Kyle and Abby Carter's* missionary journey began in typical fashion. Their home church, Houston's First Baptist, sent them; the International Mission Board (IMB) trained them; and then a string of connecting flights deposited them in West Africa, where they received additional training.
By April 2012, the Carter family arrived at their post in East Africa, committed for the long haul. They had surrendered their lives to serve as ambassadors for the Lord and knew they were the only missionary presence among a people group of 1.8 million.
With their 18-month-old daughter, Ruthie, they left every familiar thing behind and assimilated with new neighbors. Their love for the people of Africa had drawn them eastward, and their training had prepped them for the hardships of missionary life in Africa — a life the couple says was their dream.
Just a few short months into their work in Africa, though, the dream became more of a nightmare, as trial after trial descended upon their small family.
Within two weeks of arrival in Africa, Abby, who had recently found out she was expecting the couple's second child, Jonah, contracted malaria. Soon after that, Ruthie also became ill with malaria. Because of the sickness, IMB moved the family to a larger city for a time. By the time they made it to their target village in East Africa, Jonah was five months old.
Within six months of arrival in the village, Abby contracted malaria six times and typhoid once. She just could not stay well. During a two-week trip back to the United States, the couple discovered they were expecting a third child. The continued sickness and the pregnancy prompted the IMB to move the Carters to South Africa and out of the malaria zone.
Abby, they said, would not be able to return to their home in East Africa and could not re-enter a malaria zone, so what began as a two-week trip became a forever goodbye. Kyle returned to the village, packed up the family's belongings and moved them to the Carters' new assignment in South Africa. The frigid desert climate contrasted starkly with the lush tropical weather of East Africa, and the abrupt change left the entire family stricken with pneumonia within the first week of their arrival.
The spiritual climate change was just as evident, they said. Where the people in East Africa had been warm and friendly and open to conversation, the South African people did not welcome interaction and had a much heavier involvement in spirit worship.
"One time a 10-year-old girl was playing UNO with me on my floor, and she was like, 'Oh, I've got to go. I'm the spirit drummer. I've got to lead the spirits back to the graveyards tonight.'" Abby said.
Ten weeks after their relocation to South Africa, the Carters trekked to Johannesburg for medical check-ups. While there, Kyle dislocated his knee, sending him to the hospital where doctors placed his leg in a cast he would wear for 10 weeks.
At the very same time, Abby had been at an obstetrician check-up. During her appointment, doctors became concerned that something was "not quite right" with the pregnancy and decided to keep her for additional testing that week.
Between the pregnancy concerns and Kyle's knee, for which he would have to visit the hospital three times a week, the family and IMB agreed the Carters would need to stay in a missionary guest house in Johannesburg for the time being instead of returning to their village four hours away. The three-day trip eventually turned into an eight-month stay as medical concerns continued.
A Turn for the Worse
"We thought we were just going to get Kyle off of crutches, and we'd go back and finish up, and things would be great, but then things just spiraled with the pregnancy," Abby said.
"They were telling us everything from the baby didn't have a stomach, to the baby didn't have a brain, to the baby isn't going to live. It was always back and forth. We'd get a good report, a bad report. A good report, a bad report."
The baby, a boy the couple named Andrew, was born prematurely through a difficult delivery.
"We could tell he was in severe distress," Abby said. "I'm a nurse by trade. We could tell that something was really, really wrong."
Yet, once the baby was born, the midwife put him in pajamas, handed him to Abby and said, "You just need to feed him. He'll be alright. You just need to feed him." And she left.
All of the sudden Abby and Kyle were alone with their struggling infant, not having slept in about 48 hours. Not being in a hospital, no nurses were on site to check on them or to help care for either Abby or Andrew. Kyle decided to take him to a neonatal intensive care unit only to be turned away and told, "We don't babysit." He returned and tried again with a new nurse, and this time Andrew was admitted.
"She took Andrew and knew something was wrong," Abby said. "Two hours later I was woken up, and it was the doctor at the edge of my bed saying, 'Your baby is on life support. If you want to see him, you should probably come now.'"
Abby and Kyle say the scene that awaited them was a "parent's worst nightmare." Andrew had been put in a medically induced coma and had tubes and cords all over his tiny body. Doctors told Abby and Kyle that Andrew was born septic and with bilateral pneumonia. For the next four months, Abby remained at the hospital, rooming-in with Andrew, while Kyle went home with the other two children.
"It was a lot of dark days in the NICU," Abby said.
During that time, Andrew would have glimmers of hope when it seemed he might be getting better, but those moments were short lived as he returned to life support repeatedly. At one point when Andrew developed respiratory syncytial virus (RSV), the hospital cleaned out a closet to make an isolation unit for the baby. One nurse was spared to staff the closet where Andrew lay. When it became apparent he needed to be intubated—a task that requires several hands—the nurse looked at Abby and asked if she could bag and suction. Being a registered nurse, Abby knew what to do and was able to help the nurse, all the while bearing the searing pain of a mother watching her child suffer and bleed.
"After that, things just really started to go downhill," Abby said. "It was like every week on Thursday, another system would crash. He started having seizures, he went into heart failure, and then his kidneys started shutting down. They told us to prepare to lose him."
The Carters planned for a funeral. A family friend knitted a burial blanket, and Abby's parents flew to Africa from the states to say "hello" and "goodbye." They were sure Andrew's short life was near its end.
Hope Peeks Through
During this dark time, the Carters were overwhelmed with prayer letters, thousands of Facebook messages and calls from IMB, including one from then-president Tom Elliff. The support shocked them, the couple said, and also gave them opportunities to be a testimony to the nurses working with Andrew.
Miraculously, Andrew's condition began to improve, tiny bits at a time, even allowing his grandparents the chance to see him outside of the hospital for one day. Perhaps there was still hope.
Doctors diagnosed Andrew with Costello Syndrome—an extremely rare illness affecting only 200-300 people in the world. They were unsure what exact care he would need but were certain he would have long-term disabilities. After much thought, prayer, deliberation and finally a diagnosis for baby Andrew, it became clear to the family and to IMB that they could not remain on the mission field hours away from medical care.
"We fought so hard to stay in Africa," Kyle said. "That was our dream, to go be missionaries on the field for the next 20-30 years."
But it was clear that Andrew needed more care than the hospital in Johannesburg could offer. With two weeks to gather their belongings and make arrangements to return to America, there was not enough time to return to the village. As the two weeks passed, though, Andrew could not stay well enough to travel. Soon, it became evident that the only way for him to get back to America would be by air ambulance—something that would cost around $300,000, which appeared too far out of reach.
In the Lord's economy, though, it was comfortably within grasp.
"About that time, it was right after the 2012 Lottie Moon offering [had been taken] that was just a record high," Abby recalled. "Everybody had been shocked at the upswing that year. It came through that there would be money and not to worry about it. We got a call from Dr. Elliff saying, 'Money's not an object. Don't worry about it. We're getting this baby home.'"
The family was overjoyed and overflowing with gratitude.
So, Abby put Kyle and the other two children onto a commercial flight and prepared for the air ambulance to pick up her and Andrew the next day. Yet again, however, Abby got a phone call saying Andrew had crashed, was back on a ventilator and that it didn't look good. When the air ambulance arrived the next day, the crew said they were not aware of how sick Andrew was and that they could not take him. So, they turned back around and left.
"At this point, I'm at the hospital, my room's gone at the guest house, my car's been turned back in, I don't have a cell phone, and my only hope just walked out the door," Abby said.
"I couldn't call Kyle because he was still traveling, and he wasn't going to have an American cell phone after he landed for 12 hours anyway. It was just the worst feeling in the world. It just shattered me."
A friend who happened to be in Johannesburg helped Abby find another place to stay and a car while Abby and the medical team worked to get Andrew healthy enough to travel and to find someone willing to fly him home. Three weeks later, it seemed both Andrew's health and a willing flight crew may finally be in sync. A South African flight crew flew Abby and Andrew to Houston, where Kyle was waiting on the tarmac for his wife and baby. It was a very happy reunion, Abby said.
Andrew stayed in the children's hospital in Houston for another month, where doctors diagnosed a floppy esophagus as the culprit for some of Andrew's medical issues. The Costello Syndrome, however, was not so easily fixed and will likely remain with Andrew for the rest of his life. Because of the Costello Syndrome, Andrew is legally blind, in heart failure and unable to sit up, though Abby said he is learning that now. She said this Christmas marks one year since Andrew has had a seizure — something she counts as a precious Christmas present.
A New Mission Field
While their hearts ache at having to leave the mission field and the people they grew to love, especially without the chance to say goodbye, Abby and Kyle said God has been faithful to bring Africa to them. Now living in North Texas, the family is involved in refugee ministry where they are able to work with African people, speak with them in Swahili and help them get aquatinted with their new American homes and lives. They pray that someday they'll be able to return to Africa, perhaps doing business as missions, but for now, they're content to serve as missionaries among their current neighbors.
Both Abby and Kyle agreed that they want to fight against getting caught up in the busyness of American life in a way that hinders them from sharing the gospel and ministering the way they made a point to in Africa.
"[The Lord] asked us not to become too settled in America," Abby said.
She and Kyle said they think a lot about what it means to be "missional" in America and want to be faithful to follow the Lord wherever he leads them—be it Texas or Africa. Recognizing that there are no missionaries among the 4 million people in South Africa where they were last stationed, Kyle and Abby pray that God would raise up workers to water and reap where they planted.
Abby says that these days, as she sits and rocks Andrew, she remembers that it was other people's money that brought him back. If they would have remained in Africa and could not return to the states, it is very possible Andrew may have died there. Instead, she has a 2-year-old, curly-headed little boy to hold and love in Texas. For that, Abby says, she wants to say a "huge thank you" to those who gave and give to the Lottie Moon Christmas offering. These gifts, she said, allowed her and Kyle to see "very tangibly" the care and faithfulness of Southern Baptists.
"It changes lives," Abby said.
*Names changed to protect future mission work
This article first appeared in the Southern Baptist Texan, the news journal of the Southern Baptists of Texas Convention.