New life for a little girl

Please remember not to post this on social media. Thanks!

Thank you for your prayers, comments and emails! We were happy that the visas/work permits were issued about 3 1/2 weeks after we had to stop work – and since then it has gotten quite busy! We appreciate those of you who have been checking in with us. We think of you and are thankful – even when we don’t write.

Nani was a 10 year old girl living with her family in an East Palpa village.  Her mom took care of pretty much everything – not only did she do house work and the farm work, but she would also try to get daily wage (labor) jobs for which she would earn about 250 rupees per day (a bit over $2).  Nani’s father went to India about a year ago to work as a cook, but has not sent any money to help the family.  She has no siblings, but 2 uncles live there in the home – one of them can neither hear nor speak.  He does help by taking care of their goats and cutting grass for the animals.

Typical village house

So, when Nani complained to her mom of a stomachache and headache, her mother didn’t worry too much.  But 3 days later she had a fever, swelling and pains all over.  Her mom then took her to a local medical hall for a check-up, but her aunt thought she needed better treatment and brought her to our hospital.

Nani was admitted from our Emergency room into the pediatrics ward.  She was critically ill, and in a lot of pain.  She didn’t want to eat and the nurses provided an air mattress for her to try to make her more comfortable for sleeping.  She had so many tests and procedures – 7 ultrasounds, 3 operations, 2 minor operations, 6 pints of blood transfusions and 26 days on oxygen.  She was suffering from multiple abscesses, scrub typhus, and was bleeding in her intestines.  Her right hip was dislocated, and she had osteomyelitis in her right femur.  This child was hurting in so many ways!

Our surgeons worked many hours with Nani, and she spent time in traction.  The physiotherapists helped her exercise and regain strength and range of motion as she healed.  The social services/pastoral care team made sure she was provided with nutritious food, and later provided toy therapy and then help with school work.  They also spent hours giving spiritual and emotional support, teaching about health and good eating habits, and just listening and encouraging as needed.

Nani slowly began to improve.  She learned to get around on crutches, and was gaining strength from eating a healthy diet.  She started playing with others, and improving in her reading and writing skills.  She spent 86 days – almost 3 months! – in the ward of Tansen hospital.  And she got better!

Play therapy and school work with Social Services/Pastoral Care staff

Nani’s mother could not have afforded to pay for this much care on her own.  She did borrow some money from her neighbors, but the majority of her care was paid by the gifts of friends from around the world who give to the Medical Assistance Fund for Tansen hospital.  When Nani left the hospital, she swung happily on her crutches down the road towards home.  We were looking forward to seeing her for follow up in the coming months.

Unfortunately, the lockdown (Covid) started again, so the follow up was done by phone.  The report was good – Nani is able to get around using just a stick (cane) and is continuing to improve.  Her family and friends were very thankful for her return to health because of the care provided from the Mission hospital in Tansen. 

Nani wants to get back to school, but due to lockdown, classes are only done online.  She is one of the many village children who are missing out on school as there is little to no internet access in the hills, and even if there is, most families don’t have the money to purchase a smart phone in order to connect to online classes.

Thanks for praying for our hospital – and also, thanks for prayers for the children of Nepal!

5 Comments

Filed under Uncategorized

Rainy Days on…Thursdays, Fridays, Saturdays…

The wind is blowing, the rain is falling, and the clouds are drifting by (and sometimes through!) the house… Is monsoon starting? We are not sure, but we have measured at least 14 inches of rain in the past 3 days. We suspect this is related to Cyclone Yaas which was hovering over the Bay of Bengal. We do love seeing the green hillsides which is an amazing contrast from the dusty brown of just 4 weeks ago.

In the clouds during the rain….
More clouds….

Covid 19 – still around in ’21…. Nepal is still in lockdown, and it was made even more strict in Kathmandu for this coming week. Right now, the next end date is June 7. Here in Tansen, the lockdown has been tight from the beginning of May. We can get food items from shops between 7 and 9 am – but items are available on a hit and miss basis. Once again the problem of people not being able to work in order to purchase food may be a greater risk than the virus.

Yesterday we were very happy to see that for the first time in a month our covid ward had less than 20 people! We are thankful that our oxygen plant and generator have kept working through this time. (Thank you for your prayers!) There have been 23 deaths here in May from covid – the youngest was only 11, and the oldest was 80. People are still waiting for vaccines to become available – less than 2% of the population has had both shots.

In the midst of this terrible pandemic, the government of Nepal has fallen apart. Parliament was again dissolved – with elections planned for November.

To make things worse for us, the work permits for the missionaries here expired on May 22 – and have not yet been renewed. The government officials (the ones remaining in offices) don’t seem to be in a hurry to move the paperwork through. It is beyond frustrating for the medical doctors… Les has been trying to keep useful by running courses for the junior doctors – ACLS and ALSO training. But not being able to see patients is quite difficult.

Instructor mode….(mask was off momentarily…)

We continue to pray and hope that God will show mercy to this country. We are thankful for glimpses of his handiwork – including the beautiful blooms of the Queen of the Night flower which we enjoyed recently. We are thankful for our own health, and for the opportunity to learn more and more how to trust in God when the future is so shrouded in mystery. Just like the clouds which now completely obscure the view of the hills and valleys around us.

Queen of the Night. An ugly plant, with beautiful blossoms which only bloom once after dark.

Post script: It is Saturday evening now – and the Himalayas are all out and we can see blue sky again. We are looking forward to our morning walk/run tomorrow.

10 Comments

Filed under Uncategorized

We thought – hoped – we were done….

Please remember not to post on social media! Thank you

This time seems harder. It was over a year ago (March 24, 2020) that we went into lockdown for the first time. It started when there were maybe 5 cases of Covid 19 confirmed in Nepal. The lockdown was initially for 2 weeks – but it kept being extended…again and again and again. Things finally began to open up after about 6 months – and there was a spike in cases in October, but not really anything major here in Tansen.

Then – April 2021. We were starting to plan for the future again. Starting to work on visas for new people – some of whom had been waiting more than a year to come to Nepal. Starting to hope that people could get their lives back on track. Rumors started about India – and the news kept getting worse.

From Worldometer website

Tansen went into Lockdown again on May 1. The hospital once again moved patients out of the medical ward to convert it back into the isolation ward. Previously, even during the highest numbers in Oct and Nov, we had only 5 – 10 patients daily in our isolation area. Over the course of the year, we had only 3 – 4 deaths from covid here.

All of that has changed in the past 2 weeks. Our isolation ward now has 20 – 26 patients each day.

Former medical ward nursing station is now used for the isolation ward nursing station. One nurse is in full PPE ready to go in to check on and treat patients.

We can only provide oxygen for 20 patients unless we are able to get another compressor for our oxygen plant. Unfortunately, we would have to bring the compressor in from another country, so it would take 2 – 3 months to get here. We are extremely grateful to have the oxygen plant here to help at least 20 people at a time.

We have lost 4 patients already in the past 2 weeks. At least 26 staff have tested positive and most are isolating at home with only mild symptoms. Only one was hospitalized, but he has other medical conditions. We are also thankful that almost all of our staff had been vaccinated, which we believe is keeping them from more serious illness.

The out-patient department is once again pretty much empty. Our in-patient census is down as well – no one wants to come or stay here as so many are now testing positive.

As patients enter the hospital, their temperature is taken and they are asked if they have symptoms or have been exposed. If that is the case, they are either given an antigen test, or told to go home and isolate. Patients without symptoms who need to see a doctor for other reasons are sent on to the outpatient clinics.

The airport has closed down again – so flights in and out of Nepal have been cancelled. There are groups of climbers on trekking routes who are now coming down with the virus. Most hospital beds in the country are taken.

The situation in Nepal is not as bad as in India, where we hear that people are literally dying in the streets due to lack of hospital beds and oxygen. We personally know a man from Delhi who had to hire a vehicle to go to the Punjab to get into a hospital and onto oxygen. His pregnant wife and 3 year old daughter became sick after he left, and also are covid positive. Thankfully, someone helped get oxygen for the wife, and she is home trying to take care of herself and the little one. The wife’s mom lives here in Tansen and is a good friend – she is beside herself wanting to go to help, but is unable to travel to Delhi due to the lockdown…

As before, we see the wealthy and influential people being taken care of – while the poor and marginalized suffer once again. Our hearts are broken for the many who are so needy all around us. Almost 8% of the Nepali people have had at least one vaccination – but that has stopped now during the lockdown.

We are thankful to hear that things are better in the U.S. Please remember Nepal, India, and other struggling countries in your prayers.

8 Comments

Filed under Uncategorized

Strange sightings…but not April fool’s!

(Please remember not to share this on social media. Thank you!)

Just outside the hospital gate are many varieties of houses, restaurants and hotels. Most have been rebuilt and modernized with cement (rather than the traditional mud, brick and tin.) However, there are still a few places that have been put together with whatever could be put up cheaply.

Each morning we walk by a certain house where a widow and her son live. They have been there for over 10 years – even though it is not their land, but is owned by the government. We would call them squatters. When we first came, the husband also lived there, but he became ill and died several years ago.

We came to know that this widow, with whom we often chatted, was actually the second wife of her late husband. His first wife and children lived in a near-by village. This is still more common than we would like in Nepal.

So – after the husband died, the first wife decided to move in next to the second wife, and to build a hut and “squat” there, too!

The far part of the house (with the clothes hanging in front) is the original house of the second wife. The front portion is the first wife’s later addition.

The second wife has become a believer and we see her coming to church regularly. She is not able to work, and her son has been ill, so the church, and others have been helping her with food. There is no water where they live, so they have to carry it from the local springs and taps. (It is a 5 – 10 minute uphill walk to carry water to their home.)

We know that they don’t have much money, so we were really surprised the other morning as we were climbing the steps beside their homes. Les said – “Look at that! A satellite dish!” Wow. No water. No toilet. But – we have TV! We never cease to be amazed at what people consider to be important, and the choices they make!

This dish is on the first wife’s roof – and we don’t know them really at all, so we don’t want to make assumptions that may not be true. But it just struck us as something we have noticed over the years here in Nepal – the juxtaposition of the old and new.

Satellite dish on top of the newer part of the house.

7 Comments

Filed under Uncategorized

There and Back Again…

(Apologies to Tolkien)

(Please remember not to share this on social media. Thank you!)

Just a few days after our last post in December, we were on our way to the U.S.! We did a 2 week quarantine and got to spend Christmas with our grandchildren. It was wonderful. Then – we got Covid just at New Years time! We are so thankful we had only mild cases, and were able to see family again after another 2 weeks of isolating. It was a strange trip this time, but overall restful and good.

The work permits came through at the end of December for the expats in Tansen. When we returned on Feb 4, we were able to get our first dose of the vaccine! We started back to work on Feb 7 and it hasn’t slowed down since! The numbers of covid patients in Nepal has gone down hugely, and here in Tansen, our isolation ward is now empty, and will once again become the regular Medical Ward. We are thankful for this – the hospital is very full and busy these days… it is virtually impossible to maintain any distancing between people. Most are still wearing masks. Training programs are starting again, as well. Thank you for your prayers for Nepal – and we do pray that there won’t be a second wave! Vaccines are starting to become more available.

Les was finishing up today when he went back to check on a young man (15 or 16 years old) who had come in during the night as he had swallowed pills to try to kill himself. He started to wake up when Les was there and wanted to be allowed to leave so he could go get more pills and try to kill himself again. Unfortunately, our psychiatrist is away for the week, but Les and another pastoral care worker spent a lot of time talking with this young person and praying for him. Les was able to start him on some medication, but he certainly will need prayers. Les is once again back in his element and loving it!

I was happy to see that the 2021 Friends of Tansen magazine had finally arrived. Unfortunately, we are still unable to mail anything internationally, but we do have the digital version! I hope you will enjoy the stories from this past year – a bit different as everything else has been lately.

The link to read the magazine is http://www.tansenhospital.org.np/news/magazine.php

We love the comments you post – thank you so much for sharing in God’s work in Nepal and for encouraging us along the way. Here is a recent photo from a wedding we attended. Tansen in on the hill behind us.

6 Comments

Filed under Uncategorized

Waiting….

(Please remember not to share this on social media. Thank you!)

I (Les) have not been allowed to work this past week. My work permit and registration at the Nepal Medical Council both expired on Sunday, November 22, and have not been renewed.  In fact, the same thing happened to all the foreign missionaries in Tansen.  At least for me, as a US citizen, I have a 3 year visa in my passport. Those on our team who are not Americans had to go on a tourist visa to stay in Nepal legally. But none of us are working until we get the work permits. Since we arrived here 30 years ago, this is the first time we have had to stop working. This is the result of several unfortunate things converging at the same time:

1. When the last 5 year agreement was expiring in January, a new agreement still needed to be written, so we were all given 6 month extensions. But the government decided that the UMN hospitals should no longer be managed by a foreign mission, but by a trust set up in Nepal.  This is probably the result of increasing nationalism and Hindu lobbyists gaining more influence. This was announced in May, and we were given another 6-month extension to allow time for the legal work of forming the trust. UMN now has the trust established, but there was not enough time for the hospital agreement to be made before time ran out on November 22.

2. Nepal’s new federal system, written into the constitution that is being implemented now, means that the provinces have more self-governance rather than everything being managed from Kathmandu, the capital. Unfortunately, it is still not clear which powers are being given to the province. It seems that everything now requires approval from both the province and the federal government, doubling the bureaucratic red tape and administrative hurdles. The hospital is getting registered as a new community hospital in the province. But the provincial office staff are learning how to do this themselves, apparently without much guidance on what this process should involve. For example, they requested that the personal information and professional qualifications of all 400 staff be photocopied and submitted. Now that all details have been submitted, they are waiting for a committee with a radiologist, pathologist, physician, and managers to meet so they can review our application. The work in Kathmandu to get our visas cannot go forward until the hospital is registered in the province, and UMN and the government have a working agreement signed.

3. Dashain and Tihar, the 2 main holidays of the Nepali calendar, fell late this year, so most government work was shut down or running with minimum staff from mid-October for a month. And usually when the person with power to authorize something is on holidays, their duty is not delegated to anyone else, but left until that person returns. So right when the crunch was on to figure out an extension or some other deal, nothing was happening until right up to the last few days before time ran out.

4. Lock down and work from home during the Covid-19 pandemic affected all work by both the government office staff as well as the UMN staff working in Kathmandu. Even the hard working ones were struggling to get things done that had been previously managed efficiently.  

So while we are forbidden to work, we are taking a break, and have come to Pokhara for 3 days to celebrate my birthday. (We returned safely to Tansen last night) We are also praying about how long we should wait in Nepal for our work permits, before we take a longer break, returning to the USA to see family and friends. On the one hand, we don’t want to leave if God wants us to stay, and if the work permit will be approved soon. But on the other hand, it is even harder to be away from family when our reason for being here, working in the hospital and ministering to patients and visitors, has been taken away for an indeterminate amount of time.

The hospital has been struggling along with only the Nepali national staff working, at least the ones who have not been quarantined for testing positive for Covid-19. Thankfully no staff are critically ill. Hospital work is now running at under 50% of our normal capacity. It is hard to see patients waiting for tickets to be seen, or giving up and going home without care, when we are right here and willing to help. It is also sad to think of the new junior doctors, who still need a lot of supervision and support from the senior doctors, losing half of their mentors. We are certainly thankful that we have at least a few good senior Nepali doctors working hard to keep things running.

So pray, pray, pray! God knows what He is doing, even when we don’t. We are trying hard to see where God is going with all of this, and to join in with Him rather than to fight against Him. Thank you to everyone who supports us in prayer, especially in these coming days.

Les turns 60 in Pokhara. Cookies and coffee for breakfast!

12 Comments

Filed under Uncategorized

Families in hard times

(Please remember not to share this on social media. Thank you!)

Little Khari was just six months old. She lived in a mud/brick house in the village with her older sister, her mom and her grandma. Her father was away in India, trying to earn a cash income to support his family. Until the lockdown (Covid) he was working a good job at a hotel, but that ended in March. He decided to remain in India in hopes of finding some other work, as he knew there was nothing he would be able to do in Nepal. Other than a small senior citizen stipend that the grandmother receives, this family had no money coming in on which to live.

Village home
Cooking in a village kitchen

The family did have a little land, and they could grow enough to feed themselves for about 4 months of the year. However – there was only the mom and grandma to work the land and plant the crops. They also had to care for the one oxen they owned.

Look closely – there are oxen and people in those fields. Usually they are located far from the owners’ homes.

One day, Mom and grandma had to both be out working in the fields. Khari was left with her older sister – who was just a 2 year old toddler. At some point, Khari rolled into the fire used for cooking and began to scream and cry. Her mother was too far to hear, but a neighbor heard the cries and went to investigate. She pulled Khari out of the fire and took her outside and called the mother.

Khari was still conscious when her mother got to her, but her legs were badly burned. Due to the lockdown, getting any transport was difficult. They managed to get her to a nearby hospital, who referred them to another, bigger hospital in Butwal. That hospital also said they couldn’t help Khari and suggested they go another hour up the hill to the Mission hospital in Tansen.

When they arrived in our Emergency room, the doctors immediately admitted little Khari. She had 12% burns on both legs below the knees, and 2% were deep burns. She received various treatments here – and the mother was provided with a high protein, nutritious diet so that she could breast feed Khari and help her to heal.

Mom holding burned baby at Tansen Mission Hospital

This family had to borrow money to get to the hospital – and if it weren’t for the gifts sent by people like you to help give free care for poor patients, little Khari wouldn’t have been able to obtain medical care. Her mother wouldn’t have been able to get good meals in order to gain strength to be able to feed and care for her baby.

Lockdown and Covid have affected us all – but these people who had so little to start with are struggling so much. We are so thankful that – because of you – the hospital can be here….still open and serving the most needy among us.

Khari did fully recover and was able to return to the village with her mom. Thanks for your prayers – and for your support!

Mom and happy baby at discharge time

 If you are interested in hearing more stories, and about the joy that Les finds in serving here each day, please sign up to hear the Virtual Itineration on Thursday, November 12 at 11 AM Eastern time. You need to register in advance: https://gbgm.zoom.us/meeting/register/tJ0sdeyqrz4jE9Iv_j4EZe78ZHEJEcS9C_N3

4 Comments

Filed under Uncategorized

Tested!

After almost 3 days in isolation, the staff who had been in contact with the covid positive patient (5 days previously) were called to the tennis court on the hospital compound to get their swab tests. The process took about 2 hours to get everyone done.

Lining up for testing

In between each test, the area was disinfected.

As the time went on, and more were tested, eventually the guys in their hot, plastic PPE had to walk away, and take off their head gear to cool off a bit! Then they suited up again and returned for more tests….

Les was one of the final ones done.

We were so thankful to get the results in 24 hours – and to learn that Les and all the others tested that day were negative! I don’t think an hour passed before Les was dressed and back at work at the hospital. Hmmm – maybe he wasn’t enjoying all that time alone with me?? 🙂

Unfortunately in other testing, it was found that 4 staff had turned positive. They are not sick, but are currently quarantining.

The medical ward was emptied of patients, and has been completely cleaned and disinfected. Tomorrow out patient clinics will resume again. Although – patients never stopped coming – and our maternity ward is filled and overflowing into the surgical area!

Thanks for your continued prayers for the hospital. We are so thankful that in spite of difficulties, the Mission hospital can continue to serve the people of Nepal.

5 Comments

Filed under Uncategorized

Quarantined!

I (Les) saw her on Tuesday morning rounds. She had been admitted on Monday by the surgical doctors with a breast abscess (collection of pus in the breast tissue). But the surgical ward was full of patients, and since the medical ward still had empty beds that day, she was put in the medical ward. She was started on antibiotics, and the pus was drained on Tuesday morning by the surgeons. After she returned from the procedure, the medical ward nurses asked me to write the order for her to be moved to the surgical ward, since there were now empty beds there. But I noticed the surgeon had written that during the procedure her oxygen level had been unexpectedly low, and she was now on oxygen. I went to examine her, to see what was happening.

She was in a regular bed, in a ward with other medical patients. Everyone was wearing masks, which is now our routine, both for staff and patients. She said she had no breathing difficulty or coughing, but I could see she was breathing fast, and her lungs had crepitations, a crackling sound caused by infections such as pneumonia. I added an antibiotic to treat pneumonia, and asked for a chest X ray. I also asked that she be kept on oxygen in the medical ward, rather than moved to the surgical ward. When the X ray came back, she indeed did have signs of an infection in her lungs. By evening she was breathing a little harder, so she was moved to the room for critical patients.

Wednesday morning on rounds she was about the same. When the team discussed the case, we considered the possibility that this could be Covid-19. There were now increased numbers of cases in parts of Nepal, including transmissions within those communities. Although we had not seen many cases yet, we were expecting more to come. We asked for her to be tested for Covid-19, which we are still unable to do on site, but must send the sample to the regional government testing center. While the test result was awaited, it was decided to send her on to the government Covid-19 hospital in Butwal, over an hour away, which was done on Thursday morning.

Her result came back Thursday evening as positive. It was decided that all staff who had contacted her directly would be put in isolation until tested for Covid-19, but all would have to wait until 5 days post exposure. 18 of our doctors, including me, were identified as having had contact with her, as well as quite a few nurses and other staff. On Friday, the remaining doctors mostly spent the day discharging anyone from the hospital who could be, and seeing emergency patients who came.

In my second day of isolation, which feels a bit like solitary confinement, I have had some time to think things over. We are quite a pair here in our house: one of us not allowed to leave the house (me), and the other unable to do so (Debbie), due to her broken leg. We sent Sarda, our household helper, home, so that we wouldn’t be exposing her and putting her whole family at risk. We are also trying to keep safe distancing between the 2 of us, wearing masks even in the house and washing hands a lot. We are trying to stay thankful and to keep trusting God, by doing spiritually uplifting reading and watching some shows (thankful for internet!!), praying, and keeping in touch with family and friends. What is God’s plan for us during this time when we feel like we have absolutely nothing to contribute? I hope to use some of the time to think of our hospital procedures again, to avoid this kind of shut down, and to prepare presentations I need to give in the future. Perhaps we just needed to stop doing our “busy work” and to “be still”. And – I am now the chief carer for Debbie – she says I’m getting good at making chiya and getting her the things she needs!

Debbie is still not able to bear weight on her leg and uses crutches just to get around in the house. Most of the day she has to keep her leg elevated, and she continues to do her physio exercises. In 2 more weeks she will get another x-ray to see how the healing is progressing. Thank you to so many of you who have emailed and been praying for her. And now – thanks for your prayers for us! I should get a swab test done on Monday, and we are praying for negative results.

10 Comments

Filed under Uncategorized

A little singing and dancing….

There are days when I feel as if things will never change… every day is the same, every week, every month.  I stopped counting lockdown days at 100… and I have to say how thankful we are that just yesterday restaurants and hotels in our town opened again so we could enjoy a meal “out” – the first in months.  We were excited! (We do still wear our masks out in public and in the hospital!)

No one knows what the future holds – but we are hopeful that things will continue to open here to make people’s lives easier.  We are thankful that bus service within our district has opened so that more patients can make it to the hospital.  So many were waiting until too late to come or arriving much sicker than normal.  The maternal-mortality rate had skyrocketed due to the lockdown.  Now our outpatient clinics are almost at capacity again, and the wards continue to be full.  The doctors and staff are working hard!

As for covid patients – we have had very few.  For awhile, there were dozens of positive cases housed in isolation areas near us.  Virtually all were young men who had been working overseas or in India and had tested positive upon returning to Nepal.  They were housed and fed – and entertained themselves by singing and dancing.  All have now been sent home to their villages after their 2 weeks of isolation.

The schools remain closed in Nepal.  On our hospital compound, there is the small “tutorial group” which has been the school for missionary kids for many years.  In March, there were only 2 students in the school – a brother and sister from Korea whose dad is a surgeon here.  Also living on the compound were 4 other young school aged children who were home with nothing to do (their school was closed).  We decided to make a change and to invite those children to join the school for several hours 4 days a week.  We got a couple of volunteers (including myself) and the school has been very lively these past weeks.  We are thankful we can help these children to have a bit of “normality” during these strange days.  I tutor the oldest Korean boy 3 days a week in English – he is doing great!  We just finished reading “The Magician’s Nephew” which brought back so many memories of me reading to my own children here during our homeschooling days.  I also have been doing music once a week again – now that there are enough children to make it more fun!

This slideshow requires JavaScript.

Flights into Nepal are scheduled to start again on Aug 17.  We wait to see what will happen.  We continue to pray for Nepal, for the U.S., and for the world – for an end to the virus, and for an end to the hatred and division which seems to loom so large in these times.  Let us love each other as best we can!  And take time to sing and dance a little – it can brighten your day.

 

 

 

 

3 Comments

Filed under Uncategorized