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

Swaziland April 2008: Day 5 and summary

Day 5: Maphiveni

We traveled about 1 1/2 to two hours north almost to the border Mozambique. A Mercy center has been established in that area. Because of arrival time and departure time we see only saw about 156 patients. But those patients were some of the sicker patients that we've seen all week since that part of the country that we were in has a high incidence of HIV with approximately 90% of the population being HIV-positive less than five to 10% of those receiving ARVS. We saw number of young children, some as young as 10 months of age with mothers who had been HIV-positive while pregnant never receiving HIV treatment, thereby ensuring that their children were positive. We saw significant amount of malnutrition, tuberculosis, and overall general poor health.

The week has gone by quickly when we look back to see what we have done. It was quite amazing:

Madonsa: 322 patients.
Makholweni: 400 patients.
Logoba: 422 patients.
Zombodze: 438 patients.
Maphiveni: 156 patients.

Total: 1738 patients seen

Total Medication perscriptions dispensed: 5500
Total indiviudal pills, ointments, drops, etc dispensed: 22,000
Total reading glasses given: 400
Total who got HIV testing: 375
Total seen in spiritual counseling: 1738
Total number of people who participated in working the week of clinics(US medical team, local missionaries, teachers, interperetors, drivers, cooks, HIV testers,pastors,and alot more): 220

The whole team (US and local) was incredible. We all came together within the first few hours of the trip and work very well together. The missionaries here in Swaziland, the teachers, the pastors, the interpreters, the drivers, the cooks, and many many more who helped us, worked as a team with a singular and common purpose: to be Christ's servants to those who are vulnerable and ill. It has been quite the week, and quite the experience. God does some incredible things, and puts people together for a purpose.

Two residents, husband and wife Philip and Kathleen, from Baylor joined us on the last day, We were blessed find out that they were believers. It was awesome to see them openly pray with their patients and to be a part of our devotions. To see unexpected people join our group who embrace our mission is simply God's work.

The medical team leaves for the United States tomorrow. Jason and I, and Daran and Teresa, leave for Mozambique for a three day assessment trip. I hope to be able to determine the medical needs of Mozambique and how we are going to deliver medical care to the children there. I'll return to Swaziland after that to give the advanced healthcare worker course to 28 healthcare workers who have been through the basic health care worker course. I'll return home soon after that.

It continues to be a wonderful journey.

In all things give thanks,
David

Swaziland April 2008: Day 3 and Day 4

Day 3: Logoba

422 patients were seen. It seemed like a busier day than most with a lot of sicker patients than we had previously seen. We saw a lot of children who came without parents looking for healthcare all on their own. They had heard that we were there and brought themselves to the clinic with some significant and serious complaints of illnesses that needed to be treated. We gave the medications knowing that there were no parents for them to return to and that they were truly responsible for themselves. An 11-year-old with significant developmental delay and a seizure disorder with left hemiparesis arrived on his own seeking help for his seizures. Because of his developmental delay, he was unable to really communicate other than to tell us that he frequently fell down. A 38-year-old male with skeletal tuberculosis also with lower extremity paresis came for help. He was unable to walk, and his wife and he were both HIV-positive. A whole family devastated by two serious diseases.

Sometimes I wonder where the resilience and fortitude comes from. Looking around at the mass of people waiting to be seen, it was clear that survival was a common theme. But surviving at what expense? The team was more subdued today, and I think realized the magnitude of what they were doing. There is no other way look at what we do other than with hope and compassion.

Day 4: Zombodze

A day, not unlike the rest with 438 patients seen. We did have a late start and an early ending, and still saw a large number of patients. While the team traveled to the site I met with the Baylor team to discuss the healthcare of Pepe. We were able to come up with a nutritional program that would be beneficial and insure her possibility of having a comfortable life for a least a period of time. A young mother and her baby came to the clinic. Both turned out to be HIV-positive. The baby was severely malnourished as the mother had no money and was feeding the baby a dilute porridge. A little eight year old girl who had been raped last year and was seen by Sabine came back for a visit and was looking really well and had recovered from her horrendous experience.

Children's Cup has continued to grow with 19 missionaries and seven more on the way before the end of the year. Additional Mercy Centers and Care Points are being added and a new church opened just a few weeks ago, which we attended tonight. The mission here is beyond words. The growth and out reach to those who are so vulnerable is occurring at a rapid rate. We are fortunate and blessed to be a very small part of it.

In all things give thanks,
David

Swaziland April 2008: Day 1 and 2

Day one:

We started our week of medical clinics at Madonsa where we saw 322 patients. There were no surprises other than a late afternoon hailstorm, followed by a thunderstorm as we're examining children outside. The medical team got their feet wet, so to speak and finished off the day feeling more comfortable about the types of children and adults that will be seen for the rest of the week. We were visited by two doctors from Baylor, who joined us in seeing patients and it was comforting to know that our approach and treatment of common diseases was in harmony with what the Baylor team has been doing.

Day two:

Day two was spent at Makholweni where we saw 400 patients. Today was a difficult day for many of us as we began to see the impact of the epidemic of HIV and AIDS and the general well-being, both health and spiritual, of the patients that we saw. I took care of an 11-year-old girl who'd been raped and needed to be examined. I was fortunate to have Teresa, Jackie, a Children's Cup missionary and one of the teachers get her to trust me to do the examination. A 14-year-old boy with HIV, who had been on ARV medication, looking very sick told us that he had stopped taking his medications, because his grandmother refused to allow him to do so. She couldn't believe that a child 14 years of age could have HIV and AIDS. We are struggling now with finding a way to convince her to let him take his medication.

A young lady whom I wrote about a year ago, who has a seizure disorder and was raped, came back to the clinic today and had a seizure right in front of us. You may recall that when she falls she hits the right side of her face. And today was no exception. It was clear that she had been having multiple seizures, and her face was severely bruised and swollen on the right side. We saw two children with severe asthma, who required immediate intervention. And there were many more.

For what it's worth, I continue to be amazed at the resilience of those who have not. And what is more amazing is to see that regardless of what is happening to them they maintain a sense of dignity and continue to hold their head high as best they can under the circumstances. The young lady who had a seizure clearly demonstrated this. As she was recovering from her seizure and still incoherent, she reached for a paper towel that we brought to clean her face with and took it herself and started to brush herself off.

There's more to come as the week moves forward. There is more for us to see and more for us to realize how fortunate we are to have the blessings that have been bestowed on us. Being humbled is a difficult thing to experience. Today was a very humbling day.

In all things give thanks,
David

Swaziland April 2008

We are back in Swaziland for another medical trip. In addition I'll be traveling to Mozambique for three days to do a medical assessment, and then back to Swaziland to do a three day advanced healthcare worker course. On this trip we have been fortunate to have Sabine, Donald, Carleen, Maisie, Jason, Kelly, Don from Phoenix, and Jason a friend of Don's join us as our medical team.

As always, we were met by Darren and Teresa, and the rest of the missionaries here in Swaziland. The afternoon was a quiet one as we gathered our thoughts and energy to prepare for the week ahead.

I did go with Teresa to go see Pepe who has been hospitalized for some time now with multi-drug-resistant tuberculosis and HIV. She is 12 years old and now only weighs 14 kg. When I saw her she was continually coughing and was very weak. She was unable to take nutrition and seemed severely withdrawn. She was apprehensive and afraid. Having just seen her a year ago she was clearly a different child. I couldn't bring myself to take her picture.

There is a lot to talk about regarding her long-term care what she is going through. I hope to have a care conference with all the wonderful people who have been caring for her here so that we can look at the difference between keeping her alive and ensuring that she has a life. We all want to do things for her and not to her. There is an end to all things. The taskmaster is deciding when that end is.

Be with us as we begin our week. Be with Pepe.

In all things give thanks,

David