A Welcome Change of Pace

After quite a long hiatus from providing patient care (and no, I’m not counting all the doctoring I do at home), for the last few months I’ve returned on just a short-term basis to help in our cervical cancer screening clinic here at Kudjip while two of our other physicians are away. The White House, as we call it, serves not just our female

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The ladies at Xenia Nazarene Church in Ohio have made these sanitary packs that provide a woman with re-usable flannel pads, underwear, soap and wash cloths. These packs are life-changing for some women!

population, but also a growing group of patients with HIV/AIDS. I will say that after being absent from the doctor-patient relationship for a couple of years I was a little nervous about what the return to medicine might look like for me. I suppose that practicing medicine, in some ways, is a bit like riding a bicycle. There are aspects of being a physician that (for me, at least) require little to no practice. The building of a relationship and creating a space where a patient can be vulnerable are things the Lord has helped me to do with ease, much of the time. However, a doctor also needs to know things! Ha! And I feel so out-of-practice when it comes to creating differential diagnoses and choosing appropriate medication regimens. But, fortunately, I know that those things will all come back with time once I’ve returned to the hospital on a more regular basis (even though at this point I don’t know exactly when that will be).

But in the meantime, I am absolutely loving the chance to care for these precious women in our cervical cancer screening clinic. During the week, my dear friend and gifted nurse, Pauline, sees women from all over our area who have been referred to the White House for the initial screening for cervical cancer. We don’t use Pap smears here at Kudjip because they

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Pauline (middle) helps me care for this patient and many others.

require a sample to be taken, stored, transported, viewed by a pathologist and then results reported back to us. We’ve found that this method of screening presents a lot of challenges, including follow up for these ladies who often don’t have cell phones or who may have made a full day’s journey to get to us in the first place. So, believe it or not, we have an equally effective method to screen for cervical cancer and it utilizes something found in most kitchens—vinegar! A dilute vinegar solution causes abnormal cells on the cervix to turn white and also allows us to directly visualize (with a colposcope) other changes that are indicative of all stages of early cancer cells.

Each week Pauline sees ladies from all over our area who have been referred to the

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Our simple cryotherapy machine saves lives!

White House for one reason or another. She does an initial evaluation on these women and then refers the more concerning cases for me to see on Wednesday mornings. Often I’ll find pre-cancerous lesions that can easily be treated with cryotherapy (liquid nitrogen that freezes abnormal cells). This is an incredibly simple and cost-effective procedure that can be done at the time of initial evaluation and it absolutely save lives. Occasionally we find pre-cancerous lesions that are more progressed and in these cases we can schedule the patient for a LEEP (Loop Electrosurgical Excision Procedure) to be done at the hospital procedure room. And, as is sometimes the case, we discover more advanced disease. If the cancer seems localized to the cervix still, we are fortunate to have surgeons (I happen to know a good one) who can do a hysterectomy to save the woman’s life. And the

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It is a privilege to care for and pray with these ladies.

saddest cases are those that we see too late. Unfortunately, it is one of the stark realities of practicing medicine in a remote, underdeveloped place like Papua New Guinea. Some of the more advanced cancers that we see might be helped with radiation, but there’s currently not a hospital in this country that provides this service. I’m grateful that, even though we cannot always provide a life-saving measure, we CAN provide the hope of Jesus. Its really easy to feel overwhelmed by the sadness for the ones we cannot physically save and forget that there is One who provides healing of another variety that is far greater than the limited measures we can provide. And when I have the opportunity to share this very truth to the broken woman sitting before me, I realize that all of a physician’s book knowledge becomes a little less important, both for that moment and for eternity.

 

All in the Family

One of my favorite things about being a surgeon in PNG is that my children get to experience what I do in an up-close and personal way. In some ways I think it makes it much easier for them to understand the “why” when I have to leave the dinner table early or head to the ER in the middle of a bedtime story. It’s always a highlight for me when the family joins me on rounds. I think the only people who enjoy their company more than I do are my patients and the surgery ward nursing staff.

Naomi is the least shy of our four and is always there to ask questions, shake or hold a hand and greet the patients in “Tok Pisin.” The patient in this picture is a young girl who had a terrible infection of her right foot that required multiple debridements. Her heel bone ended up exposed and she’s now on wound VAC therapy to help prepare the wound for a skin graft sometime soon.

Matthias was quite fascinated by the wound VAC machine. He and Simeon always want to know how things work. They kill us with questions.

This young guy was speared in the left chest. The weapon narrowly missed the heart and injured one of the veins in his left lung. He lost a lot of blood but his family got him to the ER in time for us to help him. We thank the Lord for a team here at the hospital who can respond quickly when the need arises.

Naomi, ever the inquisitor, wanted to know why he’d been stabbed. This led to a conversation with a 2-year-old and a 6-year-old about what it means to be so drunk you can’t remember what happened. Life is just filled with teachable moments.

Ever the helper, Naomi insisted that she help Daddy with the chart. I found it most helpful for her to hold the medicine reconciliation sheet so I could check the patient’s meds while I wrote orders and notes.

This man had an unfortunate encounter with his brother’s bush knife (machete). It seems that his brother was less than pleased that the patient’s pig had gotten into his garden and damaged his crops. As an old missionary surgeon I know commonly said, “With families like these, who needs enemies.”

This is Chris. He’s been my patient now multiple times. He suffers from a terrible infection in the bone of his upper arm that has required multiple operations to try and get it cleaned and healed. This picture is from the second half of rounds. The other three kids have been otherwise distracted, but not Naomi. I’m pretty sure she thinks she’s already the Chief.

Right now we are in between trainees at Kudjip. This means that on the weekends if I want company on rounds I have to bring my own junior colleagues. That’s a pretty special privilege if you ask me!

Catching Up

Our days at home in the last months have been full of fun celebrations, visitors, and new friends. The kids are growing at lightning speed and I only wish I could share (or remember) all of the hilarious things they’ve done and said that have kept us in stitches. But this photo blog should get you caught up on some of the other highlights on the PNG home-front!

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As our household numbers grew, we realized we needed a bit more space on the inside of the house! So some of our national maintenance workers helped to build this shed on one end of our back porch. Its been a wonderful addition!
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Despite living very near the river, we don’t often ALL make it down there. But when we do, you can be absolutely sure that someone ends up falling in. I believe it was Matthias on this particular occasion.
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I knew the kids would enjoy this swing-set (which was their Christmas gift from us and their grandparents), but I couldn’t have ever imagined the HOURS of play time it would clock in from all of the neighborhood children. Its one of the favorite “hang-out” spots for the dozen kids that play together each day.
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We continue to make “family rounds” and hospital evangelism a priority in our family. Its easy for me to be home with the kids everyday and forget the reason that we’ve come to PNG! THIS is what its all about. And I’m glad anytime my kids can see lives changed because of what God is doing in this place.
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Each year on Christmas Eve the missionaries go caroling at each of the four hospital wards. We usually also do some sort of nativity play. And it usually involves enticing toddlers to wear certain hats or robes.
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I tried to get a handle on pre-school with these two (despite the multiple interruptions due to their sisters), and even if we weren’t very consistent or it wasn’t very creative most days, they still have a love for learning. Now Simeon is gearing up for kindergarten!
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Praying with patients on the wards is one of my favorite things to do. There is an openness and gratitude that is so refreshing and encouraging.
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This was Naomi’s first time in the baby swing that Grandma and Grandpops brought back from Australia!
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Boxes from America are still an absolute highlight around here!
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Thanks to many of YOU who made donations toward a vehicle, we were able to purchase this 2001 Toyota LandCruiser. In the last few months is been to several bush churches, up a couple of mountains and taken many trips on the pot-hole infested highway. We are so grateful for the freedom and flexibility it allows us!
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And it wouldn’t be a typical day around our house without some Lego play.
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Tabea can frequently be found wearing one of my scarves or necklaces. 
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This here was one of the greatest days we’ve had in awhile!  Grandma Betsy and Grandpa Lincoln arrived on May 18th and spent six incredible weeks with us. We made memories to last a life-time. And after several trips on the Highlands Highways, Mom says she will NEVER ONCE complain about a bumpy road or pothole again.
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This was the day after their arrival and this scene was repeated multiple times throughout their six weeks with us!
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Ben’s youngest sister, Lydia, graduated from high school and we had a wonderful missionary gathering with food, games, a slide show and a sweet prayer time. Lydia has since returned to the States with her parents for their furlough time and we already miss her here!
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This is a fairly typical scene on any day that Joy comes. She is quick to wipe faces and trays, sit down and play games or take both girls outside to run and play.
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And this is probably a less busy day on the swing-set!
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My parents had the “privilege” of experiencing election time in PNG (which happens once every five years). You’ll notice the candidates’ posters plastered to the wall of a store near Kudjip. Every day, from dawn to almost 10 PM, we heard loudspeakers blaring music and speeches from the LandCruisers that drove through the area.
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We are blessed to have a fresh market just a short walk (or drive) from the mission station.
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Mom and I enjoyed shopping amongst the lines and lines of used clothes that are hung up near the market each day.
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Joy and Tabea enjoy a swing together!
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I believe this was the day that everyone was hot but no one could quite be shaded properly enough. It was a LONG quarter-mile to Grandma and Grandpops’ house.
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I will treasure this photo for many years to come!  What a an absolute gift to have both sets of grandparents in PNG with us at the same time!
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With election season comes a whole host of decorated election vehicles. And this typically comes in the form of grasses and ferns that then become dried and take on the appearance of some sort of hairy car beast. We affectionately referred to them as “fuzzy cars”!
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The first ‘bush church’ that we visited with Mom and Dad is the home church of David Wan who is one of our dear friends and an anesthetist at the hospital.
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This wild band of buddies was frequently found “attacking” intruders on the road. This was the start of several weeks of playing knights and kings and princesses!
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Aunt Sheena is a dear friend who has now left PNG for her home assignment time. She was our dentist here at Kudjip and will return to another mission here in PNG later in the year. We had a “beach party” at the river for her send-off!
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Just kicking off the shoes before church!
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This is one of my very favorite photos of my dad ever. Its not a great quality photograph from any technical standards, but the meaning behind it is what makes it so special. My parents just became part of the PNG family during their visit and that will always mean so much to me.
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Church is always more exciting when EVERYONE gets a lolli afterwards!
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Pastor Tony at Konduk church had a special way with our boys!
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The main market in Mount Hagen may be over-crowded and dirty, but this little strawberry corner makes it ALL worth it. One pile of strawberries in a bowl costs 5 Kina which is about $1.50. Bring your own container!
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We took my folks to see our friend Meti’s place. Here she is with her son Lesley inside their home.
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During our trip to Rondon Ridge, a lovely hotel and restaurant on the top of a mountain, we visited their archives room that has some beautiful photos. These two especially caught my eye. 
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It turns out that Father’s Day in PNG looks a good bit like Father’s Day in the States.
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Only Grandma would think its a good idea to do playdoh on the living room rug. But it kept some kids (and Grandma) busy for the better part of an hour!
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Everyday the girls find their way to the stool that allows them to peek out the window to the garden and road…and sometimes Grandma!
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On our trip to the nearby orphanage, the kids were pretty entertained by Naomi and Tabea. And, in this case, Naomi was pretty mesmerized by the half-dozen pigs in the field nearby.
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These election posters were mounted along the entrance road to Kudjip station where they’d get a lot of viewers. 
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In the Mount Hagen airport there is a piece of modern technology that scares our boys silly!  They’re smiling, but neither one of them will go close to that hand dryer.
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And it wouldn’t be a proper photo blog post without twins in a laundry basket!

 

 

 

 

Stretching, Learning, Growing….

We’ve had some great days, some long days and some challenging days here at Kudjip. It’s been a busy time of learning, stretching, growing, and relying on God, my family and my team at the hospital.  We are now doing surgeries that have never been done in the highlands of PNG.  Thanks to Samaritan’s Purse/World Medical Mission, Riverside Methodist Hospital, Storz, Dr. Mark Potter and Dr. Mike Pyle  we’ve acquired the equipment needed to allow the people of Jiwaka Province to enjoy the benefits of laparoscopic surgery. Here are just a few of the highlights in pictures.

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Sr. Vero preparing for our first laparoscopic surgery at Kudjip.  We did a video assisted thoracoscopic surgery (VATS) procedure for child with a terrible lung infection.  The Operating Theatre staff worked hard for several months prior to this to learn how to clean, maintain and setup the equipment.  They have been incredible.  We started with several thoracic procedures since we initial didn’t have gas for insufflation to do abdominal surgery.
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One of the most fun things about helping bringing laparoscopy to Kudjip has been getting to teach Dad a few new tricks.  Who says “old dogs” can’t learn.  For all the things he’s taught me in the OR and out I needed to at least try to bring something to the table.
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I teared up and I’m pretty sure Gail and Margret were actually crying when Dad did his first laparoscopic appendectomy at Kudjip, 32 years after starting the surgical work here.  In case you wondered, I’m so proud of my Dad and the commitment to God and the people of PNG that he’s exemplified!
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Learning how to elevate a depressed skull fracture.  It’s not rocket surgery, just neurosurgery 😉
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This x-ray represents not just all the orthopedic surgeries I’ve had to learn but all the other subspecialty cases that aren’t always part of the general surgeon’s repertoire in the USA.  I’ve had some excellent teachers.  A big thank you to Paul Hitchens, an Orthopedic surgeon from Sydney, who’s now visited twice and helped me to get better and offer more to our patient’s here.
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Dr. Andy Bennett (family practice doc emeritus) has taken care of the kids of the highlands who suffered from club foot deformities.  His skill with casting and various methods meant most of those kids never needed surgery.  I’ve been able to learn how to do several procedures now for those patients need an operation.  Thanks Andy for asking me to learn how!
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Mentor and Mentee.
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“It takes a village.”  Or a big team on this mission station to make the whole place run.  These are two of our faithful and gifted maintenance staff.  They keep the lights on, the autoclaves running and water in the pipes.  Philip and Kulang represent many others who work tirelessly day in and day out to allow me to minister surgically.
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This couple are two of Jiwaka’s early adopters.  They both benefited from laparoscopic surgery.  She needed her appendix out and he was relieved of his infected gallbladder a few months later. They just missed out on our two for one special.
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Junior here isn’t so sure about his doctor’s sense of humor with the pretend stabbing.  He is recovering well after he fell out of a tree and landed on a stick.  He showed up in the ER with his intestines hanging out and bleeding badly.  This scenario bought him a good old fashioned laparotomy.  Thankfully he lived close by and his mother brought him in quickly.
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We recently reorganized our two sterile stock rooms, our pre-op and recovery area, and the surgical storage in the old hospital that is used for a warehouse.  It was a monumental undertaking but the improvement was so worth it.  It wouldn’t have happened without Sr. Roselyn and Sr. Edna, two of my scrub nurses, who kept the rest of us going and saw the project through.
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Two of our organizational consultants.  From Simeon’s hat it’s apparent that we are in desperate need of disposable and Buckeye scrub caps.
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The organizational project was initiated in preparation for the arrival of Dr. Sheryl Uyeda, our third surgeon. Yeah! I’m not the junior partner anymore!
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Teaching on rounds. 
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Since we don’t have CT scans, MRIs and many other diagnostic options, the ultrasound is a surgeon’s best friend here.  
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For us young surgeons, who grew up with all the tech and toys, its a steep learning curve to master the ultrasound and learn to rely on it.  Thankfully we have a reliable guide to the sonogram 🙂
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Dr. Cindy is one of PNG doctors.  She is part of a Rural residency that we participate in.  We’ve had the privilege in teaching surgery to her and her classmates.  They each come to us for three months of the year their first three years of training.  Cindy is the only doctor at the remote hospital where she works.  Teaching her and her colleagues to become confident with basic surgical and ob/gyn procedures has been incredibly rewarding.  In the near future we hope to expand our teaching and training.  Please pray that the Lord will open the doors for us at Kudjip to help train the next generation of PNG doctors and surgeons.
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The Surgery Ward (C ward) Team.  We couldn’t operate if it wasn’t for the nursing staff and nursing students who care for the patients before and after their operations.
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Katherine’s parents just left after being with us for six weeks.  It was a privilege to have them drop by the OR for a morning during their stay.  If you every want to impress upon your in-laws the need to pray for you, have them drop in on a thoracotomy when you have to take out most of the left lung from a terrible infection and have to control some bad bleeding.
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It was a blessing to have Sheryl operating with me on the difficult lung case I mentioned above.  If it hadn’t been for her help and the Lord’s help, our patient wouldn’t have made it off the table. Our patient continues to recover on the ward and we are grateful for his ongoing improvement.
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When we moved back to this beautiful place that I’ve called home for so many years I didn’t know what the work at the hospital would look like.  It’s been an amazing start to what we feel is a lifelong commitment to this place, this people and this ministry of healing. It’s now a place that we all call home. Katherine and I couldn’t think of a better place to raise a family.
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We don’t know exactly where the road ahead will lead but we trust God to guide and provide for our family.  Please pray for open doors to teach young PNG doctors, for supplies and medicines for the hospital and for peace for our staff and patients during the elections here in PNG (July-August).

Matters of the Heart

Being a general surgeon in Papua New Guinea means that some days I do orthopedic surgery, others urologic or gynecologic, and on others, trauma, plastic or burn surgery.  Variety truly is the spice of a surgeon’s life here. One of the more rewarding “surgeons” that I get to be is a pediatric surgeon.

Each week I have the privilege of getting to take care of children who are sick, hurting, and in need of surgical care. This past month seems to have been filled with more sick kids than usual. I wanted to share the stories of two of those children with you. Getting to take care of these small patients has been an incredible privilege.

Simpson is two-and-a-half-year-old boy who is almost the exact age of our second son, Matthias. Simpson came to the hospital short of breath and very sick. His chest x-ray showed an enlarged heart, several times bigger than normal. dsc_0152Based on the history of tuberculosis in his family, he was started on a course of treatment. However, after a couple of days of this his condition worsened. Dr. Erin, one of our family doctors, realized that something other than tuberculosis must be the cause. In the middle of the night he was having difficulty breathing and his blood pressure began dropping. After scanning his heart with the ultrasound, Dr. Erin drained a significant amount of pus from his pericardium (the lining that surrounds the heart). This temporarily relieved the pressure on his heart and allowed his vital signs to improve. The next morning I took him to surgery and did a procedure called a pericardial window to drain and washout the infection surrounding his heart. When we arrived in the OR we found that Simpson had no intravenous access because of the severe swelling from his infection. In the night, Erin had put in a special IV line directly into the marrow of one of his leg bones. Unfortunately, this was no longer working and we struggled to find alternate access. Simpson’s infection was so severe that it had caused a condition called Disseminated Intravascular Coagulopathy (DIC), which was making the veins all over his body fill up with clots. I tried unsuccessfully to put a large IV  in one of the veins in his neck, legs or upper arms.

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Simpson and his family member got to meet Tabea and Naomi.

Dr. Paul Hitchen, a visiting orthopedic surgeon from Australia, was finally able to place another IV in Simpson’s bone and this allowed us to complete the procedure.
Simpson is still in the hospital and has had several setbacks along the way, but we praise God that he will soon be going home.  He’s alive today because of the Lord and thanks to the great team of doctors, nurses and volunteers we have here at Kudjip.

 

Remna is a ten-year-old girl who has been Simpson’s bed neighbor on the surgery ward for the past couple of weeks. Remna was initially admitted to the pediatric ward with fevers and several painful and swollen joints from septic arthritis. Unfortunately, like many of our patients, she had come to the hospital very late and her disease was extensive. Despite being started on multiple antibiotics, her infection spread and she began to have difficulty breathing and, just like Simpson, her blood pressure started to drop.

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This is Remna on the morning after surgery.

On chest x-ray, her heart, like Simpson’s, was enlarged. The ultrasound showed that her heart was struggling to beat because of all the pressure from the fluid. As we were getting ready to start the procedure to drain the fluid around her heart, her heart suddenly stopped beating and we had to begin CPR in order to save her life. I quickly placed a large needle under the edge of her breast bone and withdrew some of the fluid around her heart to relieve the pressure. Fortunately, it was thin, watery fluid and not pus. During CPR I was able to place a drain into the space around the heart that allowed the fluid to come out. The drain removed almost a liter of fluid from around her heart. During the next twenty minutes (which felt more like twenty hours) we continued CPR.

 

In total, Remna was defibrillated four times, but eventually she resumed a normal heart beat and regained a blood pressure. Clearly the hand of the Lord was upon Remna in those moments. The type of drain that we used to remove the fluid from her heart is not something that could be purchased here in Papua New Guinea. However, on the most recent shipment of supplies from Nazarene Hospital Foundation, we received a number of donated pericardial drain kits. This is not coincidence, but rather divine provision!

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Dr. Rebecca (a PNG rural registrar) is reviewing Remna’s case with volunteer orthopedic surgeon, Dr. Paul Hitchen.

When the procedure was complete, we eventually drained the infection from her joints and then prayed that she would wake up. When we checked on her later that evening she was awake, talking, and telling her mother that she was hungry!  Through her recovery she has shown no signs of any brain injury or damage. Remna still needs a lot of prayer and ongoing care. She now has a deep infection in several of her major bones (called osteomyelitis) that will require months of care, and possibly more operations in the future.

 

These two children represent the reward and privilege that I feel it is to care for some of the sick children who arrive at Kudjip Nazarene Hospital. They are a testament to how the Lord provides what we need exactly when we need it. Sometimes he sends the right person to do a procedure or sometimes its a medicine or specialized piece of equipment. These kids also represent the many other stories of children that I haven’t shared. Perhaps some of those stories aren’t as hopeful and unfortunately, in some cases, the families of those children continue to feel the loss of their little ones that we couldn’t save. But in the midst of it all, we know that God provides the hope, grace and comfort that each of our patients needs.

Whatever you did for one of the least of these brothers and sisters of mine, you did for me.”           – Jesus

 

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I’m grateful for a mentor who models this truth–that while we treat patients and try to do our best, we must rely on Jesus to truly make the difference.

There and Back Again

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Since we’ve only been back in PNG for three months now, now seemed like a good time to share all about our journey home to Kudjip after the birth of the girls and a few things that have happened since. Several weeks before leaving Ohio, we found out that my brother Peter would “get to” travel with us and stay at Kudjip for a few weeks. And in hindsight, we could NOT have done it without him. Or I suppose we would’ve risen to the occasion and figured things out, but it would’ve been ugly. Here we are. All new and fresh and seemingly ready for the hours of work ahead of us. 
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Uncle Peter quickly became a sleeping buddy.
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And a carry-on packer extraordinaire.
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And a toddler wardrobe assistant.
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Back then we still swaddled the girls and it took a good bit of work (and standing and bouncing) to get them to sleep. Aside from a miraculous work of God, I’m not sure how we survived that trip.
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If we ever thought traveling with two young boys was a challenge, we got a WHOLE new taste of “traveling with young children” on this five-flight, 54-hour journey from Ohio to Papua New Guinea. When we took our first trip to PNG with (only) Simeon, I remember reading a lot of blogs about how to make life on an airplane (and in airports) much easier with small children. I was naive back then. But now I could write the blog. Fruit loops, iPads and earplugs. That about covers it. Well, not exactly. Most of you know me far too well to think I’d let the rest fall to chance. I was prepared as prepared could be and even so, we had some absolute meltdowns. But during this fine moment in the Los Angeles airport, we felt like we had conquered the world with our jammies and camping pad.
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And THEN, we moved to the other end of the terminal to wait for our 14-hour flight to Brisbane. And by now, its 2AM for those sweet little bodies and they’ve hit the wall. That is, until an ear-piercingly loud door alarm at our gate started blaring through the entire room. Our (somewhat) peacefully sleeping children were startled awake and restless for the 15 minute ordeal. And then they settled again…and we waited.
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Dr. Mike Noce is a volunteer who was on his way to Kudjip as well and we met up with him in LA. Remember what I said about Uncle Peter and how we couldn’t have done it without him? Well, the same applies to this man (who is a father of six and grandpa to many). Literally, we had JUST met him an hour before this photo and all of a sudden he’s carrying our children, our bags and anything else we could throw on his shoulders. Shortly before we thought our flight was to board, Ben looked over at our gate and saw a young family and someone in a wheelchair being wheeled through the door. Of course, we wanted to be among the first on the plane so we could snag all the overhead space and get sufficiently settled. After seeing those early boarders we realized we’d better load up and make our way to the gate. We carefully pick up sleeping children (two of which are babies already strapped to our chests) and balance our 10 carry-ons on any remaining limbs. We were a sight. We lumbered up to the gate and told the kind attendant that we were ready to board early with the other young family. And she sweetly replied, “Oh, its not time for boarding yet, but we’ll make an announcement when that time comes.” And I’m thinking, “Really? How is that possible? Could you graciously have mercy on our sorry souls and please let us on that plane?” So, we did the only thing we could. We dragged ourselves back to our seats, now with a deliriously awake 4-year-old who all-of-a-sudden starts crying (loudly) about his legs hurting and how I (since I’m holding all 42 pound of him at this point) should simultaneously hold both of his socked-feet while massaging his left calf in the process. Did I mention he was delirious? Like, night-terror delirious. He was absolutely inconsolable and hardly knew where he was. There wasn’t a comforting word or deed that I could do to calm him. His volume and requests only escalated. All 250 pairs of eyes were on us at this point. I asked the Lord for divine help in that moment. And several minutes later I was finally able to awaken Simeon enough for him to be distractible. And finally, after about 20 minutes, he fell asleep on my lap. Just in time for the door alarm to sound again.
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When we FINALLY arrived in Port Moresby with only a one-hour flight to finish our long journey, we were all exhausted. With tremendous help from a couple of immigration employees we transferred all 15 of our checked bags to the domestic terminal and quickly got our boarding passes because our layover was short and we knew we’d cut it close. We finally found ourselves in the humid 85 degree domestic terminal which was packed with passengers awaiting the last flights of the day as it was now 3 PM. We waited, paced, dripped sweat, tried our hardest to keep two deliriously exhausted boys as comfortable as possible and then we waited some more. After over an hour of delay with no word about our flight and after hearing the PA announcement of three other cancelled flights we began to worry. Sure enough, when we had reached our peak frustration and exhaustion level, we heard the dreaded words. Our flight was cancelled. To put it mildly, Simeon was a basket case when he found out. Really he was just expressing exactly what the rest of us were feeling in his own four-year-old fashion. The boy SO desperately wanted to be home and now we had to sleep in a hotel and do this all over again tomorrow. “No! I am NOT going to sleep in a hotel. No, No, No!” Over and over. There was no consoling him and frankly we all felt the same! But I donned a smile and faked a good attitude to try to encourage him that it wouldn’t be so bad and we’d all be together. We received our hotel and meal vouchers and lugged all of that baggage to the door where we’d wait for our shuttle. There was a small (lightly) air conditioned room next to the exit where we settled for a bit. Simeon was still a mess, crying and so upset. There were a handful of other passengers waiting there and this sweet lady noticed Simeon, got up from her seat and walked toward him. She stretched out her arms to him and said, “Come.” He (oh so surprisingly) lifted his tired arms to her and she hoisted all 43 pounds of him to her chest where he seemed to just absolutely relax in a way he couldn’t up to that point. He stayed there for some time before finally falling asleep in my lap. Every bit of it was beautiful.

 

 

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This is the only photo that I took once we found out that our flight out of Port Moresby had been cancelled. We got all of us and our luggage safely to the hotel. [This just HAPPENED to be the same day as some big riots and a couple of shootings at the University.] But, we neither heard nor saw anything concerning. We were safely tucked away in the Holiday Inn for the night. The boys were asleep on the beds instantly (only to be awakened a couple of hours later for a bath to wash off the layers of sweat and airport floor filth). But they slept the rest of the night until our 5 AM wake up call. This is us outside of the hotel waiting for the second 15-passenger van that would be our ride to the airport. We were all rested, clean and ready to be HOME! 
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And in the midst of all of the chaos, I was reminded that this is Peter’s very first time to visit Papua New Guinea. I realized how excited I was for him to see this place that we love. We had a REALLY happy welcoming committee! 
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And, you must remember that this is the very first time for Grandma Kathy and Grandpops Jim to meet their grandgirls in person. Wasn’t it nice of us to have a baby for each of them?!
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The seating arrangements for our 1-hour drive to Kudjip were prearranged…perhaps as far back as the day these girls were born.
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This is entry gate to the hospital and mission station. That building on the right is the hospital.  We were greeted by beautiful decorations and a lot of happy faces!
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Generally Grandma and Grandpops live about a quarter of a mile from our house, but since their home was being remodeled when we returned, they were actually living right next door. Grandpops found this especially convenient for some early morning baby snuggles. 
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I knew that when we returned to Kudjip there would be MANY helping hands. We’ve been loved in so very many ways since coming back. But I think my favorite thing is when one of our Kudjip family members takes the time to invest in our children. Emma Goossens is one of the younger examples of this! This precious young lady came to our home MANY afternoons during her summer to play with the kids and help me around the house.  
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As much as possible we attempt to get out of the house. Its a challenge sometimes, but very worth it. And if there are sports involved for Ben and the boys, its even better!
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This was our first Sunday morning walk to church. Or at least half of us are walking. 
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With Uncle Peter often comes a good art lesson or two. 
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A few weeks after our return these lovely ladies organized a baby shower in honor of Tabea and Naomi. 
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If any of you ladies ever organize a baby shower, do THIS! It changed my life in our first couple of months adjusting to life with four children here (let alone, twins!).  
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Baby shower attire. 
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Before we knew it, Peter’s three weeks were all spent and he was headed back to the States. I love it that he knows this place now. And that he’ll definitely come back!
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At the end of June, a work and witness team from Xenia Nazarene came to Kudjip. It was so fun to have Uncle Mike and Aunt Becky Hancock here along with the rest of the team. Their project during their 10 days was to work on Jim and Kathy Radcliffe’s home remodel. It was a complete gut job, so this group had their work cut out for them!
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Tabea will smile at most anything. But one of her favorites is definitely Naomi.
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Some of our dear missionary friends moved back to the States while we were away and they gave us their amazing popcorn machine. Thank you, Mike and Diane! To this day it has provided lots of entertainment. 
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Did I mention that Emma does dishes?!  She does and its amazing. 
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I tried to picture life back at Kudjip with the boys AND their new sisters. And everytime I imagined life here (at least in my dreams) it always included our Papua New Guinean friends. We had always had some help around the house, but I knew I’d need a LOT more help and probably on a daily basis. Joy has been one of the answers to my prayers about this. She loves and cares for all of us so well.  
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This is the Xenia team and lots of their national friends who helped with the house. 
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While Mom, Dad and Aunt Lydia were gone to take part in Priscilla and Wyatt’s wedding in Ohio, lots of folks here stepped up and filled in. We’ve had so many people in and out of our home now that anytime someone comes to our door, Matthias greets them, takes their hand and says, “Come in. Sit down.” And almost daily Simeon asks who our company will be! Aunt Judy and Uncle Andy Bennett brought us dinner once a week and Judy was a surrogate Grandma for a few weeks. 
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Ben’s sister Priscilla married Wyatt Mills on July 8th!  My sister-in-law, Bethany, texted me this photo that day and it made me so happy and sad all at the same time. We knew we needed to be here for the surgical ministry at the hospital to continue, but it was so difficult to miss a family wedding.
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But thank goodness for technology, because it allowed us (and some missionary friends) to watch the wedding LIVE!
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Like I said, we get out as much as we can. And this double stroller is pretty much the only way it can happen. 
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Here’s a diaper changing technique I’d never tried before.  
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We were REALLY glad when the container with some of our “twin” things arrived, including a second crib and these high chairs.
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Here’s the outside of Jim and Kathy’s house with a new coat of pain and some beautiful kwila doors. The inside is just as great.
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I have this photo to document the one (and only) time we’ve all ventured out since our return. We took a “quick” trip to town for some shopping and lunch at one of the few restaurants we have here. 
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Matthias had an outbreak of bug bites for a few days before we decided to undress the bunkbeds and wash and spray the mattresses. In the meantime, their room looked like this. 
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Joy was singing a song about blue eyes and brown eyes.  
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Frequently, Matthias wants to be a part of the sister photo shoots. 
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Matthias has adjusted well to the bottom bunk. He was still sleeping in a crib until we came home this time. I suppose his cars and trucks would be quite the deterrent to rolling out of bed!
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We’re enjoying life now that we’re settled and into a good routine. These four sweet children keep us so busy and so entertained. 
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Lately we’ve had a couple of opportunities that have reminded us why we’re here. Sharing Christ with those who enter the walls of our hospital is one of the greatest privileges of our lives. We’re thankful for the example of Dr. Jim and for the many years that he has given to serve the Lord here. 
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And what’s the end of a blog post without the latest and greatest photo of the girls??  Future posts are almost guaranteed to be shorter, but now you’re all caught up. And, if you want to stay in touch on a daily basis, feel free to find me (Katherine Stevens Radcliffe) on Facebook or (katherineradcliffe) on Instagram.