Interesting...and amazing...

I returned from Cairo, Egypt last week after 2 days of whirlwind activity. Peter Omran and Nabil Farouk lead the charge through the streets of "Garbage City" and to meeting after meeting, visit after visit, and discussion after discussion. This medical clinic was going to happen, and the Medical Mercy team was going to arrive in February of 2007. Period. End of story. Done. Well, except for a few things...We still needed some more work on getting the medicines and the equipment, but even that is coming together.

We have a full team ready to go. Things in Egypt are a little different than what we are used to in Swaziland and Cambodia: we need to be a little more careful, a little more subtle, and a lot more open to "diversity". Our clinic is in the heart of a huge Muslim population. We will certainly be exposed to things we've never seen before, and to customs and view points that are quite contrary to ours. But it is that very difference why we are going. To show a different way, a better way, a biblical way. Let the light shine and show us the way.

In all things give thanks,

David

Cairo, Egypt..."Garbage City"

Surrounded by 15 foot walls isolated from the rest of the world, 200,000 families making up a population of 1 million, live in garbage. Ezbet El Nakhel is "Garbage City".

The smell is powerful, the sights dramatic. Flies are everywhere, animals eating garbage, donkeys pulling carts of loaded garbage, children playing in garbage, houses filled with garbage, and streets with raw sewage.

And in the midst of all this is "Joy School", a Mission of Mercy safe haven for children. That is where we are building our next medical clinic: on the 4th floor. That is where I am going in a week and a half to buy the medicines, the medical equipment, assess the construction of the clinic, and meet with my 2 brothers, Peter Omran and Nabil Farouk. Once again, He has spoken, and we obey. We are moving quickly to get this all done: a Medical Mercy team leaves the US on Feb. 13th for our first medical clinic in Egypt.

Can it be done? Will it be ready? Will we be ready? Go ahead....try and stop us.

In all things, give thanks,

David

To care..

Go to Teresa's and Daran's blog (http://rehmeyers.blogspot.com) and read about "Comfort care vs. Heroic care". Then come back here. Their insight leaves me humbled. I deal with the issues of "care" everyday, both comfort care and heoic care. Practicing pediatric critical care medicine embraces both. Children are admitted who are trying to die, or will die. Over the past 26 years or so of practicing critical care medicine, I have learned that "caring" is more than we give, and less than what patients receive. I am a medical ethicist, and deal with the issues of " care" over "cure", and life over death everday and here is what I've found: ask the following questions, and you'll begin to see what "caring" means:

1. do we "care" or "cure"?
2. are we treating the "patient" or the "disease"?
3. do we have a "contract" or a "covenant" with our patients?
4. is the technology we use a "necessity" or a "convenience"?

If we "care" rather than "cure", if we treat the "patient" (the person) and not the "disease", if we have a "covenant" and not a "contract" with our patients, and if we use technology because it is "necessary" for the patient, and not a "convenience" for us (we can attend to other things, personal things, "me" things, rather than being with the patient) then "caring" becomes central in our realtionship: it's about "who", not about "what".

Any one can "take care of " somebody: it's mechanics. But to "care about" and to "care for" somebody, takes self-sacrifice and intent to be there for someone regardless. "Heroic care" is that very "care" that Teresa and Daran are talking about: caring without bounds, loving always, giving freely. And Lord knows, they do it well...

In all things, give thanks,

David

What next....

There are times when we look at ourselves in the mirror and ask why we do what we do. Most of the time the answers are not what we want to hear: "because we want to". A few weeks ago, we made a trip to Swaziland on a medical mission. Not because we wanted to, but because we were asked to. He asked us. We didn’t question why, we didn’t ask how, and we never said no. We just did it. And for that we are thankful. We overcame hurtles, obstacles, and spiritual warfare. We brought in the “big guns” and He lead the way. It wasn’t even a contest. We won. Period.

Over 4 and a half days, we saw over 1700 patients, old and young, well and sick, newly born and the not so newly born. We prescribed over 7000 doses of medicines, gave out close to 500 reading glasses, and did a little minor surgery on a patient or two. And saved the life of a little girl who came to live in our hearts: PePe. All the patients were prayed with by the spiritual counselors, with many hearing the word, and all seeing His love. All in all, a good medical trip. All in all, a wonderful testimony to His healing power and grace. All in all, a reflection on why we do what we do. Because He said so, and we listened. I’m looking in the mirror now, and asking again, why I do what I do. I know He’ll be giving me an answer real soon….and I'll be ready to go....

In all things, give thanks…

David

Missionaries Swaziland 2006

Ben












Daran
Nurse Teresa

Missionaries Swaziland 2006

Patrick
Kristin
Charles

Medial Team Swaziland 2006

Nurse Kelly
Child Life Lori
Nurse Sara
Dr. David (me)

Medical Team Swaziland 2006

Dr. Micah
Dr. Erin
Nurse Aimee
Nurse Lisa

Swaziland Medical Team: 2006

Pharmacy gurus Don and Durrell

Photographer Syndy
Dr. Troy

Makholweni..the fifth day

The last day, and we saw 312 patients in the morning. The clinic was dedicated in the afternoon with speeches from dignitaries, and local African dancing...and the evening ended with a banquest at a game reserve with a roasted wart hog. The week was over. The team was blessed by the health care workers, who prayed at our feet. The feelings of humility and love were oeverwhelming.

There is so much more to see and do. This small look into what we did is simply that: a small look. We changed. For all that we did, more was done for us.

In all things, give thanks..

David

Makholweni...the fourth day

Five hundred and one patients. Okay, let's try this...501 patients!! In one day, we saw and treated 501 patients at Makholweni where our new clinic is. The word "Makholweni" means "the place of the Christians" because of the numerous churches located around that area. The many children are left out to fend for themselves. This Care Point is just outside the city limits so it doesn't have access to many utilities and the development of the city. However many people settle here, in order to be near the limited job opportunities, and just outside the city to avoid the local taxes.

When we arrived, there were already about 100 patients waiting for us, and since everything had been so well organized by the Children's Cup team, we started off quickly. The pharmacy ran from the real pharmacy in the clinic, and all patients were seen outside. A few procedures, alot of infections, malnutrition, and more HIV came our way.



A young 6 month old infant was brought to us by her "gogo" or elderly caretaker, since the infant's mother had abondened her. The infant had severe skin changes from HIV and needed to be tested and treated. We did the best we could, giving her what she needed at that point, and hoping that her "googoo" would take her to be tested.



A young woman of 38 years, presented with complaints of stomache aches. Two weeks ago, she ingested crushed bottle glass trying to commit suicide. She had learned that she was HIV positive and was ready to die. I sent her to see a spiritual counselor, and heard that she came to Christ.




There was so much to do, and so many people to see. The heart ache was in the fact that we could do no more than what we were doing in the limited time that we had. We prayed that He would open the doors for us to continue our work there...more often, and longer...

In all things, give thanks..

David

Ngwane Park, Swaziland...the third day

There are apporximately 450 children at the Ngwane Park Care Point. It is in the largest urban community in Swaziland. It covers an area so vast, that children who come to this Care Point walk a long distance to get to it. And they came.

What an awesome day!! The weather started out cold and overcast, lending little doubt to the fact that we were in for another wet day at the clinic. Wrong. The weather by noon, was sunny with not a cloud in the and hot, a littel breeze, and a few clouds in the sky. We were blessed, content, and happy to be where we were with who were with. The children and the people of Ngwane Park.

As usual, eveything was in place or in the process of getting in place by the time we arrived. The tents were being put up, chairs and tables assembled, the meds taken to the "pharmacy", the spiritual counselors setting up and the Voluntary Counseling and Testing workers were there. Within 10 minutes we were seeing our first patient, and by the end of the day, we had seen 335 patients, all so different than what we saw yesterday, both in diseases, and spirutal openness.

There were alot of issues today. Several abscesses that needed draining, a house call for a woman who could not get out of bed, a couple of wounds that needed serious attention, a patient with a severe asthmatic attack, and a lot of other pathology. And Pepe came back looking great!!



The children came in the afternoon for their meals, and they danced and played, eating their only meal for the day, happy that love and grace was surrounding them.











There is never a better time to thank Him for our blessings and grace, than when we see how tiny we are in the great scheme of things...holding the hand of a small 1 month old infant with pus in her eyes, comforting the old man who is trying to catch his breath in between his coughing fits, looking into the eyes of a young women with 3 young children who tells you she is HIV positive and that she knows she will be dead in a year and she has no one to take care of her children...and could she leave them with us...

In all things, give thanks...

David

Mangwaneni, Swaziland...the second day

The day is cold, and rainy. We arrive at Mangwaneni already cold and wet. This is a community on the outskirts of Manzini off the road to Mozambique and is across the street from the city garbage dump. A high percentage of the people in the community are unemployed forcing them to scrap for food and clothing in the garbage dump. It is considered one of the poorest areas that we will visit and the orphan situation in this part of town is significant.

We saw Pepe again, the little girl with HIV and sepsis, and she is looking better. Another round of IV antibiotics and IV hydration, perks her up a little bit. We'll see her again tomorrow.

We only saw 250 patients today, most probably because of the weather. The atmosphere was different than any other place we have been to. There were lots of men and women with advanced stages of sexually transmitted diseases and HIV. The children seemed sicker, and less happy. Simply put, there was a sense of evil in the area. We saw those who came, offered spiritual counseling, and cared for those who were sick.

Hope and faith were needed here most...He was needed here most...I hope they let Him stay...

In all things, give thanks...

David

Madonsa, Swaziland...the first day...

We departed for our first clinic at Madonsa, a drive about 30 minutes from the hotel. Madonsa is a community that is on the northeast edge of Manzini. It is a very rural place but because of its proximity to Manzini, it is becoming more urbanized. The community itself still has a very rural Swazi feel with most of the homes made out of traditional stick and mud structures. We arrive at the Care Point to find the tents in place and the medicines already delivered and ready for use. At 8:05am we begin to see patients and by 5 p.m. we have seen 438 patients. One woman who delivered a baby on 3 days ago is sent to the hospital with her placenta still in place.

Mission of Mercy and Children's Cup children are seen and treated. Eight medical examiners work side-by-side with the healthcare workers who were trained in August, fine tuning their physical exam skills. The day is long, and the weather is brewing rain.










A quick one hour for lunch and a devotional refreshes the team and by mid afternoon we encounter our first medical emergency.

Pepe, is a nine-year-old little girl who is HIV-positive, diagnosed 3 years ago and is on ARV’s. Her mother died of AIDS and her father is close to death right now. Over the course of several weeks she has been feeling ill and today she presents to the clinic with a temperature of 104, rapid respirations, and evidence of total body infection and pneumonia. Herpetic lesions in her mouth make it difficult for her to eat or drink. She is weak and dehydrated. We start an IV, give her fluids and antibiotics. After bringing her temperature down over three hours she is looking much better. We will see her again tomorrow and give her the rest of her IV antibiotics.

There was alot of praying going on in the spiritual counseling center, with local pastors praying with every one of the patients we saw. There was also a VCT (Voluntary Counseling and Testing) team that came who offered HIV testing and counseling to anyone who wanted it. 58 people got tested.

There is never a better time than now to remember whose we are...looking at the children we cared for, and hearing their stories, seeing in some the loss of hope, gives me pause to thank Him for directing us here...we gave medicines, we saved a life or two, but most importantly, we showed that by living with Him, anything is possible...hope abounds...love never ceases...grace given freely...

In all things, give thanks...

David

And so it begins...

....October 5, 2006....Swaziland Medical Mission

Eleven of us left Phoenix for Swaziland, picking up two more members of our team in London. Alot had happened up until that point, and alot would happen between the time we left and the time we arrived. Three members of the team came down with illnesses, one needing surgery, flight delays, and lost luggage...but He prevailed as He always does, and all luggage arrrived, medical equipment and all, and health is slowly being restored. We were met by the Children's Cup missionaries, and off we go to a 24 hour safari to visist Africa before we start our medical mission. We arrive at the new clinic late Sunday night to get all the medications and equipment ready for our first day. We are ready...

And they will come...

The "nurses station" is almost complete, waiting for our arrival next week. The medicines and the equipment have been ordered and will all be in place by the time we arrive. We have 5 days of clinics that we will be holding, going from one Care Point to another and using our new "clinic" on the last day. The team is ready: 4 doctors, 4 nurses, a child life specialist, a professional photographer and her husband, and of course my partner from MOM and his wife. We expect to see 1500 patients in 5 days give or take a few hundred. The team is experienced having traveled and worked together on several medical missions in Cambodia, so we should have little down time and be off and running quickly. As we get closer to our day of departure, I'll be giving all of you our itinerary so that you can get an idea of what we'll be doing and where. I hope to be able to post updates daily from Swaziland with picutres and all. There is much that we need to do, and much more that we are unaware of. We believe in His power, and His direction. We believe that He will show us how, what, and where to go. We are in for the ride of a lifetime....a ride that gets better and better every time.

In all things, give thanks...

David

Unconditional love...

She approached me, her left arm dangling and her left leg dragging in the dirt. She stopped, and looked at me, a smile slowly coming from her face, the left side of which drooped from her stroke she had at birth. She waited, not too far away, but not too close either. I smiled back, and she came closer, her smile now wide and unrestricted, her eyes dancing. And then she collapsed. She fell to the ground, hitting the right side of her head, like she has done 10 to 15 times a day for years, her seizures barely controlled despite 2 medications. Teresa and I knelt down next to her, protecting her head the best we could, trying to make sense of who she was and what was happening. She began to awake after a few minutes, and sat up against the wall of the building, and that is when I saw the lumps, brusies, and her swollen eye from all the falls she had had. Her story was one of many that drained me of my expectations of humanity.

She has been like this since birth, cared for off and on by a mother, but mostly left to herself. 4 years ago, a man in her village offered to help adjust her medicaitons, feigning to know how to treat seizures, and lured her into his house where he raped her. Her 4 year old son is a child who comes to the Makholweni Mercy Center for food every day.

During the week that I was there, she would come to the Center everyday, sit patiently on the ground and wait for class to get out. She would come up to Teresa and I and place her arms around us, hugging and not wanting to let go. I had been teaching about "covenant relationships" with patients, and the need to look beyond our own distaste for the ugly, malformed, dirty, and sickening illnesses. It is that "covenant" relationship that is the foundation for the "unconditional love" we should have for all those who are "forgotten."

There was one man who violated her. But there is one bigger than him who gives "unconditional love", no questions asked...He loves her unconditionally, and I saw it in her smile.....may we be able to love like Him...always...

In all things, give thanks.

David

A Medical Safe Haven...

I am getting ready for the trip next month. I spent the week at Makholweni Mercy Center teaching, and watching the children to whom we have been entrusted to. I examined a number of children who were there and got a very good idea of what we are going to be treating: malnutrition, abscesses, rashes, vitamin deficiency, and unfortunately, the consequences of HIV. We have in place our medical clinic that will be ready for us to use when we get there. The Forgotten Children have a medical safe haven....

In all things give thanks,

David

And He will lift you up on eagles wings...

The moment was indescribable. Spontaneously, words were spoken, and prayers were formed. 15 teachers from the Care Points with outstretched arms, praising Him for what He was doing, filled the classroom with a feeling that came over me like I have never felt before. And this was just the first few minutes of the very first day of the Healthcare Workers training course. Over 5 days they learned basic anatomy, how to do a physical examination, common illnesses, first aid and CPR. They learned how to recognize a sick patient and how to stabilize, refer and transfer. By the last day they were able to do a full physical examination using a thermometer, blood pressure cuff. stethoscope, and pen light to exam the eyes, mouth, throat, neck, lungs, heart, and abdomen. The knew where all the organs were and how to palpate, listen to, and gently exam a hurting person.

In 5 days, these 15 lay teachers became healers. They will work with us when we go in October, and will be the healers that He has gifted to the Forgotten Children.

I was blessed by their love, their, committment, and their dedication. On the last day, they had me sit on a chair and they lifted me up above their heads as they prayed. I was overwhelmed, broken, and humbled. I was lifted up. I came to teach others how to be His hands, His servants. At that moment, I realized to whom I really belonged. "He will lift you up on eagles wings...." let Him take you were He wants you to go....for we are His always.

In all things, give thanks,

David