Saturday, April 21, 2018

No Laughing Matter




Dr. Rebecca, one of the PNG Rural Registrars that comes to train periodically at Kudjip, recently referred a patient to us. Jackson had recurrent lung infections for several months after aspirating a foreign body.  

We praise God for supplying the right resources at the right time to treat our patients. Just a few months ago Kudjip Hospital received new rigid bronchoscopy equipment, allowing us to look into and extract objects from children’s airways. Few hospitals in the Highlands have this type of equipment. 


Dr. Ben and I were able to successfully extract the object from Jackson’s airway and discovered it to be a thumbtack! Upon further questioning, we discovered that while he had been using the thumbtack to clean his teeth, he had laughed and inhaled the tack.  Let this be a lesson to us all: do not laugh while cleaning your teeth!


Sunday, April 8, 2018

Back to the Unexpected

**I meant to write this post weeks ago, but time seems to have flown by. Now that Easter celebrations are over and things are settling back to normal, we’ll revisit the events of the past 6 weeks. Shortly after returning from vacation in Brisbane with my mom, PNG proved itself again to be the "Land of the Unexpected":

EARTHQUAKE!!

photo credit: Connie Lou Aebischer
Photo credit: theage.com.au









On Monday, February 26, at 3:45am, we were all jolted awake by a 7.5 magnitude earthquake that struck the Southern Highlands of PNG, about 120 miles southwest of Kudjip. Although there was minimal damage here at the Nazarene Hospital, there were extensive structure damage and massive landslides closer to the epicenter.



Photo Credit: Sokere Hali
Photo credit: BBC.com
In the weeks following the quake, we have begun to see the extent of the aftermath as tens of thousands of people have been displaced from their homes, their land, and their livelihoods. Over a hundred fatalities have been confirmed. Victims were either crushed by collapsing buildings or buried in landslides.



Photo Credit: Connie Lou Aebischer
The PNG government is partnering with Australian military and several NGOs on the ground to distribute aid, but efforts have been greatly hampered by the remoteness of the affected area and the great number of landslides that have blocked or destroyed roads.  Several rivers in the area were clogged with landslide debris making the water unsuitable for drinking and posing the greater threat of downstream flooding when the earthen dams finally give way. For more details regarding the ongoing challenges in relief efforts please see these reports from BBC and The Age.
     After the initial earthquake, there have been more than 100 aftershocks which have slowed in frequency over the weeks. Just yesterday, April 7, we felt a large 6.3 magnitude aftershock which reportedly damaged one of the functioning airstrips in the area which will further hamper the recovery efforts. Please continue to pray for those affected.

Handing off  the surgery
 "on-call" phone
         The unexpected did not end there. In the week following the earthquake, a lightning strike took out the station's phone system, resulting in a month of very interesting on-call arrangements until the system could be fixed. During that time the autoclaves also broke which forced work at the hospital to limp along for several weeks until they could be suitably repaired (as detailed on Dr. Erin's blog) . During that same period, we also experienced an increased frequency of power outages which reminded me of a blog post I wrote last year at about this time. As they say: when it rains, it pours!


Unloading the container (on left)
Thankfully, most things are back to normal around the hospital now and not all unexpected events are bad. Several weeks ago, we got a very pleasant surprise when a long-awaited shipping container from Nazarene Hospital Foundation finally arrived. In addition to the much-needed, donated supplies and medications, we also received a HUGE order of new re-usable surgical gowns and linens. The last time our linens were updated was 20 years ago and the patchwork gowns were starting to reflect their age. Thanks to the generosity of many who have donated to the hospital's Greatest Need Fund, we hope to have reliable surgical gowns and linens for another 20 years. I can't wait to see what new surprises are in store this week and this month!

New surgical linens!!!


*If you would like more information on how to aid our work at Kudjip Nazarene Hospital through sending medical supplies or financial contributions, please click the links above. Thank you to everyone who makes our continued work here possible.

Saturday, March 31, 2018


Happy Easter!

Recently, I have been meditating on the song "O Praise the Name" by Hillsong:

1. I cast my mind to Calvary
    Where Jesus bled and died for me
    I see his wounds, his hands, his feet
    My Savior on that cursed tree.

2. His body bound and drenched in tears
    They laid him down in Joseph's tomb
    The entrance sealed by heavy stone
    Messiah still and all alone.

Chorus:
    O praise the name of the Lord our God
    O praise his name forevermore
    For endless days we will sing your praise
    O Lord, O Lord our God

3. Then on the third at break of dawn
    The Son of Heaven rose again
    O trampled death, where is your sting?
    The angels roar for Christ is King.

4. He shall return in robes of white
    The blazing sun shall pierce the night
    And I will rise among the saints
    My gaze transfixed on Jesus' face.

The greatest tragedy has become our greatest victory. Christ has risen, defeated death, and reigns on high. To him be the glory!

"Death has been swallowed up in victory. Where, O death, is your victory? Where, O death, is your sting? The sting of death is sin, and the power of sin is the law. But thanks be to God! He gives us the victory through our Lord Jesus Christ." (1 Corinthians 15:54-57)

May you celebrate victory in Christ this Easter and all through the year!

Sunday, March 18, 2018

World Travelers


After spending a week at Kudjip, Mom and I set out to explore the northern coast of PNG. We flew to Madang on a 7-seater MAF (Mission Aviation Fellowship) plane. In Madang, we met up with some friends from another mission, gathered supplies, and took a 1 hour boat ride out to Karkar, a volcanic island.


The next 2 days were spent relaxing, eating fresh seafood, playing in the ocean, and touring a coconut and cocoa plantation.



Back in Madang, we enjoyed snorkeling and kayaking before heading on to Australia.

In Brisbane, we were blessed to spend time with Mary Lean. Mary, her husband David (a pediatrician), and 5 kids will be be joining our team in Kudjip next year. They treated us like royalty during our time in Brisbane.

After exploring the Southbank with is museums, parks and entertainment venues; mom and I spent a day exploring the Lone Pine Koala Sanctuary.

We enjoyed feeding the wild lorikeets, petting kangaroos and emus, seeing koalas up close and viewing many other native animals such as wombats, platypus and tasmanian devils.
 In addition to the sites of Brisbane, I also enjoyed having some of the conveniences of Western life: stores, restaurants, and TV playing the Olympics! It was an amazing adventure and I enjoyed it while it lasted. However, once I got back to PNG, it was "Back to the Unexpected", as detailed in my next blog....





Thursday, March 1, 2018

A Special Visitor


         Three weeks ago, I had the privilege of introducing my mom to  Kudjip Nazarene Hospital. Mom came for a 3 week visit and the first week was spent in the Highlands. She brought much needed supplies, attended devotions, followed me on rounds, helped in the pharmacy, and watched me interact with patients in the clinic and during surgery. She also met some of the patients who have been mentioned on my blog and in my newsletters.  Throughout the week, She followed several surgical patients during the ups and downs of recovery. Most did well; a few did not –a  true look at life in a missions hospital.

Mom meets the twins!
        Her favorite patient experience at Kudjip was watching me deliver twins by c-section. Mom donned scrubs, mask, and bouffant hat and was carefully positioned in a corner of the room to catch all the action (with the patient’s permission, of course). She watched as we delivered a baby girl, then a baby boy, both healthy. What made this experience even more special was that she met the twins again a week later. On the way to my friend Emelyn’s house for a family meal, Emelyn told us about her niece who was recovering from surgery. It turns out her niece was my patient! Mom was trilled to hold the twins and get the opportunity to share a traditional PNG meal with these special friends.

Hagen Market
        In addition to working in the hospital and meeting my friends and the other missionaries on station, we also explored the surrounding Highlands. The Deuels and I took mom to Mt. Hagen to experience the open-air market.

Rondon waterfall
Then, we stayed the night at Rondon Ridge, perched on a mountain overlooking the valley. There, we hiked to a small waterfall, then found over 20 varieties of orchids along the winding trails of the orchid garden. Some of the flowers were only a few millimeters in size!


Kumul Lodge
Ribbon-tailed Astrapia
      The next day, we drove an hour further west to Kumul Lodge, a popular birding site. There, we saw a dozen different species of birds, including two types of Bird of Paradise: the ribbon-tail and the sicklebill. It was quite a week of adventuring in the Highlands, but that was only the start. In the next blog, we travel to coastal PNG, an island, and then on to Australia…. Stay tuned.


Another Ribbon-tailed Bird of Paradise up-close.

Saturday, February 24, 2018

Not a Fool


Hidden valleys of PNG
           Today, as I reflect upon my one year anniversary of coming to serve at a missions hospital in the Highlands of Papua New Guinea, the words of a recent sermon echo in my ears. Am I a fool? Many people would consider giving up a lucrative surgical career in the US and moving overseas to serve the poor to be foolish. Some would say that risking one's own health or life to serve people you've never met is foolish. A few might even say that focusing on saving a few lives in a far off corner of the world when compared to the global scale of humanitarian needs across the globe is foolish. To many the thought of following the teachings of a crucified, Jewish teacher who lived over two millennia ago is foolishness. The Bible, however, says, "But God chose the foolish things of the world to shame the wise; God chose the weak things of the world to shame the strong. God chose the lowly things of this world and the despised things - and the things that are not- to nullify the things that are, so that no one may boast before him" (I Corinthians 1:27-29)
Loreen receives a Bible
           God loves the poor and lowly and despised. God cares about the lives of people living in far off corners of the globe. God desperately wants to be known by those who are unknown to the world. Time and time again, I have seen God work miracles in the midst of impossible situations. When I am weakest and feel the most foolish, I see God move in mighty ways and all the glory goes to him alone. Just ask the 500 patients I've operated on, or the hundreds of surgical patients I've cared for in the hospital and the outpatient clinics, or the dozens of patients who have experienced spiritual renewal through the work of the hospital in the past year. They do not believe our work here is foolish, because they have witnessed first-hand the power of God to heal physically and spiritually. What is money or fame or personal security and comfort worth in the long run? As Jim Elliot, a missionary to Ecuador, famously stated: "He is no fool who gives what he cannot keep to gain what he cannot lose." Lord, help me not to foolishly cling to the things I cannot keep. If I am to be a fool, let me be a fool for Christ.



SaveSave
Benson, completely healed

Wednesday, January 24, 2018

To God Be The Glory




          


            Last week was exhausting. For three days straight we were overwhelmed with emergencies, traumas and difficult cases, but through it all I saw God’s provision. I especially saw God’s hand at work in one patient, a young mother of 3 who was stabbed in the buttock. At first, we thought the knife had just injured muscle and that we could treat it with local wound care. However, the patient quickly convinced us otherwise when she became hemodynamically unstable and dropped her blood count dramatically. While Dr. Bill and Dr. Mathew worked to stabilize the patient and start blood transfusion, I explored the wound and found it tracked much deeper than previously thought, and that there was a persistent arterial bleed coming from deep near the pelvic bone. In the operating theater, exploration of the abdomen revealed a large amount of blood collecting behind the inner lining of the pelvis: a retroperitoneal hematoma. This brought back memories of a case on my surgery oral board exam of a penetrating trauma to the pelvis with iliac artery injury, so I quickly got control of the major vessels leading into the area before uncovering the injury. Incredibly, the knife had gone through the gluteal muscles, down to bone, through the natural hole in the pelvis (the greater sciatic foramen) and had poked into the side wall of the rectum. The brisk arterial bleeding from deep in the wound lead me to believe the superior gluteal artery, which exits the pelvis through this canal, was severed. 
On a skeleton, this hole is easy to identify, however after adding several layers of muscle and pelvic organs, it is quite difficult to visualize in real life. In the States, we would have performed angio-emobilization: placing a catheter through a feeding artery and injecting coils to stop the bleeding from inside the injured vessel. Unfortunately, we do not have this technology in the highlands of Papua New Guinea, and the only way we could control the bleeding was balloon tamponade. She had already lost a significant amount of blood, so we opted for damage control surgery: leaving the balloon and packing in place, diverting the colon injury and closing up with plans to bring her back to the theater in a day or two.  That night, I read everything I could find about pelvic artery injuries in order to form a backup plan if the balloon failed to stop the bleeding. 
          The next day, our patient was in stable but still guarded condition, so we decided to wait a full 48hrs before re-exploration. In the meantime, we got into trouble with severe hemorrhage during anther case, a cesarean section. All the usual maneuvers were not controlling bleeding from a tear along the sidewall of the uterus going down toward the cervix. Thankfully, the night before, I had read about internal iliac artery ligation to control severe pelvic hemorrhage, and we were able to employ this technique, along with packing, to stop the bleeding. 
Praying in the operating theatre
         The next day, we took our trauma patient, Loreen, back to the operating theater. There was a slight delay, so in the meantime, Auntie Margaret, our veteran scrub nurse and OT team supervisor, chatted with her and found out that she hadn’t been going to church for the past 10 years. After talking with Auntie Margaret, Loreen decided to rededicate her life to God and the two of them prayed right there in the operating theater. 
           After 96 hours, we were finally able to remove the balloon and obtain hemostasis, but only 2 days later, Loreen started exhibiting signs of a pulmonary embolus: a blood clot in the lungs. She had suddenly become short of breath with pain in her chest and an elevated heart rate. I sat down and honestly explained the situation to her: a severe pulmonary embolus can be life threatening, but the medication to treat it would thin her blood and risk re-bleeding from her injury site. We were walking on eggshells. She nodded understanding. Then we prayed for God’s healing touch. She later told me that all day long she felt the pain and shortness of breath, but around 6pm another staff member also came and prayed with her, and almost immediately her symptoms improved. Call it coincidence, call it psychology, but I choose to believe that God miraculously intervened.  
         Many people ask why bad things happen. I don’t believe God causes bad things, but I know he uses them to draw people to himself. Through her traumatic experience and her subsequent treatment at the hospital, Loreen re-established a life-giving relationship with God. She went on to explain that after she was stabbed, she was sure she would die, but she kept hearing the voice of her 7-year-old daughter in her head crying, “Mommy, Mommy”. She looked back on the life of anger and fighting that she had lived and saw where it had brought her.  She realized, through Auntie Margaret’s counseling, that she could no longer go on living this way and that she needed God to forgive and restore her. She now gives God all the glory for saving her life, not once, but twice during this hospitalization and for all eternity. I also give all the glory to God who gave our medical and surgical teams the wisdom, the strength and the ability to care for Loreen the best we knew how, then he took care of the results. In the process, he also showed us how to save another life with the knowledge learned after researching Loreen’s injury.  As the motto of the hospital says: "We treat, Jesus heals." When I trust in my own strength and abilities, I am constantly disappointed by how often I fail, but when I trust God to use me, broken as I am, I see his grace shine forth. Truly, “we have this treasure in jars of clay to show that this all-surpassing power is from God and not from us.” (2 Corinthians 4:7). To God be the glory forever and ever. 

Loreen and Auntie Margaret