Meri Bung

Ladies from Jiwaka Province (here)

If you spend much time in Nazarene churches around PNG, you will catch on that one of the most exciting times in the life of the church here is the semi-annual "Meri Bung", literally women's meeting.  In English it's the Church of the Nazarene National Women's Conference.  Ladies go to extraordinary lengths to raise the money and plan the time.  They sell vegetables at the market, make extra bilums (string bags) to sell or find odd jobs.  Then they plan with their sisters, husbands, older children or neighbors to care for their small children for the week.

Ladies from Port Moresby

Ladies from remote areas usually have to walk out, as flying is prohibitively expensive for them.  For some of them this is their first time out of their isolated mountain villages.  For some, it is the first time to see a car or truck, a paved road or large western-style building.  They come in groups, with a few husbands and pastors coming along for protection.  They created uniforms, different for each district, consisting of matching "meri blaus", a piece of clothing that is sort a combination blouse/dress.

25-passenger buses lined up and ready to go

They come to key gathering places and then buses are chartered to take them to the meeting.  This year, it's being held in Mendi, Southern Highlands Province.  Kudjip was on of the gathering points.  I counted 48 vehicles in all, some 15-passenger vans, 25-passenger busses, open-backed trucks and a few Land Cruisers (a big sort of SUV that is very popular here).  They were meet an unknown number of additional vehicles in Mount Hagen on the way to Mendi.  Some vehicles were packed in so tightly with ladies and all their baggage that I don't see how they could move.  Most Westerners would feel pretty claustrophobic. 

Some were settled in the busses 2 hours in advance!

Departure was Sunday morning right after the church service at Emmanuel Church.  Excitement was in the air, for sure.  There has never been a bunch of junior high kids leaving for Summer camp any more excited and giddy then these ladies.  Some groups were singing.  Some were just laughing and smiling.  There were all ages, all socioeconomic groups, all degrees of education.

The meetings are being held on the grounds of a school, with the classrooms being used as dormitories.  I'm sure that the organizers also build dozens of temporary bush houses.  Many ladies are staying in local churches of many denominations.  The men who go with them patrol the grounds all night for security.

The buses head out

It's now been four days since they left.  A few missionaries went along for the first couple of days, and have returned.  In addition, Judy got a call today from a friend who is attending, who reports times of the moving of the Holy Spirit, with many receiving spiritual help.  Interestingly, she said that there were 38 street boys who have given their hearts to Jesus.  What were street boys doing at a Nazarene Women's Conference you ask?  Well, any big meeting in PNG is bound to attract a lot of locals.  I'm sure that these young men, almost certainly criminals, just heard the music and saw the lights and came out of curiosity.  But they heard and responded to the gospel message!  Praise the Lord!

AB

The Foot Club

This is why I always reinforce Jeremiah's casts with fiberglass!

Yeah, it's a pun.  As people who follow this blog know, I have a special interest in treating kids with clubfoot, (technically called "congenital talipes equinovarus").  These kids are treated by the "Ponseti Method", which involves stretching the ligaments in their feet, and applying casts.  The procedure is done weekly for several weeks, and then is usually followed by a simple operation to lengthen their Achilles tendons.

Seeing the kids over and over weekly allows me to develop more of a relationship with them than with most patients.  Most don't come to love me as much as I love them, however!

Some members of Dr. Andy's Foot Club

Lately I've had several older kids (treatment started after the age of 24 months is called "neglected clubfoot" and is usually more difficult than when you start younger.  One is Jeremiah.  He is five years old, and is not at all afraid of me nor of the power cast cutter that I have to use to remove his casts each week.

This past week, because of a heavy work load, I asked him to skip a week, and come back after 2 weeks.  This gave him extra time to destroy his casts.  He usually crawls around in the dirt and rocks, but this time has obviously been in some serious mud.  For kids who are big enough to crawl, I always reinforce the plaster casts with fiberglass.  Just imagine what these casts would be like if they were only plaster!

Feet are pointed down, turned under, twisted at the center

People here rarely have the opportunity to develop friendships outside their own or neighboring clans.  The families that gather every week outside the orthopedic room for my clubfoot clinic, have a lot in common in their children.  They get to know each other, they sometimes helps with holding kids, giving advice, etc.

The talipes work is one of the most rewarding parts of my life here.  You've seen this in some of the older posts, like this one.  Seeing a child who could only look forward to a life of disability and exclusion from a normal life be able to return to normal in just a few weeks provides a special feeling.  And for most of these kids, the contrast is really that great.  With untreated clubfoot, they are marginalized, unable to participate in many normal activities.  After treatment they usually can live and function normally.

AB

Preaching At a Bush Church

I was invited speak this morning at a new preaching point.  It is an offshoot of the Kurumul church, which is the second-oldest Nazarene church in PNG.  I didn't realize that it would be about a half-hour walk from the road, but it wasn't a difficult walk.

Here is a "preacher's-eye" view of the church.  I preached from Luke 15, the story of the Prodigal Son, one of the clearest passages we have on grace and the Father's love for us.  Nine people came forward to pray, all Christians, several of them believers for many years.

AB

Round Numbers

Number 190035.  I think.

Yeah, I'm the kind of guy who loves to see big, round numbers.  Like on the odometer of a car.  I think it's fun to notice when the mileage rolls around to 100000, or 123456, or 111111, or 020202.  I have even been known to pull over to the side of the road to stare at a number for a minute, or to take a picture of it.

So naturally I took notice when I started seeing the patient numbers at the hospital approach 190,000.  When we write a discharge summary for a patient who is well enough to go home from the hospital, we note the number so that the hospital record can be found easily later if needed.  I started wondering when the numbering system had been adopted.  Was it with the first patient who was admitted, or did they start this system at a later time.  I asked around, but no one seemed to know.

Then I had an inspiration.  I correspond with Hal Frye, who was either the first, or at least one of the very early administrators here.  I emailed him and asked about it.  He wrote back to say that he believed that the system started from the very beginning.

When I saw that the new numbers had gone past 190,000 I got to thinking that it would be fun to take a picture and to tell you all about him or her.  After a few days, I "sprung" (sometimes I spring slowly) into action, and went to the log book and looked up patient number 190000.  It was a lady named Elis who had been admitted to the maternity ward several days earlier.  I went to the ward in hopes that she was still there, but she had had her baby, and was long gone.

The next morning I was discharging a baby from the pediatric ward, and noticed that his number was only about 190035 (sorry, I didn't write it down, so I'm not sure).  I figured that he was the closest I'd come to documenting the big even number, so I took his picture.

What's the point?  It's that the hard work, prayers, giving and dedication of Nazarene people everywhere (and a lot of others as well) has resulted in ministry to 190,000 men, women, boys and girls in the wards of Nazarene Hospital.  If you think about the families of patients, I'm sure that you could multiply this number by 5 or 6.  Then think that we see about 10 outpatients for each inpatient, and the number is into the millions.

Some of those people had minor problems, some had devastating diseases or injuries.  Some recovered, some died.  Some were Christians, some weren't.  Some heard the gospel and accepted it for their soul's salvation.  Some turned cold hearts away from the message.  But every one was touched in some way.  Every one was loved.  Every one was prayed for.  Every one was more than a number.

AB

You Can't Have Too Much of Baby Andy

This is a first for me, embedding a video in the blog.  However, it is a far too important video not to publicize far and wide!



There you go!  Amazing, huh?

My Morning

So, ya wanna know what I did between ward rounds and lunch today?  Today was my "half-day", which is one day per week when each doctor has some time away from the hospital to do non patient care work, or catch up from times on call.  Whether is is really half of the day, or more or less depends on how many doctors are here, and how busy things are.  Sometimes there are enough doctors that we can leave the hospital right after ward rounds.  Sometimes we work in outpatient until lunch time.  If we are particularly short-handed, we don't take the half-day at all.  But this week we tried out a new system; after ward rounds, we see eight patients in outpatient, and then go.

Patient number 5.  With his mother.

So, I thought you might like to know about the eight patients I saw.  They represented a good selection of the patients we see.

1.  A young adult woman with a bladder infection.  She had taken medicine for a week, but didn't get better.  I was pretty sure that it was really a bladder infection, so I prescribed a different antibiotic.

2.  A young woman with a couple of lumps on her arm.  I told her that these were lipomas, and were harmless, that they didn't need to be removed.  She was quite uncertain, and asked several time if they should be removed.  Finally she asked if they were cancer.  I assured her that they weren't, and she finally seemed relieved.

3.  A man in his early thirties who had recently completed treatment for abdominal TB.  He was feeling well, his exam was normal.  Those meds really work!  And, yes, TB can infect areas other than the lungs.

4.  An elderly lady with a chronic cough.  She has been treated for both pneumonia and chronic obstructive pulmonary disease, but has recently started coughing up blood.  I got her most recent chest x-ray from the x-ray room to review.  I then sent her to the TB nurse to start TB treatment.

5.  Baby boy with several days of diarrhea.  Not sick enough to need to be admitted to the hospital (he was laughing and smiling, for goodness' sake--a sure way for a baby to disqualify himself from admission to our hospital!) I prescribed some meds, and asked his mom to bring him back on Friday, sooner if he should get worse.  See photo above.

6.  A young woman with chronic pelvic pain.  She had been treated several times for pelvic inflammatory disease, without any improvement.  When I examined her, I noted that her uterus was enlarged.  In fact, it was about the size of a uterus with a 12-week pregnancy.  Yeah, yeah, I should have asked her about menstrual periods earlier, but I asked then, and she said that she hadn't had any for at least 2 months.  An ultrasound revealed a healthy 14-week pregnancy (2 weeks error ain't too bad in this situation).  I gave her vitamins, iron tablets and paracetamol to take for her pain.

7.  Young man with a severe cough, fever and a sore in a location that suggested a venereal disease.  I sent him to the lab for a test called a VDRL, and to the x-ray room for a chest film.  Because I thought he was number 8, and I didn't want to wait around, I asked Dr. Imelda to review his results and write for meds when he got back.

So now I realize that I only saw 7.  Wait!  There was an old man who wandered into outpatient who thought that when the doctor told him to come back in 2 weeks that meant he could skip paying fees and waiting his turn in the long discouraging line.  I had sent him to go pay and wait.  I wasn't going to count him, but without him, I only saw 7, so now I think I should count him.  He has benign prostatic hypertrophy, by the way, with complete urinary outlet obstruction.  He was being treated with a catheter and medicines.

There.  That's 8.  Good variety, but not fully representative of what we see.  There was no trauma in the group, no fractures, no arthritis, no abscesses, no malaria, and no AIDS, which are all pretty common in our work.

AB

Saturday in Kudjip

What do we do on a Saturday on a tropical island?

Some of us sleep.

Some of us long to eat small children.

Some of us work on refinishing the tennis/basketball court.

And some of us watch.

Some of us make dog and cat food.

 

Some of us keep working and working.

And some work in different ways.

Newly engaged couples take romantic walks - not holding hands of course.

And we knit!

JB