Farewell to the Strasslers

Thomas and Ruth Strassler have been EBC missionaries in PNG for a number of years now. I have had the pleasure of teaching their children in PE for the past 2+ years. Joas, Remo, and Elena are not only good students, but good athletes and fun to have in PE. There time in PNG has come to a close and now they will transition back to life in Switzerland, for the kids that means school in German, not something they are use to. Joas has been attending a boarding school here in PNG, for the past 1+ yr, to help with that transition, while Remo and Elena have been in our MK school. At the end of our Christmas Lotu we prayed for them as we said goodbye. They will be missed.

Barnabas House

In June 08, a work and witness team from Arizona, led by Dr. John Brothwell, came and started the Barnabas House. Once they left, Mike and his guys took over, but finishing the new hospital became the priority, so now with the new hospital finished, it is time to focus on finishing the Barnabas House. Tues was the first day in a long time that I have gone inside to see what it looks like. They have made a lot of progress since last time I was there (on right). The house is designed to hold large teams or a number of volunteers who may come. There is a large central area for cooking, eating, and relaxing, and then 2 wings of rooms which where bunkbeds will maximize the living space. Left to be done includes plumbing alterations to install the washer and dryer, putting in windows and shelves, and cleanup. It will be nice to have the extra space when teams and volunteers come.

If you build it, they will come

As the famous Field of Dreams quote says, "If you build it, he will come." In our case, we built the new hospital and now patients are coming. Today I walked onto the medical ward to ask Bill a question and found these people on the floor. This is the first time I have seen pts on the floor in medical ward since we moved into the new hospital, but doubt it will be the last. We have 6 extra beds on medical ward, but today we needed more.


On another note from the day. A guy came into the clinic with a history of cutting himself on his forearm 2 wks prior with a bush knife. He had gone to a health care center and they had stitched it up, but he was having swelling over the site, so he came to us. I examined him and felt a fluctuant mass on his forearm and thought he had an infection that needed drained (everything here gets infected). So the medical student and I took him to the ER to perform our incision and drainage of the abscess. The student cut the mass, but no pus came, so I decided to squeeze harder. Instead of pus, I expelled a huge blood clot that squirted across the room to the wall with bright arterial blood soon following. Blood was pumping out of his forearm all over my shirt, so I quickly applied pressure. I am not sure if the student understood what had happened, but I knew this wasn't an abscess. He either had an arteriovenous fistula which we cut into (connection between the artery and vein) or he had severed his radial artery with the chop and the blood had clotted forming the hematoma and as soon as I dislodged the clot, the blood came. I attempted to blindly put a stitch in to stop the bleeding, but when blood started pumping from 2 places, I quickly stopped and asked for Dr. Jim to come. We got a tourniquet on him and I held pressure as we waited for Jim to come and prepare him for surgery to tie off the vessels. Thankfully, the surgery went well and his ulnar artery was still intact which will provide the blood supply to his hand from now on. Note to self - not everything that is swollen and fluctuant is an abscess.

Christmas Lotu

Our December English Lotu is traditionally a Christmas program put on by the MKs and this year was no different. Becky, the music teacher for the elementary school, put together a great Christmas program with Joy to the World on bells, Christmas songs, sharing of the Christmas Story, and a drama by the High School kids. It was very nice and a great way to get into the Christmas season. Afterwards we enjoyed some Christmas goodies and time of fellowship. There were almost 100 people present.

Santa Hat

In clinic this week, a little kid comes into my room with a little Santa hat on. I thought she was cute, but after she left I started to wonder why her mom put it on her. Did she just need a hat and found this one so she used it, or does she know the hat can be part of the Christmas season? Lots of patients wear things that seems strange to me, but to them it is just clothes - like a bathrobe, or a scarf when it isn't cold, or a guy with a ladies pink hat on. I should have asked mom if it was just a hat, but didn't. Later, I asked some of our nationals about Santa while doing a C-section. A college of nursing student told me she had no idea who Santa Claus was, so I tried to tell her the story, but found it hard to explain to her why Americans continue to tell this story. Magaret, our OT supervisor, told me she knows about Santa, but only because she has read about it in books, but it isn't something PNGers know about or tell kids about. Although many PNGers don't know who Santa Claus is they do know who Jesus is, which is all that matters.

Luke 2:11 "Today in the town of David a Savior has been born to you; he is Christ the Lord."

Play Time

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

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

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

Steven

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

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

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