Ethiopia July 2008: Eyes and hearts open

He came to the clinic because his friend told him that there was a medical team from the US at the place that he goes as a sponsored child of MoM. Elyas is 14 years old and more mature than many his age. He presented with a severe body rash, scalp sores and general malaise. He shared that his parents had died of HIV 2 years ago and the he was being cared for by his grandmother. He told us that he was taking a lot of medicines for he thought was TB and bad pneumonia. His story is one that may stay with you for awhile.

He had gone to a local health clinic a year ago because of some sores on his leg that would not heal and when he told the doctor that his parents had died of AIDS they sent him for some "tests" and soon after started him on "a lot of medicines". His grandmother told him he had a bad form of TB and pneumonia and that he would have to take medicines for a long time and if anyone asked that is what he had. He was walking down the street one day when he saw some beggars holding vials of medicines in their hands and slips of paper that said what they had and that they were dying and need money. Elyas recognized the vials as the same ones he had, and went to one beggar and read his paper: "I have AIDS and am dying." Elyas finally knew what he had. He found out from a beggar. He told his grandmother who told him again that he still had to tell people that he had a bad form of TB and pneumonia or people wouldn't want to be near him and that he would wind up a beggar like the others.

He wouldn't tell us in the beginning, but after we spent some time with him, he told us his story. You have to wonder how a 14 year old boy deals with this every minute and every day of his life. He has few friends, he is physically ill, and his skin is almost difficult to look at if your not open to things not normal. He found trust in us and we are taking care of him. I put him in our advanced care follow up program and he will be cared for everyday by our MoM staff here in Addis.

We have our eyes open here, looking, seeing and remembering. Elyas opened our hearts and made us realize what type of world is just outside our own comfortable and familiar neighborhoods. He doesn't have to worry anymore about being shunned or dehumanized because of his disease. We'll help him undestand this. He learned from a beggar that he has AIDS. He learned from us that he is loved no matter what.

In all things give thanks,
David

Ethiopia July 2008: The first few days

And so it began. The full team arrived, and within eight hours after having a few hours of sleep, the team began to get ready for a week's worth of clinics. Most of the medications arrived all of which needed to be packaged and labeled. And this was all being completed just as the clinic was starting. The first day began with everyone getting used to their areas of responsibility and assignments as the patients came in. Everyone became more comfortable with what they needed to do by the end of the first day. We saw 408 patients and the dental team saw 72 patients. On second day we had a wall of massive patients in the clinic area with rain falling outside and controlled chaos on the inside. By the end of the second day we had seen 512 patients and the dental team had seen 88 patients. For the first time on our medical mission trips we had a dental team led by Dr. John, who is with World Dental in Ethiopia. He had with him for local dentists who practiced with him and will be traveling with us as we go up north. In addition, we had lab technicians, nurses, and 10 local physicians, who joined us at various times with specialties ranging from general pediatrics to internal medicine, nephrology, cardiology, and ophthalmology. We started our Rapid Nutritional Assessment program as well, and have generated valuable information regarding the nutritional status of the children using WHO standards. We are now able to recognize those children who are mildly, moderately, and severely malnourished. Pharmacy has been expertly run, and is also staffed with an Ethiopian pharmacist and Ethiopia pharmacy student. It is always an incredible experience to work side by side with the local healthcare team as we care for the forgotten children together. We leave tomorrow for remote areas half of the team traveling by plane to Bahir Dar and the other half of the team traveling by bus to Zeway, where both teams will spend the day doing clinic's, spending the night, and then doing clinics the following day before returning to Addis. All in all, the first two days have been rewarding, gifted, and blessed.
In all things give thanks,
David

Ethiopia Medical Mission

I am in Chicago awaiting my flight to Frankfurt then on to Addis Ababa, where we will be having our first medical mission in Ethiopia. It was just 6 months ago when I did an assessment trip there, and on Wednesday, we will begin a 7-8 day run of clinics in Addis, Zeway and Bahir Dar. We will be splitting the team up in order to go to 2 different locations outside of Addis. Remote is remote...

Troy, Colleen, Kelly, Placida, Dawn, Donna, Shauna, Jessica, Michelle and I make up the US team. We will be joined by 3 dentists, 1 nurse, 1 pharmacist, 8 physicians and 6 support people from Ethiopia. This will be an incredible "team"! There has been a lot of ground work done by Getachew and his team for weeks now, and he has done a tremendous job! Peter, my old friend who has been with me on many tirps is there now putting the finishing touches on eveything. I am not travelinbg with the team due to being on call, etc, and will get to Ethiopia a day early to have meetings with a food supplement organization, and to give an orientation to the Ethiopian team.

We are expecting to have a unique experience. There is alot of siginificant and severe malnutrition there and malaria seems to be prominent. What else we'll see and do, has yet to be realized. It will come and it will happen. Be with us...

In all things give thanks,
David

Kenya Assessment Trip May 2008

There is always a story, always a happening that stays in one's mind after a trip. Kenya lent many of them. I spent 6 days traveling to the northern part of Kenya to an isolated area called Lokori, which is just south of Lake Turkana, and then traveled south to the small communities of Nahipai and Emarti. My hosts and friends, Hapi and Nicholas were with me the whole time. Hapi is the field project manager for MoM in Kenya and Nicholas is his right arm man.

We began by traveling with MAF. Driving to Lokori would have been a 16+hour drive, usually done in 2 days, and the road is patroled by bandits. Flying took us 1hr and 40 minutes. David, our MAF pilot and I flew up to Lokori and landed on the dirt strip next to the isolated village of Lokori. Truly some bush flying, and again my thanks to MAF and David for allowing me to do some of the flying. We pilots will fly anything anywhere. We were met by our Korean missionary hosts who oversee our MoM children in 6 villages in the area, Sungi and Pastor Daniel.

Lokori is a small village community that has surrounding it 6 smallere remote and isolated villages. We have about 700 MoM children in the villages and access to them is by 4 wheel drive all nito the bush. The Turkana comunity are for the most part herders and their dress is spectacular!


I must emphasize how remote we are. At Pastors Daniel and Sungi house, there is solar panel electricity for about 2 hours at night, water from an outside tank, and modest toilet facilites. But outside of that, there is nothing. And that is where we are going. We traveled south and visited several other areas where we have Mission of Mercy children. Emarti is an isolated village in the bush south of Nairobi, and a water project had just been completed, which we were fortunate enough to dedicate. The local dress is different from the Turkana tribes and we can see the unique differences in the health care of the children. Families live in huts made of mud and dung and are truly small with a small fire always burning inside. The family lives within this isolated area inhaling smoke constantly and for that reason, upper respiratory tract illnesses are commonplace.
On a visit to the local healthcare facilities we came across a unique and extremely progressive rehabilitation center for physically disabled children. There were approximately 70 children who lived there, and were receiving physical therapy, occupational therapy, and prosthetic devices that served to improve their lives. We established a relationship with them as Kenya was the first country that I have assessed that had a large number of children with special needs. One of our future efforts will be to establish a special needs program for those children who are part of MoM.
The pictures speak for themselves. We saw many things and witnessed incredible isolation, thirst, hunger, and significant illnesses. The country is beautiful. The people are beautiful. And the children I can assure you will not be forgotten.

In all things give thanks,
David

Swaziland Medical Trip April 2008 Team

The team at work!!!

Swaziland: Advanced Health Care Worker course April 2008

25 teachers from the Care Points and Mercy Centes attended the Advanced Health Care Worker course. This was the advanced course that I developed in additon to the Basic course that I give in differnt countries. The first day was a advanced anatomy and physiology. I held a show and tell dissection lab in the afternoon: we got a cow's liver, an oxen's heart, and an oxen's kidney, and I dissected them showing them heart valves, the inner workings of the liver and the kidney. Then when I was done, the students took the organs outside, and cooked them...and then ate them! Try that in the US!

The second day was all advanced disease recognition and algorithms. Peak Flow meters were donated to us and I showed them how to use them and then we used them on the children. Asthma is a big problem in Swaziland. The third day was basic pharmacology of antibiotics and we finished up with cases.

We now have 25 teachers who are trained on disease assessment, recognition and basic treatment. They will serve as the first health care line caring for the children at the Care Points and the Mercy Centers. This will insure that children will be cared for before they get sick so they can grow spiritually and with His love.

In all things give thanks,

David

Mozambique Assessment April 2008

Soon after we finished the medical clinics, I took off for Mozambique with Daren, Teresa and Jason to assess the medical needs there. The drive was 4 hours of beautiful scenery. We arrived and went right to work. Isaac and CArol the missionsary couple with Healing Place Church/Children's Cup have done an outstanding job in getting things going there. They set up a small room in the church to serve as a mini-clinic and stock it with medications. A Brazilain doctor with the Baptist ministry (Maria) comes once a week to see the children. I was very impressed with what they have done so far. The local government health care post where people go for care was dismal. But the government hospital that children get referred to was awesome! A seperate 32 pediatric ward, and a playroom!

The over all healthcare of the children is marginal at best, with malnutriton, malaria, URI's, and diarrhea the common casues of death and morbidity.With time, we'll have the children looking fat and healthy!!

As for us, we got stopped late evening by a group of "police/soldiers" who were loking for anything they could to get us. 3 of them with AK47's flanked the left side of our SUV while 3 of them on the right, talked to Daren telling him we had violated some law (passengers not wearing seat belts). After some "discussion" we paid them off (about $80) and they let us go. You never know what's going to happen next on trips like these.

In all things give thanks,

David

Swaziland April 2008: Day 5 and summary

Day 5: Maphiveni

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

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

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

Total: 1738 patients seen

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

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

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

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

It continues to be a wonderful journey.

In all things give thanks,
David

Swaziland April 2008: Day 3 and Day 4

Day 3: Logoba

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

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

Day 4: Zombodze

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

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

In all things give thanks,
David

Swaziland April 2008: Day 1 and 2

Day one:

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

Day two:

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

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

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

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

In all things give thanks,
David