March 28, 2011

Hello again to everyone! Thanks to everyone who sends us little messages via Facebook. We've been busy as always at the clinic. We had a stream of inpatients the past few weeks with one patient with typhoid staying 10 days. Typhoid fever does weird things to people and she kept us busy trying to prevent her from pulling out her hair, IV, or urinary catheter. Also, the local public health office down in the lowlands sent a group of people to our clinic to do education about malaria, do blood smears, and hand out mosquito nets.

As I am recovering from my fourth experience with malaria, my mom suggested that I describe a little more about it. Malaria can have a variety of symptoms but the telltale signs are usually fever, chilling, severe headache, nausea, and diarrhea. Malaria is usually cyclical so it is not uncommon to fever at the same time every day. While malaria itself is not fun, the medicine's side effects are not much better. The treatment consists of 3 drugs, chloroquine, primaquine, and Fansidar. I've gotten to the point where I cringe every time I give these meds out to patients at the clinic. With malaria I usually start feeling better by the third day, but it usually takes about a week to get my strength back.

Aside from medical things, it is planting season here. Most everyone has slashed and burned an area for their farm and now are planting rice. The farms are located on the sides of the mountains and I sometimes wonder how they manage to keep from falling off. It is an exciting time for the Palawanos and you can hear whooping and hollering all over the hills. Everyone gathers to watch when someone is burning their field. The next step is to gather all the sticks that didn't burn the first time and stack them in piles to burn again. Then the field is ready for planting. They plant rice by poking a hole in the ground and putting 6-8 grains of rice inside. They don't plant in rows, just wherever. Helping out with the farming has given me a new appreciation for the food we eat here.

Thank you so much for your prayers and encouragement!

Picture ubdate

                                                         Surlin making linidgid

                                                                Amy planting rice

                                                       Unweeded vs weeded rice

                                                         Kemantian, where we live

                                                                     Chris and Imir

                                             The family of the man who had a snake bite

                                                            Chris doing a house call

Chris and Manyar (who was recovering from Typhoid)

Sounds of the Jungle

When we first arrived here in Kemantian, one of the most noticeable things was the plethora of new sounds. About halfway along the trail to our village, the sounds of the city are exchanged for the sounds of the jungle. At first, the combination of cicaidas, crickets, and other bugs sounded so loud, but now they are background noise. At night we hear bats flying around our hut and there are owls that sound like someone is prank calling us with heavy breathing. There are tucky lizzards that call out, "tuck-y, tuck-y." There are bugs that sound like wind-up toys and others that sound like they are tap dancing. At daybreak (and usually before) the echoes of rooster crows bounce back and forth across the mountains. If 1 rooster crows, it gets them all going and inevitably one comes under our house and crows under our bed. Later we hear baby chicks, various bird calls, and the local cats looking for a meal. At 6:30 am we can hear the laughter of the school kids washing up. Before it starts raining, you can hear it coming toward you. It's nice to have that warning when we have laundry on the line. All day long is filled with sounds of people talking in the high-pitched, sing-song language, crying babies, and school children. This is just a sample of what it sounds like in Kemantian. 

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