Jungle Village Childbirth Attendant Classes

Shortly before our arrival in Yifififiki the Hewa men build this open air classroom with a one room medical clinic and storeroom on the back side.  The dark blue tarp on the opposite side was donated by Samaritan's Purse International Relief, and these tarps provided our students with shade and protection from the rain.  

The curriculum of the Community Based Health Care and the Village Childbirth Attendant course normally takes months to get through, so we had to pick and choose our topic carefully to cover the highlights and the most important items during our five teaching days.  We had lost a day due to being stuck at the airstrip in Fiyawana due to the cloudy weather.  



Our students were from at least five tribes from the surrounding region.  On one side of our open air classroom we had most of the women and children.  On the opposite side of the classroom were the men and young boys.  Even the dogs, chickens, rooster, and a young cassowary would come in and listen briefly to our teaching.  


The first few days were taught by PNG national Matthew Galman. Last August Matthew was in a head on collision with a truck and was extracted from his vehicle with a right sided pelvic fracture, however, the rescue team had to break his left leg to free it from the wreckage.  When I spoke to people about Matthew they said, "before the accident, Matthew was a good man. After the accident, Matthew has become a great man.  As I got to know Matthew I appreciated how true this was.  He has a genuine love for people and an amazing gift at being able to teach and to communicate.  He speaks English beautifully, but also speaks Melanesian Pidgin as well as a half dozen local languages.

Matthew Galman teaching class.

Matthew spent the first few days covering mostly personal hygiene issues.  We had brought 150 toothbrushes and 150 tubes of toothpaste, and Matthew explained to his students how to brush their teeth.  These people had never even had a toothbrush before. 


Dr. Stephanie Doenges and Dr. Becky Morsch spent an entire day on normal childbirth.  The following day I taught on complications of childbirth, including postpartum hemorrhage, fetal malpresentations, postpartum fever, and management of delivery of the placenta.   


Faimpat was one of the key men among the Hewa.  I liked him immediately.  He spoke pidgin flawlessly and could translate for us into Hewan.  When I taught I used Matthew to translate to Pidgin and then Faimpat would translate into Hewan.  On the second day that we were there Faimpat cut the bottom of his foot while playing soccer on the mud court.  He had a laceration between his first and second toe on his left foot.  I washed his foot and applied antibiotic ointment daily, and on the second day I placed a single suture so that the laceration would stay together.  He really needed a pair of shoes, so I removed my sandals and put them on his feet.  He was so happy to have a pair of shoes.  I think they might have been the first pair of shoes that he has ever had. 

When we our very condensed five day course the people were extremely grateful.  They told us that they never had heard nor been taught so many of these things.  The men in particular were so grateful for having been taught about childbirth, and about how they could help the women in their tribe when giving birth.  They explained that no doctors had ever come to help them before.  To express their gratitude, the last day that we were in Yifififiki the various tribes pulled together and cooked four enormous pigs and served a feast for everyone who had come to the training.  They gave us their spears and the women gave our ladies hand woven bilums (large open bags or purses) that they had woven from tree bark.  Their gratitude was genuine and sweet. 

Faimpat translating for us.

Faimpat's bandaged foot & shoes.

Dr. Sawyer teaches delivery of the placenta.

Dr. Becky Morsch (kneeling) shows a Hewa woman
how to stop a postpartum hemorrhage on patient
Dr. Stephanie Doenges.  Teresa Sawyer (top left) watches
with Susie McGough and Mikenna Kopf (left)
and Susan Kopf (right).

Washing feet...

Jonathan Kopf teaching
on Sunday morning.

Sunday, June 10, 2012 is a day we will never forget.  First I need to introduce you again to Jonathan & Susan Kopf.  They are the missionary couple with New Tribes Mission (NTM) that have lived with the Hewa for the last eleven years.  When they first came to the Hewa people there were no missionaries, no was no written language for the Hewa; the Hewa could not read nor write.  Jonathan and Susan have learned the language, created a written language for the Hewa; taught the Hewa how to read and write their language, and have translated much of the New Testament into the Hewa language.  They have raised two of their own children and now have adopted a daughter, Mikenna.  Susie McGough is the niece of Jonathan and Susan, and Susie we flew Susie in with us so that she could spend the summer in the jungle with aunt and uncle and to help to care for Mikenna. 

Susan Kopf teaching the Hewa.

Next I need to paint the scene.  This Sunday morning we were gathered under the open air wood shelter with a large blue Samaritan’s Purse tarp over the end of the roof line to provide some much needed shade.  In accordance with the customs of Papua New Guinea, the men sat on one side of the enclosure and women sat on the other.  (In general, men and women are always separate from each other in public…and often even in their own homes.)  Men and boys gathered on the ground and tree stumps, most of them wearing only leafy branches on their back sides and loin clothes draped over a tightly tied rope around their waists.  Women holding their babies and children gathered on the other side. 

Dr. Stephanie Doenges
and young cassowary.

Whenever a baby would start to cry in the lap its mother, she would simple pull her breast out of her shirt and her baby would usually grab on with both hands and pull her nipple into its mouth.  One woman sitting directly across from me completely forgot about her breasts and just left them both hanging outside of her shirt as she wiped her baby’s bottom with a soiled cloth; then tucked the cloth back into her bilum (bag or purse). 

A young cassowary bird came and sat down in the middle of the gathering seeming unusually interested in the Sunday morning gathering.  Another little boy held a tiny bird in his hands…a prize catch from earlier that morning.  Two dogs broke out in a brief fight in the middle of the service. 

Feimpat was sitting next to me, teaching on his Hewa translation of John 3:16.  He also was leading everyone in singing using a very dirty five string guitar.  Although his left hand was changing chords, it seemed that the guitar was so out of tune that the guitar was mostly being used to set the beat of the song rather than to be of any other acoustic benefit.  Several other Hewa men joined in with the teaching, and Jonathan Kopf chimed in with the teaching, teaching in the Hewa language. 

Feimpat playing his guitar.

This Sunday evening, however, was perhaps the high point of my experience in Papua New Guinea.  Two of the men that had come with us as part of our Community Based Health Care (CBHC) Village Childbirth Attendant (VBA) team were PNG nationals Matthew Galman and Joel Funfun.  Matthew had been involved in a head on collision last August and barely escaped with his life.  He is still on crutches while he waits for hip surgery to fix his crushed pelvis. 

After dinner our team joined together in the tiny living room of the Kopf’s bush house.  Around the room was Jonathan Kopf, his wife Susan Kopf and their adopted daughter Mikenna, PNG nationals Matthew Galman and Joel Funfun, CBHC director Dr. Becky Morsch, the Kopf’s niece Susie McGough, Kudjip missionary physician Dr. Stephanie Doenges,  my wife Teresa, videographer Jonathan Snider, New Tribes Mission photographer David Pierce, free lance photographer David Uttley, Samaritan’s Purse producer Arthur Rasco, and me.

Matthew Galman teaching
Village Childbirth Attendant class.

I poured some grape juice into what appears to have been a small flower vase, opened a box of unleavened Passover crackers, poured a basin of soapy water, and took out a dozen new white towels that I had purchased at Costco prior to our departure for Papua New Guinea.  Although I have read John 13 dozens of times, I have never been part of a foot washing service.  However, several months before our trip I had been reading about communion and foot washing in John 13.  

I read John 13 to our little gathering  here in the middle of the jungle, at an elevation of 3.400 feet, in a place that arguably could be one of the most remote regions of the world.  I discussed with each of them Jesus taught us to serve one another in love.  In the middle of the Passover dinner, just prior to his own crucifixion, he stood up and wrapped a towel around him, took a basin of water, and washed each of his disciples’ feet.  

Hewa people's feet as we taught the
Village Childbirth Attendant class.

I asked everyone to remove their shoes, and then proceeded to wash Jonathan Kopf’s feet.  As I did I said to him how much I appreciated all that he was doing for the Hewa people, and that it was my privilege to wash his feet.  Jonathan then washed his wife Susan’s feet, speaking to her as he did.  I then took the basin of soapy water and a new white towel and lifted PNG national Matthew Galman’s foot into the basin.  I told Matthew how glad that I was that God had spared his life last August and that he had not been killed in the head on collision.  As I cleaned and dried each of his feet I told him that I was so glad to have him as my brother in Christ and that he is doing great and marvelous things here in Papua New Guinea.  As I spoke I noticed he had tears streaming down his cheeks. 

Joel Funfun teaching
Village Childbirth Attendant class.

Next Jonathan Kopf stood up and stepped over to wash PNG national Joel Funfun’s feet.  As he spoke to Joel and washed and dried Joel’s feel, Joel was weeping and tears streamed freely down his cheeks.  After everyone had their feet washed by another in the room, we shared communion together and then spent some time sharing with each other and then praying together.  Joel Funfun, speaking mostly in Melanesian Pidgin and in broken English said that he (nor Matthew) had ever had their feet washed by anyone and that he never dreamed that he, a black man, would ever have his feet washed by a white missionary.  The experience was overwhelming for both he and for Matthew. 

I shared that what had happened this night, tucked away in this furthest corner of the globe, was the very essence of what Jesus had been trying to teach in John 13.  It was an amazing moment that I shall cherish for the rest of my life. 

"How, then, can they call on the one they have not believed in? 

And how can they believe in the one of whom they have not heard?  

And how can they hear without someone preaching to them?  

And how can they preach unless they are sent?  

As it is written, "How beautiful are the feet of those who bring good news!"  

Romans 10:13-15

The dentist is in...

Teresa and Allan see their first dental patients.

Saturday, June 9th celebrated the opening of our tiny dental clinic in the downstairs of the Kopf's house.  Jonathan Kopf had fashioned a functional dental chair for us out of a broken office chair inside of a large wheelbarrow.  This was a perfect solution to the one item I was missing...a dental chair!  After several hours of setting everything up we hosted our first brave patient.

We pulled 10 teeth our first day!  We didn't even leave any roots behind!  Months of planning really paid off.

Now if any of you are wondering what in the world I am doing as an ob/gyn doctor pulling teeth, I know it seems strange.  I knew, however, that there would be four or five of us teaching the Community Based Health Care and Village Childbirth Attendant class, and that there would be at least two of us that could work in the medical clinic.  Jonathan Kopf had asked me months earlier if I could bring a dentist with me to do some extractions.  I asked a friend of mine who is an oral surgeon if he could teach me how to pull teeth prior to our May 22, 2012 departure, which he did.

Teresa demonstrating the functionality of our
jungle dental chair...a modified wheelbarrow.

Subsequently we learned that tooth pain is a leading cause of pain worldwide.  Doing dental extractions would be a wonderful way to show compassion to these people.  One of our youngest patients was a sweet boy named Juice.  Juice's mother told us that he would cry every night because his teeth hurt so bad.  She had tried their tribal custom of cutting his cheek with a razor to relieve the pain and to let the spirits out that were causing his pain, but that didn't work very well.  We could still see the old scars on his face.  She believed that God had brought us to Yifififiki to relieve Juice's pain.

We were so glad that the oral surgeon that had providing my training had talked about pediatric patients and the limitations of dosing of lidocaine.  We gave Juice some oral valium before lunch and told them to come back after lunch.  He had several of his baby teeth that were infected and irritating the gums adjacent to his permanent teeth coming in.  We ended up extracting three of the infected baby teeth that way.  The only person in the room that didn't have tears streaming down their face was Juice's mother.  She kept saying that this was a good day because God had brought us to this place to relieve Juice's pain.  Juice was such a sweet boy that his cries of fear and pain (hopefully more fear than pain) made everyone else shed tears.

Afterwards Teresa gave Juice a brand new orange shirt because he had been so brave.  Several days later Juice showed up again as a repeat customer.  We had used all of the lidocaine that we could use on a pediatric patient and we were not able to remove a fourth stump of a tooth that was bothering him.  The second time he came back we had to not only give him oral valium, but we also gave him an IV sedative that is orally active and masked the taste of the medicine by mixing it with pancake syrup.  He loved it and kept sucking on the syringe for hours afterwards.  We also felt as if Juice was part of the reason that God had brought us around the world and deep into the jungle to relieve the suffering of this sweet little boy and to be the miracle that his mother had been praying for.  One of my greatest joys in life is to be the answer to someone else's prayers.  

Teresa and Juice after his first dental extractions. 

Tiger, the Missionary Cat

Tiger, the first missionary cat from
Jiwaka Provence to the Enga Provence in
Papua New Guinea

Tiger is the first missionary cat from the newly formed Jiwaka Provence to the Hewa Tribe in the Enga Provence.  Tiger was named by her human mother, Margret Mugang, the director of the operating theatre at Kudjip Nazarene Hospital.  On June 7 Margret brought Tiger with our team to the airport at Mount Hagen.  Tiger was medicated to make the flight a little easier.  We boarded the Mission Aviation Fellowship flight from Mount Hagen to the Fiyawana airstrip forty minutes away.  Due to poor visibility that day, we ended up spending the night in the abandoned house of missionaries Jonathan and Susan Kopf.

We wanted a safe place for Tiger, so we put her in Mikayla Kopf's former bedroom and closed the door.  In the middle of the night, my wife Teresa awoke to the sound of rats running around in the rafters.  She then was aware of the same sound coming from Mikayla's bedroom, but also another set of feet running.  As she listened to all of the commotion coming from Mikayla's room, she realized that Tiger was chasing a rat inside the bedroom and also worried that since she was only a kitten that perhaps the rat was chasing Tiger.

After a few minutes of all of the scurrying around the room she heard a loud thump, and then everything was quiet. She wondered if Tiger had killed the rat; or if the rat had killed Tiger.  The next morning we opened the door to find Tiger sound asleep inside of her carrier; quite content.  There was no sign of a rat feast to be found.

Dr. Becky Morsch tries to
introduce Tiger to Rascal.

The next day Tiger made the trip with our team in the helicopter to her new home at Yifififiki in the home of missionaries Jonathan and Susan Kopf.  Dr. Becky Morsch made a nice effort to try to introduce Tiger to her new house mates, but Tiger refused to shake paws.

The first night Tiger had an upset stomach.  Susan Kopf had made a bed for herself on the kitchen floor (partly because there were 14 people crammed into their tiny home and partly because she wanted to be available to care for the newly arrived kitten.)  In the middle of the night Susan stirred in her sleep and moved her arms onto her abdomen, only to feel a pool of warm liquid on her abdomen.  She got up to clean herself and determined the fluid was what she had suspected; Tiger had indeed had an upset stomach and had diarrhea while she had been sleeping on Susan's stomach.

Susan changed and was tiptoeing back to bed  when she stepped into another pool of warm fluid on the kitchen floor.  She hopped back into the bathroom and cleaned her foot and then cleaned the kitchen floor.  She thought it was best if Tiger spent the night outside in her carrier, so she picked up Tiger and noticed that Tiger had a distended abdomen.  It almost felt like a

Tiger hunting for bugs.

balloon inside of Tiger's belly.  In the delirium of being awoken in such a fashion in the middle of the night, she wasn't thinking clearly, and investigated the cause of the swelling by giving Tiger's belly a gentle squeeze.  That was a bad decision, as it caused more diarrhea to come squirting out of Tiger's belly onto Susan's nightgown.  Susan later told me she could only say, "Really?!  REALLY???" and took Tiger outside and then went back inside to find yet another change of clothes.

Although Susan is a missionary living in the middle of the jungles of Papua New Guinea, there are two things that she hates.  She hates bugs and she hates rats...and the jungle is full of both of them.  They rely on cats living inside of their home to kill the bugs and the rats.  She explained that she trains new kittens to kill rats by letting them first play with a dead rat that they have caught in a trap.  Then they cut open the rat and let the kittens taste the blood of a rat.  After that the kittens learn quickly to become ratters.  

The doctor is in...

The first flight out of Fiyawana to Yifififiki with Teresa on board.

Friday, June 8th started with the sounds of roosters waking up the entire village, followed by the sounds of the helicopter landing just down the hill from Jonathan's old house.  Teresa, Dr. Stephanie Doenges, Dr. Becky Morsch, Susie McGough, Matthew Galman and Joel Funfun were on the first flight out to Yifififiki.  It took the entire morning to shuttle all of us, our supplies, and jet fuel by helicopter from Fiyawana to Yifififiki.

We were met at the dirt helipad on the edge of a cliff by nearly a hundred of the Hewa and neighboring tribes who had shown up to hear us teach them and to treat their medical and dental problems.  We were so happy to walk up the muddy path from the helipad to Jonathan and Susan Kopf's house.  Susan had meat rolls and plenty of water waiting for us for lunch.

Teresa counting pills in the
pharmacy corner of the clinic.

Matthew Galman, Joel Funfun and Dr. Becky Morsch started the Community Based Health Care and Village Childbirth Attendant class immediately after lunch.  A Hewa man named Feinbot translated from Pidgin to Hewan.

The medical clinic was a tiny room, about the size of a large closet, built on the back side of the teaching area.  Dr. Stephanie, Teresa and I started up the medical clinic and began to see patients.  Teresa did a fine job as our pharmacist, and Susan Kopf translated from Pidgin and English to Hewan.

Dr. Stephanie sees a patient in the clinic.

We treated several people for pneumonia, bronchitis, asthma, pregnancy, abdominal pain, backache from carrying large loads on their backs, and malaria.  Dr. Stephanie Doenges was amazing and the people immediately took to her.

That night we set up a small projector, speakers and a laptop to show the movie Jesus of Nazareth in the outdoor teaching area.  The Hewa people had only ever seen a movie crowded around a small laptop computer.  The large image that we projected up onto our screen thrilled them.  I didn't realize that it was a 2 DVD movie, so we finally had to call it a night about half way through the movie and explained that we would finish it tomorrow night.  We poured ourselves into bed, physically and emotionally exhausted.

Hewa woman waiting to be seen
in the medical clinic.

Camping in Fiyawana...

June 7, 2012 will be etched in my memory for a long time.  The sound of rain on the roof woke me at 3:15 AM and I couldn't go back to sleep.  We would be filling up two vehicles with people and cargo in just a few hours.  Our Missionary Aviation Fellowship (MAF) plane was scheduled to leave at 7 AM from Mount Hagen, about a 30 minute drive away.  At 5:30 AM our team was on our way.  We stopped at the Nazarene Bible College to pick up a national Community Based Healthcare (CBHC) educator, Joel Funfun and crept along the "Highlands Highway" in pouring rain to get to the airport.

Hewa boy outside of Jonathan's old house.

The New Tribes Mission Aviation (NTMA) helicopter that we were supposed to be flying from Fiyawana to Yifififiki (Yifki for short) had been forced to fly to Hagen due to the bad weather.  It was at Hagen that we met our pilot, Mike, and NTM photographer David Pierce.  It was obvious that our plane would not leave on time, but after a few hours our MAF pilots Mike Davis and Nick Swalm announced that the plane could fly, but that the helicopter would have to wait for better weather.  In about an hour we found ourselves landed at the Fiyawana airstrip in the middle of the jungles of the Enga Province.  Our MAF pilots informed us that the NTMA helicopter was still unable to leave Hagen, and that we could either take our chances and risk spending the night near the airstrip, or else have the MAF plane return to pick us up and bring us back to Hagen.  

I knew from reading the manuscript of missionary Jonathan Kopf that this was not a very safe place.  Jonathan and his wife Susan and their two children had evacuated this place years earlier when a man had been murdered at their front door step.  Now the airstrip was lined with over a hundred Hewans of all ages, and they were crowding around us.  We passed out tootsie roll lollipops and brightly colored knit hats to the children.  One of the men who could speak pidgin told us that the trouble makers had recently left and that it was safe.  I asked where Jonathan's old house was located and they pointed in one direction and looked very pleased that I knew about Jonathan.  

None of us really wanted to go back to Hagen, so I told the MAF pilot that we would be fine, even if it meant having to spend the night in the basement of Jonathan's old house.  Pilot Nick Swalm looked at me in a way that was asking me if I was sure that that is what we wanted to do.  When I didn't change my mind, he agreed, climbed back into his plane, and took off.  As I watched the plane descend down the steep grass airstrip and take off into the sky and fly away I had a big lump in my throat, but still felt as if God had brought us this far and that He would protect us. 

Part of the team sitting outside Jonathan's old house.
Left to right: Hewa man (standing), Matthew Galman,
Teresa Sawyer, Dr. Becky Morsch, SP Producer Arthur Rasco

The nationals carried all of our heavy supplies and bags through the mud and up a hill to Jonathan's old house.  Within minutes the basement door was opened and all of our supplies were put inside.  It looked like an ideal place for rats, and I knew that there were plenty of flea infested rats here.  I tried to put out of my mind the diseases that rats carry here, especially the type of typhus that is endemic here in Oceania, scrub typhus, which is transmitted to humans from rats by fleas. 

We were comforted by the Hewa people who brought plates of corn on the cob and cooked squash for us.  They showed us where we could get water, and fortunately we also had a water purification system with us that had been recommended to me a month ago by a friend, Michael McLaughlin.  (Thank you, Mike!)    

As it eventually became evident that we were going to spend the night here, Matthew Galman, Samaritan's Purse photographer David Uttley, along with the Hewa man Yoke who was watching the house for Jonathan, took the door frame off the front door so that we could go upstairs in the abandoned house.  Inside we found cushions and one foam mattress.  Our dinner consisted of our supply of roasted mixed nuts, craisins, mandarins, granola bars, red vines, and Pringles.  We laid the Samaritan's Purse tarp on the floor and put the cushions and foam mattress on the tarp, and then took our three SP blankets and laid them on the cushions.  It was here that the ten of us would sleep that night.  We were even more excited to discover that the toilet still worked and that we had brought toilet paper with us.  

Freelance photographer David Uttley photographing a
young Hewa boy outside Jonathan's old house.  Yoke is
standing to the left of the boy.

My wife, Teresa, said that she woke up in the middle of the night to the sound of rats scurrying around in the rafters.  She had heard of rats in this area nibbling on the toes of adults and children while they slept.  She purposefully had left her shoes on and coiled herself into a little ball, with her hands pulled up inside the sleeves of her sweatshirt and her drawstring pulled tight on the hood over her face.  

Jonathan Kopf as he greets the Hewa people.

I woke up before sunrise and was pleased to NOT hear rain on the roof and began praying for blue skies.  When the sun finally woke up all we could see was fog and clouds.  Just as we were contemplating what we could do for breakfast we heard screaming coming from all around the outside of the house followed moments later by the thundering sounds of the NTMA helicopter landing in the dilapidated basketball court just down the hill from the house.  We ran down the stairs and out the front door to see our NTMA helicopter pilot Mike and Jonathan Kopf climb out of the helicopter.  I don't think I have ever been so happy in my life!

The surgeon is in...

Tuesdays are surgery days and Dr. Jim and I were repairing eight of ten of the flexor tendons of the hand of a woman whose husbands second wife had nearly completely cut off the first wife's right hand.  If anyone thinks that polygamy is a good idea, they need to come to Kudjip Hospital to see the consequences of polygamy.

Half way through the two hour hand surgery, Dr. Stephanie came into the operating room to tell us that a woman just came into the labor ward in active labor with twins and that twin A was breech and twin B was transverse and that we needed to do a cesarean section.  We finished the hand surgery and 90 minutes later started the cesarean.

The operating theatre (as it is called here due to the British influence in PNG), was busy.  In this first picture you can see me holding up one of the twins, with the scrub nurse in the foreground, David the nurse anesthetist just to my right, Dr. Jim wearing his favorite red Ohio State scrub hat, and then the tallest of the group is our son Andrew, who had scrubbed into surgery for the very first time.

The nursery nurse was behind Andrew, so each time that I delivered the twins, I handed the babies to Andrew, and he turned around and handed the twins to the nursery nurse.  It sounded like a presidential press conference with all of the cameras clicking in the operating room (we had a lot of observers).  Andrew was very excited and it was the high point of his day...and mine, too!

Surprise...

T

This morning we had just started to make rounds on the maternity ward when the midwife came up to us and said that a woman had just come from the bush into the labor ward completely dilated and that the baby was breech.  Dr. Mel (Imelda), the national physician-in-training that I had been working with, and I went through the doors at the end of the maternity ward into the labor area.

As we parted the curtain we saw the baby in a complete breech presentation delivering as we rapidly put on our gloves.  The delivery went well, and I was busy with the resuscitation when the midwife said, "there is another membrane here."  I turned to see a bulging bag of water.  Quickly doing an exam and feeling the mother's abdomen, I discovered a second twin, this time in a head down presentation, and in a few minutes delivered the second twin.  Both were girls and both were doing well.  I did another exam just to be certain I wasn't missing a triplet!  I had to chuckle, because after delivering babies for over two decades, I can say that I have never delivered twins vaginally where twin A was breech and twin B was vertex.  That was a first for me!

So the morning started off on a happy note, but the afternoon didn't start nearly so well.  I did a cesarean section for a woman who was 34 weeks pregnant with premature rupture of her membranes and meconium staining of the amniotic fluid and no fluid could be seen inside the uterus with the ultrasound.  The fetal heart rate had been fine.  When I delivered the baby, however, the baby was limp and was caked in the meconium.  In spite of vigorous CPR for 25 minutes we were never able to get the baby to take a breath or to get a heart beat after the cord had been clamped.  The two other doctors that had rushed to the delivery room, Dr. Jim and Dr. Susan, to help me eventually both shook their heads and we stopped CPR.

I wrapped the little baby girl in a small blue sheet and carried her over to her grieving mother on the operating table.  It is hard to explain the pain and the hollow feeling inside when this is the outcome.  As a physician, I wonder at times if it is like an Olympic athlete who has prepared a lifetime for a race, only to trip and fall and be disqualified in the final heat.  The feeling is crushing.  Everyone had left the operating room and I went back inside to write my notes and orders in the chart.  The small CD player in the room started to play the song "You Raise Me Up" by the group Selah.  Tears streamed down my face and dripped onto the papers that I was writing on.  I felt like I could hardly breathe.

The paparazzi are here...

There was a big meeting for the full time missionary staff this morning, so our older kids, Michael, Andrew, and Lindsey Brass, all helped to watch the younger kids on the station.  At one point we had 12 kids at our house.  Thanks to Frisbees, balls and a DVD of Mr. Poppers Penguins, they kept everyone entertained and busy.

After making rounds at the hospital I drove into Mount Hagen to pick up supplies for our upcoming trip next Thursday to the Hewa tribe.  We then drove to the airport to pick up the five men from the Samaritan's Purse (SP) media team.

These five men will be shooting various aspects of SP's involvement in ministry in Papua New Guinea.  Although they had flown on sequential flights from North Carolina to Los Angeles to Sydney to Port Moresby to Mount Hagen, PNG, they didn't look too bad.  Teresa spent the day in the kitchen preparing an incredible meal for twelve of homemade tacos and even snicker-doodle cookies and jello cake for dessert.  After 36 hours of airline food, the SP team devoured their meal, showered and went to bed.  

Patients and friends...

Often the patients here help to give me a sense of perspective. This patient is Margaret. She is about 28 weeks pregnant, but she has stage four cervical cancer and is bleeding nearly every day, which is causing her to be severely anemic. We are giving her blood transfusions and pain medication, however, most of what we are doing is to save the life of her baby, because her cervical cancer is terminal.  There is essentially no effective treatments available to her in Papua New Guinea, so her treatments is entirely palliative in nature. 

Below is a picture of me and my friend Peter Dom.  I have written before about Peter when I was in Papua New Guinea two years ago.  Twenty years ago, in March 1992, he was in church and the church building fell down, crushing Peter's back under the main support beam.  He was paralyzed.  Ever since then he has lived in a curtained off area of the surgical ward.  Peter is always so happy to see me.  I gave him some new medium sized yellow shirts (his favorite color) and some new knit caps that some of the Operation Christmas Child volunteers had made for me to give out.

Peter loves to receive mail.  If any of you would like to send Peter a picture of your family and a note telling him that you are praying for him, he will hang it on the wall in his cubicle. You can address it to: Peter Dom, PO Box 456, Mount Hagen, WHP, Papua New Guinea.  If you would like to send him a small priority mail box, you can includes ball point pens, or AA batteries, both of which he loves.  He uses the AA batteries to play his CD player that we gave him.  He also likes CDs of Christian music.  I go by the surgery ward to see Peter every day, and often introduce new volunteers to him. 

We are very excited about the arrival of the Samaritan's Purse media team that is coming soon to PNG.  Part of this team will be traveling with us to the Enga Province to work with the Hewa tribe next Thursday.