Nursery

One short update since my last post: PNG is seeing a second wave of Covid infections sweep through the country. This wave came on faster and has already been more devastating. We have had to temporarily close our outpatient department and close to patients from outside of our province due to staff shortages. Oxygen is in short supply, and we are praying the outbreak does not worsen.

 

The last few weeks I have been rounding in the nursery. We have several sets of premature twins as well as some other babies that need extra help adjusting to life outside the womb. I have found life and joy in caring for these babies every morning, although there have also been moments of sadness and fear. Every morning as I wash my hands before starting rounds, I check to make sure each warmer is still filled. Life for these little ones can seem so tenuous, although some hang on with far greater vivacity than I would have thought possible.

 

Each day I’ve found myself praying for these little ones and their mothers. Some of these mothers wait for months for their babies to be big enough to finally go home. This can be a huge stress for those with other children at home.

 

Please join me in praying for these mothers and babies.

 

In clinic a couple weeks ago I met Bapo, a one-and-a-half-year-old whose mother was concerned because he wasn’t walking and had a chronic cough that hadn’t responded to multiple courses of antibiotics. Concerned about tuberculosis, I obtained a chest xray (below).

 

Noting Bapo’s large heart, I took him to the ultrasound room. As I was looking at Bapo’s heart, I noticed that one of the walls of his heart looked thin. I added color flow (to see movement of blood) and noticed that blood was flowing a direction it should not have been. I called Dr Susan, our local expert, and she confirmed with me that Bapo had a VSD (a hole between two chambers of his heart).

Before Covid, a team of Australian doctors would come once a year to perform cardiac surgery for congenital abnormalities. They have not been able to come for a couple of years now, but we are hoping that they will return soon for children like Bapo.

 

Our team of doctors here has been reading a book called Promises in the Dark by Eric McLaughlin for our Friday morning meetings. This last week the chapter was about God’s promise to make all things new. The author writes, “Goodness peeks through here and there, now and then. New creation glimmers like a pinprick of light in a black curtain. Even on the worst days, I think I can say that’s true.”

 

In the midst of difficulties, with Covid stacked onto the enormous burdens already present for people here in PNG, I’m focusing on the glimmers of new life. There is joy and promise in seeing a tiny baby gain weight or no longer require oxygen. Amidst the darkness and heaviness, God is still in His work of making all things new.

Tsingoropa and a much needed update

 Two days ago was Independence Day here in PNG. In 1775, PNG became independent from Australia and thus was celebrating its 46^th birthday. It was a fun day full of color, traditional dress, lots of basketball and volleyball and a show of pride in their wonderful country.

Updates since my last blogpost

-I turned 30 and was wonderfully surprised by all the love shown to me, both from friends here and back in the US

-I climbed the highest mountain in PNG! (Mt Wilhelm which stands at 14,700ft-impressive for an island)

-We (my neighbors the Myatts and I) planted our garden

-I went to a cultural show that featured traditional clothing and dances from different parts of PNG

-I taught hurdles for PE for the missionary kids

Not part of hurdles, but a fun race nonetheless :)

-Our hospital faced a serious budget shortfall and was in the beginning stages of closing when the government came through with emergency funding and we were able to continue to provide care to our patients

-And, lastly, I went on a trip to Tsingoropa in the Jimi valley for a week of work in a rural clinic. I want to share more about that trip.

The Jimi valley starts beyond the hills just north of Kudjip. It is one of the most remote and undeveloped areas in PNG. In the 8 months that I have been here, many of our sickest patients have come from the Jimi Valley.

I traveled with Dr Matt for a week of work at a rural clinic in Tsingoropa. We were able to work with an awesome team of Nursing Officers, Gabriella and Moses, and a Community Health Worker named Joshua who staff the clinic. Our welcome was overwhelming, seeing the emotion of a community that had not had a doctor visit in a long time. Through the week we saw hundreds of patients, did antenatal visits and ultrasounds for 25 pregnant patients, and spent some time training the team of local health care workers. It was a full week including showing the Jesus film, sharing a devotion at a Thursday night fellowship, playing soccer and swimming in the river (just 2500 feet down the mountain and back).

Top: Dr Matt and I with Moses, a nursing officer at Tsingoropa; 2. Praying with a patient in the clinic 3. Matt and I with one of the mamas who had come to be seen by a doctor. 4. Wara Jimi 5. Another patient encounter 6. Peter and his mother waiting outside of the clinic to be seen

One of my favorite moments was one evening when I went to sit on the porch and watch the kids play rugby. Suddenly I was surrounded by a group of kids looking at me expectantly. Eventually I learned they wanted me to share a story, so I proceeded to give a paraphrase of The Hobbit. The kids loved the interaction and proceeded to tell me some stories of their own.

I was touched by the warmth and hospitality of these people, the way they welcomed us into their community and the difficulty of their lives. I hope to be able to go back in the future.

 

Hard days

Some days are hard.

 

I stood watching the baby struggling for breath, still cyanotic hours after her birth. She had swallowed a large amount of meconium during the birth process. Despite suctioning and resuscitation, we were unable to help her breathe normally. Now she was on maximum oxygen therapy after CPAP had failed. My heart sank even further as I read the chart. She was her mom’s fourth child, but of the three before her, only one was still alive. The next morning her crib was empty.

 

The morning before, I learned that Dora had died. Dora had been living in the hospital for the last several months. She suffered from chronic lung disease from tuberculosis as well as heart failure. Every morning I would see her, and she somehow usually was able to give me a smile. Each day I felt a little more helpless as I saw her slowly deteriorate, the medications no longer helping. She made me a beautiful bilum (decorative bag) the week before she died. We often prayed together, although I know towards the end, she was losing hope and the will to live.

 

 

Later that night I took care of a woman who had been brought into the ER after being tortured in her village, being accused of sorcery. She had burns on her back, chest, arms and legs and a deep machete wound in one leg. She struggled to answer my simple questions, on the edge of shock.

 

In clinic, I pushed through, but unable to fully hide the sadness and weariness I felt. A dear friend offered me some really good advice post-call-“Take a nap and then pray for these patients.” Later, I released them to God with tears, anger and confusion giving way to shared grief.

 

 

 

Henri Nouwen talks of service as an encounter with God, “a joyful way of life in which our eyes are opened to the vision of the true God who chose to be revealed in servanthood. The poor are called blessed not because poverty is good, but because theirs is the kingdom of heaven; the mourners are called blessed not because mourning is good, but because they shall be comforted.”

 

Today I’ve had in my mind the image of Jesus calling out to Mary Magdalene from The Chosen. Christ chooses to see us amid our brokenness, pain, and suffering. He meets us there. He was working here before I came and will stay long after I leave. He is working through my incredible PNG colleagues. I don’t always understand it, but it will always be a privilege to join Him in His work.

 

 

Wisdom from Dr Jim

It’s been a while since I have written. Sorry for the long lapse. Sometimes business makes it hard to write, but other times I find myself uncertain what to write. Life here is so varied and quick it can go from celebration to mourning to thanksgiving to frustration in a short period of time. Also, now as some of the newness has worn away it is harder to reflect on what I am experiencing.

 

So, I’m going to use a little bit of a structure to help me reflect. The structure was provided through the wisdom and life lessons of Dr Jim.

 

Dr Jim is somewhat of a legend around here. He and his family lived here for over 20 years serving as a surgeon to the hospital, and now his son Ben is our general surgeon, carrying on the legacy. All the workers who have been here long enough have a Dr Jim story, and on long runs I will run into older men and women up in the hills around station who ask me about Dr Jim.

 

Dr Jim was able to come help at the hospital as a volunteer as part of a Covid relief team. During one of our doctor’s meetings, he was able to share these pearls he learned from his many years here. Using each pearl (and combining a few to keep this from getting too long), I want to share a snapshot of my life here, what I’m learning and where I’m growing.

 

Recent staff meeting including volunteers Dr Jim and Dr Pringle

 

1 and 2. Know your calling and trust your God.

Some of my residency colleagues helped me to realize that having a vision and goal was a strength of mine, something that I hadn’t realized before. Prior to coming here my vision had been focused on making it through medical training to be able to serve people in a rural, underserved area just like this. Honestly, one of the big transitions in coming here for me was moving from having this big vision to living it, and thus no longer having a vision or goal for the future. I’ve had to learn to form visions again.

 

One of my great joys here has been running outside of station, partially because it helps me to see the big picture and think about the future. There are several different ways that I can go to get up into the hills just south of station and look back into the Waghi valley. These times help me to feel God’s presence and feel His heart for this beautiful place.

 

The view from one of my favorite running spots

 

3. Learn to laugh and have something to look forward to

A few weeks ago, I was able to go on vacation to Madang, a town on the PNG coast. It was such a blessing to have a short break and time to get to know some of the other missionaries better. We were able to go snorkeling, explore the area and have time to relax without call shifts.

 

 

 

Something that frequently makes me smile and laugh are the kids here. Yesterday during my shift, I met Maggie who had one of the best smiles I’ve ever seen. I couldn’t help but smile back and feel joy at getting to do the work I do.

 

 

One thing I’m looking forward to is a chance to climb the highest peak in PNG, Mt Wilhelm (14,793ft). I’m hoping to go with a few friends one weekend in August.

 

4. Focus on prayer

Personally, I’ve always struggled with prayer. My mind tends to wander, especially when I am tired. The last couple months I have been using a book to have fixed time prayer or “saying the offices.” It has specific prayers in the morning, noon and evening that come from the Psalms and church tradition. It has helped me to focus my heart throughout the day.

 

5. Bond with brothers and sisters

One blessing over the past few months has been getting to know some of my PNG brothers and sisters better. I’ve really enjoyed having my neighbors and some of the PNG doctors over to my house for dinner and occasionally watching a movie. Hosting is not the most natural thing for me, but there has been plenty of grace for my cooking 

 

Dinner with my neighbors and coworkers

Fellow doctors and some good friends

 

6 and 7. Say I’m sorry/Keep saying yes

Occasionally the work as a physician here can be stressful. There are many things that are new to me, and, unfortunately, sometimes I let that stress show through frustration. I have had to apologize more than once when I haven’t been very gracious or have been too task focused instead of relational. One night when I was grumbling about being called in, God showed me how a lot of my frustration was rooted in my fear of being inadequate to deal with whatever the call was about. He then proceeded to help change my mindset to curiosity and adventure, knowing that He would help me through whatever challenge might come.

 

Last weekend I got to spend a night with Apa and his family again, which was special. Hugging and playing with his kids made me feel at home and to see deeper into what the lives of the people I see every day in the hospital are like. Moments like these help me to keep saying yes to my work, especially when the work is less rewarding.

Mumu and morning fire at Apa's

Rounding

I wanted to invite you in a little closer to what rounds look like for me every morning. These are some of my patients from the Pediatric Ward.

 

My first patient is James, a 6-month-old who was readmitted after becoming a lot sicker following an admission for pneumonia. He was admitted by our ER staff overnight and in the morning my LP showed that he had bacterial meningitis. Thankfully, the ER staff had started the right medication to treat this. He initially required two anti-seizure medications to control his seizures, but on this day, he has completed 10 days of treatment and looks like a new kid.

 

 

 

This is James a few days later in outpatient clinic showing off his fancy hat.

 

 

 

The next bed is a 5-year-old girl suffering from typhoid. Sometimes these children get very sick, and they are often very irritable and uncomfortable until the medication begins to help. Next to her is a 4-month-old with pneumonia who was very interested in me, despite needing oxygen to help him breathe.

 

 

Moving across the aisle I have a set of twins, although only one of them is admitted. This baby got very sick after being born at home and had to be admitted for antibiotics and to help the baby feed. A few beds down from them is a 12yo girl who was admitted with a septic knee joint with the infection spreading to her femur. I had to make an incision in her leg down to the femur to help evacuate the puss to allow her leg to heal. While she was initially pretty shy, we’re now good friends and I go by to say hi in the afternoons sometimes. She’s starting to walk again and should be able to go home soon.

 

 

 

The next bed is a chunky 9-month-old named Eskimo who was also admitted for bacterial meningitis. Thankfully he responded quickly to the antibiotics and is well on his way to being better. The last patient is Tom. He was admitted for malnutrition. Over a couple of weeks, he gained over 1.5kg (3.3lbs). While he was initially irritable, he quickly became a very smiley and vivacious little guy. While I’m thankful for his improvement so that they can go back home, I’m going to miss seeing them in the mornings. It's been such an honor and blessing to me to be able to help care for these precious kids.

 

Loving the RUTF (Ready-to-use Therapeutic Food--souped up Peanut Butter)

 

 

In a few other updates, this week I moved to Medical Ward to take care of our adult inpatients. I was able to get my Covid vaccine, the Astra-Zeneca vaccine, thanks to the COVAX program. Also, here are a few pictures of my new house. Yesterday there was a large party to thank all of the workers who helped build the new fourplex that my house is a part of.

 

View from my back porch

 

 

I also was able to go to a rural “bush” church with a few friends this last Sunday. It was a beautiful and refreshing experience to be able to worship and pray with this small community (even though it was an adventure getting there :)