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!