Happy Birthday Megan - wish I was there to celebrate together

For the first time in 29 years, Megan and I are celebrating our birthdays on different days. Due to the time change, my birthday came before Megans by a few hours. We talked today on cell phone and on the computer, and will do so tomorrow for her birthday. Even though we weren't together, 2 other twins were together today. They were born about a month ago, and the mom let me name them, so I chose Megan for the girl and Aaron for the boy.

I enjoyed a nice lunch with the Radcliffe family for my birthday. I shared pictures of family and friends back home that they have heard me talking about. I told a few stories that I remembered from other birthdays, and just enjoyed my time with them. Before I left, they sang the Kudjip station traditional 5 song Happy Birthday melody for me and then we had cake and ice cream. I also enjoyed dinner and time with the McCoys this evening. They gave me a new tapa cloth, which replaces the one Dr. Bill gave back at Christmas time.

Hospital Reopens

After 5 days, the hospital is now reopened. On Friday afternoon, the hospital had closed because the building of the new hospital was being obstructed by local tribal folks. Throughout the weekend and until Wednesday afternoon, we remained closed. However, the community was feeling the effect of the hospital being closed. One tribal leader came to Dr. Bill concerned about his family member who was sick and needed the hospital. This leader then asked to go and speak to the tribal leader who was responsible for obstructing the progress of the hospital. Shortly after that, they both came back to Dr. Bill and the guy at fault apologized and said it won't happen again, and agreed to work with the construction crew. As a result, we opened up yesterday afternoon. I was on call, so my extended Christmas break abruptly ended. Thankfully, it wasn't too busy after opening, however taking care of the pts sure reminded me why we are here.

I was called around 2:30am for a postpartum mom who was very sick with HIV and was now short of breath and close to "going off" (word for coding here). I quickly got dressed and went to assess her. Medically there was little I could do for her that wasn't already being done, but spiritually there was still more to be done. As followers of Christ, there is always something more we can offer beyond medicine - prayer, which is very powerful. Thankfully, she was awake enough to talk a little and listen to me as I got to share the gospel with her. It seemed like her family was Christian, but she did not know the hope we have in Christ. I shared this with her and then prayed with her and her family. Later this am she passed away, but thankfully I had the opportunity to share with her and pray for God to save her.

Another pt I cared for last night, was a man with Hepatits B and Cirrhosis. I had just discharged him on the 24th after he recovered from hepatic encephalopathy. He was doing so well that when we were singing Christmas Carols on the medical ward, he was singing with us. I got called that he developed a GI bleed and was vomiting up blood and his blood pressure was very low. We don't have an ICU or pressors that I could really give him, all I could offer medically was a blood transfusion. Blood - the very thing that Jesus offered to us, His blood which covers our sins and makes us white as snow. Thankfully this pt was a pastor and knew the Lord. I talked with his family about his condition, and then prayed with them, shortly thereafter he too passed away. Thankfully, he had already been cleansed by the Blood of our Savior Jesus whose birth we just celebrated.

Continue to pray for the hospital leaders and those local tribal folks involved. Pray that their hearts would be turned to Christ, and that we can continue to carry on the work which the Lord has called us to here. As the hospital sign says - We treat, Jesus heals. Pray we would continue to have the chance to do just that.

Christmas in PNG

I am thankful that in my first Christmas away from family and friends in the US, I was not alone, but had my new PNG family to share it with. After talking with the Nash family this am and opening some presents, my day got quite busy. I enjoyed breakfast with the Radcliffe family and Mimi. Then we went to church at Mamuka - about 20 minutes up the road. Jim and Tim played their trumpets for the church and I had communion for the first time in PNG. After the service many people came up to say hi, but I was very surprised to see a girl named Rachel. She had been admitted to the hospital twice in the past month for mastoiditis and during that time the Lord worked in her life and she was now celebrating Christmas in a new way this year. She gave me a bilum as a way to say thankyou, it was very sweet.

After we got back, I joined the Riggins, Radcliffes, Becky Morsch, and Mimi for dinner at McCoys. We had a very nice ham dinner with lots of fixings including cabbage. We then sang Happy Birthday to Jesus - Aden attempted to blow out the candles. After this we watched the movie Amazing Grace, which someone had gotten for Christmas present. We went for a walk and then decided to have a bonfire at McCoy Park. We enjoyed the warmth of the fire, sang some songs and shared testimonies about our lives. It was neat to get to hear how the Lord has worked in everyone's life and how He brought them here. I am thankful that the Lord, who years ago left His throne in heaven and came to the earth as a baby, still works in our hearts and calls us to himself and uses us to share His truth with others. I pray you all have a blessed Christmas as you celebrate the birth of our Savior.

Christmas Eve Party

We all gathered at the Myers house for their annual Christmas Eve party. The night started with finding the 12 things a missing around the house. There were things in their living room that were either turned backward, or had their lights were off, or were missing - like the baby Jesus from the nativity. The object was to look and walk around and find all 12. I came up with 11 and couldn't get another one, so I turned a pillow upside down and counted it. When we were going through the answers others had also spotted the pillow upside down, but it didn't count. After this game, we enjoyed some fellowship and all the treats that everyone brought. We had a time where we could decorate cookies - one of my favorite things to do at Christmas time. We ended by playing another game were we all got to unwrap a present (that we couldn't keep) and we had to describe some sort of spiritual lesson or life lesson from it. Marriage was a common theme, and Tim the math major at MVNU educated us all on the different graphs and derivatives one could derive from a burning candle. Unfortunately due to rain we didn't go caroling around the station today. Merry Christmas.

Caroling on the Hospital Wards

This afternoon the missionaries, some who sported Santa hats, met to sing Christmas Carols to the pts in the hospital. We started in the Pediatric ward where Dr. Susan greeted the pts and then we sang a few Christmas Carols in Pidgin, we prayed, and handed out gifts to the pts and their families. Next came the OB ward with the moms and their new babies. Dr. Jim and Pattie accompanied the singing with their trumpet and flute playing. I got to give a gift to Rakel who has been here for almost 2 months. She delivered a premature baby on Nov 1, and is here until the baby gains enough weight to go home. Today she named the baby Megan. After OB, we went to C ward - medicine ward, where Dr. Bill and I have rounded for the past month or so. Most of these patients are folks I have gotten to know and pray with as they have been here for a while, so it was a joy to be able to sing for them and share a little of Jesus with them as we prayed and gave gifts to them. Then to surgery ward where there are a lot of folks with burns, and other trauma injuries. Tim Radcliffe, home for the holidays, got to visit with Peter for a while. Peter is a longtime pt of the hospital after becoming paraplegic. After this we went to TB ward and greeted the pts there, and then we went home.

PNG Mission Family Christmas Dinner

On Saturday night, the Kudjip Mission Family got together for our Christmas dinner. We had ham, scalloped potatoes, green beans, rolls, and lots of good desserts. We were all seated at tables decorated in the theme of a Christmas Carol - from Away in the Manger, O Come O Come Emmanuel, Hark the Herald Angels sing and much more. We got to sing all these songs and one table even played the bells for their song. After singing our carols, we played a game called Encore. We picked a word and then each table had to come up with a song which had that word in it. Once one table sang their song it was the next table's turn. We had a lot of "new" songs/lines of carols introduced that we heard for the first time as folks were trying to come up with songs which had the word in it. Like Silent Night, Holy LIGHT, and Rudolph - won't you guide my sleigh tonight with BELLS, we also had some nonChristmas songs trying to get past the judges - but it didn't work. It was a lot of fun and lots of laughs were enjoyed by all. After this game, we had a visit from Santa Claus who gave out gifts to the Missionary Kids. It was a good night, and lots more activities are planned for these next few days.

When a gift isn't just a gift

Gifts are usually from family or friends for Christmas, birthdays, anniversaries, going away, retirement, etc. Usually they are given with love, and received well. Getting a gift in PNG isn't always this straightforward. I have received a lot of gifts of vegetables and bilums from patients, and haven't thought much about it. Trying to give back or not receive a gift from a patient would be offensive to them. However, when a gift comes from a single guy, to a single girl then gifts take on a whole new meaning. For PNGers who are giving gifts to Americans or others, giving a gift is saying they like you. Receiving the gift is saying back to them, I like you also. I wish I knew this yesterday when someone gave me a gift. I didn't think much of it, thought it was really nice of them and took it. It happened to be a tapa cloth - a bark carving with a verse on it. These are common house decorations for the missionaries and others here. I told the McCoys about it, and they quickly said it needed to be returned so the guy didn't get the wrong message. I am thankful that one of the missionary doctors will be doing this and will discuss this with the person who gave it to me. So just remember wherever you are that a gift isn't always just a gift.

Hospital temporarily closed

As of yesterday afternoon, the hospital is temporarily closed. The PNG incentive fund is sponsoring a project to build a new hospital here. A company has been hired to build the hospital and subcontracts out part of the work to others. One of the local tribes would like to get something for themselves out of the hospital being built, and they have created problems in doing this. In the past, they stopped our hydroelectric power because we weren't paying them for our gravel, which was on our land. Their demands are excessive whether for the cost of materials or for their labor.

2 days ago the local folks threatened a cement truck coming to pour concrete and wouldn't let them pass. The local folks wanted to be the ones to pour the concrete despite having never done this before, and wanting a large sum to do so. When Dr. Bill, the hospital administrator, found out about this he wasn't happy. This isn't the first time this has happened, and likely won't be the last unless something changes. As a way to make a statement that the interfering of the building of the hospital won't be tolerated, he shut down the hospital. The hospital serves a large population of patients from many different tribes, when it is closed, lots of folks are affected by it. Typically in this situation the other local tribes will somehow influence the tribe at fault to do what needs to be done in order to get the hospital open again. He has met with the local tribal leaders, and thus far they haven't said they will make sure the project continues unopposed. Until that happens, we will be closed. We will continue to see our inpatients, and care for OB emergencies, but that is all. Pray for a quick and peaceful resolution to this problem. Until that comes I will enjoy some quieter days over the Christmas weekend.

Day in the life of this PNG doctor

I thought you might be interested in what a day is like here at Nazarene Hospital in Kudjip. Warning - this does contain some medical content and pictures, and it does not represent everyday, but here is what happened today.

I was on call last night, but thankfully slept until 0445. I got a call from Labor Ward of a mom who was 7cm dilated, but the baby's face was presenting, not the head like normal. I have never seen this, but I didn't think I wanted to try and deliver it vaginally. My call buddy (Megan) wasn't coming through with an answer, so I told them to get her ready for CS. I quickly got on the computer to look up more information about this. I found out at times it can be delivered vaginally depending what way the face is pointed. So I quickly showered and went down, checked and determined she needed to go to section. So around 0545 I started the section, which went pretty well and Elis now has a new baby girl. Praise God. I had time to come home, shower again, read my Bible, and eat some breakfast before starting my day rounding.

I met Dr. Bill and we did some Xray rounds on our C ward pts. We talked about some of the patients and plans for them, then we went to work. I have about 12-13 pts to see each am. I just go down the row of beds and see each patient. Today was a "top rounds" day, so I only needed to see those recently admited, those with new complaints, on O2 or with an IV. One of my patients - Manmul, is a lady of about 60 or so, who I just diagnosed last week with CML - chronic leukemia. Dr. Dave Oviatt had looked at the blood smear to confirm this diagnosis. I had started her on some chemo, but after 1 wk she came back not any better, in pain, and not eating. So I consulted Dr. Bill this am - the closest we have to an oncologist. We talked about starting her on a different chemo regimen since we hadn't seen a response in 1 week and she was feeling pretty bad. So he told me what to do and I prepared and gave her Doxorubicin. She will get this for the next 2 days, and then we will see what happens. Pray that her leukemia improves.

After I finished all the ward patients, I went to clinic. My first pt was a f/u for GERD - very common here. The next pt - Luther, came in with a scarf over his face. Often pts will put something over their face if there is something they want to hide or conseal. I looked through his scalebook (chart) and found that he had been diagnsosed with mouth cancer at another hospital and was sent to us to see if we could give him Methotrexate (a chemo med). So I asked to look at his face and found a 3x3cm growth on his R cheek, but the inside was ulcerated. So once again I consulted the oncologist on call - Dr. Bill, who came to give his expert opinion. As we talked, we agreed that the outside looked like a keratoacanthoma (a kind of SCC), but the inside suggested invasive squamous cell cancer. So after consulting our PNG management of malignant disease book we decided to give him Vincristine, Hydrocortisone, and Methotrexate. This was only part of what was suggested, but it was all we had available. I talked to Luther about trying to decrease the size of his tumor with the meds so that he might be able to see a surgeon who can try and remove the tumor. Luther agreed. So I drew up the meds and proceeded to give them to him. Pray for Luther that his tumor would reduce in size and he might be able to have surgery to remove it once it is smaller.

Just as I was finishing giving the meds to Luther, a group of people walked into the ER carrying a bamboo stretcher. On top was a young lady face down. They proceeded to put her on a bed and she was covered in blood. I quickly finished with Luther and attended to her. She had been stabbed by her husband's second wife. She had a wound on her back, R breast, abdomen. Her omentum was actually extruding from her abdominal wound. I quickly explored the back and the breast with my finger just as Dr. Jim walked in. He quickly did his consult and we prepared her for surgery. 2 donors to lab to give blood, IVs started, foley inserted, medicines given, fees to pay - especially the fight fee, sew up the back wound, and off she went. Pray for Sina as she recovers and for reconcilation between her and her husband and his other wife.

After this excitement in the ER, I went back to clinic to see some pts before lunch at 12. I saw a few f/u pts - for HTN, GERD, OA. It was close to time for lunch - and my afternoon off, but we still had time for another patient. So Wapi comes in. He is an elderly man who is here to get his indwelling foley replaced, but also had some vague complaints. As we were talking I found out that he had 8 wives. This is unfortunately quite common. I asked him why and he said that is a custom of his generation. He said he now has only 2 wives, and 2 kids between them. He got rid of the others because they didn't listen to him. Through all this we got to share the gospel. He thought that since he got rid of his 6 wives and was trying to do good things, he would go to heaven. My student (Swata) and I got to share about Jesus and his birth and what Christmas is about, and how He died for our sins at Easter. Pray that God would use this conversation to help him truly understand the gospel.

After Wapi, I returned to my house for lunch - tunafish, and then proceeded to have PE class with the MKs. They wanted to play a game so we played some 3-3, after I taught them some basic defensive concepts, and a pick and roll. They did pretty good and seemed to have fun. After playing, I made some calls to check on some meds we needed in pharmacy. Then I delivered some Christmas presents to the other missionaries and visited with them. Now I will have dinner, go to prayer meeting, read some, and then go to bed. Such is the life of this PNG doctor.

Voices of Christmas

Today for our monthly English Lotu, we were treated to a production "Voices of Christmas." Kathy Radcliffe and Gail Dooley helped to write the different parts for the kids. At each English Lotu, the missionaries from our station are joined by missionaries from other stations - so the EBC (Evangelical Brethren Church), the Bible College, and the CLTC (Christian learning and training center) missionaries all come. The Swiss missionaries (EBC) even sang a song in their "tok ples," a form of German for us.

The service started with piano solos, a flute ensemble, and a few Christmas carols. Then the Missionary Kids and Jeff Myers shared the voices of Mary, Elizabeth, Gabriel, Herod, Joseph, Angels, Wise Man, and Shepherds. Each of the character was played by a kid, kids, or Jeff, and told about the part they played in the birth of Jesus. Gabriel (Josiah) talked about how he revealed God's plan to different people, Herod (Ethan) talked about how he tricked the Wiseman to figure out where Jesus was since he thought he, himself was the King of the Jews. The shepherds (Lydia, Emma, and Karis) talked about seeing the angel who told them of the Savior's birth and how at first they were afraid, but then they found the baby Jesus. Joseph (Jeff) talked about doubting Mary at first, until the angel came to him in a dream, Mary (Jessica) talked about how she didn't understand what Gabriel was saying to her at first, and how uncomfortable the donkey was, but how great it was to hold Jesus. Elizabeth (Priscilla) told of her husband coming back mute and saying they would have a child, and how funny she thought that. The angels (Joas and Ramo (EBC)) told how all the angels got together to sing Glory to God after Christ's birth. At times the lines were amusing, but each kid certainly helped to make the story of the birth of Jesus alive and real this Christmas season.

Catherine and Jeffrey

This past week, I have seen a lot of patients who I have diagnosed with cancer, or have cancer and I was seeing them for a second opinion. Catherine came to me on Thursday. She is probably in her mid 40s. She had been losing weight and had been having some irregularities of her period. She looked sick, cachetic. I was worried about TB or HIV, until I did my exam. I found she has inoperable cervical cancer. Her brother Jeffrey was with her, he shed some tears as we explained the diagnosis. I hadn't seen that here before, but he truly cares for his sister. I was able to offer her supportive care and pain control, but I was also able to share with her the Love and Hope that we can have in Christ. My nursing student, Swarta and I shared the gospel with her. She now has a hope of eternal life that she didn't have before. Eph 2:4-5 - "But because of His great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions - it is by grace you have been saved." Although in this life cancer will destroy her body, she will soon have a new body in heaven.

PE

I have started teaching PE to the missionary kids. So far I have only taught two times, but I have enjoyed it. I started with basketball because it didn't require any preparation on my part. We have gone over passing, dribbling, shooting, and a little defense. There is a wide variety of ages and skill level so it can be challenging to keep everyone involved and learning. The kids are now on Christmas break, so I have some time to prepare for what we will do next. I will do it at least once a week, and if the hospital isn't too busy, twice a week. In the past, they have learned basketball and softball the most. I hope to go over football, volleyball, soccer, track, physical fitness stuff, and play some kickball and dodgeball. If anyone remembers any great PE game they played as a kid or are currently playing feel free to let me know.

Christmas Service Project

Every year the missionaries do a service project at Christmas time around the station. This year it was decided to work on the hospital chapel. The chapel is used for English Lotu - or church services the 1st Sunday of every month. It is also used for hospital wide devotions, nurses inservice programs, womens bible study, nurses devotions, and much more throughout the week. It gets used a lot, but it also needed a lot of work. We removed the cobwebs from the top of the chapel with bamboo poles and towels. We replaced the lights that didn't work, and replaced some of the windows and washed all the others. The stones along the wall of the chapel got a good washing. We are hoping to coat them with some clear varnish stuff later. We were able to remove a lot of the debris from around the outside and now have some nice flower beds that are awaiting their flowers to be planted. The crosses on the front of the doors were redone and the doors repainted. All the missionaries and their kids pitched in as we completed this project.

We cleaned the chapel this am after the half marathon that Susan and Jeff Myers, and Dave Oviatt ran. They all ran under their goal of 10 minute miles, with Dave winning. Congratulations to all who ran. The Myers have been training for this for a number of weeks now. I had started to run when I first got here, but my knees starting bothering me, so I quickly gave it up for basketball. A bunch of PNGers ran with them, some completed it, but many didn't. A number of missionaries and the kids went out in support as their road crew. They cheered for them and gave them water as they ran. Unfortunately I was on call and rounding so I wasn't able to be a part of the festivities.