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.
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.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.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!Learning how to elevate a depressed skull fracture. It’s not rocket surgery, just neurosurgery 😉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.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!Mentor and Mentee.“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.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.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.
It’s no secret that the kids are my favorite patients.
The other thing I love is my own kids getting to meet and bring joy to my patients
However, I’ve found that toddlers tend to slow down the efficiency of morning rounds
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.Two of our organizational consultants. From Simeon’s hat it’s apparent that we are in desperate need of disposable and Buckeye scrub caps.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!Teaching on rounds. Since we don’t have CT scans, MRIs and many other diagnostic options, the ultrasound is a surgeon’s best friend here. 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 🙂
The Hospital celebrated it’s 50th anniversary in March.
It’s not everyday you get to teach a GS (Nazarene pope for you non-nazarenes) how to prepare a mumu.
Getting ready for the 50th Anniversary mumu (traditional PNG feast).
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.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.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.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.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.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).
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.
Little Jim – needed a bowel resection because he had dead small intestine secondary to “pigbel”
Winston – had a large cyst attached to the base of his tongue that needed to be removed
Mr. Joe, one of our anesthesia officers safely putting a child to sleep for surgery
Mr. David, another one of our excellent anesthesia officers here at Kudjip also does pediatric patient transport
Kua was hit by a bus and had an open skull fracture and broke both of his femurs
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. Based 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.
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.
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!
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
Surgeons can do patient transport too.
Dr. Erin and I discuss patients on rounds.
Simeon, the junior consult and smile therapy director.
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.
Based 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.
Script and Scalpel 