  Afi had been looking for medical care for almost 10 years in multiple countries.  While walking with her through this surgery over the past 4 months, Natasha and I and other colleagues have had great opportunities to help her in various ways and share Biblical truths.  She stayed here in Mango for an additional 2 1/2 months due to an infection, and during that time she attended a Bible study with Natasha and some other women in our home and heard truth on many ocassions.  She returned home just a few weeks ago with a wonderful cosmetic result and a new lease on life.  She now has the opportunity to move beyond this health problem that had been the focus of much of her life and energy over the past several years.  Please pray with us for her as she is at a major crossroads.  She has already been able to be share with various friends and family about the great physical change that she has undergone, which is immediately visible upon seeing her, and we pray for her heart as well. Please pray with us for the head knowledge of salvation through Jesus alone to become heart knowledge. 

 

We also ask for your prayers for a young boy named Abou. He recently made the trip to Kenya with one of our teammates to receive further care for a severe esophageal burn caused from drinking lye a strong base.  Since his esophagus is completely closed, he has been receiving food through a g-tube for the past year.  At the same time, some of his saliva has been going into his lungs causing recurrent pnemonia.  When he arrived in Kenya after the flight, his saturations were dangerously low due to pneumonia.  They are hoping to perform his surgery in the next few weeks at Bethany children's hospital which is located next to Kijabe Hospital.  Please be praying with us for Abou, Katelyn, and the team at Bethany children's.  Pray for wisdom as the team there as they decide the best timing for operation, as well as, for the many details for this surgery which is quite complicated.

Our PAACS program has been growing.  We selected our next 2 residents to start in January of 2025.  This years class includes our first Togolese doctor.  We are excited to have Josue join our program a bit early, October 1, to start making the difficult transition from French to English.  Our PAACS residents are required to do their testing in English, and this can be a problem for some of our residents coming from Francophone countries.  This extra 3 months allows him to start now with that transition.  Unfortunately, since our least letter one of our residents was also released for academic reasons.  

In September, we were able to gather all of the residents and many of our faculty from both PAACS Togo hospitals in Kara for a spiritual retreat.  We are thankful for the support and encouragement by PAACS to take this time together to study Gods word and worship together.  We started with Revelations 21:1-8 to think about a future with God with no more tears, no more death, mourning, nor pain.  The medical work here can be quite heavy at times as we see the severe suffering in our patients and friends.  As surgeons, we often struggle with tough questions on what is best in our context, or what can and cannot be done.  It's helpful for us today, to remember that this suffering and pain is not forever.  We seek to treat and care for our patients to the best of our ability with compassionate care that models what Christ demonstrated, hoping one day they may dwell together with God as mentioned in verse 3.

One example of the physical suffering was a family from about 1 hour away who came with severe malnutrition and 2 young brothers of 7 and 8 with several holes in their intestine from typhoid.  We were able to operate safely, and they both survived despite arriving at our hospital severely ill.  Just as they were being discharged, a 3rd brother was brought to us with a less severe perforation containing only 1 hole.  His name was Andrew, and he went on to tell us about his 2 sisters were also sick and were still at home in the village.  One of our chaplains was able to join us for an impromptu visit to this village.  The two sisters were indeed sick with fevers and abdominal pain from typhoid and returned with us to the hospital.  The oldest brother introduced us to his father, and his uncle- the chief of the village.  They were from an animistic background, though there was a small church in their village with a population of about 500 people.  They allowed us to present the gospel there with the village and thanked us profusely for the care and support we had given to this family.   The two boys are now nearly ready to have their intestines reconnected in the coming month. We have already had opportunities to rejoice in their improvement, but please pray for this family as they are still dealing with the many effects of severe illness. 

Also, since our last news letter, we have been able to start treating Choriocarcinoma, a fast growing cancer that usually begins in the uterus, here at our hospital. We've had three patients with this diagnosis since June, and the upside is that this is one of the few types of cancer, that if caught early and treated, has a favorable outcome. These women have been coming in daily for weeks at a time to receive treatment and have frequent followup appointment giving us many opportunities to encourage and share Biblical truths with them. All three have just finished treatment and will be monitored closely over the next year before being declared cancer free. Please pray that the truth of the gospel will penetrate their hearts, and that the love, care, and encouragement that they've received over that last few months will be a reminder of the God who loves them and knows them intimately. 

Prayer Requests:

Our Family: Elliahna, our oldest child, is currently working through college applications.  As parents, this is certainly a big milestone.  Please pray for her and us as we work though this together and prepare for what the future holds.

Our Team: Our team will have a lot of changes coming up to begin in the summer of 2025.  Please pray for those who will be here serving during that time. We are as ALWAYS in need of more workers for the ministry here.  Please pray Mathew 9:37-38.  Pray earnestly to the Lord of the harvest to send out laborers into his harvest.  

Our PAACS team: Our PAACS residency is growing.  We are thankful for the 2 new residents who were selected by our PAACS faculty and staff this past August.  Please pray for Josue Drafor, our first Togolese trainee, who started at HBB October 1.  Please pray for Franck, from Cameroon, who is working on the details to arrive here in Togo at the end of December.  

  

June 2024 Nattier News

Since our last post, we have once again returned to Togo.  We actually arrived back in Mango in early March.  

Our time stateside went very quickly, but it was encouraging in many ways.  We enjoyed the chance to connect with some churches, families and friends, though we missed seeing many others.  It was also very productive for our children with Andrew getting his drivers license and Elliahna visiting several colleges and taking both the SAT and ACT.  We are thankful for the growth we see in all of our children, but it's also hard to come to grips with the fact that we have an 18 and 16 year old now!  Josiah our 3 year old definitely keeps us on our toes, but even he hit the landmark of being out of diapers and is now riding a 'big boy' bike! They are all growing and changing so quickly.

Our return here to Mango in March coincided with the hot season, a big change from early spring in the US. It was a bit of a challenging time to return.  We are thankful for the grace of God that sustains us despite circumstances and challenges whatever they may be.  It has been good to be back with our team here and to see how God has been at work in our absence.  Our colleagues, the Muepeps and Fergusons, who we have mentioned previously, were thriving in ministry. This was a big encouragement.  It was great to meet Arung, one of our two newest residents, and to see growth in Yannick.  Please continue to pray for all 4 of our current residents.  As they grow and are competent to do more, it allows us time to focus on a variety of other tasks.  We are starting to get a glimpse of a future when we have a full complement of residents including those in their 1st, 2nd, 3rd, 4th and 5th years of training.  Each year they gain more experience and competence and along with that comes more responsibility.  We also had a chance to host 2 senior residents (4th and 5th year) from another PAACS program in Egypt.  They were leaders and a big help, despite the fact that they were not used to some of the pathology and types of problems seen in subsaharan Africa.  This gave us yet another glimpse of the benefits we see now of investing in training and discipleship.  We also are excited for the impact they can have wherever the Lord leads them to serve in the future.  Their impact on the continent in the sense of meeting spiritual and physical needs of the people could be great.  We truly appreciate your prayers for our residents, our faculty and the entire PAACS family spread across Africa.

Here in Mango we have the joy of sharing life along with friends from a variety of backgrounds.  Daoud has been working with us as a nurse since 2018.  We were able to participate in his wedding to Yasmine back in 2021.  It was fun to be able to rejoice with them as they welcomed their first child, Ryan, this past month. 

Since being back, we have gone through some major changes with our friends who have worked in our home alongside us these past 7 years. Change is never easy, but in this case, we can see God's hand at work and are excited to see one of our friends realize a long term desire of opening her own bakery. Odile began working with our family when we first arrived in Mango in 2017. She has become a special part of our family and over the years has grown greatly in her culinary skills. This year she was able to start a new work of opening and running her own bakery in town. Her baked items are delicious and word is quickly spreading throughout town that there is a place where burgers, fries, shawarmas, and other treats can be ordered. We missing seeing her in our home each week but are delighted to see her finally putting her cooking and entrepreneurial skills to work in new and exciting ways. 

Natasha has enjoyed jumping back into Bible study with three of her local friends and one of the other surgical faculty wives. Recently, we have been studying stories of the miraculous works of Jesus and some of the well known parables. It's wonderful to see their hunger for the Word and to discuss how it is just as pertinent to our lives today as it was to the original audience. Please pray for this group of women- that the seeds of truth that are being sown would fall on good soil, that they would not only hear the words of truth, but truly understand, and that their lives will bear fruit. I, Natasha, have also been very blessed by this study. Studying the Bible in our context and culture (one that is much closer to what it would have been like in Biblical times) has made the Bible come to life in new and different ways.

In April, we had an opportunity to go to Greece for a medical conference and for a time of rest (and cooler temperatures) for our family. The conference was held on the island of Kos (the birthplace of Hippocrates).  It was put on by the Christian Medical and Dental Association and allowed us to learn and grow in our medical knowledge as the field of medicine is ever evolving.  We've already been able to put some of what we've learned into practice in our context.  One piece of information was actually used to help save the life of a surgical patient shortly after our return.  We are grateful for the organization of CMDE who not only values providing a well rounded medical conference for global health care workers but who also values providing spiritual care and encouragement. While at the conference, we were able to reconnect with friends and fellow co-laborers from our days in language school and hear about what God is doing in other parts of the world. After the conference, our family was able to enjoy some R&R by exploring some of the beauty of a few greek islands. The Bible came to life a bit more for our kids as we explored the ancient city of Corinth and some historical sites in Athens to include Areopagus Hill (Mars Hill). 

       

Some of you may remember the patient with a facial mass named Nafi that traveled with us to Kenya in 2023 for a surgical procedure.  There is another young woman whose face has been destroyed by a similar but larger non malignant mass.  We have once again worked with the team at Kijabe hospital in Kenya, and Natasha will be traveling with her in July for the operation.  The cost of her surgery and travel will likely be around $5000.  If you would be interested in helping financially with her care, you can give from the following link.  https://give.abwe.org/projects/togo-north-benevolence-surgical-care-beyond-mango

Prayer Requests:

Our Family: Praise for the Lord's continued work in our lives despite some challenges including the clutch going out on our van and a broken washing machine.  We continue to thank the Lord for the privilege of serving here in northern Togo.  Please pray for Natasha who will travel around July 21st to help get the patient to Kenya.  Please pray for the rest of us staying in Togo as well while mom is away.

Our Team: Our team had vision meetings shortly after our return to the field in March.  Please continue to pray for the unity of our northern Togo team.  We are blessed with teammates from a variety of backgrounds and giftings.  While this is a blessing, it can also be challenging when working so closely together.  Please pray as we continue to unpack the ways that God is working and ways to better minister together in a place with many stresses and challenges.  

Our PAACS Team: Our PAACS faculty comprised of the hospital here, HOH, and the southern Togo hospital, HBB, will be conducting interviews together for 2 more residents who would start in January of 2025.  This year we are interviewing 8 candidates from 4 different countries.  We spend a lot of time with these young doctors, and this can be a challenging decision with interviews over zoom in a limited amount time.  Please pray for wisdom to select the right candidates to invest in for the next 5 years. 

January 2024 Nattier News

     Happy 2024 to all of you! As we face a New Year, we are ever aware of our incredible team of supporters who continue to encourage us and enable us to do the work God has called us to do. Generally, our new year's post involves looking back at the high points of life and ministry for the past year.  We are excited to share those but also don't want to hide the fact that we have most definitely faced difficulties and challenges as well. We greatly appreciate your on going prayers in thanking the Lord with us for what He has done and will continue to do. While the challenges have sometimes felt overwhelming, we try not to dwell there too much.  That's honestly how we have learned to do life.  Celebrate the wins, and not dwell too much on the challenges or failures.  At times these challenges or difficulties aren't so easy to look past or move on from.  This phenomena of only showing the positive has been accentuated with social media, in that mostly the good things or best photos are portrayed leaving a skewed version of our own or others lives.  Honestly it's made the publication of this news letter more challenging than in the past, because we want to be real.  2023 had some high points, but it also brought with it difficult things as well.  Unfortunately, we can't share many of these in this format due to the sensitive nature- how it relates to colleagues, security risks, governments and systems, and the privacy of our patients and local friends.  What God has been teaching us from these challenges and difficulties is how to lament.  This year, the Psalms have been especially helpful, but in a different way from in the past.  We've been noticing how many times David was looking at the difficulty of life and his circumstances and crying out to God.  Let's just say, we don't have it all figured out yet.  However, we are learning from these feelings and circumstances, and have found a few helpful resources such as a book named Dark Clouds, Deep Mercy: Discovering the Grace of Lament by Mark Vroegop and Liturgies and Laments for the Sojourner by Alicia Boyce, Heather Falls and Tamika Rybinski. We would welcome the opportunity to meet with you face to face to share our life and ministry in more detail.    

    For those of you who we have not yet had a chance to chat or cross paths with, we returned to the USA the end of October.  We have enjoyed the opportunity to rest and spend the holidays with family.  Our last Thanksgiving with the Nattier side of the family was in 2015 due to Josiah's birth in 2020 which had us in the hospital over the holiday.  We have also enjoyed some cooler weather and celebrating Christmas with Natasha's family. 

   

    We are thankful for two new families that joined us in Togo this year, the Fergusons and Mupepes. They have been a great encouragement to us and helped make our break possible.  Despite the challenges, we have certainly seen God continuing to provide for us and the ministry in Togo in many ways.

    This past year, God has given us multiple opportunities to have meaningful and encouraging conversations with some of our Togolese friends. As we share Biblical stories and and converse about who Christ is and what He has done for us, we rejoice in new understanding and evidence that God actively at work in the hearts of those we've come to know and love and also in our hearts as well. 

    We praise God for opportunities to pour into several children that are near and dear to our family. Elliahna has been involved in a Bible study for young girls in our community and also had the blessing of tutoring a local friend in science and in math. It has been sweet watching their friendship grow and seeing how God is very much using our children in ministry as well. We also rejoice in the fruit we have seen as Gospel truths take hold in a child who is often in our home and playing with our children. 

     Also for those who have been following Nafi's story, please continue to pray for her and her family.  She is doing well physically.  Her healing and outcome are remarkable.  We also continue to pray for spiritual healing.  In addition, life and travel has become more difficult for her and others from her town due to increased terrorist activity.  Please pray for the country of Burkina Faso and the citizens who are suffering due to the continued instability.  Thank you to those of you who helped make her trip to Kenya possible.  In addition, we have two more patients with similar problems who need the same intervention.  One of them is young man from our city, Mango.  The other is young female who has a much more extreme tumor and is from Togo but a bit to our south.  We hope to have more information on potential feasibility and timing for surgery after our returning in March.   

    Since stateside, we have been able to connect with a local church here in Greenville, named Fellowship Greenville.  We have been attending here when we are in Greenville since 2020.  The past two months we were able to meet more of their staff and share in several ways what God is doing in Togo.  We are grateful for the increasing opportunities this has given us to connect and have community even in our short stents here in South Carolina and we are excited for this new partnership.

    This month we will be heading north on a whirlwind trip to visit several churches and friends in OH, IN and IL.  Here are some upcoming dates in case you are in one of these areas, we would love to connect.

January 21-23 - UBC Beavercreek

January 24th Englewood Grace

January 28th AM - Nine Mile, PM Salem Baptist  

    When we return to SC, Natasha and I are going to get away for a break and to celebrate our 20th wedding anniversary.  Then we head back to Togo the beginning of March.

Back in Togo the team welcomed our next two residents.  We are excited to meet them in person on our return.  This year our teams selected another resident from Cameroon, Arung.

We selected our first female resident from Rawanda, named Patiente.  

Please be praying for each of them as well as Sweni and Yannick for continued growth in surgical knowledge and in the Lord.  In addition, our PAACS program has now expanded to two sites.  Our sister hospital in southern Togo started with two residents on January 1st.  The two sites will give our residents a chance to learn from a greater number of faculty and varying hospital experiences.  Our two hospitals are under the same mission and in the same country but have a lot of differences in our types of pathology, people groups, and patient backgrounds partly due to geographic and cultural differences.   Please also be praying for our sister hospital HBB as they are undergoing a lot of changes this next year.   

Prayer Requests:

Our Family: Please pray for our remaining time stateside and good opportunities to share all that God is doing in Togo.  Also pray for the time to be restful and refreshing as we are away from some of the stresses that go along with life and ministry there.  Also pray for our return in March, especially for wisdom as we reengage in ministry.  Each time we return is a reset of rhythms and ministry.  We pray that God would show us how, where, and with whom to invest our time.  We never know how much time we have left to serve there, and we seek to use the time and talents wisely.     

Our Team: Please pray for continued water shortages.  This affects all of our expat and national team members, as it makes life and work more challenging.  Please pray for fruit and harvest in the ministry.  We see that God is at work, but there are impediments to our friends to follow Jesus.

Our PAACS Team: With the expansion of PAACS to HBB, our surgical departments at the two hospitals in Togo will be working even more closely.  There is a significant physical separation between our two sites, but we pray that this collaboration will be successful in spite of these and other challenges.  Please pray for the surgical faculty and residents at both sites.  Training, both medical and spiritual, takes work and intentionality.  We pray that these efforts would be profitable for our faculty and residents and that God would be at work and ultimately glorified through this work and in our lives.       

       

  

July Nattier News

As we sit to write another ministry update, we are excited to share that we have seen God at work here in many ways. First, we are overjoyed to update you on Nafi's surgery that happened this past February in Kenya.  We are so thankful for those of you who were praying for her and even gave towards her travel and surgery.  It was pretty amazing to see how God showed up in many ways during the process.  From little things like the visa finally being approved the night prior to our trip, to the ways we saw God give us grace during all the details of travel.  It was also great to see how our two PAACS residents and other Togo colleagues became a part of the team helping get her from Togo to Kenya and back. There was a surgeon there for the PAACS conference from Iowa who has extensive experience with these types of tumors and who was able to help with the surgery.  Nafi also had to overcome a significant language barrier given that her French was limited and Kenya is predominantly an English speaking country. But even in this we saw how God provided through an Anesthesiologist friend our ours from language school who spoke French, a PAACS resident working on the ENT service who also spoke some French, and  various others who helped in so many different ways.   We are very thankful for the opportunity to collaborate with a missions hospital in Kenya called AIC Kijabe.  They were extremely welcoming and even helped reduce some of the costs of the surgery.  Her surgery went exceptionally well, and maybe even better than expected.  Within 8 days of having surgery, she was able to walk on her own and return to Togo. This is incredible given that part of her surgery included removing a bone from her leg (the fibula) to rebuild her mandible. She is now back home with her family and 4 year old son.  We have had several visits from her and her family thanking us, and it has been a great opportunity to have some wonderful gospel conversations with them along with one of our chaplains who has been very involved in the whole process.  Please continue to pray for Nafi and her family.  Here is the most recent photo from when she came back to our hospital for a followup appointment.

 

The last 6 months have been very full with many high points and some pretty significant challenges and struggles.  While we would love to share with you some of these difficulties to pray for specifically, it is not possible to share in this format.  However, we would greatly appreciate your continued prayers for our family and the ministry here in Northern Togo.  We know that the Lord is at work here, but often that also seems to be met by spiritual attacks.  For this reason, Ephesians 6:10-20 is a great guide to prayer whenever you pray for us. 

During the first four months of 2023, the surgery department had some pretty significant changes.  We added our first two PAACS residents (Sweni and Yannick), who we introduced in our last update.  What a glorious answer to many years of prayer and preparation this has been. We also had two surgeons who were interested in long term missions join us for 4-5 months to do some additional training in areas like orthopedics. This was a huge blessing, and they were such a great help.  One of them, Dena Ferguson, will be returning in the fall with her husband Sam and new baby Lyla for a 2 year fellowship with Samaritan's purse.  We are very excited to have them joining our team and are anxiously awaiting their return!

The end of January, we had a team come from our sending church, UBC in Beavercreek, Ohio. They were able to participate in and experience many of the various ministries here.  They also helped us with our first annual PAACS Togo spiritual conference, which was a great time together fellowshipping and studying God's word. We are so thankful for the ways God allows us to partner with so many people from many different backgrounds to accomplish His plan here in Togo.  It was especially encouraging to have our worship pastor lead us in some pretty amazing times of worship at the retreat and even in our home! Our hearts were encouraged. Two members of the missions committee and our missions pastor were in the group.  Each of them was used in unique ways to minister here, and it really was a great example of how God gives us all different gifts to build up the body of Christ.  

The PAACS Togo retreat was a great opportunity to increase our collaboration with our sister hospital in southern Togo, HBB.  We have been working together to get the program started.  In January 2024 they will be welcoming two of the residents to their site.   Dr Jack Kehl and his family were with us in Kenya, and then spent the month of June with us in Mango.  It is exciting to be increasing our level of collaboration between the two hospitals.  Both have different histories and opportunities to grow the residents during their time in the program here.  Here is a picture of the 2 faculty from HBB, as well as our PAACS secretary (middle), who were able to join us for the retreat.

Finally, PAACS is a combined surgical training and spiritual training (discipleship).  For that reason, each year we will recognize the new residents with a white coat ceremony as well as a foot washing ceremony.  This was my first opportunity to participate in a foot washing ceremony, and it was encouraging to reflect on Jesus' example to his disciples during the last supper.  We wait in expectation to see how God is going to use these young doctors for His service.

We recently completed our interviews and rank list for residents in 2024. We will announce in our next newsletter who will be joining us this coming January.  

            

                    

While our surgery department stays busy, so does our maternity department. We provide care for a an ever growing number of pregnant women. I'm constantly amazed to see the large quantity of women gathered around our clinic rooms, and I find much joy in connecting with these women during their repeated prenatal visits. In April, we had a set of triplets born at our hospital. This patient showed up to our clinic, full term, having no idea that she was carrying multiples and by that night, all three were delivered safely and in good health. The mama and grandma were excited to plop a baby in the arms of three of my daughters who went up to the hospital with me to visit them. It was a sweet moment for us all. This month, we have been praising God for the safe deliveries of several "precious babies". Obviously, all babies are precious and gifts from the Lord, but a "precious baby" here is one who is born after a series of loses. We often have women who present in our clinic having had 4, 5, 6, or more losses and many only have 1 or even no living children. We've had several patients come to us lately who have had a string of late term losses with previous pregnancies, meaning the babies died in utero at the end of pregnancy or at birth. When we identify these high risk patients, we follow them much more closely, and in doing so, this gives us opportunities to share the gospel with them on a more personal level. One such patient had previously lost multiple full-term babies but was finally able to deliver a thriving,  healthy baby girl. We all rejoiced together, praising God for this special blessing. 

As we conclude this update, we wanted to let you know that our family will be returning stateside for a short furlough the end of October for 4 months.  We are excited to see many of you in person.  We will be doing some college visits with Elliahna among other events like the global missions health conference (GMHC) in November.  If you would like to meet up with us for a more personalized update, please let us know.  Our last trip stateside filled up very quickly, and we have no doubt that will be true this time as well, so help us get you on our calendar by reaching out to us. It's a great joy to have opportunities to update you in person on all God is doing here in northern Togo. As always, thank you for your continued love and support for our family and for the ministry here in Togo.

Prayer Requests

Our family: Please be praying as we make plans for the upcoming furlough.  Our oldest will be looking at and potentially visiting perspective colleges.  This will be her last chance to do that before she returns for college.  Please pray for us as we navigate this with her.  

Surgery: We are thankful for the two PAACS residents God allowed to join us here at HOH.  Please continue to pray for Yannick and Sweni as their training is challenging.  They are also away from their families and home countries which can be challenging as they both have significant responsabilities in their families.   Please pray for their spiritual growth as well as their growth in surgical skills and knowledge.  

Our team: Please continue to be praying for the security situation in West Africa.  With the recent coup in Niger, we do not take this for granted.  Please pray for wisdom and intentionality for the many ministry opportunities God continues to give during this time of relative peace and security. Also, many of you know that we have had significant water challenges for quite some time now. We ask for continued prayer for a more constant source of water and more stable power to run the pumps necessary to deliver the water to the various parts of town, including our hospital compound. 

December 2022 Nattier News

To all of our family and friends who love and encourage us so well, we hope this update finds you well.   We are very thankful for all of you around the world who support us in so many different ways and allow us to continue being part of the ministry here in Togo. We want to wish you a Merry Christmas and happy new year!  We aren't sending Christmas cards this year, but we did have a chance to update our family picture this past summer during our time in the US.  

Our time stateside was a great encouragement, seeing many of you and our family.  The three months passed extremely quickly.  One highlight was catching up with some of our supporting churches, and in particular our sending church UBC in Beavercreek, Ohio.  We were able to work with them on planning a team who will be coming here in January 2023!  We hope this will be the first of many, and that some of our other supporting churches might also come and be a part of the ministry here in the future.  

In addition to the team coming in January we have many things happening here in the next few months.  In just a few days, we will be welcoming Bryce's sister Aimee and her family and are greatly look forward to celebrating Christmas and New Years with them here in Togo.  Another great excitement and long awaited answer to pray is that our PAACS program (5 years of surgical training and discipleship) will officially begin on January 1st.  Our first two surgical residents will arrive in Togo a few days after Christmas.  We are waiting with great anticipation for this opportunity to invest in the lives of these young men and women.  This year we selected two residents.  One of our residents Yannick did his medical school in Congo.  He is recently married.  His wife is completing her medical school education in the Congo and then plans to him here in Togo.  

Our second resident for 2023 is Sweni.  He is coming from Cameroon where he did all of his medical training in English.  Since Cameroon is a bilingual country he also speaks French. 

 

We would really appreciate your continued prayers for this program.  It has great potential, but it is also a large undertaking.  We pray that God blesses and uses this program to accomplish great things for His glory.   

We would like to highlight a special opportunity for giving for those looking to make an end of year gift.  We are starting a surgical benevolence fund for cases that could be helped by a surgery that we cannot perform here in Togo.  My first year in Togo, I (Bryce) met a young women that had a very advanced mass extending from her mandible.  It was very difficult telling her there was nothing we could do.  At the time, I believed this was likely a malignant tumor of the bone.  Over time, I've learned that some of these masses are a benign tumor, called Ameloblastoma, that is very destructive. These occur in the US as well, but are normally caught early, and can be resected completely prior to invading the mandible (jaw bone).  Here in Togo with limited dental care, these masses are often not caught until they have invaded the mandible and are quite large.  Here are example pictures of two of our patients below.  

The first picture, was a young female (Nafi..). We were able to help her this past year by resecting the mass because it hadn't yet crossed over the midline. The second picture shows one of our patients who we were not able to resect, because it had clearly crossed over to the other side.  If we do a resection without reconstructing with bone from either the ribs or often the fibula, these patients would have a loss of the facial contour and difficulty eating, swallowing, and talking for life.  It's referred to as a "Gump" deformity, and it can be pretty severe.  I originally learned about the treatment of these tumors in 2018 from a surgeon named Dr. Peterson. He is an ENT that has worked at multiple missions hospitals.  He has since gone back and done training, so that he can do free flap reconstruction with Fibula from the leg.  It requires doing a microvascular anastomoses (connection) of a vessel from the leg to a vessel in the neck.  He is currently working at a missions hospital in Kenya called Kijabe hospital.  

Nafi recently came back to see me again in clinic, and we realized the tumor had come back.  Unfortunately, it was more advanced than we realized initially, and has returned now crossing the midline.  We reached out to Dr. Petterson and he has agreed to care for her there in Kijabe.  However, there are many logistics to be worked out, like getting her a passport, plane ticket to Kenya and then transport to the missions station.  She also doesn't speak English or even a lot of French, which will make things a bit challenging.  Our family was already scheduled to attend a conference for the PAACS residents in February of this year,  and the conference center is less than an hour from the missions hospital. We are hoping to take Nafi with us when we go. 

Nafi is 24 years old and has a young child who is 2.  When I told her we couldn't resect the recurrence here at our hospital, as you can probably imagine, she was heartbroken. However, she was overjoyed when we told her of this opportunity in Kenya.  If you would be interested in giving to help with the expenses it will take for Nafi to get to Kenya and back, as well as some of her surgical expenses, Click the blue giving link here if you would like to give and help make this possible.  We are excited to see what God is going to do through all of this.  We are also hopeful that this might be an opportunity for others, like the second young man pictured above, to receive the same needed surgery that is not available anywhere in this area.

Prayer Requests

Our Family: Please pray for our families physical health as we have been battling multiple illnesses these past few months, maybe like some of you stateside.  Also pray for stamina for us, as these next few months will bring a multitude of challenges and changes.

Our Team: Please pray also for our team, which has also experience many changes like a new team leader.  Pray also for us to grow in unity with the addition of several new teammates.  Within our surgical team we have some African surgeons trained by PAACS at other sites who are considering joining us in the work here.  Please pray for them as they are processing where God would have them serve.  

Surgery: Please pray for our PAACS surgery program that starts in a few weeks.  There is still a lot of prep and details to be worked out.  We pray that God would be at work and glorified in this training program.  Please also pray with us for Nafi, that her surgery would be possible and successful.  Also pray for her to to see and understand the love of Christ.

  

  

April Nattier News

It's hard to believe we are already in April.  2022 has been our busiest year of work and ministry since we arrived here in Mango.  We are grateful though to be part of what God continues to do here in northern Togo. 

We wanted to share with you an answered prayer since our last newsletter.  We were praying for a nanny to watch Josiah and Mélyna, so that Natasha could continue working in women's health.  As we were praying,  the Lord brought to mind a woman we met when she brought her son into the hospital for a severe medical problem.  We saw the way she cared for her own son who is now doing very well after a couple of surgeries.  Before we left for furlough, she asked us if we knew of any work for her. At the time, we did not, but little did we know that God was already at work orchestrating an answer to both of our prayers.  Upon our return, we reconnected with her and offered her the job. She accepted with joy and gratefulness.  She moved from the city to our north and has been caring for Josiah and Mélyna since November.  The kids love her dearly, and she loves our children as if they were her own.  Her son has become one of Melyna's best friends.  We helped him enroll in the christian school that was started here in Mango last year.  He is thriving in school and was the top in his class this past quarter.  

Natasha has been staying busy as we've had several visiting ob/gyn surgeons since the start of the year.  One of her patients that she has been caring for since she started doing women's health is a friend of ours. She and her husband got married around the time the hospital opened.  They had been trying to conceive but had been unsuccessful.  After several years of infertility consultations and various treatments, heartache and yet hope that our God indeed had a plan far bigger than what we could comprehend, it is in many ways a miracle that she has been able to become pregnant.  She is due in September, and we are praising the Lord for His answered prayers and this miracle child! 

Bryce was chosen to be the medical director for this year.  In addition to the surgery work, he has been working to improve and update the systems that are in place in the hospital ministry.  After 7 years, the hospital has changed and grown with new staff and more patients.  We really have a great team to serve alongside, and God is at work in our midst.  We have had many colleagues leave permanently and temporarily the past 6 months.  Others are scheduled for furloughs this coming summer.  One of the biggest challenges most missions hospitals face is how to maintain adequate staffing, especially of medical providers (doctors, PAs, NPs).  This year we hired the first Togolese doctor at our hospital, a new graduate from medical school.   It's challenging to find people who are willing to leave the capital, the big city with access to most things, and come to the far north to work here.  He was an answer to prayer, but it has also helped us to realize the need to consider staffing now and for the future.    

We have been praying for several years about training medical doctors at our hospital to become surgeons.  There is a program that was started in Africa to train surgeons for Africa.  It's called the Pan African Academy of Christian Surgeons.  There are currently surgery training programs in 9 countries.  Only a few of these are French speaking programs.  The program involves 5 years of training and discipleship of christian doctors to become surgeons.  In February our team voted to pursue a partnership with PAACS.  PAACS accepted our application, reviewed our site, and we are awaiting final approval at their upcoming board meeting.  Please pray for wisdom for all parties involved as we seek to move forward with this new avenue of ministry and training.  

We also wanted to let you know we will be returning stateside for a brief 3 month break in July.  As we've reflected on life and ministry, we are hoping to try and take breaks in this way approximately once a year.  We hope to see many of you, but it will be a little more challenging as 3 months will pass quickly.  Please let us know if you would like to connect while we are stateside, as we are still planning our time.  

Prayer requests:

Our family: Prayers for wisdom as we plan our 3 months stateside (July, August, September). Also, we will be in need of a vehicle large enough for our family of 8. Please pray with us as we seek out a solution to this need. Vehicles, especially large ones, seem to be extra expensive and in short supply these days.  

Our Team: URGENT NEED: We have a thriving MK school here, but we have an urgent need for a teacher this upcoming year. One of our two wonderfully gifted teachers will be permanently returning stateside to take a different ministry position. While we are happy for her to fill this new role, we are fervently praying for the provision of a new teacher to help educate and pour into the lives of our precious children. If you are interested or know of someone who might be a great fit for this role, please let us know or contact Amanda on the photo below.  Additionally, please continue to pray for wisdom for staffing and our potential partnership with the PAACS.

Ministry: Please continue to pray with us for a couple of surrounding villages where the ground has been hard and there are still no church or Bible studies.  Also pray with us for our Muslims friends who are currently in Ramadan.  This is a time during which they are seeking God, and we pray for increased sensitivity to the hope found in the Good News.

September Nattier News

Lamentations 3:22-23 NIV

Because of the Lord’s great love we are not consumed,

    for his compassions never fail.

23 

They are new every morning;

    great is your faithfulness.

We arrived back in Togo on September 1st.  It was really quite an interesting experience this time around.  This obviously wasn't our first time in Togo, so we recognized the airport and the process of arrival.  However, some things had certainly changed.  There were new Covid protocols, could pick up a free cell phone SIM before customs, and many others.  One of the changes was actually quite nice.  The bag handlers had all of our bags put on carts and ready for us before we even finished going through customs and having our arrival COVID tests.  This was really just the tip of the iceberg of the things that have changed since we left Togo about 14 months ago.  Some of the these changes are quite visible, and some of them are not.  Some of these changes have been here in Togo, and some of them have been in us as well.  For example, instead of being a family of 7, we are now a family of 8 (the addition of Josiah Murry Nattier).  For whatever reason, the stark differences between our passport country (USA) and our home country (Togo) were really vibrant this time around.  

When seeing changes around me, I'm often reminded of a saying I've heard many times, "the only thing that is constant is change".   Apparently, this was originally written by a Greek Philosopher named Heraclitus.   Though I would actually disagree with Heraclitus, because the Bible teaches that God, our creator, doesn't change, is immutable.  Therefore, the verse above from Lamentations has been a great comfort to me over the years, because I know that I can count on the Lord's unchanging compassion and faithfulness. It's new every morning to me who is constantly being changed and effected by the changing world around me.  I'm so thankful for truths like these from scripture, that help us to navigate this ever changing world.

Since, it's been a while since our last update, we wanted to try to hit some of the high points of our past year stateside.  We were blessed to be able to reconnect with our sending church, University Baptist Church.  It was awesome to see all that God was doing there even in the midst of the challenges of the pandemic.  We were able to travel to the southwest for Spring break and see several supporters, friends, and family along the way.  Our summer months were quite busy with opportunities to share at various churches in the midwest and southeast about what God is doing here in northern Togo.  We had the unique opportunity to participate in a conference specifically about the medical work at the two hospitals in Togo that was held in Indianapolis, IN.  We continue to be amazed how God works out these many details, and weaves our lives together with many of you.  We are so thankful for these opportunities to be together with you in person.  We were also blessed for several times to reconnect with our family stateside.  Our family had grown significantly since we had left the country and even more this past year while we were stateside.  Our own family continued to grow as we welcomed Josiah in November.  This restricted our travels a little bit during the winter months as we adjusted to being a family of 8.  However, the pandemic certainly shaped our time and travel more than anything and much more than we could have anticipated.   As a result, we certainly did not have a chance to see everyone we had hoped.  

We did recently get our prayer card updated with our two newest children.  (A long overdue project).  We will be working to get them mailed out in the near future.  We are planning to send some to our monthly supporters and supporting churches.  If you would like one and are not in one of these two groups, let us know.  

Our return to Togo was complicated by a 2 1/2 week quarantine after one of our kids tested positive for Covid upon entering the country.   This was actually a lot more stressful than I would have imagined, mostly due to the chance of an extended quarantine with 1 person testing positive after the next. We are very thankful that this was not the case.  We were also thankful for the help and support that our team here in Togo gave us during this time!  Both Bryce and Sofia's birthdays were spent in quarantine.  The day after Bryce's birthday, we finally got the all clear with negative tests for everyone.  It was a great birthday present!  

Greetings are an important part of life here in Togo, so it was difficult to have to put this off for our first few weeks.  What a blessing it has been to be reunited with our colleagues and friends.  They have carried on the work with endurance while we were stateside.  It really takes a team to work here, and we are thankful for the ways God has blessed us in that way. We are also cognizant that we are not necessary here for God's work to continue. But what a privilege and blessing it is that He has chosen to allow us to be a part of what He is doing here. 

Since we left with 5 children and came back with 6, it has been a great joy to introduce Josiah to our friends!  Here is a picture of Josiah and our friend who is also responsible for keeping our motos in working condition (he makes house calls quite often). 

Prayer Requests: 

Our family - Please pray for us as we get settled back here in Togo.  We are once again trying to find a healthy and sustainable rhythm for our family.  Bryce has already started back to work in the hospital.  Natasha has been working to get the kids settled in a school routine and tackling the many household tasks that are often different here from those stateside.  Please pray with us for a nanny to watch Melyna and Josiah, so that Natasha can return to work in the near future.  

Our team - Several of our team members will be transitioning away from our hospital ministry, and this will leave some major holes.  Please pray with us for more workers to help us to carry on the ministry here.  Please also pray for wisdom for our team as we work on establishing a leadership structure and vision for the future.  

Water - Our team is still searching for a sustainable source of water for the hospital.  There have been at least 5 attempts at wells here with very limited production from only one.  This was a major problem last year during dry season which is quickly approaching once again.  Please pray with us that God would provide a solution.