You might wonder, why the need for LFDS? Let me share a bit of what happened this past Thursday. The doctor team (myself, nurse, and pharmacy tech) went out to Matekane village for a regularly scheduled LFDS visit to that health center. The clinic falls under the supervision of Quacha's Nek health district in South Eastern Lesotho. It is staffed by nurses and is over 6 hours by truck (and another 6 hours from there to Maseru). As it has no doctor we go there every three weeks. It took us about 1 hour by plane to get there as we stopped to deliver a staff member back at another mountain clinic and drop off supplies. We arrived around 9:30AM and began seeing patients.
I diagnosed a variety of problems in both adults and children that day, but three were very sick. The first was a 4 year old who had developed paralysis of his legs and hands over the previous two days. He very likely had a complication from a recent infection that then resulted in an immune system attack of his own nerves. The danger was that this could quickly progress to involve his breathing. He needed to get to a hospital soon. Not long after that I saw an 8 month old girl who was being taken care of by her grandmother. Her unwed mother was working in South Africa and had left the baby in the village, with no support for the old grandmother. The baby was underweight and was HIV infected (30% of untreated HIV mothers will have HIV babies). The baby was breathing badly and dehydrated. We didn't have IV needles for babies so we had the grandmother spoon feed the baby normal saline IV solution by mouth (you can use a salt/sugar solution - ORS - but we didn't have that either). The baby needed IV antibiotics, IV fluids, and oxygen, hence the hospital. We did have injectable antibiotics to get her started. The third kid was a small 13 year old girl that had been diagnosed with suspected meningitis 10 days prior but the father had not understood the danger and had kept her at home. He had given her the oral meds (following the first injection), but had not taken her to the hospital. Now she was presenting with complications of inability to talk and paralysis of her right arm (complications of meningitis). She needed to be admitted for two weeks of antibiotics.
So what do you do? Or should I say, what did we do? Well, Matekane HC doesn't have cell phone coverage or a radio so we had to wait for the plane to return. The health center is about a mile walk from the airstrip so we told the mother with the four year old and the grandmother with the infant to start walking. There wouldn't be room for the third patient so the father said he would ride his horse with her to the hospital. That would men riding till dark, sleeping along the way, and continuing the next day for about 6 more hours to reach the hospital in Quacha's Nek!
Meanwhile, MAF pilot Melvin Peters arrived around 3PM expecting to pick up the doctor team. He had come from another airstrip with a patient with a broken leg and instructions to stop and get another emergency at another mountain clinic. That's four emergencies (what we call Code-1) in one day plus the one going by horse. So we loaded up the 4 year old and mom, the 8 month old and grandmother, and the pharmacy tech. They would have to stop off to get the other emergency patient (a 70 yr old man with pneumonia) on the way back to Maseru. As they took off I took time to ask God to give them safe passage and that God would spare the lives of the sick. I especially appreciate the logo on the tail of all the MAF planes depicting a dove, the symbol of the Holy Spirit. It would be by His mercy that the patients would live...
So that left the nurse and I without a way back to Maseru. But no problem. The clinic has a small guest room (for visiting nursing students) that I could sleep in as they had no students. And the nurse stayed in the house of the nurse that lives at the clinic. It was my first night to sleep in the mountains at a clinic. I walked over to the village store, got some sorghum instant porridge, milk and some cookies and had supper. The clinic had sheets and two heavy blankets for me so I was set for the night.
The next morning I got up at 6, had some left over porridge, had time for bible reading and prayer, especially remembering the Code-1 patients. The earliest the plane would be there would be around 9:30. Melvin arrived and flew us back to Maseru via another clinic where we dropped off supplies and picked up a staff member.
Later that day Sally and I went over to the hospital to check on the sick kids. Both were alive and doing OK. The baby was better on IVs and oxygen and the 4 year old was no worse (the paralysis had not progressed). It will likely be a week or so before the kids will be ready to fly back to their village. We thanked God for protecting and healing, and for the LFDS program. That's a long answer to the question, but gives you an idea why LFDS exists. If you will, take time to give thanks for God's provision of safety and that the kids will heal. Thanks...
Saturday, April 25, 2009
Wednesday, April 22, 2009
Last night was interesting. Around 3AM local time I was awakened by the sounds of automatic and semi-automatics weapons at a distance. It went on for what seemed to be about 15-20 minutes, then stopped. In our 12 years in Africa I have to say that it is not unusual to hear gun shots in the night. But this was a bit different as it was more extended with automatic fire. We are currently staying in housing consisting of a two story townhouse flat. Our bedroom window looks out over an open area (the municipal golf course) and so sound travels. On nights when there is a big party at the Maseru club (about 1/2 mile away) it sounds like they are in our back yard. So being awakened by gun fire was not too surprising, yet we know it is serious. We regularly pray for peace to prevail and God's ways to be followed, but we also know the history of many of the African nations.
According to the local papers and some of the Basotho we have talked to, there was an attempt on the life of the Prime Minister at his house (in the middle of Maseru town). There was also unrest near two of the military barracks. The one barracks is at the airfield that MAF and the military share. Good news is that the Prime Minister is fine, and as far as we can tell, only a few were killed. According to the 'word on the street', the opposition party is still not happy about some things that were decided in 2007 and decided to take matters in their own hands.
I car pool with some of the MAF team to work in the mornings and we drove past the PM's compound and saw bullet holes in the gated area and lots of soldiers with weapons visible. There were several police/military check points on the road, but things were calm. By midday things seemed to be back to 'normal' for Maseru.
Not to worry about things here as we place our trust in the Lord who is sovereign. We have placed our lives in His hands and trust him for our safety. We do continue to pray for this nation that the people would repent and turn to God to experience 'life abundantly' as the Gospel writer John records. That 'abundant life' is the kind of life that God intends for all people that choose to follow him. The root word is descriptive of 'a god-designed life that is full' not so much 'biological life.' And so we continue to place our faith in Jesus Christ and follow his ways (I like to call it the Jesus-agenda) seeking the abundant life. As you have a few minutes, take time to pray for God's peace for the Basotho and for the country of Lesotho.
Daily by His grace...
Wednesday, April 8, 2009
This week I began flying to work in the mountains. I am in a handover 'learning' period with Lesotho Flying Doctor Service (LFDS). You might notice TWO things on the logo. One is that it is 'doctor' not 'doctors'. LFDS began over 25 years ago when a missionary doctor pilot who saw the vast spiritual and medical needs in the mountains began flying there to provide health care and evangelism. LFDS has matured now to the point where it is a part of the Lesotho Ministry of Health and a key component to providing comprehensive health care in the mountains. But it still has only one doctor. We do have many other staff that make up the team. The second thing you might notice is that right in the middle of the logo is 'MAF'. Mission Aviation Fellowship (MAF) is what makes LFDS "flying" and not Lesotho Walking Doctor Service. Sally and I are so blessed to work with the MAF team (more on MAF in another blog). They are a great group of pilots and mechanics that love the Lord and are committed to an excellent flying program. On Monday the "Doctor Team" (myself, a nurse, an ophthalmic nurse, and a dental technician) flew about 30 minutes into the mountains to a village health center called Lebakeng to provide health care. Patients had been scheduled to come that day to see our team.
The next day MAF pilot Christiann Haak flew myself and the Primary Health Care team to a small village called Matekane. Our team on Tuesday consisted of a nurse who is trained as a midwife and in public health, a nurse assistant and myself. Matekane Health Post is not a clinic, but a health post that is run on a twice monthly basis by LFDS.
We use the house of a local pastor to run the clinic. We saw 25 women that day, about half for family planning and half for pre-natal care, and then 22 of their babies/kids for health check and immunizations. Lesotho is quite advanced in it's immunization program providing the latest suggested vaccines for it's kids!
Well, I kinda got ahead of myself. After landing at Matekane,
we walked over to the house and found just a couple of women there. We waited for about half an hour and by then there were about 20 women with their children tied on their backs. They wait to hear the plane fly over and then they start walking from their villages to the health post. The Public Health/Midwife Nurse then began health education discussion, explaining to them the new program that will provide cervical cancer screening, some discussion about breast cancer, and discussion about HIV/AIDS. Me' Phomane ('may poh-money') is quite passionate about her teaching and the ladies really participated with a lot of great questions.
After that it was time to start weighing babies, giving injections, and
examining and counseling women who were pregnant or were trying not to get pregnant. Me' Leonia (teal colored shirt) loves the kids and is so good at giving injections. She was assisted by a village health worker Me' Balantyne (red vest).
As a village health worker Me' Balantyne helps to mobilize the women in her village and surrounding area to attend the free pre-natal and immunization services as well as doing teaching about HIV/AIDS. Just recently the Ministry of Health began a program to provide a small incentive to Village Health Workers consisting of about $3/month.
Well, we finished our work around 3:30PM in time for MAF
Pilot Christiann to come and pick us up. As we took off from the grass airstrip, we could see two women by heaps of wheat hand thrashing it. The harvest was pretty good this year as they had decent rains. Praise God for good harvest.
Today I went to Manamaneng Health Center.It is one of the Health Centers in the mountains that Partners in Health (PIH) is working with LFDS to provide HIV/AIDS services. I'll share more about PIH and LFDS work in a later blog. I was blessed to work with a Mosutu doctor (George) who had just been posted to Manamaneng last week. The health center has a small staff of LFDS and PIH employees that provide the day-to-day care in the clinic. They really care about their patients. The clinic serves about 12,000 people from the surrounding villages. LFDS not only provides full time staff at the clinic but is responsible for getting the drugs/supplies/coal to the clinic. How does it get there you ask? MAF under contract from the Ministry of Health airlifts it there through the MAF/LFDS program.
By the time MAF pilot Justin Hanoker came to get us the winds had picked up and we were taking off with a 15 knot quartering tail wind. He did a great job getting us safely back to our base in Maseru at the airstrip that MAF shares with the Lesotho Air Defense Services.
The 'doctor team' heads to the mountains again tomorrow and then we are off for Easter weekend. Sally and I head to Johannesburg, South Africa for our mission's annual meeting. Meanwhile, every day Sally and I work on our language study and cultural learning. Boy we have a long way to go...