Every day we are surrounded by the language of give and take, seeking something in return for every positive action we take.
What’s in it for me?
I’ll do something for you if you do something for me.
What can this program give to me?
How can I use this to get up to a higher level?
There is a temptation to view every part of our lives as simply give and take, transactional.
There is a different way. Since coming back from Liberia last week I’ve been reflecting a lot on the concept of Grace. An idea that no, we don’t always get what we deserve, and from there we have the opportunity to give of ourselves expecting nothing in return.
Sometimes not getting what is deserved is a horrible thing. Does a 3 year old girl from a poor family in a village who comes to hospital in a coma from malaria deserve good care, antimalarials and life-sustaining intravenous fluids? I certainly think so. In Liberia she may not always get what she deserves as resources come under constraint.
But sometimes going outside of ourselves, doing what is not going to give us a material or immediate reward, creates beautiful moments. Moments which change lives and redirect programs.
Most of the people who work in and partner with the ELWA pediatric program go well beyond their paygrade. In fact many of us aren’t even paid at all. There is nothing material in it for most of us, and a lot of sweat, exhaustion and heartbreak. A lot of chasing around trying to salvage children presenting in extremis, knowing that even with all the energy and time given the outcome may still not be positive.
So why? Grace. The idea that we get things that we don’t deserve. Did I deserve the opportunity to go to medical school ahead of other equally strong people? I don’t believe so. It’s a gift. And out of that comes the opportunity to take the initiative and give knowing we won’t get the reward we deserve either.
One of my favourite moments of this journey was in 2019 when we struggled to find plumpynut (the miraculous peanut paste which rescues children from severe acute malnutrition) to operate our fledging nutrition program. Time and again we would pray for plumpynut, and time and again it would appear. But it was stressful and the program could have been cancelled at any minute, which would have left lots of the world’s most vulnerable children stranded. In the middle of this came a couple, Zach and Alie Brown, with no previous connection to ELWA hospital. Working for an organisation who at the time did not even have a medical program. No logical reason to help us.
But they did.
They chose to reach beyond themselves and find plumpynut. Seemingly out of nowhere, truck after truck began coming, bringing hope in every box. Since then, the program has never had a stock out and has grown exponentially to the point where ELWA is now Liberia’s busiest outpatient feeding center, keeping thousands of children alive and letting them thrive.
I’ll never forget the day I realised we had someone with supervisor material in our team. She sat on a bed in the ELWA feeding unit one morning with a tiny 2 month old baby who had been fed only coconut water after her mother had died. Our supervisor’s feet were swollen and had ugly cuts over both, and I could tell she was tired. Exhausted even.


I asked her what happened. Emma explained that the baby had been deep in the bush, far from where cars and bikes could reach. She had walked for 24 hours through the thornbushes to rescue this tiny baby, and arrived at ELWA with this tiny lost sheep, hoping it wasn’t too late. Emma was never paid for her efforts, and her feet still haven’t been the same since. Yet that starving baby is now a thriving 6 year old enjoying school.
These moments of Grace have paved the way for incredible beauty over the last few years. Toddlers dancing as they beat malaria. Newborns growing amidst kangaroo care and boundless love. Tiny quadruplets salvaged from starvation by care and plumpynut in our under 5 clinic. All of these only happen because of Grace. Perhaps we can grab these moments before they pass us by.


