February 10, 2012

Things have slowed down here at the clinic, or maybe we have just adjusted to the number of people we see. But no more cholera epidemics or big crises. Here are some interesting facts. In 2011, the medical clinic saw a total of 4,551 patients and 2,059 of those had malaria. There have been more births this past month as well. I have had more experiences walking into a hut and finding the baby and placenta lying on the floor. I was also called to "help" at a delivery and it was the first time the mom was still in labor when I got there. I say "help" because I was basically moral support. The mom was very shy and I don't know anything about delivering babies so I was reading a book equivalent to "How to Deliver Babies for Dummies." The more I read, the more stressed I became because it pointed out all the things that could go wrong. When I first arrived at the hut the room was full of women, but after a while I found myself alone with the mom. I thought to myself, "This is crazy. All the other women here know more about delivering babies than I do. At least they've had their own children." I felt like I was giving them a false sense of security. So I decided to take a break and told the women to come get me if they had any problems. Not long after, they called for me again and when I got there the room was full of women again and the mom had a baby girl. As soon as she was born I was allowed to cut the cord and take care of her. She's probably the warmest baby here in Palawan because she didn't have to lay on a cold floor for a few hours. I praise God for answering my many prayers that afternoon.

We have also been dealing with spiritual attacks among some Christians here. The attacks sometimes start with stomach or kidney pain and when the person is in the middle of it, they are not with it at all, sometimes screaming, sometimes sleeping. We pray, sing songs, and keep the person from getting injured. We know the devil is mad and doing everything in his power to discourage the church here. But we know that God's power is greater and the battle has already been won by the blood of Jesus Christ.

While Chris and I have been here we have had more time to study the Bible. It is becoming very obvious to us that God is calling every person to work for Him. His return is very near and while we are saved by grace, that doesn't mean we should just go to church once a week and be content to keep that knowledge to ourselves. God has a work for each of us to share what we have learned and show the love of Christ to those around us. Whether that work is being a missionary overseas, supporting the church financially, or being a missionary to those around us at home. We are already thinking about what God's plan is for us next year. Of course we have our own wishes and desires, but do they fit in with what God wants us to do? Please continue to pray for the Palawano people and for us as we seek God's will for our life.

Amy



Life at the Clinic

I thought it might be nice to share a typical day at the clinic. We open at 8:00am, and it is not uncommon for people to be waiting on the porch for us. A student worker from high school meets us Monday through Thursday to help us with our workload while learning valuable life skills. Some of the tasks they help us with are:  prepacking medicine for quick dispensing, washing cups and syringes used to give medicine, as well as daily clean up around the clinic. The staff is also responsible for teaching the students how to weigh people, taking blood pressure and temperature, finding charts, and filing them away. Some of the more advanced students are given opportunites to practice giving shots to the staff. 

Once the clinic has been cleaned up, we begin asking who is sick or needs medicine. It's basically run just like a doctor's office back in the states, except your doctor checks you in, gets all the vitals, and then takes you back to the exam room. Once we determine the illness, we prepare the medicine for the patient. The medicine is placed in plastic bags and knots are tied in the bags to separate doses for different times of the day. Each bag then represents the number of days to take the medicine. We pack it this way because most people can't read.

On a daily basis we see from 5-20 patients, depending on the weather, or if there is an event that requires people to walk by the clinic. Pediatrics makes up the bulk of our patients. The most common thing we treat for is malaria and second to that is upper respiratory illness. There are also a fair number of cases of RSV and pneumonia in children. We also see lots of kids who have sores covering their legs and bodies and I think this is due to poor hygiene.

The adults who come to the clinic most commonly have upper respiratory illness or malaria as well. However, I have seen a few cases of hepatitis, typhoid, and other interesting pathologies.  There are also lots of rashes here including ringworm, athlete's itch, atopic dermatitis, and a jungle rash that does not seem to respond to any medicine that we have.  Many adults also have dental problems and they often come with symptoms of a tooth abcess.

One of the stranger things that I have only seen in the Palawanos is that sometimes when they eat fish, green mangoes, or passion fruit, they develop severe gastritis.  They complain of sharp stabbing pain in their epigastric region, and are unable to walk around. Often they vomit once and then go into a comatose-like state and do not respond to verbal stimuli.  Usually I go to their home to treat them and they recover in a day or two.

So that is a quick snapshot of what we do here in the clinic.

Chris Kinney

Chris talking with one of the patients

 Alanna, the nurse who works with us

 

 

 All the school children

Chris is listening to the palm heart (it's the heart of a palm tree)

 

 Coming back from the farm with pulug

 Cute

Everyone helps clean the rice at the store. They are picking out worms.

Friends

Friends

One of the births I attended

One of my best friends, Naklin

 Our house

Preparing food

Science class

This is the baby girl from the story

Visiting with friends from Lup Lup

January 8, 2012

What a crazy month! It all started when a man named Labas died. Labas fell from a coconut tree 15 years ago and crushed his pelvis. He lived in a village called Lup Lup, about and hour away from our clinic, and he depended on his family to care for him. He had slowly been declining and before he died he asked to be put in a tree house instead of being buried. I'm guessing this had some spiritual meaning to him because those who are not Christians are afraid of what will happen when they die. Even the way they normally bury the dead is different in that they make a bamboo covering over the body so that the dirt won't touch them. We didn't hear about his death until a few days after it happened. The village was told that they needed to bury the body in the ground but no one was willing to because they were afraid of his spirit. In fact, half the village had moved to another hillside because they were also scared. About 1 week later, a woman was carried by basket to our clinic. She had been sick for a few days and by the time she got to us she was severely dehydrated and had heart arrhythmia's. We started an IV and sent her down to the hospital. Soon after, two more people were carried in from the same village. More came by walking. Chris diagnosed it as Cholera and we started treatment. In all, we treated 16 people from Lup Lup in our 4 bed clinic. There were people sleeping on the back porch, the front porch, everywhere! We sent 2 of our missionaries to properly bury the body and to educate the village about cleanliness and the need to boil water before drinking. Once everyone was feeling better at the clinic, we had them all shower and wash their clothes. It was quite the social event with everyone eagerly waiting their turn. Some had never seen water come from a shower head before. One older man we treated was fiercely independent and when he needed to get up and use the bathroom , he would say, "Don't walk with me. By myself only," but he was so unsteady that we would have to walk with him anyway. Later on when he was feeling better, he told us, "If it wasn't for your clinic, there wouldn't be anyone left in our village, just chickens." We are so grateful to be able to help meet the needs of these Palawanos. We we are the only medical care that they have access to. The village of Lup Lup hasn't been very receptive to our clinic and school in the past, but this outbreak of Cholera has opened the door. The past few Sundays, market day, they have been the first ones at the clinic with smiling faces. A group of church members and high school students went last week to share Bible stories and hopefully they will all one day know and accept the love and salvation of Jesus Christ. Please pray for the village of Lup Lup.

Pictures

A fellow missionary with one of the sick kids at the clinic

Chris and Elias's first taste of boiled goat meat

Kalulu and his healed hand

Standing among pulug, an edible root

At the start of our hike into the mountains

December 15, 2011

Hello to all our friends! We are in Brookes Point for 2 days to use internet and buy a few supplies. It's nice to see different scenery but the city is so noisy and hot. I think we prefer the sounds of the jungle lulling us to sleep instead of the blaring radio. We have been busy the past few months. We had our first experiences with inpatients and it was a challenge. It is a whole new level of responsibility when someone's life depends on the care that you give them. It is also challenging because we don't have many laboratory capabilities. We can check hemaglobin, blood sugar, and a basic urine dipstick. What a difference from Western medicine! One interesting medical story. Chris and I were eating breakfast when we heard a loud bang, kind of like a gunshot or firecracker. We didn't think much of it, but half an hour later we heard people shouting at the clinic. When we got there Kalulu, a witch doctor and powerful elder, was there with a towel around his hand. He had been making a bomb to kill a pig that was eating his farm when it exploded in his hand. He complained of problems seeing and also had a severly wounded hand. 4 of 5 fingers were damaged and the middle finger was barely attached at the top. The bone was exposed and Chris thought that he might have to amputate it. He decided that there might be enough blood flow on one side of the finger and sewed it back on. After 4 hours of suturing and over 100 stitches, we asked if he would allow us to pray for his hand. His family was also there which was unusuall because they don't like the missionaries and try to stay away. He agreed and allowed us to pray. We were doubtful that the middle finger would heal and told him that if it did get better, it was because God healed his finger. We saw him a few days ago and his finger looks healthy with no signs of infection. Praise God!
When we are not in the clinic we have been busy visiting and making friends. They like to have potluck and since missionaries have been here for so many years, they have been exposed to some american foods. They especially like peanut butter, nutella, and macaroni. The people are so generous that we can hardly give away more food than we receive. And relationships are of the utmost importance here. It is not unusual to go visit someone unanounced and talk for a few hours. We truly feel loved here.
While we are enjoying our time here, we have had a few struggles. Recently the church members went to the lowlands for 2 weeks to learn how to give bible studies and deal with spiritual warfare. While they were gone the devil was attacking those left in the mountains. Minor inconveniences added up. The water system broke leaving us without water. The generator broke (we use it for nebulizing treatments in the clinic), several very sick kids came in a row, staff members got sick, and one family experienced spiritual attacks at night. I was feeling discouraged after we ran out of propane during all of this and was praying to God. He brought to my mind Colossians 1:11 "We pray that you will be strenghtened with his glorious power that you may have all the patience and endurance that you need. May you be filled with joy, always thanking the Father." That has been my daily prayer and all the prior problems have been resolved. We are learning to depend on God for our daily needs. We thank you for your continued prayers and praise God for his many blessings.
Chris and Amy

New Letter From Amy

Nov. 4

Just after I sent the last letter I got to experience helping with a birth. Actually, the baby was born before we got there and the baby was just lying on the mat, still attached to the cord. During labor they have someone push down on the mother's belly to keep the baby from crawling up into the chest. All the babies so far have been born at home because that's how it has always been done here and I think they are a little scared of the clinic. We cut the cord, delivered the placenta and got the baby cleaned up and he's a healthy baby boy. I don't think they have named him yet. I also got to experience sleeping at a local's hut. Ali, Alanna and I hiked across the river to a village near Kensuli and stayed at Nini's house. We cooked spaghetti for them and they made rice and leaves. As soon as it was dark we laid out our sleeping mats on the bamboo floor and went to sleep. All the girls slept in one house and all the guys in a house next door. I had no problem sleeping on the hard floor, but I remember as a kid I preferred the floor to a bed, so maybe that's why. The nurse that was here when we arrived left last week to go home and we are very sad about that. The clinic is busy and Chris has his hands full since he is in charge. We are also teaching English classes at the high school. My students say that English is "inside out" with spelling and I have to agree. The Palawan language is nice in that everything is spelled as it sounds. The women here all make various baskets and crafts and my goal is to learn how to make some. A girl named Naklin taught me to make stars out of bamboo and another plant from the jungle. They also make a kind of basket that looks like a snake might pop out at any moment. When Chris hangs out with the men, they usually go blowgun hunting and he is getting pretty good. I am recovering from malaria and hope to never get it again. It's like getting a bad case of the flu. Please pray that we continue to learn the language and bond with the people here. We miss you all!

Letter from Amy

The first few weeks here Chris and I have been adjusting to new food, new customs, and new ways of doing everyday tasks. The hike into the mountains was not as difficult as we were expecting, probably because the trail conditions were perfect, not too wet or too dry. It took our group 3 hours. We are living in a valley and to hike to any nearby villages requires hiking straight up and down. Everyone here either hikes barefoot or wears a rubber sandal called a Duralite. The other day I went to a village wearing the Duralites because the trail was fairly dry, but it started raining and my trip down was like skiing. I'm sure I look pretty funny to the Palawanos, slipping and falling while they calmly hike down, usually carrying a very heavy load. Most days we work in the clinic for the morning and then go to a nearby village to language learn for the afternoon. It's fun to explore the trails and find new people to talk to. Most villages are really 3-4 huts on the side of the mountain. Our hut is very nice with running water and a 2-burner propane stove. Most meals are rice with ista'an (the word for anything you eat with rice), usually some kind of curry. We have been trying many different kinds of vegetables. Kumbohang and pulu are roots that taste like potatoes and are the staple (along with rice) of the people here. There is syote, sweet potatoes, and various green leaves that taste similar to spinach. The first week we were here there were two weddings. One was located in the village of Kensuli, about 45 minutes away. Everyone traveled to Kensuli the night before and met in the schoolhouse. The elders and family spent a while discussing what would happen the next day and then they started cooking. We eventually went to sleep at a family's house. Chris woke up in the middle of the night and saw them skin and cut up 4 goats. The actual wedding took place at 7 the next morning. It was a very westernized ceremony with the bride wearing a white dress and a similar ceremony to most Christian weddings in the US. They took a few pictures and then the elders decided that they needed to do a traditional ceremony as well. This ceremony is basically the elders talking about the terms of the marriage and whatever else they feel like talking about. The husband must pay for his wife and also give a gift of tadyungs (tadjung) to the bride's family. A tadyung is a multipurpose cloth that can be used as a blanket, garment, or to carry anything. The elders can also charge for different offenses. For example, this groom went directly to his bride's father to ask for her hand in marriage. Traditionally, he should have gone to the elders of her village, so he was fined. He also was fined because the wedding occurred at a later date than what was originally set. They served rice, pansit, and goat meat after the wedding was finalized and the whole thing was done by 10 am. The 2nd wedding was much smaller with just the elders talking. The bride sat covering her face with a tadyung the whole time because she was shy. Most people here are very shy and couples don't show affection in public. For the most part, men and women are separated in any public gathering with men on one side and women on the other. The clinic is busy, especially on Sunday which is market day. There are 4 of us working in the clinic, but 1 nurse is leaving at the end of the month. All in all we are very happy here. Our biggest challenge right now is learning the language. Most people are friendly and willing to help us learn. They give lots of encouragement which is nice. There is no internet and we don't know if we will have any access while we are here, so Becca is putting this on our blog for us. (Thanks Becca!) We have our cell phone linked to our Facebook page, so if you send a message to our page (1-2 sentences at a time) it will come as a text to our phone. We can't initiate a message but we can reply. Well, thanks for your continued prayers. We will try to keep this blog updated every few months or so.

Sincerely,

Chris and Amy Kinney

No Internet

Amy and Chris do not have internet access in Palawan. Amy sent me a letter with information to post which will arrive in approximately a month. I will post the letter when it arrives.

Becca (Amy's sister)