Don’t give up

“Do not be daunted by the enormity of the world’s grief. Do justice, now. Love mercy, now. Walk humbly now. You are not obligated to complete the work, but neither are you free to abandon it.”
We are one week into the New Year – 2019 is rushing by as quickly as previous years have done. We have really enjoyed hearing from many of you at Thanksgiving and Christmas. Thank you! The above quote was in one of the Christmas letters we received, and it has really stuck with me. We are so often overwhelmed by the needs around us. By the patients who don’t get well. By the struggles of families to feed and house themselves. By the hatred and anger that seems so prevalent in the world and throughout social media.
At our bi-weekly English service this past week, we shared the story of “The Other Wise Man” by Henry Van Dyke. It is one of my favorites, and it reminds me that Christmas isn’t the end of the story. And that not all circumstances surrounding Christmas were happy. We also looked at a painting of the Massacre of the Innocents – and remembered the grief of parents then and now who faced the loss of a child.
Here in Tansen, there have been several babies and children who have died while under care in the hospital. Les recently spent multiple hours trying to revive a newborn baby – but it wasn’t possible. It is devastating to us all – but especially the parents who go home empty handed. We ask ourselves – “Are we making a difference by being here?” We encouraged our gardener to get a needed operation (but not an emergency one). She was the 1 in 100 who had complications which now require more surgery and probably travel to another hospital. We ask ourselves – “Are we just causing more grief by being here?” We have multiple friends asking us for money – for children’s education, for needed housing, for medical issues….. We ask ourselves, “How can we ever do all of this? Will the work ever be done?”
Daily we need to remind ourselves – Do justice – in all the ways we can. Love mercy – for all the people we encounter. Walk humbly – knowing that only God can make a difference, and being thankful when He chooses to use us in a small way.
We are not obligated to complete the work – but we cannot abandon it! Keep the faith! Happy New Year.

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Back in Tansen – Les hard at work from Day 1

We’ve been back in Nepal for 3 ½ weeks now after our 4 ½ months away. We are enjoying beautiful mountain views, and reconnecting with friends.

And soon it will be Christmas! We pray Christmas blessings and Happy New Year for you all!

 

 

 

 

Les wrote down some thoughts after his first day back at work in the hospital (3 days after we arrived in Tansen).

“I (Les) returned to my clinical duties today – In some ways it feels like I have been away forever, with several new faces on staff and changes that have happened to the training program in my absence, which I need to familiarize myself with. But in other ways, it feels like returning after just a few days off, with many of the same problems to deal with. I was scheduled to work in the male clinic in the morning, and then help in the Emergency room in the afternoon, but due to a scheduling error, I had to start covering the ER from mid-morning. As soon as I arrived, I had to start ventilating a premature baby. KB was a first time mother, living in a remote village in Gulmi district. She found out she was expecting twins, but everything had been going well until this morning. She was 30 weeks pregnant with about two and a half months left to her due date. She had gotten up at 3 AM to use the outhouse, when she experienced sudden lower abdominal cramping. Before they could get any help, she delivered twin boys. The midwife from the health post was summoned, who finally arrived at 6:30. She found K was doing well, with her uterus well contracted and no significant bleeding. But the babies were both very small, weak, and not breathing well. They were advised to go immediately to the mission hospital. When they arrived at about 10:30 AM, one baby had already died, and the other was only taking gasping breaths. We ventilated and warmed the surviving baby, who turned pink and started to move better. He was admitted on oxygen and antibiotics in the incubator, but was critically ill all day. I continued to see other patients with a variety of infections, injuries, and other maladies. J, a 16 year old girl, arrived just after noon. Her family brought her in saying she had taken some poison at about 7 AM. They had purchased some insecticide for their vegetable garden yesterday containing organophasphate, a nerve toxin. She had pin point pupils and copious secretions, which confirmed she had ingested this. She was drowsy and not speaking much. After receiving the antidote, atropine, she was alert, but still confused. She was admitted to continue administering atropine, and to monitor her carefully. She will need counseling about why she took the poison when she is no longer confused. The Social Services/Pastoral care staff were already contacted and starting to be involved with the family. By evening, I had admitted another 6 people. Thankfully my night duty was on with an experienced resident, so I was still able to get a good night’s sleep. But my prayers for the patients I had seen continued whenever I was awake.”

Both the tiny baby and the young girl survived for which we are thankful. We appreciate your continued prayers!

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Remembering Life is short

Monsoon seems to have arrived early this year.  Yesterday, a tragedy occurred near us which is a reminder that in spite of the life giving properties of the needed rain, there are also consequences….  A group of business men and women – all from our town of Tansen – boarded a bus to travel out to a village an hour or so away in order to look at a project which their Savings and Loan was involved with.  Along the narrow road – located along the side of the mountain (as are most of the roads around here) – they met a jeep and pulled over to the edge of the road to let the jeep pass by.  Due to both the recent rains, and to the less than stellar road building practices here, the edge of the road collapsed, and the bus fell down the side of the mountain 150 meters (450 feet).

Palpa bus crash 2018

Because it was raining, and because rescue was hard on the side of the mountain, it took some time to get people up the hill and loaded into jeeps to take them to hospitals.  Because we were one of the closest, we had at least 10 (living) patients arrive in our Emergency Room needing care.  One was eventually transferred to another nearby hospital, and two others were sent by helicopter to Kathmandu.  The latest death toll is 14 – with 9 or 10 survivors.  One of our young resident doctors lost both her father and her uncle.  Another former doctor lost his uncle.  A worker at the guest house was relieved to learn that her son (the bus helper) was only injured, and another doctor’s grandmother was also injured.  Les and I walked into the bazaar last night and saw multiple shops closed, with many people sitting or standing in groups talking about the disaster.  This is a huge blow to the community of Tansen where these men and women were leaders in the business community here.

This morning, as we were having breakfast (again in rain and clouds) we heard another helicopter landing on the parade ground in town.  This brought back our memories of 6 years ago – when Les had his brain bleed and we traveled by helicopter into Kathmandu.

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We were reminded again of how short life is – and how our times are held in God’s hands.  We pray today for so many families who lost their loved ones here – and we also give thanks for 6 more years of Les’s life!

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Be careful what you teach!

Les is never excited to go to work on days when he is scheduled for office duties (admin) – but when it comes to teaching classes, he is always ready to go!  He came home recently with a great story of how he might need to be careful about the subjects he decides to tackle in his sessions!  I’ll let him tell it:

We have “tutorials” as doctors every Wednesday, where each department presents a lecture on a topic for all the doctors.  As I am the most senior person doing obstetrics now, I have the privilege of organizing topics for our department, and supervising when other, more junior, doctors are presenting.

 A few weeks ago, I was teaching a class about obstetric malpresentations.  The most common example is a breech presentation (baby is delivered feet or butt first).  I had just finished talking about how we sometimes have to use forceps to deliver the baby’s head after the rest of the body has been delivered, when there was a message from the doctor covering the emergency room that a woman had just arrived in a jeep with the breech baby delivered half way.  Several of us immediately left the classroom, and found the woman still in the jeep outside the ER.

  The resident had managed to deliver the whole body, but not the head.  We could not feel a pulse for sure, but we got the woman on a trolley and pushed her quickly up to the maternity ward, where I was able to then demonstrate the forceps application I had just finished lecturing on!  The baby was initially flat, with no pulse or respiration, but responded quickly to resuscitation by the pediatric team of doctors.

One of our therapists was not very positive about a good outcome – not knowing how long the baby had been lacking oxygen.  However, mother and baby were sent home after just a few days, doing well and happy about the care they had received.

We all had a good laugh after we were finished, saying that I need to be careful about what I teach: Sometimes classroom lessons turn into real life cases!

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Catch up and Travel

It’s May! Where have the months gone? February and March flew by here in Tansen with lots of time spent at the hospital for Les – seeing patients, teaching residents, and leading trainings for village health post workers. Debbie gave multiple hospital tours, welcomed people and fare-welled many, too.

We enjoyed a wonderful Easter morning celebration – meeting together at 6 am at the town hall along with fellow believers from all of the 7 churches in Tansen. We sang, worshiped, and heard encouraging words from various pastors. Then, the churches all walked around the bazaar area showing their joy and faith in Christ’s resurrection.

April has been a month of gatherings for us. We started in Pokhara for a 3 day retreat with all the expat volunteers currently working in Nepal with United Mission to Nepal. Our team was in charge of worship music again – and Les played guitar, I played clarinet, and we both sang as part of the group. We had an encouraging time together sharing about the work UMN is doing in Nepal, along with hopes and dreams for the future of this country.

We just returned from another gathering of missionaries – this time all the United Methodist missionaries serving in the Asia/Pacific region. It was wonderful to reconnect with people we had met in Thailand almost 4 years ago, and to meet new friends, as well. We were blessed that Thomas Kemper – head of the Global Ministries of the UMC – came again to be with us in Cambodia.  It was encouraging to be together and to learn of God’s Kingdom work all throughout Asia. The UMC sends missionaries “From everywhere to everywhere” and it was an honor for us to be among people from many different countries.

We got to enjoy some of the sites in the area – most notably Angkor Wat. It was very hot while we were there, but we really enjoyed visiting these ancient sites in the jungle.

 

We are safely back in Tansen – but we wanted to share some of our travel adventures as we have never had a trip with so many glitches in flights before.

We flew to Kathmandu on a Thursday, and on Friday morning we woke to 2 pieces of bad news. One – a plane had gone off the only runway at KTM airport, and even though no one was hurt, the airport was closed for several hours which was causing lots of delays. Two – our original ticket had somehow been cancelled and we were last minute booked on another set of flights.

So – we joined the massive crowd at KTM airport and waited many hours to catch our flight on Malaysia Airlines. It left KTM 3 hours late, and we missed our connection in Kuala Lumpur. A kind agent booked us on a flight to Bangkok, and then another one to Siem Reap. We arrived just in time for opening worship – and we ate our supper during the remarks!

Our time at the conference was fine – and on Thursday morning, we flew from Siem Reap to Phnom Pen to get our Malaysia flight back. They wouldn’t allow us to get a boarding pass at the counter because they said we got cancelled when we missed the connection the previous week! Our kind travel agent worked so hard, but couldn’t get us on the flight, so he booked us on Melindo Air to KL. We had to wait in line an hour to get through immigration to retrieve our suitcase, then re-entered the airport for the next leg of the flight. However – they told us since we hadn’t flown the leg from Phnom Pen to KL, we would have to pay a penalty. At that point, we were working really hard to remain polite. We didn’t pay a penalty, and did manage to get on the flight to KTM and made it the rest of the way without trouble.

We enjoyed visiting different Asian airports and traveling various airlines! It didn’t make for the most relaxing trip we have ever had – but we were thankful for safe arrivals.

Now we are down to two months in Tansen before we take off again for the U.S. and home assignment. Looking forward to seeing many of you at that time!

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Reluctant Servant

Happy New Year!  We are currently in Michigan – enjoying a few days with children and grandchildren – it’s wonderful!  We fly back to Kathmandu on Monday, and once we get settled back there, we’ll write more about our travel adventures.  In the meantime, here is a short story we wanted to share.  Please know we are only fellow servants – we are so thankful for each of you and for the work you are doing in the places God has planted you!

In early December, I (Debbie) escaped to Pokhara for 2 days.  I hadn’t been away from Tansen for over 2 months – and it is impossible to “escape” from work unless one actually physically leaves Tansen – and I needed a small break.

I got up the second morning – thinking to get a cup of coffee, and go sit at the lake and work on my bible study.  I found a nice little seat near the lake, settled myself with my drink and books, and started to read.

Maybe 10 minutes later, I heard a voice saying, “Namaste”.  This is the greeting in Nepal  – but I had earbuds in listening to my bible study, so I ignored it.  It happened again – and a third time.  I turned, and there was an old man with his wife – obviously not aware that someone sitting with earbuds in with a book and a coffee wanted to be left alone!

So – I said hello.  He started to share his story – he and his wife needed money.  They didn’t have a house, and had come down the hill to beg for money to eat that day.

Well – I had an internal struggle.  Here I was, sitting trying to do a bible study – something God wants me to do, right?  But – here was a couple asking for help….  What would Jesus do???

So – I put my stuff into my bag, and said if the man and his wife were hungry, I could get them some food and tea.  I’m not sure I was very gracious about it.  We walked down the path, and I found out that this couple actually had 2 living children – one with a previous wife and one in a boarding school. (They had one son who had died.)  They owned land, but didn’t want to sell it in case their children wanted it later (when they are grown).  They have other family, but said they didn’t get help from them.

I don’t always understand people as well as Les does, but I wanted to try to find out about their situation. We got to a tea shop, and I got them some bread, tea and some snacks.  They then asked for money for daalbhaat (a rice meal.)  Usually we don’t give money, but I gave them a little cash to use for purchasing some food – and I gave it to the wife asking her to make sure that is what it was used for!  I also told them the reason I was trying to help was because of Jesus and His love for me.  I encouraged them to go to church both to get help and to learn more about Jesus.  I left them there – feeling like I hadn’t really done anything to make a difference in their lives.  The problems these people are facing are much more than a cup of tea, or even a plate of daalbhaat, could solve.

I didn’t write this because I want you to think I was being a “good Christian”.  I don’t always do the right thing – and even when I do, I don’t always do it with a good attitude.  (I still haven’t gotten back to that bible study….)   We all face small decisions in our days that we wonder about – did it make a difference?  I pray for this couple – and so many more like them who don’t have what they need and have no easy way to get help.  And I pray that God will use even a reluctant servant like me.

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Health Camp

Note: This blog was written by Les – usually Debbie is the one posting.  Les went on this health camp last week and we thought it would be interesting to share.

Please remember not to link or share this blog on social media.  If you want to send the link to a friend via email or message that is fine.  Thanks!

Pyuthan District is just 2 districts west of Palpa where we are located.  It seems so close on the map – only about 40 miles as the crow flies.  However, on the roads in a bus, it took us 10 hours to arrive!

Wednesday morning at 6 AM, 13 of us set off from the hospital to serve at a free medical camp in Pyuthan district.  Our group included 2 GPs, a pediatrician, a general surgeon, an orthopedic surgeon, 2 resident doctors, 2 physicians’ assistants, a dentist, a dental assistant, a pharmacist, and a pharmacy technician.  We were 2 missionaries and 11 Nepali Christians. The group was sent by the Tansen Hospital Christian Fellowship, invited by the local church in Pyuthan, to minister to the community.

The trip, especially the final bit, was quite slow and dusty.  The location is very close to where UMN had a hydroelectric project in the early 1990s on the Jhimruk River. The church had arranged for our team to have the health camp at the local government health post.  The Health Post had moved into a new building 4 months ago, and the old building, just adjacent, was standing empty, so we could have our own space without getting in the way of the staff.  After we arrived, we found out that the local health post in charge had just done the refresher training (MLP) for 3 months in Tansen, and had a very positive regard for how we had helped her.  So she went out of her way to help us.  The local church had arranged for tables and chairs, but we needed more than that to do everything we were capable of.  This person gave us access to the procedure room in the new building for surgical procedures, which allowed our surgeons to actually treat some people with tumors, abscesses, and other surgical problems.  She also arranged that patients needing laboratory tests could go to the health post lab for blood counts or urine tests.

Our accommodation was arranged in the local hotels.  I shared a room with our pharmacist.  We had twin beds in the room, with cotton “mattresses” about 1 inch thick.  It was probably very good orthopedic sleeping posture, but I had to keep rolling in the night when my hips or shoulders started hurting!  We shared a bathroom with 2 other people in the hall.  No toilet paper or towels were provided, so I was glad I had packed some.  The floor was bare cement.  The local church had set up a mess hall in a believer’s home, about a 10 minute walk from the clinic and hotels.  Volunteers from the church prepared meals and cleaned up.  The food was village Nepali style; rice, lentils, and curried vegetables.  A local squash called lauka is in season, so we ate that almost every meal.  I was thankful for the food, even though it started to all taste about the same.  Needless to say, I was very grateful for the variety when they gave us goat meat the second night.

We had purchased about $3000 worth of medicines at a pharmacy in Butwal on our way there.  (Money had been donated by a group from overseas for the funding of the entire camp including medicines.) We spent Wednesday evening setting up the rooms, and on Thursday we started with an opening ceremony, including a hymn, a prayer, the required speech by the local politician, and also a word from the pastor of the local church.  Then we went right to work seeing patients, who had been informed about the camp ahead of time, and were eager to be seen by a doctor.  The church volunteers worked at crowd control, registering people as they arrived, and directing them, a few at a time, to the doctors’ examination room and pharmacy dispensing area.

Many of the patients had minor chronic complaints like knee pain and back stiffness, for which we just advised exercises and some pain relieving drugs.  Some were more interesting.  One of the ladies with back pain mentioned that she had an old cut injury on her knee.  When we looked at it, she had an old fracture of her patella (knee cap) that had never united.  She could not actively extend her knee. So she was walking with her knee flicked into a locked position, and this was what caused her back to be working unevenly and cause the pain.  Our orthopedic surgeon was able to advise her about coming to Tansen for surgery to wire her patella back together, and then to do therapy so she would have a normal pain-free gait.  Another man wanted advice about his diabetes and hypertension, and casually mentioned that his leg was weak “since a fall during childhood.”  That leg had normal sensation, but showed the obvious muscle wasting typical of a polio survivor!  He had no idea that he had lived through polio, and was happily putting up with his “childhood injury”.  He was obviously living a bit too well, and we were able to advise him about diet and weight control, as well as ways to compensate for the weak leg when he walked.  One man had a big fatty tumor removed from his back.  A young lady had an unsightly congenital growth removed from her chin and lower lip.

At the end of patient visits on Thursday, the pastor invited us to visit his birth home, which was just an “easy wade” across the river, to meet his family, who were now all believers.  The 2 female volunteers decided not to go, so about 12 men followed the pastor down to the river.  He walked upstream till he found the shallowest part, but it didn’t look so shallow to me.  He said we can remove our shoes, socks, AND TROUSERS, for the wade across; no problem!  So there we were, following his example, in our underwear, wading through the water mid-thigh deep, to the other side.  If he can do it, by golly so can we!  We re-robed, and had a nice visit with his family.  We also visited the first church in Pyuthan district, established just 13 years ago.  Now there are almost 20 churches in the area.  I was again humbled, seeing how actively the Nepali believers are showing God’s love to their neighbors, and inviting them to come to church.

By the end of Friday, 866 patients had been seen.  Not only was the crowd well controlled by the volunteers, but everyone who came was able to be seen.  All treatment was given for free.  There was only one dissatisfied patient I am aware of; she grumbled about that fact that we couldn’t do thyroid testing at the camp.  We are happy that for the most part people are very grateful here still for whatever care that we can give. There were also tracts and gospel literature available, and volunteers to chat with people as they waited, or to answer their questions about health or about the Christian faith.  We trust that the seeds planted will take root, as the church continues to grow all across Nepal.  The camp was officially closed on Friday afternoon with speeches of thanks, certificates of appreciation, and prayer.  $750 worth of remaining medicine was donated to the local health post.

Distant mountains

Ladies cutting rice

On Saturday, we left the camp early to start the trip home.  We stopped for some sightseeing, as well as to visit one of the volunteer team members parents’ house, arriving back in Tansen about 7 PM.  I was inspired again on this trip by seeing how everyone on the team tried to serve without counting the cost.  It’s great to see our Nepali sisters and brothers taking up the mantle of caring for the still many poor and needy across this country.

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