Haiti Wrap up…for now

Most of the team are still in Haiti, seeing children in 5 more clinics and working at the orphanage washing clothes, doing construction and caring for the 46 children that we have there. I had to return to give some scheduled lectures at the medical school where I teach the Ethics and Humanism curriculum.  The picture above is of  some of the orphans that I saw before I left Haiti yesterday. They are a little sicker than the other children we saw, but should do well.

We did what we came there to do: cholera education, nutritional assessment and rescue, and physical exams.  We will have seen over 1600 children by the time the rest of the team leaves. Interesting how we go with expectations of things gone sour due to the cholera and come back with satisfaction knowing that all the preparation, intervention and implementation of the prevention and education programs we put in place worked. I’ve been one for cauti0n over confidence. We were cautious in what we did, never getting too righteous about what we did. What was striking was the humility that each team member had. Too many times I’ve seen superiority complexes glazed in a thin veneer of concern. Not this team: Kelly, Michael, Tanner, Dave, Danielle, Allison, Annelyssa, Thelma, Michelle, Trisha, Lon, Deanna, Anne and Yolie.  Each had a pervasive concern for human welfare. So does MoM and Medical Mercy. Things will move slowly in Haiti as it does in many countries that suffer a poor infrastructure, a government that is far from stable and a physical country that is broken. I expect it to be many many years before we see significant changes overall. But…and this is the “but” that will make you smile. Our MoM children are far from that stagnant recovery. They are progressing at a fast rate, remaining healthy and growing. A few are outside the norm, but we identified them, and began efforts to begin moving them into the fold.

We’ll go back. Not right away, but sometime.We’re headed to Ethiopia and Bangladesh later on this year.  In the meantime, we’ve achieved a sense of “sustainability” of the medical care that the children need, the nutritional support they need, and the cholera education and prevention that they need.  Sustainability. Leaving in place a process that insures a long and healthy life, physically and spiritually. And so it ends, for now.

In all things give thanks,

David

Haiti Day 5

Just when you think all is well, something grabs your attention and you realize there is trouble out there. Today got my attention. We went to 2 projects, both on the way towards the border with the Dominican Republic, seeing about 200 children. Yesterday was easy. No drama, no significant illnesses, no attention grabbers. Today we saw sick children and it got my attention. Not many malnourished children, but more with chronic illnesses. I thought we had those children under control. Not so. There is a new wave of illnesses that have cropped up and we attacked them. Skin infections, pneumonia, and pustules. Did we miss something a year ago? No. Illnesses happens in some places more than others. That's why we go back again and again to make sure we're doing what needs to be done. The great majority of the children are doing well as you can see from the picture above. The thumbs up sign. But the child in the picture below is one of several that we spent time with. Medical Mercy does what it does because of these children. They got our attention today. We dealt with it and gave them a chance to live a better life. Trouble. Not anymore.

In all things give thanks,
David
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Haiti Day 4

You would think that there would always be something dramatic to write about, some miracle story, or a child who stood out because of some special need or story. The truth is, it's not always the case. Today was one of those days. (Well, except for one child. More on that later.) Two projects, one in the morning, one in the afternoon, and a total of 180 children seen. No drama, no issues. Just a lot of beautiful children and a lot of love. So there is not much to report really. And that is just fine, isn't it? Having 180 healthy children, with only 2 under the age of 5 years moderately malnourished, no cholera, all smiling and playing is alright. It means that what MoM and Medical Mercy are doing for these children is working: spiritual teaching, education, preventative medicine and assured physical growth.

And now about that child. Dr. Dave a physician who came with us on this trip saw his last patient who wasn't a MoM child but a child of a MoM worker in the project. This young child has cerebral palsy and was already showing signs of significant arm and leg stiffness. He explained in gentle terms to the mother the reason why the child was like this and followed with genuinely compassionate words of encouragement and support for the mother. God's love for all regardless of who or what they are was his message and how blessed that child was to have a loving mother like her. It struck me that those words are the words that our God speaks to us: He loves us unconditionally with compassion and grace. And so when I reflect back on today and see how the children of MoM are doing I realize it's because of that unconditional love. From Him and us. It was a good day you see. Unconditionally loved and blessed. I'm looking forward to tomorrow.

In all things give thanks,
David



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Haiti Day 3

The filth is overwhelming. The stagnant water, algae and garbage filled, surrounds the children. They live in it, play in it, and sleep in it. I wonder how they make it from day to day. From the picture above with the team at today's project, you can see what I'm talking about. I've been here 4 times in the past 15 months and it hasn't changed but the children have. With our aggressive cholera education and prevention program, we saw only a handful of children who had had cholera and did well, and saw no active cases. Our quick response and initiative paid off.

And what a difference food makes. A few calories, a little protein, carbohydrates and unsaturated fats, gives a child an opportunity to grow and live. That's what we've been seeing. Well fed children. A testimony to the MoM program of feeding children in the projects at least once a week if not more. I expected no less since we were aggressive last year in pushing nutrition as a priority.

That is not to say that we didn't see any children who were malnourished. We did. Not many though. The picture above is of a 4 year old boy who we identified today with our rapid nutritional assessment program and started him on the nutritional rescue program. Medika Mamba and of course vitamins.

We came, saw, treated, prayed, and loved. We ran 3 parallel tracts as planned: cholera education, nutritional assessment and rescue and physical exams. We had pharmacy running too as well as a streamlined registration process. All for the children. We are blessed to be where we and to do what we do. I hope that the children whom we saw today, will one day do the same for others. Our God has asked that of us. To be servants to others. He's asked that of me and I'm happy to be doing so. Today, tomorrow and always.

In all things give thanks,
David
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Haiti Day 2

He is 11 years old. Short, skinny, eyes that see little and withdrawn. He looks like he's 7. He is what we call stunted. Malnourished during the most important growing years, 6 months to 5 years. No chance now to catch up, no chance to make up the difference. What we could do is give him some high caloric Medika Mamba and hope he gains weight, feel better, and feel like a person again. Severe malnutrition does that to children. We have an aggressive program to prevent that in our children 5 years and younger and it is simply giving a balanced meal to the children each time they come to the project. Since we started this last year, the number of moderately or severely malnourished children under the age of 6 years has dropped significantly. We've identified just a handful out of the 226 children we saw yesterday.

We traveled a quarter of a mile up a river wash to get to a project, saw patients in the rain, and served those who came to see us. The team is doing well. Dave, Lon, Tanner, Michael, Kelly, Thelma, Allison, Annelyssa, Michelle, Deanna, Danielle, Yolie, Trisha, and Anne are serving. We're finished in Limbe and headed to Cap Haitien. The cholera is well controlled in our projects thanks to the program we put in place a few months ago when cholera hit. We are re-educating and reinforcing the information in each project. The nutritional assessment and rescue program is working and we are training key members of our projects to continue the assessment and treatment of the malnourished children we identified. Serving. It's a wonderful feeling. I wouldn't want to be without it.

In all things give thanks,
David
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Haiti Day 1

With considerable effort, the twin engine 30 passenger plane lifted off the runway in Fort Lauderdale. Fully loaded, and short on fuel. One sacrifices fuel for passengers and baggage. That's the law of lift and weight in an airplane. We landed an hour later on a small island in the Bahamas to refuel and made our way to Cap Haitian. 3 hours later we were at our first clinic and in 2.5 hours saw 108 children, did physicals on them all, nutritional assessments, identified those who were moderately or severely malnourished, did cholera education, gave out vitamins, de-worming meds and other medications and finished up the day. It's all good. We saw some wonderful smiles, some very malnourished children and a community of children who loved being loved on and cared about. There is nothing more satisfying than doing what God tells us to do and we did that today. Sleep is calling. He is calling. I'll answer to both.

In all things give thanks,
David
David H. Beyda, MD
Medical Director
Medical Mercy
Mission of Mercy-"One child Matters"
www.medicalmercy.blogspot.com
www.medicalmercy.com
cell: 602 228 8983

Haiti: Again…

It’s an odd thing getting a glimpse of something you know well from a time somewhere in the distant past. That distant past for me was 32 years ago, when I spent several months in a refugee camp in Cambodia as medical director of pediatrics. I was a senior resident in pediatrics and had 6 months to go before I started my fellowship in critical care at Johns Hopkins. And here I was in Cambodia. How I got there, and how I got to finish my residency in a refugee camp is a whole different story. But happen it did.

I look more or less the same after 32 years (“more” round, and “less” hair), and have been traveling the world doing third world medicine ever since. But what does all that have to do with the fact that tomorrow, a team of 14 of us leave for Haiti? Again? It’s the cholera thing. We had 2 epidemics in the Cambodian refugee camp while I was there: measles and cholera. I actually got measles encephalitis and was evacuated to Bangkok where I was in the  ICU for a week, comatose with cerebral measles. I woke up, had lost 15 pounds (it’s all back now thank you very much), and went right back to the refugee camp to keep working. That aside, it was the deaths that we saw. On day one of the refugee camp opening (around Christmas day 1980), I lost over 100 children. Every day was the same as waves and waves of refugees came over a mountain range being chased by communist insurgents. It finally slowed down, then the epidemics hit. Measles first. Hundreds of deaths from measles pneumonia, never seen here in the US. Then it was the cholera. Close quarters, hygiene issues (150,000 refugees cramped into about 10 acres), and poor control. I learned about cholera quickly, and how to treat it. I’ve never had to use that knowledge again until a few months ago. Haiti brought back the memories. The glimpses of those times, offer a valuable reminder that things sometimes don’t change. Poor sanitation, hygiene and dirty water, brings cholera to the forefront and with it its devastation. And that’s why we’re going. After my assessment trip a few weeks ago, it became clear that we needed to go back and reinforce the education and prevention programs we put into place. We’ll be doing that, examining all the children again, and doing a nutritional assessment on all of them. We’ll put those who are moderately or severely malnourished into a comprehensive nutritional ruse program using Medika Mamba (a peanut butter paste). We’ll go to 15 projects and see about 1700 children.

Glimpsing the past does change the way you look at things in the present. I know what needs to be done. I’ve seen it and have lived it. The team is ready, and we are off to face the battle. Bring it!

In all things give thanks,

David

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
Sent from my Verizon Wireless BlackBerry

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
Sent from my Verizon Wireless BlackBerry

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
Sent from my Verizon Wireless BlackBerry

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
Sent from my Verizon Wireless BlackBerry