India clinic day 5 and wrap up

After 5 days of clinic, 2 of which were half days due to travel, we finished serving the 1414 children that came to see us. The team was incredible. They worked tirelessly, without complaints and giving all that they had. There are many stories that they will come home with, some sad and depressing, some joyous, and all will be remembered for a lifetime. The theme for this week was "Who are you trying to please" using Galatians 1:10. I shared with the team that there are times that we are self-pleasing, people-pleasing and God-pleasing not so much. We talked about life not being fair, humility, realistic expectations, sacrifice and looking in the mirror to see who and what we really are. We explored our motivation for being here, our "why". And after all the talk, I asked the team to consider the question: so what? And challenged all of us to answer the question: now what? Are we ready to God-please first and foremost? Always? Can we be intentional about it? We are fallible no doubt. We are self-driven. But this trip did bring with it an opportunity to experience first hand what it feels like to God-please without thought. We did it. The whole team. Kelly, Paige, Lara, Carol-Lee, Julie, Anne, Barbara, Michelle, Deanna, David P. , Dave J., Beth, Allison, Darlene, Louie, Vic, Michael, Kendra and Fitz. 

The children are better off we hope and pray. We put in place first aid at all the projects we went to, taught and left behind a water filtration system, did dental hygiene and examined and treated many. Prayer was abundant, silently and openly. Medical Mercy and OCM serves to be a God-pleaser. This wonderful team were so as well. My prayer for them and me is that we remember what it was like this week, pleasing our God as served, as we had been asked to do, and make it foremost in our hearts and minds as we travel back to the US and back to our crazy lives. If we do so, we validate all that we did here for the children. That we gave and served and showed that it can be done. 

In all things give thanks,

David

India clinic day 4

So let's see. Over 1100 children seen in 4 days, 1 more day to go, wonder what impact we'll have. It's not about the numbers although we all are intrigued by the "number seen", me included. It gives us a sense of accomplishment, a sense of completion. Really? Not so fast. It's really about the reason why and the how we do what we do, and what the children receive. I'll let you decide what all those things are at least from the stories you read here. For me, it is simple. We have a reason "why': to serve; and the "way" is to give of ourselves and do our best to ensure the health of the children. Today is an example.

We are still in a remote area of India, isolated and far from the "big city". We saw about 320 children today, many still presenting with stunting, the product of sever malnutrition before the age of 5 years. One child in particular, the child you see above, is one of those. She is 8 years old and is the size of a 5 year old. She is chronically ill, has a persistent cough, pneumonia, may have TB, no appetite and a lack for life. She had no breakfast this morning. There was no food in the house. The parents have been "quarreling" according to the child, the mother is sick, and the father is rarely home. She is a sponsored child, and because of that she is one of the lucky ones. She gets a noon time meal Monday through Friday because of the association OCM has with a school that she attends and she is cared for by OCM staff. Medical Mercy now gives her a chance for health. I gave her medications, put her in our follow up system, the local OCM staff will follow closely and send me a report in 2 weeks as to how she is doing. We did a full nutritional assessment on her, and She'll be assessed every 6 months so I can see how she is doing. Without the medications, the follow up, the care and the intentional effort to get her better, she would pass away slowly and alone. There in lies the "why" and the "way". She will do well, she will survive, she will grow and she will be able to live her life to her potential. 

We have one more clinic tomorrow. Not a full day due to the fact that we have 5 hours of travel to get back to our base. We'll see a couple of hundred children and finish out the week with a "total number". But more importantly, we will finish out the week having served and leaving behind a chance for the children to see a lifetime of love.

In all things give thanks,

David

India clinic day 3

Almost 5 hours from where we were based, on winding roads, so narrow that only one bus can move in any direction, is where we are now. We'll stay here until we return at the end of the week, seeing children who have little if anything and wanting for not. It always seems that way. They are happy with what they have needing only meals and caring. Where we are is mountainous with rubber trees, monkeys and elephants. Far from the common place of our lives.

So they waited for us. The children all sitting wait to be seen. And we did. Each with their own personality, unique smile and their own story when we took the time to ask. They were happy despite all that they faced and gave us hope that they will be okay. The project teachers, the principal and the pastor were clearly engaged with the children and cared deeply about them. It seems that when we are this far from what we know as comfortable, we are amazed at the resilience of the children who live in an environment that we would have second thoughts about loving there ourselves. But isn't it true that if there are people who care enough to "care" are there for us, we can endure. And that is what I saw today. Teachers, pastors and staff who take care of, care about and care for the children. I can't ask for anything more.

On all things give thanks,

David

India clinic day 3

Almost 5 hours from where we were based, on winding roads, so narrow that only one bus can move in any direction, is where we are now. We'll stay here until we return at the end of the week, seeing children who have little if anything and wanting for not. It always seems that way. They are happy with what they have needing only meals and caring. Where we are is mountainous with rubber trees, monkeys and elephants. Far from the common place of our lives.

So they waited for is. The children all sitting wait to be seen. And we did. Each with their own personality, unique smile and their own story when we took the time to ask. They were happy despite all that they faced and gave us hope that they will be okay. The project teachers, the principal and the pastor were clearly engaged with the children and cared deeply about them. It seems that when we are this far from what we know as comfortable, we are amazed at the resilience of the children who live in an environment that we would have second thoughts about loving there ourselves. But isn't it true that if there are people who care enough to "care" are there for us, we can endure. And that is what I saw today. Teachers, pastors and staff who take care of, care about and care for the children. I can't ask for anything more.

On all things give thanks,
David

India Clinic Day 2

Whatever the reason, life comes at us from directions unexpected. That is not to say that all is bad, but simply to suggest that there are times when we expect certain things to go one way and they decide to go their own way, far from the path we expect them to travel on. I expected to travel on a bumpy road, to a project with significantly impoverished children who longed for a decent life. That is not what happened today. With all good intentions, we travelled to our site, saw about 185 children, identified a number of children in need of advanced care, and participated in the feeding program watching the children eat their meal that is given to them by OCM daily. We noticed that because of this program, the children were much more nutritionally on target for their age as compared to the children yesterday who did not have access to daily meals. And here is where the expectations turned a little to the north, to the positive side. I expected to see children who were sicker, more malnourished, more impoverished since we were in a locale much poorer than where we were yesterday. The children were in fact a little sicker, more impoverished but relatively well nourished and well adjusted despite the conditions that they lived in. They were happy, content and interactive. The 2 projects that the children came from today, embraced a holistic approach in giving the children what they needed and deserved in order for them to experience life to their fullest potential. It is because of the dedication of the teachers, the project leaders, the pastors and the local OCM leadership, that the children were moving in the direction of personhood and worth. 

One child who was born with a significant discrepancy in leg length, had surgery a few months ago to correct his gait that OCM financially supported through our Children's Crisis Fund. He walks without a limp now, is self confident and plays with the other children. It is things like this that make what we do worthwhile. Giving a child  a chance to be a child.

The team worked flawlessly. After yesterday nothing could slow us down. Everyone made the most of their individual talents and served the children. We leave tomorrow for another remote area and will be there for a few days. I'll wait to see where the road takes us. No expectations this time. I'll go where the road leads us and trust that it will end in a safe haven for children who have had little and now have something. Love and caring.

In all things give thanks,

David

India Clinic day 1

Every now and then we have a day that we want to forget. Or remember. A day that is so out of the ordinary, so different, that it strikes a cord in our hearts and minds and plays a tune that makes us smile or gives us pause. Today was one of those days. 

Not knowing what to expect, we drove almost 2 hours to a remote province where we walked down a dirt road to a hidden school haven with children waiting. All were in uniform, white shirts, pants, skirts ad blue ties for both boys and girls. Somewhat unexpected. Where were the poor and the isolated? Where were the malnourished and the weak? Where were the sick? Wait for it. They were there, but hidden behind smiles and a sense of community in a school that offered an education and an opportunity to pursue a better life than the one the children were born Into. And now here is the picture seen behind the uniforms and the smiles. Severe effects of malnutrition resulting in stunting. Children who looked like they were 5 years younger than what they really were. A 9 year old who was the size of a 6 year old. A 12 year old who looked like a 7 year old. Short stature with long term effects. Girls who will deliver prematurely once they become women and get pregnant. Boys who will grow up with weakened physiques  limiting them to vocations that they may not be given an opportunity to succeed on. The pictures here are of how children are affected. Healthy looking on the outside but compromised for life due to malnutrition before the age of 5 years. The tragedy behind the veil of presumed  health. 

We left feeling like we impacted lives. First aid training  given and first aid kits left behind. A water filtration system left behind. Dental hygiene taught and toothbrushes left behind. Medications given and left behind. Children with illnesses identified who needed advance care sent to facilities who could help. Love and validation that they were children who deserved nothing less than that they were children who were treasured and cared for and cared about. All 462 of them. Yes, we saw, played with, treated, cared about and loved on 462 children. Today. What a day. A day of sadness behind our smiles knowing that the children were going to be what they were, stunted, for the rest of their loves. A day of happiness for leaving something good behind. A day so out of the ordinary that it made us both smile and give pause. Bittersweet, but what a wonderful day all the same. 

In all things give thanks,

David

India October 2013

Question. Answers. More questions than answers. I am often asked how and why we choose the countries we go to. It is not that complex. We go where we think the greatest need is for the children at that point in time. So off we go to India, our 3^rd trip there, but to a different location. South, on the very tip of India to an area called “Kerla”. We have several projects there with many children who are in need of medical care and nutritional assessments. A team of 20 will be leaving, 4 doctors, 7 nurses and 9 lay members.

 

I remember India well. The children have an aura of the unkempt, many with bags under their eyes, a pouchy face, or more often than not, sunken and void of emotion, and hair that is coated with dirt. I remember the times that we were faced with making critical decisions as to whether we could help a child or not. We did most of the time. And that “most of the time” is what still stays with me. Sometimes we can’t for reasons that may surprise you. No medical facility to send the child to that can offer the medical interventions that are needed and sometimes, yes hard to believe, parents who don’t see the need to pursue medical treatment, believing in an obscure spiritual healing that is contrary to the evidence that there needs to be a partnership between medicine and religion. It is then that I realize that the critical moments in life always arrive with astonishing suddenness and then they are gone without us being able to do anything about them.

 

I have come to realize that the decisions of our past are the architects of our present. I try to make the right decisions for my patients but there are times when I am in a moral gray area. How far to go with limited resources and realistic outcomes. It’s the age-old battle between mind and heart, which seldom want the same thing.

 

We leave in a few days. We will see over 1500 patients in five days if all works out as planned. I pray that as we serve those who come to us for help, they will be comforted by the fact that whatever we do, it will be a validation of who they are: persons. No judgment, no pity, simply caring and love. For me, each day that I am with them, will be the beginning of forever. I want them to remember even though we are there for just a short time, we validate that the power of the human spirit and faith can endure any challenge, no matter how daunting.

 

In all things give thanks,

 

David

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