Tuesday, October 18, 2016

A smile communicates more than words

Falls resulting in arm or leg fractures rarely happen close to Kudjip.  They happen where the people live, in their homes, in their villages, and too often in the deep bush - which can be a few days walk away.

This little girl was trying to get a fruit from a tree she had climbed and fell and broke her arm.  They live hours from Kudjip, but dad and his 2 girls, started walking and made the journey in about 2 days.  By the time they got here, her arm was so swollen, and the bones so displaced by the trauma, that we couldn't fix her up right away.  We hung her arm up from an IV pole, elevating it, giving time for the swelling to go down after a few days.  With the swelling down, the bones went a lot easier into place.  Despite the pain, and being in an unfamiliar place, there were few tears, but instead a huge smile.

Their understanding of Tok Pisin (the trade language of PNG) wasn't the best, but we were able to get by, her smile telling me everything I needed to know.  She was doing great and ready to walk back home and be reunited with the rest of her family.

Friday, October 14, 2016

Nursery Heroes

At Kudjip we have over 2000 babies born each year.  Thankfully, many of them are born at term and are big enough to go home with their moms after just a few days.  Some babies are born a few weeks or months early, and they get the opportunity to spend some time in our nursery.

Our nursery is probably pretty different than the picture in your mind.  Our nursery is nothing more than a 8 feet by 10 feet room.  We have a connection for oxygen, we have a few bassinets for the babies to sleep in, and we have a door that stays closed, thus keeping the room warm.  Outside of that, we aren't able to do anything fancy.  We can give the babies oxygen, IV fluid and medicine - but that is all.  We can't breathe for the babies with a machine, we don't have monitors on them checking their vital signs all the time.  We do have limitations, but Praise God, the limitations are limiting to Him.

Despite our limitations our babies grow, they get off oxygen, they develop and they get to go home with mom, not in a few days, but more like a few weeks/months.  We have a baby who came in at 900 grams and is now 1900 grams and should get home in the next few weeks.  We have a 700 gram baby that was just born at 24 weeks of gestation, but 4 days later, the baby is looking amazing.

The nursing staff is amazing at finding veins in the little babies to get them the needed IV fluid or medicines, putting small tubes in their noses to help them get the milk they need to grow, they deserve most of the credit for the success of our nursery, along with the moms.

The moms are the heroes of this place.  They end up living in this small 8x10ft space for the length of time their baby is with us.  I have walked into the Nursery in the middle of the night and found a mom asleep in a chair, another laying on the floor.  These moms are giving up their lives to help provide for the newest life they help create.  It isn't easy for them, the days are long and at times their doesn't seem to be an end in sight, but they keep going.  They let us know how well the babies feed, if they have peed and pooped, etc.  They become almost like another nurse in there, helping the doctors know what is happening with the babies making sure they get the best care.

Pray for these moms and babies.  For the babies to feed and grow and for the moms to continue to have the strength, patience and perseverance to keep going and keep caring for these little ones.

Sunday, October 9, 2016

Bed Bound

Remember when you were younger and nothing scared you?  Remember when you would run and jump and climb trees, logs, swingsets and think nothing of it?  Did you ever fall and get hurt?  For most of us, if we did fall and get hurt, we probably cried a bit and quickly got back up and in no time were running, climbing and jumping again, but sometimes those falls turn out bad, and we get injured to the point where we can't get up and run and play again.  That is what happened to both Kaipa and Junior. 

Kaipa is a 5 yo boy who, while playing, fell and broke his femur (the thigh bone).  Junior, a 3yo, did the same thing not 1 week later.  In the US, breaking your leg would likely mean surgery, a cast, crutches and home in 1-2 days.  In PNG, breaking your femur means you get to be in skin traction, in the hospital for 4-6 weeks.

Imagine being 3 or 5 yo and being literally, pinned down to the bed.  You can lay down or sit up, but that is all.  You can't roll on your stomach, you can't stand, you can't go outside to use the bathroom, you can't go outside and play, you can't run, jump or climb anything, you are just bed bound.  For Kaipa and Junior, this was their life for the past 5 weeks.  They were attached to the bed and didn't leave.  They usually had smiles on their faces when I would see them each morning, as after 1-3 days the pain they felt from the broken bone was gone with the medicines.  They spent their days singing songs, coloring, playing with cars, and I think driving their moms and grandmas crazy. 

If you can imagine how hard it must be for a kid to be bed bound, imagine what the moms through during that same period.  We are on an open ward, so Kaipa and Junior are 2 of 16 kids on my half of pediatric ward.  There are no doors, no curtains, nothing separating them from the other sick kids.  If they yell and scream because they want to get up or are bored, everyone hears it.  Their moms and grandmas worked hard to help them pass the time.  They would often be all smiles for me, but shortly before I would often hear whining, and knew that their moms had their hands full.  Thankfully, this week both boys were able to get out of their traction and start to walk again with the help of crutches and walkers.  It should be about 2-4 more weeks before they are climbing trees again, but I am not sure how well their moms will be able to control that once they leave the hospital.  Keep praying for their full recoveries and for their moms and grandmas to continue to show patience to them as they recover. 

Sunday, October 2, 2016

Road to Recovery

I was attempting to sleep in between phone calls one night when the phone rang, again.  The nurse said the child on bed 23 was having more trouble breathing, could I come.  I had admitted the girl a few days prior.  She came in with cough and difficulty breathing.  The chest Xray showed a huge heart and an ultrasound showed a lot of fluid around the heart.   We started her on TB treatment and expected her to get better in the days ahead, like the many others we have seen before.

As I got dressed and drove down to the hospital, my mind was racing, trying to figure out what might be happening with the little girl.  Knowing she had a pericardial effusion, I was concerned that the fluid around her heart was giving her difficulty breathing. 

I got to the ward and found a little girl whose face was significantly swollen, and had 6 anxious family members huddled around her, obviously worried about her.  After talking to the family, and examining her, I knew the fluid around her heart hadn't responded to the TB treatment.  As I looked at her, I knew there was only one thing I could do - drain the fluid around her heart relieving some of the pressure causing her heart not to pump and fill like it needs to or she would die.    

The procedure, a pericardiocentesis, may not sound difficult you just put a needle just below the sternum or through the ribs, advancing it far enough to get into the fluid around the heart, but not too far that you get into the heart and cause bleeding that can't be stopped, but it is.  There are lots of variables in this procedure that make it something we do, when there are no other choices - meaning the patient will die if we don't, but we know that if it doesn't go well, the patient can die if we do.  So we don't take the risk lightly.

I talked to the family, I explained what I needed to do and told them the risks of doing it and not doing it.  I gave them some time to think it over and went and collected what I needed to do the procedure.  I came back to the ward and found them with their heads down, praying and seeking God for this little girl.  We prayed together and then got to work to save her life. 

The first thing we needed was to get an IV going, to give her medicine to help keep her asleep while I did the procedure and to be able to give her medicines if something went wrong.  3 nurses tried 6 times, but were unable to get a vein, so I put a needle into one of the bones in her leg, in order to get us access.  After that, we got the US machine set up and I went to work.

The first few times I put the needle in, I didn't get anything back, no fluid came.  I adjusted and readjusted what I was doing and the 3rd time I finally got the fluid.  It wasn't a yellowish reddish liquid like I was used to, it was thick yellow pus.  I was able to drain off 300cc of pus from around her heart, giving her heart the room, it really needed to contract and expand and get blood to the rest of her body.  

The following day she went to surgery, and had a hole cut into the lining around her heart, draining off more pus and fluid.  She had a rocky road after surgery - establishing an IV in her was more than difficult as every vessel was full of a blood clot, but she managed to get on the road to recovery.  I would often see her dad pushing her on a walker as she got better and was getting ready to go home.  Unfortunately, less than a week later, she came back with more shortness of breath and this time we removed fluid in her lung and continued our medicines.  She still has a road to recovery, but I am sure thankful that we have been able to help and that her family hasn't stopped crying out to God for her and her health.  Would you join them and us in continuing to do so? 

Wednesday, September 14, 2016

A "widow's" offering

Mark 12:41- 44 - Is the story of the widow's offering, where all the rich people put in large amounts of money, but Jesus sees a poor widow put in two small copper coins and calls his disciples over.  He says, "I tell you the truth, this poor widow has put more into the treasury than all the others.  They gave out of their wealth, but she, out of her poverty, put in everything - all she has to live on."

Today, I witnessed a "widow's offering" and I was blown away.  Today was the last day of the Crusade that Immanuel Church (the local PNG station church) was having, ending a week of nighttime services with the theme of "Say NO! To Sin."  Today was the day of for the Thanksgiving offering.  The altar area was lined with sugarcane, papaya, bananas, chickens, cabbage, onions and more.  Outside of the offering from everyone's gardens, there was a time to give into the offering plate that was placed in the center of the tent. 

As the offertory song was playing missionaries, nurses, nursing tutors, teachers, security guards, cleaners, chaplains and their kids stood up, formed some semblance of a line and made their way to the box to put their offering inside.  Sitting just in front of me a bit was a young boy (maybe 10 yo) named Kua. 

For the past 3 months, Kua's home has been Nazarene Hospital.  He was hit by a car and brought to our hospital and has lived here ever since.  We initially weren't sure how well he would do, since he sustained fractures of both legs, and bad lacerations to his head and face, but 3 months later, he is improving and getting closer to going home.  His fractures have healed, he is walking with crutches and I every time I see him, he is smiling. 

As I was walking back from placing my offering, I saw Kua start to move his crutches and I thought to myself, certainly, he is just moving his crutches out of the way so other's don't step on them, he isn't going up, is he?  I walked by him and sat down in my chair 2 rows behind him, watching him the whole time.  As I sat there, I realized that he wasn't moving his crutches out of the way, he was moving his crutches to get up.  Slowly, but surely, he made his way from his seated position to standing with his crutches, his sister close behind him, and then he joined the line.  Tears started streaming down my face, as I watched this boy go up and give his offering to God. 

Compared to Kua, all those who had gone before, were the rich in PNG - those with jobs, those who got fortnightly payment from the Hospital or the locals schools.  They gave out of their wealth, but as I stood watching Kua, I knew he was giving out of his poverty.  I don't know how much he gave, or if he gave everything like the widow did, but anything he gave was a sacrifice. 

Kua's family isn't rich, they don't have a regular paying job, they have found ways to keep Kua fed while he has been in the hospital, they have found ways to make sure he has clothes - but he is poor, very poor.  Yet, despite the little he has, he gave.  He gave out of his poverty, and seemingly joyfully and very happily and willingly.  

Jim Radcliffe, who has served at Kudjip for over 31 yrs was sitting next to me during the service and as folks were worshipping the Lord and the line was starting to form for the offering, he leaned over and said, "Doesn't this make you glad you are a missionary."  I hadn't thought about it before, but the reason we had a tent Crusade, that we had 100s of people at the service, that people were giving to Missions was because almost 60 years ago the first Nazarene Missionaries came to Kudjip and as a result of that the word of God has spread.  There are 100s of churches in PNG, all of which started because years ago Sydney and Wanda Knox obeyed God and came to PNG as missionaries.  The seeds they planted have born fruit over and over again, and kids like Kua and others are hearing about God's love and giving what they have to help that continue, and I get to be a part of it.  I get to try to continue to help share and show God's word and love with those who come to the Kudjip Nazarene Hospital each day - what a privilege.

As Kua got up and gave his offering, and the tears were streaming down my face, I couldn't help but ask God if I was being obedient to all God was asking of me with my money, my time, myself, my life, my career, my heart to Him, etc.  What we give to God and what God asks of us looks different for each of us and that is okay, but like the widow and Kua, we have to be willing to give it all, and be obedient to what He is asking of us.  Are you?