Monday, August 31, 2009

Taro Anyone?

This was a present from a friend. It is one of Sam's favorites, but Judy and I don't really go for it. We passed it on to another friend who appreciates this delicacy.

Sunday, August 30, 2009

Peds Ward Wall Update

I reported a few weeks ago about the murals being painted on the walls of the new pediatrics ward. The job is now complete! These photos were taken on about the last day, so they don't actually show the finished product, but very close.

In these photos are Judy, Jessica Myers and Dr. Becky Wallace. Also involved were Gail, Allison and Emma Dooley; and Kathy, Cilla, Jo and Lydia Radcliffe.

I'll try to get close-ups of the murals to share with you soon.

Saturday, August 29, 2009

In the Dark

Well, in and out of the dark.

The first photo isn't a technically good photo. That's the point. It illustrates how things were in the delivery room this evening. I believe that Sister (nurse) Maria was getting me some local anesthetic in the picture. The light is coming from a small LCD flashlight that is built into her cell phone.

Many of you know that our hydroelectric plant is out of service, and is being rebuilt. Most of the time we use the public utility power, which is very inconsistent. We have an old, worn-out diesel generator, but it doesn't always run, and is always hard to start. This evening the power was fluctuating and going off altogether at times.

Through the evening the nurse on Labor and Delivery had been keeping me informed about the progress (or lack thereof) of a young first-time mom. The report that she phoned to me at 8:00 made it clear that I needed to do something to get things going, or else go ahead and do a cesarean section. She'd been pushing for over an hour, and when I checked her the baby's head was still pretty high. But with a little encouragement, she pushed a little harder, and within a few minutes moved the head down far enough that I could consider doing a vacuum extraction. That's about when the power went off for a spell.

The power came back on, and we succeeding in completing the vacuum delivery, but as sometimes happens, there was a deep tear to sew up afterwards. We were mostly ready for that when the power went off for the longest period of the evening. I just sat in the dark applying pressure to control the bleeding while we all waited for the power to come back on. When power is off in the hospital the phones are all out, so we couldn't call the maintenance person on call to come and start the hospital's back-up generator. The circuit that is supposed to start it automatically when the station power is out is broken.

But eventually it was back on, I finished my job and went home. The photos show the product of our labor. The lady in the yellow shirt is the patient's sister-in-law. She was so overjoyed at the birth of her new niece that she freely cried tears of joy. The mom's feelings (joy and relief) are clear from the last photo!

If any of you should feel led to help with the costs of the hydroelectric rebuild, or the purchase of our new back-up diesel generator, please contact us by email.

Friday, August 28, 2009

Clubfoot

Clubfoot, or, as it is technically called, Congenital Talipes Equinovarus is a birth defect that causes one or both feet to be pointed down, twisted in and curled up, to put it very simply. Sometime I'll post some before and after photos, but at the moment I only have some after.

See these feet? Do you see anything wrong with them? Neither do I! Well, I notice that they are still pointed downward a bit, and this baby will need a simple procedure to release tight tendons. I've been treating him according to something called the Ponseti Method. Ponseti is the doctor who, from 1948 to 1963 developed a way to treat this condition without surgery, by stretching tendons and ligaments, and then placing casts on the feet. About once a week the stretching is repeated and new casts are applied. The rest of the world didn't adopt his method until the 1990s, but it is now considered the standard of care.

I was surprised to learn that Dr. Ponseti is still around! He is 95, and was actively treating kids with clubfoot until this past January, when he fell at home and broke his hip. When he recovered, he started coming once again into the clinic that bears his name, but just do observe, comment and visit. While we were in the US on home assignment a few months ago, I was able to spend 3 days in the clinic there, mostly with Dr. Jose Morcuende, one of Dr. Ponseti's "disciples". I had been learning about the Ponseti Method from books, the internet, occasional visiting orthopedists, and experience, but those 3 days gave me a big "foot up" in my learning! The older gentleman in the photo is Dr. Ponseti, the younger, Dr. Morcuende. The one between the two ages is me.

After completing several weeks of repeated casting (5-6 casts if you're good, and I'm getting better, so I'm getting closer to that ideal), most of the babies need the tendon release. After that, they wear a brace full-time for about 3 months, and part-time for several years. One problem for us here is where to get these braces. The solution has been to make them ourselves. I build them out of a piece of plywood, and baby shoes purchased in the US. I'm really quite satisfied with my present design. By mass-producing the wooden part, I can cut the time required to make one to about 20 minutes.

Here I'm trying a new brace on one of the babies. Another brace in on the table nearby. You can see that the other moms hang around, visit and form an informal "support group" for each other.

This has really become a great source of satisfaction in my work. Look at this last photo, and I think you'll understand.

Thursday, August 27, 2009

Abundance

We enjoy an abundance of fresh produce here. When Judy gets home from the market, we wash all the fruit and vegetables in a mild bleach solution, then lay them out on towels on the counter to drain. I'm often impressed at how beautiful they all are. This time I stopped to take a picture.

Wednesday, August 26, 2009

Not-so-sick in Paradise

OK. I have to admit it. I'm feeling a lot better. By evening yesterday I was able to eat. I slept a pretty normal night. I haven't made desperate runs to the bathroom for nearly 24 hours. I'm getting stir crazy.

Tuesday, August 25, 2009

Sick in Paradise

You should know that this lovely portrait of me was taken at about 3 on Tuesday afternoon. I'm not usually laying on the couch in my sweats at 3 on Tuesday afternoons. I'm usually saving lives and stamping out disease as usual up at the hospital.

Monday began with my body sending me a few little hints that perhaps all was not right within. But I shrugged it of, as my body occasionally sends me hints that prove to be false. So I went to work, but the morning was accompanied by the growing conviction that my inmost parts had been invaded by viruses, bacteria, amoebae, or perhaps an army if tiny space aliens.

I came home at lunch and laid down on the bed, from whence I moved very little for the rest of the day. Occasional forays out into the rest of the house. Frequent visits to the small room next door to the bedroom. I slept so much through the afternoon and evening, that by midnight I was wide awake. So I spent most of the night in the recliner, dozing, doing Facebook, computer games or just feeling sorry for myself.

Well, if I already have you feeling sufficiently sorry for me, I'll admit that I may be feeling a tiny bit better. I ate a banana about an hour ago, and then a piece of toast just now, without any ill effects. It's beginning to look like I may survive.

Monday, August 24, 2009

A Long Life in the Highlands

An elderly gentleman came to OPD yesterday to check up on his congestive heart failure, and to get a new supply of his medicines. He was brought by his 2 sons and the local Nazarene pastor (although the patient isn't Nazarene--way to go, Pastor!) He was such a classic older PNG man, that I couldn't resist the impulse to figure out how old he is.

He was married with children at the time of PNG's independence in 1975. In fact, one of the son's who was with him is his third child, and was a teenager at that time.

So I asked about WWII. There were a lot of flights over the highlands, so people who were older than just a few years at that time usually remember it. This gentleman was a teenager when the planes were going over. So by my calculations, he must have been born about 1930.

1930 is the year that the world "discovered" the highlands of PNG. Maybe he was one of the ones that were discovered.

Sunday, August 23, 2009

Tom

Tom has tuberculosis in his central nervous system. At least we think he does--we have no way to prove or disprove it. He was admitted several weeks ago (before we got back from furlough), was treated with TB meds, and got a lot better. He was transferred to the TB.

A couple of weeks ago he had a setback, and developed seizures. He was still very weak, especially in his legs, and couldn't bear weight at all. This week he has improved a lot, first shakily standing for a few seconds while held both his hands, and then by Friday walking a few steps without holding on at all.

As he has gotten to know me, he has gotten a lot more comfortable with me, and interacts a lot more. He smiles and seems happy to see me when I come on rounds in the morning (unlike many who cry, hide or ever scream when they see me coming).

I'll probably transfer him back to the TB ward tomorrow. He'll need to stay on TB treatment and the seizure meds for several more months.

He's not a kid who likes to wear clothes, and at his age that is quite acceptable here. He's dressed a little more formally for the second photo.

Friday, August 21, 2009

Birthdays at Kudjip

When someone experiences a birthday on Kudjip Station they are subjected to various celebratory indignities. They are often made to wear the Dooley's birthday-cake hat. But they are always made to listen to a medley of 5 songs. I don't know how the medley started. Maybe someone knew a song that got added to the super-traditional one. Eventually others contributed their favorites, and they were all sung in sequence. The fourth one in the group comes from us; it's what we sang to our kids every birthday since they were small. The last one was written by some of the MKs here in the past. It always catches newcomers off guard, because it ends without resolving to the tonic chord.

The medley is dear to our (Judy's and my) hearts, because it's how we first met most of the missionary family here. The day we arrived, we had lunch with the Radcliffes, served on their veranda. It was 5 days after my birthday, and 7 days before Judy's. After lunch the Radcliffes left us waiting on the veranda while they went in to prepare desert. A few minutes later the whole missionary family came filing out of the house singing the medley (although in those days it consisted of only 4 songs), and bringing us a birthday cake.

Today it was Dr. Steph's turn. Scott Dooley brought the hat to our weekly Friday morning teaching conference. At the end of our meeting we sang the medley for her. In the meantime, Gail Dooley took balloons to the Maternity ward (Steph's ward), and prepared the patients. After the meeting, several of us hustled to the ward to catch photos (and the above video) of the event. The ladies jumped right in to "Happy Birthday to You", but knew several verses that we weren't expecting, so none of us sang them. It was awesome to hear 20 or 30 ladies singing in English but with their PNG accents, in near-perfect unison. As they got to the name in each verse, it was a carefully articulated "Doke-Tah Stef-Ah-Neee".

The look on Steph's face said a ton about why she is here. The looks on the faces of all those patients spoke a world about how well she has shown the love of Jesus here. No question. Steph has now assumed the place of most loved missionary in Kudjip.



This is the medley. Maybe later I can grab an audio recording.

A happy birthday to you, a happy birthday to you,
Every day of the year may you find Jesus near,
A happy birthday to you, a happy birthday to you,
The best one you've ever had.

So today is your birthday, that's what I've been told.
What a wonderful birthday, you're one more year old.
On the cake there'll be candles all lighted for you,
And the whole world is singing, "happy birthday to you."

Happy birthday to you,
Happy birthday to you,
Happy birthday dear Stephanie,
Happy birthday to you.

Happy birthday, happy birthday, we love you.
Happy birthday, and may all your dreams come true.
When you blow out the candles, One light stays aglow,
It's the love-light in your eyes where-ere you go.

This is your birthday song!
It isn't very long.

Thursday, August 20, 2009

Tim

Tim Radcliffe has been back in Kudjip. For those few people in the world who don't know who Tim is, he is the son of our colleagues Jim and Kathy Radcliffe. Tim was born here in Kudjip at our hospital, so he lived his whole live in PNG (with occasional visits to the US). He has been a student at Mount Vernon Nazarene University, and will start his senior year there in just a few days.

This Summer he participated in Youth In Mission, a Summer missions program for college and university students in the Nazarene Church (back when Tim's dad, Dr. Becky Morsch and I were in the program it was called Student Mission Corps.) He was assigned to the Solomon Islands. After 2 months there he traveled on to PNG to spend a month with his family and friends.

Last Sunday evening he shared with the people of Emmanuel Church about his time in the Solomons. Then Monday morning we had our traditional circle time to say good-bye and pray with him as he left. His sisters Cilla and Lydia and brother Jo held back the tears long enough to pose with him for this photo.

Wednesday, August 19, 2009

Small Operator

"If I could just reach the controls, I know I could figure out how to operate this thing."

Monday, August 17, 2009

"...God Wanted Me Back"

Those of you who heard our main deputation presentation during our recent home assignment may remember the story of Mr. Kol, the attorney who had laryngeal cancer. For those of you who don't remember, volunteer ENT surgeon Dr. Tom Staton operated on him in 2000, an operation that saved his life. Mr. Kol became a Christian when he was in the hospital at that time.

He was here at the hospital today to see Dr. Tom for his annual check-up. He's his usual cheerful, up-beat self. His electronic voice box is working well. The quote from Kol that we used in the presentation was, "I was a great sinner, but God wanted me back".

Thanks, Tom for your ministry here through the years!


Update: Anita
Little Anita, the girl with multiple muscle and bone infections died early Saturday morning, apparently of kidney failure, although there were many things that contributed. Thanks for praying for her, and please continue to pray for her family as they grieve this loss.

Sunday, August 16, 2009

Peds Ward Wall Graphics

Judy and several of the other station ladies are painting cheerful graphics on the walls of the pediatric ward. They are using an overhead projector to project the images on the wall, then tracing the pictures. They'll paint them in bright colors.

Here are Gail Dooley and Priscilla Radcliffe (sorry, no Radcliffe blog to link to) working on the project.

Flowers

I recently had the idea of taking photos of every kind of flower in our yard. We have a lot! Today I tried it. I also included any colorful leaves, etc. Even a few insects. It was sure a pleasant couple of hours spent in the yard, and even fun editing the photos afterwards. The album is 92 photos as I recall, but that's not 92 different flowers. There is more than one photo of several of them. Enjoy.

Here's the link to the Facebook album.

Friday, August 14, 2009

Generations

I met a unique family this morning. The lady in the first photo is the mother of the lady in the second photo as well as the baby on her own lap. The lady in the second photo is holding her daughter, the granddaughter of the lady in the first photo, and niece of the baby in the first photo, who is younger than she is. Confused?

The little girl in the second photo has craniosynostosis, a premature fusion of the sutures in her skull, which doesn't allow proper growth of the brain. As a result she is mentally retarded, and developmentally delayed. She doesn't babble, make eye contact, sit up or crawl.

The older mom doesn't look old enough to be a grandma. That's at least partly because she adopted her older daughter (the younger mom) early in her marriage when the girl was several years old. So that narrows the age difference a bit!

After discussing the options for helping the baby, I prayed with them, for healing, for peace of mind, for wisdom in caring for a severely disabled child for however many months or years God gives her.

Thursday, August 13, 2009

Dressed Up

Don't fashion experts say that every woman should own a basic black dress? And flowers in your hair can't ever hurt, right? I don't know about such things, but my impression of these two little girls as they came toward me on the road as I walked home this evening was that they were dressed for a party. It's nice to have a little cheer at the end of a work day.

Wednesday, August 12, 2009

Please Pray for Anita

Anita is an 11 year old girl. Dr. Erin Meier has blogged about her. She, along with medical student Rebekah Lamb admitted Anita to the hospital almost 3 weeks ago. She had multiple abscesses, and was septic (infection in her blood). Obviously, her family hadn't realized the seriousness of her illness, and had waited far too long to bring her in, a problem that we face all too frequently here.

Erin and Rebekah drained the abscesses and started her on multiple antibiotics. At first she improved considerably. Erin blogged about her improvements just a week or so ago. But in the last few days she has taken a turn for the worse. Abscesses deep in the muscles often spread into the bones or joints. The infection doesn't show on x-ray for a time, so you have to keep repeating the x-rays until they do, or until you are sure that the patient is beyond danger. This week infections in Anita's left hip and right shoulder showed up. That means that the infection was probably already in the bones when she was first admitted. Yesterday an x-ray showed that the infection in her hip had destroyed the bone to the extend that it just collapsed. The muscles around the joint have pulled the femur up into the soft tissues above the joint.

Anita now also has pneumonia, and is now badly malnourished and weak. She is unable to eat, and has nausea when she tries to drink nutritional supplements, so I've started doing tube feedings. Her left leg is now in traction. She is receiving all the antibiotics that we have that we think could be helpful. At the moment I can't think of one thing that I could possibly do that would be of any additional help. I've already been praying for her, and now I ask you to join me.

The photo is of last evening's sunset.

Monday, August 10, 2009

Having Fun

Young people need to have fun. It's an important part of their development and emotional well-being. Well, old people need to have fun for the same reasons, but this story is about young ones. Left to their own devices, they will have fun somehow. The students at our Nazarene College of Nursing have fun visiting with each other, playing sports, and .... Well, those are the only things I know about. Oh. Occasionally some of them will do something that gets them into some degree of trouble.

Mike and Diane Chapman have been concerned that there aren't opportunities for wholesome fun for the students, so they organized a movie night a few weeks ago, and then a game night this past Saturday. Diane organized the games, Mike was in charge of pop corn. They invited Judy and me to come and just be involved. Judy made a cake, not realizing how many students would come, and how far the cake would have to go. She ultimately cut it into pieces that were about bite-sized, so most of the students got a taste.

Each student made and decorated a name tag for him or her self. Games included Musical Chairs (depicted in the photo), Rhythm, and an old "mind-reading" parlor game that I don't know the name of. The students really got involved, and had fun. Which was, of course, the object. And the older people had some too, which was a bonus.

Click here to see more photos.

Sunday, August 9, 2009

Hydro Church of the Nazarene

Yes, it's a strange name for a church. The "Hydro" part, I mean. Just like most Nazarene churches, it's named after the community it serves, in this case the area surrounding the diversion dam for the station's hydroelectric system. There are actually 3 Nazarene churches that meet on the station, Emmanuel and Knox Memorial share the building owned by the Knox church just opposite the station gate. Hydro meets in a haus kunai (thatched bush material building) at the far end of the station. This is the area that has been subject of a land ownership conflict in recent months. Ironically, some members of the church there are actually contesting the legitimacy of the mission's lease of the land, and have been opposing construction of much-needed staff housing, and the rebuilding of the diversion dam.

Our friend Dr. Larry Hull is staying with for a few days and doing some consulting at the hospital while in PNG to deal with some business matters. He went to church with us. On the way, Dr. Becky Wallace (who is on call) caught sight of him, and called him into the hospital to see a patient with a compound arm fracture. He caught up with us at the church later.

The pastor at the Hydro church is Pastor Lapa, who was the pastor of Knox Memorial when we first came to PNG. His son Philip is now attending Nazarene College of Nursing. Sadly, Pastor Lapa's wife died while we were on furlough in the US.

After church, we returned to our house for a lunch of French toast, strawberries and Canadian bacon.

Click here for more photos.

Friday, August 7, 2009

Terrible Tangled Web

When we have a lot of patients who need oxygen, we sometimes don't have enough oxygen tanks or concentrators to go around. So our nurses just place these "T" connectors and give oxygen to 2, 3, or in this case, 4 patients. I think I remember one time when 5 were sharing one source. It works, although it's hard to control how much oxygen each patients receives. We usually use pulse oximters to check whether each one is getting enough.

Just as a bonus, I'll throw in a photo of a cute baby who is getting oxygen from one of the branches of that tangle.

Thursday, August 6, 2009

New Ministry

Our friend Monica Tumap has worked at the hospital for many years. I first met her at a Nazarene Global Medical Ministry conference in Guatemala in 1999. She has worked in Primary Care, specifically in our vaccination program. In that job she would go onto the Maternity Ward to vaccinate the new babies. She would also notice if a new mom was particularly needy. She would then get some baby items (clothes, diapers, etc.) from Judy, then get up in the wee hours of the morning to slip back into Maternity to place the items on that mom's bed. Usually, if you give something to one person, everyone wants it as well, and this prevented that problem.

Monica has never married. She has, however, adopted 3 children. One is raised and away from home, the second is in high school, and the third is a new little baby whom she has named Judy Mercy (the Judy part being in honor of Judy Bennett).

Monica is in the process of changing jobs. She's going to work for our Community-Based Health Care, a program the helps communities improve their health in many ways. Monica is moving to the Southern Highlands Province. While she is originally from that province, she will not be very near her home. Sometimes communities in PNG have a hard time accepting and trusting outsiders, so it may be difficult at first.

She stopped by a few evenings ago to say goodbye (she's in the center in this photo). Please pray for Monica and Judy Mercy in this time of transition.

Tuesday, August 4, 2009

Uncle Tom's Birthday

Dr. Tom Staton is in Kudjip for his 9th time of volunteer service, along with his wife, Lois. Those who have followed this blog closely may remember that we stayed in their home in Ohio during our home assignment. Yesterday was Tom's birthday, and the party at the Dooley's drew all but 1 of the Kudjip missionary family.

Aden and Wiley Riggins and Olivia Dooley are the youngest MKs.

Despite appearances in the photo, Erin didn't have the whole bowl of ice cream. She was actually serving it.

Sorry when the photo arrangement ends looking kinda crazy. Blogspot doesn't have the best blog editor in the world.

COMMENTS

Monday, August 3, 2009

Sam's Baptism, and a Time of Remembrance

While we were home on furlough, I was at my dad's apartment. On his desk was an unused baptismal certificate. He had found it among his papers, hadn't known what to do with it, and not wanting to just throw it away had left it laying there.

That got me thinking about the fact that Sam had never been baptized. He was still fairly young when we moved to PNG. He had wanted to go through the process with some of his PNG friends, but it just didn't work out. So I brought this up to him. We talked about the significance of the sacrament, and about how meaningful it would be for it to be performed by his grandfather. Since Dad is 91, there may not be many more opportunities.Sam has made public confessions of faith in Christ in many ways, but after giving it some thought, he decided to add this formal declaration of his faith.

Dad is obviously too frail to wade out into a lake or stream to baptize a fully-grown man by immersion, but our church allows baptism by any of the traditional methods, immersion, pouring or sprinkling. I had seen Dad baptize by sprinkling when the candidate was too frail or sick to be immersed, so why not do it that way when the officiant is too frail for the other method? After discussion with Sam and Dad, it was decided to go ahead with this plan.

The fact that today is the first anniversary of Mom's death (it's still August 3 in PNG) got me thinking about our last full day in the US before returning to PNG. The family gathered at the cemetery where Mom's body is buried, for a time of remembrance. None of us had been there since the day of the funeral. We don't put a lot of emphasis on visits to graves, because we feel strongly that the person is not there, just the now-worn-out body that was the symbol of the person. I hadn't even wanted to go, but it was important to my dad, so I went. It turned out to be a sweet time of reminiscing, crying and laughing together.

Following that, we drove back to Dad's apartment for the baptism. No special clothes, no formal service, just a prayer, reading from our denomination's particular version of the ritual, and then the sprinkling of the water that symbolizes cleansing and new life, and the words, "Samuel Bennett, I baptize you in the name of the Father, the Son, and The Holy Spirit. Amen." And we all said a hearty "amen"! Then Dad signed that long-neglected baptismal certificate.

For more photos of the day and of the baptism, go to this link.

COMMENTS

Sunday, August 2, 2009

My Cup Doth Overflow (or at least my ward doth)

I've posted photos of patients on the floor of A-Ward (Pediatrics) before. I just don't understand why it fills up when other wards have empty beds. This morning I discharged 2 patients from A. I discharged about 5 from C (Adult Medicine), which already had empty beds. Through the day I admitted 2 new patients to A, none to C.

And then tomorrow, Dr. Becky Wallace and I will have to take care of A (with the help of medical student Rebekah Lamb). Drs. Erin Meier and Scott Dooley will be looking after C-Ward, empty beds and all. I tried to get some C-Ward patients home, I really did.

Sigh.

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Saturday, August 1, 2009

Operation Warm Baby

For a couple of years now, Nazarene churches have been sending little packages for us to give to little people. They are "layettes"; basic supplies for caring for a baby. A receiving blanket, a couple of diapers, some pins, a pair of plastic pants, a bottle of baby powder, a sleeper, a "onesie", a knitted hat, a pair of socks, a washcloth, and a bar of soap all packaged in a 1-gallon zip-lock bag with a lot of love. Judy and a lady from a church in Oregon came up with the name "Operation Warm Baby." It also produces warm hearts.

Some of the young mothers have very little in the way of material things. Many of them have never received a gift. So, a zip-lock bag of baby supplies, given in the name of the One who blessed the children. Help Him bless them again.

To find out how your church can get involved, contact Judy Bennett at hospitallinks@reachone.com.

Click here to see more babies and the things they got through Operation Warm Baby.

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