Play Time

Since I live just beyond above the Riggins at the Southern end of our station, I have to walk by the Riggins house to go anywhere. My comings and goings seem to be common knowledge to Aden and Wiley, who are very observant little boys.

Wed afternoon as I was walking home from work, Aden yells out to me and starts talking. I don't exactly know what he is saying, so I go to their porch and talk to him. He says he wants to come and see my tree, but he is going to Cilla's to see hers first and after that he will come over. Okay, as long as it is okay with your mom. Well Aden and Wiley didn't show up on Wed afternoon, but he didn't forget that I said they could come. So Thurs morning I am on my way to work, and Aden, in his pajamas, is standing just outside his door on the porch telling me he didn't come over yesterday, but maybe he could come today. Sure, as long as it is okay with your parents. So he runs in the house and tells his mom and dad, as I walk to work. At lunch, when I walk by their house Aden is again outside, and yells out "Auntie Erin, did you say I can come to your house now." "No, Aden, not now, but when I get home from work this afternoon." Aden, "Oh, like after nap?" "Yes after naptime is over and your mommy says it is ok." Aden always inquisitive, "Well, what if I ask my daddy?" "Yes, that is fine, if your daddy says it is ok you can come." "Well, what if I ask Wiley?" "No, you can't ask Wiley if you can come, but you can bring him along, you need to ask your mom or your dad." He tries again, "What if Aden asks Aden if Aden can come?" Me laughing, "No buddy, your mom or dad."

So after work Aden and Wiley carry some books and head to my house. Aden read his Dr. Suess book to me and we read a book on the Christmas Story. Aden kept asking about the Activity, and I wasn't sure what he was saying and realized he meant Nativity, so we talked some about that. Then we played cars, built roads, airports, airplanes, took airplane and helicopter rides, played a madeup version of cranium, played ball, and learned about house cries (kind of like a viewing when someone dies, but this one has been going on for days in the village just behind my house). Becky came by and got to read some stories as well. It was a very enjoyable afternoon and I look forward to future afternoons with my little neighbors.

Steven

Steven is 4 yo who had been suffering from abdominal pain for 2 months at home in the Jimi Valley. The Jimi is far away from Kudjip, but we are the closest hospital to them. Steven's comfort at home was being carried by his father, other than that he was crying and in pain. He was too sick to play with his friends and just stayed at home.

As patients come into my exam room, I quickly classify them in my mind as not sick, sick, and very sick. I see lots of kids each day and, thankfully, many of them aren't very sick. Most kids smile and interact with me during their exam, but one look at Steven told me I was looking at a very sick kiddo. After gathering a history and doing the best physical exam I could with a screaming child, I still didn't know what he had, but was concerned it was something very bad like cancer. I ordered some blood tests and a CXR to try and narrow down my differential. When his CBC came back with an elevated WBC and low hemoglobin (anemia), I got concerned about leukemia. Thankfully, his blood cells looked normal, there were just a lot of them working to fight an infection. Once on the ward, his urine revealed the source of his infection and Dr. Susan's found a very abnormal looking L kidney. Whether it is just infection or cancer, we aren't sure, but at least now we know where his problem lies.

After giving him some blood and antibiotics he is doing better, but is still sick. I keep trying to see if he will smile, but haven't gotten him to yet. We are awaiting more blood donors and Dr. Jim will continue to evaluate him to see if he needs to take him to surgery. It is unfortunate Steven didn't come to us sooner, but I am thankful he was able to come at all. I am thankful this hospital seeks to serve the people of this area and that we do our best to care for them medically and to share the love of Christ with them. Pray for Steven, for him to respond to the antibiotics and for Dr. Jim to know when/if he needs to do surgery.

My first Csection in new hospital

Since I was either on call or Csection call 4 times in the past 8 days I figured I would eventually get to experience the new Operating Theatre. Yesterday was the day. Betty needed a Csection because she wasn't progressing well. I asked Becky if she wanted to do the surgery, as she is trying to get comfortable in doing them herself, so the 2 of us got to experience the new OT together. I called our power person on call to switch our power to the generator to make sure we wouldn't have any blackouts during the surgery and we got things going. The OT crew has been working in the new facility for a few weeks now so they know where things were, but I took some time look around and familiarize myself with where things are kept for future reference. The OT is very nice and thankfully, the surgery went well and Betty now has a baby girl.

Giving Thanks in PNG

Today the missionaries celebrated Thanksgiving after our normal work day. There were many times when I stopped myself from saying Happy Thanksgiving to patients, they just wouldn't understand. Since there are a lot of us on station this year, we didn't have a large mission station Thanksgiving celebration, instead we enjoyed celebrating in individual homes. The McCoys (who I am very thankful for) invited Becky and I to share Thanksgiving with them. We have a hard time finding turkey here, so Marsha went with ham, pumpkin, and rolls. Becky brought green beans and corn, and I made a broccoli salad and watermelon (which I have been preparing for months in the garden.) It was all very good. After our meal, we joined some of the rest of the missionaries at the Radcliffes for a time of prayer, praise, and pies.

I have been thinking of all that I am thankful for and there is a lot. Some of them include:

• A God who loves me and died for me and the love, grace, and forgiveness He gives me
• A family back home who loves and supports me even though we are miles apart
• A mission family who has become my family here in PNG and for their love and support
• A new hospital and for all those who contributed to building it and making it possible
• A calling to serve in PNG and the freedom to share the love of Christ with the pts each day
• A privilege to serve the Lord as a physician and to care for patients each day
• An opportunity to see the miracles, both physical and spiritual, God does in the lives of pts
• A chance to see Jonathon, Fifisi, and Anna winning the fight against CML thanks to Glivac
• Another day for Ismeal as he fights his ALL
• All my supporters who are making it possible for me to stay in PNG and serve

Happy Thanksgiving to you all.

Rebekah

Rebekah is a medical student from Switzerland who has been with us for 2 months now. She speaks German and a number of other languages, but English wasn't one of those. So speaking English every day was a challenge for her, but a good challenge. When I first met her and talked to her, I felt like we were playing charades as I was trying to guess what she was trying to say and didn't know the word for it, but after 2 months she has learned a lot.

It has been fun talking to her and learning about Switzerland and how they do things there in relation to medical school, holidays, and life in general. Steph was in the Christmas spirit and thought it would be fun to have us come over and help decorate her house. So Becky, Steph, Rebekah and I spent Sunday afternoon decorating Steph's house and learning about Christmas in Switzerland. They don't have nearly the number of decorations that most Americans have, decorate their real trees with apples and candles, celebrate St. Nicholas Day, and don't tell kids about Santa Claus. They also don't have Christmas shows on TV like we do in the US, so I introduced her to one of my favorites - Emmet Otter's Jugband Christmas. It was a good time. One night she invited Becky and I to dinner and introduced us to crocodile curry, which was surprisingly quite good. It was great having her here.

Bathrooms

We are having problems with our toilets in the new hospital. People are putting anything and everything down the holes which blocks up the sewer. While I was away, everything was blocked, and it was a dirty, smelly job to pump the sewage beyond the blockage to get things flowing again. We are trying to educate the people on how to use the toilets (signs in the bathrooms, tok saves on the wards), but it just isn't something they have a lot of experience with. The majority of villagers in PNG do not have running water in their houses, and their bathroom is the bush outside and they use whatever leaves, cloth, or paper they have around. Our toilets at the old hospital were not flush toilets, so it was ok to put whatever down the holes.

Bush churches remind me of this problem and help me to understand this better. Anytime I go to a bush church, I try and dehydrate myself by drinking very little, if anything, prior to going out so I don't have to use the facilities. Some places have them and others don't. A recent visit to Tumbang church was no different. After church, Susan and Jessica mentioned that we can use the pitpit toilet if we need to. They said it was an enclosed area and was our best option unless you didn't have to go for the next 3 hours, knowing we had a bumpy road ahead of us. So we went. I was quite pleasantly surprised by what I found. There was a nice outer wall which gave some privacy. The inside was clean, didn't smell too bad, and had a small enough hole so you didn't feel like you were going to fall in. It was really pretty nice, but very few are like this. Maybe we should get the people of Tumbang church to teach the hospital patients how to keep the bathrooms clean. Pray that we would be able to sort out our sewage issues at the new hospital and that people quickly learn how to use the facilities appropriately. We have a specialist from Australia coming this week to help us sort things out.

Road conditions

The road conditions of PNG are always interesting. Huge potholes are found throughout the "highway." Bridges and roads are washed away requiring cars to travel through the crick/river below to get past. Places that use to have a bridge for a car to pass, now has logs across to act as a foot bridge so people can cross (pic on R). Other times, in order to cross a bridge, someone needs to move the planks of the bridge in order to keep going. When it rains, all the above gets even more interesting. This is why we have Land Cruisers.

The Mondomil road (previously traveled on way to Tumbang church) is one of the those roads with various challenges to it. It typically is very bumpy with lots of potholes and some questionable bridges, thankfully this weekend, it wasn't quite so bad. We saw a big Komatsu Grader along the side of the road, which has probably helped the road conditions. We also saw a guy farther up with a hard hat on. I have never seen any construction guys here wear hardhats, and he wasn't anywhere near the construction equipment, so I am pretty sure he and his had have nothing to do with the road conditions, but it isn't something we see everyday.

Esther who is from the Mondomil area, told us that road improvements are often heldup by the local lains,"Papa Graun" (the people who own the land near the road and thus consider the road theirs). These people often want some sort of compensation for working on their road, so if the people who are trying to fix the road won't pay, then they refuse them access to their road. As a result, part of the Mondomil road was quite nice, and other parts still had the huge potholes in it because the "Papa Graun" said they can't fix it. Why they wouldn't want their road fixed, I don't know, it is sad. The road problems are just on backroads like the Mondomil road, but on our Hagen Highway and other main roads as well. It is always an adventure.