Wednesday 9/16/15

Greetings friends and family,
I'm finding it difficult to put into words what this place is like....After being back in "the world" of San Antonio for a while, I tend to forget what life here is like.  For the long-term missionaries that live and serve here, there is an incredible tight-knit community that all live within short walks of each other, share there children's education and extra-curricular activities, share their work, share their meals, and share their worship time.  As "outsiders" and short-term volunteers, we are immediately welcomed into this large extended "family", and invited into their homes to share mid-day meals with their wives, husbands, and children.  Our temporary home is known as the "Guest House", which is a three story building containing several small efficiency type apartments.  The social center is the Guest House dining room, where all visiting staff share evening meals and fellowship time.  This year, we are sharing quarters with a visiting engineering team who are helping to plan the new labor and delivery suite, as well as an expansion of the "Theater" (or operating rooms).  We also have several U.S. physicians who are here serving along with us...one retired OB/GYN doctor from Michigan, and 2 retired Family practice physicians ( from Michigan and Indiana), a 3d year FP resident from Minnesota (who was born in Kenya), a 4th year Med/Peds resident, and his PA Hospitalist wife from Lexington, KY, and a surgical intern from Germany!  An incredible mix of people from around the world and from different walks of life, all coming together as the body of Christ, to share their unique talents and skills.  The guest house area is very lush, green, and beautiful; there are surrounding mountains providing a pleasant vista and the climate is very moderate....nothing like what I always imagined Africa to be.  At 6800 ft elevation the mornings and evenings are cool, and the mid-day temps are warm, but not overly hot.  As one volunterer describes it: "it feels like I'm on a mission in the garden of Eden".  In spite of our physical surroundings, the hospital work is anything but a "garden of Eden"....each time I return here I am stunned at the severity and complexity of disease and human suffering.  In the last 24 hours Marilyn and I have taken care of a young woman with twins, who came into the hospital with pre-eclampsia, bilateral lung infiltrates and respiratory distress, and oxygen saturations in the low 60% range.  She was taken directly from the emergency department to surgery where she had an emergent C-section and delivered a set of twins, who seemed to quickly rally and "perk-up" after birth.  The mother is now under my care for her persistent pulmonary infiltrates and respiratory distress.  In additon, we had a young man come in with an acute leukemia with a hemoglobin level of 4 (incredibly anemic), and a platelet count of 25K (dangerously low), and a WBC of 160,000 (very bad!!)...there is likely to be very little that can be done for him.  On rounds we found one of our admissions to be unresponsive, with fever, and a stiff neck (she had bacterial meningitis),  another young man (25 yrs old) with pulmonary edema secondary to valvular heart disease ...again, likely to die from his disease unless he can be stabilized long enough for the once a year CV team from the U.S. who comes in to do open heart surgeries and valve replacement surgeries.  In addition, there was the usual smattering of TB, meningitis, and HIV.  Death is a nearly daily occurence ( 2 on our service last night), and yet these people are so appreciative and patient...our hearts ache for them and all that they endure.  We feel so inadequate to the task....mostly we just do what we can with what we have and pray....please pray for them as well.