Foreign Bodies and Gifts

 Consequently, you are no longer foreigners and strangers, but fellow citizens with God’s people and also members of his household  Ephesians 2:19 (NIV)

At around 4 am my beeper went off and I was informed of a very unusual situation.  In fact, I asked the Kenyan voice on the other end to repeat the message.   I thought I had seen most of the known obstetric complications, but this was a new one!  I will not go into the details, but suffice it to say it was all about a “foreign body”!

We have been “welcomed” as foreigners.  We brought gifts, but the larger reality is that we have received many more gifts than we brought!  We have met some wonderful people and have been blessed by their friendship and love.   So just when you have thought you have “seen it all” you are surprised and that is a wonderful gift even as a “foreign body”!

In this time of Lent, I pray that we will be surprised by a new faith and strength in a world where separation and alienation are what we most often experience.  May we accept the invitation and be the “welcome” even if we are strangers.

Marv

Reference

 Zantvoord Y;  van der Weiden RM;  van Hooff MH. Transmural migration of retained surgical sponges: a systematic review. [Review] [69 refs]
Obstetrical & Gynecological Survey.  63(7):465-71, 2008 Jul.

Proverbs 3:27-28

“Do not  withhold good from those who deserve it when it is in your power to help them, If you can help your neighbor now, don’t say, Come back tomorrow, and then I will help you.”  I read these words in my morning devotions on one of the first days that I was here at Tenwek.  They have haunted me ever since.  These words have pushed me to respond to some of the many, many needs that surround us here every single day. Whether it is the mother at the door begging for food for the day, the father requesting school funds for his eldest daughter, the orphanage director seeking funds to run his facility, the nurse seeking to further her education, the new mom of twins requesting funds to pay her hospital bill so she can return home to her six other children; the list goes on and on.  But in reality there is only so much that we can do here in a short time.  However, there is much that can be done if we join forces as Christians from around the world to help those in desperate need.  The amazing thing about all of these requests was that they completely trusted that God would fulfill their needs. I wish that I could always say that my faith has been that strong.

Today I went into the country, down a bumpy road and up a very steep hill to attend a Women’s Bible Study with about 50 women and a few pastors, some of whom had walked an hour to get there.  It was held at the home of Willis and Marcella and their eight children, the eldest of whom has cerebral palsy and is confined to a wheel chair.   Much of what was said was in Kipsigis however; the smiles, hugs, and greetings to me and to my church in the U.S. were easily understood.  In my feeble greetings to all of them I assured them that I would be praying for them as would the people in my church.  Willis and Marcella are the proud owners of a new cow which was purchased for them through the Tabitha Ministries.  This is the same group that helped the women of my circle at First Pres purchase a cow for another friend of mine, Richard. I want to tell the women that Richard is doing well, as are the twins that I nurtured three years ago.  He is a superb father according to all reports!  Not only that the cow is pregnant and due in a couple of months! 

And so another year at Tenwek has passed very quickly!   As expected it has been different from any other year.  It has been fulfilling but also troubling as the needs are greater than ever.  Oh, how blessed we are in the U.S. and we have done nothing to deserve these blessings except we were born there.  Please remember our sisters and brothers in the Lord who struggle to survive each day.  “If you can help your neighbor now, don’t say, Come back tomorrow, and then I will help you.” God help us all to live by those words.  We can make a difference.

Love you all and see you soon,

Mom

Sunday in the Country

Yesterday we spent Sunday in the country at the shamba of one of Marv’s Kenyan colleagues, Elijah Terer.  It is about 40 minutes from Tenwek and he was kind enough to come and pick us up. The last 2 miles to his house are unbelievably rocky and rough.   How his tires hold up on this road day after day is unknown to us!  Kenyan tires are amazing!  He built his tiny house about a year ago and is very proud of it, his three cows, two goats, chickens, and his fields of cabbage and tomatoes.  When we asked him why he built so far from the hospital, he replied that this is his village and his people.  That seemed like a good reason to us as we noted how peaceful and quiet our surroundings were. 

Elijah’s wife and his five year old daughter joined us for church which was a short distance from their home.  Last year when I was here we worshipped in a tiny frame building and saw the new church rising next to it. This year the roof is on the new church and worship takes place in it.  The floors are still dirt and the windows are not in yet but it works just fine.  We enjoyed the lively music song in Kipsigis.  The new young pastor was remarkably good and preached on James 3: 1-12 and the tongue.  He was organized and fairly brief! (One hour)  He also alternated from English to Kipsigis for our benefit which was wonderful and I imagine very difficult to do.  Marv and I were both asked to speak which is common for visitors to do. 

The parents of one of the Nursery moms at Tenwek attend this church. It was fun to show them pictures of their new granddaughter and to reassure them that their daughter was doing well.  After that greeting we went to Elijah and Emily’s for some good Kenyan rice, stew and mashed peas, with pineapple and mango for dessert.  Of course it was accompanied by Fanta and Coke as we dare not drink the water.   Since Elijah had a Bible study to lead in the afternoon we did not stay too long and once again ventured onto the rough road.  Sadly we saw people with buckets looking for water.  This area has not had the rain that we had at Tenwek last week.  It is a very urgent problem for them.  We arrived safely back home just in time for a short but restful Sunday afternoon nap!

Mom

A Sweet Style

This was one of the many scenes as we walked to have lunch.  How fun to see the closeness of these families out for a Saturday morning stroll.

M&M

Educational Opportunities

School Class Visiting Tenwek Hospital

I am excited to report that I have found more educational opportunities related to the care of women and children.  There are “people on the ground” who share the vision of improved care through new educational responses.  There is excitement and anticipation of a new fiber optic connection.  There continues to be a wonderful group of young physicians who are committed to make a difference in their Kenyan communities.

I just finished reading the book “Foreign to Familiar” and was reminded that besides the differences in the prevalence of diseases, the educational tasks require a deeper understanding of the cultural differences.  We need to think carefully how the information is delivered, understood and implemented. They are the stakeholders effected by adding new diagnostic and therapeutic responses.

An example is the Bakri Balloon.  The fact that it has been used is only the beginning!  More people need to hear and understand the indications and limitations of its use.  Replacements need to be obtained within the context of limited resources.  There needs to be follow up of its use and effectiveness.

For those who would partner with Tenwek, we need to understand the limitations in our cultural and educational understanding.  Help us to continue to listen and learn about the new educational opportunities in this special place called Tenwek.

Marvin

Lunch at the Brevan Hotel

Hats!

Today was the day we passed out the hats in the nursery!  Lots of excitement as they picked out their favorite from the large assortment that the ladies of First Presbyterian knit.  I told them that ladies from my church in America were thinking of them as they knit.  They loved that and said ”thank you” over and over again.  It does not take much to make them very happy!  So ladies keep your nibble fingers going as you are appreciated in Kenya! 

Today we had a little hymn sing outside in the morning sun!  They were mopping the floor in nursery and so we had to wait to get in.  What better way to spend our time on a beautiful morning than to sing praises!  Many songs are universal and it always is amazing to me as we sing “Jesus Loves Me” or “Amen” in English and Swahili!  The Lord is much bigger than ever imagine.

People often ask me, what do you do over there?  Well the answer is many things that are not so exotic!  For the last three afternoons a friend and I have been sorting through clothing that has been donated for orphanages and needy people.  Right now we have bins stacked up in our living room waiting to go into storage.  So an answer to that question, I do what needs to be done!  We are actually going to have a garage sale here next week of clothing we cannot give away with the proceeds going to the needy people’s fund.

Our power has been really erratic the last couple of days.  We have spent many hours in candlelight!  However, today we have power and more importantly it rained!  It rained hard and long which is truly an answer to prayer.  Tonight we are eating in the guesthouse to celebrate the birthday of the German medical student who is here for three months.  Homemade pizza is on the menu!  We love meeting people from all over who come to serve here.

Till next time,

Hugs,

Mom

Tea Time

Hi everybody!  It is Sunday night and we have had a cloudy chilly day. The good news is that we also had a nice rain shower!  A real answer to many prayers.  Dad had to work this weekend but it wasn’t too bad as most of the calls came during the day!  We had church this morning, we had some people including our favorite German medical student, over for lemonade after church, then a nice nap before going to Bible quizzing in the late afternoon.  I had a different group again today which makes it difficult to form any relationships but we still had fun together. I continue to be amazed at the Kenyan children’s ability to memorize.  Many of them are well on their way to memorizing 60 verses and getting their prized gold medals.  They are studying the book of Matthew so most of the verses come from it.

I had a fun day yesterday “off the reservation”!  A group of us left about 8 AM for Kericho which is about 2 hours from here and is the tea capital of Kenya.  The tea fields are spectacular! They look like a manicured green on a golf course from afar. With the sun pouring down on the green bushes I could not help but marvel at the good earth the Lord has given us.  The tea farms are really huge plantations. The one we visited named Finleys employs about 15,000 people.  It provides housing for its employees as well as their 20,000 dependents. It also provides medical care and education until Form 1 or approximately the ninth grade.  It is a fair trade company which means that it must abide by stringent rules such as an eight hour work day.  I was truly impressed by the employees we met and the cleanliness of the entire huge area. Drinking a cup of tea will never be the same.  Only the top two leaves are picked off the bush. They must be in the in no factory more than four hours after being picked. There they wither at a controlled temperature before being further processed.  They lost me with all of the jargon of tea processing; just trust me it is complicated!    Not only does Finley’s grow and process tea, another division grows roses, carnations, astremeria, and stock in enormous greenhouses. We were surrounded by millions of roses on Valentine’s Day!  The irony was that we could not buy any!  Finley’s wholesales mostly to the European market  and its flowers reach the streets of London and Amsterdam within twenty four hours of being picked.

After our fun tours we stopped for lunch in Kericho which was a treat!  A quick trip to the “grocery” store topped off the day as we were able to find a few things that are unavailable to us here at the Tenwek “ ducas”.  Hope your weekend was also fun.  We hear that you may be getting some ice storms....surely hope not!

Lots of love,

Mom

Sewing

Sewing Circle

As many of you know I am not a great seamstress.  I can stitch a bit, mend, or put a hem in but that is about the extent of my skills.  However in Kenya I am being stretched!  My friend Suzie who is an excellent sewer and I have started an afternoon stitching group on the maternity ward.  Many of the mothers of premies remain in the hospital for months.  Although they need lots of sleep between feedings, they also get mighty bored in the afternoon and evening.  Our stitchery idea is one I have talked about on the blog in years past.  We are stitching pads for women to use and reuse for their menstrual cycle.  Often young girls leave school once their period begins or they skip a week of school out of every month because they cannot afford the pads.  If we can teach them to use these pads it could solve the problem.  The cloth pads are inserted into a waterproof pocket and snapped onto the underpants.  Our other objective is to begin a sewing business for a young mother.  She hopes to make the kit and market them to women in the community.  The idea seems to have caught on! The other result is that I am getting to know these mothers better outside of the nursery.

Tomorrow is Valentine’s Day and so I passed out heart shaped “lollies” or suckers as we call them to the Moms in the nursery.  What fun! They loved them. You would have thought that I had given them a box of Godiva chocolates!  It added a bit of fun to the morning.  Sadly a really tiny baby had passed away this morning and so there was a cloud over the nursery.  Unfortunately this happens all too frequently.   If that little one had been born in the US he probably would have survived with the use of new drugs.  At this time those drugs are too expensive for this hospital to purchase.

We send our love to all of you this Valentine’s Day!  Happy Anniversary Bill and Penny!  Give all my grandchildren a big hug and kiss from Nana and Poppy! (and give them their cards!:)

Mom

Where is the Power?

Kipchumba

We had a significant power outage at the hospital that was addressed by a diesel generator for about 30 hours.  We take power as a given and yet know how limited we are in our response to manage this critical infrastructure component.

The people power is also limited.  We have learners at all levels!  The good news is that there is an “esprit” here that looks for the strengths in each individual care provider...”Together we can go far”.   However, there is no apparent limit to the challenges that we face!  Here is the example of today:

One of the patients, LC, has no living children after 4 pregnancies.  She has been in the hospital for about 3 weeks with the diagnosis of placenta previa and today was the day for a repeat cesarean delivery at 36 weeks.   As we expected, there was a concern that cesarean would be complicated by bleeding and we were not disappointed.  The baby boy was active and healthy and named “Kipchumba” which is literally translated as “A boy born in the presence of a white person”!  It is just a description of the environment and the gender of the baby - more about naming some other time.

The other part of the story is a gift from New Hanover Medical Center of a “Bakri Balloon”.  I brought it with an expectation that sometime it would be helpful to control the bleeding that we too often see here at Tenwek.  So for the first time at Tenwek, we used this device.  As I write, it appears to be working as designed.   Let’s rejoice in a healthy baby boy, named Kipchumba and a mother who is doing well.

The “Power” was found in the gifts that make a difference in the lives of our brothers and sisters in Africa.  Thanks to all for the gifts that we were able to bring, they make a difference!

Marvin

References

Bakri YN;  Amri A;  Abdul Jabbar F.  Tamponade-balloon for obstetrical bleeding. International Journal of Gynaecology & Obstetrics.  74(2):139-42, 2001 Aug.

Beckmann MM;  Chaplin J. Bakri balloon during cesarean delivery for placenta previa. International Journal of Gynaecology & Obstetrics.  124(2):118-22, 2014 Feb.

See blog: http://motown1941.blogspot.com/2015/02/presence.html

Friends

Rebecca and Sheila

Where do I start?  Every day we have a knock at the door.  It is usually a woman, a mother, who is either hungry and wanting food or a mother asking for school fees for  her child who has passed his exams and is ready to go to Form 1 .  Form 1 is our equivalent of high school which in Kenya means boarding school.  It costs approximately $450.00 for the year which includes room and board.   It does not include uniforms, shoes, etc. which comes to another 9500 shillings or about 95 dollars.  Form 1 begins in January so this is crunch time for finding school fees. 

Rebecca patiently sat under a tree in our side yard for probably at least an hour before my house help Sarah saw and recognized her.   I could see them conversing before Sarah invited her to come and sit on the front porch.  Then Sarah came into the house and told me the story of this poor woman.   She may have nothing, but she has the heart of a mother and she is persistent when it comes to her children!  Rebecca had talked with the “daktari” who lived here before we did and who has volunteered here long term.  He and his late wife started orphanages and have a fund that helps many people. Rebecca had talked with him and was under the impression that he was going to help her.   She did not realize that he had gone to the States and that we were the new residents.  She was pleading for help to pay the expenses for her daughter Sheila who had been accepted into Form 1 at a boarding school in Kericho about two hours from here.  Thus began the saga of Sheila!  I checked with the doctor to see if indeed he could pay, he directed me to the hospital chaplain who also has funds available to him occasionally;  I was turned down at both attempts.  Marv and I could not resist and decided that we would help this family.  By this time a couple of days had passed and the funds needed to be at the school by Feb 12, this Thursday.    Getting money here is no small task because the ATM is constantly broken!  The bank said that our check, although good, would not clear for 21 days which was way too long for school fees!   I desperately approached a missionary neighbor who runs the orphanage fund and he was able to bail me out!  He wrote a check to the school and Rebecca and Sheila will bring it with them when they travel to Kericho tomorrow.  Even giving is not easy in the third world! Please pray for Sheila as she begins this exciting but very scarey new adventure.  Going from a hut with no modern conveniences to a school where she will be expected to conform to a strict schedule beginning at 4:30 in the morning as well as to maintain excellent grades will not be easy.  I expect that she might be a bit homesick as well.  If she can make it, she will be able to change her family’s life.

The other friend that stopped by this afternoon is Cecelia whom you may have heard me talk about in the past.  Cecelia is a Rwandan genocide refugee whom I met 6 years ago. She is a widow with six children.  When I first met her she was unemployed and destitute.   I am happy to report that she now works for another missionary and not only that, she is involved in the Women’s Bible Study program that reaches almost 2000 women in their villages weekly.  Her life has improved immensely; but her struggles are still very real.  I am pleased to say that since she has 3 teenage boys I gave her some of the fleeces and sweaters that I collected at First Presbyterian!  She was thrilled as it is chilly here when the boys leave to walk to school at 6 AM in the morning.   She is a marvelous Christian who puts her trust in the Lord each day of her life. She is example to me of how I should live my Christian life and a good friend.   I thank God that He has put her in my life.

Miss you all, 

Love,

Mom

Saturday morning walk

"Skeeters"

“Skeeters” 

You bring a lot of stuff to Kenya and I specifically needed to bring a hat that protects me from the sun and also insect repellent.  I have many hats, but my latest and favorite, is a gift from my family.  It is an advertisement hat for a restaurant at Atlantic Beach, NC. The mosquito insignia means something very different here in Tenwek.   Hold that thought!

Without the boring details, a young woman presents to “casualty” (Emergency Room) in the early evening from another hospital with an infection in the first part of her pregnancy.  Neither the source nor site of the infection had been identified.   The most remarkable finding noted at the other hospital was a very low platelet count and very low white blood cell count.   

In the United States, we have a whole series of causes that we have learned are associated with the low platelet counts and what to do about it!  It is a “teaching moment” to have residents share their understanding of this finding when found during pregnancy.

Early in the morning following admission, I was phoned by the intern who reported a “positive malaria smear”.  The diagnosis was made and now specific treatment for severe malaria in pregnancy could be started.

Yesterday was a learning opportunity that escapes most of the experiences of our residents in the United States.   As teachers we need to share this knowledge of marlaria and its impact on women and children.   We need to teach globally and act locally!

 

When you see a mosquito, you need to at least think of malaria!

Marvin

References:

Lacerda MV;  Mourao MP;  Coelho HC;  Santos JB. Thrombocytopenia in malaria: who cares?.   Memorias do Instituto Oswaldo Cruz.  106 Suppl 1:52-63, 2011 Aug

Herbinger KH;  Schunk M;  Nothdurft HD;  von Sonnenburg F;  Loscher T;  Bretzel G.  Comparative study on infection-induced thrombocytopenia among returned travellers. Infection.  40(4):373-9, 2012 Aug.

http://www.who.int/malaria/areas/high_risk_groups/pregnancy/en/

http://www.kemri.org/index.php/help-desk/search/diseases-a-conditions/29-malaria/113-kenya-malaria-fact-sheet

Jeremiah

I am still fighting the North Carolina bug that I brought from the states and so I have not been able to work in the nursery as is my usual haunt.  Instead I have looked for other opportunities to serve.  Yesterday‘s opportunity was to go with several other missionaries to an orphanage called Mosop which is about twenty miles from here.  The countryside is so beautiful, hilly and terraced with small sambas, or farms, and some tea farms.  The roads however are not beautiful but filled with large potholes that you try and avoid!  It is always fun to leave the “compound” and venture out into the countryside.

Mosop is a beautiful place!   It has its own school which you see as you drive in.  There are approximately 300 students who attend the school, some from the orphanage, some from the community, and some are boarding students who have families.  It is such a unique idea which seems to be working really well.  The founder and director, Elijah is a warm gentleman who just radiates pride in his home and his children.  The concept is that orphans mix on a daily basis with children who have families.  Often these families will include an orphan in their plans, bring them gifts, or invite them to their homes.  It is the hope that as a result they will grow up to be much better adjusted. 

The reason that we were there was to do Bible quizzing.  As I have said before it is like the old fashioned Bible sword drill where kids are on teams and must press the buzzer, and answer questions from the Bible within a time frame.  It is amazing what they know about the book of Matthew and how many verses they can recite!  The team named “The Sea of Galilee” won yesterday!   Hopefully I will be able to go back every Thursday afternoon and help coach them for the final quiz.

After the quizzing, we were invited to share tea with Elijah and some of the teachers and Elijah was good enough to share stories about a couple of students.   I think that he could write a book about his life and career.

Here is one story I would like to share one with you.  Jeremiah was born albino and rejected at birth by his father. The father thought he was mazunga (a white person) and the result of an affair.  The baby and mother were thrown out of the village and lived a pauper’s life.   At 14 Jeremiah was injured and brought to Tenwek Hospital.   When he recovered no one came to get him and so he wandered around the hospital until a missionary nurse, Robin Moore, brought him to Mosop Orphanage.   Elijah soon discovered that Jeremiah could not read or write and so he began tutoring him at night.   Within one week the boy was reading and Elijah realized how bright he was.  He began school in third grade and soon moved up, skipping fifth grade.  He graduated with the highest scores ever at the school; scores that no one has yet achieved.  He is now enrolled in nursing school despite his limited vision.  But that is not the end of the story. Unbeknownst to anyone, Jeremiah saved every coin anyone ever gave him and when he had enough he bought a very small piece of land and built a hut on it for his mother.  Unfortunately, he cannot find his mother and so he continues to search.  His love is unfathomable to me! To be rejected and still be able to love; that is only by the grace of God. 

Lots of love,

Mom

p.s. It has not rained yet.  We all continue to pray.

Update from Tenwek

Dear Family and Friends

It has been a week now since we have left home and time has gone quickly. We are still battling our NC colds and coughs but apart from that we are doing well.  This morning I was awakened by the mighty crow of a lively rooster who crowed not once but many times.  It was as if to say, don’t roll over, it is time to get up.  Sure beats an alarm clock.

Now let’s catch up since the last blog.  We ate at the guesthouse for the first couple of days which allowed us to get to know the people living there which are always fun.   On Saturday I went to a nearby orphanage with a couple of other visitors.  It is nearby and currently there are 64 children living there between the ages of 4 to 17.  Since it was Saturday they were mostly all there and not attending school. They were eager to see us and to perform their well rehearsed repertoire.  It is a joy to hear African children sing, clap, and sway to music.  Someone had given them a keyboard which added to the merriment.  Then we toured the facility which according to first world standards would be spartan. From an African standpoint it is quite good.  There are separate dorms with bunk beds for the boys and girls.  Each bed has a plastic mattress and a blanket.  There is a dining hall with a kitchen that is currently getting a tile floor which they are proud of!  The gas stove runs on methane from the dung produced by the 8 orphanage cows!  Their diet consists primarily of ugali, a Kenyan staple made from maize (corn).  It resembles smooth bland oatmeal.   I stopped on the way and bought 64 mangoes which I hope added some variety to their supper!  The director is trying very hard to become self sustaining and has 200 chickens which lay 180 eggs a day in addition to the milk the cows provide.  Not only does this provide protein for the children, he is able to sell some for a profit.  The children are treated for medical problems at the hospital thanks to the generosity of an American donor who established a fund for this purpose.  Another fund that has been established provides scholarships for the children to attend Form 2 or high school and some are even qualifying to go to college.  Of course there is never enough money to go around. Such a shame as education is the way out of poverty.   As I looked into the faces of these little ones I wondered what is their story?  Why are they here?  Why would someone abandon them or why wouldn’t a relative take them in if the parents died? I do not know.  One little toothless boy, probably around six, with a radiant smile particularly caught my eye.  I can’t get him out of my mind.  I have two six year old toothless grandsons.  Maybe that is why.

On Sunday we went to church and they served communion.  The week before I had been at a women’s retreat in North Carolina and received communion.  How wonderful to experience the Lord’s Supper on two continents and share with Christians around the globe.  Our God is much bigger than any of us can imagine!  On Sunday afternoon we babysat for some missionary children so that their parents could participate in the Bible quizzing contest which happens here each year.  Children from the compound as well as many children from around the surrounding area memorize lengthy portions of scripture, this year it is Matthew, and recite them under the pressure of the time clock.   It is quite amazing to watch.  I always feel for the shy child who melts under the pressure! 

Yesterday turned out to be fun as I helped at the Nursing School.  I was the timekeeper as first year nursing students rotated through six practicum sections and had to answer questions or perform a technique within six minutes.  These students get younger each year!  Even at my age I can remember test anxiety and so I was rooting for each one of them.   The nursing school is an important part of this facility.  They and their colleagues who go elsewhere are well trained Christian nurses who make a difference in Kenya.   You can check out their web site: http://www.tenwekhospital.org/training-a-research/school-of-nursing

Thus far today has been a lazy day on the computer.   Each day is a bit different.   I am hoping that tomorrow I can go to the nursery if my cough subsides a bit.  Sorry I went on so long!   I will try to keep it shorter next time. 

Love to you all,

Micki and Marv

Betsy, I am going to do my exercises right now!!!

Presence

“If you want to go fast, go alone.  If you want to go far, go together”

African Proverb

“And surely I am with you always, to the very end of the age.”

Matthew 28:20b (NIV)

On the way to Kenya during one of the “long legs” of the journey, I watched the latest movie of the “Lost Boys of Sudan”, “The Good Lie”.   This is one story of their journey and of finally reaching the United States.  We are able to see the strangeness of our American culture and the distance between the Sudanese and the Americans.  It is a good movie of a difficult journey!

The distances we all travel is what I think is the behind the idea of “far” in the African proverb!  Part of that “far”ness is the inability to connect across cultures, languages and beliefs.  The good news here at Tenwek is the support provided by those who share a common faith as partners in providing care.  They, the Kenyans, become our connection partners to the patients.

The challenges medically are the unusual presentations of disease and obstetric complications.  For the medical readers, postpartum acute blindness from bilateral severe ptosis, obstetric paralysis with pulmonary thromboembolism, and septic abortion in a patient with a hemoglobin of 3 gm% and  a positive VDRL are what have been seen in the first week.

Presence, being with others, is what is central to providing care with new partners and patients. “Being present” is what we need to implement to conquer the distance between us.  The good news is that no matter where we are, we are not alone and we all can be “present” in the lives of those around us even when the barriers appear insurmountable.

Marv

Photo from the organization: Presence Health http://www.presencehealth.org/about-presence-health

http://www.thegoodliemovie.com/