The Excitement of the Peds Ward!

The last several weeks have flown by. We are down to our last week here at Karanda. I can't believe 5 months have actually gone this fast. We've had our moments here, and there's been times I thought the end would never arrive. But as I sit here with a week left to go Shea and I both feel so lucky to have had this experience, and the thought of leaving is bittersweet. Many of our local friendships have blossomed, although saying goodbye won't be quite as difficult since we've decided to return in January. We are excited about the ministry opportunities here, and glad we can be a part of the ministry here in the near future. Its been great having Rhonda around, and we have all benefited from her marvelous cooking (especially our waist lines).

The last several weeks have been great for Shea and I as we have been in charge of the Pediatric ward. Its been quite an experience. We have really enjoyed working with the children. It has been both heartbreaking and heartwarming. Its painful to see these innocent little kids stricken with such devastating diseases, yet encouraging to see kids at the brink of death return to life with proper medical and/or surgical treatment. The ward has also been a wonderful place for evangelism as many of the families are eager to hear about the gospel, and have been very receptive to His calling!

The Pediatric ward has been so busy that it is often quite stressful trying to make rounds and keep all of the patients straight. The other day we had 32 patients in the ward. The capacity is actually 24.....but here in Zimbabwe we really don't have to worry about petty things like “fire marshals” and “regulations”. I've been told by several nurses that the previous high was 30 patients, so you can imagine it was quite a zoo. The actual room the ward is located in is about the size of an average 2 car garage. So you can imagine trying to fit 32 sick gets, there moms/family, IV poles, oxygen tanks, and what little staff we have was quite a challenge. We still have sick kids sleeping under the beds of other sick kids trying to make enough room for everyone.

We've had an incredible array of pathology the last several weeks. We've been stumped on many patients, but we have enjoyed the challenge of figuring out the correct diagnosis, and delivering the best medical and surgical treatment possible. We've seen patients with diagnosis ranging from measles, tetanus, meningitis, cerebral malaria, a necrotic thigh and tuberculosis to pneumonia, neonatal fever, burns, traumatic amputation (her dad was chopping wood and slipped), femur fractures and clubbed feet.

We've had at least 5-7 patients with hydrocephalus some who have received new VP shunts and others that have had VP shunt malfunctions and/or infections. We had one young boy who was evidently playing with a hand grenade and it went off. It took off a good portion of his right hand. (Don't ask me how he got a hold of a hand grenade....I've asked several family members and no one seems to know). We had another young boy who had 2 large tumor growing out of his back and buttock. We removed them both and are waiting for pathology results as well as his skin graft to take.

We had another young boy who was presumed to be bitten by a cobra (never a good thing). He was starting to improve and his family wanted him discharged even though we felt he would be better suited to stay another day or two. We obliged, but unfortunately the boy and about 18 or 19 others were involved in a mass trauma when a large flat bed truck carrying 12-15 people collided with another small truck about one half mile down the road from Karanda. The irony of the situation was that most of the people in the truck had just been discharged from the hospital and were leaving to go home. The trucks hit head on, as they came around a tight corner probably only going about 30-40 km/hr. The impact was still great enough that it sent most of the passengers through the air, and some ended up with significant fractures. All that to say the boy with the snakebite did fine, aside from a couple of lacerations and bruises. We did get our wish and got to keep him in the hospital another night.(I guess they should have listened to us in the first place). Also, Shea got quite the surprise when 20 injured people from that wreck showed up at the OPD right before her lunch break. That's a whole other story, I'll save that one for later.

Anyway back to the Peds ward. We've also had 5-6 patients with severe malnutrition and all are currently on our high protein feeding program. One such patient also had something called a Noma. A Noma is an ulcer on your face that usually eats through your skin and tissue until your teeth and gums are exposed from the outside. This typically occurs in severe malnutrition. This particular patient is a 9 year old boy named David who came in weighing 10 kgs (22 lbs). David was completely emaciated when he arrived. He was also unable to walk and HIV positive. Both of his parents have passed away from HIV and he is now being raised by his grandpa. His grandpa is very attentive and never leaves his side (I think David is his only family). David initially couldn't even turn to look at me during rounds. Now with several weeks of proper nutrition (aside from the occasional lolli-pop I sneak him) and treatment he actually smiles during rounds and has become quite interactive. He goes outside with his grandpa and its just wonderful to see him happy. According to our scales he now weights 15 kgs (its quite a jump, not sure I always trust our scales here, but I'm just encouraged he continues to improve). So with the Lords help David will continue to improve, and with proper HIV treatment and education he may still have many good years of life ahead of him.

So as you can see the Peds ward has been very challenging, but also quite rewarding. The rest of our time has been spent in the maternity ward doing C sections (Shea and I actually got to do a twin C section together...it was great), in OPD seeing patients, in the theater operating on an array of pathology, and at home chasing kids, and changing diapers (although a few less since Beau is starting to use the toilet alot more). Overall things are great, and were excited for one more good week of work here at Karanda. We really look forward to see all of our friends and families real soon. God Bless!

The Perfect Mothers Day Get-Away!

Happy Mothers day to my beautiful wife Shea, my wonderful mom Fran, and my arizona mom Rhonda. I'm a lucky man to have those wonderful women in my life! Yesterday Shea and I tackled “pulpit rock”. Climbing as always been one of Shea's favorite things to do. So for a pre-mothers day celebration what better then a good climb. After Paul and I finished rounding on the hospital, seeing patients in the outpatient clinic, and doing a quick C-section Shea and I headed to climb the massive rock formation.(Its so nice to have a Grammy here for babysitting, and a little break from the kids is always appreciated). It sits about 15-20 kilometer's from Karanda, but most of it is bush roads so it takes about 30-40 minutes to get to the spot where we will begin our approach hike. Legend has it that hundreds of years ago pulpit rock was inhabited by the Zulu tribe. After conquering territories in what is now Southern Zimbabwe and South Africa they left there massive rock for a time. According to the legend they returned some years later with hundreds or thousands (depends on whose telling the story) of Zulu warriors to move the rock to there new territory in the south. Now if you were to see this massive 640 meter high rock structure up close you would find it hard to believe, but you know me.....I'm always up for a good legend! (Elvis still lives...right?)

Anyway, today we were charged with getting to the top of the great rock, and enjoying one of eastern Zimbabwe's finest views. Shea and I along with Dr Stephens (who lead the climb), and our friends Nicci and Anna decided today was the day for the ascent to the top. Luckily, I can tell you there were no thrilling/death defying stories comparable to my climbing mishap in 2004. No major falls or seizures or helicopter rides to trauma centers (not that there are life flights or trauma centers anywhere within hundreds of kilometers). The outcome of this climb was much better. Although there were several moments when I wondered why we were doing this without better equipment the climb went relatively smooth.

It was interesting this was the first time Shea and I climbed together since before we had kids. In the past we have climbed some pretty “hairy” things, and probably taken some unnecessary chances. But now with kids back home waiting for us to return, the idea of taking needless risk, for risk sake seemed a bit less appealing. With those reservations in mind, we still were excited to have a couple of “kid free” hours outdoors, and looked forward to climbing again.

This climb was a bit unconventional. Shea and I are used to climbing shoes, a good rope, a harnesses, and some solid carabiners. (Not to mention a good belay device). Today we just had our tennis shoes, and Dan's old rope that he says he brought "only if the women need it" (Hey what about me, its not like I have the best Life insurance policy here). So that being said he planned that we would free climb the face of this pulpit rock. Well I guess we'd have to see about that.

So we drove our car as far as we could through the windy and rocky dirt roads. We stopped about 1 mile from the base of the rock. We hiked the last mile and enjoyed the scenery as we saw several villages scattered about between the road and pulpit rock. We got to the base of the rock and began our ascent to the top. The majority of the climb was steep, but didn't require any climbing. We just leaned up hill and maneuvered between stones, boulders, trees, and loose dirt, and used all 4's as needed. The last several hundred feet was a 4 sided cliff face without any significant switch backs. This was where it got a bit tricky. Dr Stephens, had done this climb multiple times in the past, and he was used to taking climbers of all skill level up to the top. There were two very difficult spots in the climb, the first at the very beginning and the last at the end. We all went up about half-way on the first part of the climb without any rope. But as the winds picked up and began to howl, we felt a little more comfortable at least having a rope in our hands in case a slippage were to occur. (Wasn't going to be a gentle fall to the bottom). Dan reluctantly agreed, and climbed up ahead and attached his unconventional rope to the base of a tree at the top of the first pitch. We all used this to aid in our climb to the top of the first part of the climb. As I said before it was awesome to be climbing with my wife again, and the risk of death is always a bit of a thrill, but the thought of Beau and Gracie without parents was a bit sobering. So we kept that in mind with every firm grip of a hand-hold, and securely placed foot-hold.

After finishing the first part, we gently maneuvered around a narrow switch-back and came to the base of the last part of the climb. Unfortunately, Dr Stephens left our only rope anchored back at the tree at the other part of the climb. So to enjoy our conquest at the top and the breath-taking views we had to free climb the rest. This last part was bit shorter then the first, and fortunately the rock formation formed a bit of a crack and we were able to snake/wedge ourselves against it. We would have much preferred to have a rope at this point, but aside from a loose rock encountered by Shea's right foot (took away our breath for a second), we all got to the top quite safely.

The view at the top of pulpit rock was magnificent! There were breath-taking views from all 4-sides and the beauty of Zimbabwe was so evident on the summit. What a powerful God we serve! The top of the rock was probably big enough to fit two moderate sized homes, and it even overlooked onto the Mozambique valley which lay about 20 kilometers to the east. We stayed at the top for about 30-45 minutes, but then envisioned Rhonda at home with a hungry Gracie (she still doesn't like to take milk from a bottle), and decided to head back down.

Going down brought a few hair-raising moments, but we made it down with all limbs intact and no major injuries. It was another wonderful adventure for Shea and I, and we were so lucky to have Rhonda here so we could share it together. I can't imagine raising kids with anyone other than my wonderful wife.The patience and love she displays on a daily basis to our kids never ceases to amaze me. Raising these first two kids has been so much fun, and really pretty easy I'm already looking forward to another. Although, I think  we may still have to talk more about that one. :) Happy Mothers Day Shea and Mom! 

A Day in the Life of Mr Mom!

Well today, I thought I would write about something a little unique to medicine, but none the less important. I've written about a surgery day, and an OPD day, but today I think I'm going to change gears a bit. Today I'm going to write about my “stay at home with the kids” day. I currently stay with the kids on Tuesdays and Thursdays while Shea goes to work. I've found these days the most rewarding, but also the most challenging. Here in Zimbabwe the challenges are unique. There is no car, no familiar kid distractions(YMCA/Zoo), hundreds of kilometers to the nearest shopping center, and power outages that make planning meals and doing laundry a bit of a challenge. I think I have gotten used to all the little curve balls (well at least they don't surprise me so much now.......in fact sometime there even fun) and I really love being a stay at home dad. So today there will be no stories of life and death struggle (well maybe for the ants and bugs that cross Beau's path), no blood, guts and bodily fluid (well there is the frequent diaper surprises produced by the little ones), and no life threatening infectious disease (well we did have that really bad stomach bug going around.....Oh well). So today I'll keep it simple, I'm just going to recount for you the details of my day at home with the kids here in Zimbabwe. I know, I know, I know....many of you are thinking how boring, and you know I'm inclined to agree with you. But house wives everywhere need a champion, and now with my vast 4 months of experience I think I can be that champion. So here's the story on April 29th of 2 crazy little kids, and their Dad who is just trying to keep up.

So the day for me started when Gracie woke up at 6am. Usually Shea and I just lay in bed and hang out with her, since there is very little Gracie time the rest of the day (once her big brother wakes up). At 7am I went to the hospital devotional with Paul. Today the Shona singing was beautiful as usual and Paul gave some wonderful words on the basics of salvation. After that the marathon begins. I arrive back home and both kids are up. Shea is getting them ready to eat, but leaves the rest of the job to me since she needs to finish getting ready for work. This morning's breakfast routine went pretty smooth. Usually I sit between the kids with my own bowl of oatmeal. I feed Gracie her rice cereal, and make sure Beau is hitting his mouth with the spoon more then the other parts of his face. And occasionally I'll steal a bite myself. We all finish eating, and Beau is already begging to get down and play. So I rush to the kitchen to get a clean rag, and do my best attempt at cleaning the oatmeal out of various spots on his clothes and skin. He passes the dad test and now he's off to the living room to play for a few seconds. By now its 8am and Rhonda and Shea are leaving for the hospital for the day. Luckily, we'll see them back at tea time. I finish getting Gracie cleaned up. She really wants to be held right now, but I have to put her in a spot that is safe and she will half-way enjoy as try and get Beau cleaned, changed and dressed for the day. From here I'm just going to give a little timed play by play with a little side commentary as needed:

8:15 Beau sits on the toilet (his first day in big boys....he's pretty excited we'll see how long it lasts!!)

8:20 Entertain the kids while cleaning up the bedroom (Not as easy as it sounds)

8:30 Beau is back to the toilet (he actually told me he had to go...that's a first!...he goes and get the M&M (a great reward)

8:40 We all wrestle on the bed (Gracie and I versus Beau....we always win!)

8:50 Gracie goes down for a nap (not without a fight though...she is really screaming)

9:00 Beau is on the toilet again (Are you noticing a recurring theme here!)

9:05 We've got power back on ( this has been a long week without much power, so seeing the fans spin is a welcome surprise)

9:08 I go to put the eggs on the stove for tea time( Tea time is usually from 10-1030, and we have all become accustom to hard boiled eggs at tea (its quick and its a great source of protein that the kids like)

9:10 I go outside to play with Beau and also do some Physical therapy with him (oh and by the way Gracie finally stops crying) We catch lizards, bug, and various insects. Also climb some stairs to strengthen his right leg

9:25 Beau and I run to the hospital to check on Shea and Rhonda's rounds (He likes seeing his mama at work)

9:30 More PT with Beau (we climb some stairs and hang from bars at the play ground.....yes there actually is a playground here, not with US standard regulations, but still there is some stuff to play on)

9:40 Went back inside to check on Gracie (still sleeping), and put on some hot water for tea

9:45 Beau is back on the toilet....the big boys are still dry and he gets 2 M&M's for this one( 1 for being dry and one for going......I know to much detail)

9:45 Gracie starts crying again...I give her a second and she is back to sleep(thank-goodness!)

10:00 Beau and I are back outside catching some more bugs before Shea and Rhonda come home for tea

10:10 Gracie wakes up again...this time for good

10:15 Shea is back so we have some tea, eggs, and peanut butter and bread (Beau loves the egg whites, but can't stand the yolk) This is definitely one of may favorite Zimbabwean traditions.

10:30 I get called from the hospital to put in an Intraosseous line for a man that is very dehydrated. I gladly take a small break from the kids, and go with Paul to the hospital to put in the line. We have a nice drill for these IO lines...it works pretty slick (anyway enough medicine...back to the kids)

10:50 Shea finds Beau is wet while he is sitting in his chair eating( We made it almost 3 hours...not bad for a first time in the “big boys”)

11:00 Shea and Rhonda leave back for work

11:05 I finish feeding Beau and while feeding Gracie he tells me he has to “poop” I pick him up to run to the toilet, and he says “poop in the pants”........man, we were so close....that was kind of a mess to change

11:10 So I guess were back to the cloth diaper diaper...so I changed Beau into the cloth diaper for now (Gracie is crying now(squeaky wheel always gets the grease)

11:20 I change Gracie

11:25 Played with Beau and Gracie on the floor for a while

11:45 Read them both several books (At this time April is warming up some left-overs for our 1pm lunch...thank-goodness for leftovers) April does a great job organizing our meals for the day. My job usually consists of peeling fruits and veggies, cleaning dishes and putting together some of the simpler side dishes. I'm definitely the least skilled cook in the house (even Paul is quite skilled in the kitchen). But I am learning a lot, and occasionally get to throw together a little something myself. Its been a good learning experience for me.

11:55 Took Beau to the toilet....again (another M&M is earned)

12:00 Put Beau down for a nap

12:10 Time for 1 on 1 with Gracie (as I said earlier with her big brother always around, she rarely gets much 1 on 1 attention. So I enjoy getting the chance just to play with her even if it is for a short while. She starts getting fussy pretty soon....She's tired and needs her nap!

12:30 Changed Gracie's diaper

12:35 Gracie goes down for a nap (but once again she's not happy about it and is letting out quite a scream

12:55 Gracie finally stops crying

13:15 Everyone's home for lunch

13:20 Beau wakes up

13:30 I feed Beau some of our left-over delight (he kind of picks at, not to hungry right now)

13:45 Gracie wakes up

13:50 I get cereal ready for Gracie to start eating

14:15 After meals are finished and diapers are changed/bathroom breaks taken(another M&M earned by the way)The three of us head to the shops for a nice afternoon outing. This is always a nice break in the day for me. I put Gracie in Paul and Aprils Stroller, and put Beau on my neck and we walked quite conspicuously to the shops. Its quite an interesting strip of tiny rundown buildings. There are often a few shady people walking around, with women pumping water out of a well, and barnyard animals roaming free. A white guy with 2 kids sticks out like a neon sign. I have gotten used to it, and for me its just a good chance to get out of the house, and pick up some stuff we need as well as whatever “junk food” I can find. Beau always enjoys seeing the people and all the animals that wander around down there. We got a few things, and headed back to the guest house.

15:00 We return from the shops

15:15 A visitor from the Netherlands arrives. She brought several hydrocephalus kids to be looked at, but is confused about where she is supposed to be staying. So April and I tried to sort out those issues while the kids were beginning to melt down, and dinner was in the midst of preparation

15:30 Change both kids diapers

15:45 Help with dinner preparation (stir fry tonight)

16:20 I take the kids outside to keep them distracted and avoid any big 4:00 pm meltdown. My sister Mary Beth coined 4pm as the “witching hour” with the little ones, and I've found that the phrase is very accurate. Gracie doesn't want to be put down anymore. So trying to play with Beau while holding Gracie is always challenging. And Beau always gets a little more needy at this time as well. He's also a little more rough with Abbi at this time...so I really have to watch him close. That's why I usually just go outside so the temptation to tackle her is not as strong.

17:00 Start feeding the kids as they begin there meltdown (Shea is not home yet....I think it was a busy day at the theater)

17:15 Gracie has a nice surprise for me....so I take her to change her diaper

17:30 Beau is still eating well, Gracie on the other hand is melting down. She doesn't want this cereal anymore. She just wants some breast milk.

18:00 Shea comes home and I can gladly pass off Gracie and finish getting Beau fed and ready for bed

18:20 For the next 30-40 minutes I go through Beau's bedtime routine which consists of chasing him around the house, brushing his teeth, chasing him around the house, changing his diaper, chasing him around the house(OK so you get the point), getting his “night night” shirt on, doing some stretching, reading a couple of books, and saying our prayers. He always calls me back in to let me know a few things I forget, but now at 19:10 he's in bed, Shea has Gracie in bed, and at least for now we have some peace and quiet. Another wonderful, yet exhausting day! Not a lot of “me” time today. But as I've found stay at home parenting is a full time job, with something always going on. My hats off to mom's and dad's everywhere that make it look easy. Hope you enjoyed looking into the life of a stay at home dad on the mission field!