Erin in PNG

Cutting it close

2012-01-29T20:23:00.000+10:00

The cough started the day before, but when he started having trouble breathing, his mom and grandma got a PMV and made their way to Kudjip. Along the way, his breathing worsened to the point where he couldn’t talk and he was using all his muscles to breathe. When he got to our ER, our nurses quickly noticed how sick he was and appropriately put him on oxygen, gave him a breathing treatment and called me.

I heard him before I ever saw him and the barky seal cough that greeted me as I was walking into the ER told me this child had croup. Croup, which causes swelling of the respiratory tract, is a pretty common respiratory illness that affects kids and ranges from mild to very severe, even causing death in a small number of kids.

I knew right away this 5 yo boy had the severe kind and when I looked at his mom, I could see she knew it too. His breathing was very labored, he didn’t fight my exam, but just laid still, too still in mom’s arms. If that wasn’t enough to alarm me, the medicine he had been given by the nurse had done nothing to change his condition. I explained to mom and grandma what was going on with Junior, and then we prayed for this child, that God would open his lungs and help him breathe. The nurses worked on getting him an IV and giving him steroids, while I set out to find the medicine he needed – racemic epinephrine.

I had never seen racemic epinephrine in our pharmacy, but thought that it might be found amongst all the donated meds that we receive from the US each year. Despite desperate searching, I didn’t find any. Knowing he needed this medicine, I thought there must be a way to give him the medicine just using epinephrine, which we have lots of. I finally found a book that told me what I needed to do to make this medicine and then prepared it for him.

I put the medicine in the breathing machine and placed the face mask over his head, all the time praying that this potential life saving medicine would open up his respiratory tract and that God would continue to give him the breathe that he needed.

While he was breathing in the medicine, I started seeing the other 3 pts who were waiting for me to see them in the ER. In a relatively short period of time, I realized I no longer heard the seal barking as often as before. As I glanced at mom from across the room, I saw she also was relaxed and Junior was breathing easier, Praise God.

I admitted him and checked on him 2 times overnight, making sure he was still doing ok. What a joyful sight, in the morning, to see him sitting up, talking to his mom and grandma, only coughing briefly. The following day, he was even better still and we were all Praising God for the breathe of life that He gave to Junior and gives to each of us.

Kudjip Paia wins again

2012-01-26T15:56:00.000+10:00

This past weekend we had the 2nd quiz to help prepare the MKs for their national bible quiz competition in July. The MK's team, Kudjip Paia (pidgin word for fire, look up Heb 1:7) proved victorious once again, as we quizzed on Heb 1-6. The adult team had some new faces this time with Rachel, Judy, Stephen and Bill all joining Becky and I, but it wasn't enough. The kid's effort these last 3 wks was quite evident to all during the quiz as they were prejumping and getting most of the questions right. Even with some of us trying to study while giving blood, the adults fell short, but gave a good effort. With 5 months left, the kids still have a ways to go, but they are certainly getting better and we are encouraged by the growth they have shown. Next quiz 3 wks.

D ward noises

2012-01-21T14:48:00.000+10:00

D ward - our labor and delivery ward is full of many noises, especially crying. It certainly isn't the place to be if you want to get some sleep. With 30 beds, it is usually very full of moms and their newborn babies. There are cries of being hungry, cries of being tired and not being able to sleep, cries of being cold during bath time, cries of wanting to be held, cries from being fussy and lots more. Moms cry out in pain as they are giving birth and after having a Csection when they get up and start moving again. Older siblings and family members come and visit the new babies and bring sounds of excitement when they see and hold the new baby. There are nurses and doctors who are talking to each other about the patients and the orders, or yelling for help when emergencies come up. It is hardly ever quiet, but that is often a good thing. We do over 1000 deliveries a year and our ward stays full almost the whole time. Praise God for new life.

Mystery solved

2012-01-17T10:36:00.000+10:00

For months she had difficult swallowing and eating because she had sores of her mouth. She was losing weight and the doctors couldn’t figure out what was going on. Every blood test and Xray proved negative for any specific diagnosis. Not thinking she would get better, she wanted to come home to be with her family.

Her family, brought her to Kudjip to be seen. Her mouth sores had been going on for almost 9 months, but in the last month she also developed sores and blisters of her skin. When I saw her in the ER, my heart just went out to her. She didn’t want to move because every movement brought pain through her body. Her lower abdomen, whole back, and most of her arms and legs were crusted over from infection of the sores she had, and there were some vesicles and bullae that hadn’t ruptured yet. She wasn’t able to swallow well due to the sores of her mouth, and it was obvious she hadn’t been eating much recently. With the skin lesions now present, her diagnosis was no longer in question, it was clear she now had a condition called Pemphigus Vulgaris.

We treated the infection of her skin and started her on high dose steroids and other medicines to stop new lesions from forming. They didn’t all resolve, but thankfully, they got better with the treatment we gave her. She started eating again and not being in so much pain. She was able to leave the hospital after a week and has returned for follow-up visits, where we continue to alter her medicines to keep her disease under control. Unfortunately, we can't cure her from the PV, but we will do what we can to control any new lesions, to decrease pain she has and to keep her eating.

It is such a blessing to serve here and be able to help and care for so many of God's children.

Nursery

2012-01-13T11:46:00.000+10:00

I don't often spend a lot of time on our OB ward. Steph has mostly handled the care of our moms and babies since she arrived here 3 yrs ago. Steph is now home on home assignment, so the rest of us are taking up the slack looking after the OB ward.

Our nursery isn't much more a few bassinets and warming lights for babies, but not much else. In the US, the nursery is for pretty healthy babies, whose mom's had a C/S and are resting, or for getting a bath and checking a blood test. The nursery is for babies who are born on time and whose birth weight is not low. Babies who are born premature, are of low birth weight and require lots of care would most likely be in the neonatal ICU.

We don't have a neonatal ICU, but we have lots of sick babies who we care for. Our nursery is really often an ICU because of the babies that we care for in it, not because of the equipment we have. We have babies who are 1500 grams or about 3lbs who we watch increase by 25-50 grams a day in their weight until the get up to 2000 grams and then we let them go outside with moms to the ward. We have babies who aren't able to drink breastmilk so they get fed through a tube in their nose. We have babies who have gotten an infection when they were inside mom and who are struggling to breathe and so they are on oxygen and antibiotics.

In our nursery, you won’t find any babies intubated, on a CPAP machine, with covers over their eyes, under bili lights, or even by themselves in a bassinet. Instead you find little tiny babies all wrapped up in blankets, with tubes in their noses to breathe and fee, maybe with an IV going in, who grow slowly day by day. Without high tech equipment, we are usually able to get these babies big enough to go home, but often it takes weeks or more to do so.

I am amazed at the resilience of these little babies. They do amazingly well with the little we have to offer. I think it goes to show that God knew what He was doing when he created us.

New life in Christ

2012-01-09T11:35:00.000+10:00

He was standing off to the side, watching a fight, when he felt something hit him just below his left ear. He went down and friends noticed blood coming out of both sides of his neck. He was rushed to the Emergency Room where nurses worked to apply pressure to stop the bleeding and notified the on call doctor, Bill, of a patient in the ER.

Bill walked in to find the pt was amazingly awake and able to answer questions despite having been shot through the neck not long before. As Bill examined him, he discovered that thankfully, the bullet didn’t go through any major blood vessels, his spinal cord, bones or brain, which allowed him to be awake. However, the bullet did go through his pharynx, which was going to create problems in the near future for the patient to be able to breathe.

Normally, Bill would stabilize the patient and then call Jim and let him know of the need for establishing a better surgical airway (by putting a tube into his neck – a tracheostomy.) But on this Friday night, Jim was enjoying the last weekend he had with his kids and grandkids at Kugark, and so he wasn’t available to help. Bill considered sending him to a referral hospital in Mt. Hagen, but it was already dark and there was a chance nothing would be done in the night there, and so he decided to keep the patient here, knowing that he might yet require a better airway.

In the next few hours, the patient’s neck got more swollen from the effects of gunshot wound and his breathing got worse and worse. Bill knew this guy was going to die unless he was able to get a better airway into him, so he took him to the OR to see if he could be intubated or to try a cricothyrotomy (cutting a hole just below the adam’s apple and putting a tube into the trachea to help him breathe). Not knowing any of the above details, my phone rings at 10:30pm and Bill asks if I can help him establish an airway in a gunshot wound patient. I quickly get changed and run down there knowing that, despite having no experience in this, sometimes just having another person to share the burden with and to provide moral support is just as important as someone who can do the procedure.

When I got to the OR, the patient was sitting up, struggling to breathe. Bill, David (our anesthetist), Vero (our scrub tech) and now I, were working to get everything ready to try and intubate him and if necessary to do the emergency cricothyrotomy. We prayed with him and then David tried to intubate and when he couldn’t see anything due to all the swelling and damage from the gunshot wound, Bill started to do the cricothryotomy. With a little difficulty and the patient's heart rate down to 41, we managed to get in and put the tube inside to help him breathe. As soon as he was able to breathe, his heart rate came back up and the tension of the room evaporated and we were able to get a breathe ourselves.

Kalap has required close monitoring and frequent suctioning of his tube, but is doing quite well. I got to round on him on Sunday and found him resting comfortably, and communicating despite not being able to talk. As I talked to him and his family, I learned that he was not a Christian prior to coming to the hospital, but Bill talked with him the night of admission and shared the gospel with him. The family kept talking about how he almost died 2 times, and I shared with him about God’s love and how He has rescued him from death through Christ dying on the cross and again as we have cared for him here. Kalap signaled that he already knew and believed all I was saying. Praise God for His mercy, for sparing this man’s life and bringing him to us so he could hear the Good News and for giving him new life in Christ now.

Bible Quizzing

2012-01-06T13:01:00.001+10:00

The MKs have been practicing for the national bible quiz competition next July. Bill and Stephen Hollenberg have been working with them, coaching them and the kids have been studying Hebrews, 1 & 2 Peter. Most quiz teams have competitions that they do throughout the year leading up to the district, regional, and national quizzes, but here in PNG, there aren’t any other quiz teams or quizzes going on. As a result, our team is lacking some experience and practice in competition, so Bill decided to have a quiz this weekend. We had a MKs vs young adults quiz.

Joel and Bekah Potter are here for the Christmas holiday with their twin daughters and since they quizzed when they were in high school, it seemed like a good idea to put them on the team. Becky and myself, rounded out the young adult team, despite having never quizzed growing up. We found out about the quiz a month ago, so I have been doing some studying to try and make it competitive for them.

Bekah ended up being sick, so Ethan joined our team. I think we were all a little nervous initially, but as the quiz continued everyone settled down and got better. The MKs, I think surprised themselves, by doing very well and winning both the quizzes. Everyone seemed to have fun and enjoy themselves, even the fans - well maybe not all the fans, as some were sleeping. There will be more quizzes in the next couple of months as they prepare for their real quiz coming up in July. Great job guys, keep working at it.

New Years Eve

2012-01-03T12:53:00.000+10:00

The young adults gathered at the Thompsons for a New Year's Eve get together. We had a potluck dinner and then played a number of games - guys against girls. The guys were at a slight disadvantage with having someone from Australia and New Zealand on their team, but they still put in a good effort. After some games, they sang Happy Birthday to me, and we enjoyed the birthday cake that Becky made. Then we continued to play games and talk until midnight. Outside of being on call, I am usually in bed by 9 or 9:30, so I didn't expect to be up at midnight even if it was NYE, but I did make it. Happy New Years to you all.

A happy mom

2011-12-31T15:13:00.000+10:00

Just before Christmas, Bill asked if I would be willing to help out in a C-section. I am always eager to help, but Bill doesn't usually need help with sections, so I asked what was special about this case that required an extra hand. As I found out, the mom was carrying her 3rd set of twins, after having 3 singleton deliveries. That is 9 total babies, but 2 passed away, so she was about to have number 6 and 7 - and all of them under the age of 7 at home.

Most women who have twins are pretty big, but this lady was bigger than anyone I had seen. We knew there were 2 inside, but were wondering if there might be a third hiding that we couldn't identify on ultrasound. We knew she was at risk of having some complications in the C-section for a number of reasons - the twins were not laying straight and we knew we might have a hard time getting them out, she had carried 5 babies so she was at risk of having extra bleeding after the delivery and her uterus was stretched so big by the babies that she was at risk of having it not go back to normal size after delivery and as a result having extra bleeding after the delivery. So for all those reasons, we set out together to do C-section.

Thankfully, we delivered a big healthy girl (3.4kg) and a big healthy boy (4kg) and the surgery itself went fine and mom returned to her small size again. After surgery, we ran into some bleeding issues that we had been concerned about going into the surgery. Thankfully, with 3 units of blood, medicine and lots of prayer, mom's bleeding stopped and she will be able to go home and care for her 7 kids.

Christmas Caroling

2011-12-28T11:49:00.000+10:00

Each year the missionaries get together to go caroling on the wards and hand out Christmas presents on Christmas Eve. The docs usually try and get people home for Christmas, if possible, but there are always some who get to spend Christmas in the hospital and so we bring them a present and share the story of Jesus’s birth with them.

We had little PNG kids be our Nativity guys and had a doll for baby Jesus. On maternity ward, we borrowed a little baby Jesus, who was a great actor, playing the part of a baby wrapped in swaddling clothes, he didn’t even have to change for the part. We sang Christmas Carols and some of the patients joined in as we sang. Our trumpet quartet played a few songs, we prayed for the patients and we gave gives to each patient as we wished them all a Merry Christmas.

My sister has decided she wanted to contribute to the gift giving here. So each year she goes to Kohl’s and buys stuffed animals and sends them over as part of the kid’s gift. Last year I went with her to get the stuffed animals when I was home. It is pretty funny walking up to the cash register at Kohl’s 3 full shopping carts of 20 iguanas and 20 lady bug stuffed animals and have everyone looking at you. It also is a great opportunity to share about the work here, which God does here. Megan’s boys also enjoyed helping and enjoying seeing the pictures of the kids with their animals from this year.

Christmas Eve Eve Party

2011-12-25T11:47:00.000+10:00

We had the Myers annual Christmas Eve Eve party again this year. We all enjoyed some Christmas treats, fellowship and games. None of us are competitive so the try and find the kitchen items throughout the house warm up little fun activity turned into a competition with some hiding different findings so others wouldn’t get them. We had lots of laughs and joking and enjoying the fellowship with our Mission Family this Christmas. We had a few visitors with us this year. The Potter family, the Radcliffe's oldest daughter Bekah, her husband Joel (who grew up as a MK here) and their adorable twins Dora and Sylvia. Joani also had her parents here, much to the enjoyment of the Goosens kids. Merry Christmas to each one of you.

Missionary Christmas Party

2011-12-22T10:47:00.000+10:00

We had our annual Missionary Christmas Dinner, last weekend, before some of our friends left to go home for the holidays. Our hospitality team did a great job of decorating with homemade snowflakes and more. We had a good time of fellowship with good food and lots of laughs. The kids all got presents from their aunts and uncles from Santa, and then everyone got to participate in a mug exchange where some gifts were better than others. I am sure thankful for my Mission Family, especially around the holidays.

So long, farewell again

2011-12-20T10:55:00.000+10:00

First the Dooleys, Steph and Thompsons left to head to the US for home assignment and vacation so we all gathered up in a large circle for them. Then the next day we had to say goodbye to the Kerrs as they left to head home for their HA after making a short stop to their new country of work. We are thankful for the service the Kerrs have done in PNG during their time here and know they will be a blessing wherever they go next, but we will miss them.

Hope in Christ

2011-12-18T12:52:00.000+10:00

I see pts each and everyday who have illnesses that I can’t treat medically or surgically. I can offer them pain medicines or nausea medicines, but I have nothing to “cure” them from their illness. Thankfully, medicine isn’t all I can offer.

John is 22 yo and came in complaining of weakness for the past few months. He has had difficulty lifting things with his arms for the past few months, but now feels weakness in his legs. As I began talking to him, asking him questions and examining him, I grew more and more concerned for him. It was apparent to me that he wasn’t just having trouble with his arms and legs, but also was struggling to talk. He has something called ALS (amyotrophic lateral sclerosis), which is a neurologic condition that results in weakness of most of the muscles of the body, including the respiratory muscles and most folks die when they can no longer breathe or succumb to an infection. John isn’t there yet, but based on his symptoms his condition is going to continue to deteroriate.

I shared with him and his father and tried to help them understand what was happening and what was going to happen to him in the weeks and months to come. As I shared, I was looking at the face of a young man who couldn’t fully comprehend what I was saying. Who can blame him when I am telling him things about weakness, being unable to walk or talk, unable to swallow and eventually breathe. I shared with him that there is nothing medically I can do for him, we have nothing to treat his condition and one day he is going to die. Thankfully, that isn’t the end of what I can offer, as there is hope for all in Christ. We talked about Jesus and although he has gone to church, he doesn’t know Jesus as His Savior yet. We talked more about this and then prayed that he would believe this Christmas season that the baby in the manger truly came to save him from His sins and to bring him eternal life when he believes.

1 Peter 1:18-21 “For you know that it was not with perishable things such as silver or gold that you were redeemed from the empty way of life handed down to you from your forefathers, but with the precious blood of Christ, a lamb without blemish or defect. He was chosen before the creation of the world, but was revealed in these last times for your sake. Through him you believe in God, who raised him from the dead and glorified him, and so your faith and hope are in God.”

Serendipitous Diagnoses

2011-12-16T12:51:00.000+10:00

When I order an xray, I have to fill out a little slip of paper with the patient’s name and what kind of xray I would like to be taken. The patient goes and pays 6 Kina (about $2.50) at our business office and then proceeds to the door with the red light to get their xray taken. Presumably, the xray technicians look at the xray slip, takes the ordered xray, and then sends the patient and their xray back to the doctor who ordered it.

I recently ordered a special xray called a barium swallow. I was concerned that the patient had a cancer where the esophagus meets the stomach. Typically, this xray takes about 20-30 minutes as multiple xrays are taken at various intervals to see how well the barium goes down the esophagus and into the stomach. The pattern of the barium, which coats the esophagus and stomach as it goes down and shows up as white, helps me to know if there is a problem or not. When the pt brought the xray back, I didn’t see one picture of the esophagus, all I saw was the lower abdomen and pelvis on every xray. At first there was nothing white (barium) in the xray pictures, but then as time intervals went on, I found I was looking at the bottom of the stomach which was sitting very low in the pelvis. This suggested the patient wasn’t able to empty her stomach and so was having nausea, vomiting and weight loss as a result of this. I probably wouldn’t have seen this had I gotten the xray I had written for, but I guess God knew best.

Another patient came in complaining of hip and back pain. I knew this wasn’t her main problem as she looked very thin and had been losing weight, but she denied any others symptoms outside of the pain. The family was so concerned about her hip and back pain and was asking for an xray, so I wrote for a pelvis xray anyway, even though I wasn’t expecting it to show me much. When she came back, her xray obviously showed that she had tuberculosis in a miliary pattern. This wasn’t obvious from the pelvis xray that I had ordered, but from the chest xray that she had taken instead. I would have missed the diagnosis had I gotten the pelvic xray, so I am thankful that this mistake happened, for the pt’s sake.

5K fun run/walk

2011-12-13T16:59:00.000+10:00

Stephen and Amy recently organized a 5K fun run/walk here at Kudjip and had 32 participants, both missionary and nationals participated. Thankfully it didn’t rain the night before, which left the course drier than expected. Ethan ended up pulling out the win, but everyone who participated had fun.

Christmas English Lotu

2011-12-09T17:06:00.000+10:00

Each month we hold an English church service to bring the missionaries in the surrounding communities together and each Christmas we have a special service remembering the birth of our Savior. This year we were treated to many special items helping us to remember the birth of our Savior. The MKs did a musical about Hark, the herald angel. The MAF lain sang some songs which shared the truth of Chrsitmas. The New Tribes Lain did a special little nativity scene complete with a cute little lamb and limericks. Rosie did a kid’s devotion which seemed to include half the congregation by the time all the kids got up there. Other folks did special songs and musical numbers. It was a great time of remembering the birth of our Savior this Christmas season.

Christmas Giant Pumpkin

2011-12-06T19:33:00.000+10:00

Since we don't eat the Giant Pumpkins, I thought I could try and put this one to good use. Being that it is Christmas time, I thought I would try a little manager scene, I am not much of an artist, but I had fun doing it. Carving the pumpkin reminded me of the christmas cookie decorating fun that Megan and I had in high school and college with the Stark family. We would always try and put manager scenes on the cookies, along with some surprises for those eating the cookies.

Carving a giant pumpkin isn't much different than carving a regular pumpkin, but it takes quite a while. It took me a good 15 minutes just to get the side of the pumpkin off so I could get out the insides. I ended up needing to get a bush knife (machete) out as it was longer than my kitchen knife that I was using. After I carved the pumpkin, I spent more time trying to get out as much of the inside as possible to make it lighter to carry. Bill and I were able to carry the pumpkin from the middle of the garden out by the fence. The Papua New Guineans who live behind us are always stopping at the fence and commenting on the garden and the GP, so I thought they might enjoy looking at a Christmas pumpkin. Music or the the voice of someone telling the Christmas story would be a great addition to this Christmas pumpkin, but hopefully they can see the manager with baby Jesus and the star and think of God's gift to us this Christmas Season.

Lee

2011-12-03T21:37:00.000+10:00

Lee Stevens is about to head home after serving as a volunteer with us in maintenance. He had been with us in the spring, but he had to leave earlier than he intended after he developed a blood clot in his leg. He didn’t want to leave and said he would be back, and so after some treatment, he came back. He has spent the past few months with us doing anything and everything he can to help out in our maintenance department. He recently was part of a group of folks who have cleaned up our morgue and who helped clean our chapel. New paint and some cleaning go along way in making things look new. We are very thankful for his service that he has given us both times he has been here and will be sad to see him go.

So much to be thankful for

2011-11-29T21:22:00.000+10:00

Marsha hosted the upper end of the station for an informal Thanksgiving dinner. Informal meant paper plates and blue tablecloths, but was full of thanksgiving and great food and good fellowship. We all shared some of what we are thankful for and then enjoyed all the food that everyone brought. We had grilled chicken, turkey legs, salad, green bean casserole, zucchini, pumpkin, sweat potatoes, baked potatoes, asparagus, rice and rolls. It was all very good, especially the dessert – I had the apple rhubarb crisp.

There are many things that I am thankful for, some include:

- A God who loves me despite my imperfections

- A Savior who died for me

- My family – both back home and in PNG

- The opportunity to serve here in PNG

- The chance to share God’s love everyday as I work

- Enough nurses to serve our patients and keep the wards open

- The support of friends and family who make it possible for me to be here

The next Giant Pumpkin

2011-11-26T20:50:00.001+10:00

So from the first Giant Pumpkin we had some volunteer plants come up. We let a few grow and put one by the fence so that the Papua New Guineans would be able to get a closer look at it growing.

Last week, I was out in the garden and was going to get rid of the GP plant that had stopped growing. My plan was just to open up the pumpkin and get out the seeds to give away. Before I got to it, a group of guys were at the fence talking about the pumpkin, so I asked them if they wanted seeds. I thought, I am about to destroy it and get the seeds anyway, might as well do it and give them some. They were all excited about the seeds. So I went over with my dirty shovel and I picked it up and thrust it through the pumpkin, this seemed like a very logical thing to do to me. The reaction from the crowd at the fence was one of disbelief. I think they thought I killed something or someone by doing that. They assumed that we were going to eat it and so when I put that shovel through it and destroyed it, they thought I had ruined some pretty good food. I tried to explain to them that we, especially me, does not eat the GP, but they asked if they could eat it. Sure, you can try it. So I took out some seeds and then chopped it up into smaller pieces so I could lift them over the fence. They were happy to take the pumpkin home, I don't know what they thought of it, they haven't come back to say, nor do I know who I gave it to.

The pic above is the Kudjip quizzing team that Bill is coaching that took a field trip to see the GP one afternoon after quizzing.

So long farewell . . .

2011-11-22T20:41:00.000+10:00

Dave and Rosie Kerr have served here in PNG for almost 3yrs, but when after they go home on their furlough, they won’t be returning to PNG :) We had a see you later party for them this past weekend. It is never easy to say goodbye to the friends that you make while serving, but we trust God’s plan for them and their lives and for those of us left behind.

Dave was a teacher at the Bible College who did a lot from IT things and teaching classes and helping out when the last missionary principal left. Rosie worked part time here at Kudjip as a doc, took care of their girls Anna and Grace, and helped do lots at the Bible College at other times. They will definitely be missed. We don’t know where they are going yet, but when we do they might need to prepare for visitors.

We enjoyed a hamburger BBQ and the fellowship of each other as we prayed for them as they go. Following the goodbye, the Kerrs wanted to borrow my Emmet Otter’s Jugband Christmas DVD. Instead of borrowing it, I invited them over (and the McCoys came too) to watch it and so we had a movie night with one of my Christmas Favorites. It was nice.

Dave, Rosie, Grace and Anna - we are going to miss you guys. We will be praying for you.

Cute kids

2011-11-18T20:41:00.000+10:00

I snapped this quick picture on my way to make rounds this week. Our wheelchairs here are often used for entertaining and keeping little ones occupied, it seems to be working in this case.

The things people come in with

2011-11-14T20:41:00.000+10:00

Patients are all different. Some come in with life threatening and serious complaints and conditions and others come in with something that is nothing – like a hangnail. There are things that one person notices which causes them to come to the doctor while the next pt who comes in may have the exact same problem, but they don’t see it as a problem and are here with something else. At times, I even find problems that pts didn’t even know they had or weren’t worried about, but I was. Here are some of the classic PNG complaints that are something nothing, but the patients seriously think something is wrong with them:

· My heart beats faster when I do a lot of work or play sports

· I get short of breath when I walk up hills or run for a long time

· My urine is yellow

· I get neck pain after I carry a 40 lb bag on my head full of sweet potatoes

· There is something in my arm that pumps up and down all the time (pulse)

· There is something that moves and pumps right under my ribs (heart)

· My leg is dead (a word for numb/doesn’t work/can’t move it) yet they walked into my exam room

· There is blood “no good” in my body after the fight in 1984 that you need to take out

After ruling out serious things, I do my best in these situations to try and help them understand how our body works and why our heart pumps. Sometimes they understand and are ok with a little reassurance, but many times they aren’t.

Waterfall hike

2011-11-10T06:49:00.000+10:00

This past Saturday a group of us took a trip to nearby Kurumel to hike up to the large waterfall that is there. We started with 9 (Bill, Marsha, Tim, Stephen, Amy, 3 volunteers and myself) of us from Kudjip and ended up as a group of 40+ with all the Papua New Guineans who went with us. Some of the PNGers had never been to the falls and neither had any of the other missionaries who went other than myself.

The waterfall is definitely worth the hike - at least that is what Marsha kept telling herself and convinced herself of when she said she wanted to go too. The hike isn't easy. There is a large mountain that you have to climb up and then down again as soon as you get to the top, without covering hardly any distance horizontally, so you at times seem like you are going straight up and then straight down. Sliding whether with your feet or your bottom is sometimes the best method for coming down. The PNGers are great guides and helpers, even if they are kids, they are surefooted and able to help all of us make it to the waterfall and back again.

One of the great things about the trip was being able to see the beauty of PNG and just how tough some of the villagers have it. We walked by and through numerous gardens that are sitting on the side of a mountain. They maintain these gardens as a way to provide food for their families. We saw guys fishing with a spear and a scuba mask in the river. Other men, women and boys cutting and then carrying large tree trunks to serve as house posts that they will build. We also saw kids just playing and being kids. Finding a vine and clearing a way to make it a large swing over the river, which we all ended up trying also. It was a good day.

Harvest Party

2011-11-06T20:29:00.000+10:00

We had our annual Harvest Party recently, a little late, but still lots of fun.

The great thing about wasman

2011-11-02T18:51:00.000+10:00

Here everyone comes with at least 1 or 2 wasman (watchman). They are like family members who might come with a patient to the doctor’s office or the emergency room in the US. Most times in the US they are there for moral support, maybe helping to answer some questions, but that is about all. Here in PNG wasman at times are put into service.

Tonight I got called about a pt in severe pain who had fallen from a tree and was thought to have a fractured elbow. When I got there, the man was sitting calmly on the bed and the xray showed not a fracture, but a dislocation of his elbow. Elbows, for those of you who don’t know – don’t easily dislocate. Shoulders come out quite easily in some people (me being one of them). They aren’t suppose to dislocate, but the head of the humerus kind of rests against the scapula with lots of muscles, tendons and ligaments holding it in place and allowing it to move all over. Because it just rests against the scapula, certain movements with the right amount of force can easily dislocate a shoulder. Elbows are quite different. The elbow was made to really only open and close, like a hinge – not go all the way around like the shoulder. This limited movement is a result of the big cup that the end of the humerus fits into to create the elbow. It takes quite a force to move the end of the humerus from the cup of the elbow, but apparently a fall from a tree can do it.

As I pulled out our 1950s DePalma Ortho book to look up how to reduce the dislocation, I looked around at my helpers. There were 2 female nurses working in the ER, the female xray tech and myself. Everyone is eager to help, but all are smaller than me and after looking at the amount of swelling of the pts arm and realizing what needed to be done, I wasn't sure we were going to be strong enough to get it back. For those who want to know how to relocate an elbow, DePalma says one person needs to provide countertraction on the humerus back toward the chest/head while another pulls the end of his arm and then bends the arm at the elbow to put it back in place.

I assigned one nurse to provide countertraction toward the head and I started pulling on the arm. It was quickly apparent that this wasn’t working, as I was pulling the nurse with the pt toward me and I wasn't pulling the arm itself, so I stopped. As I looked up, I spot the pt’s wasman standing there. Bypassing the other trained staff knowing that strength is what I needed now, I ask him to provide the countertraction, which he was very happy to do. He pulled one way and I tried to pull the other, but nothing happened. So I look around again and find a 2^nd wasman who had come into the ER – so I asked him to help me pull on the arm. We both are pulling on the arm and then I tried to bend it up, but again nothing. As I reread the instructions, I see it also talks about putting pressure on the end of the humerus that is dislocated and giving force down. So I look up again and find our business office guy standing watching, so he too pulls on the arm while I stand on a stool to provide the force down on the distal humerus to get it back in place. Still nothing, as the pt (under Ketamine) is yelling at us asking what we are doing as I try to bend up his arm. At this point, the security guard who was standing around decides to help also. So finally with 3 guys pulling one way, one guy the other and I pushing down on his distal humerus we got it in.

So if you end up bringing a pt to the ER or even to see the doctor here at Kudjip, you never know what we may ask you to help with.

Family Picture

2011-10-31T20:45:00.000+10:00

Bill saw a lady recently who had a number of cysts of her liver. Thinking it maybe a genetic something, he asked her if she could bring in her family to see if any of them had the same condition. So 2 days later, she returns with her husband, 4 kids, brother, and mother. Bill screened them all and then they posed for a family picture with Bill and Nellie, one of our nurses. They were a pretty cute family and thankfully are all healthy.

Dinner with the Dooley Girls

2011-10-28T20:57:00.000+10:00

Scott and Gail went to the Regional Conference in the Philippines so Bill and Marsha are getting to look after Olivia, Emma and Allison this week. I took this opportunity to spend more time with the girls and had them over for dinner. We enjoyed lasagna as I learned all about what they are learning in school and what subjects they like and dislike. They also shared many other stories and facts that were at times randomly thrown in, it was fun and interesting. After dinner we played some games - Old Maid, Pit and Uno. It was fun to introduce PIT to them, a family favorite for my family growing up. The girls seemed to have a good evening as did I. I need to do this again sometime soon.

The Great Dog Houdini - Vida

2011-10-25T20:48:00.001+10:00

Nothing can keep her in. She finds ways to go under fences and to jump over them. She can chew through leashes and breaks through chains. She even lures unsuspecting neighbors in who think she looks so cute and pathetic and want to help her when she is wrapped around a tree to take her collar off, and the she is off again.

I have found Vida outside of Becky’s house, down by maintenance, down by the tennis courts, and last night at midnight at the ER when she followed me when I was on call. Marsha said after the first escape that nothing will keep a dog contained that doesn’t want to be kept in, and that sure is proving true with this dog.

Vida is a black lab mix that belongs to Matt and now Becky Preece. The problem is, Matt hasn’t been around much as Vida has been transitioning to her new home and now he is gone for 1 month, so Vida is quite confused. She doesn’t seem to appreciate the hours that Matt and Becky spent in making a fence, the great doghouse that Randy built or the nice gate that Mike built. She wants to be free and run and be around people, which her fenced in yard doesn’t really allow for, so she keeps finding ways to get out and be with others. This evening Randy and Tim were working on a dog run which hopefully will be better than the chain around the tree that she keeps getting tangled in. We will see if this holds her as this Houdini dog seems to be able to get out of anything.

Isn't she cute though?

Mr. and Mrs. Matthew Preece

2011-10-22T20:31:00.000+10:00

Becky is now officially Mrs. Becky Preece as she and Matt got married on Saturday. The past few months have been pretty hectic for Matt, Becky and many who have been involved in helping to plan and organize this wedding and their other receptions in the US, Australia, and back in PNG during the next month or so. All the preparations paid off, as the wedding was beautiful. The sun was out and the rain held off, the view was amazing, both families were in attendance and all of Kudjip and MAF lain were there to see them commit their lives to one another before the Lord. It was a great day.

It was great to see Becky's mom and stepdad again and to meet Becky's sister. Despite hearing stories of Tami for the past 7 years, I have never met her until this week. So, I really enjoyed getting to finally meet her and to talk to her after all these years. I agreed to let her do my hair and makeup for the wedding. I was a little scared as to what she might do to me, but was willing to let her do whatever for Becky’s sake. I jokingly said to the McCoys before I left on Friday, that they may not recognize me on Sat, but I will be the short one up there. Little did I know that Tami would really transform me so that some of the Kudjip folk didn’t even recognize me initially, thanks Tami. It was a fun weekend.

Congratulations Matt and Becky. Praying for you guys as you start your lives together.

Becky's Bridal Shower

2011-10-19T20:25:00.000+10:00

Becky is getting married this Saturday so we had a bridal shower for her this past Sunday. Her mom, stepdad and sister had flown in that morning, so it was perfect timing. Our hospitality team did a great job of decorating and organizing the shower, complete with a luau theme, since Becky and Matt are heading to Hawaii for their honeymoon. We did some traditional shower things like playing games, Becky opened presents and eating - Hawaiian themed snacks and smoothies. Gail did a devotional about being a light and we prayed for Becky. It was a nice afternoon.

Thompson's and potatoes

2011-10-16T20:25:00.000+10:00

Jordan and Rachel were here for 2 yrs when Rachel served as the high school teacher. They left us in June and are now back as Nazarene Missionaries with Jordan working in our maintenance department and Rachel helping out with teaching and a variety of other things. They were definitely missed when they were gone, and it is great to have them back.

Per our Kudjip tradition, they dinner invites the first few nights they were back, so I hosted them for dinner one night. Jordan, like me when I first got here, doesn’t like many vegetables, so for dinner I went with a meat and potatoes dish. The problem is I don’t know how to make potatoes. I know this is a shock to most people who don’t know me, but I have never liked potatoes my whole life until I got here. I didn’t eat French fries, mashed or baked potatoes growing up. When I got here, I started eating them because I was served them at others house’s and so to be polite, I would eat the potatoes, but I had never made them myself before. Despite this, I decided I would make meatloaf and mashed potatoes for Jordan and Rachel for dinner.

Since I didn’t know how to make mashed potatoes, I wrote to my sister, who just recently started eating them too and asked her how she made them (she her recent blog about this). She said just add some butter, milk and salt to the potatoes after they are soft and beat them really well so there are no lumps. This may seem quite clear to those of you who have made mashed potatoes before, but not to me. Since it was late at night when I got my sister’s email, I emailed Marsha and asked her how she makes them. Unfortunately, her response was the same – which was not helpful to me at all, so I wrote back for more clarification.

Thankfully, Marsha realized this wasn’t an email something and stopped me as I was heading to work to explain more. She was telling me about checking the potatoes to know they are done and says something about cutting them up. I said to her, “Oh, so I need to cut them up first?” She started laughing (not just a little chuckle, but really laughing hard) thinking this was an obvious something that everyone should know, but I had no clue, my plan was just to boil the potatoes whole. I admited to her later that it was only a little before this that I even thought that I should peel the potatoes (I have since learned that you don't need to peel potatoes for mashed potatoes, but most do). There are obviously somethings about cooking that I just have never been taught or learned or have seen done before.

Thankfully, for the Thompson’s, my response about needing to cut the potatoes made Marsha very aware that I had very little knowledge of what I was doing with the potatoes. So although I cooked them, Marsha provided lots of instruction and served as my taste tester. My calls became so frequent, that she just started coming over as soon as the phone rang. I was thankful for all her help, as they turned out quite well and we had a very nice dinner.

Rachel and Jordan - welcome home. Marsha - thanks for all that you do for me.

Times when a history is helpful

2011-10-15T20:36:00.000+10:00

I have been here for 4 yrs now and find histories (the patient telling you what they are feeling, how long they have been sick, what events led up to their illness, etc) quite frustrating. It is often incomplete and has huge gaping holes that just don’t match up with what I find on examination of the patient. (I do understand that it is hard to ask people who have no concept of time outside of when the sun goes up and goes down to tell you how long they have been sick.) So despite everything I was taught in medical school and residency, I tend to ask very few questions and base most of what I do on my physical exam and whatever labs and xrays I might get. This is usually enough to steer me in the right direction to get the pt back on the road to health, but not always.

Today, we could have used a little better history. As walked outside the OPD building, I saw a crowd of people fighting over open window space to steal peeks inside the ER. I go inside to see what has drawn the crowd and see a lady covered in blood laying on our middle ER table. Bill, with blood all over his hands, is assisting Lash, one of our anesthesia guys, in trying to place a tube in this ladies mouth to help her breath. Jim is working to bring the suction machine closer to assist the intubation process by removing all the blood from her mouth. Becky is doing chest compressions because not only is she not breathing, but her heart is not pumping.

The guys who brought her in, told us she was hit by a car – so we were all thinking head injury and were working in that regard. Once we started breathing for her through the tube, I was reassessing her heart when I noticed blood was running down her arm. A further inspection revealed a 1 inch hold in her back, that was bleeding A LOT. (For those of you who don’t know car accidents don’t usually cause this type of penetrating trauma, so once again our history failed us). We quickly worked together to put a tube in her chest, get blood and another IV going, do a further assessment of other injuries, and kept doing CPR to try and get her back. 20 minutes later, we thought we were going to have to say sorry to the family, when the ultrasound revealed her heart was working again. Praise God. She wasn’t out of the woods, but this was a good sign.

Someone else came and was able to give us a more accurate history that she was actually stabbed by the 2^nd wife (her enemy wife) outside our station at a little market. Her bleeding slowed down after the tube went in, her heart beat came back, she started breathing on her own, and things started going in the right direction as life saving blood was going into her. Unfortunately, whatever vessel was tore and had bled initially started bleeding again as she seemed to be coming back to us. Despite another valiant attempt to stop the bleeding and save her life, we were unable to do so and she passed away. The instant we removed our hands from the body, the family was wailing and crying in the ER showing their grief at the loss of their loved one. Jim asked if we could pray for them and they allowed us to have a time of prayer before the wailing restarted.

Would an immediate accurate history have changed the outcome? I doubt it, as we still had to try and do the ABCs, as we say in medicine, which is what we were working on with helping her breathe and getting her heart going. However, an accurate history, every now and then, would be helpful.

Osteo - it is everywhere

2011-10-12T20:29:00.000+10:00

It isn’t uncommon for me to see a patient with osteomyelitis everyday. Osteo (as we call it) is a bacterial infection of the bone, which is very difficult to treat and cure. It usually comes up as a result of a small infection of the skin which goes untreated and goes deeper into the muscle and then into the bone. Sometimes it happens from trauma to an extremity and introduction of bacteria into deeper tissue, which goes undetected and results in an infection of the bone. This doesn’t come up overnight, but takes days and weeks to form – so you would like to think we could stop infections from progressing to osteo, but rarely do we succeed.

I have seen osteo in almost all bones – arms, legs, fingers, toes, ribs, clavicles, vertebra and mandibles (face). I guess I haven’t seen it of the skull, sternum and sacrum, but most everywhere else. Today though I saw something I hadn’t seen before – osteo (or near osteo) of 4 extremities at the same time. A little girl was brought into clinic about 2 wks ago and had swelling of her right ankle, and R arm and xray findings were clear that she had already established osteo of her tibia and her humerus. I put her on antibiotics and today saw her in followup. Now her left thigh was about 3 times the size of her right, full of pus, and her left shoulder had an abscess on it. She might not have osteo right now of her left femur and her left shoulder – but I guarantee you with all the pus she had in her leg and arm that I drained – we are too late and she is going to develop it.

Unfortunately, this isn’t good for this little girl – as osteo often causes significant pain and destruction to the bones that are involved. Having one extremity affected is often manageable, but to have all of them, she doesn’t have a good arm or leg left – not good. She is currently pretty sick, so pray for her to respond to the antibiotics and for the infection that is throughout her whole body now to go down.

2nd one in 3 wks

2011-10-08T20:50:00.002+10:00

Abdominal pregnancies are rare – very rare. Up To Date – a medical resource, says it occurs in 1 in 10,000 births, and in 1.4% of ectopics, which occur about 20 times out of 1000 pregnancies. I haven’t been a part of 10,000 deliveries, but I have now seen 2 abdominal pregnancies in just 3 wks time, crazy.

2 wks ago, I thought I had a ruptured ectopic, when the ultrasound actually revealed the baby was outside the tube and in the abdomen. Today, Susan and Imelda asked me to look at an ultrasound. They thought they saw something moving outside the uterus, but weren’t sure. As I looked, I saw the enlarged, empty uterus, the placenta outside the uterus (just like last time) and a moving something also outside the uterus. Putting it all together equals an abdominal pregnancy. She had already lost a lot of blood and continued to bleed into her abdomen, so we took her to surgery to stop the bleeding. In surgery, we found the baby was still partially attached to the fallopian tube, but had worked it’s way out, along with the placenta, which was attached to the omentum. We were able to remove the bleeding placenta and the tube and thankfully mom did very well.

I always feel bad for the baby in these situations because he/she gives up their life for the life of their mother. The pregnancy is what is threatening to take mom’s life by bleeding to death and only in removing the source of bleeding, will mom be okay. The babies are always way too small to survive outside of mom and are either already not living, or don’t survive very long in the course of surgery. Despite their smallness, it is amazing to me how perfect they are. They have arms, legs, eyes, little organs including a beating heart, ribs, and a little umbilical cord attaching them to mom. They are alive and are a little person growing inside of mom. They aren't a blob of nothing, they aren't something to easily cast off and kill because it is convenient they are a life that is precious to God and to their mom and to all who value life.

Ps 139: 13-16 "For you created my inmost being; you knit me together in my mother's womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. My frame was not hidden from you when I was made in the secret place. When I was woven together in the depths of the dearth, your eyes saw my unformed body. All the days ordained for me were written in your book before one of them came to be. "

Helping or Hurting?

2011-10-05T17:04:00.000+10:00

While on call, the ER calls that a kid has fallen and broken his arm. The xray clearly shows a fracture of both bones in his left arm. Despite the seemingly good straight position of the bones on xray one look at the kids arm told me it was no longer in that same position.

The boy was about 7 yo and was blind from birth. He had fallen into a hole and put his arm out to catch himself and went down on a stone and in the process broke his arm. His parents and another relative where doing all they could to keep this little guy under control, including holding him by his broken and now deformed L arm, but it was apparent he was a fighter and wasn't going to let me do anything to his arm without sedating him first.

Once he was asleep, I proceeded to put his arm in traction and to try and realign his bones. One of the few challenges we have here is that we don't have the resources to do open reductions (surgery) on the majority of broken bones, so we try closed reduction. Closed reduction is a fancy term for blindly trying to realign the bones by looking at the xray and trying to move the bones back where they need to go with brute force. We also don't have a fluroscopy machine (which can take xrays as you are doing or right after the reduction to make sure you got the bones into position), so we rely on the method of reduction and re-xray in a day or 2 to see how the position is, redoing it when necessary.

I have learned that my massive 120 lb frame doesn't have all the strength that is often required to reduce the fractures. Despite failing, I try anyway and sometimes surprise myself with the results. Most of the time, I get it close, but not quite and then usually ask Bill to give me a hand. We usually give it 2 good tries at closed reduction before we refer the patient to Jim for possible surgical reduction of the fracture.

Since this was a little kid, I was thinking my chances of putting the bones back together were going to be pretty good. I felt movement as I reduced it while on call, and then put him in a cast. The next day his family brought him back to get the xray to see if his bones were straight again. Unfortunately, the xray suggested that I made his fracture much worse. So after sedating him again, Bill helped me reduce his arm, hopefully it will now be straight.

Glivec - restores life

2011-10-01T16:36:00.000+10:00

4 months ago, Magua was in pretty bad shape as his body was losing the battle against leukemia. Thankfully, he now is winning. He has a form of leukemia called Chronic Myelogenous Leukemia which is the best kind for anyone here in PNG to have, because we actually have a medicine that works. Since his diagnosis, he has been taking a medicine called Glivec, an expensive medicine that specifically targets the mutation causing cancer, and put the cancer in a remission. Up until Glivec, all the pts we have treated for cancer have passed away, most rather quickly. Glivec gives them and their family hope of more time together through remission of their cancer. We don't have the thousands of dollars that would be needed to purchase Glivec, but thankfully the company who makes it is willing to give it away for free to patients in developing countries who qualify for the medicine. Magua has qualified.

Magua and his family live 3 hours from our hospital, but they come every month to get a checkup and to get a resupply of medicines. Magua's mom heard about our hospital and the medicine we have from another CML pt's daughter, who heard about his condition and then brought him to us. She had seen the change her mom was experiencing and wanted the same for Magua as well. Magua and his mom were overjoyed and were praising God, when I shared that his blood counts are all normal now. Magua, 12 yo, is not currently in school because he had been very sick prior to starting Glivec. He is hoping to return to school next year (Feb), but he has had some hearing difficulty and we are praying that it resolves so he can return to school.

Pray for Magua and for others in our GIPAP program who are finding their lives restored through Glivec.

Unusual pregnancy

2011-09-28T18:29:00.000+10:00

A mom came in after being referred from the health centre. She had passed out while at the health centre, and they thought she had a ruptured ectopic pregnancy (where the baby forms outside the uterus, usually in the fallopian tube, where it can not survive). A ruptured ectopic pregnancy is something we see almost everyday, so our nurses are well trained in looking for ruptured ectopics among the pts who come to the ER and in the basic stabilization of them prior to surgery. Before I knew it, a nurse was asking me to sign a slip to get blood cross matched for the patient before I even knew what was wrong with the patient.

After signing the paper, I found the pt already had an IV started and the ultrasound machine was there ready for me to do an exam. The husband reported his wife had not had a period for 3 months, had fainted at the health centre and was very weak at home. The history of no period, the fainting and the distended abdomen I was seeing on mom all made me worried for a ruptured ectopic also. As I ultrasounded the pt, I saw a large empty uterus, an irregular mass to the R side of the uterus and a lot of blood by her liver and spleen. Jim was walking through the ER at that time, so I asked him to come take a look and as I was showing him the fluid again, we found the baby way up by the spleen. This wasn’t just a ruptured ectopic pregnancy, this was an abdominal pregnancy, something I had never seen before.

An abdominal pregnancy is where the baby doesn't try and grow in the fallopian tube, but outside the fallopian tube - anywhere in the abdomen. Most ectopic pregnancies rupture (break) between 2-3 months of life and the baby dies and the mom can also die without surgery. Abdominal pregnancies, can go undetected for a longer period of time, especially here where most women aren't getting early prenatal care. This pregnancy was already 18 wks (4.5 months) when she came in. As is common with any sort of ectopic pregnancy, mom's life is threatened by all the bleeding that occurs inside of her. With quick teamwork amongst the ER nurses, lab staff and OT staff - she was quickly taken to surgery, where Jim and Maggie were able to stop the bleeding and save mom's life. The baby was too small and could not survive.

Good work everyone. I am thankful for the great team that we have here, working together to serve those who come to Nazarene Hospital.

Making the most of each opportunity

2011-09-24T18:09:00.000+10:00

Matthew is one of our Community Based Health Care nurses who has become a patient. About 6 wks ago, Matthew was driving his PMV when he got into a car accident and almost died. Thankfully, he was pulled from the car and despite significant chest trauma and multiple fractures he is still with us. He was touch and go for the first week or so, but now is hanging out on our surgical ward waiting for his femur fracture to heal. He has a long road ahead of him, but it isn't dampening Matthew's spirits.

Matthew is making the most of his time in the hospital by ministering to others. Lots of nurses, hospital workers, friends and family come to visit him and he uses that time to share about God's work in His life and to encourage them in their lives. He even encourages and challenges the nurses taking care of him to continue to remember why they are working at our hospital and what God has called them to. When not talking to visitors, he enjoys having his family visit (here he is with one of his daughters), reads lots of books and watches movies on his computer.

Matthew's heart is out in the communities where he trains villages in basic health care, but also shares about Jesus's love. He is looking forward to the opportunity to get out there again, but he has at least a month if not longer to be in the hospital. His femur was broken into multiple pieces and is going to need more time to heal. Pray that God would mend his bone and strengthen it. Pray that this minister of the gospel would get the opportunity to go out among the villages again and share the gifts God has given him.

Eph 5:15-16 "Be very careful, then, how you live - not as unwise but as wise, making the most of every opportunity. . ."

Bad beans

2011-09-20T20:47:00.000+10:00

Vegetables are a staple in the diet of almost all who live in PNG, including myself. Unfortunately, not all vegetables are good for you. There is a kind of bean that grows around here that looks like a lima bean, but has cyanide in it which makes it very lethal. Most people know which are good beans and which are the bad beans, but the bad beans still get eaten.

Despite a desperate effort to fall back asleep after the 0200 visit to the Pediatric Ward for a kid who had stopped breathing, I was wide awake at 0330 when the phone rang. The ER nurse reported a 3 yo child had eaten beans the afternoon before and then started vomiting and having seizures and was now comatose in the ER. I quickly got out of bed and got ready to go and see this kid. I knew from the phone call that I was dealing with a cyanide poisoning and was thankful that a donor had recently made it possible for us to purchase the meds we needed to treat cyanide poisoning.

When I got to the ER, I found 7 adults huddled over the bed of this small child, the mom and dad on either side holding the hand of the young boy. Thankfully, the nurse had already started an IV by the time I got there. As I examined the child, I found that he was recovering from a recent seizure, so he wasn’t able to talk or follow commands. I gave the family some instructions of things they go do to help and then went to get the medicines which would hopefully reverse the cyanide poisoning. As I was drawing up the IV meds, I had dad place a medicine under his son's nose which he could breathe to help decrease the effect of the cyanide. I talked to the mom and the dad as I was working, explaining the situation and how serious it was and we prayed for God to heal this small child, named Aron. I gave him the IV meds and then we waited and prayed, not knowing when we might see a change.

After being there for about an hour, finishing all my orders, answering all the family’s questions and seeing that Aron was stable, I made my way back home. At this point, I knew there was no way I was going to sleep, not knowing how Aron would respond or if he would respond. I was worried for him as it was 14 hours since ingestion and he ate a whole plate of beans and he was a little guy, was it too late? I continued to pray for him and his family, going back to check on him a while later when another child came into the ER with pneumonia.

5 hours after I initially saw him, I finished my rounds on the adult ward and went to check on him. He was sleeping, but mom and dad reported that he had woken up and talked to them. Praise God. The next day, I found him sitting up huddled under his sheet, talking, smiling, and acting as if nothing happened the night before. Mom says he was back to normal, so we prayed again, thanking God for his life and I sent them home.

Praise God for his life and for the medicines that we now have to treat cyanide poisoning. Thanks to all those who help make our work here possible.

Tennis Court repair

2011-09-15T21:01:00.000+10:00

While I was home on vacation the tennis court got repaired. The potholes have been filled in and sealed over thanks to Tim's expertise in driveway repair and lots of hours of hard work put in by many here. I didn't get to help in the repair, but I did get to help in spraying on the lines this week with Tim. It looks really nice, especially compared to where it was at 3 wks ago. No more excuses for bad shots due to bad bounces, I could be in trouble. I can't wait to try it out.

Thanks to Tim, Bill, Jim, Stephen, Amy, Lydia, Josiah, Andy, Randy and anyone else who helped for making the court a lot smoother.

Before I left

2011-09-12T11:28:00.000+10:00

I enjoyed a good last few days with Megan, Joe and boys. Eli took a number of falls, but he never stayed down long. Eli is quite the little eater, especially when it comes to things like ice cream and corn. Luke has started preschool and is enjoying learning and playing with other kids besides his brothers. Graham is enjoying the few hours where it is just him and Eli at home with mommy, while Luke is at preschool. Graham's love of vegetables has ended and he now seems to be only a carnivore. My time home was quick, but it was good.

Time with family2

2011-09-09T21:18:00.000+10:00

I enjoyed the time I got to spend with my Dad and Laurel while I was home. We had a good weekend hanging out, eating, playing games, and celebrating my dad's birthday. Luke and Graham enjoyed decorating cupcakes for the party, blowing out the candles and opening the presents, and my dad enjoyed it too.

Time with family

2011-09-07T09:04:00.002+10:00

While home I have gotten to see some of my family - my dad and his wife and my aunts, uncles and cousins. I haven't seen them since Christmas, so it was nice to see them again. We enjoyed catching up, eating and playing with the boys.

Eli, despite being only 14 months is quite the little climber. Today it was confirmed that he can no longer go outside unattended. He is now able to climb up the 5 foot rock wall by himself and has no fear of going down the slide. His fall out of the little window on top of the swingset today gave us all a scare. Thankfully, he landed on his stomach and despite a few scrapes and bumps is doing just fine.

Things I have learned

2011-09-04T22:04:00.003+10:00

Watching 3 kids age 4 and under isn't something that I normally do everyday. As a result there are things that I have learned only by experience. Here's a few:

- Do not tell the 2 yo that you are going to the zoo 2 hours from now. It can result in a half hour of questions fired every 2 minutes of if it is time to go to the zoo yet.
- Do not trust the 4 yo when they say the pool doesn't have enough water in it and to leave the hose on to put in more water. What is good for the 4 yo is not always good for the 1 yo (see below).
- Do not leave the 1 yo unattended in the pool for even a second. Even if the water level seems low enough for when they stand or sits, it is when they fall or go headfirst down the little slide, that you need to worry about. They can just stay underwater without even realizing the danger they are in and even trying to stand up. The older siblings will have no idea that the 1 yo could be drowning, so do not count on them to pick him up when he falls.
- Prepare to get wet when you take 3 boys outside to go swimming in their little kiddie pool. Whether from splashing, or from preventing the 1 yo from drowning - you will get wet.
- Do not leave sharp objects out anywhere. The 4 yo wants to know what everything is and thinks picking everything up and touching and trying them out helps this process.
- Do not leave the 2 yo in the room with the 1 yo when the 1 yo is trying to take a nap. The 2 yo will just talk and entertain the 1 yo and there is no nap.
- Know where the bandaids are.
- Sharing isn't an easy thing.
- Tears are a normal part of everyday.
- That I love these kid and their parents and am thankful for the time I get to be with them.

Reunion with friends

2011-09-02T11:47:00.001+10:00

We enjoyed an evening with some friends from medical school, Bob and Meghan, who have 3 kids the same age as Megan and Joe's. It was fun with all the kids playing and running around. Joe got out the rocket blaster and the boys enjoyed chasing the rockets when they landed. Then the kids all enjoyed the smores and then they had a basketball game.

Time at home

2011-08-30T11:38:00.001+10:00

It has only been a few days, but it has been great to be home with Megan, Joe and boys. Luke knew who I was, but Graham and Eli both thought I was Megan - which was good for me. They quickly figured it out once they saw us together, but thankfully are content to come to me. Pics are from Megan's office party that I got to attend.

Dress Shopping

2011-08-28T12:28:00.000+10:00

So since I was coming home and am in Becky's wedding, I needed to get a dress for the wedding while I was here. My instructions were simple - find a long lapis dress at David’s Bridal. Most of you know about my love of dresses, especially formal dresses, so I was quite excited about this outing. I am only home for 2 wks – so Megan and I went today, bright and early after me being here for less than 12 hours.

Lady ready to help when we walk in: Can I have the bride’s name?

Me: Why?

Her: To look at her registration and make sure we have everything right.

Me: She isn’t registered.

Her: Well how do you know, we can check.

Me: She lives in PNG, we don’t have David’s Bridal there.

Her: Are you sure? Maybe another bridesmaid is registered.

Me: I am really sure there is no David's Bridal in PNG and I really don't think she or the other bridesmaid is registered.

Her: Let’s check (so she does and surprisingly finds nothing). You were right. Okay this lady will be helping you today.

Now we go to where the dresses are with the helper lady. There are maybe 200 dresses in this area. She starts showing us pictures of the various kinds of dresses.

Me: It needs to be long (down to 100 choices)

Her: Oh, then come over here, to a poster of the long dresses. She starts describing them.

(I know nothing about dresses and don't even understand her descriptions of various material, cuts, etc.)

Megan: She needs to get a dress that you have in the store, she is leaving in 2 wks to go back to PNG. (down to about 20 choices)

Her: Oh, well then just look at the rack and find a dress. We can only take them in 2 sizes and we can’t let out. (down to about 5 choices)

We find only 1 dress with straps – well actually it has only 1 strap, but 1 is better than none in my mind. I overhear her tell another customer that straps can be added.

Me to Megan: She just said they can add straps, so take anything in my size.

We gather up all the long lapis dresses in my guessed size, all 5 of them. I go to try them on, and quickly find that the guessed size was wrong, so Megan goes back to see if she can find any dresses in a new size. Only 2 – one has a strap and the other has none – so easy choice – the one strap dress. While I am trying it on, Megan finds me flip flops to match my dress. Great. I come out and the lady asks what I think. I really don't have an opinion, I need a long dress in this color, and this is the only shop Megan and I really want to go to (the others are farther away), so since it fits and has a strap, I will take it. So I go to the seamstress lady to get measured for a hem and we are done. Dress shopping in 30 minutes – it was great.

More shopping, lunch at Olive Garden and even with a the traffic jam on the way home it was a great day with my sister.

Week in Singapore

2011-08-25T23:22:00.000+10:00

Mama

2011-08-20T07:33:00.001+10:00

Imagine if your whole life you were never able to talk, yet you could hear and understand what others were saying to you. Imagine that despite not talking, you were loved and cared for by many. Imagine one day all of a sudden being able to talk – what would you say?

Brenda is 12 yrs old and until recently was unable to talk. She is loved by many, especially her mother, who has looked after her and cared for her as only mother’s can do. Her mother’s love brought Brenda to Kudjip Nazarene Hospital because she was concerned about a lump on her back. Her mom had already accepted that Brenda was shorter than other kids and was unable to talk, but wanted to know if we could do something about her back.

When she walked to my room the smile she had was infectious and overflowed to me as I watched this little girl hold her mothers hand and together take small steps as they walked into my room. Her mom shared her concerns about her back, and then I asked questions about her development trying to figure out why she was so small and couldn’t talk. The whole time Brenda is smiling and holding onto my legs and hugging me. As I consulted with other doctors and got some blood work, we discovered that her thyroid gland hasn’t been working properly and possibly this has been going on her whole life.

6 wks ago, I started her on some medicine to help her thyroid. Mom couldn’t contain her smile when they came back and she told me that Brenda can now say “mama.” I couldn’t contain mine either, as we praised God that He had made Brenda able to speak. Mom says, she babbles all the time and says a lot of things that they can’t understand. Only God knows how much Brenda will be able to say after 12 yrs of silence. I pray that the medicine will continue to help her to talk and to grow, but that it doesn’t change the love that she gives so freely.

Is 35:5-6 “Then will the eyes of the blind be opened and the ears of the deaf unstopped. Then will the lame leap like a deer and the mute tongue shout for joy.”

Rainbow

2011-08-16T00:12:00.000+10:00

I have never seen so many rainbows in one place before, but maybe that is because we get so much rain here. Just the other day I was out in the garden and I looked up and saw this rainbow over the valley below. I love the reminder that rainbows provide of God's promises being true.

Trip to Area Medical Store

2011-08-13T23:59:00.000+10:00

Our hospital receives medicines and supplies from the government through something called Area Medical Store. This is a huge blessing to us, as it saves us money by not having to purchase medicines. What the government doesn't give us, we have to supplement with meds that either we or Nazarene Hospital Foundation purchases, or medicines that are donated from the US. We get a majority of our meds from AMS, so when they are out of things, we are in trouble.

Recently, we have been having some problems getting supplies because AMS doesn't have the meds that we need. After numerous phone calls to the head AMS guys in Port Moresby and trying to get in touch with our local AMS in Mt. Hagen, I decided to make a trip to see what I could find out. I have spoken to the guy in charge of Hagen AMS numerous times on the phone, but I finally got to meet him in person when I went. We talked for a while and I left with promises of doing all they can to help us and to get us meds, but some things are just out of their control.

After I talked to them, I then asked for a tour of their warehouse. It seems like a pretty big warehouse, with lots of shelving and areas all labeled for all the different meds that we can ask for. Some of the areas were empty and others were full. Most of the medicines that are in large quantities are meds that we don't use regularly. They did have a large amount of some normal saline IVF - which is always a good thing. However, currently they are out of disposable gloves and all of our IV medicines that we use everyday to treat pts, which is a problem. It isn't just our hospital that is without these meds, but all the hospitals in our area. Pray that AMS would come through with their promises and provide medicines which will allow us to properly care for the pts who come to be seen.

Talipes Kids

2011-08-10T23:51:00.000+10:00

These kids may not seem real happy now, but just wait until their feet are straight and they can really walk well, then you will see a huge smile on their faces. These are 2 of the kids that Andy and Rosie are working on in their Talipes Clinic. They come every week with their family members to get casted or fitted for braces. By the end of their 2 months or so with us, their feet will be straight and they will be walking like everyone else with huge smiles. What a great ministry that Andy and Rosie get to have with these kiddos.

Kellen's Wedding

2011-08-07T08:58:00.000+10:00

Kellen has been my haus meri for the last year or so that I have been here, but she has helped the Radcliffe's for a number of years. She got married this past weekend, so I went with the Radcliffes to the wedding. The Radcliffes weren't just spectators but were main participants in the wedding. Jim shared a message about marriage, Kathy helped out with a lot of the preparations, Cilla and Lydia were bridesmaids, Cilla's friend Laura was the photographer, and Tessia played the piano.

I haven't been to a PNG wedding before, so it was nice to witness this marriage ceremony for Kellen and Frankie. A lot of our western traditions have made their way into PNG weddings around here - white dresses, rings, flower girls and ring bearers. PNG traditions however are also present. There is the flower ring which is put around the couple to help to signify that they belong to one another and that no one else can come in and that they can't break the union or go outside of the ring. There is the illustration of roles of men and women. For men it was a bushknife and bible signifying being the spiritual leader and the worker to help build the house. For the women it was the bilum to represent the gardening and supplying of food, but also for kids and it was the sunday school chart to help teach others about Christ.

There was an uninvited guest at the wedding too, the little puppy - but he was cute, so I got his picture. Following the ceremony we all lined up to congratulate the couple and then enjoyed some mumu food before heading home for the baptism.

Cilla, Jo, Lydia get baptized

2011-08-03T18:09:00.000+10:00

One thing Cilla wanted to do when she came home for the summer was to get baptized. To publicly testify that she was following Christ, her Savior. When no other churches were having baptisms while she was home, the Radcliffes decided to have their own. So the day before she headed back to the States to start her sophomore year at MVNU she got baptized along with Jo and Lydia. It was a special day for the Radcliffe family.

We all met at the circle and walked to the hydro church where we hand a little service lead by Pastor Augus and Rev. Harmon. It was great to hear their testimonies of what God has done in their lives and how they each want to serve Him. Following the service, we walked closer to the water where Harmon and Pastor Philip baptized them with many onlooking celebrating and cheering for each one. The river was pretty cold, but no one seemed to mind. The missionary family and many of our national friends came together to witness this special time for the Radcliffes.

Cilla and friends head home

2011-07-31T08:47:00.000+10:00

After getting to come home for 8 weeks, today was the day that Cilla and her friends from college - Laura and Tessia, left to go back to the US. It was great to have Cilla home for a few months and it was great to meet her friends. Tessia is studying to be a nurse and she enjoyed her time working in the hospital, especially in the OR. Laura is applying to medical schools and had a great opportunity to see what missionary medicine looks like.

They are all going to be missed, especially Cilla. The bittersweet times of being a missionary - hellos and goodbyes, but we know Cilla will come home again. We will be praying for them as they travel this weekend, and ask that you would too.

Twins

2011-07-30T18:05:00.000+10:00

For some reason I am drawn to twins. These two little girls came into see me the other day in the clinic. I couldn’t resist a picture of them.

Houston, we have a problem

2011-07-27T12:43:00.000+10:00

One of the things I got in the container was a blanket that I had had since college. It was nothing special, just a blanket for my bed (for some reason I get cold at night). So I was washing my new towels and things and threw the blanket in the washer as well. I was quite surprised when I went to move things into my dryer to find that the blanket had turned into 100s of little blue pieces that were throughout the washer and on everything in the washer.

I had to pull things out one at a time and just shake out the blanket pieces. Thankfully my vacuum picked up all the blue pieces which made the cleanup process much easier. I had cleaned out my washer, but apparently not well enough. When I put the clothes back in to wash again, I had a similar, but less severe result. So I got to cleanup the washer and the clothes a 2^nd time. It was great fun.

A new look in my house

2011-07-23T12:25:00.001+10:00

living room before

living room after

living room before

living room after

my bedroom after

This past weekend the container from Nazarene Hospital Foundation in Oregon arrived. Since I was home in the fall, I ended up sending a bunch of stuff to Todd and having him pick up stuff for me. Most of it was for my house to make it more my own. So after the rain stopped and we got the container unloaded, I started to go through all my stuff and started redecorating.

guest bedroom after

dining room after

I got new covers for my couch, loveseat and chair and then all new curtains for my house. I borrowed the McCoys stepstool and drill for the job and in the process recruited their help in hanging up my curtains. Bill didn’t know what he was getting into and kept thinking (and probably hoping) we were almost done. With his arm aching from screwing in the new curtain rod holders and realizing we weren’t done yet, he finally went and got a bigger drill bit, which made his job much easier. With the 3 of us working, we managed to put them up in a short period of time. I don't know how long it would have taken me by myself, but I was sure thankful for the help.

With the redecorating came some cleaning as well, which was a good thing as I started to go through things and try and determine what I really need and what I don't. Now I am thinking maybe I should paint - we will see.

A reminder of God's love

2011-07-19T21:04:00.000+10:00

With her cute little waddle walk, Brenda, a 12yo little girl who only came up to my waist, made her way into my exam room with her mom. Before I got into the room, she had already showed off her huge smile and had hugged the nursing and medical student who were waiting patiently for me to return. As I enter, she looks up at me, smiles, walks with her arms outstretched toward me for a hug. She stole my heart right there.

She doesn't talk, but understands what is being said. Although she may seems handicapped or disadvantaged in someway because she doesn't talk, she actually sees the world in such a beautiful simple way that is quite refreshing. She has no reservations about skin color, age, or position in society. None of that matters to her, she just gives hugs and smiles to everyone. I was telling Bill about her and he wanted to meet her. So we went outside to find her and she turns, sees us, smiles, puts her arms out and walks right to Bill to give him a hug.

The joy and love that she demonstrated reminded me of God loves for each of us. He loves us no matter who we are, what color our skin is, how much money we make, how we dress, or what we have done in our lives. He loved us so much that he sent His Son, Jesus, to a cross to die for our sins. May we all love others as Brenda and our Lord love us.

Romans 5:8 "But God demonstrates his own love for us in this: while we were still sinners, Christ died for us."

Friday night fun

2011-07-16T12:19:00.003+10:00

So this past Friday, I invited all the teenish age girls over for spaghetti and games. There were 12 of us with Cilla being home with her 2 friends from college and 3 girls who are staying in the guest house, so it was a good size group. We ate first and then started playing games. We enjoyed telephone charades, 4 people on the couch, taboo and apples to apples. We had a good time.

One decision, one stab, one life changed forever

2011-07-12T21:01:00.000+10:00

One decision. A neighbor’s family member has died. A wife wants to give them a pig as a way to show they are sorry. The husband says no, they are already giving lots of food. The wife does not like her husband’s decision and so she picks up a knife.

One stab. She comes behind her husband and stabs him in the neck. She barely misses the large blood vessels that run alongside his neck, but she hits his spinal cord.

One life changed forever. He is alive, but can no longer walk. His R leg is totally paralyzed and his left has significant weakness in it. He will no longer be able to provide for his family and instead will depend on his family for everything – to lift him from bed, to transport him from place to place, and even to take him outside to go the bathroom.

Unfortunately, this event isn’t an isolated one, domestic violence is a way of life here. Almost everyday there is someone who comes to the hospital after being chopped or stabbed by a husband, wife, or 2^nd wife. Often the women are the victims, but it isn’t uncommon for the men to be the victims also.

Pray for the Holy Spirit to change their hearts from full of anger and ready to fight, to full of love and forgiveness.

Pray for Silla

2011-07-09T18:06:00.000+10:00

Silla is a little girl from the Jimi Valley (far away), who came to our hospital after relatives noticed that she was losing weight and wasn’t getting better. They tell me she is 7, but she weighs only 12kg (about 26lbs). This picture doesn’t show how little she is. Her ribs are all showing and there is no muscle on her arms or legs. She is little. Her chest xray confirmed that she has tuberculosis in her lungs, and she is now on treatment for that. She is also getting some extra nutrition in an effort to put some meat on her bones. Her family members welcome your prayers for her. Pray for her to gain weight, for the TB treatment to work, for her to recover and to come and know the Lord while she is here.

Jessica, a miracle child

2011-07-06T18:17:00.000+10:00

Jessica continues to be a little miracle child. Over a year ago now she was in the hospital with a horrible CNS infection, was having seizures, wasn't eating or talking and was hardly moving. After much prayers, lots of medicines and God's intervention, she went home. After going she still had a long recovery. Initially, she still wasn't walking very well, and could only say a few words and very slowly, but God has continued to restore her physically. Just this past week, she showed up with her mom, dad and brother just as a watch family while I saw another patient. It was great to see little Jessica alive and well, talking and interacting with me, walking without a limp. The mute talk and the lame walk sure came true in her life. Praise God for Jessica's live and the way God has worked and that her family knows that it was God's doing.

Waiting for a year

2011-07-02T17:51:00.000+10:00

An old papa and his son come into my room and the son says his dad has a ring stuck on his finger and would like us to take it off. I look at his finger and find a nut that was put on his finger, not a cheap thin ring, but a thick nut. I ask what happened and they said, "A year ago, when he was sleeping some kids put it on his finger. It has been on his finger for a year? Yeah, but we are just coming in now. Where do you live? Banz." Which, is only 20 minutes away, but they still waited for a year. As you can see his finger was quite swollen and there was no way this nut was going over his finger. I tried a pair of bolt cutters and even a ring cutter - but they didn't work. I was to the point where I was just going to amputate his finger, when Lydia Radcliffe brings over a pair of their household wire cutters. This happened to be just the right size and after I snapped through one side of it, his son managed to snap through the other side and free the finger. The nut had tore his skin all around his finger, and he couldn't feel or move his finger, so there is a chance that it will still need amputated, but time will tell.

A recommendation to anyone out there with a ring stuck on their finger, please don't wait for a year before seeking medical help.

Weekend in Hagen

2011-06-28T18:06:00.002+10:00

Becky has been spending every other weekend in Hagen town hanging out with Matt. I had recently seen Nikolai at the hospital, with her two adorable girls and she invited me to come out for a weekend also, so this past weekend I went out with Becky. We left on Sat am and we went to a restaurant for lunch, did shopping and cooked dinner for the Balins as well as Jen and Timon (Matt's roommate and girlfriend). We had a nice meal and then enjoyed Monsters Inc, which the girls especially liked.

Sunday we went to Matt’s United Church, where they were remembering the first missionaries who came to PNG in 1891 down in Milne Bay Province. So the Milne Bay folks who go to the church did a number of special items, many in their tok ples, which was neat to hear. It was encouraging to hear and think about the missionaries who first came to PNG and to see the fruit of their and many other's labors. It was also challenging to think of my call and was encouraging to me to continue sharing the gospel as God has called me to do with the people of PNG. It was a long service, so our planned trip to the gym to workout and maybe play tennis didn’t happen. Instead, we enjoyed playing Matt’s Wii were we battled it out canoeing, jousting, jet skiing and more. It was a good time and then caught a ride back to Kudjip with the McCoys and Radcliffes who had enjoyed a day of bird watching for Father's Day.

To cut or not to cut, that is the question

2011-06-24T18:26:00.000+10:00

Chris is about 7 yo and has cancer of his R leg. When he came in the first time, we told him that we needed to do surgery to cut off his leg and the tumor to save his life. The family went away to talk about it and didn't come back for a number of months. When they came back, the tumor had grown considerably, to about a volleyball and was just below his knee. They still weren't ready for surgery, so we offered chemotherapy, which they agreed to. The whole time we were doing the chemo, we were telling them we still need to do surgery, but when they saw the tumor shrink and his leg go back to almost normal size, they never even considered surgery. We did about 8 rounds of chemotherapy and then wanted him to go for radiation in a town about 6 hours away. We didn't see or hear from him for 2 months, but assumed he went and was getting treatment. Today he comes back with his mother, having never gone to Lae and not getting chemotherapy for 2 months. So when I asked Bill to see a pt, he says that Chris is in his room and that his leg today is the size of a very large grapefruit and he has swelling of his lymph nodes.

Once again the topic of surgery and amputation comes up between Bill and Chris and his mom and once again they are in denial. Chris starts to cry when Bill asks him if he is ready to have his leg cut off. This isn't easy for any of us. I understand he doesn't want to lose his leg, and I understand his parents don't want him to have to lose his leg, as then he can't work or fight or do much in their culture here. However, the alternative to surgery and an amputation is that sometime in the near future little Chris will die. He doesn't understand that and I am not sure the parents do either. They saw the cancer shrink one time with chemo, I am sure they think it will happen again.

I do know that Chris's quality of life for the past 9 months has been pretty good, he even had a spell where he didn't need crutches and was walking on his own, so I surely wouldn't want to take that away from him. Unfortunately, in our setting no one agrees to an amputation until it is too late. The family never agrees to surgery until the cancer has already spread and the leg is huge and they realize we were not making it up, but at that point there is nothing we can do. Our chemotherapy works a little, but is not a cure for them.

The questions kept coming up in my mind wondering if we should have done something different. Did we hurt them by trying to help and offer what we could? Is having the cancer shrink and increasing his quality of life for 9 months a bad thing if in the end he never has surgery and dies from this cancer? If we would tell them we have no chemotherapy and that all we can do is surgery, would that actually make them have the surgery?

I have no answers and know that each case is unique, but I also know that we have two (Peter and Christ) 7 yo boys with the same cancer who will die without surgery and whose families aren't ready for us to do surgery. Would you please pray for them. Pray that God would change their hearts and that they would allow us to do surgery which could save their lives. Pray that we would have wisdom and compassion as we share with them and be able to help them understand this illness and the consequences of it. Pray that we would continue to show Christ's love to them as we can for them no matter what they decide.

Giant Pumpkin update

2011-06-21T18:03:00.001+10:00

The giant pumpkin now has a circumference of 66 inches. It has slowed down considerably and is turning orange now, but is still growing. What is fun now is the PNGians who walk on the village road just behind the garden are now starting to notice it. When you are out there you can hear them talk about the big pumpkin, many not believing that it is a pumpkin and thinking it is a container. At times, they tell it each other it a pumpkin and at other times, we have to convince them it is a pumpkin. When they find out it is a pumpkin, they ask for seeds. We took down some of the corn that was blocking the view from the road so people can see it better. Some folks have suggested that we need to turn it into a witnessing tool of some kind, but we haven't figured out how to do that yet, any ideas? Until we figure it out, we just let them look and talk to them as they come and have a peek at the giant pumpkin.

A Minute to Win it

2011-06-18T15:35:00.000+10:00

So I had never seen or heard of the show, but Fri night at the Dooleys’ Emma became the game show host and we all got the opportunity to play our own version of a Minute to Win it. So the Dooleys, Thompsons, Tiffani and I enjoyed competing and Pam enjoyed watching and laughing at us as we played the game. We got to try and stack 6 dice on a tongue depressor held in our mouths, pick up keys with a paper clip on a tongue depressor, stack cups in a pyramid and take them down, move an oreo from our forehead into our mouths without our hands and more. We all had fun and enjoyed a number of laughs. Thanks Emma and the Dooleys for a good night of food and fun.

Hike

2011-06-15T15:20:00.000+10:00

Bill, Quinton, Lydia and I got up early this past Saturday and headed up the gorge to the river to hike and fish. We had a great morning, hearing some birds of paradise singing to us as we were walking. The weather was very nice and we somehow managed to escape the downpour that the station received.

We didn’t catch anything except a few leaves, but we had a great time. The last time I was fishing was 2 years ago, and I can’t even tell you the last time I was fishing before that. As a result, I made a number of casts into the nearby foliage or got it snagged on rocks as I was trying to reel it in. These snags resulted in all of us getting the opportunity to go swimming to unhook them. My last cast went into the foliage right at the base of a rapid with a whirlpool there. I went in after this one and enjoyed a cold swim, using the current to take me to the side so I could get out. Thankfully, I managed to dry out somewhat quickly.

Quinton was cold after he went swimming and tried to start a fire, but the flint broke, so it didn't happen. Bill had a secret fishing strategy that he failed to mention to the rest of us, hiding behind a rock o the fish don't know you are there. It didn't work, but looked good. It was a great hike, we saw some of the beauty of God’s creation around us and enjoyed the fellowship with one another.

Tears

2011-06-11T16:24:00.003+10:00

Tears are common around here, too common at times. There are tears of joy, tears of relief, tears of grief, tears of frustration, tears of sadness, tears of laughter, tears of disappointment and tears of pain. I see all of them in a short period of time.

This week, an older lady, with chronic lung disease, came in with her daughter in law. For the past year she has stayed with her son and his family to get medical care, as she is from the bush 4 hours away. They started crying as they shared this was the last time I would see her, as she wanted to go home to die. The daughter shedding tears because she doesn’t want her to go, the pt crying because she thinks she is going to die and that she won’t see me again. When I told them I didn’t think she was going to die anytime soon and that I would see her in heaven, she just hugged me and we embraced for a few seconds. Despite not speaking pidgin, she and I connected through our monthly visits, and she was so thankful for the care I had given her. This caused me to start to cry, as I hugged this dear lady, knowing that God had used me for some reason to bring hope and healing and His love to her for a period of time.

When I call for the next pt, a father and his daughter start walking to my room. As the daughter walks, it is obvious that something is wrong with her back. As I talk and examine her, I find a very pleasant 11yo girl, who has no pain just says she has something wrong with her back. Her back is disfigured in a way that makes her look somewhat like a hunchback. The xray confirms a fracture of one of her vertebrate and the subsequent rotation and misalignment of the rest of her spine and body. TB is the most likely culprit, and we don’t have any spine specialists around here, so our options are pretty limited. As I looked at the xray and discussed it with Bill, we agreed that we needed to try TB tx, even though we know it won’t correct her deformity. When I told them our plan, she started crying. They are from a remote area in the Upper Jimi, at least a days walk to us or longer, but that hasn’t stopped this little girl from having hopes and dreams. She broke my heart as she shared her hope that we would be able to fix her, to do surgery and make it all better. Her tears of disappointment brought the same to my eyes, knowing there are no other medical options for this girl here in PNG. We prayed asking for God’s will to be done and for a miracle to occur.

I was on call and got a call that a baby had stopped breathing on the pediatric ward. I got out of bed and made my way down to the ward and heard the wailing before I even opened the door to the ward. When I got to the baby, he sure enough had stopped breathing, which had happened many times already, but this time our efforts to bring him back did not work. The mom is shedding tears of grief, as her young child is no longer breathing, and many on the ward joined her as they realized there was nothing more for me to do.

Another night on call, and a truck pulls up and 3 men are carried out, blood all over them. The initial report is they were shot. One young man, is someone I know, and initially it looked like he had significant brain damage from the shot or whatever had happened. By God’s grace, by the end of the night he was talking to us and moving all his arms and legs. Tears of relief were shed by many when he came back to us.

Thankfully we have something to look forward to Rev 21:4 "He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away."

Rachel and Jordan

2011-06-07T16:18:00.001+10:00

Rachel and Jordan have served for 2 yrs here and are now on their way home. Rachel served as the high school teacher and Jordan helped out in maintenance and did lots of projects for many here around station. Jordan had a great ministry with our MK boys and Rachel has been helping out with the single women’s bible study. They have thrown themselves into the work around here and we are thankful for their time served.

We are also thankful because God has called them back to PNG. So this time home is a time for them to become official Nazarene missionaries, raise support and then come back to us, hopefully in a couple of months. They have had the opportunity to share with folks here some of what God has been doing in their lives at Emmanuel church last Sunday night and again at our English Lotu service this past weekend. Pray for them as they head back home and look to join us full time in this ministry here.

Giant Pumpkin

2011-06-05T17:59:00.000+10:00

Last Sunday the GP - giant pumpkin had a circumference of 26 inches and was the size of a volleyball. This Sunday, he has grown 20 inches in circumference to 46 inches and it's volume has increased 5.5 times. This is pretty exciting to Bill and I, which not everyone relates to, but that is ok. We are excited because it is something that we haven't done before and we seem to be having some success with it and it is growing at an incredible rate to us. It is now the biggest pumpkin that we have grown and are anticipating how big it might get. It is pretty neat to be able to walk outside each day and to see the size of the pumpkin grow seemingly right before our eyes. Our excitement has caught on to some here, or else we just talk about it so much that others are starting to come and wonder what we are talking about. We have gotten a lot of "wows" in response. Stay tuned for more.

Watchman

2011-06-04T20:10:00.000+10:00

Everyone who comes to the hospital has someone with them who helps look after them, bring them food, help them go to the bathroom, etc. The same is usually true for our clinic too, hardly anyone comes by themselves, there is always someone with them.

A lady recently came in with a dislocated shoulder that needed reduced. I explained that I was going to need to put her to sleep and then reduce her shoulder and then she could go home when she got up. She said ok, but she needed to get her watchman. She comes back with a 7 yo boy, most likely her son. So after we reduce her shoulder and get her in a sling, I go to speak to the her watchman to let him know what she should and shouldn't do for the next few days/weeks. One of the other docs snaps this pic as I explain his mom's instructions to him, fully expecting this 7 yo boy to be able to remember all that I tell him. Thankfully, she woke up soon after and I was able to share her instructions with her also, just in case he forgot something.

If I could be like Mike

2011-05-31T12:30:00.001+10:00

Mike Bible is a World Medical Mission volunteer who is with us for 3 months. He is a retired rheumatologist who is willing to do anything he can to help out. We can say that about many of our volunteers, but Mike has had some challenges in his life, which has impressed us all. The more I talk to him and learn about him the more I am inspired by him.

He is deaf - well mostly anyway, from a progressive hearing loss and now has cochlear implants. It is still challenging for him to hear anyone who isn’t directly in front of him, but he makes it work. The nursing students and translators have adjusted and have learned to speak loud and look at him when they talk. He can’t hear well on the phone, which would make call quite challenging, but he wouldn’t hear of not doing his part. We came up with an alternative plan of him helping out on Sat mornings, which has been great for all of us.

He is blind – in one eye. As a 5 yo he poked himself in the eye with a knife and lost his eye and vision because of that. That didn’t stop him from going to college on a football scholarship. Nor has it stopped him from injecting every joint he can on the pts who come to see him each day.

He taught himself to read in college because he could only read at a 6^th grade level after high school. Yet, he went to medical school and became a rheumatologist, and now is here in PNG treating all kinds of conditions and diseases that he has never seen before. Not being familiar with things isn’t holding him back, he read about orthopedics before he came, trying to get up to speed on what he might see here. He was practicing suturing on pillows at home since he hasn’t sutured in 35 yrs and knew we would get opportunities to do so here. He has rounded on our pediatric ward and taken care of our nursery babies despite not having training in either. He is doing everything he can to contribute.

Mike is a servant and has served us in many ways by being here, and has inspired me to be more of a servant just as Christ was.

The giant pumpkin is growing

2011-05-28T12:26:00.000+10:00

It has been 2 weeks since the last picture of the baby giant pumpkin, and in a short period of time he has really taken off. We are removing the competing pumpkins to enable this one to get all the nutrients and grow as big as it can.

A baby giant pumpkin

2011-05-22T12:44:00.000+10:00

The giant pumpkin plant is growing and just this week put on a little pumpkin. Stay tuned to see how big it gets.

Pray for Sandy

2011-05-18T12:27:00.001+10:00

Sandy came to us with seizures that wouldn't stop. She is from the Jimi, a remote area, and had been sick with a fever and headache for a few days, and then she starting having seizures before she got to the ER. I met her during one of her seizures in the ER. I didn't know what her story was, but as I looked at the chart, I found that Bill had seen her initially and had given her 3 seizure meds, but she was still seizing. I gave her some more meds, and continued the process of admitting her and trying to determine what her diagnosis was. The lumbar puncture we did suggested that she had an infection of her brain and so we treated her as such, concerned she had a brain abscess.

She went from seizing, to being somewhat comatose - not talking, not making any purposeful movements, not eating. Bill kept treating her and praying for her, and after a few days/weeks we started to see some improvement. She started drinking and eating some, then she started controlling her left arm, and would raise it up. Her eyes, that for a while were not focusing on anyone or anything, started to focus, and she would smile when you would come to say hi, and then one day she started talking. I wasn't there when it happened, but when Bill told me, I started to cry, so thankful for God's work in her life. Each day she had made progress and was even moving her R arm some, we were so hopeful.

Unfortunately, this past weekend, she took a turn backwards. She started having seizures again, with persistent high fevers. For the past few days she hasn’t been talking, much less moving her arms outside of having a seizure. We thought we were so close to having her recover, but now we aren’t sure. Please pray that as we change her meds, she will recover again. That God might just spare this little girl and her family. Her brother, Ismeal has been a faithful wasman, always saying morning to you, even if it is afternoon. Pray for wisdom for us, and for God's healing touch to be upon Sandy.

Anna turns 2

2011-05-16T15:11:00.000+10:00

The Crouch family – Mark, Esther and Anna - have joined us for one month as Mark works with us in the hospital as a FP resident. They are from Tulsa, OK at In His Image. It has been great having them here and we were privileged enough to have Anna share her birthday with us on Friday. I haven’t been around too many 2 yo girls, but Anna is very cute.

She seemed to enjoy her birthday celebration of hobo dinners in the park, smores, birthday cake/cupcakes, presents and a game for the kids. She wasn’t quite sure what to do with us when we kept singing our Kudjip birthday melody, but she sat patiently waiting for it to stop so she could blow out her candle. She enjoyed opening the presents with the help of Lexi and Emma Goosens. The little baby I gave her was quite a hit. She kept holding it and saying baby, Hi baby. The McCoys gave her a bilum hat and the Radcliffes a little bilum – so she is going to go home in PNG fashion for sure.

She also didn’t seem to mind our continued requests for her to smile or look at the camera as we were capturing her cuteness. Happy Birthday Anna, thanks for sharing it with us.

Vacation in Madang

2011-05-14T08:23:00.000+10:00

This past weekend, Pamela, Steph, Linda and I traveled to Madang for a vacation. We had a great time of resting and relaxing and enjoying the beauty of God’s creation. We did a lot of swimming and snorkeling and went kayaking one day. There aren’t a lot of great places to go to in PNG to get away, but Madang is sure one of them.

The fish and the coral were amazing. I saw lots of different kinds of fish and lots of colors, I wish I knew all the different kinds I saw. Finding Nemo sure came to life each time I stuck my head in that water. One time I came across a sea anenome and there was a mommy or daddy clownfish with his little child. It seemed to me that the parent was coming out to talk to me, to protect his child and try and get me to leave. The kid clownfish bravely swam from the sea anenome to the side of his parent to see what was going on. I stayed above them for a number of minutes just observing this dad protecting his child. Gave me a little insight into the world of fish. My favorite sea creature is definitely the blue starfish, so bright and colorful, unfortunately the pic didn’t turn out so well.

When we weren’t in the water, or in a tree, we were usually reading or playing a game. It was a very relaxing few days.

Salad

2011-05-11T16:25:00.000+10:00

I don’t know that this is the correct spelling, but this is how it is pronounced. What is it you ask? Well it is a green leaf, but not something you eat, instead it has medicinal properties, or so they tell me. Ever since I have been here, I have had people tell me that they put “salad” on what hurts them. At times I have seen people come in with redness and swelling of part of their body and when I ask about it, they say, oh I put salad on it. I just went with it, but didn’t really understand it, until now.

I had seen the leaf on an abscess, and had seen the effects of it – i.e. rash, but had never tried it until today. So I was in the ER today and I saw these 2 leafs sitting on the counter where the nurses worked. So I picked it up and started looking at it, thinking that maybe this is unused salad. So I asked the nurses whose it was, and one said it was hers, and confirmed that it was salad, which she was using on her knee, which was bothering her.

As I was holding the leaf, I noticed that it was a little rough and prickly. I asked how it is used, and said do you just put it on your body like this, and I just put the top, green side on the top part of my hand, and they said no, you use the other end. So the nurse shows me by applying it to her knee, which was hurting. As she was applying it, I noticed that she had some wheals, or bumps on her knee and that it was red. The underside of the leaf is more of a brownish grey color, and is rougher. So I said ok, and I turn it over and put the underside against my skin, I didn’t rub, just placed it there.

As I put it on my hand for about maybe 5 secs, I was asking how long the pain reduction lasts, when I started to feel something on my hand. Sure enough within 15 secs of putting it on my skin, I started to notice a slight burning sensation on my skin, and then within a minute I was noticing it was turning red, and within 3 minutes, I had some wheals – swelling or bumps of my skin, where I got poked by the salad. Within 5 minutes, my skin was burning pretty good.

Inflicting pain to reduce pain doesn’t seem like a great idea to me. They told me, after I used it, that it typically causing a burning pain for about 20-30 minutes, but takes away the other pain you have as it causes pain. When I asked how long it reduces the pain for they said a few minutes. Somehow, this doesn’t seem like a good tradeoff – 30 minutes of burning pain for 1-2 minutes of relief of your other pain. I can definitely verify that it causes a burning pain for the 20-30 minutes, but what I don’t know is if it really reduces the other pain, and if so for how long. I am sure it would take my focus away from whatever else was hurting me and I would instead focus on the burning pain, but I am not yet convinced enough to use it.

Bible Study Game Night

2011-05-07T15:50:00.000+10:00

We finally finished the book of John in our ladies Bible Study, so we had a game night at Rachel’s house. There were about 18 of us who came to enjoy the fellowship and play some games. We introduced them to Jenga, Claymania, Telephone charades and King of the Jungle. We sure enjoyed a lot of laughs throughout the night.

I never realized that my understanding of animal sounds, was an American something and that others think they make other sounds. In King of the Jungle, everyone is a different animal in the jungle and has to make their sound and an action. Then someone is the King – lion, and you say your sounds following by someone else’s and then they say theirs and someone else’s and you keep going until someone forgets what they are, or doesn’t know what other sounds to make. It must of taken us at least 20-30 minutes to do figure out what animal each person was going to be. Someone chose rooster, but there was no cock a doodle do, instead they actually tried to imitate a rooster’s clucking. There was also no woof-woof, ribbit- ribbit and more. We were forced to try and actually make the real animal sounds, which I didn’t do too well at, so I often skipped those animals when it was my turn. But we had fun.

We also had fun playing telephone charades. Here, one team member acts something out with only one other team member watching. That 2^nd team member then acts out what they saw their first team member doing for the 3^rd member, and so on. It ends up being really funny, as certain actions and parts are forgotten and others are emphasized wrongly, changing everything. Rachel, got to act out a “whiteskin” crossing a single log bridge. She did a great job, and we all laughed at her accurate representation of us almost falling while crossing the bridge, while PNGers just run across without any second thoughts. It was definitely a fun night and one we hope to do again soon.

Against all odds

2011-05-03T12:44:00.000+10:00

Against all odds this little guy is still alive. He was quite happy and content inside his mama growing as best he could 2 wks ago, when his world was changed forever. The safety and warmth of his mama’s uterus was pierced by a sharp knife held in the hands of the 2^nd wife.

His mama came into our ER with her intestines outside her body as a result of the knife wound. During her surgery, it became apparent that the knife wound went into the uterus also. Dr. Jim was able to sew up the uterus, but what effects it would have on this little guy, we didn’t know.

2 wks later, she went into labor and this little overachiever was born. He weighed only 400gms and the knife that pierced his mama pierced his leg and stomach also. Like his mama, his intestines were outside of his body when he was born. Born yesterday, no one expected him to live very long in our limited resource setting – but against all odds, he is still with us today. What a fighter. Apparently being born 4 months early and after having been stabbed hasn’t been enough to deter this little guy from spending some time in this world.

Ecc 3:1-2 says, “There is a time for everything, and a season for every activity under heaven: a time to be born and a time to die.” This little guy’s time to be born was yesterday and his time to die is in the hands of our Creator. His Creator who created his inmost being and knit him together inside his mother’s womb (Ps 139:13).

It has only been a day, but this little guy is pretty special. He should be dead, but keeps fighting and living. This little guy has certainly made me think about my life. Am I fighting everyday, am I giving it my all, doing all that my Creator is asking of me? Am I enjoying and living each day that has been given, knowing that I don’t know what tomorrow brings? Too often I don’t, but I sure want to.

An accident

2011-05-02T18:05:00.001+10:00

This kid showed up at the ER the other day because of an “accident” at school. Apparently, another kid was upset at him, so he stabbed him with scissors. They brought him to the ER so we could remove the scissors. I don’t know how he was at school, but he was quite calm, not crying or anything. Bill took care of him and was able to remove the scissors without any difficulty. I don’t know what specifically caused the other kid to stab him, but this isn’t what I would call an accident.

Helping in Pharmacy

2011-04-29T15:33:00.000+10:00

This past week one of our pharmacy workers was on vacation and another one got sick, so pharmacy was a little short staffed. On Monday, I went to pharmacy to look for a medicine and saw a number of pts waiting outside to get their meds and Susan inside helping to give out meds. Once inside pharmacy, I also saw a few nurses helping out. So once OPD was done, Bill and I went over to help out. We had 3 docs, 2 nurses, and 3 pharmacy workers working to get the meds out to the waiting pts, it was a little chaotic at times, but we got it done.

Tues, they also got backed up, so Becky and I, went to see where we could help out after we finished with the pts. Once again, there were others, a nurse and a clerk, in there helping out as well. Once we finished with getting all the meds to the pts then we helped them make up some prepackaged meds for the following day, in the hopes that it wouldn’t be as crazy.

Working in the pharmacy, sure gave me a better appreciation for all that they do each day, and for how many meds we give out. At a minimum, we see 100 outpts a day, but it is more like 150 or so when we count up all the pts the nurse and the ER sees. If we give out only 2 meds, and do so for a month – for a chronic condition, and we assume they only take it once a day, when some meds are 2 or 3 or even 4 times a day, then we would give out a minimum of 6000 tablets a day, and that isn’t including our pts in the hospital. So for 1 wk, Mon – Fri, we are talking about a minimum of 30,000 tablets, for a month around 1,200,000 tablets – that is quite a lot, and we probably give out a lot more.

Wow – thanks for all your hard work Pharmacy lain, and to Todd Winter and the Nazarene Hospital Foundation, who help to keep us stocked in meds.

Easter Sunday

2011-04-26T19:23:00.000+10:00

It was a busy day - sunrise service on the Radcliffe's porch. Talking to my family on the computer for Graham's 2nd bday party. Going to regular church here on station. Having lunch with the McCoys, Becky, Matt, Rachel and Jordan. Having our "evening church" on the McCoys porch with lots of folks from station.

I went to town 2 wks ago and ended up buying a ham. Since I had never cooked a ham before, I asked Marsha if she would be willing to make the ham for Easter. She tried to tell me that it was really easy to cook a ham, but I said, you do it and I will watch and learn for next time, she agreed. So I had defrosted the ham and she took it in the morning to cook after sunrise service. I went over to see what she was doing to it and I see the ham just sitting in a 9x13 pan. I said that is it, no water, no nothing - nope. She said it was easy, but I didn't realize it was this easy. It tasted great and with it being that easy, I can probably cook the ham next time.

Anytime you eat at Marsha's you eat a lot of vegetables. I have now grown to like almost all vegetables, which is quite a change from when I first came here. However, when I make dinner, I still usually only make one, or maybe 2 vegetables, if you count a green salad. Well I ended up eating 5 vegetables at Easter - cucumbers, a green salad, green beans, asparagus and pumpkin, hard to believe, but they were all good. It was a very nice and relaxing day with great food, good fellowship and a great reason to be together - a Savior who rose again and has given us life.

Sunday is a coming

2011-04-22T21:31:00.000+10:00

A few hours ago a nurse from the pediatric ward called me to see a baby that was having a hard time breathing. As I make my way down there, my head is running trying to think of all that could be going on with the baby and what it is I might be able to do to help. When I get to the ward, I find a nurse carefully assessing the baby, mom sitting on the bed, looking lovingly at her child, and dad with a worried look on his face, standing near the bed looking down at his child.

When I approach, mom gently lifts this 6-month-old child to her lap, and I notice that the child, despite oxygen is struggling to breathe. Every muscle the kid has in his chest is being used to breathe; even his nose is flaring in an attempt to get oxygen throughout his body. I find out from mom, that he had been doing ok since he was admitted just 2 days previously, but all of a sudden tonight, he got worse and seemed to have a fever.

I examined the child and heard a very loud heart murmur, but nothing worrisome in his lungs. As reassuring as this may seem, it wasn’t. Our limitations in children with congenital heart disease are significant, and this little guy probably had something that we can’t fix with just medicines. I looked through his chart and saw that we were already treating him with medicines for a congenital heart disease that we found on cardiac echo.

All the thoughts that were running through my head as I headed down to see the pt, were now changing. I went down there thinking I could just give him oxygen, or put him on an antibiotic to fight his pneumonia, but now I was thinking there isn’t a lot I can do for this little kiddo. I did give him antibiotics in case it was a pneumonia, and gave him a little bit of IV fluid since he was unable to breastfeed because he was breathing so hard, but other than that I couldn’t think of anything that would fix him. So now I was faced with a small child who has the real possibility of dying, maybe not tonight, but sometime soon.

Having a conversation like that with parents isn’t easy no matter what language or culture you are in. Tonight was no different. I told them the best I could, in a way that they would understand, that despite trying to do everything, there is a chance the medicines aren’t going to be enough and that he could die. Then we prayed and I asked God to heal this child and to comfort them.

Then I went to a Good Friday service, where I was reminded that despite the darkness, despite the death of Jesus on the cross, despite the seemingly hopelessness of the situation – SUNDAY IS A COMING. Sunday – the day Jesus rose from the dead, the day hope returned, the day the curtain was torn and we no longer needed a mediator between us and God, the day the hope of eternal life for all who believed came, the day of joy and happiness, and the day of forgiveness, mercy, grace and love for one and all.

For this family too, Sunday is a coming. Even though it seems like this child is against all odds in surviving in our limited resource coming – Sunday is a coming. Sunday a day of new life for this kiddo, a day where he doesn’t have a heart condition, where his parents shed no more tears, and where he sees his Savior face to face is a coming. This was a great reminder of why I am here, to serve this kid and others like him, who seemingly have no hope, except one – Jesus – and need reminded that Sunday is a coming.

Seder Feast

2011-04-21T21:49:00.000+10:00

This evening all the missionaries gathered in the Schmelzenbach's living room to talk about the traditional seder meal and to taste parts of it (Dave Kerr's reaction to the bitter herbs on the R). It was a great reminder of what this whole Easter weekend is about. Tonight we remembered the first Passover and the Exodus of the Jewish people out of Egypt and how God provided a way out for them, and still provides a way out for all of us in Jesus. It was a reminder of what today was - the day Jesus shared his last meal with the disciples and then went out to the Garden of Gethsemane and after praying to God for His will to be done, He was then was betrayed by Judas. It was a reminder of the need we all have for a Savior and that Jesus died to take away our sins. It was a reminder of the hope of a better life for all who believe in Christ, as He rose again on the day we celebrate Easter and death was defeated. What a great reminder, a great God, and a great Savior. Have a great Easter weekend.

Taking a stick out of an eye

2011-04-20T17:32:00.000+10:00

I don't understand how the stick got in her eye, but somehow it did. This little girl came in smiling and had some swelling under her L eye. Her dad said that a week ago, somehow a stick went inside her lower eyelid. He thought it wasn't anything too bad and so didn't do anything about it, but then just yesterday he realized that he could feel something poking out toward her eye. He said he tried to pull it out but couldn't. So I try and examine her, but she just screams and cries, and then I give her some Ketamine so she will sleep. I got our cool looking magnifying glasses and had a closer look at the inside of her lower eyelid. There was some pus coming out, and when I tired to brush the pus away, I felt something hard. So I grabbed some forceps and tried to grab it. I was quite surprised when the stick just kept on coming. When it was all out, it was 2 inches in length, which I thought was pretty impressive. Thankfully, this didn't go into her eye or anything else major in that area. This brings a whole new meaning to having a speck or a plank in ones eye.

A Giant Pumpkin

2011-04-16T19:28:00.000+10:00

It might look small now (left), but this is what it has the potential to become (right). When I was home this past fall, my sister’s neighbor was growing a giant pumpkin. When it was done growing it was as tall as Luke. I asked him if I could have some seeds to bring back to PNG and try and grow one here. So the other day Bill planted the seeds and now we have the start of a giant pumpkin growing in our garden. It sure seems to be bigger than our other pumpkins that we grow. I don't know that it will get as tall or big as Drew's did, but we are going to try. I will keep you posted.

New Missionaries

2011-04-12T19:07:00.001+10:00

In the past few weeks, we have had a lot of new faces here on station and especially at my end of the station. Tim and Karla Deuel have joined us as missionaries. Tim is an electrician and seems to be able to do about anything and will be helping Harmon with various things. Karla is a lab tech who is helping out in our lab and with other field office things. She has already been a big help in the lab, just working with our techs helping to improve our quality of care that we are providing.

The Goosens have also joined us. Randy is a IT guy and has already fixed some of our internet problems and has ideas for how to make it even better. We are very thankful for his expertise there as we had none before he came. Joani is an accountant who will be working on our books and their 3 kids - Emma, Lexi and Ethan have brought some life to the south end of the station. Joani had a birthday this past Sunday, so we all enjoyed gathering on the McCoys porch for some cake, our birthday song melody with the birthday hat and some fellowship. You can follow the Goosens via their blog, http://agaggleofgoossens.blogspot.com/

We are thankful for their saying yes to the call and for their willingness to come and serve here with us.

Becky is back

2011-04-09T19:13:00.000+10:00

After being home for 4 months, Becky Wallace has returned to Kudjip to serve for another year as a volunteer doctor. I enjoyed the chance to catch up with her and Matt at dinner last night. It is good to have her back.

B ward is open!

2011-04-05T19:25:00.000+10:00

After almost 2 months of having B ward closed, it is now reopened. Due to a shortage of nurses, we did not have the manpower to staff all 4 wards for all the shifts, so 2 months ago we shut down B ward (medical ward) and put peds and medicine together. This worked, in that it allowed us to continue to care for patients who needed inpatient care, while still seeing a number of outpatients each day, but it did limit who could be admitted. We only admitted those who really needed admitted and then only for a few days, knowing there were other sick pts out there who needed a few days of care also. So thankfully now we have some more beds to fill.

We still are short of nurses and have a number of new nurses who are still orienting, but together we are making it work. Continue to pray for our nurses and for more to join us as we serve the sick and hurting of Papua New Guinea, sharing Christ's love as we heal. Continue to pray for our leaders, giving them wisdom in decisions they make about our hospital. Please also pray for unity among us all as we serve Christ together.

Luxuries in PNG

2011-04-03T18:50:00.000+10:00

For the past 3+ yrs, I have not had the luxury of having my own dryer. I have used the clothes line outside my house for most of my drying needs, but have also used the McCoy's dryer. Marsha lives right next door and she has been gracious enough to allow me to use her dryer, but I sure didn't want to abuse the privilege. Due to work, I did my laundry on Saturday, which is also when Marsha did some of her laundry, so we often were waiting for one or the other to finish their load before we could put ours in. It wasn't a big deal, but not having to share a dryer is really nice! I bought a dryer last year and had it shipped here on a container from Dr. Todd Winter. It got here a few weeks ago, and Jordan was kind enough to figure out all the parts we needed to connect it to our gas bottles and install it for me. So I now have a dryer in my own house that I can use whenever I want to and don't have to worry about if there is enough sunshine outside to do laundry - what a luxury.

Why not to play with chickens

2011-03-31T20:19:00.000+10:00

This poor little boy came in the day after he got scratched by a chicken. His face was quite swollen after the puncture to his face. Thankfully, in just a day he was significantly better and soon afterward went home. So think twice before playing with chickens.

Not recommended

2011-03-27T20:07:00.000+10:00

The pressure that can build up in an abscess is pretty amazing. While doing an I&D on a small abscess on a pt's foot I was surprised at how far pus can travel. The stream of fluid that came out of the skin after putting in the lidocaine should have been a warning to me, but I ignored it. As I cut through the skin with the scalpel I released the pressure and out came a bunch of fluid and pus. Unfortunately, I was standing right in the line of fire as it sprayed all over the front of me. Thankfully the patient felt better so I went and changed.

Visiting pediatric cardiologist

2011-03-23T20:40:00.000+10:00

We have a lot of kids with congenital heart defects that we aren’t able to identify. Each year, a doctor from Port Moresby comes up to Mt. Hagen to do screening echos on kids who have heart murmurs. Depending what the echo shows, the kids may or may not qualify for surgery that can be done either in Port Moresby or in Australia. We typically send all our kids with murmurs and those who seem to be in heart failure, not knowing who can benefit from surgery and who can’t. The doctor who comes to Mt. Hagen ends up needing to see a lot of kids in a short period of time and isn’t always able to see everyone.

We are all missionary physicians who have learned to do things outside of our training, but cardiac echos have not previously been something we have mastered. This past fall, I met Dr. Kirk Milhoan at the World Medical Mission Prescription for Renewal Conference. Kirk is a pediatric cardiologist who travels around the world doing screenings on kids with heart defects to see what is wrong and if they qualify for surgery. As I got talking to Kirk and started asking questions, he said he would love to come and help teach us some basics about echos and help us out. It seemed like a great idea to me and to those here also.

So this past week we have had the privilege of learning from Kirk about cardiac echos and pediatric cardiology things. It was a blessing to have him here and to glean some of his knowledge from him. He taught us a lot in a short period of time and we look forward to having him come back and teach us some more.

WMM team

2011-03-19T19:31:00.000+10:00

World Medical Mission not only sends out physicians to help mission hospitals around the world, they also have a great team of biomedical engineers who are able to help at mission hospitals.

2 yrs ago Bill Wright, Jim Moore and Ken Thomas came to PNG to help look at some of our stuff. They fixed a lot of things while they were here and had plans for making our hospital better. While they were home, they filled up a container with a new generator, xray machine and autoclaves for our hospital. They also added in a bunch of other things to fill up the container and then had it shipped to us. It has been here for a few months now, but the WMM team just arrived last week. They have hit the ground running and are working on installing all of our new equipment, improving our power situation with a new generator and helping out with other things as we need them too. Bill, Ken, Steve, Roger and Don have been such a blessing to us, thanks so much guys.

A new mango tree

2011-03-16T18:52:00.000+10:00

This year we had a great crop of mangos. For about a month I had a mango everyday, it was great. Unfortunately, our crop is about up, but out of all our mango seeds, we now have a baby mango tree growing in our compost pile. We had talked of trying to plant a seed, but we didn’t even have to do it, it grew on it’s own and in a spot that is rich in nutrients. So in 20-30 yrs we might have another tree in the garden giving mangos, yippee.