Home Again

February 17th, 2010 by INMED
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After two very long days of travel and a few very fun hours in Narita, Japan, Ryan and I are finally home and what an adjustment it has been already!  First of all, we went from a sunny, tropical country right into the middle of a snow storm.  I don’t know how many inches are currently on the ground, but the snow is still falling.  Also, it’s amazing for me to realize now just how loud the United States is.  We went out to dinner last night and were struck by the noise that made talking impossible.  On the happy side, I can wear jeans again. : )  And of course it’s good to see friends.  However, what I want to write about today is what I miss about PNG.


I already mentioned the weather, but I do love the sun, so I miss the intense sun and the brilliantly blue sky.  I also miss the rain and the thunderstorms.  The rain in PNG is the most beautifully relaxing sound to fall asleep to at night.


I miss walking to work in the morning.  What a perfect commute!


I miss seeing the mountains on that walk to and from work.  And I miss the view of the mountains from behind the pharmacy building.  I always paused for a moment before I went in to check on the availability of whichever medication I was interested in using that day.


I miss seeing patients in the clinic, getting labs and x-rays, and having a follow-up appointment all in the same day.


I miss going to the market to get all sorts of fresh fruits and vegetables, but I don’t miss soaking them in bleach afterwards. : )


I miss the wild flowers, which were everywhere!


I miss all the doctors and other missionaries I worked with, and I miss the rest of the staff at the hospital, like Betty and Joe.


I miss speaking pidgin, or at least attempting to.


I miss all the geckos that kept us company around, and occasionally in, our apartment.


I miss how everyone said hi to us as we walked around.


And I miss the wonderfully quiet evenings….


Thank you again to everyone who supported us in this adventure through money, prayers, and encouraging words.  We couldn’t have done it without you.  God has certainly touched us through our experience in this beautiful corner of the world and we hope to touch you through what we have learned. With much love, Christine

Which side of the river are you from?

February 9th, 2010 by INMED
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Kudjip Nazarene Hospital has a specific area that it primarily serves, the Jiwaka province, with some very specific boundaries. Other parts of the country are covered by other hospitals. This is important for multiple reasons. Patient fees are based on whether someone is from Jiwaka or “longwe”. When the hospital is full, we close to “longwe” admissions altogether and refer those patients to other hospitals. This was the case a couple weeks ago in the medical ward when we had 5 people on the floor. And lastly, we only have one surgeon here, and as amazing as Dr. Jim is he can’t take every surgical patient in all of PNG, so we don’t accept longwe surgical patients unless it’s an emergency.


I’m explaining all this because a week or so ago I had a patient who had been injured 2 weeks previously and by ultrasound had a ruptured spleen. Because it happened two weeks ago it wasn’t an emergency at the moment, but it was unclear whether this man would need surgery or not. He certainly needed to be monitored to see if he was continuing to bleed. Since it was possible he would need surgery it was very important for us to determine whether he was longwe or not in case we need to refer him to another hospital.


He was from a village called Tuning, which is right on the edge of our hospital’s territory. In fact, the specific boundary is a river that goes right through Tuning. So the question gets more specific – Which side of the river are you from, Jiwaka side or Hagen side? The problem with this particular boundary is that the people of Tuning don’t make that distinction. They consider all of Tuning to be Jiwaka.


This past Thursday Ryan and I had a chance to go to Tuning. Part of the community based health program here is the Village Birth Attendant program and Tuning just graduated 8 new VBA’s. It was a very exciting time for the community with a ceremony and mumu. It was great for us to be a part of but really needs a blog all it’s own.


For me, it was great to go to Tuning that day and realize how far my patient had come and what this river was everyone kept talking about. Tuning was about 45 minutes to an hour away by car down a very bumpy, rocky road. Now imagine taking that road right after a large branch hit you in the back and you’re in extreme pain, and that’s assuming anyone is around with a vehicle who could take you. Suddenly it makes more sense why I saw this man two weeks after the accident. He was still in pain, but probably nothing like the day it had happened. And then to be asked what side of the river you’re from, knowing if you answer wrong you may be sent on another long car ride…


In the end, my patient answered Jiwaka side and stayed at our hospital. He never needed surgery, but Jim monitored him on the surgical ward to make sure he was alright. The hospital has to have boundaries, that’s an absolute necessity. But it’s interesting to see what those boundaries mean for those living on the edge. For those living in Tuning perhaps a simpler boundary can be found, but for now the question is still – What side of the river do you live on?

So, What do They Really Need?

February 9th, 2010 by INMED
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I’ve been teaching everything that I thought was long forgotten from my mind to a couple of nationals regarding electrical work, plumbing, appliance repair, and most importantly solar heating tech. The preferred method of training in PNG is apprenticeship, meaning that no matter how I explain the technology, they want to see me do it and then have me watch them before they even want to touch a job themselves. There are a few schools and training centers around; however, it seems like the majority of professionals/technicians learned their skill by working with someone else for a span of time before branching out on their own, or before the unfortunate passing of their aforementioned mentor.


My computer skills seem antiquated in the states. At times I wonder if my degree is actually in Punchcard Technology; however, here they will take whatever they can get, and old items are not thrown away simply on an account of age. You never know when you might need that MS-dos 3.5′” floppy disk again–yes I did have to use such a disk in the course of my repairs here. The Tech Center, where I spend much of my time, looks more like a technology antiques display; however, if you love to “MacGuyver” things, then the mission field has plenty of opportunities. I have married the old and new of the world of computers to make somethings work and the fun part is that what would be scoffed at back home, becomes someone’s first computer that saves them hours of overtime and walking here.


There is more more need here–with the nationals and the mission–than any one person has time to address. The point of interest that I continue to find is that you do not have to be an expert in any certain field to help. The smallest bit of knowledge is something that can be taught to and savored by another. What is considered a very common skill for most of us, can become a profession and a means of support for an individual over here. Granted, they first of all need Jesus. The vises of their culture, both from their ancestors and from the arrival of the white man do great harm to their struggle for cultural and social development; in-fact some claim that it is a fight that they are loosing; however, freedom from the spirits that continually plague them and the one hope that conquers all fear is needed here to give them the strength to stand for good and for progress in a culture trapped between two worlds. The training of nationals as missionaries and pastors who blanket this island calling for the people to repent of going after two gods, or more, and live a life seeking and depending upon the power and truth of the creator of this could-be paradise, will change these people more than anything else. Sharing God’s love in tangible ways is opening the door, but brave men and women in the same spirit as Boniface and Patrick who will walk through it will truly change the fabric of all 700 cultures here.


Finally; Kudos to my beautiful wife who is learning how to be a “Country Doc” from the talented Dr. Bennet and the brilliant Dr. McCoy (I still have yet to ask if I can call him “Bones”). She used an old Montana trick from Andy to separate a fish hook and an adolescent boy’s toe the other night that was truly impressive to watch. I would have gone for the trick using a long string and a quick jerking action, but her finesse left the crying boy with little more than a couple of holes the size of an 18 gauge needle. She is scared when she gets thrown into these environments, but she performs admirably. I am seeing a truly wonderful doctor in the making.


Thank all for your continuing prayers and support. We need them as we begin our final week here and our long trek home. Grace and Peace, Ryan

A Day In the Life

February 6th, 2010 by INMED
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This past Wednesday Ryan came with me to the hospital for the day to see more of what my life is like.  I think he enjoyed his time and more importantly, it means we have pictures.  : ) So welcome to B ward, the medical unit where my day started with rounds at 8:00.




Here is a picture of my half of the ward where I worked with Dr. Erin to see somewhere around 15 patients.  If Ryan had turned around 180 degrees and taken another picture it looks basically the same on the other end of the ward.  In the middle is the nurses’ station.


So one by one we made our way around the room talking to each patient, asking how they were doing, ordering labs and making adjustments to their medications as necessary.   It is not uncommon to pull the ultrasound machine up to the ward to scan someone along the way as well.




After we finish rounds, all the doctors head towards OPD, the outpatient department to start seeing patients.  Patients line up outside the building where they are first screened by nurses who take their history and vitals.  Simple problems the nurses will treat and send the patients home, but if they decide it is too complicated the patient continues on to the line to see the doctor.


I’ve spent some time in OPD seeing patients, but I generally check the ER first and take care of any patients that need to be seen there.  That’s where I am in this picture.  My patient is laying on a hard metal bed covered by a sheet of plastic.  The book down by his feet is his scale book.  Every patient has a book that they take to any medical facility they go to.  That is where we leave notes on the patient’s visit, prescriptions, and follow-up appointments.  Theoretically you can see a patient’s whole medical history by looking through this book.  Theoretically…


We stop seeing patients around noon and head off for lunch.  Ryan and I actually ventured off the station this day for lunch (instead of our typical PB&J).  We skipped on the betel nuts and cigarettes and went for flour balls and Coke.


Now flour balls are something like doughnuts holes, but not really.  They’re deep fried dough but much denser than doughnut holes and not coated in sugar.  They’re actually really filling.  And anyone who knows me knows I really can’t stand Coke, but it actually tastes different here!  I like the stuff!  All I can come up with is that it doesn’t have high fructose corn syrup in it.


Anyway, after lunch it’s back to more of the same.  We keep seeing patients in OPD and the ER usually until about 4:30 or 5. For the next pictures in order – First is me talking to the son of a patient whose prognosis was not very good.  Next is me doing a paracentesis on a man with extremely bad ascites.  I had taken 3 L off his belly the previous Saturday. This Wednesday he was still short of breath so I took off 3 more liters.  After that is me doing a lumbar puncture on a boy with a febrile illness of some sort.  Then me ultrasounding another patient’s belly in an attempt to figure out what his problem was. (Where’s a CT scanner when you need one…)  And of course, there is always plenty of paperwork to be done.  Although it is substantially less here compared to in the States. But that is how the afternoon continued until all the patients had been seen.

My PNG Birthday

January 24th, 2010 by INMED
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I thought it would be hard to celebrate my birthday in a strange place away from my friends and almost all of my family.  I was wrong. : )  I had the most wonderful birthday thanks largely to my husband but also thanks to old friends back home and new friends in PNG.  After lunch Andy, one of the doctors I have been working with here, came in to the ER with a delivery of flowers from Ryan along with a card.  Beautiful flowers that you can see in the picture here!


Then after work I noticed that there were a lot of birthday posts on my way on Facebook.  Thank you to everyone who left me a message.  Although I eventually caught on to Ryan’s “birthday event” (thanks Tracy), I felt very loved hearing from all of you back home.  I miss you all!


While I was checking email and facebook, Ryan was dragging his feet in the kitchen supposedly cooking me dinner.  Then all of a sudden Elana, one of our friends here, came to the door with a large tray of food.  Elana and the Bennetts made us the most amazing catered dinner.  There was the best salad we’ve had since leaving home (it’s amazing how I miss romaine) and a curry chicken dish with rice.  Such an amazing birthday dinner!


Then we went to the weekly prayer meeting which is every Thursday evening.  After we finished praying, everyone sang happy birthday to me.  And when I say “sang happy birthday” I mean they sang every birthday song ever invented.  It’s impressive.  And someone had made a birthday cake as well.  So I was able to celebrate my birthday with my new PNG family too who also made me feel incredibly loved even though they’ve only known me for a couple weeks. In all, I had an amazing PNG birthday!

One Young Man

January 20th, 2010 by INMED
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This is a story helplessness. I saw a young man in the ER two days ago. He had had a fever and headache for three weeks. Based on some clinical findings that don’t matter to this story we admitted looking at meningitis (infection in his spinal fluid) or endocarditis (infection in his heart) as possible diagnoses. Meningitis we ruled out by looking at his spinal fluid in the lab which left us with endocarditis or something else. If we were in the US we would do an echocardiogram and blood cultures to decide if he had endocarditis, here we can’t do either. Our diagnostic capabilities when it come to lab and radiology are very limited. So we put him on antibiotics and waited to see what happened next.


Tonight I am on call and my second call was about this young man. He was more restless than usual. After examining him, the doctor with me realized he wasn’t moving his right side. He had had a stroke. Probably an embolism from his heart, probably endocarditis. We still don’t know for sure, probably never will. More antibiotics. We’ll see what happens next.


But now, the difference between helplessness and hopelessness. We also prayed for this young man while we were there. Only God knows if he will recover and only God can make him better. So here in PNG we try not to think about what we can’t do, at times that could be overwhelming. We do what we can do and know that God is in control. There is both hope and peace in that.

Our Sunday Adventure

January 18th, 2010 by INMED
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We went to a different church today, about a 45 minute walk away. Yes it was a long walk, but an interesting one.  Through the muddy paths we walked through many tea fields.  Have we mentioned the tea here is good?  It’s great and the fields it comes from are right next to us.  In fact, this area is a major producer of tea and coffee, some coffee that is even sold to Starbucks.  Impressive, right?


And we saw a few pigs hanging out too.  A very precious commodity around here.  They are often used in bride prices and killed during large festivals.  These were just wandering around eating whatever they could find.


And then we got to the church itself.  Kusla Nazarene Church.  In the first picture I’m sitting on the ground outside the church talking to one of the young girls who attends the church with her family.  In the next picture you can see the church building itself.  Inside the church was very simple.  There was a pulpit and a whole arrangement of flowers and fruits and vegetables decorating the front of the church.  The rest of the room was empty with hay spread on the ground for us to sit on.  The service was simple.  We sang, had an offering, a short sermon, and prayed.  But it was beautiful to be there was people so different from us worshiping Jesus.  The service was done in a combination of Pidgin and Tok Place.  Tok place refers to a specific village’s language.  Each village speaks a different language, but then many learn pidgin as well as a second language in order to communicate with people from other villages and to do business with them.  Because each village still has it’s own language, there are over 800 languages spoken in PNG today, and most Papua new guineans are fluent in multiple languages.


After church we headed out for the second part of our adventure – the rock slides.  We went to down a muddy jungle path to an area of waterfalls and many smooth rocks that served as slides.  Climbing over slippery rocks, we all made it to the top of the slides and down we went, sometimes intentionally, sometimes unintentionally.  Unfortunately we didn’t grab any pictures of the slides we spent the most time at (mostly because we were in the water the whole time) but the next picture shows and area close to where we were sliding and you get the general concept. By the time we made it home we were very tired and very muddy.  It was a good day. : )

The Search For A Jolly Old Elf

January 14th, 2010 by INMED
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I really wanted to see Santa Clause. Continental Airlines had already firmly established itself in last place in my mind of the American based airlines—Christine and I have quite a rank list going so far—suffice it to say though, I was awake as our flight passed over the North Pole. My one great nemesis; however, in this endeavor to prove the existence of hardworking elves and the Land of Misfit Toys, was darkness. That dreaded 5 months of continual darkness for those who live way up north. I saw nothing! The mystery remains.


Perhaps as you read this, you are coming to grips with our east-west centrist view of travel as I did. In my mind, I have always thought that to get to China, you must cross the Pacific. This thinking is incorrect. You must fly north until you turn south and cross the Arctic, and the Russian Federation flag planted firmly in the ice. The only east-west of our entire trip was Columbus to Newark. Other than that, we flew the route of the Reindeer.


This alertness on a plane where we were stowed securely in the middle row, without a window in sight, kept me aft with the stewards and those waiting for the lavatory staring out a tiny window on the escape hatch—the one that turns into a giant slide after you set down gently in the Hudson or some other urban body of water. The sun did rise enough for me to glimpse a very desolate and rocky, snow-covered, Siberia (wouldn’t want to be trapped there), followed by a surprisingly flat (very flat!) Mongolian steppe, and a blizzard rocked northern China. My excitement built as around 3am (Eastern time, on which the plane operated) we neared the Great Wall of China. I don’t think that I moved more than the occasional wipe of the fog caused by my breath on the tiny plastic portal. By 3:30, still nothing, and now the sun had set. I was quite disappointed, but I guess this means that we need to return to China someday.


That’s all for today. Up next: Hong Kong (briefly), Port Moresby (also briefly), and Mount Hagen (yes, I scared off a pick-pocket simply with a stern stare!). Thank you all for your prayers and support. They are greatly needed and greatly appreciated! Ryan

Our Home

January 13th, 2010 by INMED
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Currently we reside in Doctor Guest Flat 1, a beautiful little apartment in the Highlands of PNG.  When you first enter, it really looks like any American apartment.  The main portion is one large room consisting of the living room (where you see Ryan sitting in the first picture) and the kitchen to the left. Beyond this area is the bedroom and bathroom.  So far the only obvious difference is the lack of a TV, which I have to say I actually like.


The kitchen is very much like any other kitchen.  We have a fridge, stove, microwave, and the all important coffee pot. But, first big difference – the water filter.  The water here is actually rain water and is fairly clean.  Some of the missionaries here drink it straight from the tap.  However, having sterile American digestive tracts, we are choosing to also put everything we drink through the water filter.


The other massive difference in the kitchen, which drives Ryan crazy, is that we have to soak all our fresh fruits and vegetables from the market in bleach before we eat them.  It’s an especially sad thing to do to strawberries…. The next big difference is our hot water.  It is provided via solar power.  So, if it’s too rainy, or we use too much, it disappears.  Thankfully we have an electrical back-up if we’re all out of hot water and really don’t want a cold shower in the morning.  Of course, we can’t be too picky about the shower in general.


We are really quite pampered here in our little home.  We have a washing machine, and the dryer (which involves wooden clothespins) is actually faster than the dryer I used in my last apartment.  Praise God for the strong sun that comes from altitude and being near the equator! So, despite all the differences, we are quite enjoying our temporary home and will probably even be sad to leave it when that day comes.  But until then, it’s home sweet home. : )

Journey around the world in 60 hours

January 12th, 2010 by INMED
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Before a week ago, I had never been on a plane for more than probably 8 hours.  In fact, I was antsy trying to sit still flying to Europe a few months ago.  Needless to say, it took more than 8 hours to get to Papua New Guinea.  After a 16 hour flight from Newark we made it to Hong Kong where we had a 24 hour lay over, which was just enough to get out, sleep in a hotel, and see Noah’s Arc.


We stayed in a very nice hotel that oddly had mirrors everywhere and a glass bathroom that provided no privacy.  Strange indeed!  Then we were able to take a double decker tram and a ferry to a separate island where they had a life-sized replica of Noah’s Arc.  Very cool but not nearly as Biblically based as you would think.  The theme was loving life and loving yourself.  The best part of the day was traveling around Hong Kong.  What a strange city so squished and packed with people!


From there we flew on to Papua New Guinea, which was another 7 hours of flying time.  Port Moresby was our entry point where I had my first breath of warm tropical air, and what proved to be a very interesting 6 hour lay over.  Port Moresby is the largest city in Papua New Guinea and the biggest airport in the country.  That being said, it was so small it made the Columbus airport seem as massive as O’Hare in comparison.  We went “downtown” for lunch at one of the nicer hotels then spent the rest of the afternoon at the “café” in the Port Moresby airport, which was of course the only place to eat or drink anything there.  Yes, everything in quotations because it isn’t what you would think of for a downtown or a cafe, but I just don’t know how to describe the place.  However, they are a country full of amazing coffee and tea and that was our first day to experience it.  Cheap airport coffee at the run down cafe – amazing!


Until this point everything had been moving smoothly.  We missed the crazy guy who shut down Newark airport by 2 hours and all our flights had surprisingly been on time.  That was, until we tried to leave Port Moresby.  I’m not sure how to describe this airport. After going through security a couple times, we found ourselves in a large room full of people in chairs.   At the end of the room were a few doors.  One by one a flight would be called and the people would line up in front of one of the doors.  When it came time for our flight, though, no one called for it.  And we continued to wait.  No one said the flight was delayed.  No one said it was cancelled.  No one told us anything.  Finally, about an hour later, lo and behold, they called our flight number and off we went.  Still no explanation.  When we landed in Mt Hagen, we all went into a room together and our bags were brought to us by forklift in two big piles.  Really it was a bit of a free-for-all in there.  But guess what, all of our bags made it on all four flights! We didn’t lose anything! (For anyone who doesn’t know our previous adventures, yes, this is big news.)


The last part of our trip was a short 45 minute drive with Jeff to Kudjip.  Driving through the Highlands of Papua New Guinea was such an amazing contrast to Hong Kong.  Yes, there were people everywhere walking down the road.  But the people weren’t packed together.  They had space to breath.  And the buildings were few and far between.  I felt like I could breath again too.  And that is how we made it to Kudjip Nazarene Hospital about 60 hours after leaving Columbus, Ohio.  : )


Please pray for the patients, doctors, and staff at Kujip Nazarene Hospital.  Pray for health for Ryan and I.  At the moment I can’t stop sneezing of all things.  And pray that we would be able to learn the lessons God has for us here and be able to participate in God’s work and be useful to the people here.  Thank you all so much and stay tuned for Ryan’s random thoughts on Papua New Guinea…