Friday, April 24, 2020

Bridging the Gap

Dear Readers, I am pleased to report my “little” building project is finally complete. About 4 weeks ago, I began construction on a new footbridge to replace the one that crosses the drainage ditch in front of our house. The original bridge was rotting and had sunk far enough into the ground that runoff from heavy rains would often submerge it (not the most enjoyable obstacle to cross on call nights).
As I had enjoyed many a small building project in the year we served here before, I again gained access to the Station Workshop with all its wonderful tools and leftover material. I had originally planned on a smaller footbridge design, maybe 4x6 feet, but the salvaged beams I found were long enough to envision more grandiose proportions.
A nurse anesthetist friend of mine here named Brian Bosip (AKA “Flex” - F3PNG) recently went home for Easter and posted some Facebook pictures showing the men of his village milling lumber. Seeing these fine PNG beams produced from massive jungle trunks, at great expense of manual labor, has heightened my appreciation all the more for the native hardwood used in this project.
When not on call, my typical day in clinic ends by about 3-4pm, which is conveniently during Penniella and Solomon’s afternoon nap time. So many afternoons and weekends I have slipped into work clothes, doused myself with mosquito repellent (they’re all convinced my blood is the best vintage around), and joyfully set my mind and hands to the task of measuring, cutting, sanding, painting, and nailing all the footbridge pieces together. It’s not rocket science, but I enjoy the labor and absolutely relish seeing the design of my mind’s eye take physical shape. My heartfelt thanks goes to Rachel for humoring this regular escape for sawdust therapy.
The original footbridge design was relatively simple, but with a larger footprint to work with, artistic inspiration suggested handrails would add both character and beauty. Rachel, being ever the practical thinker, cautioned that handrails would be an invitation to every kid on Station to make a jungle gym of it, and so risk unnecessary injury. But the creative seed once planted was watered sufficiently to produce the desired handrails - and it looks great!
Over the course of the last month I have asked many of our skilled construction missionaries their advice on best practices for building the footbridge, and in particular, how to create concrete footers to keep the footbridge off the (often wet) ground and securely in place for the long term. Concrete work is one area of construction I have never dabbled in, so their sage points were all greatly appreciated.
Once the concrete had set and cured for a few days, I recruited a few local guys from the maintenance crew to lend a hand moving the quarter ton behemoth to its final resting place.  In the end, my heart is full of joy to see this footbridge in place, adding value to the house and Station, and keeping future tenants’ feet out of the ditch water. Next up - landscaping flower beds around each end of the bridge!

Friday, April 17, 2020

Not coming back...Yet

We arrived in Papua New Guinea exactly 6 weeks ago today, and we moved quickly to make the most of every day. For as short a time as we would be spending here, we wanted every moment to count. We expected to depart this weekend, on April 19th ...then COVID happened...

Countries closed their borders. Airlines grounded their international flights. Fear gripped the world. Over the last month we have watched the ebb and flow of emergency preparedness here in PNG, with variable levels of lockdown both nationwide and in our Jiwaka Province. As the rest of the world has wrestled to constrain the poison, we have steadily made preparations and prayed our efforts might remain unnecessary.

This week a few more COVID cases have emerged in various areas around the country - which is more likely a representation of testing availability rather than actual case numbers. We still do not suspect the pandemic has reached our Western Highlands, but as we have extremely limited testing, we won’t really know until viral spread is demonstrated by a higher volume of suspect patients being screened in our COVID tent.

PNG is known as “the land of the unexpected”, and we are embracing the uncertainty these times have presented to us. Our inability to remain in control drives us to trusting God’s perfect planning and timing - which admittedly feels awkward, but overwhelms any doubt or fear with a tremendous peace. We are no longer returning home this weekend, but are currently projected to double down on our time here, returning in early June.

Blessed is the one who trusts in the Lord, 
whose confidence is in Him. 
They will be like a tree planted by the water 
that sends out its roots by the stream. 
It does not fear when heat comes; 
its leaves are always green. 
It has no worries in a year of drought 
and never fails to bear fruit.

Please continue to pray for us:
  • That the Lord’s peace and the fulfillment of answering His call here would overwhelm any fear or frustration. 
  • That I would have supernatural wisdom in caring for the needs of my patients.
  • That we might discern the needs of fellow missionaries and Station staff, and know best how to serve them.
  • That Rachel and I would be wise and loving towards Pennie and Solomon.
  • That we would continue to be protected from any illness or harm.
  • Thank you!!!

Tuesday, April 14, 2020

Easter Weekend at Kudjip

I hope that you all have had a wonderful weekend celebrating the Resurrection of Christ!
I am sure this Easter looked and felt different than what you are used to ... same here!  But in spite of all the unknown right now, we have reason to CELEBRATE and be at PEACE, because Jesus conquered death and is ALIVE!

      Our Easter weekend started on Friday afternoon, with a visit to the "Haus Bung" (meeting house) to walk through the Stations of the Cross.  Stephanie, a missionary here at Kudjip, did an AMAZING job setting up the stations in an interactive way, with beautifully written descriptions.
Pennie's commentary after having the crucifixion explained to her:
P: Did Jesus's feet bleed?    Me: Yes
P: Did it hurt?    Me: Yes
Me: Why do you think He let himself be hurt?
P: Because He LOVES us!
The simple truth of salvation explained by Pennie ... God Loves YOU so much, that He allowed His only Son to die for you - Do you believe in this love?  If it's been a while since you've thought about this, please take a moment now to do so.  I am happy to correspond with anyone having questions or doubts about God's love for You.

     On Saturday afternoon, Ted took the kids outside to help him work on a project he's been building.  Needless to say, mud was involved (as it always is in PNG), and Pennie and Solomon cooled off and washed up in giant mixing bowls in the backyard before coming in for snack.

      Easter Sunday was a blessing in SO many ways!  I'll be honest, all week I was really missing my WEAG Worship Family.  Good Friday and Easter Sunday are some of my FAVORITE services to be a part of.  Thankfully, I had the privilege of leading worship for the Missionary Easter Service on station.  The service was originally scheduled to happen at sunrise on Easter, but because of PNG Government guidelines requesting no large gatherings, we switched it up to a Zoom service.  My friend Rachel did an AMAZING job organizing and running the entire service - especially with the last-minute switch to Zoom.  I felt honored to lead my fellow missionaries, here and in other countries, in worship on Easter Sunday.

Getting ready to start our Zoom service & hoping the internet works! 

Ted & the kiddos watching the service from home.  

     After our virtual church service, we had an Easter egg hunt and lovely lunch with our dear friends and neighbors, the Crouches.  Their support and friendship over the years and during our transition to life back at Kudjip means THE WORLD to us!  We are so blessed to call them friends!

And they're off!


Praying you all continue to keep the Light of Easter burning in your hearts and in your homes!
"Thanks be to God!  HE gives us the VICTORY through our Lord Jesus Christ!"  
~ 1 Corinth. 15:57 ~

Friday, April 10, 2020

Primed for Sonrise

Dear Readers, 
Today marks the beginning of a four day Easter weekend here in Papua New Guinea, a timeframe for which the Prime Minister has also reinstated the restriction on public transportation. This week PNG has had it’s second case of COVID on the island of East New Britain, so efforts are ongoing to prevent the spread. In the last two weeks, our hospital has screened almost 400 patients since establishing the COVID tent, and we have yet to see COVID emerging here in the Western Highlands. Nonetheless, vigilant screening will continue as we pray for the pandemic to pass us by.

Meanwhile we remain busy at Kudjip Nazarene General Hospital caring for the sick and injured in the name of Jesus Christ. A few interesting cases are as follows:

CASE 1:  This 2 week old infant came to me in the Outpatient Clinic with a rattling pneumonia and pus gluing his eyes shut. The clues to the diagnosis were his age since birth and the fact that his mother was having a similar discharge from her birth canal. Left untreated,Chlamydial  Conjunctivitis can leave an infant blind and the pneumonia can be life threatening. Happily, we started the right meds, and his illness turned around within 48 hours. His mother and father were also both treated and educated about the risks and prevention of STD’s (an all too common problem we face here).

CASE 2:  A boy in Clinic presented to me with a seed in his ear canal. Perfectly round, completely obstructing the ear canal, and wedged deeply in place, this type of foreign body can be very difficult to remove. An ENT doc is usually required to use sedation and specialized instruments to extract such an object ...but of course we have neither the ENT or specialized instruments. So Dr Ted put on his MacGyver hat, and applied a tiny bead of super glue (kept in my medical bag for this specific trick of the trade) to the tip of a cotton swab. This was then carefully inserted into the ear canal, pressed gently up against the seed, and held for 10 seconds. With breath held, I said a prayer and gently retracted the swab ...and voila, everybody’s happy! 😁

CASE 3:  Andrew is a 14 month old infant admitted for Kwashiorkor (malnourished), but within 24 hours of admission he developed stridor and a croupy cough. I was on call earlier this week and was awoken with the request to come and assess his worsening breathing. Apparently he’d already had a few days of this raspy breathing but it had worsened significantly overnight.

I whipped up some Racemic Epinephrine (nebulized adrenaline) to help relax his larynx, and gave him a steroid shot. Two hours later on my daily Peds ward rounds he wasn’t any better, which caught me off guard. It’s unusual for croup to be unresponsive to RacEpi and Decadron. So I reviewed his history, examined him again, and decided to get a couple x-rays. His chest x-ray came back looking fine, but the lateral neck film demonstrated a significant narrowing of the upper airway.

As suspected, the film revealed a classic “thumb print” sign, so I switched theraputic gears to also treat Epiglottitis. This pre-vaccine-era illness is usually cause by Haemophillus Influenza B, which I’ve never seen before because most babies get their HiB shots. So while I got started adjusting his meds, all I could think about was the fact that within the span of two weeks I have diagnosed Diptheria and now Epiglottitis. May I take a moment to emphasize to you (mostly a first world audience) that vaccines save lives! Wowza. Anyway, the story doesn’t end there. I visited Andrew on the Peds Ward a few different times that day, and again many times yesterday, and remained concerned about his pinched upper airway and labored breathing. The tricky thing about swollen airways is that they can spasm if you mess with them too much, so I didn’t use a laryngoscope to view the cords, and we didn’t place an NG tube for feeds/meds. But despite ongoing IV steroids and antibiotics, the big difference one day to the next was his inability to cry or cough without the airway completely closing off. With all the working to breath, I was worried about acidemia (too much carbon dioxide building up in his body). Without the ability to cough and clear phlegm I was worried about accumulating mucus blocking his airway further. My solution -recruit surgery to consider placing a Tracheostomy (a breathing tube straight into the windpipe from the front of the neck to bipass the obstructed upper airway). With bigger minds than mine considering all the options, I waited and prayed ...and maybe pestered the surgery team a couple more times about it. So ultimately Andrew got his trach, a bunch of mucus was suctioned out, and he is now breathing easily out of his neck. Praise God! (Please keep Andrew in your prayers - that his airway swelling will resolve quickly so the trach can be removed ASAP).

CASE 4:  This sweet girl is named Rita and she has been on the Pediatric Ward almost as long as I have. She suffers from Osteomyelitis (disseminated infection in many of her bones), severe enough to have required surgical removal of rotten pieces of bone. Despite the constant pain, inability to move, and bed sores, she has always returned my smile. This regular glimpse of a child’s hope has reminded me of God’s promise - Heavenly peace in the face of earthly trials - so I gave her a rainbow sticker, and shared God’s promise with her.

Today it is Good Friday. Almost 2000 years ago Jesus Christ was crucified for us, taking all our sin and shame to the grave, so we might receive eternal Salvation. As I see the world come face to face with pandemic illness and death, I have found more urgency than ever to share the Good News of Jesus Christ with those who may yet choose Life over death. Adding to the burden of urgency has been the recent death of a college classmate, who recently developed Pancreatic Cancer and died within two months of getting sick, leaving behind his wife and two young kids. Wow, that strikes home. None of us are guaranteed  tomorrow - are we ready to meet our Maker? Have we lived every day leaving behind no regrets and fulfilling God’s Call to sacrificially serve others in Love? We can not do it alone. Our dependence must remain on the omnipotent power of God. Our focus must remain on Jesus. Our spirits must be tuned with the Holy Spirit. The fruit we bear reveals the source of our focus:  Is it selfish and fear-driven, or does the world witness in you the Fruit of the Spirit?
But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness,faithfulness, gentleness and self-control. Against such things there is no law. Those who belong to Christ Jesus have crucified the flesh with its passions and desires. Since we live by the Spirit, let us keep in step with the Spirit.Galatians‬ ‭5:22-25‬
This weekend, let us all set our hearts and minds on the victory Jesus has won for us. Let us give over to Him our time and resources, and give Him control of today, of tomorrow, and however many days we have left. His power is made perfect in our weakness. Amen!

Sunday, April 5, 2020

Playgroups with the Littles...

Since there was a recent documented case of COVID in PNG, the entire country has been on "lockdown" for the past two weeks.  Transportation across provinces is prohibited, police are enforcing road blocks, and schools have all been shut down... including the Missionary School on the station.  Most of my fellow moms here at Kudjip have school-age children along with a couple of pre-K/toddlers.  As many of you have come to discover in recent weeks, teaching/supervising older children with little ones running around and demanding attention is a difficult task.  Understanding this, I felt led to put my time and teaching experience to good use and host a playgroup three mornings a week for all the tiny people on the station.  The hope and purpose is to give the moms a couple of uninterrupted hours to teach and do school with their older children. 

Pennie, Solomon, and I have enjoyed two weeks of playgroups so far, and we plan to continue - since the PNG Government recently extended the "State of Emergency" for another two months.  I am not gonna lie - Ten kids under the age of 7 is exhausting most mornings, but I am overjoyed when the moms pick them up and report back how much schoolwork they were able to accomplish.

I structure the time similar to how I used to run my Early Intervention classroom in Philly.  (Shout out to Mama Carrie who taught me some of the BEST Circle Time songs!)  We start off the morning playing with homemade play-dough at the table, then we move onto Circle Time on the floor, which involves LOTS of singing.  Some of the current favorites are: 5 Little Monkeys Swinging in the Tree, The More We Get Together (w/signs), and Tiny Turtle Tim.  After Circle Time, we head back over to the table for Arts/Crafts/Games, and then we get up on our feet for Music & Movement (also known as dance party time).  Some of their favorite movement songs are: Baby Shark, Hokey Pokey, Run Baby Run, and Going on a Bear Hunt.  After exhausting them with silly dancing, we round out our morning with Snack and Story Time.  

Some of you may be wondering: "How are Pennie & Solomon handling all of this?"  
Pennie absolutely LOVES having all of her little Kudjip friends over to play three mornings a week.  Solomon, being the youngest of the group, doesn't quite understand why he has to share me and his toys/books... but all in all handles it fairly well... and if needed, I just strap him into his highchair and he "participates" from there. 😉

Here are pics from a recent playgroup session with some of our favorite tiny humans!  

Play-Dough Time! (Hint: homemade play-dough lasts longer if you keep it in the fridge)

Lucy, Maisie, & Pennie

Gabe & Solomon (strapped into his highchair!)
Hudson & Graham

Lydia & Caleb

Charley & Caleb

Our finger-paint palm leaves craft for Palm Sunday