Home Sweet Home

Praise God! Laurel and I arrived safely back in Little Rock on Wednesday.  I drove to Ft Smith the next morning to my parents' house to start a new rotation that day. Yes. I know. What was I thinking? I had to leave early from clinic because I was falling asleep in midsentence. We had been up for 36 hrs because our midnight flight was delayed till 2 am and then we flew 15 hrs to Newark, then to Houston, and finally to Arkansas. 

It's good to have the comforts of home but I certainly miss Kothara and the people there. I didn't expect the reverse culture shock since I'd only been in India for seven weeks but there it is. It seems more acute since I've been working in the hospital since the way things are done at Kothara are different from the way things are done in Fort Smith, obviously. And I miss the warm sunny weather! I'm so glad Laurel and I shared the experience together, because we can talk through the adjustment back to life here. 

There are so many more stories I'd wanted to share on the blog but alas, I couldn't spend too much time blogging (esp with the frequent power cuts) so I'll just have to share those with you in person. Thank you for keeping up with my blog and for praying for us. I learned and experienced so much more than I could imagine and received so much more than I could give. God is good. 

My heart tells me that this won't be the only trip to India for me and I feel more strongly than before that I'd like to pursue medical missions somewhere. For the next three years though, I'll work on finishing an internal medicine residency...only God knows where at this time. I and everyone else will find out where on Match Day. It's coming up on March 19! Whereever I am matched, I know God has prepared the way for me and will continue to guide me in the way I should go. Despite my overwhelming anxieties before starting another phase of my life, he has shown himself faithful time and again to lavishly provide all that I need--places to live, friends, church, ability to handle the responsibilities I'm given, and even difficulties to strengthen my faith. I will trust Him again and all the days of my life!

Last week in India

Last Tues through Thursday, Laurel and I joined other Kothara staff in running "camps" in various tribal villages surrounding Paratwada. It's absolutely been the most fun we've had the entire time in India.

On Tuesday, we set off with Deepali, the medical intern, Pramoth, the community outreach coordinator, and a couple of other World Vision staff or volunteers to hold medical screenings for World Vision-sponsored children in about five or six hill villages. We were excited to be off campus on an adventure and to visit some of the villages from where our tribal patients come. We saw incredible scenery, beautiful people, and extreme poverty. Laurel and I contributed to tooth decay in the villages by giving out tons of candy; we were selfish actually because we just wanted to see the kids smile. :)

On Thursday we held a medical camp in Bhandaraj, right next to a Hindu temple. The camp is a twice annual one that sisters from a convent nearby run on their own. They provide the medicine, arrange for the doctors to come, and publicize the camp in the nearby villages. There was a cave nearby where a priest lived in bare conditions. There were about 360 patients who came in with various ailments, from minor colds to serious conditions, like probable hepatitis and cerebral palsy. So many children had conditions that had gone on far longer than it might have. Dr Steve saw the peds cases, Dr Asha the adult gen med patients, and there were also a gynecologist and an orthopedist. The ortho techs from Kothara also screened many patients to take back on the van with us to receive free eye surgeries from Dr Shyam. In all, there were 44 patients who came back with us. Most of them were older patients who had extremely mature cataracts. The doctors said many of them had never been outside of their village so coming to Paratwada was like us going to Mumbai!

It was an amazing experience for us. We are now in Mumbai, a bit overwhelmed at first but we're loving the new sights, sounds, and tastes. It's a bit chilling to walk in the same areas where the shootings occurred, like the train station, the Taj hotel, Leopold's cafe. But we know God is our protector and we are in his hands. Pray for us anyway! Yesterday we visited the dhobi ghat, where an entire neighborhood is in the business of washing clothes. It was an incredible sight. If you've seen Slumdog Millionaire, the scenes in that movie are all around us--the begging children, the slums, the trash...as well as the high rises and wealthy neighborhoods. Laurel and I were glad we watched it on Sat night because we recognize many of the places in the movie now that we're in Mumbai!

We are going sari shopping today (Monday) and buying more luggage to fit all the stuff we've bought. The doctors at Kothara told us to haggle like Indians, so we'll try our hand at it. We have so many more stories to write about but our time in the internet cafe is limited so I'll end here.

One more thing. If you remember Atish from my last post, he passed away a few days after he left the hospital. Dr Rashmi said that his dad called her up and asked her if those girls who took pictures of Atish could give him one photo of him to remember him by because he didn't have any pictures of his son. My heart breaks for him. God be glorified even in this situation! Pray that his family would come to know and experience Christ's love for them even through this circumstance. Maybe God has a glorious plan for them.

The boy who captured my heart!

This afternoon, Atish, the four-year old boy I'd mentioned a few posts back with the liver tumor and massive ascites (fluid in the belly), came in again with his dad and his grandma. Just breaks my heart. It's hard not to cry when you see him!

Today, he looked so much more emaciated than two ago when he came in initially, while his belly was fuller and more tense. Whatever tumor is growing is making more fluid in his belly than his body can rid. He was breathing fast and using his accessory muscles because of the huge pressure on his diaphragm and lungs. Apart from the hugely swollen belly, it's just his shoulders and ribs with tiny arms and legs around which I can wrap my thumb and index finger. His whole body was burning up so he must also have an infection somewhere.

His dad took him to get a CT scan in Amravati a couple days ago and it does not look good. The radiologist said that there was no hope of a cure and that he needed to prepare himself for the end. It frustrates me so much that we have no idea what kind of malignancy it is and that he's probably not getting a definitive biopsy to figure out whether the prognosis is truly hopeless or not. The family seems to love the boy so much and the dad just looked so heartbroken and hopeless. I think they want to do anything they can do, but Dr Rashmi said they'd used up most of their money already just bringing the boy in and getting a CT done. 

Dr. Steve did another paracentesis (removing fluid from the abdomen) this afternoon to relieve the tension on his belly, which helped him breathe a little better. We took out about 500 mL of fluid slowly over three hours. Atish was an angel. For three whole hours, he laid there with hardly any protests, except for the initial insertion of the needles (without sedation or anesthesia!) and later moving them to get more fluid out. His family was required to stay out of the procedure room (and yet he was so stoic!) We stayed with him, held his hand, and sang any songs we could think of to him to keep him occupied. Despite his tiny size and squeaky voice, he seemed more like an old man than a four year old--very serious and attentive to everything going on. When the procedure was done, he took care to button the one broken button on his shirt and fold over the collar just right. I couldn't help but think that if we could only bring him back to the States, maybe he'd have a fighting chance. At one point, I considered pediatrics after a rotation on heme/onc at the children's hospital, but I know, after seeing Atish, that I could not maintain emotional distance enough to be professional and do my job!

As the family walked out of the hospital, holding Atish, we wanted them to know that we would pray for him in the name of our God. We asked Abigail, one of the nurses, to translate and she'd understood (and thus translated) that we wanted to pray for him right then. They nodded and looked at us expectantly. When I found out why they were waiting, I asked if the family would be okay with us praying, which they said they were, so I prayed for them in the name of Christ. If you do pray, please pray for Atish and his family. I thought of the occasions on which Jesus healed the child of a desperate parent, seeking some hope for his child. Pray for healing and lessening of suffering for Atish, for wisdom for doctors to know how to treat him, for resources to be able to treat him properly, for the family to come to know Christ's love for them, and for God to be glorified through this situation.

Some of my pictures are up on picasaweb. Here's the secret link:

http://picasaweb.google.com/hannah.epark/HannahToIndia?authkey=CExecYYl-LU&feat=directlink

Thank you for keeping up with my blog and for your prayers! 

Pics from Aurangabad

The last cave we visited...there is a waterfall on one side of the cave during the rainy season.
One of the Buddhist temple caves...I love the arches!
The road in front of our hotel...one of the main roads in town...can't you tell? BTW, soon after I took this shot, five other piglets came squealing across the road.
Yummy! Clockwise from the top: Naan, Rice with raita (yogurt), chicken jalfrezi, and chicken...something I don't remember but it was good...
My new Korean friends

Jesus is my protector!

We finally got the opportunity to venture off the Kothara campus on our own and do some traveling this weekend. Kothara being such a small community, everyone knew we were leaving and several people offered to help us plan for the trip, including Mr. Ravi Gaikwad, w

ho is one of the administrators of the hospital. He and his wife have been so kind and helpful in so many ways, especially planning for travel to Aurangabad and Mumbai. Now although no one said it outright, we got the sense that they were apprehensive on our behalf since we constantly got advice and comments about EVERYTHING: what to wear (the traditional salwar), where to stay, what kind of city transportation to take ("never take the taxis!"), where to visit and what to see. Always stay together. Never go off on your own. Take this list of home and mobile phone numbers of several people from Kothara in case you get into trouble. Some were surprised that it was just the two of us girls going on this long journey. I honestly thought that they underestimated our travel savvy and saw us as inexperienced foreigners. Little did I anticipate how overwhelmed we would be!

On Thursday evening, Pastor Silas and his wife drove us to the private bus company stop, where we got on a "luxury" overnight bus, a one-way ticket for two in hand (all for about $5 a piece for an 8 hr trip). But, no return ticket! We had to buy them when we got there, but...we were cool. We were grown women with travel experience, and we could handle it....or so we thought. Well, the bus had twin-sized bunk-style beds down each side of the bus, with a narrow aisle down the middle. (We thought one bunk for each of us, right?) Pastor Silas said that we were fortunate that the two of us were going together because if we'd been alone, we'd

 have to share the bed with a stranger! (What?!) Ours stated 4A on one end, 4B on the other. Pastor S talked to the driver to make sure we'd make it to Aurangabad and then came back with his wife and asked us if we would be OK. (We hope so!) We then shut the curtain and tried to get our stuff situated on the bed. Laurel didn't want to risk losing our expensive shoes below our bunk, so she brought them up and set them in the corner of the bed. Needless to say, we were a bit cramped, but Laurel much more than I. Guess this was one of the very rare instances when I was grateful to be short! Now, our American sensibilities of privacy had to be abandoned because when other passengers began boarding the bus, several of them swiped the curtains open to...I don't know...check to see if anyone was inside? These passengers (mostly male) just stared at the two non-Indian girls, even peering through the spaces between the curtain and the wall from time to time. We waited till the bus departed Paratwada to change into our PJs and climb into our sleep sacks.

The luxury bus made several stops during the night, as I vaguely remember Laurel getting off the bus for a bathroom break. After her description of the toilet, I happily held off and waited for a bathroom in Aurangabad. In the morning, the bus stopped and I woke up to see men and boys at a roadside stand, serving tea to passengers outside and through the window to those inside. L & I munched on our Marie Gold sweet biscuits and drank our bottled water. We finally arrived in the city of Aurangabad around 7am and gazed at the mixture of wealth and poverty, of modernity and traditions through the window. Apartment buildings. Tattered tents. Open fires. Car dealerships. Goats in the streets. Colleges. Hindu temples. Mosques. Supermarkets! (Praise the Lord!)

The driver pulled over on the street and abruptly yelled "Aurangabad! Off here!" There was no bus station or sign to be seen, signifying our stop. Should we get off? Were they too cheap to drive us to the station? Well, we couldn't exactly argue in Marathi, so we frantically grabbed our stuff and hopped off. A group of five autorickshaw drivers swarmed us and tried to get us to go with them. "Where you are going?!" "You want hotel?" "You go Ellora? Ajanta?" Lord, please protect us, is all I could think! Though Laurel was wary of these guys, we had no idea where in the city we were, nor how to go look for hotels. So, we ended up taking an ARS (autorickshaw) after insisting on the "metered rate" and asking for the Classic Hotel, one we'd read about in Laurel's Lonely Planet. Of course, our driver drove past several hotels, asking us if we wanted to stay there instead (he'd get commission if we did), but in the end, he took us to our promised destination. We had no change to pay the 20 rupees, only a 100 rupee bill. He said he couldn't make change, but it was a lie since he gave back 80 rupees when I gave him the 100 rupees. We walked inside and he followed us, badgering us about taking his ARS for a

 tour around the city and to Ellora. (Uh, no. We weren't stupid.) As we were discussing rooms and prices with the hotel desk clerk, he suddenly pulled out a 100 rupee bill ripped in half! He said something about giving him a ripped bill and that I needed to give him 100 rupees. (Ha! Nope, not falling for this one!) Laurel suspected he was lying as well, so she told him sternly, "No! No!" But he kept insisting to us and the hotel clerk that he had been given a torn bill. We decided the best thing to do would be to just go up to our room, so we left the guy and started walking up the stairs. On the way up, I suddenly thought, what if he's right and I have a torn bill in my wallet? I'd better check. To my utter dismay, the other half of the bill was sitting in my wallet. It'd probably ripped against the zipper. I ran downstairs and took the torn one from him as I handed him a whole 100 rupee bill. He was finally satisfied and smiled at me. I felt extremely guilty as I walked upstairs. I'd learned my lesson: don't distrust what someone says before verifying the truth, even if there is good reason to be suspicious!

After dropping off our things in our room, we had breakfast at a nearby restaurant and then took off to the Nirala Bazaar area, near the Muslim part of the city, in order to find some of the recommended shops and restaurants. We were trying to find Cafe Coffee Day, one of the major coffee chains in India, which we'd gone to in Nagpur a month ago and knew was somewhere in Nirala Bazaar. We just didn't know where, since the book listed no address and the streets were unlabeled anyway. We walked down one of the streets, asking person after person where it was, but no one knew. One young Muslim woman pointed in the opposite direction and said it was behind that bend. So we turned around and walked back the way we came, but still no CCD. We were excited to see a Cafe Coffee Break but couldn't believe the guy who told us they weren't open (at 11am!) Anyhoo, we gave up our search and took an ARS to the state bus terminal to board a bus to the Ellora caves. At the station, we saw a Caucasian girl carrying the exact same Lonely Planet India book Laurel had. We saw several more travellers during the trip carrying the same book. I could just imagine what the Indians thought of us backpackers: "welp, there comes another one with a big pack on her back, a lost expression on face, and that strange purple book in hand." Anyway, the girl was Polish, didn't speak much English, and wasn't going to Ellora but we were still glad to see another foreigner. On the hour-long bus ride to Ellora, we were the only non-Indians on board, and of course, we were stared at the whole time, as we were everywhere else in Aurangabad. :)

The Ellora caves were breathtaking! (http://en.wikipedia.org/wiki/Ellora) So much beauty yet the burden of serving all these gods hung over the place. It was interesting to see the Hindu, Buddhist and Jain caves/temples existing in one area, many of them built around the same time period. The awe-inspiring Kailasa temple is the centerpiece of Ellora, and it's twice the size of the Parthenon and carved from one piece of rock. Wow. In one of the Hindu temples, I met one of the keepers, and he told me he worked there for over twenty years. He worked shifts in the temple caves, rotating through them every month and working nights every 3 months. There was no electricity in the caves, so he'd have to walk through with a flashlight! They were creepy even during the day; I couldn't imagine guarding them at night! The temples were functioning temples, so there were people going inside the Hindu and Buddhist temples to worship. There were altars and pits in the ground so I couldn't help thinking of all the sacrifices that were offered in the past millenia and a half in those very places.

We saw some Asians in one temple, and they dutifully eyed me, the other Asian in the near vicinity, as I returned the favor. (for those unfamiliar with this protocol, please see http://www.asian-central.com/stuffasianpeoplelike/2008/03/05/25-staring-at-people/). We kept on seeing them in the other areas and I finally heard them speaking a familiar language, so eventually (after several more mutual eyeing rituals) I approached and asked if they were Korean, in Korean. The three travelers, one guy, two girls, were surprised when they heard me speak, and asked if I was backpacking around India. I told them that I was working at a hospital for a couple months and they told me they were travelling around the country for a month. After the pleasantries, L & I walked to other caves, where we saw them later, and then saw them again in a restaurant near the caves. We were absolutely worn out with walking up and down the temple steps and the roads leading up to them that we set out on one last Hindu temple that was one of the most impressive. It was beautiful. On our way down, we ran into the Koreans again, and I joked about them following us. Thought that was the last we'd see of them. We went back into town, showered off the three inches of dirt + sweat that'd accumulated and changed into a fresh salwar. We were absolutely faminished but we were just ecstatic about trying out a tandoori restaurant near the hotel that the LP book said was the best in town. We arrived at 5:30pm but the door was locked. The men sitting and staring nearby said that it would open at 6pm. A security guard said, no, it opens at 6:30pm. 

We spent the next hour exploring the Vishal supermarket nearby and finally came back to a still closed restaurant. Boo. While 

waiting for the place to open, I mentioned that it'd be crazy if the Koreans showed up at this very restaurant for dinner. Well, just before 7pm, who shows up but that very same trio? They were as flabbergasted as we were. I thought they'd want to sit with us for dinner but for some reason L & I couldn't figure out, they preferred not to. Well, at least I got a snapshot with them before they got away. Dinner was AMAZING, the waiters was hilarious, and our bellies were happy. Thank you Lord for an amazing day.

The next day, we explored Nirala Bazaar and the Muslim quarter of the city. We had lunch at a place called Smile, where I had "dosa", which looked like a version of pizza, and Laurel had a veggie cheeseburger and fries (with a Coke). Yay! While eating, a guy on a motorcycle with "Jesus is my Protector!" on it pulled up and sat there long enough for us to take a pic. :) Earlier in the day Laurel also saw an ARS with a "Jesus Loves You" window sticker on it. This sounds cheesy, but we could see how God was assuring us of his presence in our lives, even at that moment, and showing us that his children are everywhere, even in that city. More of the story and pics to come later...

Kothara and a litle girl named Kima

Laurel, the other med student here with me in case you don't already know that, wrote a nice post on a God-moment we had last week in clinic. I can't describe it any better than she can so I highly suggest reading about the cool story about a Hindu pundit who recently found Jesus. I might've wrote this already but sharing about Jesus openly is strictly against the law so any evidence of our faith that patients see comes from our "Christ-like actions and attitude" (as the staff frequently pray for) or from tracts that may be lying around. But, God is alive and drawing people to himself all the time, even when we don't realize it.

In the past few weeks, we've heard pieces of different stories about Kothara staff and how they or their families have come to know Christ. The Kothara Leprosy Hospital has been around for over 100 yrs and initially begun as a home for leprosy patients on land given by the government to The Leprosy Mission. Families brought people affected by leprosy and left them because they could no longer care for them or did not want the stigma of leprosy in their families. The patients then provided nursing care for each other since there were few people not affected by leprosy who'd live and serve in such a stigmatized community. Thus a whole community linked by leprosy was birthed, and many in the community came to know Christ because of Christian missionaries who served there. By the time effective treatment for leprosy was found, patients no longer needed to live in Kothara. They were treated, found jobs in the community and had families. Well, many of the staff today are either past patients or are children or grandchildren of past patients. Many patients had life-changing encounters with the living God and their children and grandchildren have also followed in their footsteps. It's marvelous to hear about the legacy of Kothara over the years and how God used a horrible disease to bring about good not only in the patients but also the generations that followed them.

Christians are still very much a minority in this area and the vast majority of the patients we see are Muslim or Hindu. We can usually tell which religion they follow by their clothes, especially the women, since the Muslim women wear the black hijab and the Hindu women wear brightly colored saris. It's interesting to see how the hospital is respected in the community for the medical care it has provided over the years, free of cost to leprosy patients and low cost otherwise.

Just yesterday, a little girl was brought in by her grandmother and uncle with an extruded left eyeball. It was an opaque white globe that was just hanging out of the eye socket (sorry to be so graphic). From what we could understand, her mom had died early on and the father abandoned her several years ago because of the deformity. The maternal grandmother found her not too long ago and decided to bring her to the hospital despite lacking money. Laurel and I had no idea what had caused the deformity or what it was. Dr. Shyam examined the beautiful, frightened little girl (named Kima) and diagnosed it as a staphyloma. We'd never heard of it. In fact, she'd never seen a case in ten years. Just in case it turned out to be a tumor, like retinoblastoma, she decided to surgically remove it since she had no possibility of vision from that eye anyway. Turns out that a staphyloma is just a protrusion of the eye when a malformed eyeball gets too big for the socket, here usually due to vitamin A deficiency...sadly something preventable but thankfully not very common anymore. Her family is from a tribal area and they'd heard of Kothara because of the free medical camps often held in the tribal areas. Dr. Shyam said they'd provide free care for Kima since the family had done a lot just bringing the girl in to the hospital and they might never see the girl or family again if they mentioned anything about money considering their extreme poverty. This afternoon, Laurel and I watched the enucleation (or surgery to take out the eye) and then stayed with her until she woke up. There were no one at her side to watch her! (at Children's Hospital, there would definitely be a nurse with her monitoring her vitals, keeping a close watch on her!) The sedation took a while to wear off and we were worried about her so we tried to wake her up every few minutes...so frequently that the optho tech sitting with other eye patients in the room chuckled at us calling out her name and me adding in various Marathi words I'd picked up. "Soondal Kima! " (Pretty Kima) She is so precious, so in need of love. I wonder if she was teased because of the deformity. I wonder if she was ever held by her mama. Her grandma and uncle must love her since they came all this way to get her treatment. We hope she is taken care of and loved, and shown Christ's love for her.

More food and fun to be had...

It's almost the start of another work week for us. Saturday turned out to be a busier day at the hospital than all last week, and for that, and that only, we're thankful that we didn't go to Nagpur. A man in status asthmaticus came in on Friday, got better with treatment, and then all the sudden stopped breathing Sat morning. Dr. Rashmi intubated him and ventilated him manually with an ambu bag. In the States, there would be a machine doing the breathing for him but here, a person has to stand there and squeeze the plastic bag continuously...for hours! The pt then started having seizures, which we treated with Dilantin, and then he started breathing short gasps on his own. He was transferred by ambulance to a bigger hospital in Amaravati. Another seriously ill patient came in on Friday; she was a patient with pancreatic cancer. She was deteriorating and the doctors didn't know if she'd make it so had to be with her the whole time. Then a ten year old tribal boy came in with severe grease burns on his face and body that he'd incurred the night before! I don't know the exact situation but I couldn't believe that the parents brought him in so late. Much to our relief, his corneas had been spared. Wow. What a weekend.

We're heading over to Dr. Asha and Dr. Steve's house for his 50th birthday party celebration. Laurel and I are taking over chocolate cheesecake (sort of). She did a good job of substituting things that we had for things we didn't have--like cream cheese and whipped cream, sort of..umm...essential. Laurel's quite the cook! And so is Manisha, the Anands' daughter. We're going over to their house multiple times a day in hopes of getting some treat or another that she's making at any time. It's amazing to me to see the stuff she makes, like choc cake, considering that any kind of "Western" ingredients, they have to obtain in Nagpur, which is four hrs away.

Yesterday we had a good time hanging out with Mitalee, the sweet and godly counselor for Kothara. We visited her room and she showed us the awesome rooftop that her building has. You can see around for miles, including the mountain that we were hoping to climb! It was a gorgeous view. We hope to still get a chance to go. She came over for dinner and we made quesadillas with chapatis (the flatbread we get everyday, every meal), processed cheese, chopped okra, tomatoes and onions. It wasn't authentic, but it was purty good for what we had on hand. I also fried up some okra, which was sooooo good. I had said to Dr. Shyam that fried okra is my favorite food in the whole wide world, so she obtained some for me (okra is called ladyfingers here, who knew?) Everyone here has tried so hard to make us feel at home.

Today, Laurel and I taught a new song in church after practicing it with the Dr. Sunil, Dr. Shyam and their son Nihal. We sang Dennis Jernigan's Wider than the Ocean. It's been quite a long time for me since I've played instruments during a worship service, and I have to say that I'm loving it. I've gotten quite rusty at the keyboard and it's hard to keep up with the talents of Nihal (who can play anything by ear!) but the practice is good for me. I imagine Laurel's tired of me practicing at all hours, though she says that she likes it! She's a sweetie. It's interesting that some of the well-known hymns they sing have different music to them; for example, the doxology hymn is to a tune of a different song. Totally throws me off when I'm singing and playing at the same time, yet I love experiencing different ways of praising God in different cultures. I was kinda hoping they incorporated dance into worship here since dance is so prominent in Indian culture. Maybe it'll catch on soon. Maybe I can get them started. Laurel's been treated to the sight of me dancing around her room to my ipod music. Without TV or internet (until yesterday), we have to find new ways for entertainment :) I'm entertained by Laurel's yoga moves, which I think are physically impossible for me! I guess we're immersing ourselves in Indian culture in our own ways--dancing for me, yoga for Laurel!

Morning devo

Psalm 65

1 Praise awaits you, O God, in Zion;
to you our vows will be fulfilled.

2 O you who hear prayer,
to you all men will come.

3 When we were overwhelmed by sins,
you forgave our transgressions.

4 Blessed are those you choose
and bring near to live in your courts!
We are filled with the good things of your house,
of your holy temple.

5 You answer us with awesome deeds of righteousness,
O God our Savior,
the hope of all the ends of the earth
and of the farthest seas,

6 who formed the mountains by your power,
having armed yourself with strength,

7 who stilled the roaring of the seas,
the roaring of their waves,
and the turmoil of the nations.

8 Those living far away fear your wonders;
where morning dawns and evening fades
you call forth songs of joy.

9 You care for the land and water it;
you enrich it abundantly.
The streams of God are filled with water
to provide the people with grain,
for so you have ordained it.

10 You drench its furrows
and level its ridges;
you soften it with showers
and bless its crops.

11 You crown the year with your bounty,
and your carts overflow with abundance.

12 The grasslands of the desert overflow;
the hills are clothed with gladness.

13 The meadows are covered with flocks
and the valleys are mantled with grain;
they shout for joy and sing.

Getting pretty at the bride's house~

The wedding, getting back on track, and other stuff...

Too much has happened in the last week that I've continued to procrastinate in writing another post! But that's no excuse, so here I am, sitting in clinic in front of Dr. Rashmi's computer, trying to remember the interesting things we've seen and done.

Saturday afternoon, Laurel and I were invited to the bride Sarita's house to have henna drawn on our hands. Actually, it was more like we begged if we could get henna done since it would complete our Indian wedding experience! ;) Sarita is (was) a nurse at Kothara and her father is pastor of a nearby church congregation. We went to her house where a gazillion family members and church members gathered to take part in celebrating her marriage, and we were welcomed by all as if we were part of their community. Part of the reason there were so many ppl there is because the pastor and even his parents have been a part of the Kothara Christian community for a long time. We rode an overloaded autorickshaw with Mitalee, the counselor at Kothara, to their house, where we saw a beautiful canopy in their yard and huge stockpots the size of a grown person from which emanated the most delectable smells. Sister Grace, who is Pastor Silas's sister, introduced us to all of her hundred and one cousins and nieces (or so it seemed). We met Grace a couple weeks ago when she came with her family and a group of students from a Bible college in Amravati of which her husband is president. Apparently, all of her siblings are married to pastors or are pastors. Her family has a really cool testimony, coming from Hindu and Muslim backgrounds.

Anyway, Laurel and I each had a "cousin" draw henna on one of our hands. They spoke English so we chatted with them while they drew gorgeous designs. The henna has a cooling effect on the skin, as well as softening and beautifying the skin as we were told, so it was such a relaxing experience! The multitude of ladies present sat down under the canopy and sang hymns for the bride in the meantime. And then...this is when the craziness, aka "Haldi" ceremony began! Haldi means turmeric in Hindi. Basically, the bridal wedding party and all those present get smeared with moistened turmeric powder, which was smeared on the groom and his party prior to the female members of his family showing up at the bride's house. First the bride and her family get smeared on the face, arms and any other exposed body surface with it, and then other ladies present go around and "beautify" everyone else standing around. Laurel and I tried unsuccessfully to hide in a corner; I guess we kinda stick out! We had yellow faces and necks for two days! After the ceremony, all the guests sat on the floor and ate delicious rice and mutton with raita (yogurt) on leaves as plates. Good thing we've been practicing eating with our hands. As foreigners and as people they had just met a couple weeks ago, we were so honored to take part of the family's wedding festivities.

The wedding itself the next day was a world apart from what we'd experienced the day before. The ceremony was held in the chapel, where Christmas lights and tinsel hung from the rafters. The electricity went out at least ten times during the ceremony, but Laurel and I realized afterwards that after 4 weeks of being here, we've already gotten used to the power outages. It's funny how quickly one becomes accustomed to what was extraordinary before (i.e. monkeys on the roof, multiple power outages per day, twenty ppl hanging off a tiny rickshaw, etc). Haha. Sarita is absolutely gorgeous so we were highly anticipating what the groom was like. :) They were a perfect pair. The whole family walked in with the bride and groom in the procession and sat on stage with them. The couple sat facing the front of the chapel for most of the ceremony while numerous ppl spoke, prayed at the podium and then prayed over them. We couldn't understand most of what was said, but I could definitely appreciate how deeply involved both families were in this marriage, supporting, blessing and asking God's blessings on the pair. Finally, the ceremony was over and the wedding party walked out amidst fake snow and colored rice. A mini-marching band paraded the party over toward the reception tent while thunderous fireworks went off in the night sky. :) The fireworks, BTW, were set off ten feet from the guesthouse...thank God it didn't catch fire. We'll put pics up of the reception because no explanation of mine could do it justice. I'll just say it was extravagant, it was dizzying, it was like going to the fair!

After the excitement of the weekend, Laurel and I were loath to start another working week. We were cranky with each other and in general and sort of lost our excitement in being here. We spend so much of our time reading Harrison's in clinic and not as much time seeing patients (since we can't communicate) that it's been somewhat frustrating. We HAVE started working patients up with one of the opthal students as translators and we HAVE seen some incredible medical conditions. Yesterday we saw a woman who had tuberculosis of the spine (or Potts disease). We see several scabies, worm infestations, and leprosy patients a day. Dr. Steve is one of the dermatologists here and our knowledge of dermatology has vastly improved since starting here. That is to say...my knowledge of derm was next to nil when we began so I now know a few things. Today we had a really sad case of a little 4 year old who we think has cancer. He came in on Saturday with massive ascites, or a hugely swollen belly filled with fluid, and though he was four years old, he looked more like he was two. He was one of the sweetest, cutest little boys I've ever seen. Well, he had an ultrasound of his belly done, which showed a probably malignancy in his liver. So sad. Laurel and I held his hand while he had some of the fluid drained out of his belly to help his breathing and decrease the pressure. He was sooo good while the doctors stuck needles in his belly! He didn't cry or protest. Laurel and I took pictures of him in clinic, and he just laughed and giggled when we showed him the pics. He could not be more delighted to see himself on the screen! We took some play animals to entertain him during the procedure. We don't know what the diagnosis is but we're referring him to a medical college so he can be further treated. So sad. His dad was crying as he left with him in his arms.

So we're being kicked out of the office since they're locking up. I'll have to post more later. L and I are going to Nagpur, the city we flew into from Delhi, to go shopping with Dr. Rashmi and Dr. Jai. We'll get some much needed grocery items...like CHEESE! And some stuff to make cheesecake for Dr. Steve's birthday party on Sunday. So excited. Please pray for travelling mercies. :) I'll post pics of the wedding next time. This pic is of Atish, the little boy. Please pray for him and his family.

Pictures--finally!

This is our guesthouse, which is quite large with about 6 rooms. Laurel and I are fortunate to each have a room with a bathroom! It's pretty noisy at night though, what with monkeys jumping on the metal roof and melodic car horns on the major road by the campus.



This is Dr. Jai Xavier showing us a woman with chronic cataracts that infiltrated the anterior compartment of her eye. We see a lot of severe diseases since the patients come to the hospital only after a long time. In the background is the hardworking aide Lakshman who does everything from bring in patient slips and clean the examination rooms to bring in tea for tea breaks. The doctors call him on the PA system frequently.

These are the adorable "fisher" girls who performed at the Republic Day ceremony.
Our favorite part of the performances.







Central Paratwada! This is where we bought our groceries this past weekend and were spectacles for people to stare at. Little kids came up and said "Good morning, sister!" Laurel and I would definitely NOT be able to find our way around these streets.

The OT --operating theatre. Notice the flip-flops and the short scrubs...hehe.

More pics to come later! For more now, check out my facebook photo album :)

Republic Day of India

Yesterday (Monday) was a national holiday for everyone so we didn't have any clinical duties. We were, however, required to attend the "flag hoisting" ceremony at 8 am. Little did we expect the performance that was to follow! The entire Kothara campus, including the entire medical staff, the hospital inpatients, and all the schoolchildren and teachers at the Kothara school (K-10) were in attendance. The adorable kids in their blue and red uniforms sat in uniform rows on the playground and the rest of us sat on the sidelines on chairs. Several people spoke, one guy (teacher or student?) recited an impressively long poem that I assume was patriotic or something to do with the Republic of India. It was hard to pay attention since it was in Hindi. The flag was already raised but Dr. Xavier had the honor of unfurling it, upon which flower petals showered out from the flag and we did a salute while the band played the anthem. Then the REAL fun began. Specially chosen kids came out in different dance troupes and performed a variety of dances--ranging from traditional Indian dance (as you would see in a Bollywood film) to hip-hop, performed by a group of preteen boys in baggy pants and baseball caps. Our personal favorite was the "fisherman's dance" performed by a group of beautiful young girls clad in colorful baggy clothes and pirate's cap and using fish baskets as part of their dance. It was definitely an entertaining morning. To conclude the ceremony, the staff handed out chocolates to everyone. We decided that in India, we should learn to expect the unexpected. :)
The potluck lunch was absolutely wonderful--the best food we've had thus far. The Anands (the superintendent of the hospital) grilled chicken kabobs, the Xaviers brought mutton and raita (yogurt dish), Masseys brought chicken curry, the X-ray tech and physiotherapists brought bread and Laurel and I brought our key lime/lemon pie. The pie turned out better than we expected and everyone loved it. Dr. Rashmi even said she dreamed about having more of it last night! :) We'd count that as a sign of success. We ended up mixing the lime and lemon juice and substituting graham cracker crust with some cookies but it turned out great nonetheless. Yay!
Once we get my laptop connected, we'll definitely put some pics up. I can't wait for the next potluck...

Leprosy and daily routine so far

It's Saturday afternoon here. We briefly rounded this morning, following the patients who've had tender transfers done (I'll explain that later) and who have ulcers that are healing. Basically, the leprosy bacteria attacks the nerves in the periphery (the hands, feet, and eyes), which are cooler in temperature--perfect environment for the bacteria. Those areas of the body incur damage, thus rendering the patients without sensation or ability to move muscles and tendons. These leprosy patients might walk miles on a blister on their feet until it becomes raw and infected, but they'll either not notice or won't care because it doesn't cause them any pain. They might eventually come to the hospital only to receive leg or finger amputation because of gangrene. We have several patients on the ward now with only stubs left for toes or fingers. Sorry to become so graphic but one particular leprosy patient who's had the disease for a while came in last week with scores of maggots just crawling around in his open foot wound. I got the special job of removing them and cleaning out the ulcer! In case you're curious, turpentine and ether knock the maggots out so that they're easier to remove...just for future reference. And with the smell of gangrenous flesh to go along with the sight, the work is definitely not for the squeamish!



The medical supplies they have here are definitely limited (and usually not what we're used to in the U.S.) but the staff make good use of what they do have. They also have ingenious methods to treat various conditions, some pioneered by Dr. Paul Brand at Christian Medical College in Vellore. For example, the sensation in the cornea (the clear portion on top of your iris and pupil in the eye) is often lost, so the patients don't feel the urge to blink their eyes, leading to dryness and ulceration. The nerve supplying the orbicularis oculi muscle that closes your eyelid is also damaged, so the patients cannot completely close their eyes, a condition called lagopthalmos. So, in order to protect the cornea and prevent complete blindness, surgeons stitch the edges of the eyes to only expose the sclera--a procedure called tarsorraphy. We have seen patients, however, who come in too late with permanent damage to the cornea. As the case with all diseases, the key is early detection and treatment to prevent severe and permanent effects.



One really cool procedure they do during reconstructive surgery camps a few times a year is tendon transfers. The ulnar and median nerves in the arms are often damaged, causing claw hand deformity in leprosy patients. Imagine trying to go about your daily life with your hands stuck in a "clawed" position. It's no wonder that many leprosy patients are reduced to begging since they can't continue whatever occupation they had. So anyway, the damaged and fibrosed nerves in the arms/hands are replaced with healthy ones from elsewhere in their body, in hopes that their fingers will become functional again. The results are absolutely amazing. One guy was sitting on his bed during rounds, just beaming and grinning from ear to ear because he had his cast taken off and his fingers were making waving motions. He was showing us how his fingers were stuck in a claw hand and now is almost fully functional. He's still being kept in the hospital so that he can get daily physical therapy to keep the transfered tendons from becoming stiff and fibrotic as well. Sam, the physical therapist, uses ultrasound and heat from paraffin wax to improve the fingers' mobility. Which leads to a completely different topic :) Sam brought snacks for all the medical staff on Friday because he got his results from his qualifying exam for PT and he'd come in first in his college. Laurel and I have happily noticed that it's a custom here to provide snacks for people anytime something good happens. One staff member became a new dad on Wednesday and he brought yummy fried snacks for everybody. We hope lots of good, auspicious things happen to people while we're here! :) Monday is Republic Day in India, which means that it's a holiday for everyone (yay!) and the staff are having a potluck cookout for lunch. Laurel and I have been assigned dessert so we're attempting key lime and lemon cream pie. The guesthouse kitchen is woefully lacking in kitchen tools and ingredients so we'll have to go to market today and maybe use Dr. Anand's kitchen. I'll give a report on how the potluck goes.



A last minute note: I helped with surgery yesterday in removing 26 sebaceous cysts from a scrotum! Yuck! #1. We had no idea those even existed. Yes, Laurel and I are seeing many things we've not seen before. #2. They reuse gloves, needles, and instruments here!! They sterilize them in an autoclave. Definitely not used to that, since we discard most things in the U.S.--especially latex gloves! #3. They wear rubber flip-flops in the OR!! The outside shoes are taken off and the flip-flops put on before going into surgery. The scrub nurses in the U.S. would flip out if they saw this. #4. The scrubs are really really short. You'll see what I mean when/if we put pictures online. By the way, the OR is called the Operating Theatre, or OT here. Probably a Britishism from the old days when surgeries WERE a spectacle for the public to behold.

As far as outside the hospital, the weather here has been just gorgeous--sunny, with a slight breeze. The campus is filled with flowering trees and greenery. Just beautiful. On the other hand, there are lots of screeching monkeys, some which walk right up to our door and windows and stare at us, and lots of mangy, skinny dogs. The hospital is situated on either side of a small highway, so Laurel and I see interesting scenes: lots of yellow and green autorickshaws with dozens of people stuffed inside, beautiful women wearing gorgeous, brightly-colored saris, cows pulling wagons, and random, roaming cows and goats. There's a line of mountains to the north of us, making for gorgeous scenery. Dr. Steve, a staff physician, said that a group of us could try to tackle one of the mountains one weekend. We can't wait!

Cooking lessons

One of my favorite things about visiting other countries is seeing how other people worship, especially other Christian believers lifting up the name of the Lord in different languages. We've recently gotten the chance to do that, during morning devotions as well as Sunday chapel. Even when things are said in English, Laurel and I have a hard time understanding what's being said due to the heavy Indian accent!

Yesterday we got a rare moment in time with two ladies who cook for the campus. Mrs. M and (I can't remember the name of the other lady) cook delicious meals in mass quantities and put them in Indian lunchboxes called tiffins. We get four rounded metal containers with rice, chapati, daal, and some veggie or meat in heavier sauce delivered to the guesthouse dining room table 2 times a day. Well, we were curious to find out where the food was coming from, so we sauntered over to the kitchen building in the afternoon. The other lady (not Mrs M) was preparing chapatis, which was tortilla-like flatbread, by rolling out dough and cooking it on a large flat pan, flipping them twice before throwing them on a large basket on the floor. They make these daily for everyone on campus. Wow. Well, they both seemed surprised that we were in the kitchen with them. They figured that we were there because the power outage kept us from watching TV! Mrs. M made chai tea for us and then told us about her family--her newborn grandson, her daughter who is a nurse, and her son who is studying abroad. Her English was limited but we could still communicate quite a bit! Laurel and I sat on the floor while Mrs. M and the other cook chopped up vegetables, and we learned the Marati words for the veggies--aloo for potato, gobi for cauliflower, dorkeh for zucchini...and so on. Mrs. M then brought out a praise songbook which had both Marati and English, so we sang familiar praise songs together--she in Marati, we in English. When the power came back on, Mrs. M said, "you watch TV now?" She didn't realize that spending an hour with her was far more entertaining than any TV show! Maybe by the time we leave, they'll be kind enough to give us some cooking lessons!

Happy, rested and well-fed

We arrived in Kothara yesterday evening and have settled in, meeting various staff at the hospital and getting adjusted to being here. Kothara is situated in a beautiful area, just next to some small mountains in central Maharashtra. The weather is absolutely perfect--like a nice, breezy summer day in May. We walked around the leprosy ward this morning and saw some amazing things, then attended a conference reviewing 2008 stats--finances, no of pts treated, admissions, etc. It was almost three hours but it gave us a good idea of what activities the hospital carried out and the scope of work it does. Laurel and I especially liked the yummy, warm samosa-ish snacks they gave out during the review. Tomorrow we attend chapel and rest some more before starting out a busy week!

Our internet access here has been unpredictable because my computer is not working on the network here, as of yet. We hope to get wireless access at our guesthouse next week, but it's not for sure. I have so much more to write but I'll add more later, since I'm writing from Dr Anand's laptop. Dr. Anand is the superintendent of the hospital here and she is superwoman. I'm sure of it. She has administrative duties, meetings to prepare for, visit to TLM in Delhi to prepare for, clinical duties, and a family to cook for. I look forward to getting to know her and her family in the next several weeks.

Going to Agrrraa!

Today we got an eight-hour experience with the absolute craziness that is Indian driving. You hear about all the crazy driving in various places around the world, but it's different when you're actually in the car and you barrel toward a dump truck/rickshaw/bicyclist, just missing them by an inch. Our driver Ahmed, as the other drivers on the road, had his hand constantly on the horn, since here, it's polite to honk at other drivers, for example, to let them know that you are passing them, when they're in your way, or when you're about to hit them! Sometimes, it seemed like he honked for no reason! Laurel and I were picked up this morning at 7 by a tour van for Agra to visit the Taj Mahal. The drive was really half the fun because we saw more of India and its people today than before. For one thing, we were told by a TLM person that the drive would be smooth, since we'd be on a highway all the way there. However, it was a 120 mi journey that took over 4 hrs! Every several miles or so we'd hit major traffic, meaning not only a jumble of cars but also rickshaws, camels pulling carts, wandering cows, bicycles and people dashing into the road. The tour van also picked up a couple of other passengers--an American man from CT and a woman from Austria. It was good having the fellow travelers, as they brought good conversation and humor! The driver used the word "my" in front of various places or objects, such as "this is my temple" or "this is my resort. this is my company" when we stopped for food. It was only later when he said "this is my lunch. You will come here later" in front of a fancy hotel, that we realized he meant the word as a general term NOT as a possessive. We were probably being ugly foreigners by laughing, but we couldn't help it and it only made us like him more! He spoke much better English than any of us could speak Hindi or the other languages he probably spoke.

The Taj Mahal probably deserves a post all by itself. It was breathtaking, but too postcard perfect. I wished I could remember the details from my college class when we studied the architecture and history. Walking out from all that grandeur, I felt a twinge of guilt as the kids and paraplegic beggars hawked things for money. The natural response is to give, of course, as they tried all kinds of tactics to get us to sympathize but we were advised not to. I wonder if the money would actually go to them or to some other person who takes advantage of them. Even if the beggars make a "decent" living here, none of them eat more than their fill for sure. Everyone except the tourists seem malnourished---the kids, the cows, the dogs....all skin and ribs. Laurel read from a book that half of the kids in India under 3 yrs old are malnourished. I'm not surprised after today, but it makes me cry.

Namaste!

Praise God! We made it safely to Delhi after a 13 hr flight. We got in last night and couldn't really see much of the city for the fog/smog(?). We are staying for another two nights at the YWCA before we fly to Nagpur on Friday. First impression? The poverty is quite stark in comparison with the "posh" hotels and residencies around. The international airport itself was smaller than I expected and pretty run-down, which surprised me. The beggars outside and the smell of urine in the parking lot was difficult to ignore. Yet the warmth and friendly curiosity of our taxi driver put us relatively at ease as we tried not to look at the crazy, death-defying maneuvers of the drivers here! I am so excited to be starting this journey. It's finally sinking in that we are in India. We'll have more stories to come, but breakfast calls for now! :)

NYC

Sitting here at 'snice--a little vegan/vegetarian eatery in Greenwich village--with my good friends Laurel and Sam. What a treat! I get to hang out for a few hours with my friend who just moved to NYC. This place is interesting...they have random words posted on the wall...here in front of me are the words NEW. PROUD. SUPERB. REALIZE. Hmmm? Do with them as you wish...^^

So far, the trip has been fantastic. Praise God! I think it still hasn't hit Laurel and me that we're actually going. We're gonna try to stay up during the whole flight, since we get into Delhi at 9pm and will need to sleep when we get there! :)

Anyway, thank you for praying! I'll post again when we get there.

One more day til takeoff!

The trip that Laurel and I have been planning for many months is (almost) finally here! Praise God! There were a few moments when we weren't sure we'd be going, and we've had our share of convincing/reassuring family about why we are going and whether we'd be safe, but, Lord willing, we are gett-ing-on-a-jet-plane...on Monday. And, Lord willing, we will be back the first week in March.

Of course, we realize that nothing and nowhere is perfectly safe, but, as our missions pastor said, the safest place to be is in God's will. It's when we are out of his will that we are not 'safe.' Indeed, we will be taking precautions in order to prevent looking terribly like a tourist, including hair dyeing on Laurel's part, local clothes on both of us, and avoiding expensive hotels (the easiest part). :)

I am overjoyed at the prospect of seeing him at work in the midst of suffering and poverty and look forward to meeting those who humbly and faithfully serve as his hands and feet to those who need healing. And I hope, at least for a while, to learn to let go of my materialistic and schedule-driven tendencies to focus on people and loving them as Christ does. While packing and moving some of her things to Hien's/my place, Laurel commented on how much useless stuff she'd accumulated and how realizing that made her feel guilty. I must concur. Although all of my worldly possessions fit in my smallish room, I know by just looking around that MOST of the things I buy are unnecessary. Acchh...consumerism! Anyway, we hope that in the middle of India, away from normal routine, TV, constant internet, instant gratification-everything!, family and friends, we'll take to heart what it means to be strangers in the world---to have our eyes fixed on the eternal.

Depending on the internet availability, I will try to keep this blog updated throughout the 7 weeks we are there (and maybe put pics up but NO promises). I hope that you will partner with us in prayer as we serve at Kothara Community Hospital and in the region of central Maharashtra state.