A Month to Say Thank You

As we enter the middle of October we would like to say thank you to some special families we know.  Nathan and I both grew up as pastor’s kids.  We’ve seen the high and lows that come with being in the ministry.  We’ve seen the sacrifices our parents have made and the faithfulness of God through it all.  We’ve seen the difference church members make who are not only their pastor’s cheerleaders, but also their partners in ministry.  We’ve seen the wounds that run deep when critics go a step too far.  We’ve witnessed the joys when churches come together to support each other and see lives changed.

Besides being PKs, we have many friends who have pastored.  I hesitate to list them, because my tired mommy brain is sure to forget someone, but I think it’s important for the Vavold family, Martin family, Brown family and Torgerson family to know how much we appreciate them.  We pray for you all often and whether you are experiencing the mountain top of ministry or the valleys that come as well, know that your faithfulness has not gone unnoticed.  Thank you for the work you are doing no matter where you are right now.

We’d also like to say a big thank you to the Johnson family who pastor our home church.  It’s not an easy decision to move from the big city to a small town.  It’s not easy having the full time job as pastors as well as another job to help pay the bills, but it has been exciting to see the spiritual growth.  We are grateful for your willingness to follow God’s call.

We’d also like to thank my parents who are pastoring in Medford.  I am grateful for the extra time we had to spend with you before moving here.  I got to see your ministry through the eyes of an adult and appreciate the spiritual depth you both bring to teaching and worship.  Thank you for your faithful example to following God’s leading in your lives.

During this month of October, and throughout the year, take the time to let your pastor know that you appreciate their dedication.  Be their cheerleader and partner in ministry.

The Lucky Few

Recently, I read a book entitled The Lucky Few by Heather Avis.  If you are interested in adoption or know someone going through the adoption process, it is a great book to read.  Or if you know someone who is living with disability and walking through medical needs, it also is a good book to give you a glimpse into their life.

Heather and her husband adopted three kids, two of whom have Down syndrome (Ds).  And while parts of their story is different than ours, parts of it were similar.  It was encouraging to hear from a mom who struggled with living life attached to a tube (an oxygen tube for her daughter and a feeding tube for our daughter).  She made some of the same mistakes I did and had similar emotions.

I got to read how another family navigates going out in public as a family with mixed abilities and mixed ethnicities.  There are both positive and negative aspects to how conspicuous a family becomes with those dynamics.

Heather spoke about the moments leading up surgery as she entrusted her daughter to the heart surgeon to repair the hole in her heart.  This part struck me in a way I didn’t expect, because I have recently met two mothers who will never experience the hopefully anxiety that comes with open heart surgery.  Two mothers of children with Down syndrome who will not watch their children grow much past infancy or toddlerhood.  Two little boys whose hearts are working over time to keep up with the demands of their little bodies.

Heart surgery takes special training and specialization equipment.  Our general surgeons perform surgeries far beyond the scope of a general surgeon in the USA, but heart surgery is simply not something our hospital can offer.  Had these two mothers been pregnant in the States . . .

. . . they would have had doctors who could refer their boys to a cardiologist and pulmonologist and whatever other -ologist they would have needed to fix their tiny bodies.  But had they been pregnant it the States, they likely would have had an OB/GYN who told them that a life with Down syndrome is not a life worth living.  That there were other options they could choose before these little boys were born.  Their little lives could be terminated when they were most vulnerable.  In a culture where it’s not okay to judge the life of another person, it is okay to judge that another life is not worth living.

How do I reconcile a world where the lack of resources in one country will bring about the death of children while in another country that is rich in resources, the lack of value brings about the death of other children?

At times I want to despair in these injustices, but I am reminded of the hope we have.  That God, through Jesus, is reconciling (restoring) all things to himself (Colossians 1:20).  That He has reconciled me “if [I] continue in [my] faith, established and firm, not moved from the hope held out in the gospel.”  (Col. 1:23)  As I become a servant of the good news of Christ’s restoration, He uses me in these very areas of injustice that weigh on my heart.  And He refines me, helping to strip away my selfishness and desire for ease and comfort.  And despite my fumblings, He can use my obedience to bring restoration and reconciliation in the lives of other.  He has called Nathan and I to be a part of His restoration by providing medical care where there is little available and to welcome children into our family who are so easily disposed of by cultures around the world.  It’s not always comfortable or easy, but there are blessings that come only through obedience.  Blessings we would have missed if we had chosen to walk in fear of the unknown.

“I believe that at some point in our lives each of us has the opportunity to leave our comfortable path and head into the wilderness [with God].  Each of us will at some point hold a ‘yes pebble’ in our hands.  My hope and prayer for all of us is that we will be willing to toss those pebbles into the murky waters and get our fancy shoes dirty in the mud.  My hope is that as we say yes, the ripples of our decisions will begin to form wonderful waves.  Waves, my friends, cannot be ignored.”  Heather Avis, The Lucky Few.

A Message for the Ladies

Last week about 20 of us traveled to a bush church.  When I first heard about going to bush churches I imagined long car trips with plenty of hiking to follow.  As it turns out, since we’re already living out away from the main towns, going to a bush church doesn’t take long.  This particular church was a 20-30 minute drive.

I have two choices when driving off station.  Be brave and drive the roads or be a passenger and get car sick.  This time I opted to drive one of the two vehicles.  There are four P’s that a driver has to be aware of when driving here:

Pigs – There are pigs of all sizes (tiny and huge) along the side of the road.  Occasionally they run into the road.

People – The walkways are right along the side of the road and people often use the road itself to walk on (it’s easier than walking in the dirt and brush).  Little kids often play along the side of the road and will sometimes dart out.

Potholes – POTHOLES would probably be a better description.  There are many and they are big.  You can’t travel 80 kph (50mph) very long before having to slow down for the next pothole.

Police – The police have check points occasionally that need to be stopped for.

When I drive there is one more P that drivers need to watch for.

Pokey Little Beckey – I am getting  better, but tend to be one of the slower drivers on the road.  Thankfully, last Sunday there weren’t any vehicles that pulled up behind me and I wasn’t too far behind Scott, who was driving the other vehicle.

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One of the bridges we drove across and then walked across after the service to play in the river

We arrived at the church a little early and soon had a crowd of kids around to watch us.  Most of them enjoyed having their pictures taken and then being able to see themselves on the camera.  Some of the kids were curious, but shied away from the camera.

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On the way in, our big girl  was disappointed to miss seeing the pigs along the side of the road.  Once we got to the the church, though, she was able to go back behind the building and see a little pig there.

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A PNG couple that attends the Nazarene Bible college near the hospital were the special speakers for the morning.  We all were enjoying the special music they shared so much that I neglected to get a picture of them.  Their as ples (place of origin, hometown) is near the capital city of Port Moresby and the music reflected the area.  He made some fun popping sounds during the songs, which were met by roars of laughter from all the kids in the congregation.

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Recently, I was talking with Dr. Sheryl, who is a surgeon that arrived the same time we did, about how hard it is to see the violence against women here.  A lady will come in after being stabbed by her husband and we care for their wounds, but they often times do not come back for follow up visits.  There’s not a lot of resources for women in abusive situations.  I also recently read this article about PNG being one of the worst places in the world for violence against women.

The visiting pastor had a sermon all prepared, but when he saw how many women were in the church he decided to go a different direction.  I quickly stepped outside since our baby girl wanted to help him preach, but was able to hear much of what he said from just outside the door.  He spoke about the Samaritan woman at the well and told the ladies that they are important to God and He has a plan for each one of them through this church.  In the midst of a culture that looks down on them for being women, it is through Jesus Christ these ladies are given value and purpose.  Towards the end of the sermon I stepped closer to the door to peek inside and saw the front of the sanctuary filled with ladies praying.

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As foreigners we can tell women they have value, but the impact is even greater when it comes from one of their own people.  Please pray for the national church leaders (men and women) as they communicate the good news of Jesus.  Pray that Christian husbands will love their wives as Christ loves the church and their clans will see the difference that this love makes in their marriages.  Pray for the women of this church as they seek God’s direction in how He will continue to use their lives.  Pray for the women in abusive situations, that they can find safety and find hope in Jesus.  Pray for the doctors, nurses and chaplains as they treat the ladies whose bodies and spirits are beaten and battered.

After the service we drove down the hill for a picnic and a chance to play in the river.

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It was quite a steep trek down the hill and going back up was even trickier.

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It was a great morning together and an encouraging time at church.

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A Day in the Outpatient Department – Part 2

On my return to the office a young female came in with pelvic pain that was worse with sitting.  After a brief history she laid down on the exam table.  “Are you pregnant” I asked in Pidgin.  “No,” was her response.  She looked pregnant and had something firm in her abdomen.  Off to ultrasound we went.  Hmmm . . . that’s a head . . .  and there’s a heart beat.  “Yep, you’re pregnant and about 36 weeks.”  “I know” was her smiling response.  Well, I guess I botched my Pidgin on that visit.  I will keep working.

No time to wallow in language doubts I headed back to my exam room.  A middle aged female came in with years of pelvic pain and vaginal discharge.  It did not take long to figure out she had PID (Pelvic Inflammatory Disease) from prior STD exposure.  This is far too common in PNG with promiscuity, domestic violence, and rape.  I gave her antibiotics to treat her symptoms.  Hopefully not too much scarring has occurred and the pain will resolve.

Then the watchman (a friend or family member who comes to the hospital with the patient) of a patient I saw last week came in asking my advice on his esophageal cancer as the patient was too weak to get to the hospital.  “Could your surgeons remove the cancer?” he asked.  Dr. Jim Radcliffe and I explained that the surgery would either kill him or prolong his suffering.  The best we could do was remind him of his hope in Jesus.

Next came a child vomiting water with occasional blood.  He also has watery diarrhea.  Off to the lab.  Mom and Dad return later with the blood test which looks alright.  Medications given for dysentery.  His parents are happy with his care.  His dad, it turns out, is the pastor of a Nazarene church a few miles up the road.   I cheerfully turn to my translator and say “Hey, one of my brothers in Christ.  Can you see the family resemblance?”  The dad and I laugh.  They head home with their fears released.

A new mother with Chronic Migraines, a young man for a school physical, then an elderly woman, deaf and blind from cataracts.  The afternoon was flying by.

I poked my head out the door for the next patient.   “One pela kam” I called.  A 30 year old female stood up and slowly walked down the hall.  She had temporal wasting (loss of muscle and fat), was pale, and moved slowly.  “Man, she looks sick,” I thought.  TB?  She sat down in my room.  “I’m here with a cough, short of breath, my belly is swollen, and there’s something on my back where I was stabbed one year ago,” she says.  She had fluid in her abdomen on exam and a hard mass on her right posterior chest wall.  Cancer.  We made our way to the ultrasound room.  I scanned her back and abdomen.  Liver cancer with ascites (fluid in the abdomen).  I sat facing her and her young husband.  “I am truly sorry,” I said and explained, “You have cancer of the liver.”  I paused as she and her husband sat in shock.  I slowly went on, “There is no cure.”  Tears began to stream down her face and the husband’s face tensed.  I was fighting to hold back the tears as I talked.  “Have you given your life to God and trusted Him?”

“Yes,” she replied, “my spirit is in His hands.”  I asked if I could pray with them.  They nodded yes.  I slowly began to pray in Pidgin.  They headed home to see their pastor and will come back if they need us.  She probably has 3 months or less to live.

No time to morn I moved onto the next patient.  A young man with  seizures. Then an ultrasound  of a pregnant patient that is 28 weeks.  “Congratulations.  You have twins!” I said with a smile.  One of the labor and delivery (L&D) nurses poked her head in the ultrasound room.  “Dr. Nathan we need you in L&D.  We have a laceration that needs suturing.”  No time to celebrate with this patient for now, off to L&D.  And so my day ended.

It’s not always easy but I am thankful for the chance to show the people of PNG the love of Christ.  Sometime that means sharing in their brokenness and pain and other times celebrating life with them.  Sometimes that means using my skills to help ease their suffering or being able to heal them.  Each one of you who is partnering with us through prayer and finances is also helping to treat every person that walks through the hospital doors. Thanks for all you are doing.

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The Two Mr. Js

It can be hard to find balance in what we share on here.  Truthfully, practicing medicine in a developing country is hard.  Little kids die because of dehydration due to diarrhea and vomiting.  If they make it to the hospital soon enough, we can give them fluids and save their lives.  Others times, it’s too late and despite all our attempts, the child still passes away.

Just a couple weeks ago Nathan did all he could far a man in the ER, but the man still suffocated as Nathan worked on him.  Nathan did some research to see what he missed.  Was there something more he could have done?  The answer was that with the resources available here, there was nothing more to be done.  We are one of the best, if not the best, supplied hospitals around, but there are still many limits in resources.

So while, we want to share with you the challenges, so that you can be praying, we also want to share with you the miracles.  The patients who seem to have little hope of surviving, but then we see the Great Physician step in and bring about healing.

Last week, Nathan was working in the outpatient department and saw a man standing with his family waiting to see Dr. Susan.  He looked so familiar, but Nathan could not place where he knew the man from.  After helping another patient and stepping back into the hall for another patient, this man smiled a broad grin that made him instantly recognizable.  Mr J!

A while back we mentioned him on the blog.  He had paralysis that was slowly creeping up his body.  His arms and legs were no longer moving and the concern was the paralysis would reach his chest and cause his lungs not to work.  We did not have the equipment that could breathe for him, so it would mean certain death if that happened.

Despite these challenges, Mr. J always had a bright smile when Nathan walked onto the ward.  And then one day the paralysis stopped spreading.  Dr. Bill explained to Mr. J that it was as if God drew a line on his body and said “Stop here.”  Just before Nathan began working on a different ward, Mr. J was able to move his pinky, which seemed a miracle in itself.  To see that God had healed him to the point of being able to walk into the hospital with his family was an incredible site.

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Mr. J was happy to share this picture to show all those that prayed that he is walking!

You may remember the other Mr. J that we asked prayer for last week.  Nathan came home and said it was worst way to die he’s seen yet.  Mr. J had accidentally drank pesticide and while he was not yet dead, the effects of the pesticide would cause a slow and painful death.  A few days later, Nathan went back to see the second Mr. J and could not find him on the ward.  Perhaps he had gone home, but the more likely scenario was that he had passed away.  On his run Friday morning with Dr. Bill, he found out that Mr. J had recovered enough to go home!  It was such a unexpected outcome when we were almost certain he had died.  Thankfully, Mr. J had quickly recognized his mistake and spit much of the pesticide out.  While it did burn his mouth and throat, it did not cause severe damage to his internal organs.

We are so grateful to be working with the Great Physician.  God can do what we can not and while we do not know why he chooses to heal some and not others, we trust that in both life and facing death, he brings comfort to the weak.  We are grateful he is giving us the opportunity to walk with people here in their joys and their sorrows.  And we so appreciate your prayers through it all.

If you would like to be able to help provide the equipment and medicines needed for the hopstial, please visit the Nazarene Hospital Foundation’s page.  The government supplies available to us often run out and it because of organizations like NHF that we are able to continue treating patients with the medicines and equipment that they need.

Prayer Request

Pesticides are commonly used around here.  Sometimes they are taken out of their original bottle and put into an unmarked bottle.

Yesterday Nathan admitted a patient  that is a member of one of the local Nazarene churches.  Mr. J had been out working, was thirsty and grabbed what he thought was water.  Instead it was pesticide.  I won’t detail what this does to a body, but it is quite painful and often times fatal.  It can take nearly a week before the person passes away.  We don’t know what the outcome will be for Mr. J.  Please pray for him and his family as the doctors are doing their best to help him.  Pray for wisdom for the doctors.

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Nathan’s Notes – Christ is Risen

I walked briskly up the dark gravel road dodging mud puddles heading toward the hospital from our home.  My mind was racing over the scenarios I would find on arrival at B ward.  Minutes before I had received a phone call asking me to come quickly to the internal medicine ward, they were doing CPR on a patient and needed me.  There really is only one way to prepare for this kind of emergency,  to pray.  My pace did not slow down but my mind calmed as I talked with God   With 50 feet left to my destination I could hear the loud wails and knew there was nothing more I could do, the patient had passed away.

I slackened my pace and calmly walked onto the medicine ward.  One of the nursing staff met me at the door and filled me in on what had happened.  Mrs. K, 70y/o female, was admitted earlier that day for an obstructed small bowel.  She then aspirated and fell into respiratory failure and the staff had valiantly attempted CPR.  Despite their care she slipped away.  Would I talk to the family please?

After briefly reviewing her chart I met with the family and explained what had happened to their mother.  Next I asked the family if Mrs K had give her life to Christ and trusted him.  There were affirmative nods all round the large group gathered round her bed.  We talked about how we were sad she had passed away but glad she was now with Christ and that she had no more sickness, or pain, and was happy in the presence of Christ. My heart ached for the family’s loss.  They had not had time to say goodbye given the sudden parting of there mother.  In PNG culture it is very important to say good bye and mend any hurts.  I then prayed with the family in Pidgin and English.

I left the family, signed the death certificate and left the hospital with a heavy heart.  As I walked home alone down the dark road I continued to wrestle with the events of the last half hour.  I didn’t know Mrs. K, but it still hurts to lose someone under your care.

After completing my night’s work I had some time off the next morning.  I was listening to Matt Maher’s song Christ is Risen and reflecting on Mrs K’s story.

Christ is risen from the dead,

We are one with Him again,

Come awake, Come awake,

Come and rise up from the grave.

O death, where is your sting?

O hell, where is your victory,

O church, come stand in the light,

Our God is not dead, He’s alive, He’s alive!

 

O death, where is your sting?  The heaviness was replaced with joy.  In the midst of pain and death, there is hope.  Our God is not dead, he is alive!  He’s Alive!   Happy Easter.

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Sunset at the hospital

Nathan’s Notes – Day 1

It was a beautiful March morning in 2017 as I entered B ward of Kudjip Nazarene Hospital.  The sun was softly streaming through giant windows.  The walls were a clean white.  On the nurses station was a sign “We treat, Jesus Heals.”  Thirty some patients were patiently waiting to see one of the two teams of doctors.  Today was my first day on the ward and I was working with Dr. Bill, a long time physician at Kudjip.  We began examining patients and talking about their treatment plans and progress.

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Our first patient had altered mental status with episodic fevers.  His presumed diagnosis is Typhoid with improving encephalopathy (infection of the brain).  We are encouraged as family has noticed he is acting more like himself.  My mind is racing.  “Typhoid?  I think the last time I read much on this was medical school 11 years ago.”

The 2nd patient has a diabetic foot ulcer after stepping on a nail.  Looks like he needs further surgical detriment to remove the dead tissue around the wound.   Okay, I’ve seen a lot of this in rural Oregon, but how do I counsel a low sugar diet in a country that is totally carb based?

The 3rd patient has fever of unknown origin.  We think typhoid but the test we have to confirm this is very unreliable, only slightly better than a flip of a coin.  She is possibly improving.  We will check a blood test and get a follow up chest X-ray and reevaluate later.

Forth, another possible typhoid and, no, typhoid is not an epidemic, this is typical life in the highlands.

Fifth, liver cancer.  We are trying to make him comfortable and get him home.  We will talk with the chaplain later today.

The sixth patient has ascending weakness.  We think post viral.  Could be Tb of the brain but we have no CT machine to evaluate this.

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In spite of challenges, he greets Nathan with a smile every morning

Next, the seventh patient has HIV and dysentery (bloody diarrhea).  Presumed opportunistic infection.  Symptoms slowly improving.  Hopefully we can get her well enough to get on some meds for her HIV.

The eighth patient has TB  and seizures.  Unclear if the seizures are from his TB or his medications or both.  Seems to be doing better on his new anti seizure medicine so we will monitor a little longer.

And the ninth has weight loss, with presumed adrenal insufficiency and TB.

I glance at my watch its only 9:30AM.  Most of the problems I’ve seen are rare in the USA and would not cross my mind in evaluating a sick person in Oregon.  And so the day went, one new problem after another.  “We Treat, Jesus Heals.”  We do our best to help each patient and share the love and hope we have in Jesus Christ.  Some patients will get physically better and others won’t.  We pray all learn of and see the love of Jesus.  Only in Him can we hope to truly heal the broken.

Club Foot Clinic

 

Ryan’s family (not his real name) travels for over an hour to bring him to see Dr. Andy.  He was born with club foot and if left untreated he would have to learn to walk the mountain trails walking on the sides of his feet.  And he would not be allowed to marry, all because of a treatable condition.

Andy and Judy Bennett have been serving here in Kudjip for well over a decade.  In that time they started a club foot clinic, together helping children born with club foot receive the treatment they need to be able to lead a normal life.  On March 19 they left Kudjip, headed for the States and then on to another country to work.  Everyone gathered at the circle in front of the hospital to pray for them and see them off.  It was a bittersweet time, to know God has exciting plans for them, but they will be greatly missed by everyone here in Kudjip.

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Waving until their vehicle is out of sight

The final two Fridays the Bennetts were here, Nathan was able to work in the club foot clinic with them. This gave him the chance to meet the children and get more hands-on experience in treatment as he prepares for future continue the work the Bennetts began.

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Dr. Andy and Judy are now gone, but Ryan will still be able to receive treatment.  As God has led us to walk the road of disability in our own family, he is now opening the doors to minister to other families touched by disability.  Because of our faithful prayer and financial partners, many more children will continue to receive the gift of walking in the years to come.

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In Silence

Statistics.  Our culture knows statistics.  There are numbers for how many births every year and what the most popular names for those babies were.  Numbers for how many deaths and what was the cause of death.  Everything is documented.

It’s a different story in a very rural, developing nation like Papua New Guinea.  PNG has one of the highest infant and maternal mortality rates in the world, but any statistic you find would likely not show the whole picture.

“People live and die in silence,” said Dr. Scott while giving a hospital tour.   No statistician keeps track of every birth in the Jimi Valley.  The man who died in the Sepik Province is mourned by his family, but his death by cancer is not added to the total tally.

But it is these individuals that matter here at our hosptial.  Each person is given the best care possible.  Each person has not only their physical needs cared for, but they are treated with dignity and respect.  The people of the country know this is true and will often travel for hours or days in order to be seen at Kudjip Nazarene Haus Sick (Hospital).

It is not in silence that people live and die here at the hospital.  It is surrounded by those who see God’s imagine stamped on each life that walks through the doors.  Would you pray for the nurses, doctors, administrators, maintanence staff and others as they give the best care possible with limited resources.

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On the pediatric ward