Our minds weren’t set, but they were open. In many different areas of our lives, we felt an increasing tug of our hearts toward Africa.

Henry Blackaby wrote in Experiencing God Day-By-Day, “Our Master commands us to ‘go.’ We need permission to stay!” Was God asking us to go long-term? Short-term? We needed help answering that question.

Ken and I both wanted to explore opportunities to serve The Wesleyan Church in Africa through their international ministry, Global Partners.

Early on August 6th, two months after our original conversation,  we participated in a Skype call with Bob Bagley, the Global Partners Area Director for Africa, to learn more about the areas of need in Africa, and how we might be able to fill those needs.

Immediately, I was impressed with how clearly and compassionately Bob understood our unique family dynamics, and the gifts that we bring. In order for Africa to be a good fit for our family, we would need:

1. A place where Ken would have easy access to internet and transportation, so that he could help with the French-speaking churches of Africa, and with business management.
2. A place where the kids could attend international school. Boarding school wouldn’t be a good option for our family, and homeschooling might limit our ability to build relationships, especially for our kids, who have already had to make new friends many times over in their short lives.
3. A place where I would be able to find needs and be able to fill those in the medical field. Physician assistants are not able to practice medicine in all countries, so I cannot just move anywhere and use my skills in medicine.

In advance of our conversation that day, Bob had already thought through all of these complex issues for our family, and suggested the country of Ghana.

Ghana is an English-speaking country that has many international schools that could be excellent options for our kids. Though Ghana is a Christian country, the northern part of Ghana and its northern neighbor Burkina Faso are predominantly Muslim — and this is where the church is rapidly growing! There are many churches being planted in northern Ghana and in Burkina Faso whose pastors need mentoring, training, and encouragement.

Overall, Ghana also has a tremendous need for medical providers, with a ratio of one medical provider for every 10,000 people. In southern Ghana, there is even a clinic run by The Wesleyan Church. In northern Ghana there are fewer medical resources and the ratio is one physician for every 93,000 —  the needs are critical.

At the close of our conversation, Bob recommended two things: that we consider taking a vision trip to Ghana and Burkina Faso to see for ourselves what God is doing in Africa, and to begin to fill out our applications to become long-term missionaries.

As for the trip that we spoke of with Bob in August, we are leaving for that very vision trip this Friday, October 24th. Ken will be preaching and meeting with several of the new pastors in the area to encourage them, and I will be seeking opportunities for creating sustainable health practices in Ghana using networks of the local church to address medical needs. We are excited to see what God is doing in West Africa, and to explore how God might use our family in this part of His kingdom!

Things are just about to get very interesting.

After nearly two months of praying, considering, seeking advice, Ken and I decided to start talking about Africa. Had he been hearing from God in ways that I had?

Honestly, no. Ken’s primary concern was for me. The funny thing about Ken and me is that we always worry more about the other person. I love the fact that my husband protects me more than I do myself. And in this case, he was worried about me, and more specifically, my lungs.

As many of you know, I have suffered from asthma since 2004, shortly after I moved to Tennessee. I’ve had up and down times, but it’s been manageable as an outpatient. It’s been mostly more of an annoyance than anything, but sometimes it’s been more. I’ve always had the medications and tools to manage it myself, and I’ve learned how to juggle all of the medicines and titrate them appropriately. But how would my lungs adjust to Africa? Last time we were there, they did great, but Africa is a big place.

Along our journey, God has spoken to each of us through this Scripture passage:

Luke 17:11-14 HCSB

¹¹ While traveling to Jerusalem, He passed between Samaria and Galilee. ¹² As He entered a village, 10 men with serious skin diseases met Him. They stood at a distance ¹³ and raised their voices, saying, “Jesus, Master, have mercy on us!”

¹⁴ When He saw them, He told them, “Go and show yourselves to the priests.” And while they were going, they were healed.

In this passage, it is interesting that Jesus didn’t heal the ten men with skin diseases (lepers) right away, as He had with so many others. Instead, Jesus asked for their obedience, and then their healing came along the way. Now, because the ten lepers were considered unclean, there really was no justification for them to go see the priest, unless they were already healed. So to even begin their journey as men with leprosy, they had to have enough faith in Jesus the believe that their journey would end without leprosy. Then the priest would declare them “clean” and they could rejoin society. The healing only took place while they were taking steps of obedience in faith.

Sometimes God uses the very act of our obedience as the means of our healing.

We both decided to commit my asthma to God for healing.

“So,” I asked Ken, “If my lungs were to not be  a factor, what would you want to do?”

“I would go to Africa in a heartbeat.”

It was time to start making phone calls, trusting in God’s healing along the way.

Oh, and if you’re wondering, I am now off of all asthma medicines for the first time in more than 10 years.

Ken and I were both disappointed in each other for not responding to the altar call.

Wait. Disappointed?

Did we both each really want to move to Africa instead of taking the easy path of staying put in our new home in North Carolina? Were either of us hearing God’s call, but waiting for the other to have the same clarity? Can God call a person through their spouse?

The only way to sort this out was to pray and let the Holy Spirit do the sorting.

For many years, Ken and I had decided that when it came to important decisions to trust the Holy Spirit to bring us to agreement. In fact, for years, I wanted children, and Ken didn’t, until God changed Ken’s mind. On important issues, I don’t want to convince Ken to do something he is resistant to doing, so I don’t. I trust that the Holy Spirit will bring us together as we each follow Him. So my prayer for us is that God would always make our hearts one, especially on big decisions.

So we didn’t talk about moving to Africa a lot — to each other. We read Scripture, we consulted other believers who have walked similar journeys, used our God-given reason, and waited.

For me, issues of social justice have long been close to my heart, and it has made its way into my home through two adorable African children who have opened my eyes to not only parenthood, but the world. Biblical social justice has also heavily influenced my approach to the classroom. One day as I was preparing for a class, I came across a really interesting interactive page on the website of the World Health Organization. It details the person to physician ratio in every country. (Give it a try!) What I saw was mind-boggling.

There is roughly 1 physician for every 400 people in the United States. In the Congo, it is roughly 1 to 10,000. In fact it is the same or worse in most of sub-Saharan Africa. In Liberia, there is 1 physician for every 72,000. How can one physician treat so many patients under normal circumstances, much less during an Ebola epidemic? Note that the countries below in yellow below have fewer than 1 physician for every 2000 people. Do you notice a geographic trend in healthcare shortage? I did, and my heart sunk. Why had I never seen this before?

Then one day, riding in the back of the van, Palmer asked me, “Mommy, why are there so many doctors in America, and none in Africa? My baby brother died because there weren’t any doctors.”

Any answer I could come up with sounded hollow. “Doctors don’t make enough money in Africa, so they stay here or come here after being trained in Africa,” or “Many places in Africa don’t have the right kind of schools to train doctors,” or “People cannot afford to go to medical school there.” Ultimately, I knew what the Holy Spirit was asking through my son was: Why am I here, when there is a much greater need in Africa?

“If someone has enough money to live well and sees a brother or sister in need but shows no compassion–how can God’s love be in that person? Dear children, let’s not merely say that we love each other; let us show the truth by our actions.” — I John 3:17-18 NLT

“Then they too will answer, ‘Lord, when did we see You hungry, or thirsty, or a stranger, or without clothes, or sick, or in prison, and not help You?’

“Then He will answer them, ‘I assure you: Whatever you did not do for one of the least of these, you did not do for Me either.’

“And they will go away into eternal punishment, but the righteous into eternal life.” Matthew 25:42-46. HCSB

“But be doers of the word and not hearers only, deceiving yourselves. Because if anyone is a hearer of the word and not a doer, he is like a man looking at his own face in a mirror. For he looks at himself, goes away, and immediately forgets what kind of man he was. But the one who looks intently into the perfect law of freedom and perseveres in it, and is not a forgetful hearer but one who does good works—this person will be blessed in what he does.” James 1:22-25 HCSB

I could not forget what I had heard. I could not forget what I had seen. I could not forget that my children lost beloved family members because of the disproportion of healthcare workers around the world.

And I was one of those healthcare workers.

At the same time, there is no easy solution. If I go for one week, two weeks, or more and only see patients, it will still be only a drop in the bucket in a continent dealing with desperate medical needs. Could there be a better solution? A more sustainable solution?

With my years of teaching in medical education and my love for the church, God began to create a vision in me for how He has already uniquely gifted me to serve the people of Africa.

But would anyone let me do it? Would people think I was crazy for even wanting to pursue healthcare in West Africa? Was God calling me long-term or short term? What about Ken? How was the Holy Spirit speaking to him? What would the children think? Was God speaking to them too?

After a whole month of not talking to each other about it, Ken and I sat down to talk about how God was working in my life, and in his.

And then it would be time to talk to the children.

Ken and I took a full a week to even speak about our conversation with Bob Bagley. Ken had laughed it off as an impossibility. I was afraid that it wasn’t.

Riding home from East Gold Street Wesleyan church the following Sunday, the ice was finally broken. We were discussing attending North Carolina West District Conference to try to make connections in the hopes that Ken could transfer his ordination from the Nazarenes back to the Wesleyans. The District Superintendent would be there, as well as Jo Anne Lyon, the General Superintendent. The speaker for the night was Dennis Jackson, Executive Director of Global Partners.

Ken and I had both been familiar with Global Partners for years. Ken’s college roommate, Peter, was the Director of Operations, and Ken had participated in numerous mission trips with the organization. I had been working with Global Partners for three years in mobilizing physician assistant students to do international rotations, in the hopes that exposure to the world’s shortage of medical care and theological teachings on holiness would inspire students to pursue mission work as a career and calling.

The physician assistant programs in which I have taught have been Christian programs, each with an emphasis on raising up medical missionaries. While each program has sought out applicants who have a desire to serve the poor, the number who actually became long-term missionaries was low in one program (2 in 10 years) and the other program is so new, it has yet to graduate any students. I have begun to feel wildly unsuccessful in regard to mobilizing medical missionaries, in spite of the word’s great need. Students have come to my programs wanting to do good, and the vast majority of students have left the program wanting to do well. The lure of paychecks and the skyrocketing school debt leave many hopeless that missions is a possibility for them. I don’t blame them, but I mourn my lack of success of being able to produce missionary medical providers. When I have pleaded with God to send me, the God’s answer has always been that some people are called to be “go-ers” and some people are called to be “senders.” God had put me in the senders category.

As the conversation turned to going to hear Dennis Jackson, the subject of our conversation with Bob Bagley, who also serves with Global Partners, came up.

“Wasn’t that crazy that Bob straight up told you he needed you in Africa?”

“I was wondering if you even remembered that,” Ken replied.

Remembered it? I’ll never forget it. As Ken and I talked about it, we reviewed all of the reasons why moving to Africa was a bad idea. We just bought a house, we had moved only weeks prior, our kids have unique educational needs, we have two dogs that we would have to leave behind, I still have school loans, we don’t like raising money, our last trip to Africa had been less-than-ideal, our kids may not want to go back, I just started a new job, and the timing couldn’t be worse. The list was pretty long. But nothing on the list was bigger than God.

A life of sanctification means giving God the power of veto on anything. God had called both of us when we were young to live lives of total surrender to God, and now that commitment was being challenged. Ken and I agreed that we had to at least be open to hearing the call of God on our lives. But was it God calling, or Bob Bagley asking?

The next night, Ken and I found ourselves at North Carolina West District Conference with the kids in tow. The music was moving, the atmosphere spirit-filled, and Dennis Jackson’s words were challenging. The phrase that I’ll never for get is, “We find that the best people to raise up other missionaries are missionaries themselves.” This should not have been a profound thought to me, but it was. All these years I have been trying to be a sender without ever being a go-er. But I’ve never been called to be a go-er. Was God now releasing me to go?

Finally, the moment came: the altar call. The music played softly. In a powerful moment, Dennis broke a snow globe on stage, challenging us all to break out of our tidy lives and ask if God was calling us to serve on the mission field. I waited for the prompting of the Holy Spirit — the compulsion to go forward, the pounding heartbeat, the mild nausea, the “Holy Spirit sweats” but they never came. Instead, I stood there thinking how much I thought KEN should go forward. I thought to myself, “Why isn’t Ken going to the altar? Didn’t we just talk about this? Ken is so gifted in so many ways — preaching, teaching, administration. Did Ken not hear Bob Bagley say that he needed him in Africa?”  Though strong, I resisted the temptation to give Ken a little push out into the aisle.

And then it was over. The lights came up, the service was dismissed. We socialized. We stopped by Five Guys and bought some burgers for the road.

The ride home was quiet, until the silence was broken by Ken. “Robin, I was really surprised that you didn’t go forward tonight during the altar call. I know God could really use you in Africa.”