Friday, March 24, 2017

A night to forget

Amidst the rain pouring down on the roof, I hear the phone ring and look around my house for the phone.  Locating it, I hear a nurse on the other end asking me to come to the ER for a sick child.  Thankful for a vehicle to keep me somewhat dry in the pouring rain, I make my way to the ER.  Expecting to only find one patient in the ER, I am surprised to find an ER full of patients and their loved ones.

When more than one patient is waiting in the ER for a doctor, it can be hard to know which patient to see first.  I quickly glanced at each of the patients sitting or laying on the Emergency Room, observing them each for a moment, trying to identify the sickest one that needs my immediate attention.  As I am scanning the room, my eyes fall on the child laying on Bed 3.  He is laying almost motionless on the bed, his mom standing over him, hand holding his arm, his dad, crouched down at the foot of his bed, and make my way towards them.
As I got to the bed, I asked mom and dad what was going on, as I started examining their son.  They reported the diarrhea started just the night before, and that he has been weak since, but he wasn't vomiting, had no blood in his stool, and hadn't had any pig meat.  From their history, I would have expected the child to not be very sick.  All kids have diarrhea, but the majority end up being just fine and don't even see a doctor, but not this kid.  This kid was sick.  He wasn't moving, he wasn't crying, his eyes were open, but he wasn't looking at me, he was looking more beyond me.  As I reached out to examine him, his hands and legs were cold, his skin was mottled, and I was very concerned. 

I quickly asked the nurse to draw up some antibiotics, told the parents the child (18 months old) was very sick and that we would try everything we could and then we prayed.  As I was writing up his admission, I couldn't help but think we were too late, that this kid wasn't going to make it.  Despite those thoughts, I kept writing the orders to do everything we could to help him get better and prayed it to be true. 

After seeing him, I again scanned the ER and found another child being held in his mother's arms.  This kid was crying, was pulling at the oxygen tubing that was going into his nose, both of which seemed like an improvement from the last child I admitted, so I made my way to his bed.  Mom was holding her 3 month old son in her lap, trying to console this little boy who did not want oxygen in his nose.  As I got closer and looked at it, it was obvious that he was pretty pale and likely anemic.  Mom said he had been passing dark black stool for a number of weeks, and recently had gotten short of breath, so she made her way to Kudjip. 

She lives about 2 days away, and it wasn't easy for her to get to us, but she finally made it on this wet and rainy day and not too soon.  Her son was very pale, had lost a lot of blood, his heart was pounding in his chest about as hard as the rain was hitting the roof above us.  I was encouraged that he was crying and fighting, a better sign than the last child.  He, too, was shortly admitted with IV fluid, medicines and an order to give him a blood transfusion. 

I saw a few adults and then, another mom walked in carrying her small child.  The child had sparse, thin, reddish tinged hair and looked like small for his age.  As I approached, I could tell he was struggling to breathe.  A quick glance in his scalebook, reminded me that I had seen him just a few days before, but this kid was now much sicker.  He was malnourished, his ribs were protruding out and he was using extra muscles to breathe, making his ribs seem to stick out even more.  He had pneumonia which was complicated by his malnutrition and his body's lack of strength to fight off infections.   I talked to mom about him needing to be admitted, prayed with them and then wrote up the admission. 
A few hours later, while trying to sleep, I get a call from the pediatric ward, a kid was arresting, could I come.  As I quickly got dressed and made my way down to the ward, I was thinking through the kids I had just admitted, wondering which one they might be calling about.  When I got there, I walked past the bed of the anemic kid who seemed to be struggling and made my way to the wailing at the far side of the ward.  I found the parents of the child with dying crying as their son lay lifeless on the bed.  Our antibiotics and IVFs seemed to be too late, his heart stopped, then his breathing and we couldn't change it. 

As I finished with him, I made my way back down the ward to see the anemic kid.  His hemoglobin came back at 1.7 (normal is at least above 10), he had already received blood, but he started vomiting up blood, and was having trouble breathing.  I adjusted some medicines, and prayed with his mom, but I didn't expect him to be with us much longer.    The malnourished kid was still holding on, but I wasn't real hopeful that he was going to make it either. 

I left the ward feeling somewhat dejected.  We were in the middle of celebrating the 50th anniversary of the hospital, of celebrating the lives the hospital had touched both through physical and spiritual healing, and here I was heading home after one child died, with another one about to die and a third likely going to die before the sun came up.  Questions started flooding my head - wondering if I should have used a different medicine, should have chosen a different kind of IVF, if I had missed a diagnosis, if there was anything I could have done to help change the outcome of these kids.  There was nothing I could think of to do differently, and somehow as I laid in bed praying, I fell asleep.  

Before rounding the next morning, I went to the pediatric ward and found 3 charts waiting for me to sign.  I had admitted 3 kids the day before and all 3 had died.  These aren't the kinds of numbers that I want to blog about, aren't the kinds of nights I care to remember, but they happen at Kudjip, and I wish there was something we could do differently to prevent it.  I wish we could find a way to reach all the people in the bush, in the hard to reach places of PNG and give them early access to good medical care, I wish we could better help malnourished kids, wish we had a way to help them gain weight and strength quickly, had a weigh to change their home environment so they had all the food they needed to be healthy, I wish all the kids near us got all their vaccines so they wouldn't be at risk for preventable diseases.  I wish kids wouldn't die, wish parents didn't have to wait so long in naming their child, for fear they aren't going to make it.  I wish we had all the medicines, all the supplies, all the bed space we needed to care for everyone who was sick and needed our care.  Despite my wishes, there is still a reality, a world that I live and work in, where kids do die, where lack of availability of resources, vaccines, health centers puts kids at risk of dying way before they should.  

For the past 50 years Kudjip Nazarene Hospital has been a bright spot, has brought life in many ways to many families and sick patients, and I pray we continue to to make a difference in the lives of many who come by sharing Christ's love with them as we care for their physical bodies too.  Please pray for us as we continue to seek God to know how we can continue to be a light and to offer hope to those who come.  

Friday, March 17, 2017

Celebrating 50 years of Nazarene Hospital

50 years ago the Church of the Nazarene started Medical work in the Highlands of PNG at Kudjip.  A church had been planted through the work of Wanda and Sydney Knox and from that grew a desire to help share and show God's love, through medical work.  From a health center to a hospital, from a nursing school with only a handful of graduates to a nursing college with 40 graduates + a year, from primary, rural and community based health care around the hospital to know spread throughout 6 or more provinces - Kudjip Nazarene Hospital and Nazarene Health Ministries has reached the Highlands of PNG for Jesus through Medicine.

This week, we are celebrating the past 50 years that God has worked, at Kudijp.  We are hearing testimonies of some of the first missionaries, of some of the first nursing graduates, of some of the first PNG workers at the hospital and hearts are being stirred.

DS Andrew Akus shared the first night, and reminded us that no matter what we do or where we go, the most important thing is having one person come to know Jesus.  Praise God that has been the focus of the hospital and through the years 1000s of men and women, boys and girls have heard of Jesus and become followers of Him.  The church that was originally started by the Knox's, has now had almost 80 churches started as a result of that first church.  The hospital itself has started 30 churches through the ministry of the Chaplains.  The healing that has occurred hasn't just been physical, but spiritual, something that will last far longer. 

We heard from Papa Yapo - who I knew as our ambulance driver for the first number of years I was here, but who served here for over 41 years with his wife, raising his family here, doing everything from tractor driver, to cleaner, to maintenance man, to toilet cleaner, to ambulance driver and more.  He too was a missionary, losing his place, his home and serving with his wife here at Kudjip.  They gave 40 years of their life to Kudjip and we are blessed because of it.

We heard from Sr. Kini - one of the first graduates of the Nursing College, who after finishing 6th grade went and asked a missionary nurse if her and her friends could become nursing students.  A few years later, the nursing college opened and they learned how to become nurses and were so thankful for the chance to work mission, to share Christ's love. 

Dr. Verne Ward, the Global Missions Director, shared the 2nd night, reminding us of God's love from everyone, of His desire for all to come to know Jesus.  He shared his story of how him and his wife got to go and serve in Dusin and share God's love with many different tribes who didn't know much about Jesus, and how many came to Jesus as a result, how lives were changed and continue to be changed today.  He encouraged us to continue to follow Jesus, and to obey when He calls, even if He calls us far away or to somewhere hard, God's desire is for his people to know Him, and He uses us to do that. 

As I have listened, my heart has been encouraged, and reminded that I am a part of something so much bigger. I have known this hospital and it's ministry for the past 10 years, but it is so much bigger than 10 years.   Over the years hundreds of thousands of lives have been impacted by the hospital, with 1000s of them coming to know Jesus through the men and women who have given their lives to serve.  This hospital continues to be the hands and feet of Jesus and I am thankful to have the opportunity to be a part of it, to be one of the fingers, at times, serving those who come.  Not one person who has been a part of this ministry over the past 50 years could have done it on their own, and we continue to thank God for all that He has called and ask for more to be sent (both PNG and expat missionaries) to serve God in PNG and continue this kingdom work. 

Photo credit Jeff Myers

Monday, March 13, 2017

Rural Health

Meet Gabriel Mahisu, for the past almost 10 years now, Gabriel has been the Rural and Primary Health Director of Nazarene Health Ministries.  I have worked closer with Gabriel the past year in the Admin office of Nazarene Health Ministries, as we have been a part of our Administrative Teams, but this past week I got to see what he does when he isn’t in the office.   

While I was seeing patients and working with the staff, Gabriel was a maintenance man, a community relations man, and an encourager of the staff.  He was fixing water pumps, lawn mowers, figuring out a way to connect gas to the stove, sharpening tools, and more.  He spent hours standing talking to the community about various issues that have come up over the past year, and working with them to come up with solutions to the problems.  He oversees our 6 health centers, but doesn’t live or work at them regularly, so when he has a chance to visit them, he maximizes his time, doing all that he can.  

He tries to get to the Health Centers once a year, but it doesn’t always happen, most often due to budget constraints.  It is pretty expensive just to get to all the Health Centers, which are scattered throughout PNG, many in very remote areas, only accessed via MAF plane.  It is even more expensive to send in supplies to these facilities to keep them stocked or help to repair things when they are broken.  Despite the budgetary constraints, he makes it work.  We have 6 health centers which are up and running and seeing many many patients each day, serving those who otherwise would have no access to healthcare.  We also have 4 more health centers in the works, trying to get them registered and funded and established to continue to help patients be cared for, and the gospel of Christ to go out.  

If you would like to learn more about RHS, and the work that they do, you can go here.  

Wednesday, March 8, 2017

Strengthening the Missionaries in Sangapi

The plane’s engine could be heard in the distance, as it circled above making it’s way down to the airstrip to land, the staff rush out to the airstrip to meet those getting off the plane.  For weeks they knew a doctor was coming, they had told the surrounding villages and communities when to come to see the doctor, and now she (me) was here.  

Imagine being a nurse in a remote part of PNG which is either a 30 minute airplane flight or a 2 day walk to Mt. Hagen, the 3rd biggest city in PNG and the closest hospital with doctors.  Imagine seeing patients with severe pneumonia, bad lacerations involving tendons and bones,  fractured bones, moms with complications in delivery, abdominal masses and TB, and all without a doctor, a lab, a way to do an Xray or Ultrasound.  This is the everyday life for Naomi, Gibson and Nuvi, our 3 health workers, and Nathan and Captain, our 2 laborers, at Sangapi Health Center in Madang Province in PNG

Everyday, Naomi (a nursing officer), Gibson and Nuvi (community health workers, husband and wife) wake up and serve the patients in this remote part of PNG the best they can with the skills, knowledge, training, and supplies they have.  For most all the patients who come, their training is sufficient to care for all their needs, but for some patients, they wish they could do more to help the people they are giving part of their lives to serve.  
For one week, I got to work with Naomi, Gibson and Nuvi in Sangapi.  Together we cared for and treated over 200 patients, using those patient encounters as opportunities to train and help show them ways they can do what they are doing even better.   As much as we might like to recreate another Kudjip at one of our health centers, it is much more complicated that just bringing a doctor out, you need the infrastructure, the lab, the operating room, the ancillary staff, the maintenance guys, etc.  But instead of building another Kudjip, we can strengthen the staff at the NHM Health Centers, to give the best care possible.
We gathered each day for devotions before the patients arrived and then we would have “school.”  We sat down and they asked me questions about patients that had seen, about conditions they were sure how to treat, and about medicines they had that they didn’t know what they were used for.  When their questions were done, we went through the PNG Standard Treatment Books (guide for healthcare workers in PNG) discussing each condition they commonly saw and what they should be looking for or how to best treat the condition.  They looked forward to “school”, and each day they came with more questions, furiously taking notes, trying to absorb all they could in my short time there.

When our hour or so of “school” finished, we then had a practical period where we saw patients and used that time to help them in their physical exam skills.  We listened to someone with pneumonia, seeing the child’s retractions, went over a knee exam having them feel the fluid collection and then drain it, we examined patients with back pain, discussing when to consider TB and more.  Each case was not just a patient, but an opportunity to strengthen their knowledge and skills.  

As much as I enjoyed my week in the bush of PNG, seeing and experiencing something different from everyday life at Kudjip, the highlight of my time was working with the staff. Seeing their dedication to the community they serve, to the patients, seeing their desire to want to know more to better care for their patients, they inspired me.  They are the real missionaries here, they are the ones who have given up the potential for a nice career in city with good schools, easier access to stores and electricity, but they have chosen to serve the people and God at Sangapi.  

Sangapi is, currently, one of six Health Centers (go here to learn more about Rural Health Services) that are a part of Nazarene Health Ministries, but we are in the process of having 4 more.  Please pray for our workers at each of these centers and for the chances they have to continue to learn and train to better care for the patients they serve so far away from everything else.  If you would like to help support Rural Health and the work they do, go here.