Children of PNG

Matthew 19:14 Jesus said, "Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these."

College of Nursing Graduation

This was the 33rd yr for the College of Nursing Graduation here at Kudjip, which graduates 25 students each year. The students come from all over Papua New Guinea to study nursing and when they leave they go all over the country to serve and minister to God's people. This year was a special graduation because the Governor General of Papua New Guinea - Sir Paulias Matane, was the guest speaker. PNG was once a British colony, and he is the Queen of England's representative. The Governor General is elected by parliament who acts on the advice of the prime minister and the cabinet.

Everyone came out for the event because of the Governor General. There had to be around 1000 people there if not more. After prayer, Doctors Andy, Jim, and Bill played the PNG national anthem on their trumpets. Dr. Jim also played a solo of Here I am Lord, which was very good.

The Governor General is 76 years old, has written 44 books, and has been to all 7 continents. As he spoke, he used the example of Christ in Matt 20:28 "just as the Son of Man did not come to be served, but to serve, and to give his life as a ransom for many. " He talked about leadership and service, how we need to serve with love, as Christ did, and not to work for money. He also urged the people to quit fighting and to serve each other with love.

After his speech, he handed each graduate their diploma. I had worked with many of the nursing students in the hospital, so it was neat to see them graduate. Throughout the year, the students rotate with the doctors and spend between 1-2 weeks with us. When they rotate, we have the opportunity to work with them on physical exam skills and on diagnosis. Some of these students will go out to small aid posts or health centres and may be one of the only caregivers there.

After the graduation, Bill got to sit with the Governor General at the reception. He asked why we, the Americans, come here and serve the people of PNG. Bill got the privilege of sharing with him that we take Jesus seriously and when He says to follow me, we do. What a testimony.

New Ultrasound Machine Needed

Other than xrays, ultrasound is the only radiologic modality we have to aid us in diagnosis. There is hardly a day that goes by where I don't use the ultrasound machine. If I don't use it, someone else definitely has. It aids us in all aspects of our patient care. In OB, we use it to determine gestational age, position of the baby and placenta, to check the fluid of the baby, and determine presence of fetal heart movement. In the ER, we use it to rule out ectopic pregnancy, to look for free fluid in abdomen, to find a place for a paracentesis, and more. In OPD, we use it to evaluate the liver, spleen, kidneys, uterus, and ovaries for pathology, to look for abscesses, to try to evaluate if something might be cancerous, and anything else that might come up. We often are bringing it to the ward to evaluate pts that have been admitted, or we bring patients down to the machine, which is outside our OPD area.

None of us have formal training in ultrasound, but we all learn as we go. Before I came, I spent some time with ultrasonographers in the States, but nothing compares to just doing it. When I first started, evertime I did an US I would ask someone to come in and check what I was seeing to determine if it was normal or not. I still ask lots of questions, but am feeling more comfortable on my own. Although I have been doing US for 6 months now, it wasn't until just recently, when I did 4 with Bill, that I finally figured out how to tell what was the uterus and what was the bladder (a very important distinction). Liam's (Bill and Marsha's grandson) famous saying "Keep Looking" is how we learn. We learn by doing and looking and trying to remember what normals looked like and then finding something abnormal and trying to remember what that looks like. When in doubt you can always scan yourself, as Bill is doing, to figure out what normal might me (this assumes you are normal).

Recently I had a pt with a breast mass and I went to US it to try and determine if it might be cancer. I haven't done this before, so I asked Bill for help. He looked at it and determined it was normal, so I asked what cancer looks like. He wasn't really sure and said he needs to "keep looking" and do more scanning of breast cancer to get a feel for it. The next day I had another lady with a breast mass which seemed like cancer from palpation. So I ultrasounded her, mostly to figure out what it looks like on ultrasound for the future. I got Bill to come and take a look with me, and now we both have a picture in our heads of what it looks like (picture to L, not as clear as the one in my head). This is how we learn.

The more we use the ultrasound machine, the more we rely on it. We use it a lot in emergency situations to determine if there is a placeta previa, ectopic pregnancy, or free fluid in the abd that we needs to go to surgery. We have pts coming in requesting scans for every ailment they have. We explain that we can't use it for everything, but we do use it for a lot. With all the use, our machine has started to show some wear and tear. We are now starting to get permanent shadows and some streaks that flash on and off the screen. This isn't good and makes scanning very difficult at times. As a result, we are trying to obtain a new ultrasound machine. This is where we could use your help.

We have a contact at GE and a new ultrasound machine will cost us around $20,000. This is a lot of money, as you all know. While we raise the money for the new machine, we be getting a new probe for our old machine which will extend the life of the old machine for a period of time. After we get the new machine, our current one will serve as a backup.

So if anyone is interested in contributing to helping us purchase a new ultrasound machine, please do. Here is how: make checks payable to World Medical Mission, under memo use project code 003466, which is a fund set up specifically for me to use for hospital related things here. This is all tax deductible. Send to: World Medical Mission P.O. Box 3000 Boone, NC 28607

Any questions please email me. Thanks for your support.

Peter gets a wheelchair

Peter, has been a patient for over 15 years now, Nazarene Hospital is his home. Peter was in a church when the roof came down and he became a paraplegic as a result. Initially after his accident he went home, but after developing pressure sores and having to be hospitalized numerous times, he now has his home in a waterbed in the corner of D ward. He has a curtain which gives him a little privacy, and his walls are decorated with many different Bible verses. He almost always has a visitor who has come to visit with him. Peter spends the majority of his time in the waterbed, and only gets out when someone comes to wheel him around in one of our not so sturdy wheelchairs. At times, you would find him helping out in pharmacy, or just visiting with others. Thanks to a couple's generous donation, things are changing for Peter. June and Buryl Osborne from Washington were gracious enough to donate a new electric wheelchair for Peter. A few weeks ago, the Bennetts gave the wheelchair to Peter, who initially didn't know what to say or think. He is sure warming up to the idea, and today when I was walking by the hospital he was out in his new chair.

PE - Soccer

This past month I taught soccer to the kids during PE time. I tried to recall all I had learned when I was 7 years old and played indoor soccer for a few years, but there wasn't much to recall. Thankfully, I found some websites that explained how to pass, shoot, and dribble correctly. I tried to make it enjoyable for the kids, but also teach them the basics. We played a fun game I found, called blob tag, In this, 2 kids are "it" and hold hands and work together to try and knock the ball away from someone dribbling. If your ball gets knocked away you become one of the blob and go after someone else. This proved a very fun game that everyone enjoyed, and at times we got all tangled up playing. After doing a few drills, and fun warmup games, we would then play soccer for real. We rotated all the positions to give everyone a chance at each, and to give people an opportunity to catch their breath.
Up next is football, which we start tomorrow. I tried to look online for some drills, but couldn't find much that was helpful to me in this setting. The McCoys gave me a lesson on the basics - positions, blocking, and different passing patterns, so I should be ready to go.

Spelunking

Sam, Kevin (FP resident volunteer), Bill and I went on a hike to a bat cave about 3 hours away from the station. We met up with some local folks - John, Pastor David, and bunch of kids who served as our guides. We hiked about 2 hours before we got to the cave, and then spent about an hour in the cave. I can't say I was real excited about going into a cave, much less a bat cave - but after last weekend, I thought I would give it a go. It appeared as someone had recently been in the cave and killed a bunch of the bats, I can't say I was disappointed. We did have to watch out for bat pekpek as we placed our hands on the walls to steady ourselves. We saw the famous stalactites (on roof) and stalagmites (on ground), it was pretty neat.

We started the descent into the bat cave by repelling down an 18 foot waterfall. We were all soaked after that, but we kept going. Thankfully Sam said something about a plastic bag for the camera or we would have been in trouble. We made our way through the cave by the use of our headlamps (a very practical Christmas present). At times we worked through narrow passages, at others we had to crawl through on our hands and legs. At one pt, there was another smaller waterfall that we had to go down. As I looked, I wasn't quite sure where to put my feet, but I gave it a go. Thankfully, Sam and Bill had gone ahead of me and were watching from below in the water. They caught me as I fell a few feet when my foothold didn't quite hold up. We made it to the end of the cave, where we looked down another long waterfall descent - apparently no one has gone down there and we weren't going to be the first. On the way back, Bill detoured us slightly off course, the same detour that I had taken on the way in, how was he to know that the way was actually 5 feet above us, not on the ground beneath?

We finished in the cave, had some lunch, and then started back on our well marked out trail. On the way there, much of the trail was just bush that was cleared with a bush knife, so on the way back, we actually had some idea where we were going. John and Pastor David tried to make fire for us using bamboo and some brush, but they couldn't get it. Instead, they made traditional bush hats for us to wear as we walked back. Sam and Kevin stayed to sleep out in the bush, but Bill and I kept coming to home with warm showers and comfortable beds.

Weekend on Call

1 hospital, 100 beds, 5 bed ER, 1 doctor responsible for 48 hours

18 ER evaluations including 8 admissions, 8 hours of sleep, 6 C Sections (3 girls, 3 boys), numerous visits to B (maternity) ward, numerous power outages, 2 severe preeclamptics on Magnesium, 2 hours locked out of my house, 2 dinner invitations, 2 songs played over and over in OR and in my head from Jars of Clay– I Need Thee Every hour, God Will Lift Up Your Head, 1 bad chopchop, 1 neonatal resuscitation requiring intubation, 1 rapid HIV test on B ward, 1 child hit by motorcycle, 1 child died with dehydration/malnutrition, 1 CS partially done with flashlight & headlamp, 1 rape victim, 1 guy run over by a tractor trailer, 1 game of basketball, 1 hour of Bible Study, 1 HUGE time of brokenness, weakness, and questioning

Value of weekend – PRICELESS – GOD proved Himself faithful and strong over and over, He provided help and comfort when I needed it most, He restored my spirit and gave me a joy for serving again. 2 Cor 12:9 - "My grace is sufficient for you, for my power is made perfect in weakness."

on L - During 1st CS the lights go out just as Mr. Mugang about to put in Spinal. Flashlight and headlight illuminate work area.

on R - Gideon (nursing student), Jennifer (scrub tech) and I just after power was restored during the CS which required the use of the headlight and flashlight to sew up the uterus.

on L - working in ER by headlamp since had no power

on R - Baby boy Bii resuscitated after CS which required intubation, both mom and baby doing well

on L - Sister Peru, after being trained by lab, does first Rapid HIV test on maternity ward at night

on R - removing bandages from David who was chopped multiple times in both arms sustaining multiple finger amputations. I prayed with him and assisted Dr. Bill in sewing up the skin. Today, after receiving 2 units of blood, was transferred to Goroka Hospital for definite surgery.