Saturday, January 14, 2017

Boa Entrada

Happy New Year! We've enjoyed wet and warm weather here in Kalukembe, in its midst of rainy season. 2016 will not be remembered as lacking excitement or strenuous times, both on the global stage and in our personal lives. It's wonderful knowing you are genuine partners in our efforts here. And 'efforts' is the right word; we often don't feel like there's much to show for results, but we hope to be found faithful in trying. And so, thank you to those who join hands to loosen chains of injustice, to find cloth and bind up others' broken hearts, to comfort others in mourning, to share our freedom in Christ. Thanks!

The stories are sometimes heavy. . . but we want to share the good and bad; our struggles and successes. Stories from here are often dramatic because, well, life and death matters ought to be considered such. And the One here with us is Jesus... even when we are without medical tape and gauze for dressing changes; when normal saline and Ringers' lactate ran out yesterday and we are "resuscitating" with D5W; when our operating technicians have shown up little to work this week and yet we were able to operate on perforated peptic ulcer, intestinal volvulus, intra-abdominal abscess, intestinal tuberculosis, gastric tuberculosis, gangrenous legs, perforated typhoid, ruptured ectopic pregnancies, procedures for septic knee, hemopericardium, empyema; broken ultrasound machine just prior to our campaign for free prenatal ultrasounds (more later); no lidocaine; nurses who have disappeared from wards; etc; we go with intermittent electricity; due in part to government "diversions" of medicines, we have not had TB medicines since July 2015; no rapid HIV tests; no hospital ambulance that can make a transfer to the provincial capital. Ahhhh!

But Christ is with us here. From the beginning of the Bible and throughout, we see God moving to us in trouble (see Psalm 10, especially v. 14: " But you, O God, do see trouble and grief; you consider it to take it in hand. . .") The One we believe in knows our's and our community's troubles and does not turn a cold shoulder. This week an elderly lady with advanced bladder cancer reminded me that she has a God who is holding her in her last days on earth. This was not an empty conversation. It was weighty because i didn't have anything to really offer her beyond an inevitable prognosis and over-the-counter pain medication. There are eternal issues that weighed on her heart and mine. . . . The life and death matters we face at work draw us into these eternal matters. The late Helen Roseveare reminded me the question is not, "Is this all worth it?" when we're in a difficult context; the question should change to "Is He worth it?"

On a brighter line of thought, we are pleased with the results of this week's free prenatal ultrasound campaign. i don't know the exact number of ultrasounds, but somewhere in the range of 150 with the lion's share handled by our nurse colleague, Antonio Salomão. In spite of Priscila's portable ultrasound breaking down just weeks before, the big surge in outpatient numbers was managed. Due to some miscommunication, a large number of ladies from a neighboring province arrived to see Priscila for gynecologic complaints and, well, any complaint really! Even goiter or other odd bumps or whatever seemed to concern them. The week turned out well, as there were many first time prenatal visits for women who've even had several prior pregnancies. And as for incidental findings, there were several ladies with chronic hypertension, an intrauterine fetal demise, and (crazy but true) two ladies with ruptured ectopic pregnancies. Those ladies are doing much better now after their operations. It's your support and partnership that helps us reach out to others in this way. And it's a small step forward in addressing Angola's maternal-infant troubles (worst country in the world for infant mortality).

Ok, pictures!

Naomi with big sister Mina, Christmas eve swimming in the local creek

Naomi and Eliel putting water for the garden to another use

Thanks to your partnership! Through your help in sustaining us here, this mother with her newborn will hopefully have a happy year ahead. The mother brought in her child septic from an imperforate anus (no hole in the baby's bottom). She couldn't afford transfer so Priscila placed a temporary colostomy until the baby grows. Baby was discharged, growing, feeding, and gladly pooping out of his temporary opening :)

Area kids have been using recently cut grass and bamboo to construct  houses in our yards. These led to stories from Helena, our house helper, who lived in such makeshift homes during the civil war when they were hiding in the bush. Very difficult years; so glad we could hear stories that had not known about--all out of these elaborate constructions that our kids love.

Nurse Antonio Salomão and his assistants ultra sounding one of our lovely pregnant ladies who came during this week. He was a huge assistance. The idea behind offering free prenatal ultrasounds was to combat our very high obstetric complication problem in the area. For example, around 25% of our C-sections at the hospital turn out to be uterine ruptures--a sign of very prolonged labor. A large percentage of our C-sections deliver dead babies. And the weight of our campaign has been highlighted by 3 maternal deaths in the last 3 weeks (eclampsia, perforated typhoid and postpartum hemorrhage). So we hope that, providing exposure and counseling ladies about things to expect in labor and encouraging coming early to the hospital, these preventable tragedies would diminish. Again, thank you for your partnership with us in this and other programs we have planned for the year 2017!