Sunday, August 16, 2020

New Buildings

 


Our Hospital Expansion Project keeps up their amazing work of transforming our Hospital and building new buildings.  We are now using our new Lab and Pharmacy.  We are getting closer to moving into our new Admin building.  

Our 2 new Operating Rooms have been up and running for a few weeks now and are working well, we look forward to having the other 2 completed.  We also have transformed our old Pharmacy into a Respiratory Isolation Ward - for when/if Covid comes up to Jiwaka Province and we need to isolate folks before we figure out if they have Covid or not.  Lots of changes at Kudjip.  




Tuesday, June 9, 2020

There is some good in this world . . . and it is worth Fighting for.

One of my favorite movies is the Lord of the Rings.  I was recently reminded of a line between Sam and Frodo, when things seemed hopeless for them and Middle Earth, towards the end of the Two Towers.  You can watch the clip here - https://www.youtube.com/watch?v=k6C8SX0mWP0.

F - "I can't do this Sam.”  S - I know, it is all wrong, by rights we shouldn't even be here.  But we are.  It’s like in the great stories, Mr. Frodo, the ones that really mattered, full of darkness and danger they were, sometimes you didn't want to know the end, because how could the end be happy?  How could the world go back to the way it was when so much bad had happened?  But in the end, it is only a passing thing, this shadow, even darkness must pass, a new day will come and when the sun shines, it will shine out the clearer.  Those are the stories that stay with you, and meant something, even if you were too small to understand why.  But I think Mr. Frodo, I do understand, I know now folk in those stories had lots of chances of turning back, only they didn't, they kept going, because they were holding onto something.  F - What are we holding onto Sam?  S - That there is some good in this world Mr. Frodo and it is worth fighting for. "


I don't know what your world looks like these days, but from the news it would be easy to think darkness is upon us with so much bad happening around us - from lockdowns to killings to riots and famine, etc.  It would be easy to want to give up, to turn back, to think there is nothing that can be done to help the sun shine.  But, as Sam says a NEW DAY WILL COME.  We don't know when or what it will look like, but this darkness, this season won't last forever.  And until it does - we keep fighting, because as Sam says - there is some good in this world, and it is worth fighting for. I would like to share a little of what that good can look like and what we are fighting for in PNG today.

A few months ago, I wrote about a boy named Daniel - a 9 yo little guy who lives about an hour's walk from the hospital who presented to the hospital with an abdominal mass.  Just yesterday he returned to the hospital, a hat now covering his sparse hair, but his abdomen free from any tumors that I can find on Ultrasound.  He has completed 4 courses of chemotherapy and should make a complete recovery.

Peter is a 35 yo man who suffered a stroke many years ago, but had made a full recovery, and then started feeling weak 3 weeks ago, to the point that he was passing out.  His stroke history clouded his history and presentation to various health facilities in the past 3 weeks, but upon examination was found to have a very irregular heart beat, causing a very low blood pressure, resulting in his weakness.  After a few days in the hospital, he is feeling so much better and his heart, while likely not returning to it's original state, is working well enough to perfuse his body, thus eliminating his weakness and helping him to feel like himself again.

Carolyn is a women with HIV who presented with abdominal swelling.  Tuberculosis would often be the source of the problem for most of our patients here, but in her case, she had liver cancer.  As I shared this diagnosis with her and her husband, there were some tears, but also peace.  They had started going back to church a few weeks ago, and were trusting the Lord, one who is bigger and better than all of us with her life.

Susan was a women of about 50 who came about a month ago and was told she had cancer in her bladder.  When first hearing a diagnosis of cancer and hearing there isn't much that can be doing medically, our patients often don't fully understand the situation.  So when she returned, I asked her what she remembered about what we told her last time.  She very clearly articulated that she had cancer and we couldn't cure her medically.  We talked some and then I asked if I could pray with her before she left - she started crying as we held hands and thanked the Lord for the life we have today and as we ask Him for the strength for each day He gives.  

Lucy was a young pregnant lady from the Jimi Valley - a remote area of PNG.  She was trying to deliver her baby at a health center in the Jimi, and she started having problems.  Her blood pressure went very high, she started to become confused and she quit making progress in her labor course.  At 0800 she was referred to us, at 1500 she arrived - having a seizure, confused, the baby's heart beat was dangerously low, the baby's head was showing signs of being too big for the opening that it needed to travel through.  Knowing a vacuum delivery would be our quickest mode of delivery - I attempted to pull the baby out of a small opening, and her illness and thrashing on the bed made those attempts futile.  We rushed her to the Operating Room, and with some difficulty, delivered a baby girl that barely was alive.  There was a very weak heart beat, but no respiratory efforts.  As I worked to repair the uterus that gave way in ways I wish it wouldn't have as I was trying to get the wedged head out, our midwives and Anesthesia folks worked to help that baby breathe. When the cry finally came, we all breathed a sigh of relief, that this mom, had made the long and difficult journey from the Jimi Valley with Eclampsia to Kudjip Nazarene Hospital and we were able to save both her and the baby's life in the process.  

There is some good in this world and it is worth fighting for.

Things haven't been easy for us here in the midst of our Global Pandemic.  Like you, we have had to adjust and readjust our plans for our lives as well as the running of the hospital - more than once.  We are still triaging the patients who come with coughs, having screened over 1300 patients now, thankfully we still have only had 8 cases in the country for Coronavirus that we know of - but that doesn't mean we are back to normal.  

Some of our lives are back to normal as far as the Hospital goes - babies are born, kids get diarrhea and suffer from malnutrition, tuberculosis is diagnosed and treatment started each day, people get appendicitis, car accidents happen, kids fall and break their arms, abscesses fester making their way to the muscle and bones, hypertensive patients need their meds and kids need their vaccines, and so much more.

Some of our lives are not back to normal as far as the Hospital goes.  We are currently working with a staff of 1 General Surgeon, 1 Surgical Trainee, 1 Pediatrician and 3 Family Practice doctors.  Our normal staffing of about 10 doctors is down to 6.  Quarantines, limited flights, travel restrictions, medical illnesses, waiting on paperwork and more have been hurdles that have exacerbated our shortage of doctors.  This has altered our ability to care for all we would normally care for.  As the only hospital for a Province of around 400,000 people, when we have to limit services, lives are affected.  

When I called our government Medical Supply company this week asking what they had as our stock on the shelves was getting lower and lower, I was told - Disposable Gloves - nil stock, syringes - nil stock, Pain medicine for surgery - nil stock, certain antibiotics to treat infections - nil stock.  I stopped asking any more.  When I asked if they knew when they would be getting anything in - they said we don't.  We live in a country that relies on other countries to supply us with the medicines and supplies we need to keep running - limited air travel is making the country's and thus our some of our supplies reach a level of critical shortage.  


And yet despite these trials and hardships - there is some good in this world and it is worth fighting for.  Kids with diarrhea and dehydration go home.  Moms with difficult deliveries walk home with their newborn babies.  Those diagnosed with TB are better in a few weeks and after 6 months of daily meds are cured.  Patients with appendicitis or ruptured ectopics or bowel obstructions can have surgery and be cured.  Patients with diseases while without a cure in our medical setting, can hear of the hope and love of Christ, and go home with peace.  

Can we do it better - absolutely.  Can we stretch our resources even further, to help more people until we get more - absolutely.  Can we love those who come and who we serve with better - absolutely.  Can we trust in the One who gave His life for us and has called us to love and serve the people of PNG - absolutely.  Can we keep fighting to stay open and keep serving - absolutely, that is what we were called here for.  

"For God, who said, "Let light shine out of darkness," has shone in our hearts to give the light of the knowledge of the glory of God in the face of Jesus Christ.  But we have this treasure in jars of clay, to show that the surpassing power belongs to God not to us.  We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be manifested in our bodies.  For we who live are always being given over to death for Jesus' sake, so that the life of Jesus also may be manifested in our mortal flesh.  So death is at work in us, but life in you." - 2 Cor 4:6-12


There is some darkness in this world today, but a New Day will come, and the sun will shine again, and when it does it will shine out all the clearer.  There is hope in this world, there is good in this world.  While always looking to improve, we are praying that we are part of that goodness and hope and love that the world needs right now.  We pray we can keep fighting to stay open and keep serving and sharing that goodness and love with those who come.  Please pray for us as we continue to seek for that SON to shine out all the clearer. 

Friday, May 1, 2020

New Normal


The world is talking about "New Norms" when it comes to Coronavirus and what the world is going to look like as a result of battling this.  It is hard to know how that applies in PNG and how it applies at Kudjip Nazarene Hospital.

Although we have been in a State of Emergency for the last month, what that looks like for PNG is a bit different than what it looks like for other Western countries.  Papua New Guinea doesn't have the ability to educate their kids via online school, or to hold church services online, or to even do telemedicine.  These things don't happen in PNG unless they happen face to face.

So just as in every other country the leaders are doing their best to make decisions based on the information they have, the same is happening in PNG.  As a result, PMVs have started to operate, but with less occupants, schools will be opening on Monday, markets are open and functioning and through it all Health Care still needs to happen.


What has always been normal and continues to be normal at Nazarene Hospital is the number of patients we see who need our help.  Just this week, we had a women who had a ruptured ectopic pregnancy with over 2.5L of blood in her abdomen and had she gotten to us much later, I am not sure we would have been able to save her.  We had a women who was bleeding in her 8th month of pregnancy who needed a            C-section to save her life and the life of her baby.  We had a guy who walked for 3 days to get to us, who has a mass near his kidney and needs surgery to remove it.  We had a girl who fell and dislocated her hip a month ago, and finally made their way to us, and now has her hip in the right place.  We have kids with pneumonia, adults with meningitis and tuberculosis and HIV and much more.  We have people who need to hear of Jesus's love for them in the midst of their cancer diagnosis, after becoming a quadriplegic after a car accident, after having their baby die, and so much more.


The new normal for Jiwaka, includes Kudjip Nazarene Hospital still having it's doors open and being able to do surgery, help deliver babies, having immunizations visits and tuberculosis being diagnosed and treated.  As a result, we continue to screen those patients who have fever, cough and shortness of breath in our tent, which is now in our parking lot.  We have screened over 800 patients now, asking for 7 to be tested, waiting on the results of 5 of them.  Thankfully, we have no increase of Respiratory Deaths in the past few months compared to last year, so while we suspect it is here, it doesn't seem to be affecting those we are caring for at this time, and for that we are thankful.   We screen them not because we can do something different with them, and not because we can tell if they have Coronavirus in our tent, but because we need to continue to have our whole hospital run.  We need to continue to have our staff healthy to care for the kids on pediatric ward and surgical ward.  We need our doctors to see be able to take call.  We are short of doctors, and until borders open up more, that will be a rate limiting factor to the care we can provide, but we want to keep providing care and we want to keep sharing Jesus, no matter what the new norm is.

Wednesday, April 22, 2020

Life and Death

For 9 months, the mom and dad talk about and dream about their child, anticipating all the ways their life is about to change with the addition of a new life into their family.  What many don't anticipate or think much of, is the potential toll this process takes on the mom.  On the one who has carried this new life inside of her for the past 9 months, on the one who is expected to be the major care giver to this new life, not just in the first few hours, weeks and months after birth, but through the child's life.

Thankfully, around the world - most women have babies and walk away without thinking much of giving birth or doing it again.  But that isn't always true, according to the World Health Organization, in 2017, about 810 women, EACH DAY, died from preventable causes related to pregnancy and childbirth.  810 each day = 295,650 each year, which is currently more than Coronavirus deaths this year.  In PNG, WHO reported that for 2017, the maternal mortality rate to be 145 women die out of 100,000 live births, which was around 340 women who died in 2017.  That is 340 babies who were born with their mom giving their life in the process.  340 babies, who may have siblings who no longer have their mother to help care and guide them as they grow up.  Maternal mortality doesn't just affect the baby born, but all the others in the family, who were already born or who won't be born as a result.

Some recent difficult deliveries have brought these numbers to light again for me.  These difficult deliveries would have certainly resulted in death, if our Hospital wasn't here, if our doors weren't open, if our lab didn't have blood to give to those bleeding, if our Operating Room didn't have staff or a surgeon who could do a Hysterectomy.  The only reason these lives were saved was because we had a team of people working hard to save their lives - at one point there was 5 doctors, 2 anesthesia guys, 2 lab folks, and 4 nurses/midwives in the room on the L working to save the life of this mom.

In 2019, we had over 2900 deliveries at our hospital, 375 were by Csection and the rest vaginal deliveries.  Each year our # of deliveries increases, which means each year we work harder to ensure that the moms who come here have a safe delivery and are able to walk out of here with their baby.  While that doesn't always happen, it usually does, and I am thankful for the team that makes it possible.  We have a number of trained midwives who handle the majority of all of our deliveries.  They call the doctor when something isn't routine, and do a great job dealing with a lot of  high risk moms.  We would be hurting without this group of dedicated men and women who do all they can to ensure moms and babies go home together.  We look forward to having Laura Myatt join us later this year or early next year.  Laura is an OB/Gyn who will be with us for 2 years through the Post Residency Program.

Pray for our moms, midwives and doctors who are doing their best each day trying to ensure good outcomes for moms and babies despite some difficult situations.


Friday, April 17, 2020

PNG Church

Last month, before lockdown happened, I got to go to a "bush church" with some of the other missionaries.  A bush church, is any church off Kudjip Station.  I don't often go to bush churches, as it always requires a man to go with me, and requires more planning than just going to church on station by myself, but these 2 Sundays were nice.

Jordan preached at the first service about the need for forgiveness.  Many people responded to his message, some even coming up and asking him for forgiveness.   During the service, his boys were being entertained by a game, and this little PNG girl was quite interested in what they were doing, which was pretty cute.



The 2nd week, I got to walk to a church about 5 miles away with some of the volunteers who were visiting with us.  We enjoyed a beautiful morning, the scenery around us and the PNGians that we saw along the way.  The church was pretty surprised when we showed up, but were very happy to have us.  They normally do their service in Tok Ples (which is the language of the Ples or village, which isn't something that any of us understood), but the Pastor for the day, was able to do it in both Pidgin and Tok Ples, so we were able to listen as well, which was nice.

It was fun to be with our PNG neighbors and to worship together.  As was said numerous times, the color of our skin doesn't matter, we are all brothers and sisters in the Lord, which is so true.

Coronavirus has certainly broken down any sort of differences between us in the world.  Age, skin color, wealth are no barriers to this virus, just as they are no barriers to God's love for His people.    May all of us find joy and peace despite the unknowns surrounding us these days.

Sunday, April 12, 2020

Resurrection and Life


The past month has brought significant change into the lives of almost everyone across the whole world.   From lockdowns to masks to drive by testing centers to fear to social distancing to online church and so much more.  While PNG, thus far, has been spared with case numbers, the fear and uncertainty that comes with lockdowns and reports of what is happening across the world is very real.  

Despite the uncertainty of tomorrow, I am thankful that there are some things that never change.  Thankful for love - which is able to permeate lockdowns and isolation through the internet - enabling us to share our lives with those we love - no matter how far away we are. Thankful for kindness - which is seen in humanity all over the world with the numerous acts that people are doing to help their neighbor.  Thankful for the service of men and women, all over the world, in health care settings who go to work each day to help those suffering from physical ailments, knowing they are potentially risking their lives to help another find life.  

I am so thankful for the certainty of the Cross.  Today, in PNG, it is Easter Sunday.  With the lockdown and lack of technology in most churches, there are few churches that celebrated Palm Sunday last week, but that doesn't change that it was the day we remember that Jesus road into Jerusalem, willingly, knowing that he was close to giving His life, so others might live.  Jesus did, what many are doing today, but in a bigger scope.  Jesus walked into the Hospital full of Coronavirus patients, he walked into the hurting and suffering of Humanity, and gave His life - so that, even though we die on this earth, there is a resurrection coming for each of us.  Just as there was for him today - Easter Sunday. 
 
John 11:25 says "I am the resurrection and the life.  The one who believes in me will live, even though they die."  

I don't know about you, but this Pandemic has certainly made me pause and ask if I am really ready to die, if my time comes?  We have <20 152="" 1="" 350="" 9="" a="" all="" almost="" and="" are="" around="" as="" be="" bed="" but="" case="" come="" comes="" country="" day="" die="" e="" each="" earth="" end.="" f="" font="" for="" going="" has="" have="" hospital="" i="" if="" imported="" in="" is="" isn="" it.="" it="" keep="" last="" my="" nbsp="" no="" none.="" of="" one="" only="" our="" over="" people.="" people="" png="" praying="" province="" serve="" t="" that="" the="" there="" this="" those="" to="" truly="" ur="" ventilators="" walking="" way="" who="" will="">
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Those who are sick, who are bleeding, who are coughing, who are short of breath, who are malnourished, they all come because they need healing and our doors are open.  They come for physical healing, come looking for hope when no one else can give it, come for answers that other hospitals and health centers can't provide.  It is the physical ailment that often brings them up, but they often leave with Spiritual healing and peace.  This Spiritual Healing and peace, in a world of uncertainty, is why I keep going to the Hospital.  To tell the people in PNG about the Man who laid down His life on a Cross over 2020 years ago and rose again, so we can have Life.  Life not just on this Earth, but in the one to come. 

Thank you for making it possible for me to be here.

Tuesday, April 7, 2020

The Team and the Tent


We put the tent to use the past 2 weeks screening everyone coming to us with a fever, cough and shortness of breath.  It took some getting used to, but the patients were very understanding of our desire to screen folks for Coronavirus.  Some patients came to us specifically asking if they might have it.

As of Monday, we have seen over 280 patients, and only had 2 patients that we considered might have it, but thankfully both were negative.  Jiwaka Province has set up isolation centers at various Health Centers across the Province, for patients to go to who are exhibiting symptoms that might be suggestive of Coronavirus.  Thankfully, we haven't needed to use them too much.

In our planning process, we had some seamstresses sew up some masks and laplaps with some fabric we have had.  Our staff do have appropriate masks when caring for patients, but they have appreciated having something, even when not taking care of patients, that is theirs and they can wear anytime they want to.  So we have had a whole group of ladies busy making masks.

One thing this Pandemic has reaffirmed to me, is how much of a team we are at Kudjip and how much of a team we need to run this Hospital.  From the Maintenance guys getting the tent up with power and water, to the Nursing Staff and Clerks working in the tent collecting demographic information and screening patients, to the Doctors seeing the pts, to the Nursing Directors working and reworking schedules to ensure we have the coverage we need, to Security doing everything they can to ensure our safety and to helping the patients understand our new procedure, to our Hygenists who are keeping our facility clean, to our Finance team processing payroll quickly, to our Drivers going and picking up and dropping off our staff each day so they can get to work, to our Administrators working with Jiwaka Province planning on the best course of action for us and the Province, to Pharmacy preparing medicines to be used in the tent, to Xray adjusting to take X-rays in a new building for potential Coronavirus patients, to our Storeroom folks gathering our supplies, and much, much, more.

I am thankful to be a part of this team of workers at Kudjip - committed to the Lord and to serving those God brings our way.