Nepal Day 5

This climb was difficult at times with several moments of questioning why we do this. The last day of clinics was for me the hardest, as we saw several children for whom we could do nothing. The very last patient of the day came to me. An 18 month old little girl, with a large head, who hadn't started walking yet, was carried by her mother who wanted to know why. She had been told by a physician a few months back when she took her daughter for her immunizations that all was well. She clearly was not. This little girl has hydrocephalus ("water on the brain") and without surgery she will pass soon. Sharing bad news is something that I do as a critical care physician. Sharing bad news through an interpreter to a mother who for the first time is hearing that her daughter will need surgery or she will pass is hard. The father is a "drunkard" - her words. He was there as well and looked shocked as I told the news. You are probably asking why then don't we just give them a handful of money and send them to a hospital, get the surgery and all will be well. Because, there is much more to just doing that. Follow up, rehab, high chances for infections, even higher chances for a need to revise the device that is used to control the hydrocephalus, additional costs, etc. They live far from Kathmandu, no money for transportation to get back and forth for the frequent visits needed to the hospital, no means of transportation. Do  you see the dilemma? When I think of our sponsored children, we have a way to at least address issues like these. We have in place a medical referral process that allows us to look at every case, see if we can help financially and for the most part, we can with certain limits. This little girl was not sponsored. A few days ago a mother and her 2 daughters came to clinic. Their father had passed away a few months back. They were emotionally drained. We were fortunate to have a child psychologist (Dr. John) with us who did a wonderful job counseling them. Pastor Michael did a great job with the spiritual side. Our team is made up of many different people, each with gifts and talents that God has given them, and together we serve. There were many more good things that happened on this trip. We identified numerous serious illness and started therapy that made a difference. We held the hands of those who were hurting. We prayed with and for those who asked. We reached the "summit", the goal of why we came here: to serve. We finished the 5 days of clinic having seen 1200 medical patients and 175 dental patients. The 26 members of this team gave and gave some more. 22 members from the US and 4 members from our India OCM office: Kelly, Sara, Anne, Aimee, Olivia, Kristen, Joshua, Charlene, Michael, John, Carol-Lee, Susan, Darlene, Carol, Dave W., Robert, Diane, Jeremy, Dave J., Leeanne, Placida, Janak, Sudip, Judith and Kevin. There is so much more to do here. Sustainable healthcare – not so much yet. We brought water filters and showed them how to use them. Clean water now. We brought first aid kits, showed them how to use it and left them. We did dental hygiene education, and more. It's a start. We reached the "summit" but I'm not ready to raise the flag just yet. We need to come back and make the climb again. And maybe again after that. Thank you to the team for all that you gave and sacrificed. It was a privilege and blessing to have made this "climb" with you.

In all things give thanks,

David

Nepal Day 4

About a 45 minute drive outside of Kathmandu, we found ourselves once again in a fairly remote area, and requiring a 15 minute trek to the project. No worries there. We walked single file exchanging hellos with the wonderful people of Nepal, passing stalls with fresh meat laying on tables that had been there for days, flies everywhere, vegetable stalls, small kiosks of different wares, and people just sitting in the street living life. A life that was simple yet hard. For all of that, they seemed pleased with who they were and with what they had which was nothing much, but to them it was everything and that is all they needed. We on the other hand see things differently. We saw people who were poor and living in places we wouldn't or couldn't even imagine living in. We saw people smiling when we would have been crying. We saw children playing with no shoes on, dirty, torn clothes, yet laughing and having fun no different than any child who would be in a developed country. And we wondered how and why all who we saw were at peace with who they were and with what they had. I think I figured it out. It's because they know nothing else, and are content with having just what they need and nothing more. I wish I could be like that. 

The project we went to was a school, a nice school with relatively new buildings, children in uniforms, teachers who were well versed in their roles, and a wonderful place to grow and learn. My assessment of the children: health – good; emotion – good; outlook on life – good; relationship with God – good; nutritional status – good. OCM's children are thriving here. A balanced meal every day, teachers who care, a focus on God and a school mission of teaching children to learn and embrace life. At the end of the day, they sang for us, clapped in thanks for us begin there and high fived us a s they passed us by on their way home. 

We had climbed up another few thousand feet on our trek to our summit of improved health care for the children and a summit for them to begin to able to look out over the world and say "yes this is mine and I am healthy enough, knowledgable enough, and spiritually filled to go out into this world and live a life that is full and not be hungry, dirty, and sick." 

In all things give thanks,

David

Nepal clinic day 3

There are times when we wonder if what we do is worth it all. There are times when we realize that no matter what we think, life brings about a joyous moment. Here is a letter written by someone who has been sponsored the last 13 years. I need not say more after today's clinic. We are blessed.

"Dear Sponsor,

I am 18 years old and live in Nepal.  You have sponsored me since I was 5 years old.  Many things have happened in my life since you chose to help support me.  I now know Jesus, I am about to graduate and go on to college in computer science and I now volunteer teach computers at my school.  None of these would have happened were it not for God using you to help in my life.

I want you to know that I have kept every letter and card you have ever sent me.  What you have sent, I will treasure for a lifetime.  The best was that you gave so that I could be a man. You have prayed for me and even sent clothes for my mother.  I keep your photos and pray for you.

You see, my mom is my only parent, we are very poor, and she works in a hotel making just enough to pay our rent and food.  What you have done for my family has shown me one very important thing: in your eyes and in God's, one child really does matter."

Sincerely,

Bijay Tamang

Nepal Day 2

The rising sun brought those who were going to the base camp on Mt. Everest to a gathering place where they awaited their ride. 17,500 feet which they would reach in 4-6 days depending on their strength and endurance. Then another 10 days to 2 weeks at the base camp getting acclimated to the altitude in preparation for the trek to the 29,300 feet summit. They wait for a "window of opportunity" in the weather where they have 2 weeks to get up and back. I am in awe of their fortitude and determination. At the same time those of us who were going to a project to hold our medical clinic gathered in a place to await our ride. A 30 minute ride to the project, a full day of clinic, children a little sicker than we saw yesterday, and I am in awe of the team's fortitude and determination. Two very different purposes, two very different destinations, and two very different goals.We "acclimate" not to altitude, but to the poverty that we see, to the malnourished children, to the sense of hopelessness that sometimes covers the faces of the mothers who have little to care for their children. We approach our "base camp" no differently than the trekkers. Slowly, methodically, sure of every step, making every thing count in order to reach our goal. We had our own trek. We walked about a half mile today into the project and again back out, carrying all of our supplies. No "sherpas".This little girl in the picture perhaps gives you a sense of who we cared for today. We treated children with asthma, pneumonias, and ear infections. We saw children who were stunted, short for age, as a result of being malnourished. And those children will be vulnerable to chronic illnesses and a short life span. Our sponsored children were seen, given the best we had, and for that they have been given a chance to reach the "summit". The summit of making a life out of nothing and being able to breath without coughing and wheezing. As for us tonight, we rest, and prepare for tomorrow, becoming more acclimated to what we've seen and ready for what will be seen tomorrow. Nepal is a beautiful country. The children are uniquely beautiful with facial features and smiles that radiate. I'll sleep a few hours tonight and wait for the rising sun and gather to a place in the morning where we will trek to the next project. A few thousand feet more and we are closer to the top: healthcare for those who need it the most.

In all things give thanks,

David  

Nepal Day 1

When nothing happens out of the ordinary, one wonders what went wrong. And that is just what happened today. This was probably the best first day of clinics we've ever had in all the trips we've made. Easy setup, smooth flow, patients seen, changes made without questions, and 200 patients seen with time to spare. Well, there were a few glitches. No electricity, no generator, therefore no power to drive the drills and power tools the dentists needed to do their job. They improvised all the same, and teeth got pulled, repaired, beautified and cleaned, and all was good. The children were relatively healthy with a few falling outside the norm, but were easily attended to. Several children caught our attention: a 10 year old girl with a hear murmur who was told she needed surgery at the age of 2, and got lost to follow-up, only to return today, 8 years later wondering if now was a good time to get the surgery done. Nope, wouldn't happen, not today, not tomorrow, not any time soon. A 10 year old boy shows up in a wheel chair with a mechanical brace on his right leg. History: hit by a motorcycle 1 year ago, some type of surgery was performed, the leg put in this brace, and now a year later, having not walked all this time, asked us to fix it so he could. The leg was misaligned, turned inward and would need a competent orthopedic surgeon to make things right. Out of the blue, an anesthesiologist who also happened to be the director of a private hospital close by, comes for an unannounced visit, and offers to have an orthopedic surgeon see the child at no cost. Go figure. So we started the "climb", got a few hundred feet up the mountain, and there we sit until tomorrow. Then up we go. Serving those who come to  see us.

In all things give thanks,

David

Nepal Day 1 in the middle of the night

Sleep is elusive. It's 1am here in Kathmandu, and the mind is racing, the emotions surfacing, the fear of the "mountain" is there. We arrived after 48 hours of travel, tired and with all our luggage and the medications, supplies and equipment. We rested, got to know each other, had fellowship and had our orientation, getting ready to start the "climb". I asked the team to reflect on the question of "why". Why are we here, and why did we chose to do this. Many have asked me "what" Medical Mercy does, and that is easy to answer. We bring needed healthcare to the children who need it. I am then asked "how" do we do that. That is easy to answer as well. We hold medical clinics, we build medical clinics and staff them with nurses and local doctors when we can, we train local teachers to become healthcare workers so they can continue to deliver needed health are, we teach first aid, we show them how to filter their water, we show them how to brush their teeth, and we show and teach them good hygiene. But the question I am rarely asked is "why" do we do what we do. Few really want to know. They are more interested in the "what" and the "how". Both are more tangible, easier to get their minds around. So when I'm asked about the "what" and the "how", I wait for the "why" and if it doesn't come, I offer it. I've asked the team to reflect on the "why" this week. I've asked them to be prepared to answer the question if ever asked. I have my answer. It took awhile, but it is there. It's solid, indisputable, non-negotiable, never needing defending, and personal. It is what gives me the strength to climb this "mountain" this week, this "mountain" of long days in clinics, sick children, at times frustrated because we can't "climb" higher because we just can't, and the slow trek upwards of making a child healthy enough to be able to smile and not feel pain. I have an answer as  to "why". I'll share it with the team at the end of the week , and trust that the team will share their answers with me. We may find that we all have the same answers to the "why". We leave in a few short hours for the "base". I need to get some rest, and prepare for the "climb". But before I do that, I'll spend a few minutes talking to someone who knows me and what my reasons for "why" are. He's the answer you know. 

In all things give thanks,

David

Nepal and the mountain.

In two days, we leave. A mountain that has claimed many lives and has given many more the satisfaction of beating it, beckons us not to climb it but to wonder in awe how magnificent it is. Children beckon us as well. Children who are cared for by loving teachers and pastors. We will also wonder in awe how beautiful they are, how innocent they are and how much they need. We will be there to run 5 days of medical clinics and to bring a sense of calm to the illnesses that the children have. We make no pretense of being able to climb the mountain of sustainable healthcare and perfect nutritional growth just yet. The 22 members of the US team have been preparing for this climb, this trek. We have been in prayer, we have had many many emails back and forth, we have had set backs, roadblocks and yes even a slip or two down the side of this mountain. Not too far, but far enough that we've had to climb a ways back up. But no worries here. As those  who begin the climb of Mt. Everest, so too will we begin the climb of daily clinics, seeing as many children and adults as is meant to be. We will go slowly, methodically, carefully, taking each step with determination, comforted in the fact that we have the best "guide" with us. Him. 

In all things give thanks,

David

Swaziland Day 5 wrap up

We did it. Final day of rain, wind and cold, over 150 patients seen in about 4 hours and things buzzing with activity. We finished the week seeing 1111 patients in 5 days many of which were cut short or started late because of the weather. After all was said and done we saw who we needed to see and more. The team worked tirelessly and we saw children with illnesses ranging from pneumonia, simply infections, to complex illnesses, and some significant illnesses which required referrals to advanced healthcare facilities. There was one day when we came across children who had no shoes and had no decent clothing who were shivering in the cold and the rain and wind and team members took off their own socks and gave them to the children in addition to shoes that have been brought over by a team member. Any clothes that we had on were also given to the children that we thought would help with the cold. The team members were servants above all. This trip that was not meant to be for Swaziland but Zimbabwe, turned out to be one of the most powerful trips that we have done in a long time. The children needed us, we needed them, and without the incredible help, guidance and support from the Swaziland home team we would not of been able to do this. Our thanks to them. Internet has been lacking and again I can only post a short message with one picture. I am currently on my way to Mozambique to see how our almost 700 children are doing there, to be followed in two days by a trip to Zimbabwe. As for the team we parted ways this morning with their return to the US and my utmost gratitude and thanks for their sacrifice for all that they did. The stories that they have, the relationships that they developed with the children, the things they saw, the things they heard, and the things they did will stay with them and with the children to whom we came to serve for a very long time. There's nothing more rewarding than following God's will.

In all things give thanks,

David

Swaziland day 4

About 2.5 hrs north of Mbabane, is a small project, isolated, on the border of Swaziland and Mozambique. Rain continues to disrupt an even flow of children in the clinic, but we manage. Poor is poor. The children are well cared for but still are in need of more. Barefoot, cold and in tattered clothes, they come. They come for their meal that sustains them for another day, and a night of sleep. I wonder how 1 billion dollars is spent on a presidential campaign, most of which is donated money, when that 1 billion dollars could make a difference in these childrens lives or in the lives of the many children who are homeless in the US. I see the faces as they look at me, and wonder what they are thinking. I hope it is a thought of comfort knowing that we are there for them.
Internet service is out so a short blog and pictures. I know you understand.
In all things give thanks,
David

Swaziland day three.

Rain. Lots of it. We were in a remote area, working under a big tent, and the rain came. And the thunder. And the lightening. Metal poles were not our friend. We collapsed the tent, ran for shelter, kept seeing patients under flashlights and in a crowded room. About 100 people in there. We did what we could. Medical Mercy at work because one child matters. (Internet out. Still using my BB)
In all things give thanks,
David

Swaziland day 2

A place far from the main city finds a small project with 150 children. A somewhat slow day, leaves us moving through the patient load easily without stress and able to spend time with our patients. The children are anxious for attention, going from one of us to another, looking for and receiving hugs. We look to their faces as they sing, seeing happiness despite the lack of comforts as we know them, and I wonder if we should look at ourselves once in awhile and see if we truly need all that we have.
Internet service is lacking still so a single picture and a small token of an update typed on my BB. All is well. The team is cohesive and working in unison, the purpose evident.
In all things give thanks,
David

Swaziland Day 1

No internet service. I'm emailing this from my BB to my blog address so it is short and limited. Not even sure this will get out. We went to the very first project ever opened years ago and where we had built out medical clinic over 5 years ago. 307 patients were seen after a late start. A few very sick children, one who was sent to a hospital and one child who was severely neurologically devastated from birth. One who need her foot amputated due to progressive gangrene. All that in addition to 5 hours of lectures to the HCWs, nutritional assessments, dental hygiene, VBS, spiritual counseling, pharmacy, all patients entered into our database using bar codes, reading glasses for the elderly and more. The team didn't blink an eye. For now, everyone here sends hello to their loved ones. We were promised a working internet server tomorrow. We'll see. Tomorrow is another day, another test of our endurance and a test of faith.
In all things give thanks,
David

Tomorrow we leave - Swaziland

We leave tomorrow....

One week from today...

Just when we think that everything is in place, the ground shakes and it all tumbles over. Such is the case with our well intentioned plans to go to Zimbabwe. A team of 26, planning for a year, stacks of credentials collected from the medical folk who were going, over 200 emails (yes I counted them), and a lot of behind the scenes work from a group of dedicated, tireless, and uncomplaining partners on the ground in Zimbabwe went all for naught in a matter of days. Getting approval from those who would credential us to practice medicine in Zimbabwe was not to be. New plan. Swaziland. It took just 3 days to pull it all together, with our partners in Swaziland openly agreeing to welcome us and to make flight changes, hotels, arrangements, and notify the team so that they could decide if the change in where we are going would change their heart for going. Nope, it didn't. So, off we go to Swaziland in one week to go to 5 projects, work with 48 health care workers, do public health education, first aid training, VBS, and more. We'll see patients, children and adults, making sure to do what we do best. Follow God's lead. And that's what it all comes down to. God's lead. I'll be traveling to Zimbabwe and Mozambique after Swaziland to see how we can help. So, if you are curious about how it all plays out, check back. In the meantime, I'm following my "leader". Him.

In all things give thanks,

David

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Kenya wrap up: Sustainable healthcare

Many wonder when they ask what Medical Mercy does, is whether we are simple a "band-aid", "feel good" medical team going in and doing a song and dance and leaving. Hard words, but asked all the same. After 7 years of medical trips totaling close to 50, treating and caring for over 75,000 patients, I can honestly say that we are firmly ingrained in "sustainable" health care. When we leave, we leave something behind. Continued health care for those who need it. We establish referral liaisons with local physicians and hospitals, we build physical medical clinics that are then staffed by local physicians and nurses, we work along side local nurses and physicians when possible, we train local lay people to be healthcare workers who stay behind and care for the children, and we follow up on the collaborative healthcare programs we put in place with the projects. This trip to Kenya is an example of that.

18 US team members (Amanda, Caleb, Sue, Anne, Kelly, Richard, Mary, Michelle, Bridgette, Ben, Darlene, Michael, Charis, Alyssa, Erika, Patricia, Samuel) joined 16 Kenyan HCWs who we trained over 3 years ago to care for 850 of our MoM children. Lectures every morning before we left for the medical clinics, honing physical examination skills along side the US team members and seeing patients for 5 days, gave the Kenyan HCWs a stronger foundation of knowledge and skills to care for the Mom children. Sustainable healthcare. We did nutritional assessments, treated on the spot those we identified as moderately or severely malnourished with a program of supplemental nutrition and put in place referrals for those children who needed additional care and put in place a concrete follow up program. Sustainable healthcare. Just a few of the many pictures taken will tell the stories. No need to say anything else. I'm proud of what we do and stand behind our mission to give the children the healthcare they need whether we are there or not. My thanks to the US and Kenyan tema members. Yes, we did "feel good" about this trip, but we did so humbly knowing that we left something behind.

In all things give thanks,

David

Kenya: when it feels right

Another day in the bush at a small Masai community called Olootepes, population unknown due to the nomadic nature of the Masai. 150 MoM children though. And another 150 children not in the MoM program. 300 children, all trying to grow. I learned that drought season here is dismal. Children may get 1 cup of water a day if that. The river beds are dry. When it rains the river is dirty and is not drinkable. We are so far into the bush that trucking water in from the nearest town costs 250 dollars not including the cost for the 500 gallons of water. One wonders how they survive. MoM feeds the children and they drink from the sources put in place. It helps. Somewhat. More can be done though.

Atop of a mesa, surrounded by the plains of the Rift Valley, we worked side by side the HCWs examining the children and some of the adults. It all is worth it. Far away from what we know as home, it still felt right. Now all we need to do is to make sure that the water flows and that the children can drink. We're working on it...by prayer.

In all things give thanks,
David

Kenya: rough as rough is

50 kilometers from Kajiado is a small village called Kiburro. It took us 2 hours to go the distance. 30 miles. It gives you a sense of how deep into the bush we were. This was Masai territory, traditional in dress and culture. Beaded jewelry on the women, rhythmic dancing, leaping men with long sticks, and machetes. We were greeted with that and blessed with it when we left.

I looked out from where we were holding clinic and could see for miles, the valleys of the Masai territory. Umbrella trees giving shade to acres of bush and then open plains. We saw gazelle roaming freely and small herds of goats roaming under the watchful eyes of young Masai boys. I grew up in Somalia and being here in Kenya brings back so many memories of my years there. I feel at home. I'm back fulfilling a dream of being a doctor and practicing in east Africa. I was 6 years old when I made that my goal. God is amazing.

We saw all of the MoM children and then some. The HCWs shined as they examined the children, their skills becoming fine tuned under the guidance of the US team. We are a total team of 36, Kenyans and US. We have one purpose. To care for the children where no one else wants to go. And that is Kiburro. The MoM children we so much healthier than the children in the village who are not MoM children. A testimony to a HCW program, sponsorship which ensures food, clothing, education and love. Perhaps one day we will have all of the children of Kiburro under our wing.

The US team is powered by a spirit of love and grace. We move to another village tomorrow, distant as well. We are not weary. We are privileged and blessed.

In all things give thanks,
David

Kenya: When it rains it pours

It's the rainy season here. Therefore it rains. Rivers flood and washes overflow. You'd think we'd know better....wouldn't you. Not us. We forged ahead. I am typing this on my BB and can send only one picture but it will give you an idea of what we went through. We walked across and took all our med over in a small truck, making it across okay. Coming back we didn't. The truck got stuck in the middle of the wash. No 4 wheel drive but a lot of pulling and pushing the truck worked. We spent just 4 hours in the village before we had to leave since the clouds were gathering and we were afraid to get stuck there overnight. The children sang and danced for us and we then worked with the healthcare workers examining them. We go back there today. Hopefully it will be better. Sorry about no pictures. I'll make it up when I get back. My fingers are cramping from typing on this BB keyboard anyway. I'll hope to be able to send you something later. We are well and thankful for being able to do His work.
In all things give thanks,
David

Ethiopia: Healthcare worker assessment

Joyce is a Medical Mercy HCW in a small village about 70 kilometers south of Malindi which is on the eastern coast of Kenya. The village is in the bush and is isolated, remote, and as far from anything one would consider civilization as one can imagine. We have about 150 MoM children there and they all are being cared for by Joyce. She set up her "clinic" with medications and a little table. You see her record books in front of her and copies of the certificates I gave her for completion of the different levels of HCW training she went through. He fanny pack is her "doctor's bag" with her stethoscope, blood pressure cuff and all the tools she needs to do a comprehensive physical examination. Her scrubs identify her as a HCW. She is one of 16 healthcare workers that we've trained in Kenya. They'll be joining the US team in 2 days as we do 5 days of clinics. I'll be giving them additional lectures, moving them into more advanced assessment techniques, and they will be seeing patients with us gaining advanced physical diagnosis skills. Remember the theme I shared from Ethiopia: fruits of our labour, plant the seed, teach them to fish..sustainability. Healthcare for the MoM children.

In ll things give thanks,
David
(Note: we will be in a region that has no internet service and the data service on my phone will be marginal, so I don't know if I will be able to get blogs up and posted. I promise to do the best that I can. Be with us in prayer as we bring His word to those who seek it.)

Ethiopia: Fruits of our labour

 



Fruits of our labour. Plant a seed. Teach them to fish. All are familiar phrases that address doing something for someone in order to make them self sufficient and show their success, to give them an opportunity to succeed, and to put in place a plan that will grow. It is what we strive to do for those who are less fortunate than most, and who are willing, dedicated, motivated and driven to make the best of what they have been given. The Healthcare Worker (HCW) program I developed 7 years ago, is that seed, that teaching to "fish", that opportunity, to give those lay persons who are responsible for the welfare of our MoM children, the knowledge and the tools to ensure that our children are healthy. The intent of the HCW program is to ensure sustainability of healthcare needs of the children after our medical teams leave. The HCW becomes the one source for healthcare needs in their projects. There are now trained HCWs in Cambodia, Swaziland, Ethiopia and Kenya. The question is, has the HCW program been successful. That's why I'm here in Ethiopia. To see if it has made a difference. I spent several hours the first day reviewing their knowledge base, given them some advanced lectures and quizzing them. No need for worries there. They were sharp, inquisitive and motivated. I then went to the projects and did a medical standards assessment on the healthcare of the children. Here is a summary:

We have 11 projects in Ethiopia with about 3000 children that we care for. There are 9 HCWs here, having completed their training just over a year ago when we came here to do clinics. They worked with us for 5 days and were seeing patients on their own most of the time, making the right diagnosis and starting the right treatment. In one year since they have been on their own, here's what I've found:

1. referrals to outside clinics are down by 55%

2. healthcare costs for the projects are also down by 50%

3. the HCW is seeing on average 10 children a month

4. 32 children were identified with potentially life threatening illness, treated and never hospitalized

5. children with chronic illness such as TB, malnutrition and anemia have been identified and are followed on a regular schedule of physical exams and treatment by the HCW

6. medical records for all children are now in the child's respective folder

Outcome measures that are positive, fruitful and successful. There is more that I've found in addition to what I've listed above, but I hope you see the effect of this HCW program. The MoM are well cared for.

I leave for Kenya tomorrow to do the same there, except this time, I'll have my medical team with me. 18 US team members. We will have 5 days of clinics and the HCWs will work with us. Fruits of our labour. Planting a seed. Teaching them to fish. THe children are better for it.

In all things give thanks,

David