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9/11/06 (Monday)

Monday, September 11, 2006 

I awoke at daylight after 10 hours of good sleep.  It was dark at 8 PM and I went to bed.  We do have solar panels that provide some electricity.  I have no lights for my room so I decided to just sleep.  When I awoke I looked at my clock and saw it read 6:20.  I now have showered (cold water!), shaved, deodorized and dressed and am reading and waiting for our day to get started.  Jane said we will start seeing patients about 9:00.  We do not know how many people we’ll see. 

Lord, You brought me here and I am here to serve You.  Empower us all to have a great ministry among the people here.  Protect us from harm and evil so we may carry out Your work here.  Lord Jesus, I want to walk with You and today we’ll walk here in Zapallo Grande.  Thank You, Lord! 

Jane told me this morning that there are 2 doctors and a dentist here.  The dentist is employed by the government and has been here for several years.  The doctors are here also by the government.  One speaks some English and is in his 1 year of rural service before continuing on with residency or practice. The house we are staying in was originally built to manage the river blindness project.  Raquel has conducted the river blindness work for Ecuador and HCJB for several years.  River blindness is all but eradicated here in Ecuador thanks to Raquel! Today, one of the physicians and one nurse are heading upriver to distribute river blindness medicine to the people there.  In the “hospital” building next door there is a 16-year-old in labor who will give birth sometime today.  The physician stationed here is attending her and has offered to me the opportunity to participate as well.  That will take me back 20-some years for sure! 

I learned from Raquel that Zapallo Grande has a population of 700+.  The city recently installed plumbing to deliver water to all the homes.  Before this Jane said we would shower with a 5-gallon bucket and pitcher to pour water on yourself.  She had prepared me with this information and was surprised at the luxury of running water.

This morning I resumed my reading through the Bible this year and started 2 Timothy.  The verses, 1:7-9, had a pertinent meaning for being here in Zapallo Grande.  “For God has not given us a spirit of timidity, but of power and love and discipline.  Therefore do not be ashamed of the testimony of our Lord, or of me His prisoner; but join with me in suffering for the gospel according to the power of God, who saved us, and called us with a holy calling, not according to our works, but according to His own purpose and grace which was granted us in Christ Jesus from all eternity…”  We are called to suffer for Christ.  I feel called to come here and suffer by stepping out of my comfort zone to serve Christ, the Lord.  Thank You, Lord Jesus, for bringing me here! 

Our clinic this morning was busy.  First, I met the lady (16 year-old) in labor.  She has been contracting for a couple days.  I examined her and found her to be progressing slowly.  The fetoscope was a museum relic – mainly an ear trumpet through which I heard the fetal heart fairly well.  Obstetrical care here is so limited.  If she needs a C-section after all this she would go by canoe to Borbon and possibly be transferred to Esmeraldas for that.  The physician attending here asked me to help him with the delivery when that moment arrives.

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This was the operating room converted into an exam room.  We used a gown as a cover for the patients and worked off the other table for pap smear supplies.  Many of the women we saw had their first ever pap smear.

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Raquel is interviewing a patient.

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Raquel is arranging the supplies.

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Raquel held a flashlight for me to see while I did the pelvic exam and pap smear.

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Jane and Raquel in the hallway between consultation rooms.

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An exam room.

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The delivery room.

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The delivery room table

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The other end of the delivery room.  We came very close to delivering a baby here.

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Another exam room.

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The emergency room.

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Jane and Raquel discussing a patient. 

We saw 31 gyn patients, mostly for paps, in the morning.  We did schedule a couple surgeries for next week.   One instrument I got to use was their fetoscope.  We had some pregnant ladies come in for a prenatal check.  Usually, they would only get a couple prenatal checks during the pregnancy.  The fetoscope was what one would see in a medical museum in the States.  I was surprised I could hear the fetal heart beat so well with this.

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The fetoscope was made of wood.

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We saw a few pregnant ladies, including one lady with twins.  I was able to hear both heart beats.  This lady was about 5 months along and I could hear the heartbeat with the fetoscope.  It is such a difference when what we work with at home involves so much electronics, monitors, ultrasound, etc.  Here it is just your hands and listening with the fetoscope. 

Lunch was served and was fried chicken, rice and lentils.  Very tasty!  We had plenty to go around.  Raquel asked me if I wanted more and I said just a little more rice.  She came back with a full plate of rice, piece of chicken covered with lentil soup.  Of course, I ate it all. 

I now have had a nice after lunch nap and feel rested.  We are ready to return to see some more patients.  We had a nice rain during the nap.  It was sleep inducing with the rain on the tin roof. 

Back at the clinic we saw more patients for a total for the day of 45.  One lady came in with a mangled left hand.  One month ago she caught it in a sugar cane pulverizer losing her middle finger partially.  The hand was swollen and sore.  The remaining stump of a finger was black and cold.

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After the clinic we walked through the village and took some pictures.  I wonder what the economy is here.  The village sits along the riverbank.  There doesn’t appear to be any significant farming, certainly no industry.  There is a school and a church.  The kids love to play soccer and pose for pictures.

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Walking through the neighborhood.

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Main street in Zapallo Grande…no cars or bikes.

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The local church.

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The school.

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Playground for the school.

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Typical classroom.  Notice the computer lab and the audiovisual equipment?

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The teaching end of the classroom.

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A local pet under a house.  We saw a pig here and there and lots of chickens running loose.

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Paths that you walked on along the river bank.

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This house was directly across the river.

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Local transportation.

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Soccer game in progress.

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Of course, the children come running when they see you with a camera.  Especially a gringo.

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This bush had several pink flowers that looked like hibiscus. 

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Three houses down from the dorm.  She was doing laundry.

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View from the dormitory porch.

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Phyl sent a thermometer with me to see what the temperature and humidity was in San Lorenzo.  Here it is 80 degrees and 77% humidity – at 6 PM after dark. 

I have checked the laboring patient at request of the attending physician a couple times today.  She has made very slow progress, possibly stalling out now.  She has been in labor for 2 days now.  I examined her and the baby’s head is not engaged and even floats away.  This concerns me in that she may not deliver and needs a C-section.  That means transferring her to Borbon by canoe for C-section capability.  What a problem!  Having a baby in this rural and primitive environment raises the risk greatly if the labor doesn’t progress well.  I know what really should be done but the best care right now is to wait and watch.  She can’t go to Borbon until morning. 

This afternoon when I was checking her a family member was sitting on the dirty floor with a couple large chunks of meat.  She was cutting the meat into strips with a very large knife, almost like a machete.  I wanted to take a picture but didn’t feel I should. 

Our evening meal was largely a repeat of lunch plus some very tough meat.  The flavor was good, just a lot of chewing.  I am tired and my feet are swollen and it’s time to turn in for the night.  Who knows, I may get called for another obstetrical consult. 

Lord, it’s been an interesting day.  Life is so harsh here.  Yet, many of these people know nothing else.  Wrap Your arms around them, Lord.  Sustain them and draw them unto You.  Thank You Lord for bringing me here.  Amen.

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