Monday, 29 November 2010

Christmas English Lotu

Start:     Dec 5, '10
Location:     Chapel, Kudjip
English church service for Kudjip and the surrounding missions.

Caroling on the hospital wards

Start:     Dec 24, '10
Location:     Kudjip Hospital

D-ward Party

Start:     Dec 31, '10
Location:     Dr. Steph's house, Kudjip
Tentative date!

Becky 2's Un-staying Party

Start:     Dec 3, '10
Location:     Barnabas House, Kudjip
We are really going to miss you, Beck!

Missionary Christmas Party

Start:     Dec 18, '10
Location:     Barnabas House, Kudjip

Christmas Eve Eve Party

Start:     Dec 23, '10
Location:     The Myers house, Kudjip.
A Myers family tradition!

Turkey Day

Since it is an American holiday, Thanksgiving is not celebrated by the general public in PNG.  Yet we missionaries hold fast to this custom from our homeland.  Families and friends gather together for the celebration feast--after everyone has finished work for the day.  It is often referred to as "turkey day" after the main dinner course.  At Kudjip, it is usually "big chicken day" or maybe even "ham day."  Turkeys are few and far between, expensive, and not always edible.

A few months ago I was shopping at Best Buy.  No, it is not an electronics store but one of the better places to buy groceries in Mt. Hagen.  While browsing through the meat section,  I was surprised to find a freezer full of small turkeys at a bargain price of 18 kina (about $7).  I was a bit skeptical.  First of all, could I be sure this was really a turkey and not a large chicken?  And if it was a turkey, it was probably imported from somewhere far away.  There was a possibility that it wouldn't be any good.  But hey, for 18K I was willing to give it a try.  I bought the turkey and put it in the freezer to be saved for a special occasion.

This year Beck and I were invited to the Dooleys' house for Thanksgiving dinner.  Five volunteers also joined the party:  the Kerrigans (surgeon and wife covering for Dr. Jim's furlough), Missy (FP resident), Renie (EBC nurse), and Dave (here to install our new phone system).  Dinner was set for 6:30 PM.  Beck and I would bring the turkey, gravy, and green bean casserole.

I don't think I have ever cooked a turkey all by myself before.  There have been several holidays where cousins gathered together and made a group effort, usually with lots of encouragement over the phone from our mothers.  And a few disasters such as potato peels spewing from the garbage disposal.  I was nervous about being responsible for such an important part of the meal.  Thanks to the now functioning internet and Google "how to cook a turkey," I found several recipes and some good advice.  The bird went in the oven mid-afternoon.  The house was soon filled with the aromas of the holiday.  Of course the turkey took a bit longer to cook than I calculated.  I think as a watched pot never boils, so a roasting turkey never gets to 165 degrees.  But it really wouldn't be Thanksgiving in our family if you had dinner on time.

At 6:45 the turkey was finally done and whisked away to the Dooleys' to be carved.  We gathered around the table, so beautifully decorated with fall plates and napkins, pilgrim place cards, and candy cups.  Dr. Kevin gave thanks to the Lord for his goodness and provision.  Let the feasting begin!  There was hardly enough room for turkey and all the fixin's... mashed potatoes, stuffing, gravy, pumpkin souffle, green bean casserole, crescent rolls, cranberry sauce, berry salad.  I am sure I am forgetting something.  Once we were finished, there was hardly room for dessert... derby, pumpkin, and peanut butter pies.  Just like a Thanksgiving back home.
Since Thanksgiving is a time of giving thanks, I have so much to be thankful for this and every year.  I want to especially thank the lord for my families.  Yep... families.

I am blessed to have family back home in the US, one that has supported me in my crazy life and adventures.  We have had so many wonderful times together from Ohio to Texas and soon to be PNG.  You continue to love me from the other side of the world with your care packages, Skype calls, and prayers.  I love you so much.

I am grateful for my PNG family.  The Dooleys and the other missionaries and I may not share the same DNA, but we are related by blood--the blood of Christ.  We laugh and cry and pray together.  We share holidays and special times together like families do!  This Thanksgiving was definitely one of those special times.

"Give thanks to the Lord, for he is good;
his love endures forever.
~ 1 Chronicles 16:34

Wednesday, 17 November 2010

“A new command I give you: Love one another. As I have loved you, so you must love one another. By this everyone will know that you are my disciples, if you love one another.” ~ John 13: 34-35

Hot chocolate with marshmallows

Early this year, my fellow missionary doctor Erin and I started a Bible study for the single ladies who live and work on station.  We were also joined by Rachel, the MK high school teacher and honorary single gal on Wednesday evenings.  I was excited about the possibilities for this ministry, a chance to grow closer to the Lord and build relationships with the Papua New Guineans.  I had no idea...

We began with the book of 1 Timothy and soon learned that most of the girls had never been involved in such a Bible study.  We decided to move out of church issues and back to the foundation of our faith, the life of Jesus.  For the the last 7 months or so, we have been making our way through the Gospel of John.  (We just finished chapter 13, almost.)  I have been stretched:  learning to study the Word, learning to lead others and teaching them study.  I have been challenged:  to love one another and wash feet and live like Jesus, and so much more.  Wow, this has way exceeded my expectations.  

We finish each study with a round of "hot drinks," a choice of tea or hot chocolate.  Hot chocolate is the preferred drink just about every time.  Thanks to one of my Texas LINKS churches for the supply!  It is definitely being put to good use.

Marshmallows are a favorite, too.  Grace is especially fond of them.  One night she asked me where they came from.  No, they don't grow on a bush!  Hee hee.  This week I introduced the gals to roasted marshmallows.  We cooked them over the gas burner.  And they were a hit!  Just wait until you try smores :).

It is always a special time of getting to know each other, learning about each others families and cultures.  I just love storying with the girls :).  I have been so blessed by their friendships.

"Dear friends, let us love one another, for love comes from God.  Everyone who loves has been born of God and knows God.  Whoever does not love does not know God, because God is love.  This is how God showed his love among us:  He sent his one and only Son into the world that we might live through him.  This is love:  not that we have loved God, but that he loved us and sent his Son as an atoning sacrifice for our sins.  Dear friends, since God so loved us, we also ought to love one another.  No one has ever seen God; but if we love one another, God lives in us and his love is made complete in us."
~ 1 John 4:7-12

Sunday, 14 November 2010

Short staffed

"The harvest is plentiful, but the workers are few.  Ask the Lord of the harvest, therefore, to send out workers into his harvest field."
~ Luke 10:2

The harvest is oh so plentiful.  Every day, people from around the Western Highlands and across the country come to Kudjip Hospital.  They receive care for typhoid and hypertension and pyomositis and cervical cancer.  Wounds are bandaged and bones set.  Babies are delivered and surgeries performed.  Most important of all, our patients have the opportunity to hear about Jesus and see his love in action.

We are in desperate need of workers for the harvest.  Due to recent staff transfers and resignations for a variety of reasons, we are seriously short staffed.  The most critical shortage is nurses.  And without nurses, you can't run a hospital.

On Monday morning, we closed our gate to "longwe" patients.  "Longwe" or "long way" refers to people from outside Jiwaka.  This was done so that we can continue to care for patients in our primary service area without overworking our remaining staff.  The closure makes sense.  It is something that had to be done.  But I am sorry to think about all the patients we will be turning away.

Kudjip Hospital needs your prayers.  Will you pray with us for harvest workers?  Please pray for our current nursing staff and students, that they will be strengthened and encouraged despite the overtime and extra shifts.  Pray for all of us, that we will not miss one opportunity to share Christ with our patients!

Matters of the heart

Sunday last week was quite a call.  After rounds, the day was unusually quiet.  Things began rolling around 5:30 PM when I received a call from the nurse in the ER.  A young woman was just brought in who had swelling of the abdomen and legs, and she was really sick.  Could I come see her?  I grabbed my stethoscope and my bilum of doctor tools, headed out the door to the hospital.

I picked up the skel buk (a portable medical record) and scanned the brief history.  There were no previous entries, which suggested that this was her first visit to a doctor.  The patient was too sick to speak so I gathered further information from her family members.  Apparently Salome had been ill for about 5 months... weakness, shortness of breath, fevers, swelling of her lower legs and then her abdomen.  I looked at her and shook my head.  She had been sick for 5 months, and today might just be too late.  Why it took so long for the family to bring her to the hospital was never really clear.

I pulled my pulseox from my bag and the saturation read 90%.  Her pulse was palpable, but weak and thready.  Heart sounds were distant, and I couldn't hear nay air moving in her left lung.  Her abdomen was swollen with ascites and her legs edematous.  Ultrasound confirmed a 5-6 cm pericardial effusion, or fluid around her heart.  There was barely enough room for her heart to fill and contract.  No wonder her pulse was weak and thready!  I could also see that the left side of her chest was completely filled with fluid from a plerual effusion.

Pericardial effusion is not an uncommon finding or diagnosis at Kudjip.  The most common cause, we suspect, is tuberculosis pericarditis.  (TB does all sorts of weird stuff.)  Infection from viruses or bacteria is another cause.  And cancer would also be at the top of our list.  Well, we can't do anything about cancer.  We treat what we can.  I admitted Salome to medical ward and started her on antibiotics and TB treatment.  I asked the nurse to call me with any change of her condition.

Before Salome went off to the ward, I took a few minutes to talk with her.  You are very sick, I said.  We will do our best to take care of you, but I am afraid your illness will win.  Sickness of the body is one thing; the condition of your soul is the most important.  Salome said that she had been a Christian but had fallen away from her faith.  We prayed together, and she gave her life back to Jesus.

Around 10:00 PM I received another call.  There was a chop chop in the ER.  I evaluated the patient, looked at the wound and decided that the almost amputated hand was a little too much for me to handle.  Our volunteer surgeon came up to help stop the bleeding.

While working on the chop, the ER had filled up with patients.  I looked through the skel buks that were lined up on the counter.  The patient in bed #3 had a heart rate of 220.  He was the first priority.  Unlike my first patient, he had been to Kudjip before.  Notes from the other doctors documented a liver mass that was suspicious for cancer.  He had been doing fairly well until this evening when his heart suddenly started to race.  I did a quick exam and confirmed the tachycardia.

Back home in the Sates, a patient like this would have been immediately hooked up to a cardiac monitor.  An EKG would be on the chart before the doctor even made it to the bed side.  Things don't work that way here.  We have one EKG machine.  It lives in the lab and EKGs are done by a lab tech, if the tech knows how.  Thankfully our on call lab person was already working on a CBC for the chop.  Since the phones are out, I sent the nurse with an urgent request for EKG.  

Meanwhile, I was concerned that my patient would become unstable.  The heart can only beat that fast for so long before giving out.  I searched through the crash cart and found an amp of adenosine.  The nurse quickly inserted an IV.  I placed my left hand on the patient's chest to monitor his heart rate and pushed the medication with my right hand.  I felt the heart rate slow and become irregular.  The lab tech arrived with the EKG machine.  The read out confirmed my now suspected diagnosis of a-fib with RVR.  I returned to the crash cart and searched through the vials.  I hoped that digoxin would control the patient's heart rate because it was my only option.  The patient was loaded with dig and taken to the ward.  I sped through the last of the waiting patients and headed home with the hope of getting a little more shut eye.

And hour or so later, I was awaked from a restless sleep by the ringing of my cell phone.  Salome, the patient with pericardial effusion, had no pulse or blood pressure.  I pulled on my scrubs, jumped into Herbie, and sped up the road to the hospital.  Salome was still conscious, but neither could I feel a pulse or get a blood pressure.  I did a quick sono and found that the fluid around her heart was no longer allowing it to fill with blood.  Cardiac tamponade!  This was a true emergency.  Pericardiocentesis is a dangerous procedure, but it was the only thing that would save her life.  I explained to the patient and her watch meri that I needed to stick a needle into her heart.  It could kill her.  But if I didn't try, she would surely die.

I had only ever seen one pericardiocentesis months before, so I called in Dr. Bill.  He has seen and done just about everything.  We set up for the procedure and had a word of prayer.  I got the first try.  I pointed the needle into Salome's chest and slowly advanced it toward the heart.  The syringe began to fill with blood tinged fluid.  A slight readjustment stopped the flow.  I rechecked her vitals... pulse was slightly stronger but still no blood pressure.  Dr. Bill tried a second and a third time.  We never got a continuous return, but the 300cc we took off was enough for the time being.  Salome's pulse was stronger, her heart rate had slowed form the 160s to 90s.  And she looked better.

As I headed out of medical ward, I walked by the bed of the patient with a-fib.  He was now complaining of severe shortness of breath.  I suspected that he may have through a PE, a blood clot to the lungs.  The nurse tried to start oxygen.  He was too distressed and pulled it away.  She prayed for him, that God would bring peace and comfort.

I stumbled back to my bed, this time for another hour or two of sleep.  It was waaaay too early when my alarm went off.  I got ready and headed to work, making a detour through medical ward to check on my patients.  Salome was sitting up, still alive and looking a little better.  We got her through the first night, but whatever was making her sick was too big and too bad.  She died the following day.  I am confident that she is in a better place.

I paused at the bed of my second patient.  He was no longer conscious and his breathing labored.  He was also not long for this world, and died just a few hours later.  I grieve that I did not take time out of my busy night to pray with him.  I am thankful that the nurse did.

"But in your hearts revere Christ as Lord.  Always be prepared to give an answer to everyone who asks you to give the reason for the hope you have.  But do this with gentleness and respect."
~ 1 Peter 3:15

Thursday, 11 November 2010

Meri meri quite contrary... how does your garden grow?

This scene caught my eye on the way home from lunch today.

Thanks be to the Lord for the wonderful showers and even a thunder storm that we have had over the last couple of weeks. The greatest blessing, especially for my PNG friends and neighbors, is that gardens are starting to grow again!  It will be a few weeks before the food can be harvested.  So please pray that the rains continue to come.

I just wanted to share a little PTL :).  Em tasol.

"Ask the Lord for rain in the springtime;
it is the Lord who sends the thunderstorms.
He gives showers of rain to all people,
and plants of the field to everyone.
~ Zechariah 10:1

Saturday, 6 November 2010

"Now that I, your Lord and Teacher, have washed your feet, you also should wash one another's feet. I have set you an example that you should do as I have done for you." ~ John 13:14-15

Washing feet

In our Wednesday evening ladies' Bible study, we have been working our way through the Gospel of John.  This past week we arrived at Chapter 13.  I was the designated leader, so I reflected on this passage for an entire week before our meeting.  I think I must have had a thing or two to learn.  Wow, it was quite a challenge!

The context of the passage is this... a few days before, Jesus entered Jerusalem on the colt of a donkey and to the cheers and praises of the crowds.  This is also what we know as the Triumphal Entry.  Jesus knows that his death is approaching.  "I tell you the truth," he says, "unless a kernel of wheat falls to the ground an dies, it remains only a single seed.  But if it dies, it produces many seeds."  With only a few hours remaining before his arrest, Jesus withdraws from his public ministry to spend time with his closest friends.

John doesn't tell us much about the preparation for this last supper.  Mostly he spends the next 5 chapters recording Jesus's final words to his disciples.  If you turn back a book, Luke 22 gives us a bit more info.  The disciples have made preparations and they are gathering for dinner in the upper room.  An argument breaks out... who among them was the greatest?

Jesus responds by showing them the full extent of his love.  He takes off his outer garments, wraps a towel around his waist, and bends down to wash their feet.  The Creator of the universe, the King of kings, the Messiah humbled himself to the role of slave for this rag tag band of fishermen and tax collectors and sinners.

Jesus makes his way around the circle, washing the dusty feet of each disciple.  Can you imagine the hush that fell over the room?  He stoops in front of Peter.  And it typical Peter fashion, he tries to take control of the situation.  "You shall never wash my feet," he says to Jesus.  Peter, you are my follower and your heart is clean because of the words I have spoken.  But the worries and distractions of this world are like dust on your feet.  Let me refresh and renew and sanctify you.  For unless I wash you, you have no part with me.

Jesus finishes washing the feet of the last disciple.  He says, "Now that I, your Lord and Teacher, have washed your feet, you should also wash one another's feet.  I have set you an example that you should do as I have done for you."

And what was that example?  Washing feet was the symbol of something bigger.  The Kingdom of God is not about power and might and greatness.  It is about service.  It is about humility.  It is about loving one another with a love that is greater than ourselves.  "A new command I give you:  Love one another.  As I have loved you, so you must love one another.  By this all men will know that you are my disciples, if you love one another."  (John 13:34-35)

"Your attitude should be the same of that of Christ Jesus:
Who being in very nature God,
did not consider equality with God something to be grasped,
but made himself nothing,
taking the very nature of a servant,
being made in human likeness.
And being found in appearance as a man,
he humbled himself
and became obedient to death--
even death on a cross!"
~ Philippians 2:5-8