Dominican Republic: A week to remember

The first thing I felt was the heat and the humidity. The second thing was the sense of anxiousness that something was going to happen. The first was real, the second would eventually come. Tracee, Lauren, Shelby, Deanna, Krystle, Jessica, Sue, Kelly and I arrived and met with our local team members, headed by Dimas and the week began. In five days we saw just short of 2000 patients, traveled to 5 outlying projects, some as remote as dirt roads, no electricity, and little tin shack houses. The heat was unbelievable, the humidity sticky and unrelenting. But we prevailed.

We saw and treated many different types of diseases, from parasites, to flu, pneumonia, arthritis, breast cancer, HIV, and just old age. Each of us had our own experiences, shared and some not shared. What we did feel was an unrelenting need from the people we treated to be heard. Simple. But not really. With hundreds of patients waiting to be seen, and the heat taking its toll on us, the pharmacy backing up, running out of medicines, dealing with issues in Kenya, Ethiopia and Swaziland by emails coming through on my phone, it was a difficult task. This little 4 year old boy, mentally handicapped was brought to us by his father, also mentally hadicapped, and was the boy's only caretaker. All he wanted to know is if he was doing a good job taking care of his little boy. To this little child who was born with her intestines hanging out and the local physicians telling the mother that they could do nothing until the child was much older. And the child living with this everyday, on the edge, waiting for the loops of intestine to twist and get infected, when it could have easily been fixed at birth. There was not much to do for these 2 patients we saw, other than to listen. And it was like that for many. Simple complaints of "cold and cough", when really all they wanted was to have someone tell them that they were well. And we did that. Over and over again, almost 2000 times, with smiles on our face and love in our hearts. We were there as servants. And I for one am glad that we were. There was no better place to be in the world at that time, then to be there. With them.
And then on the very last day, at almost the very last hour of our time in clinic for the week, we saw this patient. He was having a severe anaphylactic reaction. His airway began to close, his eyes swelled shut, and he was going down. We always prepare for things like this. Krystle gets an IV in before we know it. Benadryl is given, albuterol nebulizer is administered and an epi-pen is thrust into his thigh. Without any of that he would have died. Period. And after we caught our breath, we wondered why. Why did those particular people who we saw come to us, why did we do the things we did, and why did the memories we form, happen. We didn't ask for them. They came to us. We went and it happened. And that's how it is every time we go somewhere, no matter the country. There is a purpose, a happening, a moment, that was there for us. A learning experience, a move towards getting us closer to what we believe in, a time for us to again remember who we belong to. And that is always alright with me as I need constant reminding, simply because it helps me feel that He is always with me. And that is the third feeling I felt on this trip. And still feel it. Do you?

In all things give thanks,

David

Ethiopia July 2008: The days that followed...

It's been several days since I've been able to put anything down in writing. We have been traveling, working, and being exposed to a different way of life, a different way of looking at how people are treated and how people live. We've seen everything from the ordinary, to the extraordinary and beyond. There have been moments of confusion, happiness, frustration, and wonder. We've seen children who are so malnourished that they don't even measure on our growth charts. We have seen poverty that is indescribable, and beyond description. We have seen people who are so dirty that their skin is not even visible. We've seen deformities, untreated injuries, and birth defects. We have seen babies suckling at the breast crying because there is no milk to be had. And we have seen the smiles on the faces of those whom we helped. It has been a remarkable few days.

We have seen an amazing amount of patients, averaging 350 to 400 patients a day. Our dentists have been averaging 80-100 patients a day. The actual number of patients we've seen so far doesn't really matter. Its how they've reacted to how we've cared for them that makes a big difference. There are patients for whom we've not been able to help and there are those for whom we've made a difference. The pictures speak for themselves.

A few days ago we split the team into two sending one team to Zeway and the other team to Bahir Dar. Each team saw over 300 patients in the two half days of clinics that were held. The team that went to Zeway drove by bus for several hours, and the Bahir Dar team flew. There was time for some sightseeing, and for reflection. But most of the time was spent doing what we came to do: to see those who sought our help, physical and emotional and spiritual.

Yesterday we went to a project in the outskirts of Addis Ababa called Kotebe. Again, we saw extremely poor and isolated human beings, living day to day with nothing but the clothes on their back and existing on an occasional meal of bread. And today, in stark contrast to what we've been seeing, we met with the President of Ethiopia, exchanging "thank you's", us for the privilege of being here in his country and him thanking us for helping. The pomp and circumstance of the event was interesting at best, but cemented for me the vast differences that are evident within a social structure in a Third World country. For what it's worth, the President of Ethiopia heard that we were here because of the healthcare needs of an impoverished lower class and all I can hope is that he felt some discomfort with the fact that people from another country had to come to his country to care for his own people. I am perhaps a little cynical, but after all that we've seen in the past few days one can only wonder how those behind those palatial walls can rest comfortably at night knowing that just outside their gates are children who are dying of starvation, and mothers struggling to find a meal for their children. But then again I look at our own circumstances in the United States and know that there are those who sit behind palatial walls knowing that just outside their gates there are poverty-stricken areas of urban cities, the Appalachia's, and the ghettos, where the human existence and suffering is no different than what we are seeing here.

These have been difficult days, at least for me. I see the unwashed and hungry children in my mind every time I close my eyes. And I see the hopelessness in the eyes of those who came wanting more than we could give them. The last patient I saw in Bahir Dar was an old man of 90 years. He was walking hunched over with a walking stick, blind, and alone. A stranger had brought him to us. He sat next to me and as I held his hand, he told me he was blind, he lived in the street, he had no money, no family, and that he was hungry. I asked him how I could help. He looked at me through eyes that hadn't seen life in years, and said quietly, "Can you help me die?" I never answered him. I didn't know how. I simply held his hand and kissed his cheek and said a silent prayer. He was a Muslim looking to us for help. As I watched him walk away I wondered whether I fell short of what I came here to do. To show those who are hurting that there is still love to be had. And I will wonder for a very long time, if he ever got over wanting to die. I can only hope.

In all things give thanks,
David

Ethiopia July 2008: Eyes and hearts open

He came to the clinic because his friend told him that there was a medical team from the US at the place that he goes as a sponsored child of MoM. Elyas is 14 years old and more mature than many his age. He presented with a severe body rash, scalp sores and general malaise. He shared that his parents had died of HIV 2 years ago and the he was being cared for by his grandmother. He told us that he was taking a lot of medicines for he thought was TB and bad pneumonia. His story is one that may stay with you for awhile.

He had gone to a local health clinic a year ago because of some sores on his leg that would not heal and when he told the doctor that his parents had died of AIDS they sent him for some "tests" and soon after started him on "a lot of medicines". His grandmother told him he had a bad form of TB and pneumonia and that he would have to take medicines for a long time and if anyone asked that is what he had. He was walking down the street one day when he saw some beggars holding vials of medicines in their hands and slips of paper that said what they had and that they were dying and need money. Elyas recognized the vials as the same ones he had, and went to one beggar and read his paper: "I have AIDS and am dying." Elyas finally knew what he had. He found out from a beggar. He told his grandmother who told him again that he still had to tell people that he had a bad form of TB and pneumonia or people wouldn't want to be near him and that he would wind up a beggar like the others.

He wouldn't tell us in the beginning, but after we spent some time with him, he told us his story. You have to wonder how a 14 year old boy deals with this every minute and every day of his life. He has few friends, he is physically ill, and his skin is almost difficult to look at if your not open to things not normal. He found trust in us and we are taking care of him. I put him in our advanced care follow up program and he will be cared for everyday by our MoM staff here in Addis.

We have our eyes open here, looking, seeing and remembering. Elyas opened our hearts and made us realize what type of world is just outside our own comfortable and familiar neighborhoods. He doesn't have to worry anymore about being shunned or dehumanized because of his disease. We'll help him undestand this. He learned from a beggar that he has AIDS. He learned from us that he is loved no matter what.

In all things give thanks,
David

Ethiopia July 2008: The first few days

And so it began. The full team arrived, and within eight hours after having a few hours of sleep, the team began to get ready for a week's worth of clinics. Most of the medications arrived all of which needed to be packaged and labeled. And this was all being completed just as the clinic was starting. The first day began with everyone getting used to their areas of responsibility and assignments as the patients came in. Everyone became more comfortable with what they needed to do by the end of the first day. We saw 408 patients and the dental team saw 72 patients. On second day we had a wall of massive patients in the clinic area with rain falling outside and controlled chaos on the inside. By the end of the second day we had seen 512 patients and the dental team had seen 88 patients. For the first time on our medical mission trips we had a dental team led by Dr. John, who is with World Dental in Ethiopia. He had with him for local dentists who practiced with him and will be traveling with us as we go up north. In addition, we had lab technicians, nurses, and 10 local physicians, who joined us at various times with specialties ranging from general pediatrics to internal medicine, nephrology, cardiology, and ophthalmology. We started our Rapid Nutritional Assessment program as well, and have generated valuable information regarding the nutritional status of the children using WHO standards. We are now able to recognize those children who are mildly, moderately, and severely malnourished. Pharmacy has been expertly run, and is also staffed with an Ethiopian pharmacist and Ethiopia pharmacy student. It is always an incredible experience to work side by side with the local healthcare team as we care for the forgotten children together. We leave tomorrow for remote areas half of the team traveling by plane to Bahir Dar and the other half of the team traveling by bus to Zeway, where both teams will spend the day doing clinic's, spending the night, and then doing clinics the following day before returning to Addis. All in all, the first two days have been rewarding, gifted, and blessed.
In all things give thanks,
David

Ethiopia Medical Mission

I am in Chicago awaiting my flight to Frankfurt then on to Addis Ababa, where we will be having our first medical mission in Ethiopia. It was just 6 months ago when I did an assessment trip there, and on Wednesday, we will begin a 7-8 day run of clinics in Addis, Zeway and Bahir Dar. We will be splitting the team up in order to go to 2 different locations outside of Addis. Remote is remote...

Troy, Colleen, Kelly, Placida, Dawn, Donna, Shauna, Jessica, Michelle and I make up the US team. We will be joined by 3 dentists, 1 nurse, 1 pharmacist, 8 physicians and 6 support people from Ethiopia. This will be an incredible "team"! There has been a lot of ground work done by Getachew and his team for weeks now, and he has done a tremendous job! Peter, my old friend who has been with me on many tirps is there now putting the finishing touches on eveything. I am not travelinbg with the team due to being on call, etc, and will get to Ethiopia a day early to have meetings with a food supplement organization, and to give an orientation to the Ethiopian team.

We are expecting to have a unique experience. There is alot of siginificant and severe malnutrition there and malaria seems to be prominent. What else we'll see and do, has yet to be realized. It will come and it will happen. Be with us...

In all things give thanks,
David

Kenya Assessment Trip May 2008

There is always a story, always a happening that stays in one's mind after a trip. Kenya lent many of them. I spent 6 days traveling to the northern part of Kenya to an isolated area called Lokori, which is just south of Lake Turkana, and then traveled south to the small communities of Nahipai and Emarti. My hosts and friends, Hapi and Nicholas were with me the whole time. Hapi is the field project manager for MoM in Kenya and Nicholas is his right arm man.

We began by traveling with MAF. Driving to Lokori would have been a 16+hour drive, usually done in 2 days, and the road is patroled by bandits. Flying took us 1hr and 40 minutes. David, our MAF pilot and I flew up to Lokori and landed on the dirt strip next to the isolated village of Lokori. Truly some bush flying, and again my thanks to MAF and David for allowing me to do some of the flying. We pilots will fly anything anywhere. We were met by our Korean missionary hosts who oversee our MoM children in 6 villages in the area, Sungi and Pastor Daniel.

Lokori is a small village community that has surrounding it 6 smallere remote and isolated villages. We have about 700 MoM children in the villages and access to them is by 4 wheel drive all nito the bush. The Turkana comunity are for the most part herders and their dress is spectacular!


I must emphasize how remote we are. At Pastors Daniel and Sungi house, there is solar panel electricity for about 2 hours at night, water from an outside tank, and modest toilet facilites. But outside of that, there is nothing. And that is where we are going. We traveled south and visited several other areas where we have Mission of Mercy children. Emarti is an isolated village in the bush south of Nairobi, and a water project had just been completed, which we were fortunate enough to dedicate. The local dress is different from the Turkana tribes and we can see the unique differences in the health care of the children. Families live in huts made of mud and dung and are truly small with a small fire always burning inside. The family lives within this isolated area inhaling smoke constantly and for that reason, upper respiratory tract illnesses are commonplace.
On a visit to the local healthcare facilities we came across a unique and extremely progressive rehabilitation center for physically disabled children. There were approximately 70 children who lived there, and were receiving physical therapy, occupational therapy, and prosthetic devices that served to improve their lives. We established a relationship with them as Kenya was the first country that I have assessed that had a large number of children with special needs. One of our future efforts will be to establish a special needs program for those children who are part of MoM.
The pictures speak for themselves. We saw many things and witnessed incredible isolation, thirst, hunger, and significant illnesses. The country is beautiful. The people are beautiful. And the children I can assure you will not be forgotten.

In all things give thanks,
David

Swaziland Medical Trip April 2008 Team

The team at work!!!

Swaziland: Advanced Health Care Worker course April 2008

25 teachers from the Care Points and Mercy Centes attended the Advanced Health Care Worker course. This was the advanced course that I developed in additon to the Basic course that I give in differnt countries. The first day was a advanced anatomy and physiology. I held a show and tell dissection lab in the afternoon: we got a cow's liver, an oxen's heart, and an oxen's kidney, and I dissected them showing them heart valves, the inner workings of the liver and the kidney. Then when I was done, the students took the organs outside, and cooked them...and then ate them! Try that in the US!

The second day was all advanced disease recognition and algorithms. Peak Flow meters were donated to us and I showed them how to use them and then we used them on the children. Asthma is a big problem in Swaziland. The third day was basic pharmacology of antibiotics and we finished up with cases.

We now have 25 teachers who are trained on disease assessment, recognition and basic treatment. They will serve as the first health care line caring for the children at the Care Points and the Mercy Centers. This will insure that children will be cared for before they get sick so they can grow spiritually and with His love.

In all things give thanks,

David

Mozambique Assessment April 2008

Soon after we finished the medical clinics, I took off for Mozambique with Daren, Teresa and Jason to assess the medical needs there. The drive was 4 hours of beautiful scenery. We arrived and went right to work. Isaac and CArol the missionsary couple with Healing Place Church/Children's Cup have done an outstanding job in getting things going there. They set up a small room in the church to serve as a mini-clinic and stock it with medications. A Brazilain doctor with the Baptist ministry (Maria) comes once a week to see the children. I was very impressed with what they have done so far. The local government health care post where people go for care was dismal. But the government hospital that children get referred to was awesome! A seperate 32 pediatric ward, and a playroom!

The over all healthcare of the children is marginal at best, with malnutriton, malaria, URI's, and diarrhea the common casues of death and morbidity.With time, we'll have the children looking fat and healthy!!

As for us, we got stopped late evening by a group of "police/soldiers" who were loking for anything they could to get us. 3 of them with AK47's flanked the left side of our SUV while 3 of them on the right, talked to Daren telling him we had violated some law (passengers not wearing seat belts). After some "discussion" we paid them off (about $80) and they let us go. You never know what's going to happen next on trips like these.

In all things give thanks,

David