The Challenge of Continuing Education

Many of you probably understand that all doctors in the United States are required to acquire continuing medical education in order to maintain licensure.  So . . .  why should that matter to a missionary doctor you might ask?  Well, for several reasons, not the least of which is my desire to try to stay up-to-date with current medical knowledge.  But more pressingly, in order to remain licensed in PNG I must remain licensed in the U.S.  Therefore, even when I'm here in PNG I need to keep up on the requirements.

While there are many ways to earn continuing education credits, one of the best ways continues to be live, in person medical conferences.  There are none of these offered in Papua New Guinea.  I can try to attend some during my furlough time while in the U.S. but many of the conferences offered there are not particularly relevant to my work here.  Most missionary physicians have a similar problem.

For a number of years now, the Christian Medical and Dental Society has offered a solution.  Dedicated volunteer faculty from all over the U.S. go out every year to teach CME courses to missionary doctors.  Many of them have either served in the past on the mission field or have volunteered at missionary hospitals.  They understand the conditions under which we practice.  The meetings are designed to also be a time of spiritual refreshment for the missionary families.

The doctors here at Kudjip take turns attending the conference which is held in Thailand.  This coming February its my turn!  The hospital here helps as much as they are able.  There are still many expenses involved that are not covered by other funds.  It will cost about $5000 for Judy and me to go.

Would you prayerfully consider helping us to attend?  If you want to chip in, please send your donation (which is tax deductible) to: Nazarene Financial Services, 17001 Prairie Star Parkway, Lenexa, KS 66220.  Mark the check "Work of A & J Bennett."

If you prefer to give online, go to this web site.

The Independence Day Accident

PNG's Independence Day is September 16; it fell on Thursday this year.  Since a lot of our staff like to have a long weekend, the hospital administration decided to stay open on the 16th and close on the 17th.  So it was pretty much business as usual for us on the morning of the 16th.

For me, Thursday morning is Talipes Clinic.  I've written several blogs (also here) previously about my work with kids affected by talipes (clubfoot). 

 Taking a cast off one of my talipes babies.  Another is waiting her turn.

I do the talipes work in the orthopedics area, adjacent to the emergency room.  I was finishing up, just before lunch time, thinking about going to the house for some food, a cup of coffee and the chance to sit down for a few minutes, when Judy (who was there helping me with the talipes clinic) told me that a vehicle had just arrived carrying 13 victims of a motor vehicle accident. We have something called "Public Motor Vehicles" or "PMV"s.  These are privately-owned, but licensed to carry passengers for hire.  Some are small vans, some are larger buses, and some are open-bed trucks fitted with benches that can carry 20 or 30 passengers.  It was one of these that had slipped off the road on a steep slope and rolled down the hillside.  The accident occurred about 45 minutes travel time from the hospital.  We never found any evidence of alcohol use on the part of the driver.

Me, working on one of the motor vehicle accident patients

As I looked up I saw that there were already patients on most of the exam tables in the ER, and they were starting to bring a patient into Ortho.  As I was finishing with the last of the talipes babies and sending him on his way, our medical student Charlotte arrived, and the two of us started screening the patients.  An ER nurse started phoning the wards to ask any nurses or nursing students who could to come to help.  The initial screening process consisted of feeling for a pulse (if the pulse rate is normal, there isn't much blood loss), seeing if they were breathing, and asking the patient where they were injured.  If they could respond that also told us something about their mental status.

Nursing staff working with MVA patients

As extra help started arriving, I instructed that each nurse or student should attach themselves to one patient, get full vital signs and evaluate them in some detail.  A piece of paper was placed with each patient to record the vital signs, and other information as it was gathered.  Very early in the process, Dr. Susan Myers came over from Outpatient.  Also, Dr. Steph Doenges was already there, but was tied up treating a child with severe facial injuries from a different incident; she eventually was able to join us in the fray.

Family members watch at the ER window

Only one patient stood out in the first round of screening, an older lady who seemed to have injuries in several areas of her body, and a rapid pulse rate.  I ordered IV fluids and some x-rays.  The trouble was, the x-ray staff had gone to lunch, and one had the morning off.

Then staff called me to re-evaluate a young lady that hadn't seemed too bad on the initial check, whose pulse rate was only a bit up, and who was talking at first.  They called out to me that she was struggling for breath.  We quickly started ventilating her with a bag and mask, and then intubated her trachea so that we could ventilate more effectively.  Immediately, air started accumulating under her skin, indicating major injuries of her lungs and airway.  She died within moments.

Family members (or curious onlookers) outside the ER window

We all continued working our way around the patients.  Eventually the ones who needed IVs had them in.  Patients with fractures had splints on to stabilize the injured limbs.  Before long the x-ray folks got back from lunch, including the one who had had the morning off, and x-rays started coming back.  Dr. Graham Wetzig, our volunteer surgion had been in the operating room all morning.  He was able to come in and take over the supervision of the situation.  Eventually the rest of us were able to go get some lunch.

One other young man seemed to have some internal injuries, and Graham took him to the operating room later that afternoon, and cleaned out a large accumulation of blood from behind his bladder.

Later we learned that 2 men had died at the scene of the accident, and hadn't been brought to the hospital at all.

The old lady with multiple injuries died later that evening.

A number of less-seriously injured patients were brought in throughout the afternoon.  Altogether we believe that we treated over 20 survivors.  Many were treated and released, but a good number were admitted.  Most have now been discharged.  One little girl will undergo some skin grafting on her face later this week.

 A boy with minor injuries waiting to be treated

I was pleased at how well things went.  Staff worked well together.  Patients were evaluated in an orderly way and treatment started promptly for those who needed it most urgently.  Thank you for your prayers--it is God's strength that keeps us going every day.

AB

She's Not Heavy, She's Sombody's Grandma

Walking past one of the grassy areas by the hospital this afternoon, I saw three nursing students helping an elderly lady out of a wheelchair so that she could sit down on the grass.  The urinary catheter trailing out from under her skirt confirmed that she was a patient.  She obviously preferred to sit on the ground over sitting in the wheelchair.

I was impressed with how tenderly the students were treating her.  They couldn't have been more gentle and kind if she had been their own grandmother.  Who knows?  She could have been a relative of one of them.  It's a small country, and it's not rare that a relative of a student or staff member is a patient here.

AB

Kids In The Trees

The kids are pretty good about asking if they can climb our guava tree to pick an afternoon snack.  We joke about the fact that PNG children have no idea what ripe guavas are because they pick them as soon as they are big enough to eat.

I heard a cry for help and there was Emelton hanging precariously from a high branch.  As the tallest person there, I ran to help him and caught him as he fell.   One of the injuries that the doctors see often in the emergency room is broken arms from falls from guava trees!  In fact, Andy remembers one little girl a few years ago who managed to break both arms in one event!  Since both arms were in long-arm casts, she couldn't feed herself for several weeks.

The pictures here are reenactment of a real event!

JB

Being There

So, we spent a week high in the Bismark-Schrader mountains.  Judy and I were at Dusin for the full week, and Jonathan and Sam spent 3 of the days in Gebrau.

The first photos are of Dusin from the air.  You can compare them in the photo in the last post.  You can spot the house just off the airstrip.  Unfortunately, my photo software at the moment doesn't provide for drawing, or I'd add an arrow or a circle.  Also, note how many more houses are around now as compared to 1970.

The third picture is just a face to represent all of the great people we visited with during our time there.  More details later.

AB

Getting Away

We're about to go on vacation.  It's a pretty exclusive resort.  In fact we'll only be the 3rd party to stay there this year.  The luxury accommodation has 4 bedrooms, and indoor plumbing!  It will have running water as soon as we get the pump fixed.  Until then, the "running" water will run on 2 legs!  The cost?  We have a list of repairs to do while we're there.

It looks like we're packing to move, but it's just for a week.  The food at this resort is good, but you have to bring your own groceries.  And cook.  The fridge at Dusin no longer works.  It is (or was) kerosene-powered.  Yeah, I'm with you, I still can't really understand how a little flame can make something cold.  In this case it doesn't any more.  So we're taking a big industrial-quality cooler chest full of frozen food and ice that is guaranteed to give us fresh meat even on our last night.

If you wonder where Dusin is, don't bother looking on any map you are likely to find.  If you can find the old NWMS (now NMI) reading book called "The Edge of Nowhere" by Daryl Schendel, there is a simple map there.  Let me just say that Dusin is so far into the mountains that if you go any farther you're going out the other side.

As an afterthought, I'll go find a copy of the book and scan the map and maybe a photo.

Here it is.

Dusin is in the upper left quadrant of the photo.  Note the little rectangle that represents the airstrip.  The airstrip is build on a 12% grade, which makes it very "interesting" to land at.  However, since the first landing there on May 17, 1973, Mission Aviation Fellowship (and a few other agencies who occasionally use the strip) have a perfect safety record.

Notice the lower left-hand corner where the arrow points down the road, and it says "To Kudjip" and the legend that says "Simbai to Tabibuga (2 days' walk)".  You should know that very fit nationals can make that walk in 2 days, and about another days' walk from there to Dusin.  You understand why we fly!

And here is a photo of the airstrip under construction.  The house shows as a white rectangle just to the right of the center of the photo, just off the runway.  I'll try to get a shot from this angle to compare, and post it when we get back.

See you in a week!

AB

Extreme Makeover: Pokarumb

Each time we passed the Pokarumb church on the way to town we noticed how rundown the building looked but we understood that the cost of a gallon of paint is roughly equivalent to 5 months of a pastor's salary ($80 US!). 

Pokarumb was the third church started in PNG.  Syndey Knox, the pioneer missionary, worked to build a building for them to worship in, in 1957. Its land has unfortunately been at the center of some terrible tribal fighting over the past 6 months.  The lay pastor, Pastor Elis, tells the story of being "hands upim" (held at gunpoint) with M-16s in the front yard of the church.   The enemy line cut down the huge old trees surrounding the building, stole windows from the church and tried to destroy the sign.  She pleaded with them not to destroy the parsonage and they left it standing, after taking everything from inside.  The house of the retired pastor was dismantled and taken.

The fighting is over now.   17 men were killed on both sides.  The church almost died also.  It went from a sanctuary full of men and women to 7 faithful women.  The men had to flee the land to save their lives.

The faithful few prayed that the Lord would help them to fix the church building.  They felt it would be a new start for the small group of believers.  The next day Jonathan, Sam and I talked with them about coming to help!  How sweet the Lord is!

We, along with a team of MKs and volunteers, spent a Saturday painting, repairing, installing new window glass and having our own tribal war with 2 hives of bees (they eventually lost but left wounds on many of us!).  A group of us went the next to day to worship with them.  What a privilege it was to encourage this small group of brothers and sisters in the Lord.  We took two special pictures--one of mostly women who had stayed during the fighting and one of young men who had fled and now returned home.

JB

For an album of photos and captions that go with this story, click here.