Saturday 30 October 2010

Stephoscope: November 2010 Newsletter

Dear friends of PNG,

Here is my November 2010 newsletter (one day early).

There are quite a few stories about babies in the nursery.  It has been a hopin' place this past month!  (Each blue/underlined word or phrase is a link to another story if you would like to read more.)

If you are interested in maternal health, read about my patient with "a new name" and maternal mortality in PNG.

I've included some links to fun stories, too... I recently learned a thing or two about speaking English from some of our volunteers.  And yesterday we enjoyed our annual Harvest Party!  Check out the costumes :).

Thanks for your prayers for the included requests, and for the WEF Plus offering that is coming up in November.

Happy Thanksgiving!
~ steph

Lost in translation

There are some American holidays that have obvious PNG counterparts.  Instead of President's Day, we observe the Queen's birthday.  PNG's "Memorial Day" is called Remembrance Day.  Independence Day is celebrated in September rather than July.  Churches celebrate a Thanksgiving, though it has nothing to do with pilgrims and turkeys.

But some of our customs don't really translate to Pidgin.  The idea of a harvest is one of those.  You see, we live in the land of perpetual spring.  Except for the recent havoc that a prolonged dry season had on gardens, food grows year round.  Some things like coffee and mangoes are seasonal, but most fruits and vegetables can be picked straight from the garden any time of the year.


Nevertheless, we missionaries hold fast to some such traditions... even if they are lost in translation!  Every year about this time, we get together for our annual Harvest Party.  The homemade costumes this year included a lumber-jack-o-lantern, clown, Mt. Wilhelm skiing accident, black cat, pirate, indian, 80's chick complete with leg warmers and security guard, and a bride who was running a bit late for her wedding to a man having an identity crisis.  


Bobbing for lemons is one Harvest Party tradition, because lemons are free and much easier to find than apples.  We also cooked hobo dinners on the coals of the fire and made smores.  Graham crackers and marshmallows and chocolate bars were imported from the US especially for the occasion.  Did you know that you can make sparklers from steel wool?  No, not an urban--or in this case bush--legend. 







 






















One very special event this year was the carving of an orange pumpkin.  Pumpkins do grow here, but they are usually green and a bit small or the wrong shape.  Someone had given Meti some orange pumpkin seeds and they produced a crop of 3 pumpkins.  The Myers saved their pumpkin for about 5 months so that they could make a jack-o-lantern during the Harvest Party.  Emma Dooley said it was the first time she had seen one in real life.

It was such a sweet night, just being together with the missionary family :).  The best kind of fun you can have.

For more pictures of this interesting evening and last year's festivities, here is a look at what we do for fun in PNG!





Now he who supplies seed to the sower and bread for food will also supply and increase your store of seed and will enlarge the harvest of your righteousness.
~ 2 Corinthians 9:10

Wednesday 27 October 2010

Maternal mortality

In 2008, 1,000 women died every day from complications of pregnancy and childbirth: 570 in sub-Saharan Africa, 300 in South Asia, and 5 in high-income countries (WHO 2010).  The most common causes of death are bleeding, infections, high blood pressure, and unsafe abortions.

Maternal mortality ratio is the number of maternal deaths per 100,000 live births.  According to the World Health Organization, a maternal death is "the death of a woman while pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management."  The definition of a live birth is basically a baby that shows any signs of life, from heart beat to muscle contraction.  This number represents the risk associated with pregnancy and delivery.

Maternal mortality ratio is one of the indicators that is used to asses health in countries around the world.  Countries with more resources, better education, and adequate health care have lower ratios than poorer countries.  In fact, this statistic shows one of the widest gaps between the rich and the poor.  Here are a couple of countries for comparison (WHO 2005 data):
Afghanistan = 1,800/100,000
Brazil = 110
Guatemala = 290
Haiti = 670
Ireland = 1 (the best place to have a baby)
Papua New Guinea = 430 --> 733 (should be orange on the map)
Sierra Leon = 2,100 (the worst)
Sweden, Greece, Italy = 3
United States = 11

There is a major problem with using maternal mortality or any other sort of statistic as a health indicator.  Calculation of such a number requires accurate records of births and deaths.  In a place like PNG, you are unlikely to find such information.  So I don't know how in the world they come up with the ratio.  This definition also does not account for the birth of a dead baby, as obviously it is not a "live birth."


In 2000, world leaders gathered at the UN in NYC and adopted the United Nations Millennium Declaration.  This Declaration was a partnership to reduce extreme poverty by the year 2015.  The Millennium Development Goals were designed with specific targets for reducing poverty.  Several of these focus on improving health-related indicators.  Target 5.A aims to reduce maternal mortality ratio by 75%.



So 10 years in to the Millennium Declaration, how are we doing?  Well, the world is actually doing better:  maternal mortality ratio declined by 34% from 1990 to 2008.  Good progress is being made but still a long way to reach the 75% goal by 2015.  PNG, on the other hand, is not doing so well:  the maternal mortality ratio has almost doubled from 430 to 733.  (Though I do wonder about the accuracy of the information.)  One of the contributing factors is that only 50% of women in PNG are delivered by a skilled birth attendant.  That means that the other half are delivering at home or in the bush or at a health center that doesn't have a nurse.  The mother might have an untrained friend or family member assisting her.  If there is an emergency, it is very difficult to get to help... mountain paths, bad roads, unreliable or no vehicles, rascals, distant health centers, etc.  You can probably see why our maternal mortality ratio is so bad.

During my 4 years of medical school, 3 years of residency, and one year of fellowship in the United States, I don't remember even hearing about a maternal death.  I can think of 4 since I came to PNG in early 2009.  The first was a mother with liver and kidney failure.  The second was a woman with heart failure.  In both of these cases, the pregnancy and delivery worsened the underlying illnesses in an already critical patient.  The third patient came to our hospital after laboring for several days at home.  The fetus was already dead when she arrived.  Mother had an infection, she was very sick with sepsis.  Her condition was complicated by a difficult delivery and post partum hemorrhage.  The combination of sepsis and hemorrhage damaged her kidneys and caused renal failure.  She died several days later.  Dai was the fourth.







With about 1,200 deliveries a year, that would make the maternal mortality ratio of Kudjip Hospital about 333 per 100,000 live births.  Though this number is higher than I would like, I remember countless faces of women who were saved because of the care that they received at our hospital!






"A woman giving birth to a child has pain because her time has come; but when her baby is born she forgets the anguish because of her joy that a child is born into the world."
~ John 16:21

Monday 25 October 2010

A new name

Names in the Bible are so full of meaning.  Someone's name might be a description of their character or prophesy about the future.  In Genesis Chapter 15, God changed Abram's name to Abraham.  "Exalted father" became "father of many."  Isaac's name means "he laughs" because his mother found it amusing that she would bear a child in her old age.  Esau was a hairy man, and so he was called.  Jacob was born grasping the heal of his brother.  Any guess on what his name means?  Naomi suffered much in her life and changed her name from "pleasant" to Mara, which means "bitter."  Skip ahead a few generations to the birth of Jesus.  His name means "the Lord saves."

I started caring for Dai about a month ago.  There were two sort of foreboding things about her case from the beginning.   The first was her list of medical problems, which was quite impressive and only got more so as time went along.  I will get to that in a minute.  The second was her name.  "Dai" means either "to faint" or "to die" in Pidgin.  I'm wondering if her name had another meaning in her local language?  I sure hope so.

Dai came from the Southern Highlands, one of our neighboring provinces.  The doctors at the hospital there referred her because she was pregnant and had a low blood count.  One of her family members works at the local tea plantation, so she ended up at Kudjip.  I saw her in clinic and started her problem list:  23 weeks pregnant with twins, anemia (Hgb 9), enormous spleen, asthma, and hepatitis B.  As tiny as she was, I was amazed that two babies and the big spleen could all fit inside her short little abdomen.  And she still had 17 weeks to go!

A couple of weeks later, Dai returned to clinic with nose bleeds and jaundice.  Dr. Bill saw her and ordered a complete blood count.  Sure enough, her anemia had worsened and platelets were so low that her blood was not clotting well.  She was admitted to the hospital where I took care of her on D-ward.  I ordered all the lab tests I could think of and came up with a working diagnosis of "hypersplenism."  Big spleens are common in some parts of PNG, usually from multiple infections with malaria.  A big spleen can become overactive, collecting platelets and breaking down blood cells.  I gave her a couple of units of blood and her blood count stabilized.  She was discharged after several days in the hospital.

Another week passed by and Dai returned to clinic with yet another problem to add to her list.  Now her blood pressure was high, she had a head ache and quite a bit of swelling in her legs.  Multiple blood pressure checks and a few more lab results confirmed the dreaded diagnosis of severe pre-eclampsia.  This is a sickness of pregnancy that is only cured by delivering the baby.  Dai's condition continued to worsen.  If we didn't deliver the babies and soon, she was going to die.  Even so the decision was not an easy one... at 27 weeks gestation, the twins were not likely to survive in PNG.

Dai was re-admitted and started on medicine to control her blood pressure and magnesium to prevent seizures of eclampsia.  I think it was during this second admission that I decided to call her "Hope."  Anyways, the induction was quite a process.  It took three days to get her into labor!  She finally delivered her babies early Friday morning.  As I feared, the babies were too small.  The first was a boy who died shortly after birth.  The second was a girl.  She weighed only 875 grams.  This one lived through the day but died Friday evening.

Dai herself was quite ill by the time she delivered, starting to show signs of pulmonary edema.  Dr. Susan was on call and stayed with her through the early hours of the morning.  Dai received a couple of units of blood to keep her from bleeding to death and a medication to clear the fluid from her lungs.  I saw her later in the afternoon and she was already starting to look better.  By rounds on Saturday morning, Dai was doing amazingly well.

On Monday morning, Dai looked like a new woman!  What an improvement from how sick she was, and a dramatic example of how delivery cures pre-eclampsia.  It seemed as though we had made it through the most critical period.  I decided to keep her one more day to tune up her asthma and re-check a blood count.

Tuesday morning I walked into D-ward and found the crash cart at the foot of Dai's bed.  Not a good sign.  Dr. Susan who was on call again.  She and a crowd of nurses were hovering over the patient.  Apparently Dai had gone outside and had fallen down.  By the time she was found, she was unconscious.  Somehow the nurses got her back to D-ward and they called Dr. Susan.  Dai was going in and out of consciousness, her blood pressure was low, pulse weak, and her abdomen was starting to swell.  Dr. Susan did an ultrasound and discovered free fluid in the abdomen that looked suspiciously like blood.  Dr. Bill, Dr. Rosie, and I all arrived and listened to the story.  We concluded that the fall had probably ruptured the Dai's enlarged spleen and she was hemorrhaging into her abdomen.  The surgeon was called.  Drs. Susan and Rosie went to give blood.  The nurses started a second IV.  The first unit of blood had just started to go in when Dai became unresponsive and stopped breathing.  Our team worked hard at CPR, but we were unable to save her.  Tears brimmed in my eyes and flowed freely down the cheeks of others.

Sorry for the heaviness of this story.  We don't lose many mothers at Kudjip Hospital, and it is always a tragedy when we do.  But I want to leave you with the happy ending to this story.  Dai was a Christian.  She believed in Jesus and tonight she is with Him in heaven!  I would imagine that she has already received her new name... "Life."


Zion's new name

"The nations will see your righteousness,
and all kings your glory;
you will be called by a new name
that the mouth of the Lord will bestow.
You will be a crown of splendor in the Lord's hand,
a royal diadem in the hand of your God.
No longer will they call you Deserted
or name your land Desolate.
But you will be called [My Delight is in Her],
and your land [Married];
for the Lord will take delight in you,
and your land will be married.
They will be called the Holy People,
the Redeemed of the Lord;
and you will be called Sought After,
the City No Longer Deserted."

~ excerpts from Isaiah 62

Watchman

When a patient is admitted to the hospital, one of the family members will also stay with him or her on the ward.  We call this person the "watchman."  We have a small staff compared to the number of patients we serve, so the watchmen are very important in helping to care for patients.  Basically they do the work of an orderly or nursing assistant extraordinaire:  they cook for and feed the patients, wash them, turn them (sometimes), help them to the bathroom, transport to x-ray, take them outside for some fresh air, notify the nurse if there is a problem.

On pediatrics ward, the watchman is usually a mother or father who stays with their child.  Spouses or siblings or parents or cousin brothers or all of the above watch for patients on medical and surgical wards.  In the nursery, she is almost always the baby's mother.

When I walked into the nursery this morning, I was amused to find some rather unusual "watchmen" looking out for several of the babies...  Can you spot them?  A good laugh is a great way to start Monday morning :).

BTW, baby of Dorothy was the main character in my blog "Teeny tiny."  She was only about 1300 grams when she was born.  As you can see, we recently celebrated her 2000 gram milestone!




"I lift up my eyes to the hills--
where does my help come from?
My help comes from the Lord,
the Maker of heaven and earth.
He will not let your foot slip--
he who watches over you will not slumber;
indeed, he who watches over Israel
will neither slumber nor sleep.
The Lord watches over you--
the Lord is your shade at your right hand;
the sun will not harm you by day,
nor the moon by night.
The Lord will keep you from all harm--
he will watch over your life;
the Lord will watch over your coming and going
both now and forevermore."
~ Psalm 121

Tuesday 19 October 2010

"I tell you the truth, unless a kernel of wheat falls to the ground and dies, it remains only a single seed. But if it dies, it produces many seeds. The man who loves his life will lose it, while the man who hates his life in this world will keep it for eternal life." ~ John 12:24-25

A Night at Kudjip Hospital

"A Night at Kudjip Hospital" is a video documentary recently posted by Engage Magazine.  It tells the story of one of Dr. Bill's call nights without electricity and in the dark.

Well, I'm sorry if I have ever complained about the sporadic electricity.  Now we are having problems with TOO MUCH power...  

The first power surge came about three weeks ago.  There was a loud boom during Monday morning chapel.  Loud boom = not good.  The surge burned out the station phone system, home computers and electronics, and various equipment around the hospital.  When and how the phone system will be fixed isn't clear yet.  Maybe the end of November?  For now if there is an emergency or other need at the hospital, the nurses have to send messages to the on call doc by security guard.  (I haven't decided if this makes call better or worse.)  Pray that our patients won't suffer from delays in notifying the doctor!  

The second surge came last Thursday during prayer meeting.  Suddenly the lights in the room became brighter and began to buzz.  Brighter buzzing lights = not good either.  The following morning we learned that the internet was no longer working.  Our best method of communication with the outside world was knocked out... yet another martyr to PNG Power.  Luckily we were able to get some parts and the service was restored early this week.

Power surges and power outages.  We are so in need of rebuilding our hydroelectric dam.  Proposals and plans are in progress but a new hydro is still months or years away.  Your prayers would be appreciate for this as well.

Writing on power issues has turned my thoughts to the Source of all power.  In light of our challenges here on earth, the power of God only seems more perfect and holy and awesome!  Papa, thank you for your life-giving power.


"His divine power has given us everything we need for life and godliness through our knowledge of him how called us by his own glory and goodness."
~ 2 Peter 1:3

Wednesday 13 October 2010

On speaking English

We at Kudjip have the pleasure of working with volunteers from all sorts of places.  Frequently visitors come from the US, though we do have some from other countries on occasion.  During the past several months, we have had a number of volunteers come from other parts of the English speaking world.








Charlotte and Nick are newlyweds who came to PNG directly after their honeymoon.  They are from Cornwall in the south of England.  Charlotte is in her 4th year of medical school, so she spent her time with us at the hospital.  She has such a sweet spirit and really ministered to our patients.  She was a special blessing to one of our D-ward mothers who named her new baby "Charlotte."  Nick comes from a farming family and is also a bread baker.  He mostly worked with maintenance and did all sorts of handy things around the station.  Did I mention that he bakes bread?








Francine is another UK medical student who recently came for elective rotation.  She is from Jersey... the country, NOT the state.  I never knew there was any such place as Jersey.  Although I suppose if there is a "New Jersey" there must be an original.  What do you know... there really is!  Jersey is a small island off the coast of France.  Since it doesn't appear on every map, Francine makes a habit of adding Jersey graffiti, as she did on our bathroom shower curtain (at my insistence).

Once upon a time Jersey belonged to France, but after WW2 it came under the British Crown.  The politics of it all are still a bit confusing to me... under the Crown but not part of the United Kingdom, or something like that.  Francine will be aghast that she spent seven weeks at Kudjip and I am still not completely clear.  But even she would admit that it is complicated.  

Francine is attending medical school in Wales, which IS in the UK.  She spent about seven weeks with us.  I loved hanging out with her, as she is so full of life and passion for Jesus!  I enjoyed hearing about her home and her culture.  Now that I have a friend from this recently discovered country called Jersey, I will definitely have to visit some day.




Graham and Elaine are on their second "tour" to Kudjip.  They are from our neighboring Australia.  They came last year to get a feel for the place, and are now back for a couple of months.  Dr. Graham is a general surgeon and is covering for Dr. Jim while he is on home assignment.  Graham and Elaine are amazing, really... jumping right in to things and becoming part of our mission family.  It has been such a blessing to have them here!

It has been really fun to learn about culture and language from these visitors.  Despite our common language, I have found that there are quite a few differences.  Sometimes we have to translate because words or phrases have different meanings.  And there have been a few laughs along the way!  For example, when in the UK you should probably not refer to the rubber thing on a baby bottle as a "nipple."  Apparently that word is a bit crass in British English.  See below for the more appropriate term.

Here is a bit of an "English" dictionary for you...

United States Cornwall/Jersey Australia
hello, etc. g'day
dude bloke mate
awesome brilliant
dishes crockery
silverware cutlery
dinner tea
not sweet, salty? savory
French fries chips chips
French press cafetiere coffee plunger
baby stroller pram
baby bottle nipple teat
14 pounds (weight) one stone
2 weeks fortnight fortnight
premature prem
GERD GORD (o=oesophagus)


"After this I looked and there before me was a great multitude that no one could count, from every nation, tribe, people and language, standing before the throne and in front of the Lamb.  They were wearing white robes and were holding palm branches in their hands.  And they cried out in a loud voice, 'Salvation belongs to our God, who sits on the throne, and to the Lamb.'"
~ Revelation 7:9-10

Sunday 10 October 2010

Itty bitty

And I thought that baby of Dorothy was teeny tiny.

Well, let me introduce you to our newest arrival to the nursery...  baby of Rosa was born at home on Tuesday or Wednesday last week.  She was brought into the ER on Friday because she was having some difficulty breathing.  I was shocked to learn that this little one had been living and surviving at home for three whole days!

Baby of Rosa's admission weight was 1200 grams (2.6 pounds).  As expected she has dropped a bit to about 1125 grams (2.5 pounds).  She is on IV fluids and antibiotics, and just started feeding yesterday.  So far so good for such an itty bitty thing!  But she has a looooong way to go.

There is only one warmer in the nursery, so babies of Dorothy and Rosa are sharing a bed.  Baby of Dorothy, who is now growing like a weed, looks like a giant compared to her new roommate!

Friday 8 October 2010

Seeing double

The nursery has been full-up the last couple of weeks.  There are babies everywhere!

Among our patients we have several sets of twins.  Babies of Maxie and babies of Grace all arrived around the same time.  Both sets of twins were admitted because of low birth weights.  We have been keeping them warm, supplementing nutrition, and watching them slowly grow.

And they are growing!  This week all four babies reached the 2000 gram milestone.  Party time... an 8000 gram party!  Here are some pictures of our celebration :).




















Thursday 7 October 2010

Miracle on Mercy Street






The road that brings you to Kudjip Hospital enters the station by the main gate, goes past the ER of the new hospital, and ends at a place we call "the circle."  This road was formerly called Mercy Street.  I remember taking a picture of the street sign when I came to PNG as a medical student.  The road has been renamed to something like Knox Road after the first Nazarene missionaries to PNG.  Though I rather like the thought of our hospital being located on Mercy Street :).





Francine, a volunteer medical student for the month, and I were on call together two Sundays ago.  Sunday on call is almost never as bad as a Saturday, but this one was pretty bad.  We started out the morning doing rounds on maternity, and were notified about one of the mothers in labor.  Her water had broken about two days before and the nurse was concerned that the baby wasn't positioned correctly.  We quickly evaluated the patient and discovered that the baby was breech.  Mama needed a c-section.

Lucy was taken to the operation theater and we were ready to begin shortly after lunch.  Let's just say that things didn't go well from the beginning.  Our nurse anesthetist had difficulty putting in the spinal anesthesia.  This is the medicine that numbs the lower half of the body during surgery.  I thought that I was going to have to give it a try, which is ironic since I myself have never given spinal anesthesia.  (Though I am told it is basically the same procedure as doing a lumbar puncture.)  Margaret, our scrub nurse for the case, is well known as a prayer warrior.  She said a prayer and the spinal went in smoothly without my help.

A few minutes later, we started the c-section.  I made a Pfannenstiel incision and the first few steps of the surgery were pretty routine.  Upon entering the uterus, I was surprised to find that the presenting part was a hand rather than breech.  Uh-oh... the fetus was transverse.  Babies who lie side ways are often a challenge to deliver.  I struggled for a few minutes trying to get the kiddo out, but he just wouldn't come.  Finally I made the dreaded T-incision, an extension of the cut so that it looks like like an inverted letter "T".  You should be able to get any baby out of a T-incision.  You should, but I couldn't.  I struggled for what seemed like eternity but the baby was stuck tight.  I paused to take a deep breath and Margaret prayed again.  I extended the incision one more time and thank the Lord we were able to deliver the baby.

But the drama continued.  The baby came out floppy and was not breathing.  I broke scrub to help with the resuscitation and left Francine holding pressure on the bleeding uterus.  We bagged the baby and attempted intubation several times but were unsuccessful.  He had a strong heart beat at first, but because we weren't ventilating well the rate began to drop.  At one point he seemed to stabilize, so I re-gowned and continued to put mom back together.  I broke scrub a second time when the baby's heart rate dropped again.  We still couldn't get him intubated and started doing chest compressions.  I had no hope that this baby was going to survive.  I re-gowned again and returned to finish the surgery, tears streaming down my face.  I told the nurse to stop the resuscitation.  This time it was Francine prayed because I couldn't find the words.

Wait a minute... what?  You were finally able to intubated and gave epinephrine?  The baby has a heart beat and is breathing on his own?  Can you repeat that?  You said he is breathing on his own?  UNBELIEVABLE.  The tears flowed again, but this time they were tears of joy.  I thanked the Lord for his mercy and this miracle.








Baby of Lucy was taken to the nursery and was extubabed shortly after we finished the c-section.  He had a bit of a rough start, with a seizure or two in the first day of life and a little bit of trouble with feeding.  We started him on IV fluids and antibiotics.  The seizures stopped and he learned to breast feed.  He has made an amazing recovery and is now doing quite well.  This baby truly was a miracle on Mercy Street.









"The desert and the parched land will be glad; the wilderness will rejoice and blossom, 
it will burst into bloom; it will rejoice greatly and shout for joy.
They will see the glory of the Lord, the splendor of our God.
Strengthen the feeble hands, steady the knees that give way;
say to those with fearful hearts, 'Be strong, do not fear; your God will come.'
Then will the eyes of the blind be opened and the ears of the deaf unstopped.
Then will the lame leap like a deer, and the mute tongue shout for joy.
And a highway will be there; it will be called the Way of Holiness."
~ excerpts from Isaiah 35

Tuesday 5 October 2010

Teeny tiny

Once upon a time I was a bit scared of taking care of babies in the nursery.  (OK, still scared on occasion.)  As the intern on pediatrics call, I had to do an occasional admission for sick or premature baby going to the NICU.  It was all a bit overwhelming... breathing tubes and oxygen masks and IV tubes and beeping things were massive compared to the little people that they supported.  Of course we don't have all that fancy equipment at Kudjip.  It was quite a learning curve when I first started looking after the nursery.  And now I love it!


Yesterday you met one of our larger residents.  Baby of Selah weighted 5kg or 11 pounds when he was born.  Such a big baby is actually pretty rare on our maternity ward.  


Preterm and low birth weight babies are more the norm for our nursery.  Baby of Dorothy twin 2 is one of the smaller ones that I have cared for.  She and her sister were born at about 30 weeks gestation, 10 weeks before their due date.  Both of them were quite small, weighing only 1300 grams or about 2.8 pounds.  Teeny tiny!  Twin 1 did poorly from the start.  She developed respiratory distress syndrome due to prematurity and died after only a couple of days.  But twin 2 was born a fighter.  She has remained strong despite being small and having neonatal sepsis.  After an initial drop in weight, baby of Dorothy is now growing and is up to 1450 grams... well on her way to a 2000 gram party!







"For I am the Lord, your God,

who takes hold of your right hand and says to you,

Do not fear; I will help you."

~ Isaiah 41:13

Monday 4 October 2010

Happy birthday baby








Today is my mom's birthday, a very special one ;).

Mom... if you were here, I would adorn you with the official Kudjip birthday hat and sing you all 5 birthday songs.  But instead, I delivered a baby in your honor.  A very BIG baby.  Baby of Selah was born by c-section this morning.  He weighed in at a whoppin' 5 kg or about 11 pounds!  Wow, what a chunker.

Happy happy your day, Mom!


P.S.  Mom just informed me that she weighed less than half of baby of Selah when she was born.

Friday 1 October 2010

Stephoscope: October 2010 Newsletter

Dear friends of PNG,

Welcome to the October 2010 version of my newsletter (see attached).

I hope you enjoy reading about Brutus and his visit to Benny, one of my patients in the hospital.  I think it must be the slobbery kisses and wagging tale that make him such a good therapist!

Thanks so much for your prayers for Pastor Robert... he has regained most of his vision!  Thanks to the Lord for working a miracle.

And please keep praying for rain!

Hugs from PNG,
~ steph

P.S.  If you would like to receive this newsletter by email, send me your info!