"Awake my soul to the hope You hold, Your grace is all I need."
As we waved another doctor off of Kudjip station I thought about the days, weeks or months ahead.
The damage of the Coronavirus pandemic on our mission so far has been decidedly collateral. While we have established triage protocols and increased our use of PPE in specific areas of the hospital, our entire highlands region has confirmed only 28 cases at the conclusion of 2020 - none fatal.
Meanwhile, the burden from pediatric pneumonias and diarrheas, vaccine-preventable-disease, premature newborns, trauma, difficult obstetric deliveries, HIV, tuberculosis, typhoid, cancer and myriad other ailments continues. The workload which was previously managed by our missionary and PNG physicians and supplemental volunteer doctors has now been funneled onto a dwindling "Gideon's Army."
As part of that ongoing effort, we are adjusting the workflow so that the most demanding cases, surgeries and deliveries are reserved for the doctors. While it empowers our nurses, it means that nearly every patient I see, every day, might be facing a life-or-death condition that I am supposed to help them with. And I know my powers and my profession are limited in the light of such miseries. Even my prayers are wearing thin.
"Heaven's story breathing life into my bones -
Spirit lift me, from this wasteland lead me home"
As I scuffled from the emergency department to the clinic to the delivery rooms on Thursday morning, I was interrupted by our labor and delivery nurse still wearing bloody gloves (never a good sign) nearly running across the corridor to find me. "Dr. Mark, mipela nidim yu!"
I entered delivery bay 1 and saw blood-soaked clothes and bedding being removed while IV lines were hung. Unable to palpate a radial pulse to match what I heard through my stethoscope, I asked the woman her name. A feeble voice answered, "Maria." So she was semi-conscious and knew who she was - better than I had thought. Her heart rate pounded out at 130 beats per minute and the blood pressure cuff could detect nothing.
Maria had delivered her seventh child in the bush of the Jimi Valley - one of the furthest habitats in the world. Her placenta did not deliver and she bled for hours until she could manage transportation to Kudjip.
As we rushed to get unmatched type O negative blood for a transfusion I hastily scribbled some orders for antibiotics and went to retrieve the anesthesia and instruments I would need to remove the placenta and stop her bleeding.
With the assistance of our midwifery student I removed the afterbirth and gave strong medications to contract the weakened uterus. A unit of blood infused during the procedure. The cuff read out a systolic blood pressure of 80 millimeters of mercury ... my heart nearly sang. As I left to attend to the outpatient department patients, I hoped that we did enough to prevent seven new PNG orphans.
Our senior clinic nurse said that they had already used up their quota of doctor clinic visits for the day but people were upset. I looked at the line of patients and charts still awaiting me and said that I would work as quickly as possible, but if they were truly emergencies to send them to the ER and I could see them when I finished in the outpatient clinic.
An hour or so later I picked up the record book of a man named Gideon. He had paid no physician fees. He had not been entered in the list of patients to see the doctor. But his wasted frame sat on bed 7 of the ER and I immediately knew his diagnosis. After sedating a pediatric patient for our nursing student to repair a laceration and setting a fractured bone, I walked Gideon to the now-closed outpatient ultrasound room. A quick scan confirmed my suspicions - a massive hepatoma, a slowly growing liver tumor, now consuming his body and impeding his ability to eat.
We took some time to discuss his illness. I answered his questions. I reassured them that our medicines could help his pain, but would do nothing to cure him.
What was his faith like? Gideon and his watchman, Glen, had been baptized in the church as kids, but walked away. Gideon engaged when I shared that we would all face a burial in this ground ... but that a new life awaited those who trusted in Christ's redemptive sacrifice at Calvary. His misty eyes told me that he wanted and needed to hear that.
They both prayed to receive Christ in that moment.
And we all agreed to place whatever the next steps were in His hands.
"Now I find my life in Yours -
My eyes on Your name."