March 2024

 Do we still blog? Though it is an ancient form of communication, but yes! We still do! Do we still live in Kalukembe? Yes! And we would like to share a few updates in our ministry and work there. In January, we began receiving intern doctors from a partner hospital in Lubango for 2 week rotations each month. Pri and I have for a long time wanted to participate in educating colleagues here, so this has been a wonderful answer. Each of the interns who have come seem to have had positive experiences. The overarching goal is to help train physicians for general medical care in resource-limited settings. The focus for the brief rotation at Kalukembe is to experience pediatric and OBGYN care, but also to see patients through our emergency ward. Since it will be one intern at a time, we hope to tailor didactic training to their interests as time goes (EKG interpretation and cardiac ultrasounds, for example). But, well, 2 weeks has a lot of patient care that can make getting in "formal" didactics a challenge! 

As of December, construction for the maternal waiting home has been under way. With walls up and floors down, we are looking closer to completion. We are working out if and how solar power could be provided, and plumbing work is yet to be done, but the potential this place holds is quite exciting. Imagine first laboring at home far from anyone, then getting transported by motorcycle while in labor after a day or two of no progress to several clinics before finally arriving at our hospital; then imagine feeling labor begin and just walking from the womens waiting home right down the road to the hospital to safely have labor monitored and delivery assisted, whether vaginally or operatively without significant delays. There will be much to learn about what barriers might be to utilizing this service, but seeing how it's been done well in other places, we believe this is the right thing to do here to reduce mortality and increase safe and healthy deliveries in our community. 

At home, the kids have recently been busy with their snack restaurant business. They buy coal, oil and local food ingredients to then prepare and sell. Their menu usually includes fried potatoes, juice and now even guava paste. They also make hospital deliveries, which has been great for Pri, who often can't get back for lunch. I haven't heard if they're ready to expand to international deliveries yet, but I highly recommend the sweet potato fries! 

And below, a few pictures!

Visiting nurses dedicated to helping women who suffer obstetric fistula visited our hospital for almost 2 weeks in February. They came with women from the central area of the country whom Priscila cared for and operated on. Nurses Domingas, Elisa, and Mariana brought much compassionate care for these ladies. And in addition to sharing on the hospital veranda about healthy pregnancies, they also shared at the local womens church organization. We are very grateful for their visit and the work they continue to do in Huambo province!

Working out of our temporary ER space, Dr. Hermenegildo from CEML in Lubango did a fantastic job taking care of patients. Dr. Hermenegildo and Dr. Ana have both now rotated through Kalukembe and have been great ambassadors for physician trainees at our hospital. Our nurse colleagues have appreciated working with them and our patients have benefited from added doctor presence. Please keep praying as we develop this training experience so that doctors who pass through might learn quality care in austere environments

Man, I am impressed what these guys come up with. They built a tree house out of bamboo and scraps, and no injuries (that's where my ER mind goes)!

Most of the time, I am on children's ward where the largest number of patients and highest mortality lies. Occasionally, I will see patients on mens ward, especially ones who need to be transitioned to palliative care. It is a painful but important challenge to help staff and family transition with patients when they enter the active phase of dying. Having conversations about prognosis, treatments that can be accomplished and ones that should not be pursued, dying with peace in their hearts: peace with God, peace with themselves, peace with their loved ones. . . these are all issues requiring wisdom that I know i am far from having.  I see not only the difficult fragility and endings that face patients and their families in these moments, but my own limits to healing and restoration. It's painful, it's beautiful and it's a privilege to be with them in those times. Romans 12:15-16 is a beautiful reminder to make this a habit of living with others as we all experience the joys and setbacks of life. 

Julia (L) and Anna (R) here with one of our lovely fistula patients (all permissions given). Julia has been more involved this time in ancillary care of our obstetric fistula patients--purchasing food, checking on housing, helping them settle in to their often prolonged stays at our hospital. Both young women have been a delight to have with us since we returned to Kalukembe. We have benefited so much from their kindness to especially our children and our family. We are excited to learn that Anna has also been accepted to medical school!