An old tradition here on Kudjip Station, is for the missionaries to carol on the ward on Christmas Eve, and to give gifts to the patients. Throughout the year Judy, as storeroom manager, saves items that come in donation boxes to include in the gift packages. On the 23rd she is usually ready with her assembly line. She counts patients on each ward, and makes gifts for each category. She includes clothes, toothbrushes, soap and a few pieces of candy for everyone. Lotions for the ladies, diapers and baby powder for the babies, toys for the kids. On Christmas Eve she does a last-minute re-count to make sure that there's a gift for every patient. She makes a couple extra of each kind, to account for last minute admissions.
But this year she was worried. There weren't many gift items in the storeroom. She just didn't have enough to make up the bags. That's when it came.
Several times a year we receive a 20-foot container of donated supplies from Nazarene Hospital Foundation. Dr. Todd Winter in Medford, Oregon has made this his ministry. He gathers medical supplies for Kudjip hospital, loads the containers and ships them to us. He holds fund-raisers to help pay for shipping costs. He has been here several time, and knows our needs well. He manages to get items that are most needed, and in good quantities. People who have items to donate to our ministry can also ship their gifts to him, and he includes them in the containers. This has become very important with the great increases in shipping costs.
On the 23rd the latest container came. Judy's day was already busy, but the container is a real big deal for us, the medical supplies are the very important to our work. So, busy as she was, and concerned as she was about the Christmas gifts, she happily supervised the unloading of the container, and the distribution of supplies to the various storage areas, or departments of the hospital. We've recently had a serious shortage of certain sizes of gloves, and that container had a lot of gloves. But if the container had arrived a few days later, it would have been just as valuable to our work.
Baby powder, hats and toothbrushes don't save lives, but they bring joy to people who have little, and the container had an abundance of great items for the Christmas packages. And it didn't arrive later, it arrived just in time for Judy, along with Gail Dooley and her girls, to assemble the gifts. The clothes, toothbrushes, toys and lotions were transferred to pillow cases, tied up with bright ribbon (the color of the ribbon coding the type of patient it was intended for) for us to give out on Christmas eve.
Another great friend of Kudjip Hospital is Dr. Larry Hull. This kind, gentle orthopedic surgeon from Centralia, Washington has come to PNG every year for the last...well, I've lost track of how many years, to do surgery, and to encourage us. All year long he looks for ways to help us out. We hadn't heard anything about it, but somewhere he had found a large quantity of camoflauge hats, trousers and shirts. He sent them to Todd (he and Todd are old friends, by the way) and they were in this container. Every big kid got a hat. Every adult got a shirt or trousers. Imediately trading and bartering began for those who wanted complete outfits. You should see them all!
So we went from ward to ward, singing, praying, shaking hands and giving out those pillow cases. It brought great joy to each patient and to each family member. And great joy to us.
If you would like to help us by helping Dr. Todd (through Nazarene Hospital Foundation) with the cost of shipping containers to us, go to the NHF web site. Look over the whole site, but go to the donations link. NHF has no salaried staff, just volunteers, so 100% of any gifts to them are directed to the ministry of Nazarene Hospital. Any donated supplies or equipment need to be cleared with Judy prior to shipping to Todd. We are bursting at the seams in our medical storeroom and need to build a new and larger building. Of course, your continued support of our work is also greatly appreciated.
Some photos shamelessly stolen from the Dooley's blog. Take a look at it for a lot more photos of Kudjip Station during Christmas week.
COMMENT
Friday, December 26, 2008
Christmas Gifts
What do you give someone who has everything?
The perennial question at Christmas time. Each year we have had to be pretty creative in getting Christmas gifts for each other. Sometimes we have had something brought from the US. That, of course, requires advance planning. You need to have some kind representative do the shopping for you, or buy something on line, and have the gift shipped to someone who is traveling to PNG, and make sure you get it to them on time for their trip.
Some years we have found a nice item here in PNG. There are stores in Mount Hagen that have a fairly good selection. One year Judy found a really nice coffee press for me. And one year I found a wall hanging with a maple leaf on it--the perfect gift for my Canadian wife. Well, at least the best I could come up with under the circumstances.
So this year, Christmas loomed closer and closer. I knew that I hadn't found anything, and cryptic comments from Judy indicated that she hadn't done any better.
The Nazarene church here in PNG has been planning it's every-four-yearly Nazarene Youth Conference. This is a time when the young people have an event planned and tailored just for them. Speakers who are known to be gifted at communicating with youth, classes and Bible studies that address their special needs. Hearing about this brought back memories of a similar event in 1970, back in the US. Decisions that I made that week continue to shape the person I am today. That I am a missionary in PNG today is due in large part to commitments I made to God that week.
So we believe in NYC. There are 5 young people here at Kudjip that we also believe in, and whom we felt very strongly should attend NYC. This year NYC is to be held in Wewak, on the north coast of PNG. Travel costs are therefor higher than in previous years. From the Highlands were we live, the best way to get there is by road to Madang, and then by ship on to Wewak. Some groups are trying to save costs by hiking overland, but we didn't want "our" kids to do that. They will travel with a group from here, in a van driven by one of our hospital administrators.
We decided to direct some of the funds that you, our friends and family have given to our work to be used to pay their registration and part of their transportation. We also decided to help the kids with food costs on their trip. Then we realized that none of these 5 have ever owned their own Bibles. So Judy bought 5 small Pidgin Bibles, and made up small packages with the Bibles, a pen, a notebook, and a 50-Kina bill, each in a little canvas bag with a Christmas name tag. The day before they were to leave for NYC, they gathered in our living room. I explained to them what NYC meant to me, and why it was important to us for them to attend. We prayed for them and gave them our gifts.
Of course, we didn't explain that those were our gifts to each other.
The perennial question at Christmas time. Each year we have had to be pretty creative in getting Christmas gifts for each other. Sometimes we have had something brought from the US. That, of course, requires advance planning. You need to have some kind representative do the shopping for you, or buy something on line, and have the gift shipped to someone who is traveling to PNG, and make sure you get it to them on time for their trip.
Some years we have found a nice item here in PNG. There are stores in Mount Hagen that have a fairly good selection. One year Judy found a really nice coffee press for me. And one year I found a wall hanging with a maple leaf on it--the perfect gift for my Canadian wife. Well, at least the best I could come up with under the circumstances.
So this year, Christmas loomed closer and closer. I knew that I hadn't found anything, and cryptic comments from Judy indicated that she hadn't done any better.
The Nazarene church here in PNG has been planning it's every-four-yearly Nazarene Youth Conference. This is a time when the young people have an event planned and tailored just for them. Speakers who are known to be gifted at communicating with youth, classes and Bible studies that address their special needs. Hearing about this brought back memories of a similar event in 1970, back in the US. Decisions that I made that week continue to shape the person I am today. That I am a missionary in PNG today is due in large part to commitments I made to God that week.
So we believe in NYC. There are 5 young people here at Kudjip that we also believe in, and whom we felt very strongly should attend NYC. This year NYC is to be held in Wewak, on the north coast of PNG. Travel costs are therefor higher than in previous years. From the Highlands were we live, the best way to get there is by road to Madang, and then by ship on to Wewak. Some groups are trying to save costs by hiking overland, but we didn't want "our" kids to do that. They will travel with a group from here, in a van driven by one of our hospital administrators.
We decided to direct some of the funds that you, our friends and family have given to our work to be used to pay their registration and part of their transportation. We also decided to help the kids with food costs on their trip. Then we realized that none of these 5 have ever owned their own Bibles. So Judy bought 5 small Pidgin Bibles, and made up small packages with the Bibles, a pen, a notebook, and a 50-Kina bill, each in a little canvas bag with a Christmas name tag. The day before they were to leave for NYC, they gathered in our living room. I explained to them what NYC meant to me, and why it was important to us for them to attend. We prayed for them and gave them our gifts.
Of course, we didn't explain that those were our gifts to each other.
Friday, December 12, 2008
Growing Family
1
Don't get excited by the title--it's only temporary!
Our collegues, Scott and Gail Dooley are off to a mission meeting in Singapore. Because of the infrequent flights, they have to be away for 10 days to attend 5 days of meetings. They couldn't take their kids, so we get them! It's a combination of a stroll down memory lane to when our kids were little, and a preview of grand-parenthood, when we will hopefully have little ones visit.
2
Allison is 10, Emma is 8, and Olivia is 3.
So now we (well, Judy does most of this) supervise naps, help with homework, and read books with little ones cuddled up on our laps. We have lively conversation at meals, and watch fun videos. And best of all, I have help with the supper dishes!
We have a Grandpa Stool in our bathroom again (my dad made these for his grandkids and greatgrand kids for years, and we still have one). There are bright-colored tooth brushes by our sink. We sing "Twilight's A-Stealin'" (our old traditional family lullaby) at bed time. We have kid's books targeted at a wide range of ages all around the house.
4
We're now 3 days into our adventure. Stay tuned for further details!
Photos
1. Family supper table
2. Olivia tucked in for a nap
3. Emma's evening ablutions
4. Bookworm Ally
Sunday, December 7, 2008
Video Party
Saturday, Judy invited the ladies of the Tumba and the Kopsip churches to come to our house to see a video on HIV/AIDS. We had just received some wonderful boxes of goodies from Karen Comstock, who along with her husband Ray, served here as volunteers for a bout a year and a half. The box contained a large supply of craft kits to make some manger ornaments. Making the ornaments involves gluing gotether a lot of popcycle sticks and toung depressors and other items. So Judy thought that with the Christmas season here, we should make ornaments for each lady. She was expecting about 30! She got the idea about 2 hours before the ladies were due to arrive. So she had to recruit some help to get the ornaments made. Guess who that would be!
So we created an assembly line, and ground out 26 ornaments. Judy figured that while the ladies were watching the video, she could make a few more. Fortunately, only 13 ladies and 2 babies showed up. Well, unfortunately, for the possible influence of the video, but the ornament crisis was averted.
I slipped away before the guests arrived to practice some music for the English worship service that whe have on the first Sunday of the month. When I slipped in the back door, the video was near the end. It's a sad story, and the ladies cried. Paster Elis, of the Tumba church lead a discussion, and then a time of prayer. All of the ladies cried out to God in unison for their families, their communities and their nation.
Each of those ladies knows someone who has AIDS or who has died. They have all heard stories, if not witnessed first-hand the terrible way that AIDS victims are often treated here.
When the prayer time was over, Judy served tea and brownies, and passed out the ornaments, much to the ladies' delight. All in all, a very successful afternoon.
COMMENTS
So we created an assembly line, and ground out 26 ornaments. Judy figured that while the ladies were watching the video, she could make a few more. Fortunately, only 13 ladies and 2 babies showed up. Well, unfortunately, for the possible influence of the video, but the ornament crisis was averted.
I slipped away before the guests arrived to practice some music for the English worship service that whe have on the first Sunday of the month. When I slipped in the back door, the video was near the end. It's a sad story, and the ladies cried. Paster Elis, of the Tumba church lead a discussion, and then a time of prayer. All of the ladies cried out to God in unison for their families, their communities and their nation.
Each of those ladies knows someone who has AIDS or who has died. They have all heard stories, if not witnessed first-hand the terrible way that AIDS victims are often treated here.
When the prayer time was over, Judy served tea and brownies, and passed out the ornaments, much to the ladies' delight. All in all, a very successful afternoon.
COMMENTS
Sunday, November 9, 2008
Happy Birthday, Judy!
...and she's only 4!
Oh, yeah, and she's only 2 months.
And it's not as simple as that. There are many little Judys around the Wahgi Valley!
Four-year-old Judy lives here on Kudjip Station. Her dad works at maintenance Her mom is the daughter of one of our veteran pastors from the Jimi Valley. Judy (the adult one) has set a president (so far it hasn't gotten out of hand) of baking birthday cakes for her little friends. I got this photo of little Judy, her mom Rachael, her brother Elias, with big Judy when they came to pick up the cake Friday.
Today we went to Pastor Jerry's newest preaching point, where I preached, and we met his new adopted daughter, who is, of course, named Judy. Hers is a bit of a long story. Her biological father died of unknown causes, and his family assumed that it was AIDS. They blamed his pregnant wife for this, and threw her out of the family. Pastor Jerry took her in, and she asked him and his wife Mary to adopt the baby, which they ultimately did. The great irony of the story is that the mom has repeatedly tested negative for HIV.
However, baby Judy now has a loving mom and dad, and 4 adoring big brothers. Titus is the brother in the photo.
Jerry's primary ministry is to people with HIV and AIDS, and includes a hospice where AIDS victims can stay if they are abandoned by their families. Maybe some day I'll devote a whole blog post just to Pastor Jerry. It would be a long one!
Oh, yeah, and she's only 2 months.
And it's not as simple as that. There are many little Judys around the Wahgi Valley!
Four-year-old Judy lives here on Kudjip Station. Her dad works at maintenance Her mom is the daughter of one of our veteran pastors from the Jimi Valley. Judy (the adult one) has set a president (so far it hasn't gotten out of hand) of baking birthday cakes for her little friends. I got this photo of little Judy, her mom Rachael, her brother Elias, with big Judy when they came to pick up the cake Friday.
Today we went to Pastor Jerry's newest preaching point, where I preached, and we met his new adopted daughter, who is, of course, named Judy. Hers is a bit of a long story. Her biological father died of unknown causes, and his family assumed that it was AIDS. They blamed his pregnant wife for this, and threw her out of the family. Pastor Jerry took her in, and she asked him and his wife Mary to adopt the baby, which they ultimately did. The great irony of the story is that the mom has repeatedly tested negative for HIV.
However, baby Judy now has a loving mom and dad, and 4 adoring big brothers. Titus is the brother in the photo.
Jerry's primary ministry is to people with HIV and AIDS, and includes a hospice where AIDS victims can stay if they are abandoned by their families. Maybe some day I'll devote a whole blog post just to Pastor Jerry. It would be a long one!
Saturday, November 8, 2008
A Piece of Bread
The significance of a gift cannot be measured by it's price or it's complexity.
Kunje and Kenem (I'm using real names this time) are dear friends. We estimate that they are about 5 years older than us. We hadn't seen them for several weeks, and had worried that they were sick, or having some other problem. Judy had asked Pastor Elis (a mutual friend) about them a few days earlier, and had heard that they were fine. We were pleased when they showed up at our door Thursday, along with their grandson, Jedediah. They were bringing (as usual) some gifts from their garden; a pineapple (they grow some of the sweetest), and a few ears of corn.
Judy mentioned that we had been concerned when we hadn't seen them for a while, and they laughed. Kenem said, "Well, we didn't have anything from the garden to bring you, and we didn't want to come without anything." I replied, "We are always happy to see your faces, whether you bring anything or not." They smiled and laughed. They appreciated the words, but are still unlikely to show up empty-handed.
I could tell you a lot about them if I thought you had the patience to read it. They are strong laymen who raised their family in a near-by church. A few years ago, they moved, along with their daughter and son-in-law to another community to help start a new church, one that is thriving and growing today. They have stood strong for right in the face of nearly overwhelming social and cultural pressure. All five of their kids are strong active Christians, and two of their daughters and sons-in-law are involved in ministry. They always seem to be happy. Their smiles and sparkling eyes always lift our spirits.
After we visited for a while, Judy went into the kitchen, and returned with a half-loaf of bread (all that was left, I think) which she had sliced up. This brought a long, delighted "eeeee" from Kenem, and an "ooo-ah" from Kunje. Kenem took a slice from the bag, and couldn't resist tasting it before passing slices to her husband and Jedediah. The Kunje commented on how much better Judy's bread is than the store-bought kind (an understatement, indeed).
Gifts. Fruit, bread, smiles, laughter, handshakes, hugs. Friendship. It's all priceless.
Photo: Kenem, Jedediah, Kunje
Friday, October 31, 2008
Brief Update
Just to let you know. The lady I called "Amban" in the story from a few days ago is recovering nicely on the surgical ward, at least in terms of her physical wounds. I'm quite concerned that she does not have any family members staying in the hospital with her. She said that her family has visited, but that no one is staying. Please pray that her family will support and care for her in this time of great need.
COMMENTS
Tuesday, October 28, 2008
Photo Gallery
Here is a link to a gallery of photos taken by Matt Powell, of World Medical Mission, an organization that helps mission hospitals (like ours) find volunteer doctors. They are also the organization that supports Dr. Erin Meier and will support Dr. Rebecca Wallace (to arrive soon) in their post-residency fellowships. Matt was here last March (as I recall) and took lots of photos and video.
There's a video that he produced about Erin, but I can't find the link right now. I'll post it later.
There's a video that he produced about Erin, but I can't find the link right now. I'll post it later.
Monday, October 27, 2008
Alone in Paradise
1
You are never more alone than when you have trouble or pain, and none of your loved ones are there to share and comfort you. At such a time, even a kind stranger is welcome relief.
I've been trying not to dwell on the negative, the violent, the tragic aspects of life in PNG. But that side of things exists, and I can't ignore it. This story has a bright side, too.
Amban was walking by herself along the road when she was attacked. I didn't get the whole story, but I heard something about the family of one of the other wives. I'm pretty sure that it was a man who wielded the bush knife. It was a very sharp knife. It's hard to cut all the way through an arm with a single stroke. We see lots of attempts to do just that, but only occasionally do we see a complete amputation.
The good Samaritans drove Amban to Nazarene Hospital, helped her into the ER, and then went back to find and inform her family. I gave her pain medicine and antibiotics. Dr. Salim Wahab, volunteer surgeon, took her to the operating room, cleaned up the damaged tissue and closed the skin. She's now recovering in surgical ward.
I don't post many blood and gore photos (I sure could if I wanted to!) but here is Amban as we first met her. I'll make it very small here. If you are brave and interested, you can click on this image and see a larger one.
Because you give and pray, we are here to help people like Amban. If Nazarene Hospital were not at Kudjip, what would have happened to her? Would the strangers have been willing to drive her all the way to the government hospital? Would a surgeon have been available to operate on her on a Saturday afternoon? Would the doctor have prayed with her? We don't know, and because you are faithful, people like Amban don't have to find out.
Photos
1 Sunset in Madang. We don't have many palm trees in the Highlands.
2 Kids from Kudjip station playing at the river. Don't worry, responsible adults are nearby.
COMMENTS
You are never more alone than when you have trouble or pain, and none of your loved ones are there to share and comfort you. At such a time, even a kind stranger is welcome relief.
I've been trying not to dwell on the negative, the violent, the tragic aspects of life in PNG. But that side of things exists, and I can't ignore it. This story has a bright side, too.
Amban was walking by herself along the road when she was attacked. I didn't get the whole story, but I heard something about the family of one of the other wives. I'm pretty sure that it was a man who wielded the bush knife. It was a very sharp knife. It's hard to cut all the way through an arm with a single stroke. We see lots of attempts to do just that, but only occasionally do we see a complete amputation.
2
The attackers left her there, bleeding, crying and in awful pain there alone by the road. In PNG culture there is no real obligation to help people from outside your own tribe, but it happens all the time. Someone saw the attack, waited until the attackers were gone, and then went to Amban's aid. They wrapped the bleeding stump tightly in whatever cloth they could find. They wrapped up the severed arm and brought it along, no doubt hoping that we could sew it back on. Unfortunately, reimplantation is well beyond our technical limitations.
The good Samaritans drove Amban to Nazarene Hospital, helped her into the ER, and then went back to find and inform her family. I gave her pain medicine and antibiotics. Dr. Salim Wahab, volunteer surgeon, took her to the operating room, cleaned up the damaged tissue and closed the skin. She's now recovering in surgical ward.
I don't post many blood and gore photos (I sure could if I wanted to!) but here is Amban as we first met her. I'll make it very small here. If you are brave and interested, you can click on this image and see a larger one.
Because you give and pray, we are here to help people like Amban. If Nazarene Hospital were not at Kudjip, what would have happened to her? Would the strangers have been willing to drive her all the way to the government hospital? Would a surgeon have been available to operate on her on a Saturday afternoon? Would the doctor have prayed with her? We don't know, and because you are faithful, people like Amban don't have to find out.
Photos
1 Sunset in Madang. We don't have many palm trees in the Highlands.
2 Kids from Kudjip station playing at the river. Don't worry, responsible adults are nearby.
COMMENTS
Tuesday, October 21, 2008
The Girl in the Red Hat
She didn't think it was funny, either, that I was talking about her blue hat as a red one. PNG kids don't often correct their elders, and if I said that the hat was red, I could just think that it was red as far as she was concerned. She looked mildly worried when I swiped it and put it on, and even more mildly relieved when I gave it back. Actually, her expression changed very little the whole time she was in my exam room. That's Marla the student nurse, who is more interested in my camera (being operated by Roselyn, the other student nurse) than in my lame attempt to be funny.
Sunday, October 19, 2008
Payment
My honorarium for speaking at the Kukon Church of the Nazarene this morning.
This includes 1 large cabbage (which hasn't been shared by any snails--how do they do that?); 2 small pineapples (this is the sweetest variety); 5 very large green bell peppers (that's "capsicum" to all our British, Ozzie and PNG friends); 6 large, ripe (despite being green in color), sweet oranges; 6 "sugafrut", a sweet (rather than tart) variety of passion fruit; and one small bunch of asparagus.
And you didn't think missionaries are well-paid!
This includes 1 large cabbage (which hasn't been shared by any snails--how do they do that?); 2 small pineapples (this is the sweetest variety); 5 very large green bell peppers (that's "capsicum" to all our British, Ozzie and PNG friends); 6 large, ripe (despite being green in color), sweet oranges; 6 "sugafrut", a sweet (rather than tart) variety of passion fruit; and one small bunch of asparagus.
And you didn't think missionaries are well-paid!
Facing The World
.
DON'T SCROLL DOWN!!
Yeah, I know. You weren't thinking about scrolling down until I mentioned it. It's just that I want to tell you about the pictures before you see them. The first one looks a little disturbing, but it's a happy story, it really is.
When the nurse called me (precisely 30 minutes after I got into bed, as is almost always the case) said that it was a footling breech, and that it was the young woman's first delivery. I groaned inwardly. At least I'm pretty sure that I didn't groan out loud. I was too groggy to be sure. You see, this combination of circumstances dictates that I must to do a cesarean section. I told the nurse to call the OR crew, and that I'd come right in.
A breech presentation (for those of you who don't already know, but are still interested) is when the baby's bottom is leading the way, rather than the head. In most breech deliveries, the buttocks come first, with the legs laid flat along the body. When the feet come out first, we call it a "footling breech." For a mom who has had previous babies, we will go ahead and deliver the baby vaginally, but for a first delivery, we always do a c-section. Usually our nurses are quite accurate in diagnosing breech presentations.
Bleary-eyed, I staggered into the delivery ward, found some sterile gloves and checked the patient. It certainly wasn't the baby's head I was feeling, and it sure wasn't feet or buttocks. There was a hard lump, then a hole, then a soft lump. Gradually, the truth dawned on me. I was feeling a chin, a mouth and then a nose. This was a face presentation!
My previous experience with face deliveries totals exactly 1. Oh, and read about it in a book once. The books say that most can deliver safely. It worked out OK the other time I had seen it.
This mom had already been pushing for a while, and was tired. I coached her to push harder. I can usually get better pushes out of the patients than the nurses can. She was having hard contractions, and was giving it a good effort. Still, things didn't seem to be progressing. I contemplated doing a c-section, but then whole head was now well down into the birth canal, and I didn't think I could get it out the other way! So I tried to be patient.
As time stretched out, push after seemingly futile push, I began to occasionally see slight progress. Then I'd get discouraged again. I thought about other options. I had already made a large episiotomy, but there are various other things that one can cut (you don't really want the details, do you?) to make things open up better. I had even scrubbed the skin and injected local anesthetic to do something called a symphysiotomy, when I noted a bit more progress.
As the little face became more visible, I could see the effects of the pressure. The face can't take the pressure, and the pounding of contractions and pushing the way the top of the head can. The soft tissues of the face become swollen and purple. Several times I asked the nurse to listen for the baby's heart beat, to assure myself that it was still alive. It was.
Finally, after what seemed like an eternity, or at least like a long time, the head slipped out, and the rest of the body followed easily. The baby made no effort to breath. There was no movement. It looked far worse than the picture that you are slowly scrolling down to. (I didn't have my trusty camera on my belt, so I didn't get the picture until the next morning.) I gave it a few breaths with a breathing bag, and it took, first a feeble breath, then a stronger one. There was a little tiny cry. The ugly white body turned a beautiful pink. The face was still purple, and not a shade that went nicely with the pink. But he was alive, and breathing on his own.
I then spent the next hour sewing up his mom. It was close to 4 a.m. when I crawled into bed, happy with the good outcome of my night's work.
The first photo was taken in the nursery the next morning. I had left him there on oxygen, but by morning he didn't need any extra help, beyond what babies commonly need.
By Friday morning he and his happy mom were ready to go home. I stopped in the ward just in time to get the additional photos.
DON'T SCROLL DOWN!!
Yeah, I know. You weren't thinking about scrolling down until I mentioned it. It's just that I want to tell you about the pictures before you see them. The first one looks a little disturbing, but it's a happy story, it really is.
When the nurse called me (precisely 30 minutes after I got into bed, as is almost always the case) said that it was a footling breech, and that it was the young woman's first delivery. I groaned inwardly. At least I'm pretty sure that I didn't groan out loud. I was too groggy to be sure. You see, this combination of circumstances dictates that I must to do a cesarean section. I told the nurse to call the OR crew, and that I'd come right in.
A breech presentation (for those of you who don't already know, but are still interested) is when the baby's bottom is leading the way, rather than the head. In most breech deliveries, the buttocks come first, with the legs laid flat along the body. When the feet come out first, we call it a "footling breech." For a mom who has had previous babies, we will go ahead and deliver the baby vaginally, but for a first delivery, we always do a c-section. Usually our nurses are quite accurate in diagnosing breech presentations.
Bleary-eyed, I staggered into the delivery ward, found some sterile gloves and checked the patient. It certainly wasn't the baby's head I was feeling, and it sure wasn't feet or buttocks. There was a hard lump, then a hole, then a soft lump. Gradually, the truth dawned on me. I was feeling a chin, a mouth and then a nose. This was a face presentation!
My previous experience with face deliveries totals exactly 1. Oh, and read about it in a book once. The books say that most can deliver safely. It worked out OK the other time I had seen it.
This mom had already been pushing for a while, and was tired. I coached her to push harder. I can usually get better pushes out of the patients than the nurses can. She was having hard contractions, and was giving it a good effort. Still, things didn't seem to be progressing. I contemplated doing a c-section, but then whole head was now well down into the birth canal, and I didn't think I could get it out the other way! So I tried to be patient.
As time stretched out, push after seemingly futile push, I began to occasionally see slight progress. Then I'd get discouraged again. I thought about other options. I had already made a large episiotomy, but there are various other things that one can cut (you don't really want the details, do you?) to make things open up better. I had even scrubbed the skin and injected local anesthetic to do something called a symphysiotomy, when I noted a bit more progress.
As the little face became more visible, I could see the effects of the pressure. The face can't take the pressure, and the pounding of contractions and pushing the way the top of the head can. The soft tissues of the face become swollen and purple. Several times I asked the nurse to listen for the baby's heart beat, to assure myself that it was still alive. It was.
Finally, after what seemed like an eternity, or at least like a long time, the head slipped out, and the rest of the body followed easily. The baby made no effort to breath. There was no movement. It looked far worse than the picture that you are slowly scrolling down to. (I didn't have my trusty camera on my belt, so I didn't get the picture until the next morning.) I gave it a few breaths with a breathing bag, and it took, first a feeble breath, then a stronger one. There was a little tiny cry. The ugly white body turned a beautiful pink. The face was still purple, and not a shade that went nicely with the pink. But he was alive, and breathing on his own.
I then spent the next hour sewing up his mom. It was close to 4 a.m. when I crawled into bed, happy with the good outcome of my night's work.
The first photo was taken in the nursery the next morning. I had left him there on oxygen, but by morning he didn't need any extra help, beyond what babies commonly need.
Monday, October 6, 2008
The Big Meeting
First things first. I'm always going to change names in my stories. People in PNG read blogs. There is a PNG Gossip Newsletter that finds and distributes links to interesting blogs about PNG. The last thing I want to do is to further compromise the privacy of people who are already hurting. I'll change other facts, too to help obscure their identity. The core facts of my stories will always be true, but many of the details will be flat out lies! There, I've confessed in advance.
They've been married just a few months. Within a couple of months of their marriage Maria began to be ill. She felt weak, had frequent nausea, and lost weight. By about 5 months into the marriage John began to worry that Maria had AIDS. It's a testament to his faith in her that he assumed that in order for her to have it, he had to be HIV positive. So instead of suggesting that she be tested, he went and had himself tested, and was quite relieved to be negative. He let the matter drop.
A few months later, as she was getting worse, he went and repeated the test. Still negative. Finally, just a few weeks ago, he took her to a hospital in a province near ours. Among the many tests that they did there was an HIV test, which was positive. By then her symptoms included confusion. Her mother was with her there, and for reasons that I don't understand, took her, and they slipped out of the hospital and ran away back to Maria's home village. Perhaps the mother underestimated the depth of John's commitment to Maria, and was afraid that he would take some reprisal.
Within a few days, her family began to recognize how ill she was (although only her mother knew about the positive HIV test), and brought her here to Nazarene Hospital. John has relatives who work here, and was actually staying here with them, but it was a day or two until he found out that she'd been admitted. In her evaluation here, the HIV status was confirmed. John was tested yet again, and was again negative.
So, as Maria herself was now too confused to give informed consent herself, I felt it was John's right to grant me permission to tell the family. I discussed it with some of my colleagues, and decided that that was indeed the best way to proceed. He would ring her family and ask them to come to the hospital Saturday morning because the doctor needed to talk to them about Maria.
Saturday morning I went to do ward rounds with a sense of dread. I knew that it could be a difficult and even tense meeting. I had mixed emotions when I got to the ward and discovered that Maria and her mother had again run away! But a couple of hours later I learned that the family had tracked them down near the provincial border. They were probably heading back to the first hospital. The meeting was now rescheduled for John's relative's back yard.
I was surprised at some of the people who were there. There were several other people from the station who were related in some way. John's relatives had invited Pastor Robert from the nearby Nazarene church. He opened the meeting in prayer, and then turned it over to me. It wasn't an easy task. It was hard to know what to say at all, but then I had to say it in my second language, and the more nervous I get, the worse my Pidgin gets.
I stated the facts as simply as I could. Then I stated that I was no longer speaking as the doctor, but as a friend. I talked about the fact that not one of us there was without the need for forgiveness. We've all done wrong, and God has either forgiven us, or is ready and willing to do so. I said that just as past actions (especially Maria's) have affected present circumstances, our actions now would affect our lives into the future for better or for worse. I turned to Maria's family and stated that they must have seen some good in John if they had allowed their daughter to marry him. There were nods of agreement. I turned to John's family and stated that they must have seen good in Maria to allow one of their young men to marry her. Again, the nods.
3
"Those things have not changed," I said, "they are still there. This hasn't changed them." Again there were nods all around. "These young people will need the support of both families if they are to get through this and strengthen their marriage. Anger or fighting won't help them. Only your love and support will help." I asked for the privilege of praying with them, and asked God to direct and guide them all.
I looked up to see a security guard from the hospital who had obviously been sent to summon me back there. I explained that I had to get back and excused myself. On my way I passed near Maria's dad, whose eyes met mine. I could only imagine the flood of emotions that were going through his heart. Sorrow for his daughter. A sense of betrayal. Anger. He offered me his hand, and shook mine warmly.
Several hours later I passed by the house where the meeting had been held, and saw Maria's family at the road loading into the truck that they had come in, while still visiting with John's family. I saw no blood, wound or bandages, so I was happy! They all greeted me cheerfully, but it just wasn't a good time to ask about details of the rest of the meeting. Later I talked to one of John's relatives, who told me that it had gone very well. There had been hours of speeches, of course, but in the end they all agreed to help and support this young couple. Later yet, I learned that a few days before, John had prayed to recommit his life to Jesus.
4
Please pray with me for John and Maria. God knows their real names! He knows the pain in their hearts. He knows the pain and frustration of their families. Please pray that Maria will be consistent with medical treatment, which will probably involve the use of anti-retroviral drugs. Pray that she will follow John's lead in committing her life to Jesus. And pray for me, Bill, Jim, Susan, Scott, Erin, and the soon-to-come Rebecca and Stephanie as we battle on against AIDS, violence, and the countless other consequences of sin and evil in the world. Pray the the Great Physician would give us strength, wisdom, good judgment and the stretching of limited resources.
Yours and His,
Andy
Photos
1 A sunset seen from near Konduk
2 A flower of some kind. Photo by Sam Bennett
3 A wedding, not John and Maria's. The couple are kneeling, surrounded by a large wreath of flowers that has a lot of the same symbolism as a wedding ring, but also symbolizes the prayers of their families which will continue to surround.
Ok, the last 2 photos look a little silly and out of place, but really they fit in nicely. They are three of my fellow doctors here that I request prayer for in the last paragraph.
4 The always-dignified Dr. Bill McCoy, holding treasure.
5 To introduce my soon-to-be-newest colleague, Dr. Rebecca Wallace, seen here dressed as Strawberry Shortcake during a Harvest party on her visit last year. She will be arriving soon. She will be coming as a post-residency fellow, like Dr. Erin Meier (shown here on the right in a costume that I don't recall), who is one year into her two-year fellowship.
1
So, with that in mind.... Maria and John. Yeah, Maria and John.A few months later, as she was getting worse, he went and repeated the test. Still negative. Finally, just a few weeks ago, he took her to a hospital in a province near ours. Among the many tests that they did there was an HIV test, which was positive. By then her symptoms included confusion. Her mother was with her there, and for reasons that I don't understand, took her, and they slipped out of the hospital and ran away back to Maria's home village. Perhaps the mother underestimated the depth of John's commitment to Maria, and was afraid that he would take some reprisal.
Within a few days, her family began to recognize how ill she was (although only her mother knew about the positive HIV test), and brought her here to Nazarene Hospital. John has relatives who work here, and was actually staying here with them, but it was a day or two until he found out that she'd been admitted. In her evaluation here, the HIV status was confirmed. John was tested yet again, and was again negative.
2
John's dilemma was that when Maria's male relatives finally found out the situation, they would assume (as he himself had) that he was the one who had infected her, and would attack and possibly even kill him. He wanted someone in a position of authority (you'll be surprised to learn that he was thinking of me!) to be the one to inform them that she has AIDS, and at the same time explain to them that he was HIV-negative. Because of the advanced state of her AIDS, it is in fact likely that she contracted HIV long before she met John.So, as Maria herself was now too confused to give informed consent herself, I felt it was John's right to grant me permission to tell the family. I discussed it with some of my colleagues, and decided that that was indeed the best way to proceed. He would ring her family and ask them to come to the hospital Saturday morning because the doctor needed to talk to them about Maria.
Saturday morning I went to do ward rounds with a sense of dread. I knew that it could be a difficult and even tense meeting. I had mixed emotions when I got to the ward and discovered that Maria and her mother had again run away! But a couple of hours later I learned that the family had tracked them down near the provincial border. They were probably heading back to the first hospital. The meeting was now rescheduled for John's relative's back yard.
I was surprised at some of the people who were there. There were several other people from the station who were related in some way. John's relatives had invited Pastor Robert from the nearby Nazarene church. He opened the meeting in prayer, and then turned it over to me. It wasn't an easy task. It was hard to know what to say at all, but then I had to say it in my second language, and the more nervous I get, the worse my Pidgin gets.
I stated the facts as simply as I could. Then I stated that I was no longer speaking as the doctor, but as a friend. I talked about the fact that not one of us there was without the need for forgiveness. We've all done wrong, and God has either forgiven us, or is ready and willing to do so. I said that just as past actions (especially Maria's) have affected present circumstances, our actions now would affect our lives into the future for better or for worse. I turned to Maria's family and stated that they must have seen some good in John if they had allowed their daughter to marry him. There were nods of agreement. I turned to John's family and stated that they must have seen good in Maria to allow one of their young men to marry her. Again, the nods.
3
"Those things have not changed," I said, "they are still there. This hasn't changed them." Again there were nods all around. "These young people will need the support of both families if they are to get through this and strengthen their marriage. Anger or fighting won't help them. Only your love and support will help." I asked for the privilege of praying with them, and asked God to direct and guide them all.
I looked up to see a security guard from the hospital who had obviously been sent to summon me back there. I explained that I had to get back and excused myself. On my way I passed near Maria's dad, whose eyes met mine. I could only imagine the flood of emotions that were going through his heart. Sorrow for his daughter. A sense of betrayal. Anger. He offered me his hand, and shook mine warmly.
Several hours later I passed by the house where the meeting had been held, and saw Maria's family at the road loading into the truck that they had come in, while still visiting with John's family. I saw no blood, wound or bandages, so I was happy! They all greeted me cheerfully, but it just wasn't a good time to ask about details of the rest of the meeting. Later I talked to one of John's relatives, who told me that it had gone very well. There had been hours of speeches, of course, but in the end they all agreed to help and support this young couple. Later yet, I learned that a few days before, John had prayed to recommit his life to Jesus.
4
Please pray with me for John and Maria. God knows their real names! He knows the pain in their hearts. He knows the pain and frustration of their families. Please pray that Maria will be consistent with medical treatment, which will probably involve the use of anti-retroviral drugs. Pray that she will follow John's lead in committing her life to Jesus. And pray for me, Bill, Jim, Susan, Scott, Erin, and the soon-to-come Rebecca and Stephanie as we battle on against AIDS, violence, and the countless other consequences of sin and evil in the world. Pray the the Great Physician would give us strength, wisdom, good judgment and the stretching of limited resources.
Yours and His,
Andy
5
Photos
1 A sunset seen from near Konduk
2 A flower of some kind. Photo by Sam Bennett
3 A wedding, not John and Maria's. The couple are kneeling, surrounded by a large wreath of flowers that has a lot of the same symbolism as a wedding ring, but also symbolizes the prayers of their families which will continue to surround.
Ok, the last 2 photos look a little silly and out of place, but really they fit in nicely. They are three of my fellow doctors here that I request prayer for in the last paragraph.
4 The always-dignified Dr. Bill McCoy, holding treasure.
5 To introduce my soon-to-be-newest colleague, Dr. Rebecca Wallace, seen here dressed as Strawberry Shortcake during a Harvest party on her visit last year. She will be arriving soon. She will be coming as a post-residency fellow, like Dr. Erin Meier (shown here on the right in a costume that I don't recall), who is one year into her two-year fellowship.
Saturday, October 4, 2008
Faces of C-Ward
Inspired by Dr. Erin Meier's nice collection of photos of patients from her ward, I decided to do one of faces from my ward. Trouble is, her patients (being kids) are cuter than mine. But the folks in C-Ward have their own special appeal. I'll add in a couple of patients who aren't actually on my ward, but I want to tell you about them and show you any way. Three of these are victims from last Tuesday's MVA. The man with the facial injuries, and the little girl with the hand injury were the main focus of my attention that afternoon.
Wednesday, October 1, 2008
Going Home
Not us. We are home. Well, at one of our homes.
I'm talking about the folk from last week's MVA (motor vehicle accident). I am still amazed that none of them were more seriously hurt. The last of the ones that we admitted to medical ward (they would usually all go to surgical, but there were just too many) went home this morning, with plans for a 1-week follow-up. I haven't checked on the little girl with the bad forearm injury, but I'll look in on her in the next day or two and report how she and her mom are doing.
I really recommend Erin Meier's blog. She does a way better job than any of the rest of us at keeping up. Sometimes you will learn more about Judy and me there than here! Check out the "Faces of the Pediatric Ward" that she posted a few days ago. (Sometimes it's just fun to make links.)
By the way, we sure enjoy it when you leave comments. On some of the recent posts I've added an extra-big COMMENTS link, but they all at least have the little "0 COMMENTS" link in tiny font at the bottom. Click on any of those to comment, and please sign your message.
I'm talking about the folk from last week's MVA (motor vehicle accident). I am still amazed that none of them were more seriously hurt. The last of the ones that we admitted to medical ward (they would usually all go to surgical, but there were just too many) went home this morning, with plans for a 1-week follow-up. I haven't checked on the little girl with the bad forearm injury, but I'll look in on her in the next day or two and report how she and her mom are doing.
I really recommend Erin Meier's blog. She does a way better job than any of the rest of us at keeping up. Sometimes you will learn more about Judy and me there than here! Check out the "Faces of the Pediatric Ward" that she posted a few days ago. (Sometimes it's just fun to make links.)
By the way, we sure enjoy it when you leave comments. On some of the recent posts I've added an extra-big COMMENTS link, but they all at least have the little "0 COMMENTS" link in tiny font at the bottom. Click on any of those to comment, and please sign your message.
Sunday, September 28, 2008
A Night in Paradise (Part 3)
You'll remember that I originally wrote this just over a week ago. Here's the rest of the story.
1
Dave went to his apartment for a water bottle, and I found a few peanuts in my locker (I always keep some there). We sat and visited for a few minutes, feasting on peanuts and water while we waited for the crew to get everything ready, then went down and did the operation. Again, it went well. This time, there was no dread ring of the phone at the end of the case. At about 4:30 we went to Labor, just to check, then made our way home.
I ate a bowl of cornflakes, then crawled into bed a little after 5. But the story doesn't end there.
The local custom here is that the doc on call Friday night will come in on Saturday morning to round on his or her own ward, leaving the rest to the doctor who is coming on call for the weekend. Judy knew that she had to wake me. It was pretty hard to get out of that warm bed at 7:45. For some reason, I didn't make it to the hospital until nearly 9. Judy had been out jogging, and told me that something was going on at the ER, but she couldn't really tell what.
3
So now I'm home, sitting at my computer reliving the night. I'm thinking of that young woman, who wanted so much to be a mom, and of that little life, ended before it really started. I'm thinking of those two healthy babies, now sleeping contentedly by their moms on the maternity ward. I'm wondering about that young man who died in the ER--I don't even know if he has a wife or kids. I'm thinking of the thousands of people who would have no health care without Kudjip Hospital. Kudjip Hospital is me. Kudjip Hospital is Dr. Erin, and Dr. Bill, and Dr. Scott, and Dr. Susan, and Dr. Jim, and the dozens of volunteer doctors and medical students who come here each year. Kudjip Hospital is those OR nurses and anesthetists who just say, “That's alright, we'll do it.” It's the ER nurses, trying to save lives threatened by violence, alcohol and bad roads. It's the labor ward nurses and aides staying long after their shift is over. But it's also you, praying and giving to keep us going.
COMMENTS
Photos:
1 Kudjip Nazarene Hospital
2 Dr. Susan Myers and Dr. Scott Dooley discussing a patient
3 Dr. Jim Radcliffe on the ward
4 A scenery shot to remind you what a beautiful place this is
1
Dave went to his apartment for a water bottle, and I found a few peanuts in my locker (I always keep some there). We sat and visited for a few minutes, feasting on peanuts and water while we waited for the crew to get everything ready, then went down and did the operation. Again, it went well. This time, there was no dread ring of the phone at the end of the case. At about 4:30 we went to Labor, just to check, then made our way home.
I ate a bowl of cornflakes, then crawled into bed a little after 5. But the story doesn't end there.
The local custom here is that the doc on call Friday night will come in on Saturday morning to round on his or her own ward, leaving the rest to the doctor who is coming on call for the weekend. Judy knew that she had to wake me. It was pretty hard to get out of that warm bed at 7:45. For some reason, I didn't make it to the hospital until nearly 9. Judy had been out jogging, and told me that something was going on at the ER, but she couldn't really tell what.
2
When I got there, I heard that Dr. Erin Meier (click to see her blog--I'll bet there will be a story there by now) was swamped in the ER with 9 victims of a motor vehicle accident. I did rounds on my ward (Adult Medicine), checked on the patients from last night, and caught up with Erin, who filled me in on the MVA. She mentioned that a lot of off-duty nurses and nursing students had rushed in to help with the work. Before I could go home, I had promised to do something for the friend of a friend, which I did in my exam room in the Outpatient Department, next door to the ER. No sooner had I started than one of the ER nurses called me to come and help them. One of the victims of teh MVA had stopped breathing, and had no heartbeat. I went to check on him and made a brief attempt to get a breathing tube into him, but quickly concluded that he was now beyond my help.3
So now I'm home, sitting at my computer reliving the night. I'm thinking of that young woman, who wanted so much to be a mom, and of that little life, ended before it really started. I'm thinking of those two healthy babies, now sleeping contentedly by their moms on the maternity ward. I'm wondering about that young man who died in the ER--I don't even know if he has a wife or kids. I'm thinking of the thousands of people who would have no health care without Kudjip Hospital. Kudjip Hospital is me. Kudjip Hospital is Dr. Erin, and Dr. Bill, and Dr. Scott, and Dr. Susan, and Dr. Jim, and the dozens of volunteer doctors and medical students who come here each year. Kudjip Hospital is those OR nurses and anesthetists who just say, “That's alright, we'll do it.” It's the ER nurses, trying to save lives threatened by violence, alcohol and bad roads. It's the labor ward nurses and aides staying long after their shift is over. But it's also you, praying and giving to keep us going.
4
Judy has gone to take a group of people up the river so that they can float back down on inner tubes. When I came in, the dogs told me that they love me unconditionally. My nice new coffee maker (a "going away" gift from Sam) is gurgling, and emitting the smell of brewing coffee. I don't know if I'll make it through day without a nap.COMMENTS
Photos:
1 Kudjip Nazarene Hospital
2 Dr. Susan Myers and Dr. Scott Dooley discussing a patient
3 Dr. Jim Radcliffe on the ward
4 A scenery shot to remind you what a beautiful place this is
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