Mission to Cambita 2025

 

Our Plans for Cambita Garabito

January 25- February 2, 2025

 

 I found out that our plans for the project in Cambita hit a snag with a problem with the hospitals credentials on December 13th.  The government said that we couldn't go there so alternate plans were being made to go back to Monte Plata.  Then five days later the problem disappeared, and we were back on track to go to Cambita for the project, but the camp where we are staying can't accommodate us until Sunday afternoon.  So, more quick plans by our Dominican hosts and a new camp for Saturday night has been found for us.  Did I mention that changes make people nervous.  We kept on planning and planning. Saturday January 25^th was our day of transition.  Transition from the normal routine to the new normal for the next week.  

Forty-three of us began early in the morning, but some started earlier that most since they were coming from the airport in Portland Oregon on Friday evening.  We made our trips from the comfortable, spacious homes we enjoy and the families we enjoy thru the airports of the US- Portland, Wichita, Kansas City, St Louis and Boston to come together in the Dominican Republic.  All the participants arrived over a 4-hour period, and we only had one person lost (he actually wasn’t lost but there was a miscommunication of his schedule).  Getting us all together along with almost #1400 of supplies and medications loaded on three vehicles for the hour-long ride to our temporary camp was quite a feat. 

We stayed at a new camp for those of us regulars due to scheduling problems with our regular camp.  After a brief unpacking, we were able to enjoy our first of many meals of beans and rice. An orientation was then done, and we were able to unpack all the supplies and separate them to medical and surgical in nature for use the following day.  The new camp was stuck in the middle of an urban area.  The rooms were very small and set up for 4 people but not for suitcases, so we were cramped.  The bottom birth of the bunk beds had only 24” of clearance so you couldn’t sit on the bed only recline.  Sleep was elusive for me with the bar next door that played loud music until midnight.  When they finally closed, I was able to clearly hear the constant drip of the toilet despite my earplugs.  Needless to say, my sleep was not sound even though we had arisen at 2:30 the previous morning to get to the airport in Kansas to start our day.

We were going to be able to “sleep in” until 7 am, but I gave up and got up at 5:30 to begin my day and have my first cup of Dominican coffee. 

Breakfast was good and we were fortunate to have a pastor in our group this year and he presented an encouraging and uplifting message on the five-fold ministries of the church and how everyone’s gifts and talents contributed to the team as it does to the church.  We reloaded the truck and buses and traveled to Hospital Municipal Cambita Garabito.   We arrived and did the necessary reconnaissance in the hospital determining what rooms we could use and where to put everything, then unloaded the box truck with all our surgical equipment and supplies.  The team went to work with unpacking and setting up a “new” hospital in a hospital.  As that occurred, the doctors began to see roughly 100 patients and began the screening and scheduling of the patients for surgery for the week.  One of our translators was a young man that I have known for almost 20 years as he has served as a high school student who spoke 4 languages and served as a translator.  He is now a physician, having gone to medical school in the DR all the while working with us with MMI. 

Those friendship mean a great deal to me as I return year after year.  The Clinic team left in the afternoon to the main camp to unload and prepare for the clinics for the coming week.  Each day would be to a new location and so we would set up and tear down every day with our supplies.  At the end of the day at the hospital, we were asked to see an emergency room patient with abdominal pain that might have a case of acute appendicitis.  The diagnosis was not definitive, and we suggested admission and repeat exam and lab in the morning.  We put the patient on the schedule for the following morning.  It was almost 7:30 by the time we got home for our evening meal.  After our meal, we were all scurrying to set up our dorm rooms.  Lights out couldn’t come soon enough for most of us.

Monday morning, we began with a praise song in acapella and prayer as we did before each meal.  We then had breakfast together and one of the first-time participants provided our morning devotion.  We were off and running to get to our hospital and the clinic to their site.  The hospital was a 45-minute drive in good weather and the clinic also had a commute to get to their site for setup.  By 10 we were able to begin the first case.  Our patient with the possibility of appendicitis had been transferred to a larger hospital during the night so we began with a “hole” in our schedule.  We did 20 surgical procedures on the first day, while the clinic team saw 150 patients and gave out over 400 prescriptions.  By the end of the day, we were all beginning to relax and get into a routine.

The clinic team returned to camp on time (around 5:30 pm) but surgery was late getting home to camp.  Our 50-minute drive each way to and from the hospital seemed like it got longer as the week continued.  We finished our meal by about 8 pm and then gathered under one of the cabanas for a little more time to become more acquainted with each other.  It was good to hear each of our stories about how we came to join this team.  We finished by 9:30 and then I completed the schedule for surgery for the next day and was in our bunk room to bed by 10:45pm.

My alarm went off at 5:30 am after having a much better night’s sleep.  After a cold plunge (that is what I called my morning shower without hot or even warm water) and a cup of coffee, we all gathered for breakfast at 6:30 of pancakes, sausage and fresh fruit.  Our morning devotion centered on the book of James and its relevance today to control of our tongues.  We were all in our buses and off to a new clinic site and the to the hospital by 7:45.

Our hospital day was very full with 25 cases being done and another 4 procedures being done at the clinic site.  This was the first year that we sent a surgeon and nurse to the clinic site to do minor, local anesthetic procedures. 

It was quite successful, and 46 procedures were done in total, and another 19 consultations were done in the clinic which spared the patient from going to another site to have procedures done.  Each morning, we start with a praise song called Alabara which means I will praise my savior.  It is well known to the citizens of the towns we serve.  We then pray and enter the hospital to begin our day.  The OR crew then readies the rooms, the preop team is checking in the patients for the day.  The surgeons are making rounds to check on the patients that stayed overnight to discharge them to their homes.  Today during our scheduled cases an emergency case came in with a patient that had a miscarriage.  Since we had taken over the OR’s with our equipment and procedures, we made room to add this case on in the GYN room.  This did push our schedule back somewhat and then the last case in that room ended up taking almost 3 and a half hours, finishing at 6:30.   She had low blood pressure, and we stayed at the hospital until 7:30 before driving the hour back to camp.  We ate our dinner after 8:30 and were in contact with the nurse at the hospital until 10:30. During the night, the hospital director came back in and decided to transfer the patient to the capital of the province to a larger hospital.

The following morning, we were told about the transfer and that she had to have blood transfused and reoperated.  This dampened the mood of the OR team in concern for the patient and her family.  Our morning devotional made the comparison of situational awareness at our workplace to the situational awareness that we need to have concerning the things of God.  Wednesday was the heaviest surgical volume scheduled so far and while the OR crew was getting ready for the day and beginning the first cases, the hospital director had me in his office to explain the protocols that we were to follow going forward after the difficult case from the night prior.  This municipal hospital did not have a blood bank, but all major cases, by their definition, had to have 2 pints of blood on site prior to surgery.  This was a protocol that is not currently in place in the United States.  He also stressed that all patients needed to have preop lab work.  Once again, not something that we encountered in the DR before this trip.  The director then cancelled 3 of our cases for the day. The patients left and went to the capital to purchase blood and return the following day.  We also contacted the patient for Thursday and instructed them to do the same.  With our schedule being shortened, we were able to leave in time to return to camp even before the clinic returned.  They had a long day in the clinic today serving in a small village in the main square under a large tent.  A hot long day for them. 

One patient was a 54-year-old man who was very thin and came with family as most patients do.  He told our doctors that he had recently been diagnosed with lung cancer but had not seen a doctor to find out any details or options.  Our doctors were able to determine that he had advanced disease by their exam.  They were able to talk to him about his diagnosis thru the translators and explain the gravity of the diagnosis.   They were able to pray for him and he responded by saying that he didn’t know how long he had left but he would be praising Jesus all the same.

The following day we returned to begin our scheduled cases.  Sure enough, the three major cases we had scheduled showed up with a unit of blood as well as the two from the day before.  We were in communication with the patient sent to the capitol and her husband said she was doing better, and he was appreciative of all that we had done for them.  That was welcome news to everyone.  One of scheduled cases had high blood pressure that had not improved since seeing her in the clinic and she was cancelled and sent to see a cardiologist to obtain clearance before surgery could be done.  So, that allowed us to add one of the cases on from Wednesday.  Then another patient revealed that she was on a blood thinner, something that had not been revealed before to us.  She likewise was cancelled until she could be taken off of the blood thinners for 3 weeks prior to surgery.  And the second patient in waiting was added on to the schedule.  God knows these things.  Further discussion with the hospital director yielded a plan for next year where he, as a physician, will screen all candidates for surgery two weeks prior to our arrival to check them for surgery and obtain any lab or clearance we need.  We were encouraged that they still wanted us to come back next year.  A full day of surgery was completed just late enough for us to have to drive home in heavy rains on winding narrow roads but safely.

Friday was met with mixed emotions.  I was sad that the project was coming to an end but pleased with all we had accomplished.  The plan for the day was to finish the schedule at surgery with a short day since we could not do major overnight cases due to our leaving and not being able to discharge our patients the day after surgery.  One of our highlights today was seeing and doing surgery on a precious 3-year-old named Sonja. 

When I had evaluated her on Sunday for surgery, she was found to have a mass on the inside of her mouth on the lower lip.  She was happy and at the end of the examination, she told me in Spanish that she could speak English.  I said great, talk to me.  She responded by saying in perfect English, “one, two, three, four!” with great satisfaction.  When she came with her mother on Friday, her personality was still as effervescent as before.  She was carried by the anesthesiologist to the OR without hesitation.  When the surgeon prayed over her before surgery as we always do, she joined in with the Amen.  She then joined in singing “Alabara” even providing verses we didn’t know.  All went well with her surgery, leaving smiles on the faces of the team. 

When we finished the last case at 3 pm (a couple of hours later than we had planned), we still had to take down the entire OR and pack it into the white box truck for transportation to the next project.  The clinic team also had to see all their patient and then pack for transporting all the supplies back to the warehouse in Santo Domingo. 

So, by the time we all returned to camp we were all tired but satisfied.  After our evening meal we gathered under the cabana and had a time of sharing and debriefing to be able to look back over the week. 

I enjoy hearing the comments of the participants during this time.  It is so encouraging to see the life-changing insights that come from these experiences.  We were able to share the preliminary statistics that we keep to track our progress.  All were pleased.  Some of the impressions of the team centered around the gratitude they saw from the patients not only for what we could do for them but also just the fact that we came.  The participants were also excided the be part of a cohesive team and the camaraderie that developed so quickly among all team members from repeaters to new timers, doctors to general helpers.  They also became more aware of how fortunate we are to be living in the US today and for all that we have.

Saturday, we got to “sleep in” again since we set breakfast at 7:30 instead of 6:30 am.  We enjoyed our last meal at the camp and then packed all our personal belongings to put into the buses and trailer.  The remaining part of the camp equipment was loaded on the truck, and we were off to the capital, Santo Domingo.  It took over an hour since we were traveling thru the middle of town, and it is always “rush hour” like traffic.  We parked just on the outskirts of the colonial zone and left our buses with the drivers and walked into the square. 

We were all able to visit some of the sites and have lunch before the those who were leaving for home, returned to the large bus and headed to the airport.  Sixteen of the team stayed over until Sunday to return home to be able to enjoy the city before the long trek home.  We stayed at a new hotel for us near the location where the buses waited to take the rest of the team home.  At 3 pm we were able to check into our hotel (along with 30 other folks, and yes, they only had one person to do the checking in (fortunately he spoke English.)  The last husband and wife of our group checked in and to our dismay the last person of our group could not find his passport in order to check in.  He looked through all his bags and his backpack, where he had seen the passport earlier.  He did have a picture of his passport which the front desk person said was okay for him to use.  We all knew that was the least of his problems since he couldn’t fly without the passport.  He was getting ready to drop his bags in his room and run back to where the bus was parked to see if he could find it along the way.  (Yes, I know what you are thinking and that is what I was thinking also.) 

Just then the couple that checked in last came thru the elevator doors excitedly remarking “I found it!”  When they had gotten to their room, she had prayed out loud “Lord, let it be in the backpack.”  When she looked in her backpack, his passport was in the top.  We later pieced together that their backpacks were beside each other in the bus and apparently his passport fell out of his backpack, and someone noticed it and just put it in the nearest backpack, which was hers.  What an answer to prayers, certainly not in the way we expected.

The remainer of our day was restful and uneventful.  We were able to do some sightseeing and enjoy a couple of meals together.  On Sunday at lunchtime, we went to the airport and began our travels home to the cold weather but also to the hot showers.  The flights back home were not nearly as rushed and customs not nearly as tense because we were home.  But the new people we had met and befriended and the lives we had touched were still freshly imprinted on our minds.  And the plans for next year have already begun.  I think that I am beginning to better understand that process of planning.

 

PROVERBS 16:1 (CEV)
WE HUMANS MAKE PLANS,
BUT THE LORD HAS THE FINAL WORD.

Cambita Garabito; It's All About The Plans

 

Jeremiah 29:11 begins with "I know the plans I have for you, declares the Lord".  The unfortunate thing is that I am pretty sure that I don't know what His plans are when it comes to the mission trips we make.  You would think that I know that by now after 34 trips, but I just keep learning. Take for instance our recent MMI trip to the Dominican Republic on January 29,2024.  

MY PLANS

It takes quite a while to "plan" for a trip like this.  But this is not just me, it involves coordination with a large number of people over a long time.  Sheri and I and Bill and Pat Waswick are involved throughout the year in advance of the trip.  The challenge is that we don't know how many people will go with us, how many people we will take care of, nor what those conditions will be.  So, making plans in and of itself is complicated by any number of erroneous assumptions.  But we have the benefit of experience and a history of doing this kind of thing.  One of the difficulties is in remembering that this is God's plan and not our own.  We make a prediction of how many we will have and what we will do, then go about trying to achieve that goal.

Peoples

It begins with the people who join us.  We know that to set up and run a clinic we need at least 5-10 participants and in surgery we need 15 to 20 to run two to three surgical tables.  The size of the places we go can limit us also.  So, when we had 33 sign up to go, we thought we might have a few too many.  Most people who go, want to be busy.
  Jim Collins, the author, says it's not enough to have the right number of people on the bus, they have to be sitting in the right seats to make an organization productive.  But when one of our participants had to return home for a family emergency and two more came down with COVID, we ended up with the right amount of people and those were sitting in the right places.

Places

This year we were returning to Yaguate where we went last year.  At least we thought we were until we were told around 2 weeks prior to leaving that the hospital in Yaguate was being remodeled and we couldn't go there after all.  A new hospital had been recently opened in Cambita Garabito.  As we found out, so new that the surgery area had not been used at all.  We were scheduled to go to 5 different villages and set up our medical, dental and vision clinic but not until we arrived did we find out that 3 of the villages could not host us. 
Fortunately, the MMI staff in the DR was at work behind the scenes and replacement sites were found.

Products

What we can do is certainly controlled by who and how many we bring, but also what we bring has an impact on what we do, namely the supplies, equipment, and medications.  In the DR, MMI has a warehouse that can hold the big equipment and supplies such as tables, lights, anesthesia machines and sterilizers that we need for a project since we can't count on all of the hospitals to have what we need.  We are able to set up a "MASH" like hospital in almost any facility.  But, the disposable supplies are more of a problem. 

We generally bring 1,000 to 1,500 pounds worth of supplies as our checked luggage (27-gallon Rubbermaid-like tubs).  We collect those supplies year-round and process them here then take with us.  Medications are purchased from a non-for-profit wholesaler.  We know that we usually see around 500 patients in the clinic so we try to bring enough medications to provide for that number.

  Vitamins are commonly given out to each of the patients as they represent a luxury for the people there.  So, I ordered 18 bottles of 1000 each to take only to find out in November that they couldn't supply the order since there had been so many worldwide needs (Ukraine, Tsunamis, Earthquakes).  So I approached our church and a "Vitamin Sunday" was set up for people to bring vitamins to church on December 3.  Together with what was collected and cash donations made, we were able to take almost 13,000 doses of vitamins.  I have to send a list of each bottle and amount to Customs in the DR 6 weeks in advanced so I sent my list only to find on my front porch three days before Christmas a box that had the full 18,000 vitamins that had been backordered.  God provided abundantly and more that we planned.  The abundance provided for future projects that didn't have vitamins with them to also provide for these needs.

HIS PLANS

I have learned that the best way for me to follow His plans is for me to not get to far ahead and be willing to be flexible if I find that I was wrong about what I thought I heard Him say.  These projects certainly prove that.  Being flexible seems to be one of the most valuable skills that one needs to participate in a mission project.  So, with that view thru the rear-view mirror, I can better see how His Plans have unfolded.

Unity

1 Corinthians 12:25-26 So that there will be no division in the body, but that its parts should have equal concern for each other.  If one part suffers, every part suffers with it; if one part is honored, every part rejoices with it.  We were able to bring 33 people from the US and work with 11 from the Dominican Republic with such diverse backgrounds to include 2 countries, 10 cities, 5 states, multiple jobs at home, and most of who didn't know each other prior to landing in a foreign country.  It was that common purpose that united us all into a cohesive and productive "body" that we equally suffered and equally rejoiced during the project.

Service

John 13:15  I have set you an example that you should do as I have done for you. 

Year of Project	2024
Patients Seen in Clinic	442
Health Education	837
Prescriptions Filled	1,634
Eye Exams	192
Dental Patients	101
Major Surgeries	48
Minor Surgeries	33
Consults	107
Commitments to Christ	10
Project Location	Cambita Garabito

 The wonderful part of going on a mission trip is that everyone who comes does so voluntarily and of their own free will expecting to serve.  Almost every year, I have people share that this type of comradery and environment is why they went into health care in the first place.  Likewise, the responses to us by the patients and families we see is heartwarming.  
Statistics are a poor way of quantifying our impact but still help to underscore the services that we were able to provide to "the least of these" that Jesus talked about.

I received a beautiful hand-written in lovely cursive English from one of our patients that I would love to show you some time as it  hanging on my wall.

  It was interesting that she thanked us not for our medications, our dental work or even our skilled surgical procedures but for our presence.  We just showed up and followed God's plan.  If I stopped my post here, it would be considered just nice heartwarming entertainment.  But there is more.

YOUR PLANS

So now the hard part.  What does this mean for you?  There are many opportunities to serve on mission trips with MMI in over 23 countries annually.  For some, that is not a good option.  For some, going with us to the DR next year around the last week of January may be an option.  Or maybe it's helping with the purchase or packing of the medications and supplies.  And hopefully, it includes praying now for next year.  But the Great Commission, as I read it, doesn't seem to have a "none of the above" option.  So, consider going, giving, praying or maybe all of the above for the least and the lost as we begin to try to figure the Plans He has for us all.

Following and Changing in Yaguate

    We generally tell people who go on a mission trip to a developing country to "Be Flexible" and they usually get it.  But I have found that it is the repeat participants that seem to have more trouble with that flexibility because they were flexible... the first time.  Thereafter, they get used to the new different and then it changes again and we have to be flexible all over again.  We had planned to return to Palenque in January of 2023 for some time but three weeks before we were to leave the US, I got word that we were changing hospitals for the project.  My first thought was "nobody ask or talked to me about this".  Submission is part of the flexibility thing I talked about that I am still working on.  Apparently, the hospital's backup generator was broken, whatever that means.  I should have suspected something since last year, when we were at that hospital, I saw them "jump-start" the hospitals generator with a Honda Accord.    So, we were going to San Gregorio de Yaguate instead of Palenque.

Putting together a Team

    This year we had 37 participants go to the DR.  The process of recruiting a team is both easy and hard.  This was almost the largest group that I have taken to the DR. This is great since we had seen marked decreases in participants since COVID changed the world.  Half to two thirds of the participants are folks who return year after year with us and have become some of my most treasured friends.  Another group are people who have been once or twice before, but don't come every year.  The last group are first timers.  This group is a lot of  fun because they see everything thru new eyes.  The last participant to join us only decided 3 weeks before we left to come.  This year we had 11 physicians, 2 CRNA's, 1 Nurse Practioner, 1 Pharmacist, 12 RNs, 2 Medical Students and 8 general helpers.  Those of us repeaters are constantly talking to others about the mission and I am adding names to my master email list through out the year.  Then, when the project is set I begin by sending out an email to ask people to consider going and begin the planning.  As it turns out this year we had more gynecologist than in years before and that changed the case mix of surgeries we could do.  If we had gone to the original hospital we would have not had the physical room to do all the surgeries that we did.  I had no way of knowing that, but apparently, God did.

Thorns and Roses

   

There are always troubles or difficulties and blessings that present themselves during a mission project and one must be careful to always look closely to see the flower among the Thorns.  We changed our hospital this year because of difficulties with the back up generator at Palenque.  But we didn't anticipate that the "new" hospital would be without running water.  It seems as if there was a problem with their cistern holding water.  That meant that the toilets had to be bucket flushed.

  I was surprised to find that some of our younger participants needed to Google it to learn how (actually we ended up telling them).  That meant that we had to use hand gel for hand cleaning and Avagard for sterile preparation of our hands  for surgery.

    We did have air conditioners in the OR and actually in our sleeping rooms.  Very much a Rose, but the Thorn was that few people came to the Caribbean with a blanket to sleep under.  And when we ran low on gowns toward the end of the week, it was chilly in the ORs. 

    Prior to our arrival on a project, our Dominican director will make site visits to the local community and work out the dates and locations of our surgery and clinic teams.  He will also let them know our team composition and capabilities.  The hospital director then spreads the word to the local people and a list is developed of people that may need our services.  This year they identified 135 people and apparently told them to all show up on the Sunday we arrived to set up so that they could be seen and scheduled for surgery. 

We were able to see 75 patients the afternoon we arrived and we told the rest to return on Monday.  There are many factors that go into scheduling patients for surgery including the number of surgeons, the number of staff members, the number of recovery room beds, the amount of supplies and medications as well as the condition of the patients.  Based on all those factors we anticipated being able to do 100-110 surgeries and ended up at 98 total.  So, the Thorn of having to change hospitals at the last minute became a Rose of  allowing us to do almost 20 more surgeries due to the larger size of the preoperative and postoperative rooms.

    The medical clinics work in the same fashion.  Our director meets with the local sponsor of the project that in this case was a pastor from a local church.  Clinic site locations and dates are picked and then the local pastor spreads the word to the communities and helps arrange the actual locations for the clinic to be held.  Sometimes they meet in a church, sometimes a community center, but this time one was held in a local library. 

    It is an unusual experience for those of us in health care to be welcomed with a "Rose" of applause but not in the DR.  Each morning as we arrive to the clinic and to the hospital all the patients for the day are there with their family. When we are introduced to the crowd, they break into applause. We all begin the day with prayer and a Spanish praise song, Alabare'.  At the hospital, all the patients show up at 8 am for the day and have their preoperative COVID test and then wait their turn for surgery.  When the nurses come to the waiting area to call the next patients name, everyone applauds and congratulates the patient.  There was a long hallway from the OR sites and the postoperative recovery rooms.  In the hospital, people could wait anywhere in the hospital and the waiting area was between the OR and the post op area.  As one young body was being transported from the OR by the waiting area full of people, he was quite sleepy from his surgery but did manage to raise a thumbs up to which the crowd cheered and applauded.

    If there was any question as to whether we were appreciated, it was answered when one happy patient returned the day after his surgery with a pan full of 36 home made empanadas for the whole surgery crew.  They were very good and were made with yucca as the pastry shell.  It is a local favorite as well as some of us.  The hospital staff also served us the last day with a fried Caribbean sea bass and tostones which are twice fried plantain slices.  All were very tasty.  

Earthquake

    I have encountered many different things while in the DR, but this year I was able to add a new experience.  During our teams morning devotional, one of the participants was presenting a devotion on the Hope of God.  In the middle of the presentation, all the people upstairs simultaneously got up from their metal chairs on a tile floor.  It was about that time, I realized that there wasn't anyone upstairs that the building was shaking.  Yes, we experienced an earthquake at exactly 7:11 in the morning.  We were all getting ready to head outdoors when it quit as quickly as it started.  Later, we discovered that a 5.6 earthquake had occurred 30.6 miles away from us. 

Later, I texted my wife and she told me that she had been awakened at 5 am (there is a 2 hour difference between Wichita and the DR) and had felt led to pray for our teams safety at that same time.  What a coincidence! Just kidding.  The scheduled village that day was closer to the epicenter but they didn't see any damage. The school officials had called off school and most everyone stayed home rather that coming out to the clinic. After lunch the people showed up in crowds to be seen.

Struggles of the Patients

    One of the patients needed a hysterectomy because of heavy bleeding. However, her blood count was too low to safely proceed with surgery.  Our doctors recommended that the patient have a transfusion prior to surgery.  For us in the US, that is not a major problem.  But in the DR it is.  The day that she was scheduled for her surgery, she didn't show up.  After we found a number to call her, we were told that she had to travel by moped to another city to buy her blood.  She arrived later (on the moped) with her blood in a Styrofoam dinner container with ice cubes in a plastic bag. We administered the blood to her and then took her to surgery and she was home the next morning. 

    I saw a patient on Monday afternoon as I was filling in the last slots in the schedule.  She was weak and kind of shaky and I ask if she was okay thru the interpreter.  She responded that she hadn't had anything to eat or drink since Saturday in hopes that we would do her surgery.  After we left Sunday and told people to return the next day, she had just stayed at the hospital in hopes to be the seen for sure.  She was willing to do anything to get help.  We gave her some IV fluids and her surgery went well.

    I had a male around his mid 50's who was a neighbor of the hospital director, who arrived late on Tuesday to be seen to see if we could squeeze him on the schedule.  He had an abdominal wall hernia that had been present for 12 years.  I also noticed that he walked with a cane. We saw him and did an evaluation including checking his blood pressure.  We checked it several times and it was 224/129!!  We immediately told him that he couldn't have surgery with that pressure and sent him around the corner to the Emergency Room (yes, it was a room with people in the halls).  As he was going I asked about his limp and he said he has had that since his stroke a year ago, undoubtedly due to high blood pressure.  As we were leaving in the evening, he came by my room and said they got his pressure down with meds to 149/100 and he ask if we could go ahead with the surgery.  The answer was no, as it was still too dangerous to operate in an elective fashion on a non emergent hernia.  We advised him to keep taking his blood pressure medication and to return on our next project to be evaluated.

    It is sometimes not just the patients who are under stress.  For instance, we had two brothers, 2 and 6 years old, that need to be circumcised and their mother wanted them done on the same day.  So, the first one went well and when he was taken to the post operative room mom came in to sit with him until he was ready to go home.  We then did the second boy and when he went to the same room to recover, mom needed help and the boys grandmother came in to help.  When both boys cried we looked over and saw that grandmother had passed out on the second boys bed.  Everything turned out good, but it was a little chaotic in that crowded room for a bit.

Speaking Your Heart

    We had daily devotions during our time in the Dominican Republic beginning on the first day, Sunday morning.  The first day the message highlighted a devotion that I had shared almost 10-15 years ago.  It focused on the concept of doctors needing others around us to make us productive. 

Then another devotion resonated with the person that was sharing that one of us had shared a few years ago.  Neither one of us remembers much of the details that we had shared at that time but it shows how important that it is to share your heart because you never know where people are at the time you share your insights or how important that they are to them.  The devotion times during the projects remain a source of encouragement to each of us and allow us to focus our efforts each day.

"I can do all (these) things"

    Frequently, we hear the verse from Philippians 4:13 quoted and used to encourage us to do anything we want to do.  But, recently I read that this verse must be read in context with the preceding verses, 11 and 12 which go something like this in the NASB. "Not that I speak from need, for I have learned to be content in whatever circumstances I am.  I know how to get along with little, and I also know how to live in prosperity; in any and every circumstance I have learned the secret of being filled and going hungry, both of having abundance and suffering need.  I can do all things through Him who strengthens me."  The "all things"  that he was referring to was the preceding things like being content in any and every circumstance.  That contentment that he learned was thru Him who strengthens me also.  Contentment is what allows us to be strong like these people from the Dominican Republic who don't seem to have a portion of what we materially have but have an abundance of His strength.