This is Michael writing this prayer update as Cheryl is finishing up her time in the states to help with our first grandchild.   But even though I have missed her greatly, I really haven’t had much time to pine away as the hospital has been extremely busy and we have been short-staffed.  Russ Ebersole, our pediatrician and my long time fellow Yankee fan, had to return to the States earlier this month due to medical problems and may not be coming back to the field for at least 3 months or more.   It will be difficult without Russ, but his brother-in-law, John Briggs, a fellow Family Physician with impressive God-given surgical skills, arrived back from furlough just as Russ was departing (that my dear friends is a God-orchestrated blessing).  Also, Joanie Miedema, an Internist with Pediatric skills, and Christal Duncan, OB/GYN, arrived this month and have been a true blessing not only taking the stress off the call schedule but more importantly being compassionate lights to the Togolese staff and patients.    And compassion (love in action) is sometimes all we can give as patients continue to arrive at our front door in such serious medical/surgical/obstetrical condition that there is very little we can do.  We have seen more than the usual number of patients die over the last 2 months.  Typhoid is rearing its ugly head again, malaria is taking its usual toll on children less than 5 years of age, and indiscriminate use of herbs found in the market place which is destroying livers and kidneys.    But these desperate times are when we find ourselves depending on God more and more which is exactly where He wants us to be.  We are seeing miracles as people who are appearing to be taking the their last breath get better and leave the hospital, and others who do take their last breath leave behind family members at the bedside who are broken and desperately seeking hope which only Christ can give.  So even though some die and we physicians lose a physical life, God is gaining many a soul in heaven for eternity.   As we finish 2010 and head into the new and wonderful year of 2011, let us remember the most precious gift ever given—Jesus the Christ—the blessed hope and assurance that will never fail us.  A special thanks to all of our family and friends and churches and individuals who so faithfully support us prayerfully and financially.  God has truly blessed us and the Togolese His ministry here in Togo.   To God Be the Glory, Great Things He Hath Done [and continues to do!!]   Love to all.  Until next year.   Michael (and Cheryl) Gayle, ABWE, Togo Medical Missionaries and Assistant Church Planters