Sunday, 15 September 2013

Low birth weight week

Low birth weight means that a baby weighs between 1.5 and 2.5 kilograms at birth (3.3-5.5 pounds).  Very low birth weight is 1-1.5 kg (2.2-3.3 pounds).  And extremely low birth weight babies are less than 500 grams (1.1 pounds).

In developed countries where there is a NICU with ventilators and surfactant, super-specialists, and all sorts of medical technology, a baby who is born at 24 weeks gestation or about 500 grams is considered viable.

Our nursery doesn't have much in the way of fancy equipment.  It is a small, toasty room with one working warmer, a few baby beds, an oxygen concentrator, some IV tubing, NG tubes, one nurse or CHW or student, and lots of mamas taking care of their little ones.  Our 1.5+ kg babies (about 32 weeks gestation) have a pretty good chance of making it.  Get below 1.2 kg and the chances decrease rather quickly.  My smallest that has survived was 1 kg.  Baby of Diana!

Because of all the high risk OB over the last few weeks, we have babies that fit into every one of those weight categories described above--low, very low, and even extremely low.

Baby of Agnes (on the left with mom) was one of twins.  Mom delivered at home, as many PNG mothers do.  The babies were brought to the hospital after a couple of days because they weren't feeding well.  Both were small (1.3 kg) and sick with infection, so they were admitted to the nursery for antibiotics.  The first twin died shortly after admission.  The second one recovered from sepsis and has done really well... growing like a weed!

Serah (on the right with her baby) was admitted to the hospital at 32-33 weeks with PPROM.  Basically, her water broke too early.  After a couple of days on antibiotics and steroids, Serah went into labor.  The baby was delivered by c-section for breech presentation.  He weighed a whoppin' 1.7 kg!!!

Baby of Elis is another one who was born at home.  She was about 1.3 kg when she was brought to the hospital.  She has had a bit of a tougher course, still requiring oxygen and NG feeds.

Margaret was about 6 months pregnant when she started bleeding.  She came into the labor ward and was admitted for observation.  Several days later, she began to bleed so heavily that she passed out in a pool of her own blood.  I diagnosed her with a placental abruption.  The placenta was prematurely separating from the wall of the uterus.  We gave Margaret IV fluids and a blood transfusion to stabilize her condition.  She went into labor and delivered a 600 gram baby.  I had absolutely no hope that this little one would live more than a few minutes.  I was surprised to find that she was still alive several hours later.  Baby of Margaret was moved into the nursery where we cared for her until she was transferred to heaven--four days later.  I count every one of those days as a miracle!

When low birth weight babies grow to about 2.4 kg, they are discharged from the hospital.  I generally have them follow up with me a time or two to make sure that they are gaining weight.  After that they they go to the Maternal Child Health clinic for routine checks and immunizations.  I don't usually see them again unless they are sick.  This past week I saw one of "my babies" in the outpatient department.  Baby of Julie was about 1.8 kg when she was born.  Now she is almost 3 years old!!!  Her name is Cinderella :).  What a sweet encouragement after a week of craziness.

"So neither the one who plants nor the one who waters is anything, but only God, who makes things grow."
~ 1 Corinthians 3:7

Friday, 6 September 2013

High-risk obstetrics

I can't even begin to tell you about OB craziness that we have had the past week.  Well, let me try to give you just a little idea:  abruption, severe pre-eclampsia, eclampsia, aspiration pneumonia, preterm labor, chorioamnionitis, obstructed labor, post-partum cardiomyopathy, ectopic pregnancy.  Oh, wait... I forgot a few:  placenta previa, breech, PPROM, shoulder dystocia, classical c-section, hand presentation, post-partum hemorrhage, vacuum delivery, malaria.  And at the end of the day on Friday, a molar pregnancy.

GEESH.  I think we covered pretty much every complication listed in Williams' Obstetrics--plus some.  I don't think malaria is even discussed in that particular book.  With a week like that, there must be a full moon out there somewhere.  I need a vacation!

I kept telling the nurses to stop having emergencies, but they didn't listen.  Finally I had to write an official doctor's order and post it at the nurses' station.  I was on call last night, and guess what?  Not one phone call from D-ward!!!  Now why didn't I think to write an order sooner.

"But he said to me, 'My grace is sufficient for you, for my power is made perfect in weakness.'  Therefore I will boast all the more gladly about my weaknesses, so that Christ's power may rest on me...  For when I am weak, then I am strong."
~ 2 Corinthians 12:9-10

Tuesday, 3 September 2013

Serve in PNG with Work & Witness

Have you ever thought about taking a trip to the far end of the earth?  Well this could be your chance!!!  A W&W team from Oregon is seeking additional members.  Here are a few of the trip details...

Date:  from June 9, 2014
Route:  LAX to PNG, with 3 days in Sydney
Approximate cost:  $4100
For more information contact Jeff and Jeralie Fairbanks:

Please pray about this wonderful opportunity!

W&W team built this toilet block for Nazarene Bible College. 
Dorm for male hospital staff was started by a W&W team.

Monday, 26 August 2013


I wanted to give you a brief update on the hydroelectric... uhh... "waterholderbacker" project.  (Apparently Earl, the hydro engineer, has gotten himself into trouble by using the more technical term in church.)

Back in May, Pamela and Brutus and I went for a walk down to the river to take a peek at the project site.  The river was roaring down the far side of the valley.  The near side was a muddy pit with some cement forms and rebar sticking out of the goo.  That is going to be a dam???  OK, Earl.  You seem to know what you are doing, so we  will take your word for it.

Tim and Karla and Staci were driving down today to check on the progress of things.  Since it had been a few months, I decided to hitch a ride.  WOW.  Let's just say there has been a LOT accomplished since the last time I visited the site.  The cement gates stand guard over the water like a great Egyptian sphinx.  Well maybe not quite that huge.  But still rather impressive for PNG.  The dam itself extends to the midpoint of the course of the river.  Now it really does look like a waterholderbacker!  Or at least half of one.

The workers have just diverted the river to the completed side so that they can finish the second half of the dam.  The water is flowing through the open gates, which won't be closed until their doors arrive early next year.  Probably about that time is when we will reap the benefits of this labor--affordable and stable power!

Here are a few pictures from today...

Just teasing ;).

"Joshua said, 'By this you shall know that the living God is among you...  Behold, the ark of the covenant of the Lord of all the earth is crossing over ahead of you into the Jordan.  Now then, take for yourselves twelve men from the tribes of Israel, one man for each tribe.  It shall come about when the soles of the feet of the priests who carry the ark of the Lord, the Lord of all the earth, rest in the waters of the Jordan, the waters of the Jordan will be cut off, and the waters which are flowing down from above will stand in one heap.'

"And the priests who carried the ark of the covenant of the Lord stood firm on dry ground in the middle of the Jordan while all Israel crossed on dry ground, until all the nation had finished crossing the Jordan.

"And Joshua said to them, 'Cross again to the ark of the Lord your God into the middle of the Jordan, and each of you take up a stone on his shoulder, according to the number of the tribes of the sons of Israel.  Let this be a sign among you, so that when your children ask later, saying, "What do these stones mean to you?"... So these stones shall become a memorial to the sons of Israel forever.'"

From Joshua 3 and 4

Saturday, 17 August 2013

Bye-o, Beck!

This week I packed up and sent my roomie off to America... for good.  She is going home to spend time with her ailing father, and then transitioning to a new job with Nazarene Compassionate Ministries.

Beck and I met way back in 2000 when we were both attending Loma Linda University.  She was doing her residency in preventative medicine and I was working on my M.P.H.  Little did we know that 9 years later we would be sharing a house in PNG!  Over these years she has been a wonderful friend, listener, and counselor.  We have had made some great memories with Bones, fuzzy mustaches, our lemon-squeezing-dish-washing roomie, the Queen's birthday, sometimes crazy pets, little sisters, and care packages (just to name a few).  Our adventures have taken us from Aniwa to Thailand to Hewa to Fiji.  I have learned much from her as we have lived and served together in some of the most remote parts of the world.

Thanks, Beck, for an awesome 4 1/2 years!  I could not have done this without you.  I miss you, my friend.  Well, everything except your incessant humming.  Hee hee.

Here is a photographic tribute to the fun times we have had together :).

Home sweet PNG home
Classic Beck 
Our first house
Pete the ax-murdering-chicken-cat
Our baby, Boo!
Sweet P being ornery as usual
Our lemon-squeezing-dish-washing roomie, Pamela.
Pamela loves Brutus!!!
Out on the town in Herbie the Love Bug
Your family
And mine

Our sister Meti
Meti's first birthday 
At Kawi church
Meti's ground

Team Aniwa
Beachfront property 
PPH water

Little sisters
Our first group
Making pizza
Susan's baptism
Decorating Christmas cookies!
Spa night

More fun times
Mostly involving costumes :).
Italian dinner party
Mad Hatter Tea Party
Care package!
The Queen's B-day
National doughnut week
Harvest party

Zip line in Thailand
Cruising Fiji! 

On our way to the big bush
I can't believe I included this one.
Hewa tribe

The orphanage