Wednesday, June 27, 2012

Is It Safe?

Since I coordinate volunteers and students at Nazarene Hospital, I am often asked questions about safety in PNG.  Well, to be honest there are some security concerns, but we do our best to be careful and prudent.  In any country, including the US there are certain places you shouldn't go at certain times or in certain company.  It's no different here.  We try to follow some practices that we think will help avoid unnecessary risk.

But ultimately, our security isn't in policies, or procedures, or avoiding danger.  Our security is in God.  Here is a link to a blog by John McHoul, with HeartLine Ministries in Haiti.  It says it far better than I can.

Haiti Can Be A Dangerous Place

Saturday, June 23, 2012

Samuel's Wheelchair

Monday was busy in Outpatient.  Killer busy.  One of those days when the stack of charts of patients waiting to be seen seems to be growing taller as the day goes on, rather than smaller.  Each of the doctors here has ways of trying to cope with that kind of day, ways to make themselves go faster.  You think harder about whether you really need xrays, or tests.  You ask yourself if the results will really change anything about how you care for the patient.  Sometimes you postpone things until the next time the patients comes in.  It's all necessary.  The time you save increases the total number of people you can help.  I find that on those days I talk less with the patients, spend less time finding out who they really are, what they are about.

But when little Samuel came in, it really slowed me down.  His mom's immediate concern was his cough, but it was obvious that there was a lot more going on.  He obviously had less than normal muscle tone.  His arms were a little stiff.  He didn't make eye contact.  He didn't show the normal apprehension that a child his age (about 4) would usually show toward a big, ugly, white doctor.  He didn't speak.  As I asked questions and thumbed back through his record book, the story gradually emerged.

About a year and a half ago, Samuel had developed a fever and seizures.  Although the family lives near Nazarene Hospital, for reasons I don't understand, they took him to the government hospital in Mount Hagen.  He was admitted there for almost 4 months.  Although his mom concluded that he must not have been treated properly, I know that this isn't necessarily the case.  They had done a lumbar puncture and had documented that he had meningitis.  They had treated him with intravenous antibiotics.  I can tell you from frustrating experience that sometimes you do everything right, but meningitis takes a terrible toll on a child.  Whenever I make this diagnosis, I now routinely tell parents that sometimes children recover well, sometimes the die, and sometimes they are left with brain damage.

I asked Samuel's mom if she knew about the rehabilitation program at a nearby Catholic mission.  Although this program is not active at the moment because of lack of staff, it has provided valuable help to many people over the years.  "Yes," she replied.  "They taught me how to exercise his limbs, and how to take care of him!"  As I examined him, I noticed that he had pretty good flexibility, and that his skin was in good condition.  Apparently they had taught her how to secure him safely in a chair so that he could sit up and watch the world around him.

Just then we were interrupted by a knock on the exam room door.  I'm a believer in "divine appointments".  Sometimes God plans events that seem random to us, but accomplish His purposes.  This was one of those events!  It was Judy at the door.  I have completely forgotten what she came for--some relatively-trivial question, or to give me something.  But as soon as she saw Samuel, the original purpose of her visit was forgotten.  Judy loves kids, and has extensive experience working with cerebral palsy kids as a speech therapist.  She immediately focused on him.  She was delighted to know his name (you understand that Samuel is one of our favorite names).  After visiting for a few minutes, she said that she had a "CP chair" that she thought would be about the right size for Samuel.  We planned for Samuel and his mom to come back on Thursday, both to follow up on his cough, and to try the chair.

Later in the afternoon, she brought the chair to my exam room.  I put it in the corner for the time being, and a couple of days later had a chance to look at it more closely.  It looks to me that this wheel chair was a custom chair for a particular child, with attachments needed by him or her.  (Edit:  Judy just reminded me that the name "Ethan" is embroidered on the backrest!)  I'm guessing that he or she was a little bigger than Samuel.  It was obviously used, but well cared for, and in very good condition.  I noted the tools that I would need to adjust it.

We receive valuable equipment and supplies from many sources, but two organizations help us a lot.  Nazarene Hospital Foundation, in Medford, Oregon, under the leadership of Dr. Todd Winter has supported us for many years, shipping 2 to 4 containers per year.  I have blogged about the arrival of their containers several times.  You can see stories here, here, and here.  We also occasionally receive containers from Project S.A.V.E., out of Chick, California.  Both of these groups send us high-quality, useful equipment.  Judy isn't sure which group sent this chair.  It had been in the storeroom for some time.  A special item like this sometimes has to wait for a while to find just the right person to go to.

Yesterday, Samuel and his mom were back.  When she saw the chair, her eyes lit up!  I busied myself with my tools, moving the various fittings to accommodate Samuel.  There were a couple of items that I didn't think he needed that I removed.  I adjusted the straps and foot rests and headrest.  The chair is still a little bit too big for him, but close enough.  The addition of a thin cushion at his back made it fit pretty well.  I showed his mom how to use the different features, including adjusting it from fully upright to fully reclined.

Then it was time for another divine appointment.  Missionary Mike Chapman came to the door of my exam room.  Again, I can't remember why he came, but as he usually does, Mike had his Cannon D7 camera hanging around his neck  He took the pictures that help you all to enjoy the story.

Imagine the difference that this chair will make in the lives of Samuel and his mom.  Instead of tying him to a chair to allow him to sit up, she can just squeeze a lever, and move the chair to the upright position.  When he needs to rest, but it isn't time for bed, she can just tip him back into a recline.  When she wants to give him a different view, she can just wheel the chair.  And as he grows and gets heavier, she won't have to carry him, along with whatever else she needs to transport.

Please pray for Samuel and his mom as he grows and his needs change.  Pray that the whole family and village will be supportive and helpful.  Pray for Nazarene Hospital Foundation, and for Project S.A.V.E., and all the other groups that are blessing others in the name of Jesus.  Pray for us as we serve those around us day by day.

For more photos, see our Facebook page here.

Tuesday, June 12, 2012

Telling The Story

These days there are lost of ways that missionaries can share with people both in their own home countries, the country where they serve, and around the world.  This blog is one obvious example.  To see how far-reaching this medium is, just scroll down and look at the left-hand column.  You'll see a map of the world, with red dots representing places from which people have seen this blog.  Pretty amazing!

Then look at the upper left-hand corner of the page.  Do you see that box with the Facebook logo and a picture of Judy and me?  That's something new in just the last couple of days.  It's a link to our page on Facebook.  Please notice that a page is different than a personal profile.  Ever since Judy and I joined Facebook, we've used our profiles to tell about our mission work.  Lots and lots of people have become our friends on Facebook primarily to find out about our work.  We don't really know them in person.  They may or may not be interested in stories about our nephews and nieces, or pictures of our grandson (unlikely as that seems!)  Now we're trying to make the profiles truly personal, and to use the page to share about missions.

The page is almost purely about our work and the country and people of Papua New Guinea.  It would have caused less confusion if we had given the page a catchy name like "Andy and Judy the Missionaries" or "Our PNG Adventure" or something.  But alas, we gave it the name "Andy and Judy Bennett", and many people have trouble distinguishing it from "Andy Bennett" and "Judy Bennett", our personal profiles.  Sorry.  I'm planning on looking into changing the name, if that wouldn't cause even more confusion.

Facebook and blogs are very different.  I've worked to make the blog nice in appearance, and have added "extras" in the side bar, like links to other missionaries' blogs, church and mission web pages, a search bar, and of course now a link to our Facebook page.  I try to keep stories on the blog short, but I consistently fail.  Facebook is much more suitable to the quick info bite.

Here's my plan.  I'm going to do both, as long as it isn't too time consuming and difficult.  The longer, more detailed stories will be here, along with a few pictures to keep it a little more interesting.  Facebook will have the shorter, quicker stories, and albums of photos, links to interesting sites, etc.  I'd urge you all to look at both from time to time.

If you are not a fan of our Facebook page, please just click on that Facebook box in the upper left-hand corner of this blog.  After that, you will get little items in your news feed about posts on the page.  Of course, you can also just visit the page from time to time.

Thursday, June 7, 2012

The Rest of the Story

This week I had a reminder of an experience from the early weeks of our time in PNG. It seemed like a good story to make into a blog post. So I sat down to write it. The further I went in writing, the more I had the feeling that I had written it before, maybe shortly after it happened. In those days we used an email list to share information about our ministry. That was before blogs and Facebook, believe it or not!

Kamda and Yamul with Lori's little brother

So I stopped and looked back through some files that I haven't accessed for years, and there it was. Interestingly, I had included many of the same peripheral information then as I was including in the new version. There were a few facts that were told differently than I now remember them. The earlier version is more likely to be right. The "reminder" alluded to above was a conversation with Kamda and Yamul, the parents who adopted the baby in the story. My old version was closer to what they told me than were my later recollections.

As I read the old story, I realized that I probably couldn't tell it any better now than I did then. Let me just paste old version with just a little editing, and then I'll tell you the "rest of the story".

We called her Susie.  Her "real" name was Winda, but many PNG people have several names, and change them at different times and for different reasons.

On the maternity ward I don't often have a chance to get to know the patients well.  Even here with our high infant mortality rates, most women come in labor and leave a few days later with their healthy child, and do not require much attention from the doctor.  Not so with Susie.  She came to Nazarene Hospital initially from her home in the Jimi Valley because her abdomen was swollen to a much greater size than could be explained by her 7 months of pregnancy.  When I first saw her, I allowed myself a brief hope that maybe she was carrying twins or triplets.  But as soon as I examined her I knew it was something far worse.  Her huge abdomen was filled, not with a term-pregnant uterus, but with fluid.  There is a short list of possible reasons for this condition, and none of them are good. 

There is a medical superstition about things coming in threes, and this was following that tradition.  When she came in last November, she was the third similar case I'd seen within a few weeks.  The first had delivered successfully, had come back a few times after that, and then had been lost to follow-up, presumably because of death.  The second delivered, then was quickly taken home by her family to die.  In reality, she probably died shortly before or while being carried out by her relatives.  I don't know anything about either baby.

It was with a true heaviness of heart that I confirmed the diagnosis with ultrasound; normal-sized uterus with a vigorous-looking, thirty-week fetus, a huge sea of watery fluid and a small, shrunken liver.  Cirrhosis, probably caused by a hepatitis B infection.  What, I wondered, would be this child's future?  If we could delay delivery for a few weeks, she would have a fighting chance.  But then what?  Motherless children in PNG are usually cared for by relatives, or by their father's new wife.  Often they are loved and well cared for, but not always.  There are always problems with what to feed them.  Many have a relative who still has breast milk, and who is willing to nurse them, but not all.

So I admitted Susie to our maternity ward, and she was there long enough to get to know her well.  At first she was fearful of everything.  She was physically very small (as are many people from the Jimi), and came from a very remote place, the village of Kwipun.  She had had little or no contact with modern technology (even the paltry bit that we have) or with expatriates.  But it didn't take long for her to realize that she need only expect to be treated with kindness.  Then her natural sunny disposition became evident.  There are many Jimi people who work here at Kudjip station, and they quickly rallied around to make her feel welcome and safe.

At first she showed signs of premature labor, so we gave medicines to stop that, and medicines to try to prepare the infant should we fail in our efforts to delay delivery.  If we could just buy a few weeks' time, the baby would be mature enough to make it in the "outside" world.  After nearly a month in the hospital, Susie went into labor, and delivered a beautiful baby girl.

We didn't know whether to measure Susie's expected life-span in weeks or months or years, but we optimistically performed a tubal ligation on her, in case she recovered and lived long enough to get pregnant again.  We needn't have worried.  We discharged her at first to stay with relatives who live nearby, but after her follow-up visit, she went home to the Jimi.  I know the doctors who work at the small health center near her home, and I sent a note to them along with her, and instructed her to follow up with them as needed.  Then she was gone from my life.  I thought of her from time to time, and wondered what might have become of her and her baby.  I thought that maybe some day I would have a chance to ask the doctors from the health center if they had had any contact with her.  But that was all.

Until Lorrie arrived on A Ward.  Lorrie had pneumonia, but not a severe case, as far as severe pneumonias go here.  She is a chubby, bright, happy healthy baby girl of about 8 months.  She seemed secure and happy.  She has evidently had some contact with BUWGs (Big Ugly White Guys) as she didn't seem too afraid of me.  She would even smile for me when I saw her on rounds.  Her mother was attentive and competent, answering my questions clearly as she sat nursing her baby.

It was only after she had been in the hospital for a few days that one of our nurse's aids who is from the Jimi, slipped up beside me while I was seeing Lorrie.  "Do you remember the patient Susie who was on bed B-5 last November?  She had bad liver disease."  I had to think for a moment before the memories of Susie's hospitalization came flooding back.   Yes, of course I remember her.  "This is the baby that she carried here; she died just two or three weeks later.  This mother has adopted the baby.  She has never carried a child, but she has breast milk for the baby." 

"Yes," added one of our nurses, "she took some Metamide, and now she has plenty of milk for the baby."  "Plenty?" I asked incredulously.  "Plenty?"

"Yes, plenty," said the mom, as well as several others more or less at once. "Plenty!" 

Lorrie is clearly well-nourished.  She hasn't had formula.  Baby formula is very expensive here.  It would take more than most families' entire income to supply a baby with formula if they have to buy it at the drug store.  We give some away as we are able.  People feed babies the milk that is available here, sometimes watered down.  Sometimes they feed them Milo, which is a chocolate powder that you can add to milk to make a tasty beverage that is popular here.  More often people have to mix it with water to feed the baby.  Milo in water has little or no nutritional value.  But it is all some babies get.  Even worse, many families use unsafe water sources, either out of ignorance or necessity.  We give either or both of two medicines to adopting moms that can sometimes stimulate some milk production, but this is usually not very successful, especially if they have not had a baby recently.

But here was this miracle right before my eyes.  Lorrie's dad is Kamda, a cousin of Susie's.  He teaches at Melanesia Nazarene Bible College, and directs the Extension Bible College program for pastors who cannot attend school full-time.  He and his wife Yamul had not been able to birth children, but now they are the obviously-proud parents of Lorrie.  As an adoptive father, I could relate to their happiness.

Romans 8:28 reads, "And we know that God causes everything to work together for the good of those who love God and are called according to his purpose for them. (Holy Bible : New Living Translation. 1997 (Ro 8:28). Wheaton, Ill.: Tyndale House.)  I have to admit that I struggle with the application of that verse many times.  Did God allow Susie to die, just so that Kamda and Yamul could have a baby?  No, I don't think so.  But in a world where sin and evil still exist, God takes terrible circumstances and brings good out of them for His glory.

So, that's the story I told in February, 2005. Since then, Kamda has become the District Superintendent of the Bromley District of the Church of the Nazarene, which includes the Jimi Valley. To be honest, I had failed to make the connection between Kamda, the new DS of the Bromley District, and the couple of the story above. But this past Wednesday evening I had the chance to visit with him and his wife Yamul, and they reminded me. They mentioned that their daughter Lorie was a baby that I had helped to bring into the world. With a few reminders, the story came back to me.

Lorie is now a happy healthy 9 year old, and is in grade 3. Kamda and Yamul have now adopted 5 children. She has successfully breast-fed all of them. As I was visiting with them a 4 year old was sleeping contentedly on his dad's lap.

Most of the patients I take care of come into my life for a short time. For many, they come for a relatively-minor problem, and there really isn't much of a story. For those that I've been more deeply-involved with, they may come back, but many times see a different doctor. Or they come for a new problem, and don't realize that I don't remember the earlier events, or they assume that I wouldn't be interested in being reminded. So there often isn't any "rest of the story". But I love it when there is!