Este es el dia que hizo el Senor, me gozare, y le alabare.

That title means, "This is the day that the Lord has made. I will rejoice and be glad in it." It is a very appropriate title considering I am blogging about one of the best Sabbaths I have ever had. It has some work included (which maybe is a bit blasphemous), but if you like what you do as much as I do, is it really work?

1.) Iglesia:

Most of the missionaries here go to "missionary church," i.e. gringo church. Now, I can imagine for those people who are here full time, it is probably much needed nourishment to worship and fellowship in your native language. For J and I though, one of favorite experiences of traveling is the experience of worshipping God with people of other cultures and in other languages. So anyways, Penny and John, 2 missionaries, do not go to gringo church but go to a Honduran church a little ways down the road from the hospital. We asked if we could go with them and planned on doing just that. Well, that morning there was a mini emergency that John and Penny had to attend to. They are the transportation for all of the kids at La Casa de Ninos so that responsibility then fell to us. Josh was scared to death driving a pick-up truck with at least 12 children in the back. They kept chanting for him to go fast, but he held fast. The service was a sweet time of worship. The children lead praise and worship, and there is something special about how children sing. It does not matter if they are out of tune or whether they have any rhtyhm at all. They are joyful worshippers singing at the top of their lungs and dancing with all of their energy. The message was on Romans 7---the passage where Paul says something along the lines of "I don't do what I want to do, and what I want to do, I do not do." Anyways, I have been also working through Romans in my quiet times, and it was good to meditate on these passages during church. Now that saying sounds a bit confusing, but I think we can all relate a bit to the battle between flesh and spirit. I know what it is that I want to do but I just don't do it. The only good news comes a little later in Romans 8 where it says, "For the law of the Spirit of life has set you free in Christ Jesus from the law of sin and death." Praise the Lord!

Dolly one of the women at the church. She is a beautiful, strong woman of God who reminds me of another strong, beautiful women of God in another country all of the way across the world. I am remembering my friend Rose, and her family while I'm writing this blog. She is the wife of a pastor in South Sudan.
Some of the kiddos. The young lady in the forefront of this picture came to la Casa as one of the worst cases of malnutrition they have ever seen. I have seen the pictures. It is not pretty. As you can see now, she is well-nourished, beautiful, and happy.

There is a joke here in Honduras that goes something like this. "How many Hondurans can you fit in one truck?" The answer is, "always one more." They truly live by this. One of the missionaries said he one time fit 38 people in his pick-up truck. By the way, the gringo is one of the missionary's grandson who has been living here for the past 10 months. He was the person who was baptized at the waterfall a while back.

2.) Deliveries:

Here is the second part of my awesome day. Now this is maybe when you would say that perhaps I was not taking a true Sabbath. But what better worship is there than to help bring new life into the world? There is nothing more awe-inspiring than a newborn baby with her fingers and toes so perfectly designed.

"For you formed my inward parts; you knitted me together in my mother's womb. I praise you, for I am fearfully and wonderfully made." Psalms 139: 13-14

3.) Lastly.... food and fellowship:

The OB doc here invited J and I to his house for dinner. Oh, man! He was grilling as we walk up chicken from the farm on site here. We walk in, and his wife is making all sorts of treats: beans, corn casserolle, fresh vegetables, roles, and ICE CREAM! We eat our full and enjoy the fellowship. The doc and his wife actually worked in Zimbabwe at a hospital I spent a month at when I was younger so we swapped stories.

Well, J is looking over my shoulder telling me that this is too long so I will wrap it up. Thank you all for reading our blog and keeping up with our stories.

NH

photos only

Toco Toucan-pretty shy but I managed to get a few shots

No that's not a banana in my pocket. It's a "Bunch" of bananas

Get excited! This is called a Trogon and is really rare. I've asked around and some of the other bird watchers have never even seen one.

Army ants- You really have to watch where you stand around here. I was looking up in the trees taking pics of birds and all of a sudden my feet are screaming in pain. From what I've heard they don't sting but there bite hurts something awful. Believe me!

Bat- Maybe a Big Brown. Just not too sure about the ones down here. We helped get this out of one of the teachers room.

Just a pretty swampy area right off the beach. Lots of beautiful trees. I like big Buttresses!





Thats all for now. Heading to dinner with one of the Dr's.

J

Insert clever title here

This was a little girl who lives at the children's center with her young mother. The funny thing about this was that she was also my picture, and the last time I saw her, I was squeezing pus out of an abscess over an eye. About 10 seconds after this picture was taken, she remembered me from that and started squalling uncontrollably.
This is Marilyn, another child at the children's center. Apparently she LOVES J. We played a really fun game where I would pretend like I was going to pick her up, and she would cling to J. Its the opposite of what usually happens at church where children look at him and start crying. He was loving it. I think here she was looking at him wondering where his big ole beard went.


Big Sister doing her hair.

Our friends before a rousing game of deer, shield, pistol. The kid to our right has finally forgiven us for kicking his tail in soccer and then not letting him cheat. We were not quite sure what we were arguing about, but I'm pretty sure we were right.

NH here:

Well, its been a few days, and there are a few things about which to update you all.

I was able to go to Rio Esteben, a town a little ways down the road to do prenatal clinics. It has basically been an effort to provide women in more rural towns access to prenatal care. The vast majority of babies born in Honduras are born at home, and the women/child death statistics are atrocious. As you can imagine, a breech baby born at home.... not a good idea. Post partum hemorrhage.... common cause of momma deaths. So John, a midwife here, had the idea to go out into these rural villages and bring prenatal care. There was alot of hesitancy at first, but he said that the doppler has been his saving grace. Women EVERYWHERE love to listen to their baby's heart beat. We measure bellies, listen to heart beats, try to figure out when the heck their due date is, and encourage first time moms and moms with risk factors to deliver at the hospital. At this clinic, I also met Patricia. She is a 17 year old Honduran girl who is going to nursing school and working at these rural clinics as well at the OB clinic in the hospital. It was very fun to work with her and teach her how to measure bellies and find fetal heart tones.

Last night, J and I were invited to pizza night at a missionary family's house. The pizza was delicious, and we enjoyed picking their brain about their years on the mission field, raising support, etc. And as with any dinner that includes 3 doctors (both the husband and the wife are physicians), the conversation always ended up back on medicine. We can't help it! Anyways, as we were finishing up, there is a call on the radio. A 29 week baby was born. At first the physician had handed the baby back to mom to hold thinking that there was no way that she would make it. But then this little fighter started crying, looked pink, and had pretty decent tone. She was working hard to breath, but this little girl was fighting. They were calling to speak to the Pediatrician so we headed down the hill. After much debate of what could be done for this little one with the resources we have. (We do not have a pediatric ventilator, only had one does of surfactant that was 5 months expired, and the closest place with a pediatric ventilator was in San Pedro Sula.... at least 4 hours away). After much debates and nobody really wanting to be the one to make such a horrendous decision, we decide to give a dose of surfactant (which I became the "expert" on having seen it done maybe once by our NICU nurses and read about in Harriet Lane on the way down the hill) and bag the baby until La Ceiba (1.5 hours away). They would then be able to transfer them to San Pedro. The catch is, as before, the ambulances refuse to come out this far, because they say it is too dangerous with all of the drug/gang violence/farm animals in the road.

I volunteer to go, and J volunteers to go with me. Also coming with us is the leader of the children's home (who ends up getting roped into these drives on a semi regular basis), the midwife (to take care of mom and to interface with the Honduran physicians), and one of the EMT's. The EMT, interestingly enough, is leaving for the states on Monday and had requested some neonatal resuscitation teaching which I had JUST done the night before. Coincidence? I think not. Nothing like putting your new found knowledge into action. We bag this tiny little baby all of the way to La Ceiba, and she remains relatively stable the whole time. We arrive and the same resident who was there last week greets us as we enter. We drop mom and baby off head back towards the hospital. These situations are difficult to deal with in the states, but the decisions are nearly impossible here. I mean, the baby looked good for 29 weeks, but there are alot more factors to take into account and alot more hurtles for this little one to jump over.

On a random side note, we were driving back and had several close encounters with farm animals walking in the road. You see, if they are facing you, you see their eyes shining. If they are facing away, however, it is difficult to see them, and this fact is the cause of many car/motorcycle accident. Anyways, our driver mentioned a brilliant idea for a short-term mission team. He said, he thinks it would be really helpful if a team came in and painted the back side of all of the cows and horses with reflective paint so they would be easier to spot while driving at night. Something to think about, Oasis Church, if you're reading. Hahahahah.

On a more personal side, this time here has made me think about where it is the Lord would have in the future. I have been praying alot about it and trying to be still and quiet before Him waiting for a word. I have not heard one. I am someone who believes that the God can definitely give people specific callings on their life (There is no way I would be a doctor had I not had that specific calling). I also believe though that there are times when we do not hear his voice directly, and it is not wrong to look at the gifts and passions He has given you and move towards those things. So the things that I know about myself: I have a passion for the poor and for women's and children's health. I enjoy working in other countries but fear losing the broad set of skills that my residency has afforded me. I do not love emergencies but seem to thrive in them. I have a PILE of loans left to repay and feel that it is my burden alone to repay. Missions does not lend itself well to paying off loans. I do not LOVE the idea of raising support, but I DESPISE the idea of other people paying off my loans. I have also been told by others though that the later you wait to go on the mission field, the less likely you are to do it. As you can see, there are many thoughts floating around in my head. Pray for clarity. Pray that I would be but clay in His hands to be used for His glory.

That's all for now. Going to watch Survivor with our missionary sponsors. Oh, yeah!

NH

Rock,paper,scissors,lizard,Spock

Baby Gecko

Baby Basilisk

Butterfly

The Stanky Leg Lizard

Hey guys J here.

Went into Ceiba yesterday to do some grocery shopping. Picked up hopefully enough stuff to get us through the next 2 weeks. Sadly there was no coconut milk so our plans for curry have been foiled it would seem. I could probly just find a coconut around here somewhere though. While at the grocery store/mall I was able to go eat some chinese at the food court and pick up a few bootleg DVD's for movie nights here. So that was exciting. Also picked up a Domino's pizza to bring back for NH and myself. Went back to the childrens home to hang out with some of the kids again and were recruited into a impromptu soccer game. Not exactly sure who won. There was alot of yelling though(mostly in spanish). We were also taught a new form of rock, paper scissors by some of the girls. Although not quite as cool as, rock, paper, scissors, lizard, Spock, it was still really fun. Apparently you have a gun which beats the deer (or some horned animal atleast) then shield which beats the gun. and finally the deer jumps over the shield. You play till one of you wins 10 times and then you get to squeeze the losers cheeks while everyone laughs. Fun times.

It's really beautiful out today, but so hot I'm having trouble convincing myself to go outside. Maybe later this evening. Hope everyone is doing well back home.

J

Cuban tree frog?

Humming bird

Butterfly

Howler Monkey

Hey guys J here.

Sorry I haven't written in awhile. Ben kind of busy/lazy this weekend. We were here with a skeleton crew and were house/dog/cat sitting for some folks. It was pretty nice to have a cat in the bed again. The dog is still being house trained so that wasn't nearly as nice. He did look alot like George though Trent, so at least he was cute. We definitely get our exercise here walking up and down these hills. I have no idea what the grade is but I know you can't go any higher than 2nd gear and actually go anywhere. I found it pretty amazing that all we had to do was go up the mountain to the next tier of houses to find a completely different set of wildlife. Different butterfly species lots of lizards like Basilisks and this other kind that seems to have touretts. I'm serious, every time they stop walking they start shaking their front feet like they are waving at you. Lots of rain. Apparently this is the beginning of the rainy season which mean instead of rain 1-2 times a week it rains 5-6 days a week. Not like afternoon showers back home either. It's the rain forest for a reason which means they get over 200 inches of rain a year for those of you who didn't know what actually makes something a rain forest. Saw some sweet howler monkeys as you saw in the pics above. Name is pretty self explanatory, because they are really loud. Every time a car drives by the jungle seems to explode with this horrible....howling. They are pretty fun to watch though. especially the ones with babies riding around. NH finally got to go snorkeling the other day. Rimas took us out to the really good reef this time. Which means we had to swim out like a quarter mile at least. On the way out I stopped and turned around one time and thought to myself. Yeah if a shark bit me I would totally bleed out before I could get to shore, let alone a hospital. After all my whining and complaining and nearly drowning I made it. Last but not least. Once i got there though all the fatigue seemed to instantly drain from my body as I saw some of the best reefs I have ever seen. P.S. I've snorkeled the Great Barrier Reef so when i say this it actually means something. I have to work on my deep diving though. I was having a little trouble with my mask and the pressure in your ears is pretty painful as you go down if you don't have an effective way to equalize the pressure. Even though I stayed mostly near the surface it was still freaking awesome. I didn't take many pics because its really hard to focus on something when you aren't able to stay still. I took a few more videos but wont be posting those because they are too long. It felt really good when we got back to shore though. It wasn't until then that I realized our feet hadn't touched solid ground for an hour and a half. Never knew I could tread water that long. Glad to have Trent finally following along and posting. Hopefully this will motivate me to blog more now that I don't feel like this is a give only relationship. Seriously people we want you to post every once in awhile. It's kind of disheartening to log on and feel like nobody is reading this stuff. Especially when I make up complicated equations that relate to everyday life. Ok putting my soap box aside. Looks like I'm heading into ceiba tomorrow to do some grocery shopping. We are running dangerously low on supplies. And by dangerously low I mean I'm tired of peanut butter sandwiches for 3 meals a day. More to come.

J

P.S. I shaved today for the first time in 2 months. NH's jaw dropped when she saw me. Swears I look 12 years old.

Pictures only blog

Interesting cross walk. Way to be green, Honduras. This was taking in one of the bigger cities we drove through on our way out to Loma de Luz.

Avacados from the tree behind our place.

Abuse is alive and well here in Honduras as well as in the states. I have this ethical dilemma, because I want to post pictures of my patients, but I feel weird about it. I mean, mothers and babies are one thing, but pictures of abused or sick kids... I think that's a little different. So I'm sorry I'm leaving this pictures out. But I thought x-rays would be a safe bet. First x-rays shows a skull fracture (indicated with an arrow) and the 2nd one is an old healing humeral fracture. If the picture turned out better, you'd also be able to see a healing clavicular fracture.

The Twins I helped delivery. So very, very cute, right?

Our two little friends Josenia y Reina. They are girls who live at the Children's Center that I have mentioned before. I wish I could take them both home with me. If my hair looks like a mess, well, that's because they proceeded to "make me over" and that is the result.

More pics to come, but this has made me realize why I don't do picture blogs.... they take so much more time.

Black Cloud

Buenos Dias, Amigas. NH aqui:

It has been a few days since my last post and so much as happened. So remember when I mentioned the great missionary Exodus? Well, Thursday night, the missionaries leave the compound. I am left with another family practice doc and Abby, the ER doc, to man the entire hospital. The missionaries have been joking with me in the week leading up. They'd be like, "It will be FINE. Most likely, nothing will happen. Remember that year though during retreat when there was an 11 person MVC and only 2 docs with so many injured patients? Remember that?" Very comforting. Well, anyways, Thursday night and Friday were not that bad. I got a 6am call to come help with a delivery. The family doc had been on call but since they like to have a doc for the baby and a doc for the momma since the nurses are not NALS certified, I went. The delivery went fine but the baby came out depressed. Since I am house sitting all of the way up the hill, I do not make it until the baby was already out. I walk in and the baby is not crying, and they say to me, "Do you know how to tracheal suction." "Yes," I say. But I'm thinking to myself, "Well, in theory at least." But I do tracheal suction and eventually the baby starts crying. I rounded on all of my patients and then was actually able to steal a couple of hours to go snorkeling for my first time EVER. We swam way off the beach to find this beautiful reef, and I could not believe the diversity of wildlife and the colors of all of the coral.

Josh and I are up the hill around maybe 5pm, and I hear over the radio the ER doctor. There's a delivery, and she needs some more help. I get down there pretty much in time to gown, glove, and catch baby. Baby is a little depressed but looks pretty good. Mom has a small lac that i get to repair. Fun stuff. Everybody who is reading this knows this is right up my alley. However, then we start having trouble keeping the baby's saturations up even though the baby actually looks pretty good. We decided this is an urgent but not emergent need for transportation to Ceiba, a city about 1.5-2 hours drive from here. Oh, and there are no ambulances running tonight so if we want them to be transported, we will have to do it ourself. As Abby is arranging this and sorting throught he mountain of paperwork (birth certificates, etc.), I see a man in the ER for her. At this point,we are busy, but it is under control. We get a call saying there has been a motorcycle accident. As soon as Abby walked into the ER and saw the chaos, she sent out a radio call. "Everyone who has hands and/or a car, COME!" A husband, wife, and 2 year old boy had been on a motorcycle (in the dark, mind you) and hit a horse. The wife had some minor lacerations but otherwise looked ok. The husband has a pumping scalp laceration and is covered in blood and his eyes are both swollen almost shut indicating further head injuries. We are putting him a C collar when I look over and say, "Who's the kid?" Abby said, "He must have been a part of the accident too," and we quickly turn our attention to him. The 2 year old has complete left hemineglect: eyes are looking off to one side and he is only using one side of his body. Abby, being the ER doc she is, decides he is the most urgent (as we are almost certain he has a head bleed) and starts preparing a car to take him to La Ceiba. She decides, since I am most up-t0-date on my pediatric life support certification, to send me with the intubation kit, a monitor, and a suction kit with the reassuring words, "He has a good chance of seizing, coding, or dying on the way there. Be ready." Thanks very much.

As she is putting the child in the back seat of the car, he starts seizing. I have already drawn up Phenobarbital and push a dose as we take off with mom, grandma, and our driver, Brad. He does not stop seizing with the first dose of phenobarbital so I give him a second dose. He finally stops seizing and remains pretty stable the rest of the trip with an occasional desaturation that goes away with suction. The whole trip, he only responds to painful stimuli and when he does respond, it is only with his right side. We get to the government hospital, which Brad says is a great improvement on the previous facility and walk immediately into the ER bay. I have been told to BE FORCEFUL, because if I am not, this child could have to wait hours to even be seen. I meet a doctor who I know at once is a resident, probably an intern, by the fatigue and panic in his eyes. I tell him the story and tell him that the patient needs a CT scan STAT. He is very kind and seems to know what he is doing and understand the urgency of the situation. But they don't do CT scans anymore here and would have to take the patient 20 minutes down the road to another hospital. Ok, let's do that. Now. The little boy now starts waking up and to all of our amazement and relief, he starts moving all of his extremities and crying. YAY! Perhaps his paralysis is not an expanding head bleed but a smaller one causing seizure activity. He still needs a CT scan, but we are thankful that he's showing improvement. Anyways, we leave the little boy once the attending comes down. The family, of course, does not have the cash in their pockets for the CT scan, because they came straight from the sight of the accident to the hospital. Brad give the money (about $150) to the hospital so they can take the child. I know this is not "When-Helping-Hurts"-Savvy but who cares? What are you supposed to do? The rest of our transports have arrive: the post-partum lady, her baby, and the husband. The husband apparently had an arterial pumper from his scalp lac that they were unable to repair at Loma de Luz. Instead, they put a large pressure dressing around his head that seems to have stopped the bleeding for now. I get back to the hospital around 1am.

I am actually on call Sat., and I am busy with ER consults but its nothing too bad. A vomiting child, a foreign body in the eye, a miscarraige, you know. I had one nighttime consult but was in bed by midnight and did not get any other calls. This morning is Sunday and there is no ride for me to go to Honduran church and the missionary church is not going on so Josh and I are taking a true Sabbath this morning. (Well, besides me going in to round.) There is more, but I am tired of writing, and you are probably tired of reading. I know I keep promising pictures, but they will come. Thank you all for your continued prayers. They are much needed.

Oh, and as far as the "black cloud" title goes, I believe that mine has followed me here to Honduras. Its kind of a big joke back in Greenwood, but I forgot to warn Loma de Luz in my application process that I draw in chaos. Kindly though one missionary said that she has been praying for this. She has been trying to train nurses, but their census has been low. Since I have come, they have gotten lots of learning. That's one way to look at it.

Philippians 4:19 "My God will supply all my needs according to his riches and glory."