February 6th, 2016 by Kristen Allcorn-Killen
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The weekend is here! While I look forward to the restfulness that often happens on weekends, this weekend is a little different; one of the Ghanian doctors got married earlier this morning, so most of the doctors (all except 1) are gone. I was nervous that rounds would take all day long…but some of the Ghanian medical students rounded with us, which helped move things along.

Today, I saw a spectrum of things…a Fulani man who was eager to go home finally well (although I am not sure the reason he got sick…or the reason he is now well) who loves greeting me (as I love greeting him); in his warm greeting and handshake, I am reminded of my Grandpa Birch and his warmth for all people. I also watched a stroke patient die before my eyes knowing that there was nothing I could do to help him. In addition, I greeted the man I met on my first day here (the one with that huge hole in his stomach); he is doing well and his surgical wound is finally healing. I praise God that that patient knows Jesus and the ultimate healer. I also saw a woman with a mysterious growth in her abdomen and another who is recovering from severe pancreatitis (she also knows Jesus and her smile is infectious!). I also saw some people who look perfectly well from the outside and even say they feel well, but who have spiking fevers at night despite negative tests.

I see lots of patients and a variety of medical conditions every day. Some, I easily know how to treat, whereas others are trial and error (even for seasoned missionaries here). The fact of the matter is that we are in a low resource setting and we have to work the best with what we have and trust God with the rest. It is sad when people die or have long term health issues (like a 13 year old girl with heart failure or a 6 year old with massive liver disease) and I know that we can only do our best to manage their disease. On the other hand, it is amazing the services that are provided to the patients and families here at the BMC. Here, you do not have to suffer alone; chaplains are available and talk with all patients with more serious conditions or as requested. They share the gospel, pray with the patients and family, and more. People with chronic diseases like high blood pressure, CHF, COPD…come on a monthly basis to get medication refills; while they are waiting for clinic to start, the chaplains present a message. People are not only receiving physical healing, but also spiritual healing.

Today, an ER doctor from El Paso arrived; he comes to the BMC twice a year to work and support the missionaries here. He has great experience and I am excited to work with him. Another volunteer is also traveling here; pray for her safety.

Thanks for taking this journey with me and for committing to pray. Please pray specifically for physical stamina (as well as emotional toughness). Also pray for the Harmatan to quiet down (here, it is dry, hot, and windy…which makes for lots of dust and keeps planes (like the one I am supposed to fly out on in a little over a week) from flying; worse case scenario, I ride a bus for 15 hours…but I prefer to pray for the best case scenario!

February 6th, 2016 by Kristen Allcorn-Killen
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I’m so thankful for Friday! We are all so worn down from a hectic week and are looking forward to the weekend. We had rounds in the morning (busy as usual) followed by clinic (more busy than usual). It felt like we were working a Monday! I saw more patients than I can remember from severe hypoglycemia and alcohol withdrawal to leg infections to pregnancy issues to mysterious infectious diseases (fever without a source) to a kid with liver cancer (seriously so sad) to wound infections to arthritis to CHF to malaria to…the list continues! I was excited to finally have learned how to interpret an US of a fetus and will eagerly US any woman who needs it in the next week!

Clinic lasted until 6:30, which is long for clinic. I had one patient waiting on a urine pregnancy test, so I waited in the lab for it to finish; it was negative, so I gave her some medications for stomach bloating. The patient appreciated me staying late just for her. Afterwards, we were invited to a missionary’s home for dinner…veggie lasagna with green beans and salad…and APPLE PIE! It was all so good! I told them that Tyler would be jealous that I got homemade apple pie (it is his favorite!). The fellowship with that family and their sweet girls was the perfect end to a hectic and exhausting week.

February 6th, 2016 by Kristen Allcorn-Killen
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Thursdays are lighter days…thank goodness. Seeing all this sickness around me and knowing that I am limited in what I can do is draining. I know however that God is the ultimate healer and is always in control.

After rounds, we had a delicious lunch, then I took a much needed nap. Afterwards, I went with another student and missionary to market. Market is such a bustling place…lots of vegetables, fruits, spices, maize, cloth, and street food. Kids yell “Saminga” or white person hoping for a toy, candy, or attention. I often wonder why I was born in the US and have lived a life lacking nothing vs being born in a third world country and lacking many basic necessities. The missionary described how she has developed a relationship with a woman who had a tumor on her leg, who has since had to have 2 amputations (I assisted in the second amputation). This woman now stays near the hospital and the surgeon has developed a strong relationship with the patient and her family. The surgeon makes house calls and is arranging to bring a Ghanian with her on one of the visits to share the gospel message with this patient. God is so good! I pray for this patient to have an open mind about the gospel and choose to believe in Jesus; I also pray for her to join a group of believers in her hometown once she is better enough to travel home; lastly, I pray that her wound heals well and that the tumor is gone forever.

I am in the middle of reading Radical, by David Platt. In it he discusses the gospel message and our responsibility as Christians (especially US Christians who have plenty) to be going to the world and using the blessings God has given us for His glory. Tyler and I will definitely be talking about this when I get home about how we can best use our resources to serve God.

Thursday night is the station meeting with all the other missionaries. One family just left Ghana for their previous home in Burkina Faso…so the group was smaller. We discussed ways of sharing the gospel through reading scripture (either in Mamprusi or through a translator) then asking questions about the passage…like what sins are present, what does God teach us, what are the promises here, what knowledge can we gain…it is definitely a format I plan to adapt to my own scripture reading to hopefully retain more scripture and come to understand and appreciate its’ full meaning.

February 3rd, 2016 by Kristen Allcorn-Killen
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Last night was great! I was invited to a missionary family’s home for dinner…which was Mexican…my favorite! I loved spending time with them and talking about missions. I also enjoyed loving on their little girl and playing games with their son.

My good friends Chelsea and David left today to travel back to the US. I relied on her medical knowledge and on David’s calmness in any situation. They are a neat, Godly couple, one that I am so thankful to have known and hope to continue the friendship in the US. This means that there are three medical students here…which is a little scary, but rounds and clinic today were good. I felt very supported and given advice when I was unsure what to do.

In all these experiences here, I can say only one thing for sure…my God is greater. He is the sustainer of me when I see the umpteenth patient that day…the one who gives me patience when the glucose strips run out or a medicine is not given…and the one who gives me energy when I am running on empty. I am so thankful to be able to call on Him. I pray that you too have a close relationship with God…and if not, that you have the courage to ask someone (or me) about a relationship with Christ.

February 3rd, 2016 by Kristen Allcorn-Killen
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We had pancakes the other day and they were so good! One of the other volunteers decided to make French toast with the leftover syrup, which inspired me to do the same. I went all out and had French toast, leftover egg casserole (complete with chicken, tomatoes, onions, and peas), and coffee for breakfast…and boy was it delicious! I definitely needed a break from oatmeal and protein bars.

We had our weekly lecture on meningitis this morning. It was good to have a reminder of the different organisms that cause meningitis as well as the treatments for it that are available here. Afterwards, we rounded as usual.

During rounds, one family was transporting their family member home; he had a stroke 1 week ago and was not improving, and they finally decided to take him home. Another man who was in a motorcycle accident and had a c-spine injury decided that he wanted to be taken home; we were trying to arrange transport to a larger hospital with neurosurgery capabilities (since he has massive paralysis), but he insisted on going home despite the risks to his health…even further paralysis or death. As I was trying to explain the risks to him and his family (via a nurse translator) he said that the patient still wanted to go home; so I arranged for the chaplain to come see him before he leaves. I wanted to tell the patient that travel home (especially on the back of a motorcycle, which was his idea) would likely be impossible, and could worsen the injury…even causing death. The nurse refused to tell him that he may die; here death is not talked about and not planned for…it comes and people deal with it. Here, the chaplains are the ones who discuss sensitive issues like death. I think it is great to have the spiritual support when talking about the possible death of a patient and grief with the family members.

The kid from last night with the hand injury was looking great this morning! I was so happy to see him smiling! Another little boy wanted to be discharged so badly, but he still had spiking fevers every night. I told his mom that it was too dangerous for them to go home today, but I promised to bring him back something to do. After rounds, the volunteers had lunch together. Then, I went back to the hospital and handed out coloring books and crayons along with balls to all the kids; they loved it! It is great to spread joy (and takes only a small effort on our part).

Recently, I finished reading this book “The Same Kind of Different as Me.” Which tells the story of how two strangers from two completely different worlds (one a rich, white art dealer, and the other a poor black homeless man) come together, teach other, and in the end become best friends. It is a great read. It made me think about the simple ways that I too can genuinely show Christ’s love to others who are different from me (or even who are the same as me). How can you show His love to others this week?

I am so thankful for all your kind words and prayers. This work is both exhausting and fulfilling at the same time; the patients are incredible and the workers are great. I pray that as I work, I am working for the Lord…and that others will see Christ in me.

February 3rd, 2016 by Kristen Allcorn-Killen
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A new volunteer arrived this morning…after a grueling 15 hr bus ride from Accra, Ghana. I sure hope the planes are flying when I leave. She is another medical student, and I am excited to work with her. We went to the hospital to round as usual. It seems like we discharged lots of people, but then we turn around and there is another one in his/her bed! There are tons of patients all the time (and it is not even the rainy season, where there are 3 kids to each bed!)

After rounds, I helped with a few procedures. Then lunch. Then clinic. Clinic was super busy (because it was a Monday and because it was a Market day). At one point, there were three doctors, 3 Ghanian translators/nurses, 3 patients, and 5 family members in one tiny room; it was crazy. At another point, I was speaking to a nurse who spoke to another patient’s relative in Mamprsi, who spoke to a Fulani man (the patient) who then responded and it was translated back. After some laughs and miscommunication, I think we got it figured out.

Some interesting cases from the day included: an incarcerated hernia (she went to surgery the next day), cellulitis after local medical treatment of a wound, severe malaria, enteric fever, snake bite, leprosy, a man with a huge testicular hydrocele (surgery for him is in a few weeks), a woman with a large growth (2in x 12 in) from her ear, and a child with a brachial cleft cyst, and lots of pregnant women, plus the usual HTN, COPD, Acid reflux…The last man was an elderly Fulani man (part of the three-way translation) who had multiple complaints (none of which was my chief issue…his poor breathing quality from COPD). So we discussed treatment for a few issues and he will return if he wants to discuss other symptoms. At the end of our discussion, he thanked me for caring for him and smiled from ear to ear.

Clinic finished at around 6:30, which gave us time to eat and rest a bit before going back to the hospital for night rounds, where we see all the new admissions for the day and write orders. We work like a well oiled machine and finished rounds fast. I saw that Fulani man again on the ward and he introduced me to his brother, who was admitted earlier that day; he was still very grateful for the care.

At the end of rounds, I pleaded for us to help this one boy; he had fallen from an orange or lemon tree and a thorn went through the palm of his hand three days ago. When we saw him his little 5 year old hand was swollen to the size of an orange (and no, I am not exaggerating). His hand was very sore and the pain was spreading by this time up his upper arm. I was afraid that if we waited until morning to cut open his hand and relieve the pressure, that he could have permanent damage to his hand. Thus, we took him to the procedure room, gave him a little ketamine, then cut his palm open; pus and blood spurted out as we relieved the pressure; after getting all the junk out, we packed it with gauze. I was so thankful that we went ahead and did the procedure that night…and I know that boy is too!

February 3rd, 2016 by Kristen Allcorn-Killen
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I love Sundays! We got up earlier than normal to round so that we could go to church. We finished rounds in record time. After rounds, I went to the church in TB village. It was great! The church was under a tree near the nurses’ head quarters at the TB village. They used three benches to form a “U” shape. I sat with the women and another volunteer sat with the men. We sang a few songs where there was a leader, then the rest of us repeated the same words after her/him. I didn’t know what I was saying, but the words, the rhythm, the drum, the rattles in the hands of dancing children was so pure, so simple, and so heart-felt. These people literally have almost nothing; they have TB and must live in this village to get treatment for 6-9 months. They have few possessions with them and do not see family much; yet, they continue to praise Jesus. I was humbled by their worship.

The preacher is also a primary school teacher. He preached on Daniel and chose a passage that involved people who are having feuds; he discussed how we are to love others and to resolve conflict. People who live in TB village are from several tribes around Nalerigu. Sometimes, that causes undo tension. There are also normal disagreements between neighbors (just like in the US). He was preaching to help us see the need for reconciliation before the end of times.

Afterwards, I took a much needed nap…as I’m always exhausted after a long week. I woke up refreshed and enjoyed lunch with the rest of the volunteers. Later, I played games and entertained some of the little missionary kids (I am convinced that babies and little ones cross my path to put a smile on my face!).

January 30th, 2016 by Kristen Allcorn-Killen
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Yay! The weekend! I slept in 15 more minutes than usual before rounds, rounds went pretty well with lots of discharges…which was great because we are so full we had several people and kids on the hard floor for a bed. I saw most of the same patients I saw yesterday…which is great for continuity of care and developing a relationship. I saw the older woman from a few days ago too who had the emergency surgery; she is doing well aside from pain. I held her hands today and asked if I could pray for her; she smiled and said yes please (at least that is what I think she said). Afterwards, she seemed to be a bit relieved. God is good.

When I was finished with rounds, I made my own rounds on the kids. I handed out coloring books and crayons again (kids come and go frequently). They were so happy to get the books! One girl, who previously was upset at her mother and had a hysterical episode at home, followed by other outbursts in the hospital, sat on her mat quietly coloring…it was calming for her. Again, a simple gift had such a profound impact on those kids.

After rounds, Dr. Tim and I checked on one of my sickest patients. She was previously admitted to the hospital with pneumonia, treated, and sent home on treatment. After she was home for a few days, she started coughing up blood, so they brought her in. We immediately started blood transfusions and several antibiotics. We also evaluated her CXR and found that her pneumonia now involves her entire lung…and that her blood is not coming from her stomach. We decided that it might help her to drain off some of the blood fluid, but it was too thick to drain. We were stumped…she could have a cancer, some weird infectious thing, or she could have ingested some local “herbal medicine” that is somehow causing her to have a hemothorax…or for her lung to bleed. After asking multiple questions multiple ways, we finally learned that the family had given her some unknown herbs before she started spitting up blood. We still do not know the exact cause and can only provide her with supportive treatments like blood transfusions and pray that she gets better.

I’m about half way finished with my rotation here…time has sure flown by! I feel like I have gained lots of medical knowledge on tropical diseases and management of hospital patients in a low resource setting. I am also learning and practicing integrating my faith into medicine…and loving patients and those I work with. It is incredible how God uses people…many of you are praying and supporting me, and I am working and supporting the local missionaries here, who in turn support the community of Nalerigu, who support the missionaries in tough times, and the missionaries support me…it all comes full circle. Thanks for taking this journey with me…and being faithful to pray. It means the world to me!

January 30th, 2016 by Kristen Allcorn-Killen
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Last night was AWESOME! First, the other short term people and I went to TB village, which is a short walk from our compound. TB village is a place where people who are TB+ go to receive treatment by nurses through the directly observed treatment program. It is a WHO campaign to increase adherence to TB treatment thereby improving success rates for treatment and decreasing drug resistance. There are about 30 “houses” there each with an outdoor courtyard area surrounded by 5 “rooms” each about 5 ft x 10 ft and an open area for cooking. The people who live in TB village are assigned a room and stay there for 6-9 months for their treatment. Afterwards, they return home to their village.

While in TB village, we met Nelson, an older man who spoke English (Thank goodness), who showed us around. We gave out balls and other small toys to the children there. The adults were also curious and they all wanted some too (mostly to give to their kids when they return home). They were so excited! One child was initially fearful of us white strangers, but after Nelson gave him a ball, he started running up to us. Another child shrieked with laughter after receiving one. It was awesome!

Later, we had station meeting, which is a time for dinner, worship, devotion, and prayer with all the missionaries on the station. 1. There was chocolate cake. 2. The worship was amazing with people from Belgium, the US, Burkina Faso, and Ghana all singing praises to God. 3. It was great to hear stories of how God is moving. By Thursday, I am always exhausted, and the station meeting was a time for me to refocus…to remember why I am here and that it is on God’s strength that I make it through each day. I am so thankful that I can come across the world to serve Him. Working here, I have come to be more thankful for what I have and to see suffering on an entirely different level.

On Friday, we rounded on patients then had clinic. It was a busy day as usual (pretty much all days are busy here it seems). I saw a variety of patients…from a teenager with leg infection after a snake bite, to a man with HIV and likely reactivation of TB, to a man with gun shot wound to the leg, to a man with bowel obstruction and another with acute kidney failure, to a woman with diabetes, another with a huge spleen from recurrent malaria infections, to another who has terrible pneumonia and is coughing up blood. Then, I went to clinic and saw a variety of patients including HTN, CHF, pregnancy management x 5 women, lots of upper respiratory infections, arthritis, joint pain, malaria, and shortness of breath…and others I cannot recall.

Friday night, we watched “God’s Not Dead” with the missionary family from Belgium. It was fun to watch it in a different setting from the comfortable theatre or couch at home…and to hear the missionaries’ take on the American film. Afterwards, it sparked a discussion about how Christianity is perceived in the US…and here in Africa. Through the film, I was reminded that God is still moving and working here…even when we think that we have nothing left to give or do in a tough situation, we have faith that God will carry us through…and that He is enough. God is definitely Not Dead!

January 28th, 2016 by Kristen Allcorn-Killen
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Thursday is a rounds and procedure day…which is supposed to mean a lighter day…but that is not always the case. While on rounds in the male ward, an attendant comes to me and says “Doctor, please come quickly, there is a woman who is unconscious and needs your help.” I look around and realize that he is talking to me…even though I am not quite a doctor yet. As soon as I register this, a cart is rolled into the ward with an older female patient; she is not responsive. As they were transferring her to a bed, I try to get info from the family about what happened; one of the Ghanaian doctors heard the commotion and came running. Apparently, she was not feeling well at home, so they were driving her to the hospital; on the way, she collapsed. She had no pulse and was not breathing, so the Ghanaian doctor started chest compressions, and I was bagging her (with a bag that was not connected to oxygen since the oxygen machine was in a different ward). After a few minutes we switch jobs; eventually, he checks her for a pulse and respirations and says it is finished. Everyone leaves the room as quickly as they had come. A sheet is wrapped around her body; her son comes and sits on the edge of the bed in utter disbelief. I walk over to offer a pat on the shoulder and my condolences, but that is all (since I cannot speak the language). After a few quiet minutes, the same cart that brought her to the ward wheeled her away and to a pick-up truck where she would be transported to the morgue.

At the same time as the code was happening, Chelsea was called to assess two gun shot victims. When I finally found her, I was shocked; We are not at a level 1 trauma center…far from it…but we just dealt with a code and two gun shot victims. Apparently, they were shooting a gun as part of a local ceremony and it backfired and hit people bear by…or something like that. One guy had bullet fragments in his face…and I did not see where the other one was shot; in any case, I was reminded that no matter how much we try to control life, there are things that happen that are out of our control. And regardless of what happens, that God is still good.

I finished rounding on patients for which I am stumped. One has entire body swelling with horrible kidney function and he probably needs dialysis (which we do not do here…so he will probably be transferred). Another woman has severe abdominal pain…with a massive spleen…I mean I and no one else in the room had ever seen a spleen so big; she likely has some bleeding disorder. We sent for some outside labs which will take days to return before we have any idea what is wrong. Another woman has body swelling, is 6 mo post-partum, and may or may not have had a seizure overnight that resulted in her being mute and weakening both of her hands…crazy, I know…and no, we still do not know if it is her kidneys, liver, or brain with psychiatric issues that is the problem. It is difficult to ask questions and get the answers I want through a translator sometimes…which makes diagnosis and treatment difficult. The last lady I saw was a new admit with lots of abdominal pain, no labs back yet, and a small child as well; I could only offer a few more tests and pain medicine. Hopefully we have some results back soon so we can start treating her.

At 11:30, I was “done” for the day and went back to the guesthouse to relax until the others returned for lunch. We are planning to go to TB village later today. TB village is a place where people who have tested positive for TB go and live for the duration of their TB treatment. This treatment program has shown to improve compliance and decrease drug resistance. It should be fun to visit the patients there. I am taking some small toys for the children…I cannot imagine how hard it would be to live apart from your family for months of treatment. Later tonight, we have our station meeting, where all the missionaries come to the guesthouse for dinner and fellowship. It should be a good rest of the day.

I appreciate your prayers through this time. Two weeks have passed, and I have about three more until I am back in the US. Time is flying, and I am trying to enjoy every minute. I am also working a lot (at least a lot more than most 4th year medical students). I am mostly emotionally exhausted from all the sad things I see here, yet I know that in the midst of the hurting, God is still good. I know that God has greater plans than we can ever imagine and I am so thankful to have this experience. Please pray for renewed energy for the full time physicians here. The hospital will be short staffed in the next few weeks; pray that the patients are still well cared for and that they come to know that Christ cares for them even more than we do. I appreciate your prayers!