Sunday, April 23, 2017

Alcohol

So some fellow missionaries shared this video that gives a good look at the problem of alcoholism in Uganda. The language in the video isn't great but it is a pretty accurate portrayal of the issue.  My chief complaint about it is that he doesn't actually get very far out of the urban area. If he had he might have found that people use the booze as food instead of with food. And in Karamoja the kids are often fed the dredges of making the alcohol. I still recommend watching.

Video

The missionaries who posted this also discussed why chrisians don't drink at all here. Also worth the time. Their blog (also with the video)  here.

Saturday, April 22, 2017

There, I said it.

God fixes thing right? I know He can. God intervenes in people's lives. He can. He has the power to do the miraculous. Sometimes He chooses to.  And it hurts so much when He chooses not to. I trust you Lord. You can fix and heal and mend and set right. But then you don't. And this erodes my hope and confidence. And it hurts. It becomes easier not to hope and just stop praying that He'll fix it.But then what?


Friday, April 21, 2017

Islands of Hope

Carrying clinic tables
Setting up. 
I spent the past three days on the islands in Lake Victoria helping another mission team with their medical outreaches. Here are just a few pictures. 



HIV testing


Several hour commute in this little boat on a very big lake. Notice the guy in the back right baling water....

More pictures


Drying fish





Sunday, April 9, 2017

Earth has no sorrow that heaven can't heal

It's Sunday afternoon, trying to get ready for the coming week.... Truthfully, this past week wrung it out of me. Two miscarriages at the clinic due to malaria. Told two different ladies that they had cancer. Frustrated with the poor quality care at the hospital. Lots of home visits for the sick and in the village the hunger and food shortage is astounding. People are literally starving. Especially affected are the elderly and chronically ill. We visited an elderly couple who together might have tipped the scale at 100 pounds. We brought them rice and chicken broth and they literally licked the bowls. The rains should be started by now so there should at least be a few fresh things to eat and hope for the coming months but it is still stunningly hot and dry.

So, now just sitting quietly, asking for fresh joy for the week. I profess to having a hope that unbelievers don't have. So no matter how depressing, discouraging, frustrating or pointless the day feels I have something to share.

Found encouragement in this one tonight. Listen

Friday, April 7, 2017

Really, is that all?!

My eighth April in this country.....

Thursday, March 30, 2017

Witchcraft, curses and babies

I'm really not sure how to write about this one
​, b
ut it is something I've been thinking and praying
​ a lot​
 about 
​​
lately. I'm sure if I'd written this eight years ago it would have come out much differently but I've seen and heard s
​o much​
 since moving here. 
 
  • Last week I was told a terrible account of a body of a young child found beheaded right outside of Soroti town. He had been killed in witchcraft in order for someone to obtain a "blessing". 
  • A few months back I was praying with a woman who knew she was an alcoholic and wanted Christ in her life but had been told that she couldn't. This woman had recently lost two children to what she believed were curses. She didn't tell me illness or accident had taken their lives but was very specific and firmly believed that it was witchcraft. I didn't argue with her, just prayed and asked that the God of Truth clear her mind, bring right thinking and also release her from the alcohol that feels like an escape but is actually a trap. 
The most recent event that his brought this topic to the fore is Judith's (her story yesterday) concern that a curse killed Anna. While sitting at the hospital, waiting for the death certificate, scant hours after Anna's death, Judith leaned close to me and in a s
urreptitious whisper told me she was afraid a "big man" (meaning wealthy man of some social standing) in the community wanted her baby's life. A friend at church had told her that she had a dream that this man was trying to steal the baby. Anna fell sick that same day. Judith realized that some of Anna's clothes had been stolen
​,​
 too. Then, suddenly when it looked like she was getting better the baby died. Anna had a strange choking episode (as her mother described it) and never breathed for herself again then died within the hour. Her mother added all this up and concluded that it was a powerful curse that took her daughter's life.
 
Now, this is a 
​C​
hristian, 
​B​
ible
​-​
believing, church
​-​
attending woman! 
 
​​
First off, how do I respond? Pre-africa me would have been quick to reassure her that this was crazy thinking and there was a clear medical reason for her death and that curses are not real. I still believe there might be an explainable medical reason why she fell sick initially then stopped breathing but I no longer believe this stuff of witchcraft is a figment of active imaginations. Is it something to point to when grieving mothers want something to blame?  Maybe. But is there something more?
 
I've come to believe
​ that there is demonic 
power that we in the western world like to ignore. The 
​B​
ible references it too many times for sorcery and witch craft to be a pretend thing. I still firmly believe we children of God are safe as we are covered by the blood of Christ. But are there some sins that open us up to the influence of satan?  Do witch doctors really receive favors when being obedient to evil? Are innocent lives lost when people make terrible choices?  We know it happens. 

I'm going to visit Judith again today, about a week from the death of her only child
​, w​
ho
​m​
 she fears was taken by evil forces
​, ​
I want to reassure her with the promises of God. I want to speak only Truth. I want to bring peace. 
​​
What should I say?

Lord God, One could say that you also lost your only child to evil forces. But you didn't, not really. You released him and allowed satan to do his worst. But you still triumphed. So we call on that name right now. The name of the one that overcame all that evil and darkness. 
As we sit with Judith, help us to share your peace. Let us not share what we think is true but let us share only what is really Truth. May be bring a little love and comfort in this hard time. Amen. 

Tuesday, March 28, 2017

Last post about baby Anna

I have some terrible news. Most of you regular readers remember baby Anna born in November?  She was still waiting for her permanent VP shunt surgery and her cleft lip surgery. She fell sick two weeks back and after fighting an unknown illness passed away 4 days ago.   We admitted her to Bethesda on Friday the 17th due to extreme dehydration and high fevers. After spending all weekend there with no improvement (and practically no medical care! but that is a rant for another post...) I got very assertive on Monday morning before clinic.  The nurses did step it up a bit and by midday they had attempted several IV lines and the lab was working on some stuff but really we weren't any further than on Friday evening so I packed up mom and baby and got them to the neuro hospital in Mbale where she was directly admitted to the ICU. I never heard if they got a dx but heard from her  mother that she perked back up quickly and was moved back to the general ward after one day. She was starting to act like her normal self and they were getting ready for discharge. Then suddenly we got a call early morning of the 24th that she had been put on a vent. An hour later we got a second call that she had died. 
Mom and I scrapped all our plans and headed to Mbale. This is a village family with no means to transport a body home so we went to go be with Judith and also help in this way. 
About midday when we pulled into the rural home where the baby would be buried the family was already starting to gather to mourn with her. 
Thank you to all who prayed for her. Please keep praying for this mother who has just lost her only child. 

The parent's trip

So my mom and dad left late last night for the airport. They said goodbye to the kids in the evening as they tucked them into bed. I cried all over again when this morning, after I arrived back at Benj and Christina's house, Ellie asked me why Grandma and Grandpa didn't come back from the guesthouse with me.
We had a great time doing fun stuff like two nights on an island on the Nile. And playing hours of Legos and barbies. The adults played hours of card games and board games. (Our current favorites are Castles of Mad King Ludwig and 7 Wonders, both of which I highly recommend.)
But don't worry, it wasn't all fun and games.













We also made them work very hard. Mom and I packed birth kits and I made her work two shifts in the clinic. We even had a laboring mother and could have done a delivery but everyone (my mom included) decided it was better if we just brought her to the hospital. We spent several hours making 34 jars of salsa and prepared several meals for my freezer.

Dad spent hours welding, mixing cement, digging holes, hanging lights, rewiring several things, fixing door frames, knocking out walls and hanging a hammock.
Mom and Dad also both preached on Sunday.















The highlight of my mother's trip was going to the Jinja Snake park. (Actually we dragged her along kicking and screaming.) See this weak little fence and small piece of plywood between them and this 650 kg/ 1000+ lb monster?  This is only one of many reasons she didn't want to go. Ellie was most interested in the donkeys and Grandma was OK with that. 


Overall it was a really nice time and was over far too soon. 

Wednesday, March 15, 2017

Another quick one- just got back from clinic. 52 pediatric patients today. (We need a doctor!) Several of them quite sick.  Few good meds and only one other staff member working today. I took two of teh babies into town and had them admitted in the hospital. One is a little two week old girl who is septic. We are afraid she is HIV positive. Waiting on her mother's blood work to see if there has been exposure. This nurse is already toast and it is only Wednesday......

Friday, March 3, 2017

Mom and dad arrived without difficulty! It was a bit like Christmas morning here as we helped them unpack! Thanks everyone who sent so many things! 



Ellie got some barbies and practically hasn't stopped playing with them since the packages were opened. Grandma had to help.

 Even Benji had to get in on the action.



And legos, pounds and pounds of legos. 
Even I got several nice gifts. Thanks Nick! 


Thursday, March 2, 2017

So many pictures of newborns on my camera!! Who doesn't like to see all these babies?!





Motorcycle vs. Bull

I'm just sitting here in Jinja with my niece and nephew waiting for my parents to arrive so I though I'd take a quick minute to update the blog.
A few days back I mentioned on FB that I had my first patient who had been impaled by a bull. On Sunday at church a couple of the members told me they were worried about a neighbor of theirs who had had an accident with a bull and was only in the hospital one night and had been sent home. They were wondering if I would be willing to check in on them. So after church a couple of us headed over to check on Sam. Sam had busted his face up pretty badly, had put three teeth out through his top lip (never to be found again), displaced his jaw and split his bottom lip down to his chin. So, though he really wanted to tell us about the accident, we got only minimal details as speaking (and understanding him) was limited. His wife knew a few things from the police that arrived on the scene so she tried to answer my questions. Sam was coming home on his piki, downhill, and on the side of the road a male cow was trying to get frisky with a female cow. The female dodged and the male lunged into the road just as Sam passed. This is not at all how the Ugandans described it to me but there is no way I can do their description justice (and honestly you wouldn't have understood half of it anyway as it had a lot of innuendo in it along with Ugandan's characteristic vague/strange English phrases). Anyway, the motorcycle hit the bull, the bull hit back. Sam has road burns on both arms and legs along with his smashed up face. But the whole thing that just made the story was that he also has a very deep, tunneled puncture wound that starts in front of his right hip, goes around his side, through his right butt cheek and exits just above and to the right of his ischial tuberosity (take that Dr. McKelvey!). I could put my whole fist in the entry wound in front and the exit wound is roughly the size of a quarter. Needless to say there is also a lot of swelling, bruising and foul drainage.
He had overnighted in the hospital where they stitched up his face, cleaned out the wounds and started him on abx. Then sent him home. He was weight bearing on his right leg but he can't walk. He can't eat anything solid. And he still has significant post concussive symptoms. Seems like a perfect candidate for discharge.
Anyway, I cleaned him up and packed the wound. Taught them how to make bone broth. Discussed neuro symptoms to watch for.
Then they asked me if I could also treat the cow. Here, when livestock cause accidents, the law is that the injured party gets to keep the animal that caused the problem. This is usually as payment for damages and because the owner of the animals is supposed to be responsible for keeping them out of the road. So Sam was fighting for possession of the bull. But it has a broken leg so it is still at the owners house and they can't go get it until they can walk it to their place. So they REALLY wanted me to plaster it so they could bring it home. I had to explain that this was very much outside my scope of practice and really, really too much for a Sunday afternoon.
I've been back every day to change the dressing and by now his wife can do it.  I don't have any pictures of this craziness so instead you get a selfie Ellie took while I was typing.

Tuesday, February 28, 2017

Hepatitis B training

The hepatitis B immunization campaign continues out in Obulle. We are doing roughly 200 a week now. That means each Friday we register, screen and inject people. We are one of the few clinics in the district still offering to give it so people are coming from far to be tested and receive the vaccine.

 This is a very normal look for Friday mornings at our tiny clinic.
There has been so much confusion and false information surrounding Hepatitis that I offered to do a training. We had it scheduled on a Saturday afternoon at the local school but because of some miscommunication it was canceled. But it actually worked out alright because I've been asked to do the training for smaller groups in different locations. I've given it twice and have two more scheduled.

Both had good turnouts and people had tons of questions so I'm happy with them. 










Monday, February 27, 2017

Inservice

I preformed my first inservice in the clinic today. Overall it was well received. At few of our last deliveries the babies have given us some challenges so we discussed the first five steps of the newborn resuscitation logarithm.  (They don't have the resources to go beyond those first five steps). It was obvious that Tony and Barbara had never had this training before and John and Rose had been in discussions as students but had never seen or held an amb bag or done anything beyond some lecture of hypothetical situations with vague suggestions.  They thought it was great that I could give them "rules" to follow. I tried to explain that these aren't rules exactly, and that they still need to follow common sense and what each situation calls for, but they took it very seriously.  All four of them practiced and we had good discussion about intrapartum suctioning with meconium present, how to do apgars and several other things that I had just assumed they already knew. It was good for all of us. Now I pray we never need to use it again. 

Saturday, February 25, 2017


Prayers please for this sweet little girl who got a nasty burn three days ago. Her family, unfortunately, neglected to care for it and then when they heard I was coming, they sprinkled flour on it to make me believe they were using antibiotic powder. It took the VHT and I nearly an hour this  morning to scrub it out, remove all the dead tissue and get her wounds covered. She got a pretty hefty dose of codine (can you use that on three year old?!) but it was still really painful. She didn't fight us at all. Just sat still and sobbed while we made her bleed. I'm worried about the scar tissue in her axilla inhibiting the use of her right arm however, we need to get through this high infection risk time before we can worry about anything else. Her family has already shown us they aren't really interested in taking care of her so, she needs your prayers. Have I mentioned recently how much I hate treating burns, especially in little kids. Yuck!!


Wednesday, February 22, 2017

Parents!!

Hey Mom and Dad! Don't forget, you need to head to Chicago in 6 days. We are busy getting ready for you here. I have some good news and bad news for you. First the good, it seems like the dry season heat wave has broken. This could be a false alarm but it seems like possibly our days of 100+ degrees might be over.  We had a great rain last night and today was much more tolerable.  I still don't have running water but that could possibly be resolved by the time you arrive. OK, more good news, We are doing easily 10 births a week at the clinic. Dad, this won't effect you so much but Mom, you may want to throw in some scrubs. I have every intention of making sure you go home with some stories.
OK, now the bad news, yesterday, I received a rooster from a patient as appreciation. He is way too skinny and stringy to eat so I'm keeping him as stud. Is that a thing for chickens?  Anyway, he is pretty loud and starts around 5am. Sorry about that.
See you in a week!!!