The Least of These

MMay the weak say I am strong,

May the poor say I am rich

May the blind say I can see

What the Lord has done in me.

This is the song that for me shows the extent of God’s love for the whole world and reveals the need everyone of us has for Christ, no matter where we are from.  Where ever we live and where ever we go, God calls us to join Him in reaching out to other people, even when the needs are overwhelming and we feel our contribution is inadequate.  I love that God has called me into the third world to serve and I love that God has called me into my home town to serve.

I see the mother, ravaged by AIDS, with a nursing baby and five-year old daughter lying on a bed in a remote Papua New Guinean hospital.  No support.  No help.  Waiting to die.  What of her children?  Who will help them?  Truly these are the weak and the poor.

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A suffering  mother and her 5 year old daughter.  Gulf Province, PNG.

I see the woman nursing an ailing husband at home.  There is oxygen tubing running to his nose, morphine liquid by the bedside, ready to be given when the desperation for breath becomes too much in a body fighting lung cancer and emphysema.  A palliative care team comes each week.  A well equipped hospital is nearby.  Still, this cannot keep at bay the heart sickness of a woman who will soon lose her best friend and life companion.  This is right here, in my neighbourhood, my everyday work.  The weak walk beside me.

I see the mother struggling to carry her six-year old son, concussed, drowsy back to our clinic.  I met the father earlier – proud of his family, eager to get his children immunised.  He is prone to rages and threw his eldest boy from the window of their hut on stilts. Across the field I see a woman struck to the ground by her husband with a heavy stick.  She makes no cry, simply gets up and walks away.  This happens frequently enough that no one takes any notice.  This is the ugly side of beautiful PNG.

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Transporting a 6 year old boy with concussion to hospital.

I see a mother, struggling with lightning pain shooting from her neck to her fingertips as bone and disc press on nerve.  I see her shadowing her grown schizophrenic daughter, dreading the harm she could do herself if left alone, fearing a call from the police, patiently accompanying her to appointments and hospital admissions where improvement is painfully slow in coming.  The daughter begs mum for alcohol and seeks comfort from men who only abuse her.  This is the pain of a mother in my home town.

I see myself struggling with what I can do to help in a world where so much is wrong.  I too am weak.  I can’t do much by myself.  But, I can do all things through Christ who strengthens me (Phil 4:13).  I can’t supply Papua New Guinea with a health system where all can receive treatment and welfare is provided to support the poor.  I can’t cure cancer or schizophrenia.  Yet I can do a little.  I can listen, pray and learn more.  I can bring some physical and emotional comfort, using my medical skills.  I can go to PNG and teach on health and health care.  I can encourage someone with suspected tuberculosis or AIDS to go and get tested…and treated…and perhaps their life and livelihood will be saved.  I can be part of a team bringing the love of God to people in remote areas by providing health care.

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Doing clinics in a hut.  Babaguna village, PNG.

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Women’s health talk. Demonstrating the birth process with the model placenta. This produced lots of giggles!

Whatever you did for the least of these brothers and sisters of mine, you did for me (Matt 25:40).  Where ever we live and where ever we go, we will encounter the ‘least of these’, the poor, sick, lonely and grieving.  We may find ourselves becoming the least of these when our own circumstances become desperate.  The wonderful thing about being a part of God’s family is that we can share the love He has given us in very practical ways.  God’s blessing is released through people willing to be His hands and feet in a hurting world.

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New friends – Irimuku village, PNG.  Elizabeth (white and blue shirt), age 16 wants to be a nurse.  She shyly watched me all day before I went to chat with her at the end of clinic.

 

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My First Cruise – Sailing, Sea sickness and Medical Mission

A few years ago, I took my first cruise.  Not P&O.  It was aboard a 30 year old ship that had once been a training vessel for Japanese fishermen.  My destination was not the Pacific or Mediterranean Islands, Alaskan coast or European rivers.  This ship did not have multiple dining rooms, theaters, gyms, running tracks or hot tubs.  It did have a dental clinic and storage for medications, wound dressings and medical equipment.  This was not a typical holiday, but an adventure in providing basic medical care to people in remote areas, far from hospitals or medical clinics.  This was the YWAM Medical Ship, Pacific Link.  Our starting point was Port Moresby, our destination Daru, Western Province, Papua New Guinea.

YWAM Medical Ship

YWAM Medical Ship

I had heard about the ship through an email from a medical organisation.  I was excited to see that they wanted doctors with general practice experience.  I had long had an interest in medical mission.  This was the perfect opportunity for me to join a team of health professionals for a short term medical mission, not far from my home country of Australia.  The team consisted of 50 people from 10 nations.  There were doctors, nurses, a physiotherapist, optometrist, dentists, general volunteers and the ship crew.  Over two weeks (one week in Port Moresby, one week in Daru), we would do clinics in villages, providing health checks, consultations, immunisations, wound care and health education, eye checks, glasses and dental care.

Life aboard a relatively small ship was a novel experience.  There were so many people that we couldn’t all fit into the dining room at the same time and ate dinner in two shifts.  There were still port holes in the dining cabin and lounge area.  Everything was very compact, from stairs to tables and benches to the bunks.  Workmates, curious about my time on the ship had asked if I got my own cabin!  Down below are men’s and women’s dorms.  The bunks were certainly designed for Japanese fishermen and not long-legged Westerners.  Each room contained four bunks (two top and two bottom bunks), separated by a narrow central aisle, big enough for one person to stand in.  Each morning, I would lean over to put my hand on the top bunk across the aisle before letting myself down off the bunk.  Each bunk was cosy, with a navy blue curtain you could pull across for privacy, a reading light and small bookcase, useful for stashing all my personal items that didn’t fit in my locker.  I tried to make mine more homey by sticking up pictures of the kids and a painting done by my 3 year old.

I love the port holes!

I love the port holes!

Compact locker space

Compact locker space

The bunks

The bunks

I was glad I had followed instructions to pack light, as each person has a locker, or really half locker with 3 shelves and 10cm wide hanging space.  The girls shared a small table and mirror in the main corridor which had power points all around it.  There was always a tangle of cords from phones, ipods and cameras plugged in for recharging.  This was not a trip for anyone who does not like to get close to their fellow homo sapiens.  I loved it.  It was like school camp in the old days.  It was social and multicultural and a great way to meet people.  Some people got a double cabin – a little luxury, but certainly not like the state room on the Queen Mary!

The lounge area was large and spacious, with a good sized screen for watching movies and presentations about our trip.  This was also a great place to hold meetings.  On the aft deck was a large storage cupboard with a cumbersome wooden door, nicknamed ‘Narnia’ by David, our team nurse.  There was an air of mystery surrounding this cupboard as a person who entered may not re-emerge for sometime as they searched for particular items among the medical paraphernalia.  On my second trip, ‘Narnia’ had disappeared, to be replaced by a variety of well ordered and compact storage areas.  The aft deck was opened up to be used for meals and barbecues.  This was a marvelous innovation, but I felt nostalgic for ‘Narnia’.

Compact medical storage, a replacement for 'Narnia'.

Compact medical storage, a replacement for ‘Narnia’.

Showers were limited to 3 minutes per person a day as the water supply was obtained by desalinating sea water.  The girls had 3 showers between them, no doors, just a shower curtain and a bath mat.  This brought on the challenge of dressing quickly and maintaining modesty without getting clothing soggy wet.  The toilets would regularly get a blockage due to the curious bends in the old pipes.  It was the lucky job of the earliest risen member of the ship’s crew to grab a plunger and remove the offending blockage and smell on the mornings this happened.  These little things are bound to happen anywhere a large group of people use a small range of facilities.  The crew were very handy and always quick to fix any problems.  A blockage did occur at the start of one of our sails.  Going up onto the deck for fresh air, the wondrous aroma of fresh sewage would waft towards our nostrils as we lay prostrate, fighting off the waves of sea sickness.  God bless the man who fixed this problem early in the voyage!

Sea sickness is funny in retrospect.  At the time, it felt like an ordeal that would never end.  It did not take me long to turn green.  Ironically, I threw up just after taking my second sea sickness tablet.  I think it was the claustrophobia of navigating narrow ladders down to the bunks while the ship rocked beneath me.  I grabbed a bucket from the laundry, kept there for the express purpose of gathering the stomach contents of the truly sea sick.  That bucket became my comfort item for the rest of the voyage and I held onto it for almost 24 hours.  I didn’t need to use it, but felt safer with it nearby!  I lay on the aft deck with a group of other similarly affected people.  We lay on woven mats, side by side, as the ship moved relentlessly up and down, sea air blowing across our faces.  Every now and again, a large wave would cause the ship to tilt to the port or starboard side and we would slide in unison across the deck, just like a can of sardines.  I counted hours until our projected arrival.

Towards the end of the voyage, the waves levelled out.  We were approaching land.  I grinned with relief.  We were almost there.  I would soon feel my equilibrium return to normal and be able to face the thought of food without flinching.  It would be a week until our return voyage.

At the bow

At the bow

I had an incredible time, serving with a health care team in the Western Province.  I loved meeting the people of Papua New Guinea and have returned since.  Next week I venture to Port Moresby again – this time with my husband.  I am happy to say, I don’t have to sail this year as we will be based in Port Moresby.  Soon YWAM will add a new ship to the mission, one that is larger and more stable in the water.  I am banking on this one being less likely to induce sea sickness and look forward to visiting it soon…and sailing without a green-tinged complexion!

Beth and Enwah – PNG and the fight for life

Papua New Guinea lies on Australia’s doorstep.  I have visited twice now and will be returning later this year.  Increasingly I find myself thinking about PNG and her people, especially those that I have met and talked with and briefly shared life with.  Beth, a young mother, and her newborn son, Enwah are two of these people.  Enwah, like many babies in PNG began his fight for life very early.

My time in PNG was spent with a medical ship that takes health professionals to remote areas along the southern and eastern coast where basic medical care is not easily accessible to most people.  PNG is mountainous and covered by thick jungle.  In the Gulf Province and Fly River system in the west, most people travel by dugout canoe along the intertwining river systems.  Roads are few and far between and often in poor condition.  With 88% of people living in rural areas and health facilities sparsely distributed throughout the country, most people with a serious health problem will not have the chance to be treated in a hospital.

Jungle along the Oriomo River

Jungle along the Oriomo River

In 2011, I was part of the primary health care team on the ship.  This was my first journey to PNG.  The ship sailed 27 hours from Port Moresby to the Western Province where we anchored off Daru, the capital.  Each day we would travel by zodiac (inflatable motor boat) from the ship to a village or settlement where we would set up our clinic for the day.  Our role included seeing and treating people for a variety of medical conditions, vaccinations and health education.

The last two days of clinics were to be spent at a village named Abam, well up the Oriomo River.  The only way to reach this village was via the river.  Floating debris had to be skirted carefully to avoid catching the propeller and resulted in many a disappointed attempt to spot a crocodile!  Along the way we passed dense jungle, traditional villages and smiling families in dugout canoes.  The people of this area hunt, fish, harvest sago and grow vegetables, much as their ancestors have done for centuries past.

We received a warm welcome from the villagers who helped us unload our gear and mount the steep banks.  They gave us the use of their school house for the clinics, a two storey building made from traditional materials and surrounded by lush green lawns.  There were dirt floors, blackboards and desks with benches made from planks of rough wood.  Most of our patients presented with conditions seen frequently in Australian general practice – respiratory infections, diarrhoea and musculoskeletal problems.  However in PNG, a flu-like illness could easily be malaria or a chronic cough, tuberculosis.

On our final afternoon, riotous laughter drifted through the school house windows as some of our team played with the children on the lawn, turning skipping ropes and blowing bubbles.  Not long after, I was called to see Beth and her newborn baby, Enwah, only 10 days old.  Enwah nestled in a colourful blanket, crying weakly, skin taut across his tiny skull, with the wizened appearance of marasmus.  Beth and her parents had left their village, further up the river at 5am that morning, having heard about the visiting medical team.  We settled Beth into the storeroom with our team leader, Jennifer.  I advised them on how to express some breast milk and syringe feed the baby.  While Jennifer helped Beth to feed Enwah, she told us her story.

Jennifer feeding Enwah

Jennifer feeding Enwah

Beth had been attending high school in Daru, capital of the Western Province, but became pregnant at age 19 and returned home to live with her parents.  She worked hard and ate little on the advice of her mother in the hope she would have a small baby and easier delivery.  Beth received no antenatal care.  Eight months into her pregnancy, Beth became ill with a fever and went into premature labour.  She delivered a baby boy, Enwah.  After a few days, he became ill and stopped feeding at the breast.  Beth tried to spoon feed him for the next six days; however Enwah took very little orally and continued to grow weaker.  Enwah had now been ill for six days and had not fed for 24 hours.  He was severely dehydrated and malnourished.  Beth and her parents were distressed about Enwah’s condition.  The nearest healthcare facility was in Daru.  Their only mode of transport was dugout canoe.  It would take nearly two days to make the journey to Daru, paddling day and night.

After discussion with Beth and her family, it was decided that mother and baby would return with us to Daru for transfer to the hospital.  Beth’s parents would follow in their canoe.  This journey would take 1 ½ days in dugout canoe from Abam.  The same trip would only take one hour in the zodiac.  We prayed for Enwah as we set out for Daru.

Dugout canoes, Oriomo River

Dugout canoes, Oriomo River

Jennifer accompanied Beth and Enwah to the hospital and visited them the next morning to check on their progress before our departure for Port Moresby.  The doctor’s initial attempts to insert a drip into Enwah’s collapsed veins were unsuccessful.  Overnight, he developed vomiting and diarrhoea and continued to be syringe fed with breast milk.  Eventually an intravenous line was inserted.  By morning, he was crying more strongly.  It seemed as if Enwah had turned a corner and the doctor was more hopeful of a positive outcome.  I believe Enwah would have died if unable to get to the hospital.   Another day, he would not have had this chance.

Maternal mortality rates in PNG are among the highest in the Pacific at 250/100 000 live births1, compared with 8/100 000 live births in Australia2 (2009).  Child mortality is also high in the under 5 age group at 68/1000 live births1 compared with 5/1000 live births in Australia2 (2009).  It is not my aim here to address solutions to this problem, simply to share the story of Beth and Enwah, who for me have personalised the challenge of delivering health care to remote communities.  After our return, Jennifer tried to find out what had happened to Enwah.  The only information we were able to find out was that they weren’t at the hospital anymore.  We don’t know what the final outcome for Enwah was, only that he was given a chance that day that normally would not have been available to him or his family.

  1. Global Health Observatory, World Health Organisation.  Papua New Guinea – health profile (2009).
  2. Global Health Observatory, World Health Organisation.  Australia – health profile (2009).

Not a Scratch! The story of a barefoot doc in PNG

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Alita – this lovely lady helped me up the steep slope behind her village to visit the fruit and vegetable plantation.

Feet are important.  Footwear equally so.  Especially for a clumsy white girl doc like me visiting remote villages in Papua New Guinea, a tropical country just north of Australia.  I expected to learn a lot from this trip, volunteering with a medical ship providing health services to communities where health care is not easily accessible.  I didn’t expect my feet to be a source of revelation.  But then, God uses all sorts of everyday objects to teach us things about himself.

I had been to PNG before.  During my previous trip it was dry and the ground relatively flat.  Flip flops (or thongs to us Aussies) had sufficed, especially in the humid climate.  And so I packed my flip flops once again, ignoring the tiny voice in my head that suggested reef shoes would be a good investment.  Gulf Province, PNG is remote.  People travel via the network of rivers and waterways in dugout canoes, or a dinghy if fortunate enough to own one.  It rains.  Everyday.  Even when it’s not the rainy season.  You can imagine what this does to the landscape.

Each day we would load up our gear for clinics into the zodiacs (inflatable motor boats) and head out to a village.  The most challenging part of each day was getting out of the zodiac onto a muddy shore or steep embankment and helping to move huge backpacks and boxes with all our gear.  The embankments were muddy.  The trek to each village was muddy, rocky and sometimes quite steep.  I have never been a mountain goat and have always felt anxious on unsteady ground.  Nerves make my balance even worse.  Bulked up in raincoat, lifejacket, personal back pack and medical back pack, I was an accident waiting to happen!

Flip flops are great, if you want to get stuck in the mud.  Mud sucks voraciously at your foot as soon as you plant it.  Attempts to lift the leg pulled down by the maudlin mud results in a tug-of-war which invariably results in the strap giving way and the base of the flip flop dangling uselessly from a suspended foot.  Very elegant.  Thus I took to strapping my flip flops to my back pack and only donning them when we made it to our clinic area.  Meanwhile, my team mates all sported the latest in reef shoe design – streamlined shoes that fitted snugly to their feet, grips that really gripped on all sorts of terrain, water resistant breathable materials.  Have I convinced you to buy a pair yet?  Oh, how I wished I had a pair!

Mud slide!

Mud slide!

One morning we arrived at the village of Babaguna.  I stared in consternation at the hill we had to ascend.  It was very steep and smooth.  For now it was damp mud.  I resigned myself to the fact that I would probably take a tumble on my way down at the end of the day.  The village houses were built on the side of this very steep hill.  The locals had no problems scrambling up and down.  Their balance is perfect.  They never miss a step and make it look so easy.  Our clumsiness on their turf provided a few laughs.  Luckily there was usually a group of eager young men to grab out gear and hoist it up the hill wherever we went.  Sure enough it rained that day and as I slowly made my way barefoot down the slope, I took my first mudslide resulting in lovely mud smears to my cargo pants and backpack, bruising to my bum and wounded pride.

Muddy ground everywhere, the result of daily rain.

Muddy ground everywhere, the result of daily rain.

Over two weeks we went to ten different villages.  Each time I went barefoot – across shores where sharp shells were embedded in the mud, up slopes where rough stones and rocks jutted out of the mud, over rickety walkways constructed from palm branches and slippery with mud and rain.  And would you believe it, I didn’t get a single scratch to my feet.  Not a sprain, not a cut, not a bruise, not a mark.  Amazing.  I thanked God for his care and protection and reflected on this verse.

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.

Psalm 23:1

Yes, I slipped.  But my feet were not hurt the tiniest little bit.  God cared for my feet.  A tiny detail, but an essential thing for me to be able to go out each day and serve with this group of medicos in remote jungle villages.  A sprain could have laid me up.  A cut could have led to serious infection.  But I was okay.  However, I have vowed that whenever I return to these jungle villages along the rivers, I too will have the latest in reef shoe design!  (Another peril of bare feet – I did take a nice helping of albendazole on my return home in case of hookworms creeping into my body via my exposed feet.)

The Lord God is my strength.
He will set my feet like the deer.
He will let me walk upon the heights.

Habbakuk 3:19