Resources

Here are some suggestions of resources we used to help prepare and inform us while we were in the missions field. If you are considering medical missions or want to know more about sharing the gospel through practical and loving service, you may find these useful. Enjoy.

BOOKS:

Let the Nations be Glad! The Supremacy of God in Missions by John Piper

Your Mission: Get Ready! Get Set! GO! By Dr. Bruce Steffes

Medical Missions: Get Ready! Get Set! GO! By Dr. Bruce Steffes

When Helping Hurts: How to Alleviate Poverty Without Hurting the Poor and Yourself By Steve Corbett & Brian Fikkert

On Being a Missionary By Dr. Thomas Hale

            Don’t Let the Goats Eat the Loquat Trees

            On the Far Side of Liglig Mountain

(these last two books are also by Dr. Thomas Hale, and are a great way to read about the day-to-day life of a medical missionary in Nepal)

WEBSITES: 

World Medical Mission (the amazing sending organization we worked with)

www.samaritanspurse.org/index.php/wmm

Christian Medical Dental Association (lots of good information on finding sending organizations and preparation for the field)

www.cmda.org

United Mission Hospital – Tansen (the phenomenal hospital we served at for 5 months)

www.tansenhospital.org.np

Lighthouse Community Church (the church family we are blessed to be a part of)

www.lighthousesouthbay.org

BLOGS (mostly of families we served alongside with in Nepal, please check them out to learn how to pray for them and what God is doing in and through them!)

www.beinebunch.blogspot.com

www.mollestad.blogspot.com

www.theshoobee.blogspot.com

www.medicalmissionsblog.org

krazy in Kathmandu!

Praise God for delivering us safely from Tansen to Kathmandu! The Saturday before we left Tansen, brought a new Prime Minister into office and a peaceful agreement by all parties to extend the Constitution deadline for yet another 3 months. It was good news for us as it cancelled all "bandhs" that would have kept us off the roads for three days thus possibly being stranded in various parts of the country as we made our way back to Kathmandu. By God's grace, in spite of all our contingency plans, we were able to leave Tansen as originally planned, and arrived here with no incident!

It's a strange feeling living in a modified "Western World" again. Television, multi-lane roads, western toilets in restaurants, restaurants of any ethnic cuisine, name brand stores with Western prices, and movie theaters all keep our heads spinning as we wander the streets of Thamel and Durbar Marg. We actually escaped to the Garden of Dreams this morning (thanks for the awesome tip, Rachel!) just to get a break from the chaos of the big city. We also enjoyed an afternoon at Bodhnath (one of the largest Tibetan Buddhist Stupas in the country) yesterday. Even though it was quite busy with people, no cars are allowed in the area, and the place seemed to instill a bit of calmness in everyone which was greatly appreciated by our frazzled nerves!

So we have two more days here in Nepal, and are doing our best to keep our eyes focused on things above and appreciate each experience as it comes. We trust in God's will and we know that He is using this time to help us grow and re-adjust to life in the developed world. We pray to bring home humble hearts full of patience and grace as we prepare for the transition home. In the meantime, we will continue to enjoy food choices beyond daal bhaat, and look forward to some quality time on the beaches in Thailand! We look forward to seeing our family and friends back in LA in just over ONE WEEK!!!

some of our dear friends turned out to "wave us off" the morning we left Tansen
left to right: Rachel (hospital director), Joan, Rebecca, Ganesh, and Lisbeth is behind him

our last glimpse of Tansen-Palpa out the back window of the jeep

you know you're in Kathmandu when you see monkeys running around overhead!
after trying to cross the streets ourselves (a bit like the game Frogger), these monkeys are smarter than they look in taking the "overpass" option

Wednesday was Teej, the Hindu Women's Festival
the streets of Kathmandu were full of women dressed in their best red saris (red is the color Hindu brides wear at their weddings)

a quiet afternoon at Bodhnath (in some comfortable shoes :)

good-bye for now...

 It's hard to believe that it is our last week in Tansen. God has been so faithful in providing us a home, a community, and a life full of friends and fellowship in this special place. We will forever remember our first (pahilo) visit to Tansen, and pray that it will not be our last (antim)!

the town of Tansen just below and to the left of Shrinagar Hill

Pizza lunch in Nepal! Thanks to our forgiving friends, everyone enjoyed the pizza and pasta at our place :)
left to right (back row then front row): Pratima (PT), Deepa (OR nurse), Joan (Pediatrician, James' sister), Sumisti (intern), Rebecca (OT)

a game of "Spoons" after Sumisti's yummy dinner of momos (Nepali dumplings) at Joan's house
left to right: Nita (resident), Laksmi (anesthesia tech student), Paras (PT), Sumisti (intern), Joan

a traditional Nepali dinner and fellowship at Kasi Raam's home
He is the amazing tailor who made all of our clothes here
left to right: Yermila, Kasi, Kasi's younger sister, Mona Lisa (Kasi's daughter), and not in the photo is Bikram (his son who after attending 2 years of Bible College, now works at Tansen Church)

Laksmi, our dear gardener didi
she and Kim keep each other laughing with her limited English and Kim's limited Nepali
we will miss her amazing smile in the mornings!

dinner with Ganesh and his family
Ganesh has been our life saver in Nepal... he runs the Guesthouse and manages all accommodations for the bideshis (foreigners) on the compound; he's also quite the salu (the hockey game we play every week) player
left to right: Alisha (12), Laksmi (one of the Guesthouse didis who fed us well when we first got here), Monica (10), and Ganesh 

Jaattraa in town
everyone turns out to the town square for this Hindu festival celebrating the birth of Krishna

part of the large parade for this festival is this Hindu shrine carried by dozens of men

we just had to share a photo of the little mouse who eluded Tom's attempts of trapping it for almost 4 weeks... sadly, the little guy met his end in a bucket of water and a well fed cat; at least he won't be eating our rice or pooping in our flour anymore!

the rest of the photos are just from our last few walks in the hills and valleys here
we will miss the fresh air and abundant beauty of this place

sometimes we encounter creatures here that we couldn't even imagine existing!

All in a Day's Work....

For this blog entry, Kim will be given a much-needed break, as she has been the one diligently writing all the blogs up to this point.  She has been a blessing to me in so many ways, and updating the blog is just one of the many responsibilities that she has taken on so graciously.   Which is a good thing since she’s a much better writer than I am….

In case you were wondering what it’s like to work as a physician here at the mission hospital, I thought I would give an example of a typical day at work.

First of all, I had to learn quickly that missionary docs in general are often asked to work outside of their comfort zone.  For me, that meant working primarily in the Pediatric department here.  Back home, I was seeing mostly adult patients in my practice.

I also learned quickly that a dependence on God and lots of prayer were crucial to making it through the challenges of each day.

7:45a- 8:00a  Morning report.   We start with a devotional given by one of the missionary doctors, then the interns (1 medical and 1 surgical) will present the patients that were admitted overnight.  Almost every day, the surgical intern would present someone falling from a height (usually a tree) and breaking an arm, leg, hip, or other bone.  This ranged from young kids to even an woman who was 70!

Why kids break bones out here.

8:00a- 10:30a Rounding on the wards.  Right now, the pediatric team is Dr. Joan Shu (a pediatrician who’s from the San Fernando Valley), Prakash (General Practice resident), two interns (Abhijit and Shreshal), and myself.   This being monsoon season, we’ve been seeing a high volume of meningitis and typhoid fever, plus the occasional snake bite.

We have a critical care room, a newborn nursery, and will see newborns in maternity.

Don’t mind the boy on the right peeing in a cup.  Thankfully his identity is protected….

Dr. Joan (we’re all called by our first name)

This 9 year-old girl was bitten by a neurotoxic venomous krait snake and needed intubation.  Thankfully the girl recovered fully.   

Example of a krait in the middle bottle.

10:30a-11:00a “Conference time”.  Actually this is when our team goes to the canteen for a chiya (Nepali tea) break.  My favorite part of the day.

11:00a-1:00p Children’s Outpatient Department (OPD).   The patients are first seen by CMA’s (Clinical Medical Assistants) who take a history, do a physical exam, and order relevant lab tests and X-rays before seeing the physicians. 

Outpatient waiting area

1:00p-2:00p Lunchtime.  I live about 200 feet from the hospital so I get to go home and eat with Kim, which is great since I don’t get to do that back home. 

2:00p-5:00p Children’s OPD again.   What kind of stuff comes in?  Here’s what I treated one recent afternoon:

-Giardia (intestinal protozoa infection)

-Ascariasis (intestinal worm infection)

-Dysentery (bacterial and amoebic)

-Pneumonia

-Acute hepatitis A infection (with jaundice)

-Rectal prolapse

-Follow up on a young child who developed aspiration pneumonia after ingesting kerosene

-Urinary tract infection

Ascaris worms from one unfortunate patient (he had enough to fill 3 bottles)

At any time during the day, we can get called to the operating room for C-sections and be available to do neonatal resuscitations.

I would say it’s taken me a good 3 months to really get the hang of the medical side of things here. The work has been challenging, frightening, exciting, and humbling, but I haven’t been put in any situation that was more than I could handle, and I thank God for that.  I’ve been required to do procedures (with a lot of anxiety) that I haven’t done in many years, like lumbar punctures.  There are some days that I feel completely lost and useless, but I’ve always been able to ask for help from the other physicians (which I still do a lot of the time). 

We may not be able to save every life, but we can touch the lives of every patient and sometimes their family members with our care.   We have a Pastoral Care team that shares the gospel with every admitted patient upon his or her discharge from the hospital; they are the heart and soul of the hospital….

Well, we’re down to just about 3 weeks to go here in Nepal, believe it or not.  We're looking forward to coming home.  Thank you all for your support and prayers!

Namaste, Tom

chijbij

We titled this post "things." As we consider transitioning back to life in America in just over one month from now, we look back at the many crazy and amazing things we've experienced out here thus far. We know God still has a lot of work for us in these last 5 weeks, so we are doing our best to stay present in each moment to come. But for this post, we wanted to share a few photos that capture moments of God's grace, providence, beauty, and love in this land of Nepal. 

We are forever grateful to our friends and family back in the states who are faithfully praying for us and keeping us updated on the goings-on back home. Hearing stories of family birthdays and gatherings, the progress on our new church home, the blessing of VBS week, the growth and development of the precious little ones in our lives, and of course, the blessed event of weddings of dear friends this summer, inspire a sense of awe and wonder at how God is faithfully at work all over this world. So please enjoy these photos of His presence in Nepal!

"Jesus saved us all!"

This past Wednesday, the United Mission Hospital in Tansen made the news across the country. 

Below is a photo of a jeep laden with passengers (up to a dozen inside, and another 10 or so on the roof) that provides the usual means of public transportation in and around Tansen. This is the typical load that can be seen several times a day around Tansen.

On Wednesday, this is what happened to one of those jeeps.

This sign is located at the front entrance of the hospital to greet every patient and visitor who enters the hospital each day. It serves as a reminder to the community that in this hospital, the physicians and staff will provide loving service and care, but we leave the healing to our Lord and Savior, Jesus Christ.

Now before you get too worried about the outcome of this story with such dramatic photos, let us simply say that, from our perspective, God's sovereign hand of protection was clearly evident and tangible on this day. In Nepal, we have witnessed and heard many stories of God's amazing works in peoples' lives from miraculous healing to the most unlikely of folks coming to faith through tremendous hardship. To us, this particular day was just a confirmation that God's presence in this place is very real, and people are taking notice.

As you look at the next few photos, keep in mind these facts and how they all worked together in such a providential way.
- On Wednesdays, all of the outpatient clinics run at the hospital are closed. So the number of patients and visitors to the hospital is greatly reduced compared to any other day of the week. The accident occurred on a Wednesday.
- The accident occurred literally at the front gate of the hospital where all the visitors and families of the sick patients in the hospital wait for the gates to open at 10am (under the sign that reads "We Serve, Jesus Heals"). On an average day, there are usually several dozen people waiting in this small area.
- The accident occurred at 10:07am. Every last visitor waiting in that area had entered the hospital and no one was there when the jeep came through the wall.
- The driver of the jeep knew something wasn't quite right with the vehicle. So before reaching the part of the road that becomes the steep decline to the busy hotel and shop intersection, he had all the passengers who were sitting on the roof either find a seat inside the vehicle or get off and walk. No one was sitting on the roof of the jeep when it crashed through the wall and tipped over (remember the photo of the typical number of people who ride on the roofs of jeeps around here).
- When the brakes of the jeep failed as it came down the steep hill, the driver used the exterior wall of the hospital to try and slow it down (thus the end result). Had he not done so, the jeep would have run through a very busy intersection and most likely injured many people in the hotels and shops at the base of the hill. As a result of the driver's decision, no bystanders or witnesses outside the vehicle itself were injured.

As physicians and staff rushed out to take care of the passengers in the jeep, murmurs of amazement swept through the growing crowd. There were 10 people total inside the jeep. All but 2 of them walked away from the accident. The two who were injured were taken to the Emergency Department right away, and one was released after just a few hours. Please pray for the man who did suffer a fractured pelvis and internal injuries in this accident. He remains in the hospital at this time.

As the crowd came to look at the accident and wonder how so few people were injured, one of the nurses overheard some bystanders talking. One man exclaimed, "Jesus saved us all!" The man standing next to him said, "which Jesus are you talking about?" And the first man simply replied, "the Jesus that is written on their sign." 

We pray for healing of the man who remains in the hospital with injuries sustained in this accident. We praise God that He spared so many more lives that day. And we pray that God may use this circumstance to open the eyes of this community to see that He is in fact real and He is full of grace and mercy. We pray these things in the name of Jesus, Amen.

P.S. A few months ago, someone had written in Nepali "bideshis go home" (translated: foreigners go home) on the exact bit of hospital wall that the jeep crashed through. This particular sentiment is now buried in the rubble.

VACATION!!!

Last week we were blessed with the opportunity to get away from Tansen, and for the first time in three months, play "tourist" in this amazing country. One may think that spending five months away from home qualifies as a really long "vacation," but we've learned that no matter where you are living, a "vacation" from anywhere is almost always appreciated. The primary objective of our time in Pokhara was to obtain a two month extension for our visas to allow us to stay in the country until the end of August. Though knowing all that Pokhara has to offer, we were quite willing and excited to take care of such "official business." So we headed out with our good friends Graham and Elaine Wetzig (who also had to renew their visas) on the four hour drive from Tansen to Pokhara. 

Thank you all for your prayers with regard to our safe travels during this very wet monsoon season. The roads were quite muddy, and there were land slides across some areas of the road which slowed us down a bit, but by God's grace, we made it safely there and back again! We also thank you for your prayers for God to bless us with a happy and understanding government official the day we went to apply for the visa extensions. There were definitely a few nervous moments and several beads of sweat upon the brow when he told us the extension we were asking for isn't given at the Pokhara office. As we "played it cool" on the outside, we were frantically figuring out how we were going to get to Kathmandu to get the correct extension, or even possibly a flight out of the country before our first visas expired! But by God's grace, the nice man decided to do us a "special favor and make a call," and with our 20,000 rupiyaas in his hand, he signed our visa extensions. Praise God!

As for the rest of our time on vacation, we figure the photos will give a clearer picture than our words. Here are a few stats to help round out the picture of our time in Pokhara:

- # of pizzas devoured: 4 (each)

- # of milkshakes consumed: 2 (each)

- # of close calls with donkeys: 2

- # of rupiyaas spent in souvenir stores: a lot

- # of times we said, "thank God for AC!": at least 11

- # of times we got to flush a toilet: EVERY time we used one!!!

- # of leeches found on our person: 17 (but not to worry, there were no "Stand By Me" moments)

- # of stairs ascended and descended: 4252+ (see photo below)

- # of times we praised God for His amazing creation and the blessing of experiencing it: countless

Enjoy the photos from our three-day, two-night trek to some of the more remote villages in the foothills of the Himalayas, and the rest of our time while on VACATION!!!

the first day of the trek: the town of Landruk is behind us across the valley, and that's where we were headed on the second day of the trek (sidenote: although we have lost some of our extra poundage, the Nepali diet of intestinal parasites and amoebas is NOT recommended!)

the trek: started in Nayapul and spent the first night in Ghandruk; second day through Landruk and Tolka to spend the night in Dhampus; third day a short 2-hour walk downstairs to Phedi and then a 45 minute drive back to Pokhara

Nepali traffic jam. A note about donkeys: it's best not to follow them on the trail as they tend to leave a mess in their wake; and once you hear their bells, if they are behind you, move faster; if they are coming at you, move out of the way! 

we weren't sure what these two were doing, but they were quite obliging for their photo to be taken

added note about donkeys: try not to be on the bridge at the same time as they tend to make it bounce and sway more than you'd like

all in a day's work

the blessing of rain: lush valleys and beautiful waterfalls

most of the homes, paths, and stairs in Syauu Bazaar are built with this gorgeous rock

due to the fact there are no roads in this region, the donkey trains are the only means of transporting goods and supplies in and out of these villages; as we bought bottles of clean water at each village, we grew in our appreciation for these large, and sometimes scary, beasts of burden

sorry, we were too tired to verify this number

stairs were definitely a theme on this trek

rice, millet, and maize are the primary crops of this region

as this is the monsoon season, rain was the second biggest theme of the trek

the village of Ghandruk: this a Gurung village with traditional Gurung homes

early morning in Ghandruk: this was the closest we got to seeing the mighty Himalayas; at least the clouds revealed their own unique beauty

on the second day of the trek, we descended down one side of the valley, crossed the river, and ascended up the other side of  the valley; the town of Ghandruk, where we had stayed the night before, can be seen at the top of the photo just below the clouds

we met this girl carrying her little brother when we had stopped to administer some first aid to a young buffalo herder; the little one was a bit skeptical of the camera (or maybe just the strange looking foreigners behind it)

in the foreground is a traditional raincoat that makes the people in the fields look like diligent turtles plodding along in their work

how many leeches are there?
aside from the obvious creepy factor of these creatures, they are quite resourceful and persistent little things: Niraj, our guide, had us walk in front of him and Kishna, our porter, because once someone passes them, due to scent or vibration, they start reaching from their perch on the leaves for the next "meal opportunity" to come by; this small plant represents the average number of leeches that could be seen on each plant along the trail if you were willing to stop and risk the chance of them hitching a ride and a meal on your person

at the end of the trek: Kishna is on the left, and Niraj is in the green shirt

dinner with our Australian friends, the Wetzig's
(that is indeed a large scoop of ice cream on top of a crepe filled with nutella in front of us!)

this is why your prayers are so very appreciated as the monsoon tends to cause a lot of landslides and damage to these hillside towns

our drive back to Tansen: a river swollen with the rains of the monsoon