Today marks the end of the Foundations for Health class for the pastors at our Bible school.  They are taking their final today. The only thing left for Christine and I to do is grade their final take home project next month.  We had a great time teaching.  We introduced them to the game of Jeopardy for the review session for the final.  Christmas cookies and soda rounded out the party for the last day of class.  Below are a couple fun pictures of teaching the Heimlich maneuver.  My stuffed moose have upgraded to "moosenaries."  (Thanks Uncle John).  They came in handy as pretend infants.  We also practiced splinting with available supplies to transport a person with a fracture to clinic.

 To celebrate Kathleen's birthday, we all gathered at Christine's house and learned about jack fruit.  The Sawka's taught us how to cut and eat it.  It's in the mulberry family and is the largest fruit that grow on trees.  They can be up to 80 lbs!  The flesh is mild flavored and sweet.  The seeds can be boiled, and Sue describes aptly as a cross between a macadamia nut and a boiled peanut.  Ken decided to be a fruity Santa. Can't accuse us of not having fun!

 Along the way this week I managed to see about 5 different patients for various housecalls in the afternoon.  My best payment yet--gingerbread cookies!  I also had my next govt meeting for Helping Babies Breathe.  Little more paperwork/letter obtaining and I should be set.  Please keep it in your prayers.   Looking forward to my equipment arriving and setting dates for the training.  To keep with the health and teaching theme, Sunday I was asked to talk to the youth for a session during their retreat this week.  Today I had a great time doing a question/answer period on HIV/AIDS that segued nicely into their next session on purity.  Love how the Holy Spirit coordinates things.  I didn't tell them my topic, and they hadn't told me the rest of the program.  We just "happened" to be ordered that way in a 4 day retreat.  The students were very energetic and open.  I was happy to share truths about HIV/AIDS (where it came from, how it's spread, how we can help stop it) while sharing my own testimony of purity.

Lastly, I wanted to share my newest neighbor in my yard.  A very cute chameleon.  He was not as excited to see me as I was him.  Those eyeballs followed me very closely.

You can tell how busy I've been by my lack of posting.  Much has happened already in the month of December.  

On the medical end the little anemic preemie unfortunately lived only another 3 days before passing away.  I saw a baby back for a follow up visit after I admitted her the week before with fever and jaundice.  One of those stretching times.  The bili lights worked but I had no bilirubin lab to check (the lab was out of distilled water so couldn't run a bili).  Running on averaging the time under the lights and prayer.  She looked great and mom was so happy-baby was alert and breast feeding well.  I left the hospital worrying about a 10 y/o boy who came in with sever malaria.  He was unconscious to begin.  Thankfully half way through his first quinine dose he woke up but was still not with it.  He was also very pale, Hgb 6.8.  He got transfused because his other numbers showed it was a quick drop, not slow decrease like the malnourished kids with hemoglobins that low.   I was grateful when the nurse called me yesterday to tell me he went home from the hospital just fine.  The girl with seizures and brain damage from Fringilla Clinic was able to find a home for handicapped children.  Sounds like a good place where they teach them at their level, and she will be well taken care of.  Thank you for the prayers.  

Saturday we had a Balm Clinic free screening day! We had 30 people! It was a good day of reaching out to the community. The patients seemed pleased so they can come back and tell others to come too. Dr. Nkole and the rest of the staff are so great to work with! (and the new sign started getting painted)

We've had several medical meetings.  The best was when we connected with the people at the Ministry of Community Development Mother and Child Health.  Christine and I visited a local clinic to see how they do cervical cancer screenings so we can do it right on our mobile medical clinic.  It seems like a simple thing to set up a meeting and see this but the number of factors that needed to align to make this happen are innumerable.  I was overjoyed that it all worked out, and we learned just what we needed.  I also connected with them about Helping Babies Breathe training.  They had me write a letter to the Permanent Secretary of that division which led to a meeting with the physician in that office which led to a different group I should contact which leads to another meeting next Monday.  Praying it all goes well.  The kits and instruction manuals are on their way from China!

This week and next week Christine and I are teaching at the Bible School.  Our Foundations for Health class for pastors has gotten off to a great start. I'm enjoying co-teaching with Christine and meeting a wonderful group of pastors. This lesson in the picture was on nutrition and health promotion. I had them divide all sorts of food into the food groups. The fun part was when they didn't know what cantelope was so we had a spontaneous tasting snack.

All smiles! I finally got to ride a bike. It's been more than a year. Thank you Pastor Stephen (pastor, gardener, mechanic, and all around guy with a great heart) and Paula! Glad Chris and Rob got me a little off road biking before I left Michigan...that's what all the roads I can safely ride on look like here. I promised Nancy and my mom I won't ride on the highway that is Great East Road.

Phew! Riding it reminded me how much I can't breath. Looks like a trip to Dr. Bastian for a bigger hole in my vocal cords when I get back to the States.

 The small things that make me feel at home here: On the way home last week I had one of those small but meaningful encounters. I was getting gas and ran into a person I know from one of the churches. So nice to know I've been here long enough to run into people randomly. Miss that small town feeling.

Lastly on the church ministry front:  Mike and Judy Santiago asked if I would do a session in their leadership seminar. (It was at the church I call home here: Oasis of Love). I was worried at first b/c I feel like a leader by default because of being a doctor but not someone who can lecture people on how to lead a church or business. The topic he gave me was on self-observation. All about being a person of character equals being a good leader. I felt good about that topic. Preparing for it, I got really into it. Presenting it went really well and people really responded to the message. I love how the Holy Spirit makes certain points stand out to different people. Amazing and humbling when the Holy Spirit moves.  

Our hearts were somewhat sad but excited as we sent Nancy and Archie off to Malawi this week.  They will be doing somethings still in Zambia but be living in Malawi.  I will miss having them so close but am excited to see the new things God is doing in Malawi and hope to join them for a visit later in the year.  

Here's some of the gang at our Camerican Thanksgiving celebration (four lovely Canadians joined us...think they just like the food since their Thanksgiving was last month).

These were my contributions.  The pies didn't look very pretty but were very tasty!

Interesting medical week.  Interesting in the medical world is not usually a good thing.  Mine was a mix of good and bad.  I had my first diagnosis of Guillan-Barre syndrome.   It's a postinfectious demylenating, ascending peripheral nerve paralysis.  It starts in the legs-paralysis and loss of reflexes and goes up the spinal cord.  The problem is when it reaches the diaphragm and breathing is paralyzed.  In the States people are put on ventilators for breathing support and IVIG can make the healing process faster.  Then it's just waiting several weeks for the nerves to regrow their sheath and work again.  Unfortunately at the little hospital there is no ventilator (unsure if sending her to the UTH in Lusaka would have helped-may not have vent available and the nurses have been on strike all week).  She came in labeled as meningitis but I only saw her that first day.  Friday, the nurse told me she passed away about 3 days later.  

I saw two different preemies.  Each only one day old.  One was born at 28 weeks by dates but looks about 30-31 by exam.  She is doing perfect besides being very small (2 kg).  The other was a little older, about 35 weeks but only 1.2 kg.  She is very pale likely due to a maternal placenta problem.  I tried getting blood for a hemoglobin and possible blood transfusion but failed.  Praying she can turn the corner.  

My other puzzle is why a 10 y/o boy became mostly deaf after being treated for meningitis.  Part of me was very happy to see his progress from last week.  He could only lay in the bed and was moaning.  This week he was up walking around and smiling.  The problem is he appears to not be able to hear anything.  The antibiotics used aren't ototoxic so I'm wondering if it was the meningitis itself.  Hoping the ENT doctor at UTH can help him.  

The last girl I saw in clinic.  She is school-aged, was totally normal until she had a fever and seizures and now has right sided weakness, can't talk, is incontinent, and has limited understanding.  She is so sweet in her disposition.  She made tears come to my eyes as I examined her and she would lay her head on my shoulder or take my hand to her face.  We need wisdom to know the best steps to help her medically and socially.  

In other news, I spent last night and will tonight playing in an orchestra!  I joined the Lusaka music society and we are putting on Handel's Messiah with the choir.  The orchestra is all comers with a neat outreach music program in a small town, Choma, in Southern Province.  It's an outreach of a Christian group there to help teach instruments to nationals.  We may not sound exactly professional (orchestra at least), but we are playing with all our hearts.  I still get goosebumps as everyone stands and we play the Hallelujah Chorus.  He truly is our King!