Just a quick note to say that we are back in the good ole USA! Only a few events occurred between my last email and this one. We had no problems with travel - The Lord took good care of us and returned safely.
Overall the trip was one of rest, focus on God, a time to make connections for our church to return to Bolivia for a pastor's conference this summer, and of evangelism to locals, patients, and doctors; a humbling (in the sense of not being used much medically) trip, and one that we gained experience (which i heard defined as "something you get when things don't go as planned") in another culture and rely upon The Lord to do what He has planned. We appreciate all of your prayers and support, and look fwd to answering some of your emails and calls. For me a verse that has been in my head for days is "God opposes the proud, but gives grace to the humble." - as God is continually breaking down my pride.
On the way home we were able to visit the historical Macchu Piccu (one of the last cities of the Incas high in the Andes mountains). The mountains in Bolivia and Peru are beautiful - jungle like terrain with dense undergrowth in Peru, leading up to snow caps in the highest mountains.
To get to the site, the only access is a winding train through the mountains. This provided for a God-sent interaction with a fellow we met, who sat directly across from me on the train. Kristen and i were both able to tell him about the greatest man in history, who came into this world to save the lost. He already had lots of ?s ready to be asked - as it seems back home he had no one to ask. We began by simply letting him know why we went to Bolivia - to share the gospel with the people there. To let them know our stories of how He has worked in our lives -e.g. - that He opened my eyes to show me that i was living my life in rebellion to a holy and just God who has given me everything (life, breath...) and that i have broken his commandments, and the Bible clearly shows the penalty for that is death, an eternal separation in Hell apart from God - which, of course, is all bad news. But, John 3:16 let s me know that He loved us so much, He came down here, to take the penalty for me - to die for me - and that i have eternal life by believing upon His work - not my good deeds, but trusting that He died for me, and that His work on the cross is all i need to enter heaven (there is nothing i can do to earn such a gift - only He can merit it)... anyway, He asked lots of typical ?s - like what about al the other religions, and do we believe they are the same or not - well, we just answered with scripture (it doesn't matter what i think, it matters what God says) - "I am the way, the truth, and the life. No one comes to the Father apart from me?" - words of Jesus in John 14:6. I believe it was a divine interaction that God used to speak into this man's life - that was one of the highlights of our return trip.
If you ever plan to visit Macchu Piccu in Peru - book it early!!!! That was another lesson learned.
Sunday, May 4, 2008
Machu Picchu!
Matt and I had a great time at Machu Picchu..it was beautiful! We also had an awesome conversation with a Canadian about Christ on the four hour train ride.
Our whirl wind tour...La Paz, Bolivia to Cuzco,Peru to Machu Piccu to Lima, Peru!
see pics at
www.snapfish.com
user: sorensenk@uthscsa.edu
password: india
Our whirl wind tour...La Paz, Bolivia to Cuzco,Peru to Machu Piccu to Lima, Peru!
see pics at
www.snapfish.com
user: sorensenk@uthscsa.edu
password: india
Wednesday, April 23, 2008
Bolivia!
Dear Family and Friends,
I hope you all had a good week. Sorry for the delayed email, the internet doesn´t always work (nor the water or electricity, but our needs are well cared for).
Last week we worked at the hospital most mornings with various doctors. One morning Matt shared his testimony and I translated and we both drew out the gospel and interacted with the patients in the waiting room. God was good to open many opportunities after morning rounds this week to share our testimony and the gospel with the patients here. Many of them know Christ and are living for Him, but there are also many who do not Him and who are trusting in their good works to get them into heaven instead of trusting in the fact that Christ did everything through his death and resurrection so we could spend eternity with Him.
On Thursday, we went with a local physician into the mountains to provide medical treatment to the children at a school in Mal Pasos, which means ´´bad paths´´ which is ironic because we off roaded for over an hour up the mountain along the dirt trail to the village which is at an altitude 15,000 ft! We were definitely out of breath after hiking to the school where we provided medical treatment for the children and people in the village. Most of the people live in very small stone homes (literally a village made out of stones, like Bedrock on the Flinstones), speak Cetchua, and have a stream as their only source of water. Matt and I really enjoy doing medical missions in this enviornment so we were very excited. First we educated the Children about the importance of sanitation, washing their hands, using boiled water, and then we shared the gospel with them. After, we split up into teams, saw a lot of patients with diarrhea, and Matt was able to use his manipulation skills on a woman´s sacrum. It was a bit disorganized but we enjoyed serving the children in the mountains, which were beautiful. The school was very grateful and invited us back.
We have also been going to various orphanages in town. There are an overwhelming number of orphans. At one place we held babies and played with the children to show the love Christ has for His children.This orphanage was started by a very young Christian woman from the U.S who has served there for over 4 years. I really enjoyed carrying around one little baby who was wearing a cute Pooh blanket.
Another orphanage that we went to had 70 boys only. The orphanage is run by Bolivian Christians who are mainly supported by American donations. The boys all attend school, help with the chores, and are well organized. I was impressed as to how well behaved the boys were. Matt really enjoyed playing soccer with them with the Andes in the background! THis is a great organization as they bring up these abused and neglected children by helping them through their traumatic past and teaching them about their heavenly Father who will never desert or mistreat them. Thus, most are believers and desire to serve God in missions someday! Please pray that God would continue to provide for these orphans and that they would understand that they have a heavenly Father who loves them very much! Matt 19´13,14.
¨Kid Washing¨
This was started by a local Christian Bolivian man who felt God leading hime to provide baths for the children who live on the streets. We washed over 40 kids. God has totallly provided all the funds and volunteers both American and Bolivian, for him to set up a tent with small baths for the children. Every Saturday he brings a huge generator to warn the water and set up a tent with 3 small baths. The children are bathed with soap and water individually in the tubs by the women, given clean clothes, have their hair styled, and given bread and mild. It is an awesome display of the body of Christ serving the poor. I helped to bath the children while singing Jesus songs to them in Spanish and Matt was vital in sharing the gospel with the mothers and using his strength to carry and pour out the water.
CIC church,
We were able to worship this past sunday with many of the local missionaries and a great growing church that is a mix of both Bolivians and missionaries. The church is an oasis for local and short term missionaries. They have a vision to equip other local pastors by having confereces at the church ' to basically provide some formal bible training and fellowship as most of the pastors here have no formal bible-seminary training and little or no accountability or fellowship. As this is also a passion of our pastor in harlingen, we feel we have made many contacts for our home church to return and continue such ministries. It is unfortunate that many of the local chrisitians have do not reach out a lot to their fellow bolivians. This is due to their culture, which doesn´t reach out much, but who are more focused on making a living, providing food, and helping their own family. However, CIC has begun taking locals out to minister into the jungle areas and they are loving it, catching the vision to serve. They are doing a great job supporting the goal most ministries have, which is to get the local christians to reach out locally.
I think God is bringing us back to the basics, God is teaching us to be patient in the midst of a different culture. To rest and to listen to His voice, something I feel we take little time for in America. To love the Lord our God and to love others Matt 22 37 40 and John 13 34 35, those being the greatest commandment according to Jesus, as they sum up the rest. Not an easy task, but somewhat simplifies life. We often forget that loving the Lord means sitting quietly and patiently at his feet, another not so easy task for our driven culture!
Feel free to share what is going on in your lives, we love to hear from you! We will be returning home in a few days - sunday afternoon. Thank you for all of your emails and prayers, we really appreaciate the body of Christ - what an awsome family!
Matt and Kristen
I hope you all had a good week. Sorry for the delayed email, the internet doesn´t always work (nor the water or electricity, but our needs are well cared for).
Last week we worked at the hospital most mornings with various doctors. One morning Matt shared his testimony and I translated and we both drew out the gospel and interacted with the patients in the waiting room. God was good to open many opportunities after morning rounds this week to share our testimony and the gospel with the patients here. Many of them know Christ and are living for Him, but there are also many who do not Him and who are trusting in their good works to get them into heaven instead of trusting in the fact that Christ did everything through his death and resurrection so we could spend eternity with Him.
On Thursday, we went with a local physician into the mountains to provide medical treatment to the children at a school in Mal Pasos, which means ´´bad paths´´ which is ironic because we off roaded for over an hour up the mountain along the dirt trail to the village which is at an altitude 15,000 ft! We were definitely out of breath after hiking to the school where we provided medical treatment for the children and people in the village. Most of the people live in very small stone homes (literally a village made out of stones, like Bedrock on the Flinstones), speak Cetchua, and have a stream as their only source of water. Matt and I really enjoy doing medical missions in this enviornment so we were very excited. First we educated the Children about the importance of sanitation, washing their hands, using boiled water, and then we shared the gospel with them. After, we split up into teams, saw a lot of patients with diarrhea, and Matt was able to use his manipulation skills on a woman´s sacrum. It was a bit disorganized but we enjoyed serving the children in the mountains, which were beautiful. The school was very grateful and invited us back.
We have also been going to various orphanages in town. There are an overwhelming number of orphans. At one place we held babies and played with the children to show the love Christ has for His children.This orphanage was started by a very young Christian woman from the U.S who has served there for over 4 years. I really enjoyed carrying around one little baby who was wearing a cute Pooh blanket.
Another orphanage that we went to had 70 boys only. The orphanage is run by Bolivian Christians who are mainly supported by American donations. The boys all attend school, help with the chores, and are well organized. I was impressed as to how well behaved the boys were. Matt really enjoyed playing soccer with them with the Andes in the background! THis is a great organization as they bring up these abused and neglected children by helping them through their traumatic past and teaching them about their heavenly Father who will never desert or mistreat them. Thus, most are believers and desire to serve God in missions someday! Please pray that God would continue to provide for these orphans and that they would understand that they have a heavenly Father who loves them very much! Matt 19´13,14.
¨Kid Washing¨
This was started by a local Christian Bolivian man who felt God leading hime to provide baths for the children who live on the streets. We washed over 40 kids. God has totallly provided all the funds and volunteers both American and Bolivian, for him to set up a tent with small baths for the children. Every Saturday he brings a huge generator to warn the water and set up a tent with 3 small baths. The children are bathed with soap and water individually in the tubs by the women, given clean clothes, have their hair styled, and given bread and mild. It is an awesome display of the body of Christ serving the poor. I helped to bath the children while singing Jesus songs to them in Spanish and Matt was vital in sharing the gospel with the mothers and using his strength to carry and pour out the water.
CIC church,
We were able to worship this past sunday with many of the local missionaries and a great growing church that is a mix of both Bolivians and missionaries. The church is an oasis for local and short term missionaries. They have a vision to equip other local pastors by having confereces at the church ' to basically provide some formal bible training and fellowship as most of the pastors here have no formal bible-seminary training and little or no accountability or fellowship. As this is also a passion of our pastor in harlingen, we feel we have made many contacts for our home church to return and continue such ministries. It is unfortunate that many of the local chrisitians have do not reach out a lot to their fellow bolivians. This is due to their culture, which doesn´t reach out much, but who are more focused on making a living, providing food, and helping their own family. However, CIC has begun taking locals out to minister into the jungle areas and they are loving it, catching the vision to serve. They are doing a great job supporting the goal most ministries have, which is to get the local christians to reach out locally.
I think God is bringing us back to the basics, God is teaching us to be patient in the midst of a different culture. To rest and to listen to His voice, something I feel we take little time for in America. To love the Lord our God and to love others Matt 22 37 40 and John 13 34 35, those being the greatest commandment according to Jesus, as they sum up the rest. Not an easy task, but somewhat simplifies life. We often forget that loving the Lord means sitting quietly and patiently at his feet, another not so easy task for our driven culture!
Feel free to share what is going on in your lives, we love to hear from you! We will be returning home in a few days - sunday afternoon. Thank you for all of your emails and prayers, we really appreaciate the body of Christ - what an awsome family!
Matt and Kristen
Monday, April 14, 2008
Bolivia!
greetings friends,
Here is are some emails from Matt and I!
thank you for your prayers. we really appreciate them.
Bolivia is a very beautiful country with the Andes mountains and temperate climate. The city we are in, Cochabamba, is basically an eternal spring weather in my book. It is currently Fall here as we are below the equator, but the weather and flowers are springish. most days start cool - around 60, and increase to about the upper 80s. The altitude is over 8000 ft, so the sun is very bright when out. The city basically sits in a valley surrounded by green, grass covered mountains, with a few rugged peaks containing snow filled crags. Behind the hospital is a strong display of the green mountain and spring flowers on our grounds.
Many of the indiginous rural peoples grow flowers to take into town and sell. It isn´t unusual to see a field full of Iris´s or other multicolored flowers. The women typically are the ones who tend to the field. Men also work sometime, but usually only for the harder manual labor such as plowing or moving the cattle. yes, many have diary cattle for milk and plowing, but only a couple. Some cannot afford that luxury. Homes in these rural areas are on mountainsides (not steep), built out of concrete, brick and wood. Some older buildings are built of mud/clay bricks - i will try to show some pictures once i return. Do to working outside contantly under the bright sun, the `people age quickly, and apparently get skin cancers frequently, although i have yet to see any. The indiginious peoples are short, with typical wear that i will post once at home. Most seem very calm, with friendly demeanors. Of course, within the busy city itself, there are those who are less warm, but for the most part everyone keeps to themselves. The city is much like Mexico, but somewhat cleaner and better observance of some (not all) traffic laws. Each city has a center, which consists of what we would call a city square, with many benches and green grass and trees to provide shade. People congregate around these areas, including many street vendors with local foods, as well as typical items needed within the home, plus bootleg CDs and DVDs - again, much like a mexican market.
The foods here are varied. We have eaten both chicken and beef dishes, usually with rice or potatoes. Saturday we had some Saltenas, which are like a beef soup enclosed within a sweet bread, that was very tasty. Interestingly, their ¨picante¨foods are actually quite mild. I guess they don´t have the jalapenos we often see in >Tex-Mex. There are also many local fruits grown in this climate - some of which no one can explain due there originality. Just like many other countries, they like to fry bananas. Apparently we are going to eat some yucca and llama tonight?! They also have a burger king and pizzeria downtown if we need american foods. However, the city of cochabamba is actually about 45 min away. We ride in small vans, that resemble the old VW van for all of you hippy type, in which we pack about 15 into what should probably be about a 8 person vehicle, and, if you are over 5´5¨, there is no leg room. It is very cheap - costing about 20-25 cents to ride about 20 kilometers. This transportation style is giving us a loook at what it is like to live in a big city. Most people do not own cars. Most of the food costs about a 1/4-1/3 of the cost of USA.
The hospital - well, Kristen mentioned a bit of it below. They really do not have much patient volume, which is quite surprising. I can explain more of that later. Essentially, the hospital is out of the city a bit, and not as well known as needed. Many of the patients are from the Adventist University right around the corner, and so far seem to know the Lord. There is an on fire charismatic chaplain who preaches interactively with the waiting patients each am, and seems to do a great job. The doctors here who are Christians seem to leave sharing the gospel to him. I have been able to see some cases here, including typhoid, some lab pathology showing malaria, TB, cryptosprodiosis, trichomonas, and some typical problems such as abscesses, osteomyelitis, COPD, ruptured appedix, cholecystitis, and multiple ortho injuries, including 2 clavicle fractures from apparently the most dangerous activity in Bolivia - futbol (Soccer)! Don´t worry mom and dad, i haven´t played... yet. Unfortunately, i have no crazy medical stories to tell due to low number of patients. Will continue to keep you updated as able. >Thank you again for your prayers.
We are doing well. This has been a bit of a different experience than we thought it would be. God is good and we´re trying to just trust Him. We don´t have much access or time to do internet so I´m sorry for the short message.
I am a bit trapped at the hospital and our house because it isn´t safe to go out alone. So I go wherever Matt goes which is a blessing to have him here. God is giving me a rest from running and more rest in general which is a blessing.
I shared my testimony in Spanish to the patients waiting in the waiting room the other day and I gave a presentation on the Chagas disease. We´ve gotten to share our faith with the patients and with some of the Bolivians in the street. We have also seen some cool surgeries. The other day we went to an orphanage to share Christ with the kids and play with them.
The other girls that are volunteering here (they are 4th year med students) are really sweet. Our house hosts (Iris and Thomas) live at the guest house with us, cook some of our meals, and are very kind. Their little girl is also adorable.
We are trying to make connections with the different churches and missionaries here because our pastor in Harlingen is coming to Bolivia in August to do a pastors conference. They supported us quite a bit which was a huge blessing.
Bolivia is beautiful with all the all the Mts. but is a very poor country. The hospital is a bit lacking in patients and we are observers which is pretty frustrating (esp for Matt). Also, few of the Drs. speak English so I´m translating as best as I can.
I am enjoying the beauty and rest, speaking Spanish, and spending lots of time with Matt.
Please pray that God would show us our purpose here, open doors to share our faith, joy in the midst of frustration, and that our relationship would continue to grow.
We got to see the Christ on the hill (which is larger than the one in Rio de Janiero!)and also watch a Bolivian soccer game which was very cool.
Hope all is well with you all! I love you all lots. Email me prayer requests!
Matt and Kristen
Here is are some emails from Matt and I!
thank you for your prayers. we really appreciate them.
Bolivia is a very beautiful country with the Andes mountains and temperate climate. The city we are in, Cochabamba, is basically an eternal spring weather in my book. It is currently Fall here as we are below the equator, but the weather and flowers are springish. most days start cool - around 60, and increase to about the upper 80s. The altitude is over 8000 ft, so the sun is very bright when out. The city basically sits in a valley surrounded by green, grass covered mountains, with a few rugged peaks containing snow filled crags. Behind the hospital is a strong display of the green mountain and spring flowers on our grounds.
Many of the indiginous rural peoples grow flowers to take into town and sell. It isn´t unusual to see a field full of Iris´s or other multicolored flowers. The women typically are the ones who tend to the field. Men also work sometime, but usually only for the harder manual labor such as plowing or moving the cattle. yes, many have diary cattle for milk and plowing, but only a couple. Some cannot afford that luxury. Homes in these rural areas are on mountainsides (not steep), built out of concrete, brick and wood. Some older buildings are built of mud/clay bricks - i will try to show some pictures once i return. Do to working outside contantly under the bright sun, the `people age quickly, and apparently get skin cancers frequently, although i have yet to see any. The indiginious peoples are short, with typical wear that i will post once at home. Most seem very calm, with friendly demeanors. Of course, within the busy city itself, there are those who are less warm, but for the most part everyone keeps to themselves. The city is much like Mexico, but somewhat cleaner and better observance of some (not all) traffic laws. Each city has a center, which consists of what we would call a city square, with many benches and green grass and trees to provide shade. People congregate around these areas, including many street vendors with local foods, as well as typical items needed within the home, plus bootleg CDs and DVDs - again, much like a mexican market.
The foods here are varied. We have eaten both chicken and beef dishes, usually with rice or potatoes. Saturday we had some Saltenas, which are like a beef soup enclosed within a sweet bread, that was very tasty. Interestingly, their ¨picante¨foods are actually quite mild. I guess they don´t have the jalapenos we often see in >Tex-Mex. There are also many local fruits grown in this climate - some of which no one can explain due there originality. Just like many other countries, they like to fry bananas. Apparently we are going to eat some yucca and llama tonight?! They also have a burger king and pizzeria downtown if we need american foods. However, the city of cochabamba is actually about 45 min away. We ride in small vans, that resemble the old VW van for all of you hippy type, in which we pack about 15 into what should probably be about a 8 person vehicle, and, if you are over 5´5¨, there is no leg room. It is very cheap - costing about 20-25 cents to ride about 20 kilometers. This transportation style is giving us a loook at what it is like to live in a big city. Most people do not own cars. Most of the food costs about a 1/4-1/3 of the cost of USA.
The hospital - well, Kristen mentioned a bit of it below. They really do not have much patient volume, which is quite surprising. I can explain more of that later. Essentially, the hospital is out of the city a bit, and not as well known as needed. Many of the patients are from the Adventist University right around the corner, and so far seem to know the Lord. There is an on fire charismatic chaplain who preaches interactively with the waiting patients each am, and seems to do a great job. The doctors here who are Christians seem to leave sharing the gospel to him. I have been able to see some cases here, including typhoid, some lab pathology showing malaria, TB, cryptosprodiosis, trichomonas, and some typical problems such as abscesses, osteomyelitis, COPD, ruptured appedix, cholecystitis, and multiple ortho injuries, including 2 clavicle fractures from apparently the most dangerous activity in Bolivia - futbol (Soccer)! Don´t worry mom and dad, i haven´t played... yet. Unfortunately, i have no crazy medical stories to tell due to low number of patients. Will continue to keep you updated as able. >Thank you again for your prayers.
We are doing well. This has been a bit of a different experience than we thought it would be. God is good and we´re trying to just trust Him. We don´t have much access or time to do internet so I´m sorry for the short message.
I am a bit trapped at the hospital and our house because it isn´t safe to go out alone. So I go wherever Matt goes which is a blessing to have him here. God is giving me a rest from running and more rest in general which is a blessing.
I shared my testimony in Spanish to the patients waiting in the waiting room the other day and I gave a presentation on the Chagas disease. We´ve gotten to share our faith with the patients and with some of the Bolivians in the street. We have also seen some cool surgeries. The other day we went to an orphanage to share Christ with the kids and play with them.
The other girls that are volunteering here (they are 4th year med students) are really sweet. Our house hosts (Iris and Thomas) live at the guest house with us, cook some of our meals, and are very kind. Their little girl is also adorable.
We are trying to make connections with the different churches and missionaries here because our pastor in Harlingen is coming to Bolivia in August to do a pastors conference. They supported us quite a bit which was a huge blessing.
Bolivia is beautiful with all the all the Mts. but is a very poor country. The hospital is a bit lacking in patients and we are observers which is pretty frustrating (esp for Matt). Also, few of the Drs. speak English so I´m translating as best as I can.
I am enjoying the beauty and rest, speaking Spanish, and spending lots of time with Matt.
Please pray that God would show us our purpose here, open doors to share our faith, joy in the midst of frustration, and that our relationship would continue to grow.
We got to see the Christ on the hill (which is larger than the one in Rio de Janiero!)and also watch a Bolivian soccer game which was very cool.
Hope all is well with you all! I love you all lots. Email me prayer requests!
Matt and Kristen
Friday, February 15, 2008
Leprosy info.
Leprosy: (Hansen’s disease).
Leprosy is a chronic inflammatory disease caused by Mycobacterium leprae infecting macrophages and peripheral nerve Schwann cells.
It’s presentation and progress are determined by the patient’s cell mediated immune response to the mycobacterium. Most people (~95% develop an effective immune response to clear the M.leprae. The minority that cannot mount this immune response develop clinical leprosy.
Clinical Features of leprosy:
Classification Spectrum of Immune response Skin Lesion Nerve Involvement
Indeterminate Solitary hypo pigmented 2-5 cm lesion. Centre may show sensory loss. May become TT like. None clinically detectable.
Tuberculoid
(TT)
paucibacillary Strong but ineffective immune response to the bacteria which damages peripheral nerves and skin Lesions with well defined borders and sensory loss.
Patch is dry (loss of sweating) and hairless. May have one peripheral nerve affected. Occasionally presents as a mono-neuropathy.
Borderline Tuberculoid
(BT) Varying immunity and bacterial loads. Irregular plaques with raised edges and sensory loss.
Satellite lesions at the edges. Asymmetrical peripheral nerve involvement.
Borderline
(BB) Varying immunity and bacterial loads Many lesions with punched out edges. Satellites are common. Widespread nerve enlargement. Sensory and motor loss.
Borderline Lepromatous
(BL) Varying immunity and bacterial loads Many lesions with diffuse borders and variable anesthesia. Widespread nerve enlargement. Sensory and motor loss.
Lepromatous
(LL)
multibacillary Cellular anergy towards M.leprae with abundant bacillary multiplication. Numerous nodular skin lesions in a symmetrical distribution. Lesions are not dry or anesthetic. There are often thickened shiny earlobes, loss of eyebrows, and skin thickening. Widespread nerve enlargement. Sensory and motor loss.
Presentation:
1. Skin lesions
2. Nerve Damage: Weakness and Numbness occurs in the peripheral nerve trunks. Great auricular nerve, ulnar nerve (elbow), radial cutaneous nerve (wrist), median nerve (wrist), lateral popliteal nerve (neck of the fibula), and posterior tibial nerve (medial malleolus) lead to regional sensory and motor loss. Small dermal nerves are also involved producing patches of anesthesia in TT/BT lesions and glove and stocking sensory loss in LL patients.
3. A burn or ulcer in an anesthetic hand or foot
4. Borderline patients: nerve pain, sudden palsy, multiple new skin lesions, pain in the eye, or systemic febrile illness.
5. Ulceration and digit loss is due to secondary damage in neuropathic hands and feet.
Transmission:
Untreated patients discharge bacilli from he nose.
Infection- M.leprae invades via the nasal mucosa with hematogenous spread to skin and nerve. Leprosy bacilli can survive for several days in the environment.
People in contact with people have a greater but still small chance of becoming infected.
Incubation period is 2-5 yrs. For TT and 8-12 yrs for LL cases.
Diagnosis:
1. Macular hypo pigmented, hypo aesthetic lesion skin lesions.
2. Nerve enlargement
3. Positive skin smear for Acid Fast Bacilli
*Test Skin lesions for sensation.
*Palpate peripheral nerves to assess enlargement and tenderness.
*Assess nerve function b testing the small muscles’ power and sensation in hands and feet.
*Check eye function- Visual acuity, corneal sensation, and eyelid closure.
* Serology is not helpful.
Management:
1.Chemotherapy to treat the infection:
Leprosy Type Drug: Monthly Supervised Drug: Daily self administered Treatment Duration
Paucubacillary (2-5 skin lesions) Rifampicin 600mg Dapsone 100mg 6 months
Multibacillary (>5 lesions) Rifampicin 600mg Clofazimine 50 mg 12 months
Clofazimine 300mg Dapsone 100mg
2. Educate the patient: Patients are non-infectious within 72 hours and can lead a normal life. No limitations on touch. This is not a punishment from God. Deformities are not a result of the disease but due to the patients lack of sensation and harm without knowing it.
3.Prevent disability: Monitor sensation and muscle power in pts. Hand, feet, and yes as part of routine follow up so that new nerve damage is detected early. Treat any new damage with Prednisolone 40 mg daily, reducing by 5mg/day each month. Protect hands and feet!!
4. Support the patient socially and psychologically.
Leprosy is a chronic inflammatory disease caused by Mycobacterium leprae infecting macrophages and peripheral nerve Schwann cells.
It’s presentation and progress are determined by the patient’s cell mediated immune response to the mycobacterium. Most people (~95% develop an effective immune response to clear the M.leprae. The minority that cannot mount this immune response develop clinical leprosy.
Clinical Features of leprosy:
Classification Spectrum of Immune response Skin Lesion Nerve Involvement
Indeterminate Solitary hypo pigmented 2-5 cm lesion. Centre may show sensory loss. May become TT like. None clinically detectable.
Tuberculoid
(TT)
paucibacillary Strong but ineffective immune response to the bacteria which damages peripheral nerves and skin Lesions with well defined borders and sensory loss.
Patch is dry (loss of sweating) and hairless. May have one peripheral nerve affected. Occasionally presents as a mono-neuropathy.
Borderline Tuberculoid
(BT) Varying immunity and bacterial loads. Irregular plaques with raised edges and sensory loss.
Satellite lesions at the edges. Asymmetrical peripheral nerve involvement.
Borderline
(BB) Varying immunity and bacterial loads Many lesions with punched out edges. Satellites are common. Widespread nerve enlargement. Sensory and motor loss.
Borderline Lepromatous
(BL) Varying immunity and bacterial loads Many lesions with diffuse borders and variable anesthesia. Widespread nerve enlargement. Sensory and motor loss.
Lepromatous
(LL)
multibacillary Cellular anergy towards M.leprae with abundant bacillary multiplication. Numerous nodular skin lesions in a symmetrical distribution. Lesions are not dry or anesthetic. There are often thickened shiny earlobes, loss of eyebrows, and skin thickening. Widespread nerve enlargement. Sensory and motor loss.
Presentation:
1. Skin lesions
2. Nerve Damage: Weakness and Numbness occurs in the peripheral nerve trunks. Great auricular nerve, ulnar nerve (elbow), radial cutaneous nerve (wrist), median nerve (wrist), lateral popliteal nerve (neck of the fibula), and posterior tibial nerve (medial malleolus) lead to regional sensory and motor loss. Small dermal nerves are also involved producing patches of anesthesia in TT/BT lesions and glove and stocking sensory loss in LL patients.
3. A burn or ulcer in an anesthetic hand or foot
4. Borderline patients: nerve pain, sudden palsy, multiple new skin lesions, pain in the eye, or systemic febrile illness.
5. Ulceration and digit loss is due to secondary damage in neuropathic hands and feet.
Transmission:
Untreated patients discharge bacilli from he nose.
Infection- M.leprae invades via the nasal mucosa with hematogenous spread to skin and nerve. Leprosy bacilli can survive for several days in the environment.
People in contact with people have a greater but still small chance of becoming infected.
Incubation period is 2-5 yrs. For TT and 8-12 yrs for LL cases.
Diagnosis:
1. Macular hypo pigmented, hypo aesthetic lesion skin lesions.
2. Nerve enlargement
3. Positive skin smear for Acid Fast Bacilli
*Test Skin lesions for sensation.
*Palpate peripheral nerves to assess enlargement and tenderness.
*Assess nerve function b testing the small muscles’ power and sensation in hands and feet.
*Check eye function- Visual acuity, corneal sensation, and eyelid closure.
* Serology is not helpful.
Management:
1.Chemotherapy to treat the infection:
Leprosy Type Drug: Monthly Supervised Drug: Daily self administered Treatment Duration
Paucubacillary (2-5 skin lesions) Rifampicin 600mg Dapsone 100mg 6 months
Multibacillary (>5 lesions) Rifampicin 600mg Clofazimine 50 mg 12 months
Clofazimine 300mg Dapsone 100mg
2. Educate the patient: Patients are non-infectious within 72 hours and can lead a normal life. No limitations on touch. This is not a punishment from God. Deformities are not a result of the disease but due to the patients lack of sensation and harm without knowing it.
3.Prevent disability: Monitor sensation and muscle power in pts. Hand, feet, and yes as part of routine follow up so that new nerve damage is detected early. Treat any new damage with Prednisolone 40 mg daily, reducing by 5mg/day each month. Protect hands and feet!!
4. Support the patient socially and psychologically.
Tuesday, February 12, 2008
PICS
Hey Everyone!
I'm back safely and have uploaded pics
www.snapfish.com
email: sorensenk@uthscsa.edu
password: india
I hope you all enjoy!
My last week was a bit of a crazy "whirl wind" tour of India. New Delhi, Jaipur and Agra and I started last week on Inpatient with the Christian Family Practice Residency in Harlingen. (I get to work with Matt close by again which I really enjoy!) It was a hard transition back and I was very tired but it is such a blessing to be so welcomed by my friends here and to be encouraged again in my faith.
I will be posting an essay on leprosy soon for those of you who are interested. God bless! Thank you all again so much for your prayers! It's great to be back safe and sound.
I'm back safely and have uploaded pics
www.snapfish.com
email: sorensenk@uthscsa.edu
password: india
I hope you all enjoy!
My last week was a bit of a crazy "whirl wind" tour of India. New Delhi, Jaipur and Agra and I started last week on Inpatient with the Christian Family Practice Residency in Harlingen. (I get to work with Matt close by again which I really enjoy!) It was a hard transition back and I was very tired but it is such a blessing to be so welcomed by my friends here and to be encouraged again in my faith.
I will be posting an essay on leprosy soon for those of you who are interested. God bless! Thank you all again so much for your prayers! It's great to be back safe and sound.
Tuesday, January 29, 2008
Week 3 / 4
I had the most wonderful last week! I went with Doctors on Tues. and Nurses on Wed. to do rounds in the villages (home visits and setting up clinics in the villages)! I loved doing medicine outside, in the beauty of nature, in people's homes, and in the quiet and peace of the villages...it's hard to explain, but I could see myself doing that!
We did a lot of antenatal exams and I of course enjoyed to be able to feel the women's belly and listen to the baby's heart beat. There was also a lot of health maintenance (HTN, diabetes, COPD, asthma etc.), making sure people are taking their meds., referrals to the hospital, and follow ups from the hospital. We saw some cool things like chicguru dz.(I spelled that wrong), rheumatic heart dz., mumps, and well baby exams (getting to hold the babies was awesome).
CMC/CHAD has spent 26+ yrs. mapping out all the villages around this area and serving them and referring them to the community hospital (CHAD). They also tell all the women to go there to have their babies where they also perform the C-Sections, tubals, and other surgeries.
There was a undergrad who went with me on Tues. from Virginia and she was very cool. She was taking a yr. off to work on the Mercy ships, come here, and then go to Uganda! How awesome! I still would love to do the Mercy ships. Then today there was a med. student who's going into Family Med. from Denver with me and we had so much in common...Jesus, ministry, traveling, sports etc. It was a blessing to have fellowship. The Docs and nurses have been so friendly and during our lunch break the Indian Docs and nurses all sang Indian songs and worship songs! Too cool. =)
I went swimming in a nice pool that is just around the corner from the campus...an oasis for the foreigners & the missionary families.
I've been super tired. My days are long but so good. I just love doing medicine outside and in homes!
My last day was at the Leprosy hospital which I will have to blog about later because there is so much I learned.
We've been traveling and touring like crazy since Friday with early and late hours on trains, planes, and auto rickshaws! We've been to Chennai, Delhi, Jaipur, and now Agra! Crazy with very little sleep.
I have lots of stories that I look forward to sharing. Please keep praying for protection b/c we had a very scary experience in Delhi.
Scott wasn't traveling with us yet, and I am so glad he is now b/c touring with just girls is unsafe.
I am exhausted but am glad to be seeing the sights.
I saw the Taj Mahal today and it was incredible!!
I also road and elephant today..haha!
I want to come back and see the beautiful places in India (ie the Himalayas and Kerla)!
God is teaching me through Matt 8-10 recently. Will have to share more later.
So much overwhelming poverty here (sheep without a shepherd).
Please pray for continued safety as we travel. I will blog more later in the week and upload more pics!
More Verses:
Matt 6:25-7:12
Ps. 107:9b,14,16,18-22
rom 8:28, 1peter 1:3-5
We did a lot of antenatal exams and I of course enjoyed to be able to feel the women's belly and listen to the baby's heart beat. There was also a lot of health maintenance (HTN, diabetes, COPD, asthma etc.), making sure people are taking their meds., referrals to the hospital, and follow ups from the hospital. We saw some cool things like chicguru dz.(I spelled that wrong), rheumatic heart dz., mumps, and well baby exams (getting to hold the babies was awesome).
CMC/CHAD has spent 26+ yrs. mapping out all the villages around this area and serving them and referring them to the community hospital (CHAD). They also tell all the women to go there to have their babies where they also perform the C-Sections, tubals, and other surgeries.
There was a undergrad who went with me on Tues. from Virginia and she was very cool. She was taking a yr. off to work on the Mercy ships, come here, and then go to Uganda! How awesome! I still would love to do the Mercy ships. Then today there was a med. student who's going into Family Med. from Denver with me and we had so much in common...Jesus, ministry, traveling, sports etc. It was a blessing to have fellowship. The Docs and nurses have been so friendly and during our lunch break the Indian Docs and nurses all sang Indian songs and worship songs! Too cool. =)
I went swimming in a nice pool that is just around the corner from the campus...an oasis for the foreigners & the missionary families.
I've been super tired. My days are long but so good. I just love doing medicine outside and in homes!
My last day was at the Leprosy hospital which I will have to blog about later because there is so much I learned.
We've been traveling and touring like crazy since Friday with early and late hours on trains, planes, and auto rickshaws! We've been to Chennai, Delhi, Jaipur, and now Agra! Crazy with very little sleep.
I have lots of stories that I look forward to sharing. Please keep praying for protection b/c we had a very scary experience in Delhi.
Scott wasn't traveling with us yet, and I am so glad he is now b/c touring with just girls is unsafe.
I am exhausted but am glad to be seeing the sights.
I saw the Taj Mahal today and it was incredible!!
I also road and elephant today..haha!
I want to come back and see the beautiful places in India (ie the Himalayas and Kerla)!
God is teaching me through Matt 8-10 recently. Will have to share more later.
So much overwhelming poverty here (sheep without a shepherd).
Please pray for continued safety as we travel. I will blog more later in the week and upload more pics!
More Verses:
Matt 6:25-7:12
Ps. 107:9b,14,16,18-22
rom 8:28, 1peter 1:3-5
Monday, January 21, 2008
Pics
I'm slowly putting pics on a snapfish account!
http://www2.snapfish.com/thumbnailshare/AlbumID=213478095/a=119916684_119916684/t_=119916684
I don't know if you can open this so if you want to see them please email your email address to speedycc@aol.com.
Thanks!
http://www2.snapfish.com/thumbnailshare/AlbumID=213478095/a=119916684_119916684/t_=119916684
I don't know if you can open this so if you want to see them please email your email address to speedycc@aol.com.
Thanks!
Ending week 2
Hello!
Last week was a very good learning experience. I saw so many severe pre-eclamptic patients which is so sad because they have to induce labor to help the mom, and the babies often don’t make it b/c they are pre term. We also saw a patient with TTP, forceps deliveries, an ECV (external cephalic version ie rotating the baby from breech to cephalic) that worked, and a patient with anemia. Also, there is a belief by the women here that they shouldn't give blood (and don't like to). This causes there to be quite a shortage of blood which can then cause some tension within the hospital (especially when a pregnant women needs blood and none of her relatives will donate).
I was sad to leave L&D because the nurses, staff, and patients were very nice. I am blessed to be able to learn here even if it can be very sad at times.
For the weekend we all went to Mamallapuram to enjoy the beach in the Bay of Bengal. We had to be very careful and keep covered if we were not in the ocean b/c the Indian men just walk up and down the beach staring at the foreign women. It was a blessing to get away and relax after a busy week. I also feel God restoring my joy.
This week I am at the CHAD hospital which is the community hospital for the CMC. I enjoy that I can walk to the clinic that I am working at because it is just down the road.
I also like the clinic b/c it is open air and you feel as though you are outside which is great now b/c the weather is very pleasant (70's and 80's)! They do everything here, and also take weekly trips to the local villages which I will do Tues. and Wed. There is a missionary doctor from the states that works there so I hope to talk to him this week.
On Thurs. I am going to the Leprosy clinic that Paul Brand (the scholarship that I received) helped to start up.
I just started reading his book “The Gift of Pain” which I highly recommend!
I found out a lot of disturbing statistics today at the clinic meeting.
The suicide and murder rate (with in the family) is very high here. Last month there were 58 suicides that were reported to the CHAD clinic- the causes are poisoning, hanging, and burning. This is very sad and difficult for the clinic to know how to change and approach.
Some other things I saw in clinic today:
A young girl with neurocysticercosis, tropical pulmonary eosinophilia, depression, hypertension, menorrhagia, and lots of pregnany women. Children with rheumatic heart dz, fevers, colds, and hypothyroid.
Some verses for the week to experience God's grace: Rom 12:1, ps 51:10, ro 3:24, 1john4:9-10, john 3:16-18, col 2:13-14, john 15:15
Have a great week! I enjoy hearing from you all! Thank you for your prayers and support!
Random thoughts:
The most dangerous thing to do here is cross the street.
I eat rice with every meal and am becoming fond of the flavored rice: esp. coconut rice. We had some yummy crepes too! There are also bougainvillea plants all over, which reminds me of Harlingen.
Last week was a very good learning experience. I saw so many severe pre-eclamptic patients which is so sad because they have to induce labor to help the mom, and the babies often don’t make it b/c they are pre term. We also saw a patient with TTP, forceps deliveries, an ECV (external cephalic version ie rotating the baby from breech to cephalic) that worked, and a patient with anemia. Also, there is a belief by the women here that they shouldn't give blood (and don't like to). This causes there to be quite a shortage of blood which can then cause some tension within the hospital (especially when a pregnant women needs blood and none of her relatives will donate).
I was sad to leave L&D because the nurses, staff, and patients were very nice. I am blessed to be able to learn here even if it can be very sad at times.
For the weekend we all went to Mamallapuram to enjoy the beach in the Bay of Bengal. We had to be very careful and keep covered if we were not in the ocean b/c the Indian men just walk up and down the beach staring at the foreign women. It was a blessing to get away and relax after a busy week. I also feel God restoring my joy.
This week I am at the CHAD hospital which is the community hospital for the CMC. I enjoy that I can walk to the clinic that I am working at because it is just down the road.
I also like the clinic b/c it is open air and you feel as though you are outside which is great now b/c the weather is very pleasant (70's and 80's)! They do everything here, and also take weekly trips to the local villages which I will do Tues. and Wed. There is a missionary doctor from the states that works there so I hope to talk to him this week.
On Thurs. I am going to the Leprosy clinic that Paul Brand (the scholarship that I received) helped to start up.
I just started reading his book “The Gift of Pain” which I highly recommend!
I found out a lot of disturbing statistics today at the clinic meeting.
The suicide and murder rate (with in the family) is very high here. Last month there were 58 suicides that were reported to the CHAD clinic- the causes are poisoning, hanging, and burning. This is very sad and difficult for the clinic to know how to change and approach.
Some other things I saw in clinic today:
A young girl with neurocysticercosis, tropical pulmonary eosinophilia, depression, hypertension, menorrhagia, and lots of pregnany women. Children with rheumatic heart dz, fevers, colds, and hypothyroid.
Some verses for the week to experience God's grace: Rom 12:1, ps 51:10, ro 3:24, 1john4:9-10, john 3:16-18, col 2:13-14, john 15:15
Have a great week! I enjoy hearing from you all! Thank you for your prayers and support!
Random thoughts:
The most dangerous thing to do here is cross the street.
I eat rice with every meal and am becoming fond of the flavored rice: esp. coconut rice. We had some yummy crepes too! There are also bougainvillea plants all over, which reminds me of Harlingen.
Thursday, January 17, 2008
OB
Delivery room is going well! It's very sad and hard when pre-term babies don't make it. And we see a lot of high risk pts. Today we delivered from a woman who has TTP with very low platelets and it was a bit of a scare when she wouldn't stop bleeding due to her disorder. Praise God that He helped her to recover (after blood and fluids).
(Correction to my previous blog...they do use pain meds. every 6 hrs.)
(Correction to my previous blog...they do use pain meds. every 6 hrs.)
Wednesday, January 16, 2008
Jan. 13-Jan. 16
Hello from Vellore,
Sunday was relaxful which was a blessing. I didn't sleep much the first week so it was nice to sleep in! We have a mini Mt. or a big hill next to the college so we all hiked to the top to get a great view of the city. We also ate lunch at some nice hotel's this weekend to enjoy some really good Indian food. They have a church on campus so we went to the 6pm service in English and it was a physician speaking which was awesome. He talked about Phil 2:5-11 and how our attitude should be like Christ and not the world. Christ made Himself humble unlike us who can become more prideful as we progress in our training. He asked: "How have we shown love to others or do we demand love? Christ overflowed with love, not expecting it back.... We can never love Him to the extent that He loves us... Do we have a getting or giving attitude? Also, we need to evaluate and expose our lives and attitudes to bring change so that "streams of living water" can flow through us..."
It was very insightful and a good reminder for me because it is more difficult to have a good attitude in new situations.
OB (OG here) has been very cool! I've gotten to deliver about 4 babies, assisted on c-sections and two uterine ruptures(one the baby lived and the other died), and got to do my side of a tubal ligation! It's been a bit slow at times, but great learning. The other med students, nurses, and attendings have been very nice which is a huge blessing. We have patients with ITP, lots of pre-eclampsia, and many other high risk problem. They do things a bit different here (for example no pain meds. and they only do vaginal checks every 4-6 hrs. depending on the stage of labor), but I actually think some of their methods are a bit better way of doing things.
It's a holiday week here (the Harvest festival) and so they closed all the computer labs since Sun. So I haven't been able to upload pics yet, but hopefully will be able to soon.
Please pray for patience, open opportunities to show and share Christ's love, and for a joyful spirit.
Verses:
Matt 9:12-13
Mark 9:16-28
Jeremiah 32:17
Psalm 139
Sunday was relaxful which was a blessing. I didn't sleep much the first week so it was nice to sleep in! We have a mini Mt. or a big hill next to the college so we all hiked to the top to get a great view of the city. We also ate lunch at some nice hotel's this weekend to enjoy some really good Indian food. They have a church on campus so we went to the 6pm service in English and it was a physician speaking which was awesome. He talked about Phil 2:5-11 and how our attitude should be like Christ and not the world. Christ made Himself humble unlike us who can become more prideful as we progress in our training. He asked: "How have we shown love to others or do we demand love? Christ overflowed with love, not expecting it back.... We can never love Him to the extent that He loves us... Do we have a getting or giving attitude? Also, we need to evaluate and expose our lives and attitudes to bring change so that "streams of living water" can flow through us..."
It was very insightful and a good reminder for me because it is more difficult to have a good attitude in new situations.
OB (OG here) has been very cool! I've gotten to deliver about 4 babies, assisted on c-sections and two uterine ruptures(one the baby lived and the other died), and got to do my side of a tubal ligation! It's been a bit slow at times, but great learning. The other med students, nurses, and attendings have been very nice which is a huge blessing. We have patients with ITP, lots of pre-eclampsia, and many other high risk problem. They do things a bit different here (for example no pain meds. and they only do vaginal checks every 4-6 hrs. depending on the stage of labor), but I actually think some of their methods are a bit better way of doing things.
It's a holiday week here (the Harvest festival) and so they closed all the computer labs since Sun. So I haven't been able to upload pics yet, but hopefully will be able to soon.
Please pray for patience, open opportunities to show and share Christ's love, and for a joyful spirit.
Verses:
Matt 9:12-13
Mark 9:16-28
Jeremiah 32:17
Psalm 139
Saturday, January 12, 2008
Week one!
Hey Everyone!
I was on surgery this week and had a very good experience. I was told that this is probably the best teaching hospitals in all of India. The surgery department functions similarly to our medical school. We have rounds, grand rounds, surgery days, and clinic days. There are medical students and residents of all levels.
The teaching is very good and I believe because it is a Christian Medical School the surgeons were all very nice.
Wednesday:
We started out grand rounds with prayer and a Bible study which was awesome because you rarely see a group of surgeons who are willing to be open about their faith.
We read through Genesis 12:1-8 and Hebrews 11:8-17 and discussed:
1. How do we realize the purpose and significance of life?
2. What difference does it make in our lives when we realize the purpose and significance of our life and the lives of others?
We rounded for a very long time and had lecture almost all day. Then we had a trauma surgery (bowel exploration) in the afternoon (only retroperitoneal and anterior hematomas were found).
Thursday:
Very cool OR day (here it’s the OT (operating theater) and ward rounds.
We saw about 9 surgeries:
+ TSSA (four of them) which is a very common surgical procedure her for varicose veins.
+ Colostomy closure on a young girl who was in a very bad accident.
+ Laparoscopic cholecystectomy (their TV screens were just as nice as ours and all the same instruments used)
+ Femoral/ popliteal bypass
+ Brachial artery pseudo aneurysm repair (This was huge and the coolest surgery!! See photos!)
+ Aorto-bi femoral bypass
+ Testicular hydrocele
Surgery here is pretty much done the same as in the states and they seem to be up to date on the latest procedures. I wasn’t able to scrub in due to the number of residents and their medical students, but this allowed me to bop between OR’s. I also peeked in on a cleft lip/palate surgery for a bit. The only big difference is the quality of the hospital.
Friday:
We had Ward Rounds, then reviewed CT’s and CT angiograms with the radiology department, and student lectures were given:
I did my presentation on Klippel Trenaunay Syndrome, and one of the residents did theirs on chest trauma (pneumothorax, hemothorax, flail chest etc.). After, we performed lymph node biopsies and I was able to suture close one of them. =)
The afternoon was clinic which is crazy busy. It is amazing the number of people with vascular disease here. On the ward and in clinic you see so many necrotic feet and ulcers due to Berger’s dz, arterial vascular dz., thrombophlebitis, and some due to diabetes. There is also quite a bit of very bad varicose veins.
One young girl had lost both of her legs due to a vascular dz.
Even though there is a language barrier with the patients, I have found that touching them and smiling at them goes a long way. I was able to tell some of them that I would be praying for them.
Winter Symposium: http://www.wintersymposium2008.org/
This has been going on all week here at the college which has brought in an impressive group of Cardiologist lecturers from all over the world. The keynote speaker was the Nobel Peace prize winner: Laureate Peter Agre
(AQUAPORINS – Unique role of water channels in cell physiology)!
Saturday:
We got to tour the famous Fort and Temple here and enjoy some good food and be tourists for a day.
Personally:
I had a bit of frustration due to confusion with our housing, but praise God we got to move into a bit nicer of a place at the end of the week which I am truly grateful for. Everyone also got their luggage which is an answer to prayer. I am enjoying my experience, enjoy serving people through medicine, and am impressed by the quality of medicine here. God is teaching me how to love a new culture and to let go of our “American standards”. The girls on the campus have also been very nice and so I enjoy talking to them on the bus rides to and from the hospital. I truly enjoy serving people who have very little. We are student observers so we can’t do a lot, but I am just enjoying learning about the culture and people. It is also impressive that medical students rotate here from all over the world (Australia, U.K., Germany, Switzerland, etc. as student observers).
India is just very over populated, loud (the honking of horns is a bit out of control), and has a lot of traffic (so it is very dangerous just to cross the street). So it's such a blessing to come back to the College campus which is very quiet and peaceful. The random cows in the street are quite funny. I really like the colorful and comfy clothes here as well as the food. (Some of it is a bit too spicy but I’m adjusting.)
Ida Scudder’s Story: (Please read!)
She is know as their “mother” and when she died her death was grieved like no other (except maybe Mother Teresa)
Ida was the woman who started it all here!
The story of Ida Scudder's visionary mission begins in the late 1800's when she was a young American girl reluctantly visiting her medical missionary father, John Scudder, at his post in Tamil Nadu, South India. One fateful night, Ida was asked to help three women from different families struggling in difficult childbirth. Custom prevented their husbands from accepting the help of a male doctor for them and being without training at that time, Ida herself could do nothing. The next morning she was shocked to learn that each of the three women had died. She believed that it was a calling and a challenge set before her by God to begin a ministry dedicated to the health needs of the people of India, particularly women and children. Consequently, Ida went back to America, entered medical training (practically unheard of for women at that time) and, in 1899, was one of the first women graduates of the Cornell Medical College.
Shortly thereafter, she returned to India and opened a one-bed clinic in Vellore in 1900. Two years later, in 1902, she built a 40-bed hospital, the forerunner of today's 1700-bed medical center. In 1909, she started the School of Nursing, and in 1918, her fondest dream came true with the opening of a medical school for women. (Men were admitted in 1947). With the training of these women as doctors and nurses, Indian women would now begin to have access to health care professionals. This was the beginning of the vision of Ida S. Scudder which continues to grow to this day.
In addition to the care of women, Ida Scudder saw the need for bringing health care to the poor, the disabled, and the neglected of India. She traveled regularly to outlying villages, bringing medical care to the doorstep of poor villagers, many of whom had never seen a real doctor or nurse, starting CMC's first "roadside" dispensary in 1916. Over the years, these roadside dispensaries have developed into extensive rural health and development programs that have become internationally acclaimed in the Community Health field. These dispensaries have attracted members of the medical community from around the world, from young medical students to nurses to highly skilled surgeons, to study and contribute their skills.
The 100 years since Ida Scudder opened the first small clinic have seen remarkable growth. Here is an example of the daily activity that goes on there today: 2,000 outpatients per day, 1,000 inpatients, 43 operations, 22 clinics, and 16 births. Ten Bible Classes are held each day and 380 patients are visited by a Chaplain. In addition, there is the work of CHAD, CONCH, and RUSHA, which go out to the villages and rural areas bringing methods of disease prevention, health care and community empowerment to tens of thousands more. Started with one woman and her vision, CMC employs over 4300 people today.
But, the story of CMC is not merely growth, high tech surgery, and medical degrees. It is the story of people sharing their time and talents in a loving and caring manner. Throughout its history CMC has taken up each new task in response to Christ's command. In the words of Ida Scudder, ";we thank God for the way He has led us in the past and look forward to an even greater future."
Hope all is well at home.
Some verses that have spoke to me: 1Thess 5:23-24, 2 Corin 12:9, Matt 5:3, Jeremiah 32:17, psalm 23, Psalm 27:13
Isha (Jesus in Tamil)
"The Spirit of the Lord is on me,
because He has anointed me to preach good news to the poor.
He has sent me to proclaim freedom for the prisoners
and recovery of sight for the blind,
to release the oppressed,to proclaim the year of the Lord's favor." (Luke 4:17-19)
Prayer: For a joyous and accepting spirit. For a way to show the people here that I care even though I can’t communicate with them. For personal growth and change.
Other Blog sites with very cool stories too!
Rachelhassan.blogspot.com
Paulbgravel. blogspot.com
Rebeccavellore. blogspot.com
Kathrynfick-indiatrip blogspot.com
itinerantinindia blogspot.com
I was on surgery this week and had a very good experience. I was told that this is probably the best teaching hospitals in all of India. The surgery department functions similarly to our medical school. We have rounds, grand rounds, surgery days, and clinic days. There are medical students and residents of all levels.
The teaching is very good and I believe because it is a Christian Medical School the surgeons were all very nice.
Wednesday:
We started out grand rounds with prayer and a Bible study which was awesome because you rarely see a group of surgeons who are willing to be open about their faith.
We read through Genesis 12:1-8 and Hebrews 11:8-17 and discussed:
1. How do we realize the purpose and significance of life?
2. What difference does it make in our lives when we realize the purpose and significance of our life and the lives of others?
We rounded for a very long time and had lecture almost all day. Then we had a trauma surgery (bowel exploration) in the afternoon (only retroperitoneal and anterior hematomas were found).
Thursday:
Very cool OR day (here it’s the OT (operating theater) and ward rounds.
We saw about 9 surgeries:
+ TSSA (four of them) which is a very common surgical procedure her for varicose veins.
+ Colostomy closure on a young girl who was in a very bad accident.
+ Laparoscopic cholecystectomy (their TV screens were just as nice as ours and all the same instruments used)
+ Femoral/ popliteal bypass
+ Brachial artery pseudo aneurysm repair (This was huge and the coolest surgery!! See photos!)
+ Aorto-bi femoral bypass
+ Testicular hydrocele
Surgery here is pretty much done the same as in the states and they seem to be up to date on the latest procedures. I wasn’t able to scrub in due to the number of residents and their medical students, but this allowed me to bop between OR’s. I also peeked in on a cleft lip/palate surgery for a bit. The only big difference is the quality of the hospital.
Friday:
We had Ward Rounds, then reviewed CT’s and CT angiograms with the radiology department, and student lectures were given:
I did my presentation on Klippel Trenaunay Syndrome, and one of the residents did theirs on chest trauma (pneumothorax, hemothorax, flail chest etc.). After, we performed lymph node biopsies and I was able to suture close one of them. =)
The afternoon was clinic which is crazy busy. It is amazing the number of people with vascular disease here. On the ward and in clinic you see so many necrotic feet and ulcers due to Berger’s dz, arterial vascular dz., thrombophlebitis, and some due to diabetes. There is also quite a bit of very bad varicose veins.
One young girl had lost both of her legs due to a vascular dz.
Even though there is a language barrier with the patients, I have found that touching them and smiling at them goes a long way. I was able to tell some of them that I would be praying for them.
Winter Symposium: http://www.wintersymposium2008.org/
This has been going on all week here at the college which has brought in an impressive group of Cardiologist lecturers from all over the world. The keynote speaker was the Nobel Peace prize winner: Laureate Peter Agre
(AQUAPORINS – Unique role of water channels in cell physiology)!
Saturday:
We got to tour the famous Fort and Temple here and enjoy some good food and be tourists for a day.
Personally:
I had a bit of frustration due to confusion with our housing, but praise God we got to move into a bit nicer of a place at the end of the week which I am truly grateful for. Everyone also got their luggage which is an answer to prayer. I am enjoying my experience, enjoy serving people through medicine, and am impressed by the quality of medicine here. God is teaching me how to love a new culture and to let go of our “American standards”. The girls on the campus have also been very nice and so I enjoy talking to them on the bus rides to and from the hospital. I truly enjoy serving people who have very little. We are student observers so we can’t do a lot, but I am just enjoying learning about the culture and people. It is also impressive that medical students rotate here from all over the world (Australia, U.K., Germany, Switzerland, etc. as student observers).
India is just very over populated, loud (the honking of horns is a bit out of control), and has a lot of traffic (so it is very dangerous just to cross the street). So it's such a blessing to come back to the College campus which is very quiet and peaceful. The random cows in the street are quite funny. I really like the colorful and comfy clothes here as well as the food. (Some of it is a bit too spicy but I’m adjusting.)
Ida Scudder’s Story: (Please read!)
She is know as their “mother” and when she died her death was grieved like no other (except maybe Mother Teresa)
Ida was the woman who started it all here!
The story of Ida Scudder's visionary mission begins in the late 1800's when she was a young American girl reluctantly visiting her medical missionary father, John Scudder, at his post in Tamil Nadu, South India. One fateful night, Ida was asked to help three women from different families struggling in difficult childbirth. Custom prevented their husbands from accepting the help of a male doctor for them and being without training at that time, Ida herself could do nothing. The next morning she was shocked to learn that each of the three women had died. She believed that it was a calling and a challenge set before her by God to begin a ministry dedicated to the health needs of the people of India, particularly women and children. Consequently, Ida went back to America, entered medical training (practically unheard of for women at that time) and, in 1899, was one of the first women graduates of the Cornell Medical College.
Shortly thereafter, she returned to India and opened a one-bed clinic in Vellore in 1900. Two years later, in 1902, she built a 40-bed hospital, the forerunner of today's 1700-bed medical center. In 1909, she started the School of Nursing, and in 1918, her fondest dream came true with the opening of a medical school for women. (Men were admitted in 1947). With the training of these women as doctors and nurses, Indian women would now begin to have access to health care professionals. This was the beginning of the vision of Ida S. Scudder which continues to grow to this day.
In addition to the care of women, Ida Scudder saw the need for bringing health care to the poor, the disabled, and the neglected of India. She traveled regularly to outlying villages, bringing medical care to the doorstep of poor villagers, many of whom had never seen a real doctor or nurse, starting CMC's first "roadside" dispensary in 1916. Over the years, these roadside dispensaries have developed into extensive rural health and development programs that have become internationally acclaimed in the Community Health field. These dispensaries have attracted members of the medical community from around the world, from young medical students to nurses to highly skilled surgeons, to study and contribute their skills.
The 100 years since Ida Scudder opened the first small clinic have seen remarkable growth. Here is an example of the daily activity that goes on there today: 2,000 outpatients per day, 1,000 inpatients, 43 operations, 22 clinics, and 16 births. Ten Bible Classes are held each day and 380 patients are visited by a Chaplain. In addition, there is the work of CHAD, CONCH, and RUSHA, which go out to the villages and rural areas bringing methods of disease prevention, health care and community empowerment to tens of thousands more. Started with one woman and her vision, CMC employs over 4300 people today.
But, the story of CMC is not merely growth, high tech surgery, and medical degrees. It is the story of people sharing their time and talents in a loving and caring manner. Throughout its history CMC has taken up each new task in response to Christ's command. In the words of Ida Scudder, ";we thank God for the way He has led us in the past and look forward to an even greater future."
Hope all is well at home.
Some verses that have spoke to me: 1Thess 5:23-24, 2 Corin 12:9, Matt 5:3, Jeremiah 32:17, psalm 23, Psalm 27:13
Isha (Jesus in Tamil)
"The Spirit of the Lord is on me,
because He has anointed me to preach good news to the poor.
He has sent me to proclaim freedom for the prisoners
and recovery of sight for the blind,
to release the oppressed,to proclaim the year of the Lord's favor." (Luke 4:17-19)
Prayer: For a joyous and accepting spirit. For a way to show the people here that I care even though I can’t communicate with them. For personal growth and change.
Other Blog sites with very cool stories too!
Rachelhassan.blogspot.com
Paulbgravel. blogspot.com
Rebeccavellore. blogspot.com
Kathrynfick-indiatrip blogspot.com
itinerantinindia blogspot.com
Tuesday, January 8, 2008
Thank you all for your replies. It's nice to get messages since it's weird not to be receiving texting or calls. My first day on surgery was very interesting. We had clinic all day and saw huge hernias, obstructive jaundice, Klippell Trenaunay Syndrome (Which is apparently very common and I had never heard of it. Due to my lack of knowledge I am assigned a discussion on it for tomorrow!), breast cancer, ulcer perforations, varicose veins, lots of anal fissures, TB abscesses and gut tubercles, foot ulcers,etc. The attending was very nice and in the afternoon we did minor procedures (I got to assist). I feel a bit like I'm at camp.
I don't have much time today but I've been reading through Matthew because I have felt distant from God and reading Jesus' life always draws me near. So my verses for you all to read if you want are Matt. 4:23-5:16 because I feel that I am experiencing this here . I will write more later. Love you all!
I don't have much time today but I've been reading through Matthew because I have felt distant from God and reading Jesus' life always draws me near. So my verses for you all to read if you want are Matt. 4:23-5:16 because I feel that I am experiencing this here . I will write more later. Love you all!
Monday, January 7, 2008
I've arrived.
Hey Everyone,
I made it here safely. It was an good trip here (a bit interesting in Delhi). We are getting oriented today and will start on Tuesday. The place we are staying is hard to describe but I think it is nice (others might disagree). It is open air with buckets for a shower, but I like it that we feel as though we are in the forest.(Yes, there are monkey's in the tree's.) The college campus is very pretty with trees, trails, and pretty flowers, and the buildings are very old. But, it is a nice oasis from the craziness of the city and the hospital. It is definitely a culture shock and eye opening.
India is probably similar to Mexico and Africa in that it is very dirty, poor, over populated and run down. You don't see any, what we would call "nice" buildings and the streets are all dirt which if different from American standards. Traveling wasn't so bad (24 hrs. of plane, a hostal, another 3 hour plane ride from Delhi to Chennai and a 2 hour drive to Vellore). We arrived in Vellore at about 4pm on Sunday. Our hostal we stayed at was a bit sketchy in New Delhi & we were moved to another hostal b/c they were run by the same guy(interesting). I'm learning just to go with the flow and to have light expectations. We slept fine and had a nice breakfast. Life here is very simple and our accommodations would be comparable to what people in Mexico live in, but I like the open air and not having to worry about cleaning everything. The people here are very nice and seem like very gentle people. We have also learned minor things that will help the next group.
I really like the women's "sari's" and other attire. They are beautiful colors and super comfy so we bought a few "sari" like dresses so to wear to work so we look appropriate.
I will be rotating at in surgery this week, OB my second week, and medicine/ CHAD(village medicine) my last week. The hospital is huge and flooded with patients and so I am eager to start tomorrow.
I have also had time to spend with the Lord in the morning (due to loud Indian/ Hindi music playing at 4am) which is refreshing. I'm just praying God will allow me to accept the culture and people with out judging eyes. Their way of life is different and you realize how ridiculously spoiled we are in the states, and our obsession with cleanliness and new things.
I really like the food. Lunch was yummy rice and vegetables, and dinner was a crepe and egg layered together. There is also a store where we can get normal snacks and cereal. I am looking forward to starting tomorrow.
Please pray for acceptance, to go with the flow, and to not be frustrated by the language barrier.
Please pray for Rachel, Paul, and Rebecca b/c their luggage was "lost" and isn't here yet.
I am so blessed to be here and for this experience.
smiles in Christ =)
I made it here safely. It was an good trip here (a bit interesting in Delhi). We are getting oriented today and will start on Tuesday. The place we are staying is hard to describe but I think it is nice (others might disagree). It is open air with buckets for a shower, but I like it that we feel as though we are in the forest.(Yes, there are monkey's in the tree's.) The college campus is very pretty with trees, trails, and pretty flowers, and the buildings are very old. But, it is a nice oasis from the craziness of the city and the hospital. It is definitely a culture shock and eye opening.
India is probably similar to Mexico and Africa in that it is very dirty, poor, over populated and run down. You don't see any, what we would call "nice" buildings and the streets are all dirt which if different from American standards. Traveling wasn't so bad (24 hrs. of plane, a hostal, another 3 hour plane ride from Delhi to Chennai and a 2 hour drive to Vellore). We arrived in Vellore at about 4pm on Sunday. Our hostal we stayed at was a bit sketchy in New Delhi & we were moved to another hostal b/c they were run by the same guy(interesting). I'm learning just to go with the flow and to have light expectations. We slept fine and had a nice breakfast. Life here is very simple and our accommodations would be comparable to what people in Mexico live in, but I like the open air and not having to worry about cleaning everything. The people here are very nice and seem like very gentle people. We have also learned minor things that will help the next group.
I really like the women's "sari's" and other attire. They are beautiful colors and super comfy so we bought a few "sari" like dresses so to wear to work so we look appropriate.
I will be rotating at in surgery this week, OB my second week, and medicine/ CHAD(village medicine) my last week. The hospital is huge and flooded with patients and so I am eager to start tomorrow.
I have also had time to spend with the Lord in the morning (due to loud Indian/ Hindi music playing at 4am) which is refreshing. I'm just praying God will allow me to accept the culture and people with out judging eyes. Their way of life is different and you realize how ridiculously spoiled we are in the states, and our obsession with cleanliness and new things.
I really like the food. Lunch was yummy rice and vegetables, and dinner was a crepe and egg layered together. There is also a store where we can get normal snacks and cereal. I am looking forward to starting tomorrow.
Please pray for acceptance, to go with the flow, and to not be frustrated by the language barrier.
Please pray for Rachel, Paul, and Rebecca b/c their luggage was "lost" and isn't here yet.
I am so blessed to be here and for this experience.
smiles in Christ =)
Subscribe to:
Posts (Atom)