Haiti cholera assessment day #5

The questions asked were interesting: if cholera is in the water and in fish, should we not swim in the ocean; why are the dead burned and not buried; where did cholera start; can you get cholera more than once; and what does cholera look like? These were just a few of the many questions asked by the 65 participants at today's training. Pastors, teachers and volunteers from all 15 projects attended. I spoke on the cause of cholera, prevention, treatment, and assessing the sick patient. We had a "show and tell" on how to make chlorinated water, ORS and how to wash our hands. We ended the week of assessment with a powerful take home message: no one should die of cholera and no one should get cholera. Hygiene and sanitation is the key to prevention, and fluid, fluid, fluid are the mainstay of therapy: stay hydrated.

We will be back here in less than a month. I'm bringing a Medical Mercy team of 15, 8 medical and 7 lay. We will be working at a cholera treatment center taking care of the sickest of the sick and doing a comprehensive nutritional assessment of all the children in the projects to identify those who are moderately or severely malnourished. There will be a lot to do, but if it hadn't been for Edrice (our Haiti country facilitator) who put in place the protocols we sent for chlorinated water, the use of ORS and hygiene, we'd be way behind this cholera epidemic. Edrice did an incredible amount of work without complaint or question. He is a true servant. And thanks to Jack for his preliminary assessment of the children and identifying those that I needed to see and for his logistical support and for everything else that he does that goes under the radar but is so important.

The intervention and implementation of our cholera prevention and treatment program served the children of MoM well. I leave tomorrow morning, tired but comforted that what we did worked. And for that I say,

In all things give thanks,
David

Haiti assessment #4

It's all good. At least for our children in our projects here in Quanamenthe. We saw children from 7 projects, and the orphanage, and I examined about 150 of them who looked sick. Thankfully only a few needed referrals to a clinic, and none needed urgent attention. All in all, cholera has met it's match, at least in our projects. The chlorine is being used, soap is being lathered up and the children are happy. We visited the local hospital and spoke to the organization that was setting up a cholera treatment center. I was very pleased with what is available for our children if needed.

Tomorrow I speak to about 65 of our project representative who will become our "prevention specialists" responsible for continuous cholera prevention education. I'll be going over the physical findings and how to assess dehydration in children in addition to reviewing the use of chlorine, soap, and the water filters. I can't say it enough. Our projects are in good shape and the children are receiving the best that we can give them.

And so if you're wondering why all the fuss, if you could see what is happening outside the "walls" of our projects, you would see devastation and despair that is never ending. It is hard to imagine.

So for now, we push forward and in all things give thanks.

David

Haiti cholera assessment #3

I am at the border of Haiti and the Dominican Republic. Cholera travels. We visited 4 of our projects today and I examined over 100 children and found them all to be healthy! A few had chronic illnesses, but there were no signs cholera in our children! What wonderful news! The chlorine, soap and education is making a difference I believe even though the projects are in some very remote places as a picture above shows. Filth everywhere.

The little child shown was sitting in his mother's bed. She was critically ill with cholera. The face says it all. I could not walk away without making sure that the fragile woman lying there was going to make it. I spoke with the medical team caring for her and went over their plans. A few suggestions, a slight change in therapy and we all agreed she would make it. I can't accept anything less.

We go to 5 more projects tomorrow. I'm hoping to see children who have not been hit by cholera. If that is the case, I'll begin to finalize the plans for the Medical Mercy team that will be coming here January 2-10, 2011. One year after the earthquake. We were here then to help the earthquake victims. We went to India and Kenya after that. Now we'll be here again to help the cholera victims. Then onto Ethiopia and Bangladesh. Because one child matters.

In all things give thanks,
David

Haiti cholera assessment #2

When you think everything is under control and is going smoothly, something grabs your attention and takes over. An 8 year-old boy did that today. We went to 3 of our projects to look at a group of children who were identified last week as needing a more thorough "look-see". Jack and Edrice had done a very nice preliminary assessment of the children and identified those who looked moderately or severely ill and dehydrated. It was my turn to look at them now. Jack and Edrice had also handed out chlorine, soap, and education material to get the projects up to speed on cholera prevention. And from what I saw it was working. We saw about 100 children from the 3 projects, referred 14 of them for further care and transported 1 child urgently to the cholera treatment center. He was the one who got my attention. 8 years old but looked like he was 5, severely dehydrated,but also severely malnourished, more than likely from being ill for a while. He was lethargic, pale, weak pulses, and to be frank, looking to collapse permanently in just a few more hours. We rushed him to the CTC and he was immediately treated after I consulted with the physician there. By the time we left, he was getting IV therapy and was on a comprehensive fluid resuscitation protocol that the local physician and I put together. We also planned out a 1 week nutritional rescue program for him that would insure his recovery. He will do well.

We established a relationship with 2 hospitals that will take our children and care for them when needed. We meet with several physicians and discussed long term plans for cholera prevention and intervention. Cholera is here to stay for awhile, but I will tell you, that our projects are way ahead off the game, by having the chlorine, soap, and education in place. I am very encouraged with what I've seen and with what we've been able to do for our children.

As we move through the country, there is still evidence of the toll that cholera takes. I came across a young woman sitting in a wheel chair, an IV In her arm, and a blank stare. She was dripping the classical rice water stool from her wheel chair, unaware of the pool of diarrhea that she was leaving below her. People walked around her. I did too, but stopped briefly to touch her arm, to tell her that I was not ashamed to be there next to her, to let her know that she too should not be ashamed. I turned and left and knew that she may not make it. I could only hope that she felt my touch and knew that I was not afraid of her or her illness. Cholera in Haiti carries a stigma, no different than AIDS did many years ago, with people afraid to be near those affected. She deserves more than that.

I am so thankful for what we've done in our projects to prevent and avoid what I saw in the CTC tents. We move on tomorrow to 5 more of our projects. I am ever thankful for what we have in our lives, no matter how bad things may seem for us. Look at the pictures above. I think you'd agree.

In all things give thanks,
David

Haiti Cholera assessment pictures

Pictures of cholera treatment center.

Haiti Cholera Assessment #1

(Hard time up loading pictures)

There is never a shortage of things that need explaining and what is happening in Haiti is one of them. The election for a new president was yesterday and there were 19 candidates running,15 of whom have now said that there has been fraud and the announcement of the winner will be within the next 24 to 48 hours. Demonstrations and perhaps even worse is expected. And here I am. Assessing what the cholera epidemic is doing to our children in our projects. There is never a moment in this country that is without hardship. Poverty, and earthquake, TB, slow recovery, and now this, a cholera epidemic. It's been said that even a mouse will kick an elephant when it's down. Well,kick away. This elephant, this country is staying down for a while.

We have 15 projects here in Haiti, with over 1600 children under our care. Jack from MoM HQ's and Edrice our country coordinator have been busy this week. They got supplies from the DR, visited all the projects, did a quick assessment of the children using an algorithm table I developed and began teaching the projects how to prevent cholera. I arrived several hours ago, and within 15 minutes of landing, was at the Justinian Hospital meeting with physicians that I have known, Nate from Konbit Sante, and off to a cholera treatment center (CTC). Within 2 hours we established the referral pattern for our sickest children and collaborated with the Baptist Hospital in Carrefour La Mort run by the Haitian Hospital Appeal. A CTC was being established there. I made quick rounds and saw extremely dehydrated and sick patients getting treatment. Rows and rows of them. A triage system is established with "A" for oral rehydration, "B" for oral and IV rehydration and observation,and "C" for seriously ill and dying patients. Chlorine basins are everywhere. Our shoes are sprayed with chlorine when we leave the area. Patients are coming by the hundreds.

But what about our children and the projects? I begin a comprehensive assessment of all projects tomorrow. I wanted to have the referral process in place before I went out so I could be able to send children somewhere if I needed to. Here is what we are doing for the projects:

1. Each project has 2 people identified as "prevention" specialists who are being trained by us to teach hand washing, hygiene, waste disposal, and assessment of signs of dehydration.
2. Each family (1600 of them) have received a gallon of chlorine for their water, enough to last one month with more to come
3. Each family (1600) have received 5 one pound blocks of soap
4. Each project now has a water filter
5. Each project has enough ORS packets to treat at last 50 children until they can be sent elsewhere
6. We will be assessing latrines, sewage, and waste disposal next

It's been a long day. I am hoping for calm tomorrow with no civil unrest. We have so much more to do. I feel like time is slipping away, and I wonder if it will ever slow down. I will rest little tonight, knowing that there are many who will slip away. The humiliation of laying in your own diarrhea, dehydrated, and passing away, is what I see even with my eyes closed. I wonder what they see.

In all things give thanks,
David

Haiti emergency relief trip

I’m leaving for an urgent trip to Haiti in a few days. Jack from MoM is arriving today. Several of our children are critically ill, some have passed away, parents, church members, and pastors are all affected. We are urgently traveling there to assess and assist. Jack, myself, and our wonderful partners on the ground in the DR and Haiti are going to do our best to bring some semblance of health care and prevention to those who are suffering. There is civil unrest, riots, an election coming up and danger. I know that we are protected. Without Him we are nothing.

For the past week, Jack and I have been planning, implementing and assessing what our intervention can accomplish. We have ordered a lot of supplies from the DR that are being transported to Haiti. Here is what we are doing:

1. Evaluate all the projects for:

· Water sources, supplies, cleanliness, utilization and potential for wells and/or filtration systems: we are taking a supply of water filtration systems with us

· Hygiene and sanitation protocols

· General health conditions of the children and families

o Nutritional

o Infectious

o Document number of people with cholera

o Degree of illness

2. Ongoing treatment

· Plans for referrals to hospitals or clinics for medical care

· Meet with our local MD who we are working with to coordinate efforts

· Visit Justinien Hospitals and Milot Hospital

o Evaluate their ability to care for more patients

o Evaluate supply needs

3. Evaluate collaborative efforts with Konbit Santé and the local hospitals

4. Establish a plan and priorities for our January medical team dependent on the findings from this trip

5. Reinforce aggressive education to prevent any more child deaths.

a. Invite all mothers/children to come to the projects each day:  They will get a bowl of porridge and ORS

b. Training for making ORS, hygiene, sanitation, water purification will be done at separate teaching stations that families will rotate through so that each mother/family can clearly see the importance of each and not get overwhelmed.

6. Following the list of registered children each project will keep attendance records each day and follow up with the families that haven’t come.

7. Home visits will be conducted frequently to follow up on assessing sanitation, use of products, and additional education.

8. Any child/family member identified as being at risk in any of the above steps will be either moved to the project for observation and ORS treatment or taken to clinic/hospital for IV treatment.

We have a lot to do. We are anxious, yet comforted by the fact that we will be doing what we know He wants us to do. I’ll be posting to the blog and tweeting as I can starting on Sunday evening (November 28^th). In the meantime, during this time of thanks, remember what you have and what you don’t have, and…

In all things, give thanks.

David

Update November 2010

A team leaves in a few hours for Cambodia. I unfortunately will not be going with them, so there will be no blogging at this site. Michael, our pastor will be blogging from his site http://developingworkers.com so please follow them there, and on our Medical Mercy Facebook page. This will be a very special trip.

 

Some of you may be wondering about Haiti and what Medical Mercy and Mission of Mercy has wand will be doing there. Medical Mercy is taking a team to Haiti on January 2, 2011 and we’ll be up north near Cap Haitian and in the areas most hit by the refugees and in our projects. We’ll be working at an orphanage as well. When the cholera endemic hit, we put in to place an aggressive educational and prevention program. Here is what we know and what we have done so far:

 

•             The two areas in the North where the cholera is present is Cap Haitian and Lembe

•             MoM has gathered all the data on the living conditions of registered children.

•             Each partner has identified two members in there church that will help with the follow once the training is done.  They will make sure that each household understand what the necessary steps to prevent cholera.  They will also make sure that the items MoM will provide is being used properly.

•             MoM has identified who is using the water filters and the ones that are not using.  Additional water filters are being purchased and will be sent.

•             We have a doctor there  who is  helping with the training and has also with him enough oral rehydration kits to teach them on how to prepare and when to use it. 

 

In January we will be working on education, prevention, nutritional assessment, assessing residual complications of those affected by cholera, and doing ongoing medical care. I expect that we will be busy.

 

Pray for the Cambodian team. They have a long way to travel and a lot that will be done. Be with them as they do what they do for whom it is most important.

 

In all things give thanks,

 

David    

 

Kenyan Health Care workers

Let me introduce you to the graduated Health Care workers from Kenya, trained by Medical Mercy:
Peter, David, Reuben, Shadrack, Boniface, Jackson, Ruth, Wilson, Nuru, Priscilla, Simon, Pastor Daniel, Nathaniel, Esther, Elvis, Joyce and Josphat.
Well done and congratulations!!
David
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Kenya Medical Mission Final Thoughts

As it began, so it ended. With excitement and gracious giving we finished 5 days of clinics in Kenya seeing 1476 patients and completing the training of 17 Health Care workers. And this morning I had breakfast with Pastor Daniel, one of the HCWs we trained and who is the pastor of a community where we have about 200 sponsored children. He affirmed that what we did here this week is God given, and God driven.

I came to Kenya 1 year ago exactly to give a 1 week course to these pastors and teachers that worked with us this week. It was the first part of a 2 week program I developed several years ago to train them to be Health Care workers. To be able to recognize a sick child, start basic treatment, and know when to transfer to an advanced health care facility.. This week was the second week of their training, their “practical” or “skills” training, where they actually worked with us seeing patients and putting into practice what they learned in class. The training was intense. The learning curve steep. The excitement and the commitment of the HCWs solid. The US medical team members (Lara, Melissa, Sarah, Heather, Deanna, Aimee, Anne, Glenda, Stephan, Michael, Kelly, Sue) were instrumental in the success of the program. They worked tirelessly, teaching patiently and  slowly, taking time to explain what the HCWs were seeing. By the end of the week, the HCWs were seeing patients on their own. They also learned how to dispense medications, and to do a nutritional assessment. Last night, we had a graduation dinner and ceremony, handing out their certificates and each received a medical bag filled with medical supplies and medicines that they were now going to use in their projects. It was a wonderful end to a wonderful week. Pastor Daniel shared with me this morning that he saved a woman’s life a few months ago because  he had learned the Heimlich maneuver last year in the course. He had in turn taught it to his community members, and 2 of  them had used it on family members who were choking on food. Pastor Daniel said that he and the other HCWs stayed up late last night and talked about all that they had learned and did this week. He shared that many of the parents of the children seen this week were touched by the fact that one of their own, their community pastors and teachers, were giving of themselves to help others in ways that were never expected. The patients and parents were comforted by the fact that the hands that were touching them, were hands that were known to them and part of their culture. Pastor Daniel said it finally made sense to him and the other HCWs what I have been sharing with them all this week: the most powerful tool or medicine that they will bring to their patients is themselves. Affirmation given that what we did was blessed and bountiful. The children of MoM are better for it. The villages and the communities are better for it.

What is it that brings us back to countries like Kenya? What is it that brings us to a place of humility in our hearts when we see what we have and what we are blessed with, and how we are sometimes not good stewards of our given gifts? For me it is the realization that all that I have is meaningless unless it is used for a greater purpose. The purpose for which it was given: to serve and to be His light. We did that this week. There is no greater reward than to give and know that it is given freely without need for anything in return. The great irony in it all is that I do so more readily in the countries we go to, than I do in the US. Hypocritical yes. But I am trying to do better, and openly confess my shortcomings. This week, being with the forgotten children and the HCWs have shown me once again, that I am not really all that I make myself out to be. Being humbled is a hard taskmaster and one that I am not very good at, but I am getting more used to it.

So how about you? I trust that the gifts and talents given you are well used and freely given. Look in the mirror with me. Do you see “what” you are, or do you see “who” you are?  You may be surprised.

In all things give thanks,

David                             

Kenya clinic day 4

And so it began. We stopped to buy more meds, having run out of some that we expected would be needed where we were going, and we were right. Over 200 patients later, we were glad we did.
Greeted by singing children, we expected an easy day of it. It was for the most part. A minor emergency here, a procedure or 2 there, and patients lined up for what looked like blocks, kept us busy. The HCWs became more comfortable with their roles as servants to those who came to them for help. They became comfortable with their physical examination skills.
The US team has been remarkable. Each a teacher, bringing with them their experience and knowledge, freely shared.
There are many things in this world that gives us satisfaction. Being in the countries MoM serve, caring for the children, teaching HCWs who will stay on and make a difference in the children's lives, and serving Him, is satisfaction guaranteed. I can think of no better way to live my life.
In all things give thanks,
David
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Kenya thoughts

A different type of entry this time. Sleeping can wax and wane, then receding into wakefulness for hours. All this may be due to jet lag, or just a sense of searching for questions asked. We're here after months of planning, the date set a year ago, a lot of coordinating, emailing, purchasing, and organizing. Kelly has lead the charge in all of that and has shined through once again.

Now here's the issue. When we arrive in places like Kenya, how do we center ourselves on what is important, or more importantly who is important. Prayer, being ever vigilant of whose we are and why we are here, and obedience to a calling. Medical Mercy is about all of that. Do we do a good job of it? I would think we do. So here's the question. When we go back to the US, we have our families, friends, jobs, activities, hobbies, and everything that we put into our lives to make ourselves happy. There it is: "Make us happy". What would it be like if we went back home with the same mind set that we have here, obedience, giving, charity, kindness, love and grace...all the time, never ending, always present. Being here in Kenya is bringing out the best in us. It feels nice and warm, heart filling and rewarding. We head off to another clinic in a few hours. We'll feel loved and will love back, caring for those less fortunate. I wonder, just wonder, if I am like that all the time in the US. Silly me. I'm not. And that is what keeps me awake. Trying to understand how easy is to be so wonderfully giving to the children and families we see in the countries we travel to, and how hard it is to do the same in the US. I say all this out of open confession. I am not always who I want to be. These trips do however reinforce the fact that I am perhaps a little better because of them. Humility remains paramount in my life. For without Him, I am only who I think I am and not what He has made me. All that said, maybe I can catch a bit of sleep now.
In all things give thanks,
David
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Kenya clinic day 3

A much better day. Really. Almost 300 patients today, all outside with the wind blowing and the tarps a'flying. The clinic ran smoothly, the HCWs made significant progress, and all was good in the world. We were gifted with traditional Kenyan ware and with love from the children. I'll say it again. A wonderful day serving those who asked for nothing, except acceptance and love. Short message tonight. Time to recuperate.
In all things give thanks,
David
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Kenya clinic day 2

Sometimes, things just don't seem fair. And today was one of those days. We saw just over 200 patients, in a village far from any paved road, about an hour and a half outside of Malindi. It was remote, a few mud huts and a lot of vegetation. The Kenyan HCWs and the US medical team worked together seeing patients, with light drizzles of rain and bursts of sunshine taking turns throughout the day. We saw lots of malnutrition and a host of other diseases, and we all agreed that the children we saw today were sicker than those we saw yesterday. There was also a clear difference between the health of the sponsored children and those who weren't sponsored. The sponsored children were sick, but the others were much sicker. Gives some affirmation that what MoM does for their children gives them at least a much better chance at life. And so what about this "life isn't fair" issue? Without getting into details, we saw 2 children who had significant medical issues which could have been addressed and the children made better, but due to circumstances, they were not going to be able to be helped. They were un-sponsored children with complex medical issues that would involve a great deal of resources, time and commitment. The sadness of it all was that if done right, both would be able to go on and life better lives. We struggled with the questions of should we jump in and start the process of diagnostic tests, referrals to specialists, and recommending advanced medical care, or leave well enough alone, knowing that unless we did this right and committing to see it through all the way (years of specialized medical care, etc), we were only giving false hope for a better tomorrow. To start a process and then abandon it half way through just doesn't make sense and just should not happen. There is a right and best way to do things. And the right and best thing to do here was to leave well enough alone. Sounds cold and uncaring doesn't it. But here's the question I pose of you: would you have done anything different and if so would you have been able to make a 100% guarantee of full commitment? Because if you couldn't, that child living in the bush of Kenya, will be waiting for the promise of cure and a better life, becoming more and more disillusioned with life than he was before. There is nothing more heart breaking than a broken heart from a broken promise. So we decided as we did and that is the reality of third world medicine. There are just some things we just can't do. You turn away and hope that they don't see the tears in your eyes. Life isn't fair is it. Today was bitter sweet. We helped a lot of children, were gifted with colorful T-shirts from the village and walked away from 2 who needed more than we could give. And I'm so sorry for that. Can 2 children with very special needs find it in their hearts to forgive? I hope so.
In all things give thanks,
David
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Kenya clinic day 2

Sometimes, things just don't seem fair. And today was one of those days. We saw just over 200 patients, in a village far from any paved road, about an hour and a half outside of Malindi. It was remote, a few mud huts and a lot of vegetation. The Kenyan HCWs and the US medical team worked together seeing patients, with light drizzles of rain and bursts of sunshine taking turns throughout the day. We saw lots of malnutrition and a host of other diseases, and we all agreed that the children we saw today were sicker than those we saw yesterday. There was also a clear difference between the health of the sponsored children and those who weren't sponsored. The sponsored children were sick, but the others were much sicker. Gives some affirmation that what MoM does for their children gives them at least a much better chance at life. And so what about this "life isn't fair" issue? Without getting into details, we saw 2 children who had significant medical issues which could have been addressed and the children made better, but due to circumstances, they were not going to be able to be helped. They were un-sponsored children with complex medical issues that would involve a great deal of resources, time and commitment. The sadness of it all was that if done right, both would be able to go on and life better lives. We struggled with the questions of should we jump in and start the process of diagnostic tests, referrals to specialists, and recommending advanced medical care, or leave well enough alone, knowing that unless we did this right and committing to see it through all the way (years of specialized medical care, etc), we were only giving false hope for a better tomorrow. To start a process and then abandon it half way through just doesn't make sense and just should not happen. There is a right and best way to do things. And the right and best thing to do here was to leave well enough alone. Sounds cold and uncaring doesn't it. But here's the question I pose of you: would you have done anything different and if so would you have been able to make a 100% guarantee of full commitment? Because if you couldn't, that child living in the bush of Kenya, will be waiting for the promise of cure and a better life, becoming more and more disillusioned with life than he was before. There is nothing more heart breaking than a broken heart from a broken promise. So we decided as we did and that is the reality of third world medicine. There are just some things we just can't do. You turn away and hope that they don't see the tears in your eyes. Life isn't fair is it. Today was bitter sweet. We helped a lot of children and walked away from 2 who needed more than we could give. And I'm so sorry for that. Can 2 children with very special needs find it in their hearts to forgive? I hope so. I'm asking for it.
In all things give thanks,
David
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Kenya day 1 clinic

Amazing day. About 1.5 hrs out of Malindi, all dirt roads, we set up a clinic, examined patients (almost 300) outside under a tent canopy, and dispensed pharmacy from a mud building. The HCWs worked with us, using what they had been taught in class, and seeing patients. We weighed and assessed the nutritional status of every child we saw, identifying 50% of the children we saw as malnourished. The usual diseases, malaria, pneumonia, skin rashes, TB, a few suspected cases of HIV, and parasites, made up the most of what we saw. Children got a meal of rice and beans at mid-day, and off they went. The afternoon clinic was much the same. Another day of practicing medicine in Kenya. So different that what I was doing just a few days ago in the US. Taking care of severely ill and injured children in a 10 million dollar pediatric intensive care unit, with everything I needed. Today, it's dirt and sand, medicines out of boxes and baggies, a generator driving a computer we're using to input the nutritional assessment data, mud huts, mosquitoes, no bathrooms, children who haven't seen a doctor ever, and the life expectancy of these children of about 35 years. Go figure. Is one place better than the other? Of course the technology and the immediate availability of things needed that I have in the US would trump what we have now. Not so. What we have here is not always available in the US. Acts of giving with wanting nothing in return. Covenant relationships. No insurance forms, no billing, no co-pays. Just agape. The act of giving love without need for anything in return. The HCWs are showing it. Their first time holding the hand of a patient who has come to them for help. And they have taken that hand and held on tight. Unafraid, graciously and caring. It is so wonderful to see. We will leave behind a group of dedicated teachers and pastors who have accepted the role of caring healer openly and selflessly. It's really has been an amazing day.
In all things give thanks,
David
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Kenya Day 1

We arrived in Malindi and went right into teaching the review course for the Health Care workers. 4 hours of lectures and practicing physical examination skills. We're all tired. Clinics start tomorrow. More tomorrow. We all can barely stay awake.
In all things give thanks,
David
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Kenya arrival

We made it to Nairobi. Midnight here. 1000 lbs of medicines and suitcases and team members. 1 suitcase and 1 med box lost. Sleep for a few hours then catch a plane to Malindi. We have just begun.
In all things give thanks,
David

Kenya: August 20-39, 2010 - -It begins.

Somewhere, there are children who haven’t really had a good night’s sleep, possibly because they are hungry, sick, alone, or scared. And that somewhere could be anywhere. The US, Europe, southeast Asia, and Africa. Tomorrow, Medical Mercy leaves for Kenya to be with those children. It’s been an interesting process. The team came together, a few had to drop out, medications ordered, some didn’t arrive, 100,000 vitamins are tied up in shipping somewhere here in the US, we found 100,000 vitamins in Kenya that we are purchasing last minute, we found out that extra luggage will cost a lot of money, flight connections coming home are tight, we hired a truck to take all our stuff from Nairobi to Malindi due to the small aircraft that we’ll be flying with that truck driving 10 hours to get stuff to us on time to start clinics (hopefully), packing over 6000 unit doses of prescriptions, preparing for 5 hours of lectures to be given to the Health Care Workers for review, and…the list goes on. But, is all that important? Not really, because from where I sit, the team that is going, has everything they need. Him. I have always said that the most powerful tool, the most powerful medicine that we bring to the bedsides as caring healers is…ourselves, and what we have in our hearts. Grace, compassion, empathy, understanding, trust, integrity, and love. We are silent servants taking hold of the hands that have reached out to us for help. We leave tomorrow. We’re privileged to be able to go and hold those hands.
In all things give thanks,
David

Kenya Medical: August 20-29, 2010

I just heard the news. Medical missionaries killed in Afghanistan, reasons given by the murderers: evangelism. So very far from the truth. So very far from any understanding of how such hatred can make people do what they do.  But so it is. We, team members of Medical Mercy, have found ourselves on some occasions (Cambodia, Egypt, Mozambique, Haiti), falling within the boundaries of such hatred, within the boundaries of danger, but thankfully protected by common sense, trust, planned security, preparation of the team with clear instructions for evacuation, code words to be used, and faith. Yes, faith. No different than the medical missionaries who were murdered.  And so how is it different for us? It isn’t really. We open ourselves up to danger, understanding that it is there, praying that it doesn't happen, and thankful for when it doesn’t. I make every effort to make sure the team is safe and protected. Many of the members on trips have seen  that. Many too, are unaware of what is happening behind the scenes, without their knowledge, to keep us safe. And yet, even with all that, anything can happen.

With all that, we depart for Kenya August 20th. Right now the team stands at 14 members. The team members are caring souls, who give of themselves to serve others. We will be working along side the 16 Kenyan teachers and pastors who I trained last year  to be Health Care workers. We will be seeing over 2000 patients in 5 days. We will be traveling to the coastal area of Kenya, Malindi,  going to more than 8 projects, all of which are desolate, isolated, poverty stricken, and burdened with disease. Over 1200 forgotten children. Forgotten for now, but not for long. We’ll be there to make sure that they are given every chance to live a long and cherished life.

This will be quite a journey. Just wait and see.

In all things give thanks,

David

New Delhi, India: Day 6

We finished our last day of medical clinics, and in 5 days saw 2000 patients, dispensed over 10,000 prescriptions and prayed a whole lot. And with all this comes a sense of remorse for not being able to do more. How silly is that. Okay…perhaps not so silly.

When I look back at the 5 days we spent working in some of the worst slums in the world, I see a little speck of light in the otherwise dark cloud that hangs over the lives of these people. The smiles of the children, the glisten of tears of thanks from the parents, and the soft touch of a calloused hand that has felt nothing but garbage all of its life, gives me solace in knowing that at least for now, for even a brief moment, they feel worthy of being valued. They feel the warmth of dignity, the pride of being recognized as human, and the love that they may not have felt for a very long time.  We in turn, felt saddened, angry, frustrated, and confused at the indignities they suffer. But now, we must let all of that go, and realize that it is not easily fixed. What we did do, is leave behind a memory for those who choose to remember, the short time we spent together. The “slum dogs” and us. A memory of being valued and loved. No pity was shown, for that is not what they need, nor I would guess, is what they want. But empathy, compassion, and caring, all of which is sometimes very hard to do and give. This team, this group of 12 servants, did all that. Erica, Greg, Amy, Grant, Ashley, Kelly, Anne, Heather, Jesse, Gretchen, Sarah, and Cammie. Well done silent servants.

There are no pictures this time. I want you to close your eyes and see yourself in what I’ve described to you. I want you to see yourself living in a slum and being called as dog. I want you to make your own picture. And then burn it. You’ll not want to look at it again. But do one more thing for me. Every time you feel like you’ve been dealt a bad hand, give thanks for it, because it will never be as bad as what has been dealt to the “slum dogs” of  India.

In all things give thanks,

David

New Delhi, India: Day 5

Sangam Vihar is one of the largest unauthorized colonies in Asia and has a population of close to 2 million. We only saw a very small part of it. The” Rag pickers” slum is one of the many slums within this unauthorized colony and the rag pickers slums have some of the poorest people I’ve ever seen living in absolute inhumane living conditions.

There is no potable water for people to drink. Slum Clusters (houses) are made of plastic and  low cost materials. People go to the city very early in the morning to collect garbage and bring it back to their slum and sort the garbage into plastic and  metal, for re-cycling. The schema of how this works is beyond comprehension. A wealthy landlord owns 1/8th acre parcels of land. He hires a “contractor” to manage theses properties. Rag pickers rent a 1/8th parcel of land to live on. The rent is about $300 a month, much too expensive for one just one family. So 9 families share that 1/8th parcel of land, and share the monthly rental cost. Once the garbage is sorted, a bushel bag of let’s say plastic is sold to the contractor for $1. The contractor in turn sells the same bushel to a recycling plant for $50. A large portion of that goes to the land owner, the contractor keeps some, and the rag picker gets a dollar. You can begin to see how many bushels of garbage needs to be picked and sold to the contractor for $1 in order to pay the rent and live. Parents do not want their children to go to school as they are needed to go out and collect garbage in order to add to the income of the family. This is one of the neediest areas for medical care as almost 20% children do not see their 5^th birthday. These people are from West Bengal and speak only Bengali which makes it difficult to get jobs to earn any better income. This is where we spent the day today. This is where we saw 346 children. This is where we began to understand that no matter how hard we try, we’ll never know why life is dealt out the way it is. The haves and the have not's.

For now, we just keep going, waiting to see what tomorrow brings. And hope that it is a little better for those who live here. It is a difficult time for us. Asking questions, knowing that there are no answers. Why young girls are sold to the sex trade. Why people are kidnapped, drugged and operated on, only to wake up and find that both of their kidneys have been removed and sold for a great deal of money, and they now will die unless they can find the money to pay for someone's else's kidneys. I know that I will close my eyes tonight to go to sleep , but will find sleep illusive, as the questions are posed over and over again all the same. And if I do fall asleep, I pray that I dream that those whom I saw today, find a better life. It’s been said, that dreams can come true. Will you dream with me?

In all things give thanks,

David