Holding Down the Fort

Dan headed to the states on Sunday to interview for possible job opportunities in Idaho and Washington.  He'll have a busy schedule as he flies between the two states and visits several different locations.  Please pray that he'll make the best choice as he considers many different aspects of each job as well as their different locations.  We're excited to see what the Lord has for us next and should know within the next four weeks where we'll be headed.

In the meantime, I'm holding down the fort here in Shell.  It was a little harder to say goodbye to him, knowing he'll be in another country and not just at the hospital, but already I've had lots of offers of help with the kids if I need it and invitations to hang out with others.  Hopefully this can be two weeks filled with lots of laughter and fun in the house and not frustrations.  Dan may get BBQ steaks and corn on the cob in the states but we get to dine on Mac N Cheese, which actually is a treat.  We thought about sneaking the kids on the plane with him but decided it wouldn't be too practical.

Anna would have been Dan's checked luggage and Caleb and Jael his carry-ons/

Beautiful Babies and Parasite Paradise

The last few weeks have been busy at the hospital, as more people have been trying to get in for their regular check-ups before school starts.  Many new babies have been brought into the world as well.  Dr. Egberth and I performed a c-section on a mom with double-breech twins.  Everyone did great, and it was really fun to be involved with this family's excitement (even if she did need her surgery emergently at 3 am).  We had another mom who came in with her baby in the transverse position.  Working together, we managed to help that baby do several summersaults before she finally settled into a head-down position.  At that point, we broke the mom's water and induced the labor, hoping to keep the baby aimed in the right direction.  Unfortunately, the rascal switched back to transverse, and we ended up performing a c-section after all.

10.5 pounds of joy

We at Hospital Vozandes aren't the only ones who have been busy lately.  Apparently the worms in the jungle are also prospering and expanding their horizons.  Last weekend I took care of three babies in room 8 of our hospital.  One of the babies had Rotavirus (a virus that makes the patient have bad diarrhea) that had caused dehydration.  Another had been sick with a fever for weeks.  We ruled out the most common infections (malaria, dengue fever, tuberculosis and leptospirosis) and settled on a diagnosis of "Jungle Fever."  Patients like him come to our hospital every now and then, and we usually give them a kaleidoscope of antibiotics to cover oddities like brucellosis and Q fever.  The third baby presented with extreme weakness and pallor.  His hemoglobin, which is a measure of red blood cells, had dropped to 2 (normal for his age would be about 10-13).  He was diagnosed with severe anemia, which had evidently developed over several weeks.  Dropping a person's hemoglobin down to 2 acutely would cause shock and death, but the body can often make compensations if it is a gradual process.

The anemic baby was found to have an infestation of hookworms.  This parasite can burr through the skin of the feet to enter the bloodstream.  It's next stop is the lungs.  From the lungs, it climbs up into the throat and jumps down into the esophagus, with the goal of setting up a new home in the duodenum of the small intestine.  There, it attaches to the wall and drinks blood to its heart's content.  Our anemic baby with the hookworm infection quickly got better with a blood transfusion and anti-parasite drugs.  The other babies were also getting better, but their moms were concerned that they had persistently-bloated bellies and poor appetites.  We also treated them for parasites, and many interesting things were found in their diapers over the next few days.  In the end, all of them got much better and were taken home by their happy mothers.

Looking better after getting rid of Rotavirus and other critters

Addition of blood and subtraction of hookworms equals a fat, happy baby

After successful treatment of "Jungle Fever"

 (All pictures taken and posted with permission of the patients and their families)

The Past Few Weeks

We’ve fallen a little behind on our blogs lately, but we’re alive and well here in Shell.

We attended another very special wedding this past month when one of the couples in our marriage class decided to get married in a civil ceremony. In Ecuador the civil ceremony is the official and legal ceremony, sometimes followed by a church ceremony if it’s affordable. Unfortunately we can’t share our pictures from the wedding since our camera, telephone, and electronic reader were stolen on the bus to Quito one afternoon, but we do have a shot of our latest class.

Celebrating our last marriage class

 We were blessed to have our good friends from residency training in Idaho come and visit us last week. Ryan and Alanna were great sports as we showed them around Shell, they played with our kids, and were even (un)fortunate enough to share the flu with the rest of our family one day. We took them for a hike on the military base here (which always feels a little intimidating to leave your passports at the gate as you drive past camouflaged young men with large guns). Currently there is a baby ocelot that was confiscated from a family trying to keep it as a pet and we had the chance to hold the little guy.

Ryan and Alanna in front of the "Shell" sign

Playing with the tiger baby.

One morning while Alanna and I were talking, Caleb calmly walked in and told me there was a snake on the back porch. The kids are always pretending so I told him I’d be out in a minute to “kill” it. When we finally made our way outside we discovered Caleb wasn’t pretending.  I put an end to him, though it took me a shovel and machete to do it. Another missionary later told me that it is some kind of blind, snake-like worm that wouldn’t hurt anything….oops. It’s difficult not to be too judgmental when there are slithery creatures near your house.

Our slithery visitor

Dan will soon get another medical blog posted.  He's on a seven-day, four-call workweek, but should get a chance soon.

Some First Goodbyes

Part of the life of a missionary is saying goodbye: goodbye to your homeland and family and friends in the states, but also to friends we get to know in out new "home".  Though we don't plan to leave Ecuador for over three more months, today we said our first "official" goodbyes to our good friends the Bartons who will be in the states for the next year.  Paul works as an anesthesiologist and Kim is a pediatrician.  Their four boys were good friends to our children, especially Josiah, who became Caleb's best buddy here.  They will be greatly missed by all of us in the missionary community.

The Barton Family

Caleb and Josaih fighting the "Evil Daddy Dragon" for chocolate eggs.

Jael playing with Isaac.  Jael is convinced she's marrying Josiah and told him they were going on a date the other day.

Wedding Weekend

This weekend we headed up to Quito to celebrate the wedding of our friends, Jen and Harrison, who we met while in language school at the Nazarene seminary. Jael and Caleb had the honor of being the Flower Girl and Bubble Blower (Jen wanted Caleb to be involved too :)

 

It's hard to believe it's been over nine years for us!

A family pic before the wedding

"No petals!  What do I do?"

Notice the concentration.

The kids did a great job, although Jael took quite awhile to proceed as she made sure to drop a petal on each stair she stepped down, and the entire congregation heard her exasperated cry of, “Mommy, I’m out of petals.” 

Celebrating after the ceremony

I thought I'd better add a new pic of Anna, too!

We’ve been blessed with many new American and Ecuadorian friends during our almost two years here. As we prepare to head back to the states in November we look forward to reuniting with old friends, but we will have to say goodbye to many amazing people here, too.  We're so thankful that God has provided us fellowship not only for us, but for our children as well while we've been here.

Buggin' Out

A few more bug stories from Ecuador to share with you. Lately we’ve had a large influx of shield bugs on a specific tree near our home. We’ll pass and see many congregated in piles on top of each other. (I think it’s mating season.) Yesterday I heard the kids laughing and yelling about the bugs outside. I went outside to see what Caleb and Jael were up to and was greeting by my children covered in bugs and an awful stench. They had decided it would be cool to see how many bugs they could get in Caleb’s bug box, but in the process were “sprayed” as they attempted to catch them. I stripped the kids clothes and washed them up but couldn’t totally get rid of the smell. A few minutes later we discovered that the spray also left a strange yellow coloring on the kids’ hands. We’ve washed them numerous times, but it seems as though the coloring is just getting darker with time instead of going away. Hopefully it isn’t toxic and the kids will remember to ask before going bug collecting next time.

Caleb with a few of the bugs on his elbow and shirt.

Their collection!

Caleb's hands a day (and many washes) later.

A few hours later the kids were playing outside when we noticed a loud drone and looked up to see a huge swarm of bees. We rushed the kids inside for awhile but didn’t hear anything so thought they had flown away. We looked around and discovered a huge “bee ball” in the tree outside our kitchen window. There was nothing in the middle of them except more bees and they didn’t make a sound as they sat there. Our neighbors had had the same thing occur last week, but their “ball” was larger, the size of a basketball. We found someone who had bug spray (and could run quickly) and got rid of our bee problem.

Our bee ball.

Little Carlos; Kristina's Run

Carlos is a little 9-month-old who presented to us a few days ago.  His mother gave me permission to publish his picture and story on our blog.  He had been having fevers, and, as you can see in the picture, a bad infection of some sort that seemed to be eating his nose.  Even more worrisome was his extreme malnutrition.  This little guy weighed in at about 9 pounds on his admission, which is about half of what he should have weighed.  It was difficult and sad to see his tiny little arms and legs, which consisted of nothing but bone covered with a bit of skin.

Carlos had already seen a couple of docs here in Ecuador, but had not gotten any better.  We were thinking that his nose problem was a result of a bacterial infection or a parasitic infection called Leishmaniasis.  We sent a tiny biopsy to look for the parasite, and in the meantime, his nose did seem to get a little better with antibiotics.  He also gained 2 pounds in his first week on a high calorie diet (the picture above is his "after" picture).

Carlos has a few tests pending to help us to know more about his condition.  He still has a long way to go before he's out of the woods.  In the meantime, he would appreciate your prayers as he tries to gain some weight and fight off this difficult infection.

You may or may not know that Kristina has developed into quite the runner.  I have to try to keep running some as well, primarily so that I'll be able to catch my wife.  While out on a 4-mile tempo run a couple of days ago, Kristina was met by an unexpected visitor who left a nice souvenir on her calf.  As you might have guessed by the picture below, the visitor was a pretty good-sized dog who was surprised at seeing such a fast runner going by.

We washed the fang marks out really well, and Kristina began antibiotics to prevent infection.  She's also had to get some shots to make sure that she's properly protected against rabies, though I've not heard of a case of rabies here outside of the deep jungle.  Kristina's had a great attitude about the whole thing, but she says that she'll make sure to run on the other side of the road when she passes that house the next time.