Wednesday, November 28, 2007
In case any of you heard about the suicide bomb here in Kabul yesterday, I am fine. The blast was heard here at the hospital, though. Please continue to pray for the people here as they live in almost daily fear of something like this happening.
I just wanted to say thank you to all of you for your love and support. I have felt it while I've been here. I look forward to seeing you all and sharing my experiences with you.
Until then, take care and God Bless!
Saturday, November 24, 2007
Me with "my" twins
Wednesday, November 21, 2007
Other than that, I had a good day. I gave another lecture. Things are going well here. I'm finally feeling back to normal. I have one more week here, and as the time to leave approaches, I must say that I have mixed feelings. I'm definitely ready to go home, which is a strange feeling for me. Not that I don't always miss people back home, but in the past, when I've been in Romania and Myanmar, I just feel so drawn to the place that I'm resistant to return to the States. That, for whatever reason, is missing this time. I have enjoyed my time here, and I feel a burden for this country and these people. But, it just doesn't seem the same. I guess I'm not meant to feel called to every country, right? That always makes leaving difficult, though, because everyone wants to know when you'll be back. So, I guess I'll need to work through that.
I hope you all are doing well.
Sunday, November 18, 2007
Me with 2 of the midwives (Victoria and Najeeba)
Wednesday, November 14, 2007
I don't have much to blog about today. My lecture today went well. I just found out that I will get to operate tomorrow, so I'm very glad about that!
Keep the comments coming. Tim and Christy - can you please send me your email address? It was so great to hear from you. Amanda - more blogs please :)
Tuesday, November 13, 2007
Things here are going well. Since I blogged last, I've seen lots of patients in the clinic. It continues to amaze me how people will travel days just to get her to be seen. In many of the villages throughout Afghanistan, there is no health care at all. So, people travel for days, some on foot, to come here and wait for hours to be seen. How lucky we are - and to think that people throw a fit if their doctor is an hour behind!
I had a good day today with the OB/GYN fellows here. There was a urogynecologist from Eggers military base that came and gave a very good lecture. It was fun talking to him and he even had an Indianapolis connection. Then, I did a journal club with the fellows. Dr. Minor, if you're reading this, you would have been proud. The purpose was to help them learn how to clinically evaluate medical articles that are published. They all said that they learned a lot, so that's good.
Also, last night, I had dinner with the doctor and his wife who started this hospital. It was a wonderful time and it was great to hear their stories of how things have changed in the last few years.
So, that's all the new news I have from here. No word on Malalai yet. I will try and call her this week.
Take care and God Bless!
(p.s. - For my fellow residents, please let me know how interviews went)
Monday, November 12, 2007
Yesterday was tough. I was working in the OB outpatient clinic, and I saw a woman I had seen last week. She is currently pregnant with her 5th pregnancy and has no living children. She has made it to full-term with all of her previous pregnancies and has had deaths of her children either prior to, during, or immediately following labor. So, when I saw her on Wednesday, I was determined that we would get her a successful outcome. We sent her for testing of the baby, which looked good. She was only 35weeks at the time, and here, they cannot do much for premature babies. So, we decided to do close testing and instructed her well on monitoring her babies movements. We decided we would electively deliver her once she reached 37wks. Turns out, we should have just delivered her that day. She came back yesterday for her testing and the baby was dead. I sat there dumbfounded when the midwife handed me the ultrasound report. Did I miss something? Should I have done something different? More importantly, how is this poor woman going to deal with this in a culture where women's only worth is found in their children? My heart broke for her as before my eyes she went through the stages of grief - denial, wanting a 2nd opinion, and then finally it hit her. As she sat there crying, I just wondered "Why Lord?" I know that He has a reason for everything, but sometimes I just don't understand. We are not allowed to pray with the patients at the hospital, so in my heart I said a prayer for her and I got her phone number so that I can call her. Her name is Malalai - please remember her and her family in your prayers as they go through this difficult time.
Now that you're thoroughly depressed - I did have a bright moment this morning. I was checking email and I found out that my "nieces" who are 2 1/2 and 1 1/2 were both asking about me last night. What a joy to hear! By the way, for those of you who were following Anara's story through her surgery, she is doing great and now home. You can go the Hubartt family link on my blog to read more.
Hope you are all well. I'm about halfway through my time here - look forward to seeing you all when I get home.
Thursday, November 8, 2007
I've seen other interesting things here as well. A lady was transferred in from a province about 4 hours away in a semi-comatose state. Two days after she delivered, she complained of a severe headache and then had a seizure. Following that, she couldn't move the right side of her body. She was supposed to come here that day. Instead, her family took her to a mullah (an Islamic holy man), who beat her to try and beat the evil spirits out of her. She is now clinging to life and almost completely unresponsive. It just breaks my heart that if these people would have better access to care, things like this could be avoided.
So, things have been busy. The OB fellows here (have finished residency, getting one year of extra training) are full of questions and eager to learn. They want me to give lectures on all kinds of things, most of which I can't give off the top of my head. So, this weekend (Friday and Saturday), I will be working on lectures. I am forming good relationships with them, though, and hope that I am more a help than a hinderance.
It is starting to get cold here now. At night it is in the 30's and during the day in the 60's. Thankfully, we just had heaters installed in our rooms yesterday.
So, that's what's going on with me. I hope everyone is doing well. Keep the comments coming - it makes my day when I read them.
Wednesday, November 7, 2007
Sunday, November 4, 2007
Backing up a little bit, the team flew out on Friday, after multiple mishaps trying to figure out when their flight actually left. I moved into the CURE guesthouse - where I have my own room with a double bed and a balcony. Some of the comforts we had at the other guesthouse, however, are missing here. No one to do my laundry, electricity only a few hours/day, and lukewarm showers with no water pressure. But, I have certainly survived worse and I know that it is still leaps and bounds better than what most people deal with on a daily base here. The house is pretty full right now - 2 family medicine residents from Oklahoma, an orthopedic surgeon and his wife who came here from spending 6 weeks in Africa, a Brazilian pathologist and a nurse who is half German and half Afghani. Oh, and a pulmonologist from New York who is originally from here. What a melting pot!
On Saturday, I went with the Afghan doctor to a teaching hospital that is associated with the medical school where he trained. He gave a lecture there (slides in English, but he spoke in the local language), and I was able to pick up some things. After that, I was invited to his niece's home, who is a FM intern at CURE, for lunch. It was wonderful! I got to experience home life in Afghanistan and we were served a feast, which we ate sitting Indian style on the floor. It was wonderful to really experience the culture.
Which brings us to today. The work week here is Sunday through Thursday. I spent all morning in the prenatal clinic. It was very busy and I saw lots of new patients. I had an "interpreter" who could speak only a few words of English for the majority of the morning. So, it was just a little bit frustrating. By the end of the day, though, everyone was asking to see the foreign doctor. I'm sure this was very frustrating for the locals, who are just as qualified, if not more, than I am.
I think it will take some getting used to schedules, etc, but I am really looking forward to the next few weeks. I must admit, though, I am a little homesick. I'm hoping that getting into a routine will help that.
I love and miss you all. Keep praying!
Friday, November 2, 2007
Then we go to tour the hospital. I was once again humbled as I saw protocols hanging on the walls that were right on with what we do in America. They really are trying to provide good health care, they just lack the resources they need. We saw 3 women who had just delivered. The midwives told us that it was a slow day, as they usually deliver 1500-1700 babies/month (not including operative deliveries)! We hope to establish a relationship with this hospital as well.
For lunch, we took all the teachers from the school up to the Intercontinental Hotel for a beautiful lunch buffet. They really enjoyed it and we spent a lot of time talking with them and learning more about their lives. Then, in the afternoon, we took all of the medical supplies we had brought over to CURE. They were so excited about them and were impressed at the amount (we pulled out some to give to Rabia Balkhi hospital). I'm really looking forward to getting started there.
But, there is one sad thing about today - the group from my church is leaving. It has been great reconnecting with them and it will be hard to see them go. I am thankful, though, that I have had this week with them.
One other piece of news - an internist that I know from home (Dr. Dee) was planning on coming over for 3 weeks and flying back with me. I found out the day I left that she was no longer coming, and I was pretty bummed about this. But, not to worry, I got an email today that her trip is back on. So, that's something to be happy about!
Hope everyone at home is well. Amanda, it was great to talk to you last night. Mom - try answering your phone!
Wednesday, October 31, 2007
Today was a great day. We started out at 7 am sharp (Holly and I) at CURE hospital, where I will be for the next month. I must say that I am extremely impressed at this point with how organized everything is and how they truly are attempting to run it as a legitimate teaching facility. We went to morning report this morning, which is where an interesting case from the night before is shared. Ok, for those of you non-medical folk, you may want to tune out for the rest of this paragraph. The case presented was a patient who is 20wks pregnant and presented with shortness of breath. Long story short, she has severe mitral stenosis from rheumatic fever with severe tricuspid regurgitation and pulmonary hypertension. Her prognosis for this pregnancy is very poor, with a mortality rate of approximately 40%. So, now it becomes an ethical dilemma - they may raise money to send her to Pakistan for a balloon valvuloplasty. It was an interesting discussion.
Ok - non-medical people can tune back in now. Following morning report, we went on morning rounds with the team and then Dr. Hill, the OB/GYN who will be supervising me, gave Holly and I a tour of the hospital. It is comprehensive and I am impressed at the organization. We discussed goals for the next month and I am very excited to get started. I think that I will have some to offer, but I will definitely learn a lot. I will start there on Sunday and will be involved both in hospital work as well as clinic work. One big project will be to help develop protocols - both for prenatal visits and for inpatient.
Following this, we went back to the school and had some interesting spaghetti prepared by Peter. It was very spicy! While eating, we enjoyed several stories about his many exploits over the years. For those of you who know Peter, I'm sure you could imagine. We then went to an orphanage to take them cookies and fruit as well as gloves/scarves/hats that children from ECS had collected. This was one of the things I was looking forward to the most. It was an all-boys orphanage, and although we were told that there were 280 kids there, when we arrived, we found out there were actually 420! It was heartbreaking to think that most of them were likely there due to the years of war that this country has been through. It was not like my orphanage experiences in Romania and Myanmar - the kids kind of looked at us as though they weren't quite sure what we were there for. There was no attaching themselves to us or coming up to us. They were excited about the treats, but we were whisked out pretty quickly, so we did not get to spend much time with them at all. Hopefully we blessed them with a few moments of happiness.
Ok, now if you're wondering where the title came from (don't worry, this will be brief). After leaving the orphanage, we went to a place called Chicken Street. It is a large outdoor market. It was a little crazy and one of our drivers hit another car. We were able to find a few things and made it out unscathed. We are definitely a novelty here, though.
Ok, I'll stop rambling. I hope that my blogs haven't been too wordy. I'm really happy with how things are going and continue to be humbled by the workers who are here all the time and live in these difficult conditions.
Tuesday, October 30, 2007
Today, I saw the real Afghanistan. The morning started out with Pastor Bret going to the airport to retrieve the one bag that didn't arrive with the rest - the one with his 14 year old daughter's clothes in it. Needless to say, it still hasn't arrived. But, Madison is being a trooper about it and they are currently out in search of some jeans and shirts.
Then, we headed to Istalif, a village about "1 hour" north of Kabul where SoZo (another NGO) has a health clinic. We arrived there about 2 hours later. First, after we had gotten out of the city and were on the highway, we hear a loud blast. Don't worry, it wasn't a bomb, but it was our tire blowing. As we looked around, we saw all kind of interested bystanders. Thankfully, we had a spare tire and our Afghan driver along with a couple of the men with us were able to change out the tire. Just as we thought the hard part of our journey was over, we turned off the highway onto a dirt road. To say that it was bumpy would be about the biggest understatement ever. We rocked up and down and side to side for about 45 minutes. Each time we passed a cluster of roadside houses, we though "Great, we're finally there." But no, there was more to go. Then came the windy road up the mountain that was only wide enough for one car with a steep cliff off the side. (See pics below). At long last, we arrived at the clinic. Oh, did I also mention that we had a woman who is 38wks pregnant in the van with us for the whole bumpy ride?
I was very impressed with the clinic. They have special rooms for treatment of tuberculosis and leishmaniasis. They also see kids and adults as well as do prenatal care for women. Also, they do normal deliveries there (5-10/wk). The bed they deliver on is an exam bed like you see in a doctor's office. And, the typical postpartum stay is 6 hours! They were very happy to show us around and you could tell they were proud of the work they are doing there. They keep meticulous records and seem to have a huge emphasis on patient education.
The ride back was much easier, and we even stopped at an American-like coffee shop for a snack (as our lunch had consisted of trail mix and cheese on wheat crackers).
So, that was my day. Along the way, it was like driving through biblical times. There were mud houses surrounded by mud walls everywhere. What a hard life they must live!
So, here are my impressions so far:
- I am amazed by the resilience of this people. Just 5 years ago, major war was going on here and nearly everything was destroyed by bombs and gunfire (evidence of this is still everywhere). But, they have survived and the amount of new construction everywhere is amazing.
- The chinese that are here reaching out the people have amazing conviction and passion. They work tirelessly against much opposition. They truly are an inspiration.
- I have been humbled to see how good the medical care that is being given is. What they lack are supplies and continued education. So far, everything I've seen, as far as medical protocols, have been consistent with American standards. I do think I will end up learning more than I teach.
- Life here is hard - there are no modern conveniences (except internet and cell phones), it is dirty everywhere, your lungs are full of dirt, and most of the work that is available is hard labor, and they continue to live in fear of suicide bombers. But, when you look around, you can see rays of hope - a child smiling, new homes and businesses being built, people serving others. It sure does make you realize that many of the things that we get upset about are meaningless.
Here are some pics:
The reward of a grueling drive - a beautiful view
Monday, October 29, 2007
Today was a good day. We woke up to mini pancakes for breakfast and peanut butter - what a nice surprise. Then, we were off in search of hospitals serving women. The one that proved most helpful for me was one that we were not originally planning on going to. It is close to the school and one of the teachers at the school works there occasionally as a midwife. The sister of our dentist here also works there as a nurse. It is a comprehensive hospital, but has a significant OB/GYN ward. We were introduced to some of the midwives as well as the head physician, who was so welcoming. We talked to them about how they do things and what the biggest problems they see are. They were very willing to talk and eager to learn things from us. This particular hospital is supported by an Italian organization and are not lacking for much. (For the medical bunch among you, their biggest problem is pre-eclampsia/eclampsia.) We then went to Malalai hospital, which is a government-run hospital. They do between 80-120 deliveries/day! They have VERY limited funding and are supported only by the national Ministry of Public Health, which does not have much to give them. They are hurting badly for supplies. We started to go on a tour and talk to more people, but were cut short as we were informed that we needed a letter from the Ministry of Public Health in order to be there. So, we are working on that now.
We are coming up with ideas and are starting to think that the area we might best be involved in would be in training midwives, as they are key in serving women here. We are looking into how we could best do this.
Tomorrow we will be headed about one hour north of here to a village community that has started an outpatient clinic that has OB services. I'm excited for this.
One close call today - we were riding in a van and got pulled over by the police. Thankfully, I think it was just a traffic stop, but boy was I praying! Praise the Lord for His protection.
One more prayer request - pray for protection of my GI tract. I forgot to use bottled water to brush my teeth today :)
Sunday, October 28, 2007
The scene coming into Afghanistan was a beautiful one - lots of mountains. Then, as we got closer to Kabul, it became a vast of brown dust with no relief of green. The airport wasn't too bad. Peter Chun was there to meet us - for those of you who don't know, he is a missionary from my church back home that has started the work here in Afghanistan. The only hitch - our luggage wasn't there to meet us. We had to transfer it over in Dubai, and we're hoping it gets here tomorrow morning. Time to be flexible.
Today, we went to the school that Uncharted has started and met the staff there. Their hospitality and joyful spirit were amazing to me. We also went to CURE hospital to look around and I was able to meet Dr. Hill, who will be supervising me. I will be going back on Wednesday to do morning obstetric rounds with them and meet everyone. I'm very excited about that!
It seems like doors are opening - tomorrow we will go to 2 government women's hospitals to see what care there is like and what the needs are. On Tuesday, we will be going to a village clinic that was started by the organizations that is housing us (SoZo) that has an OB clinic. I'm getting excited about getting started.
Thank you all for all your prayers! I can feel them. Please continue to pray for safety - so far, I have not felt threatened at all. Also, please pray for wisdom for me that I can compassionately and critically look at the situation here and give my best advice to the team from Uncharted about how they could potentially fit into the medical scene here. Speicifically, we would like to do something that would meet the needs of the people, while being able to establish meaningful and purposeful relationships.
Until later - I'd love to get some comments! I'll try to post pics next time.
Thursday, October 18, 2007
Things have been very crazy as I prepare to go. I'm paying for being gone for a month in that I've been on call pretty much every 3rd night this month. For those of you outside the medical field, that doesn't just mean that I'm on my pager. It means I'm in the hospital for a 30 hour stretch and up pretty much the whole time. So, that has been tiring. To add to that, last week I was more sick than I have been in a very long time. It lasted for a week and made being at work and on call very difficult. Thankfully, I am feeling much better now and ready to be productive.
I have raised all of the funds that I needed, so that's a huge praise. The OR team here at Women's has been collecting supplies for me to take and I think I probably have enough to fill several suitcases. Also, the nurse manager at our clinic, who just happens to be Afghani, has collected about 150 bottles of prenatal vitamins for me to take. So, packing should be interesting. It really has been amazing how everyone has pitched in and help.
Other than that, my life is just full of preparations. It's not easy getting your affairs in order to be gone for an entire month! I'm just making list after list, feeling better as I'm able to cross off each task. Is anyone else as weird as I am about that? I love lists.
Well, since I am supposed to be working, I should probably go. Hope this satisfies those of you who are actually reading this (Amanda :) And, just in case you were wondering, I use Colgate Extreme and so far today I've only delivered one baby.
Sunday, September 30, 2007
The CURE International hospital in Kabul
So, stay tuned. I have found out that I can use my laptop at the hospital, so I will be updating this post, hopefully frequently, while I'm there.
Monday, August 27, 2007
Some prayer requests as I prepare:
- That I would be focused on the Lord and His will in the upcoming weeks
Thanks all! Blog again soon.