03 September 2010

Normal



NOR-MAL adj \ˈnȯr-məl\
1. usual; regular; common; typical
2. constituting a standard
These past few months I have spent many hours pondering the idea of normalcy, how what I consider to be normal is so drastically different from other parts of our globe. How being immersed in and surrounded by what is normal to me brings with it a huge sense of security, of safety. And although I thought myself to be one who seeks adventure, welcomes change, craves things that are different and new, when it came down to it this summer, all I wanted was to be back at home, in my normal environment.
For those who don't know, this summer Casey and I were blessed to be able to participate in a SIMS (Students for International Mission Service) trip through Casey's medical school, LLU. We filled out our applications months prior, selected three countries that were of interest to us on the list of approved hospitals around the world, and were eventually told that Papua New Guinea would be our home for one month this summer, that Casey would be working under a surgeon and I would be giving lectures to nurses twice a week on "basic nursing skills". Backpacks were packed, medical supplies gathered, and lectures prepared. Next thing we knew Casey had officially completed his first year of medical school (attaining honors status in a few classes! Go Case!), and we found ourselves on the infamous A-380 crossing an ocean. Much thanks to my parents, we were able to stop in Sydney for 3 days on the way to Papua New Guinea to experience the city together! We stayed right by Darling Harbour and walked all around the city, through the Royal Botanical Gardens, across the harbour bridge and through China Town. We ate calamari, sipped lattes, and enjoyed a ferry boat ride.Wallabies were pet, as were Koalas and emus. It was magical, to say the least. And by our departure date, we were anxious to get back on a plane, onto our great adventure in PNG.
We arrived in Mt. Hagen airport to be greeted by scores of locals being held back by a chain link fence, a few airport employees, and no one in particular who was specifically looking for us to take us to the hospital as we had been informed there would be. After a few minutes of wandering around and feeling completely lost (and realizing that we did not have with us the phone number of the physician who was expecting us, or a phone to use for that matter), slight panic began to set in. We spotted a small group of white people and started making our way over to them. This was the first moment I recall wanting to be comforted by something normal to me. Although I would love to think that we would have figured out the situation on our own, when it came down to it and we were surrounded by people we could not communicate with and we had no way of getting in contact with the one person who was expecting us, we moved towards something that felt more normal. As it turned out, they were a lovely group of missionaries working with MAF, and one of the pilot's wives was raised in Marysville, Washington! Small world... When we explained our situation, they just chuckled and said "Welcome to PNG!" as if to say, Get used to things happening differently than you planned, lady! They took us to their home and were going to let us use their internet to look up the phone number for Dr. Granada and their phone to contact him. Before this happened, however, one of the missionaries who had driven off a different way crossed paths with a Landcruiser that said Adventist something on it's side, and because we had told them that we were to go to Porgera to an Adventist hospital, they waved down the truck, discovered that that was the truck that was indeed supposed to pick us up, they guided the Landcruiser to us and there we had it...a ride to Porgera. How grateful we are for those missionaries who helped us find our way.
Peculiar finding: The landcruiser's windows were all covered with metal grating. When I asked Benjamin (our driver) why, he said plainly and without emotion "because people throw stones." >Hmmmm.
Surprise number two: We were to spend the night in Mt. Hagen and make the 6 hour drive up to Porgera in the morning. Alrighty, no problem! Would have been nice for a head's up, but no worries. We paid the gentleman the 50 kina (~$17) requested for our room that night and we were home for the evening. We were lulled to sleep by the sound of rats scurrying over our ceiling ALL night, and were greeted in the morning by a moldy shower pan with a trickle, and I mean trickle of cold water to clean with. But at least we had running water... and so we were grateful.
We had been advised by Dr. Granada (the surgeon in Porgera) that Malaria was not a large enough risk to warrant taking prophylactic medications, that there simply were not mosquitoes in Porgera. I woke up this morning with 4 mosquito bites. I guess Mt. Hagen has a different mosquito population than Porgera. I began praying that the lovely bugs that chose to feed on my blood were not infected ones. And here we go...
Casey had met a local friend the night before just outside our little place, and he and another boy brought us to the Hagen market the next morning. Rows and rows of fresh produce greeted us. On our walk back, an ambulance (also with metal grates covering the windows) cut us off and asked us if we were Casey and Chelsea. Ah ha! Our ride to Porgera was here, and managed to find us in the middle of the city (we were two of the only white people there... stuck out just a tad). Back to the little house to get our bags, and off we went trekking up the mountain. The ride up was a bit bumpy, yes, but fascinating because we were able to enjoy the beauty of the country from so close. Lush hillsides, waterfalls, and seeing several villages so closely were all wonderful. I didn't feel anything but extreme excitement until we had to slow down because of several people who were linked together by their arms and were chanting and dancing down the middle of the road. The driver, James, along with the others in the ambulance immediately started laughing. When I asked what the people in the road were doing, James explained to us that their dance was "compensation" for the murder they committed.
"So they killed someone?" I asked.
James: "Yes, and when you kill someone you have to pay compensation so that someone else will not be killed in revenge."
>Hmmmm.
Me: "So are there police here that arrest people when they murder?"
James: "Not really. The police don't really help. For example, if someone were to harm my wife, I would just kill them instead of going to the police because it would be easier that way."
Wow.
So there we were, squished in the front of the landcruiser, squinting constantly to see through the tiny holes of the metal grates, and wondering if I was prepared to be where I was. Casey, like always, is a rock for me. Steady and calm. He just held my hand tightly and looked at me with kind eyes that said don't worry honey. I so I didn't. Yet.
We were greeted in Porgera by a rain storm, which as we would soon learn was not too uncommon. It actually felt nice, as we are somewhat deprived of rain all together in Southern California. Again, although I don't prefer it all the time, being from Seattle means that rain=normal to me. So I quickly welcomed this little gesture of comfort, of familiarity in an unfamiliar setting. When we drove up to the little home that we would dwell in for the next month, the door opened and two of Casey's fellow LLU students, Brad and Derek, excitedly greeted us and welcomed us in. We were to spend 2 weeks living with them, then they would depart and we would have one week alone, and the last week was to be spent with 2 more LLU students, Tricia and Kristy. So there we found ourselves, in a foreign country surrounded by all things new, and then were greeted by two friends from home. This was a comfort that at the time I don't think I fully realized I desired. The boys had already been in PNG for 2 weeks, and thus had much wisdom to share. They quickly told us that they had each delivered several babies and gave us the long list of surgeries they had already helped perform. They showed us the cell phone that would ring at any time of day or night to notify us that there was a laboring mother and thus a baby to be delivered, and they explained that this same cell phone could be used to receive phone calls from the States. >Ahhhhh.... excellent. Although I had been extremely excited at the thought of being completely detached for one month from email and phones (and anyone who knows me well is probably thinking to themselves, isn't that your norm anyways? Not answering emails or voicemails for months at a time?) I found myself feeling instant relief by the sight of the cell phone, a connection to home if I so desired. And later I would be praising the Lord for that cell phone, for the conversations it allowed me to have with my parents were a large part of what kept me going.
Our first night was spent at Dr. Gerogaline's house, along with Dr. Granada and his wife. We ate fish, rice, vegetables and beans. I was amazed at the selection of food, as I had very low expectations for what would be available to eat. The two families could not have been more welcoming, and Casey and I went to bed that night encouraged and excited for what was to come.
Within days Casey had delivered several babies, sutured many open wounds, and assisted in surgeries. My heart was overjoyed watching him light up as he was participating in real medicine, as the body he had been studying the whole past year was now brought to life. I just would look at him in his blue scrubs and think to myself, thank you Lord for this incredible opportunity. We know Casey isn't entitled to being a physician, but thank You for allowing him to become one, for allowing him to live this dream.
One thing that became apparent very early on was the lack of proper PPE (Personal Protective Equipment) for the hospital staff. The HIV rate in PNG is unknown, but thought to be extremely high, and thus protecting one's self becomes increasingly important. Casey had a fabulous attitude all along, feeling like he would do whatever he could to protect himself, but at the end of the day if the necessary equipment simply isn't available, we just need to do our best and still give care to those who need it. I, on the other hand, struggled with this more. I watched Casey be splashed in the eyes delivering a baby, poke through several gloves because he had to suture holding the needle with his finger as there was not clamp available, and stick his hand into body cavities with "sterile" gloves that had been washed, gased, and reused many times and easily tore. My anxiety surrounding this issue of disease transmission rose daily, and I felt fairly consumed by it. I spent much of the time in the OR observing the 3 boys perform surgeries with Dr. Granada and much of the time my eyes were locked on Casey's hands, watching the needles that others were holding by his hands, watching the needles he was using and how he was handling them, inspecting his gloves from afar for holes. And the thing is I knew that from my stool in the corner of the "theatre" (OR) that I was helpless, that nothing I could do would change the outcome. And yet I still felt frozen in that place, that by my watching him I could somehow prevent harm from falling on him. I prayed over and over again that God would put a hedge of protection around my Casey, that he would put a dome over him and protect him from harm. And all the while I hated myself for being so consumed with this obsession that I was missing opportunities left and right where I could get involved, out in the wards amongst the nurses and patients. I helped in the OR where I could, taking vital signs, placing IVs, bagging patients while they were intubated and under anesthesia (as the hospital did not have a ventilator), folding gauze to be sent through the autoclave, performing newborn assessments following cesarian section deliveries, etc., but I know that I did offer as much help as I should have. I truly felt paralyzed by fear.
The other component that soon added to my high level of anxiety was the increasing intensity of violence surrounding the village where we were living. Local tribes were (are) fighting with each other and it became unsafe for us to venture far at all. We did not go to the market alone, we were driven very few places, and when we were it was only in the vehicles with the metal grates protecting us. We soon learned that the missionary surgeon who Casey was working under had not been to a local village once in the 12 years he had lived in Porgera "because they would kill me", as he so bluntly said. We had many patients come to the hospital with bush knife wounds, their bodies sliced by another. There were shootings and many deaths. It quickly became apparent that this was normal for Porgera. We were told that if a tribe member is killed, the only way to make the situation right is to take another life from the opposing tribe. And so the cycle continued... "Road blocks" were occurring, where men set up stations on the roads, stopping cars with large rocks or tree stumps piled in the road, and they take the passengers belongings and rape the women.
Without going into too much more detail, I will just say that I was a wreck. Simply put, I was terrified. Casey and my parents talked me through much of my fear, Casey on a daily basis and my parents through their many phone calls. How grateful I am for them.
Side thought on that note... I love being known so intimately by others. My husband and my parents can look at me, or just hear my voice over a phone half a world away and know exactly what to say to fill my need in that moment. What a blessing...
My greatest source of comfort, however, was found when crying out to my Creator. I found myself in a dangerous situation, one that could not be controlled by myself or Casey. So where else to turn but to the one who made me, who knows my every thought, my every fear, my every move. I believe that it was God who helped transform my fear that had been so paralyzing into a deep sadness for the nation of Papua New Guinea. Deep sadness for the people who know violence, murder, war, to be normal. Although my fears and anxiety remained, they were quieted and my focus was then able to move from being solely on myself and Casey, to being on others around us.
My prayer for Papua New Guinea became and is still:
"In the last days the mountain of the Lord's temple will be established as chief among the mountains; it will be raised above the hills and all nations will stream to it. Many peoples will come and say, "Come, let us go up to the mountain of Jacob. He will teach us his ways, so that we may walk in his paths." The law will go out from Zion, the word of the Lord from Jerusalem. He will judge between the nations and will settle disputes for many peoples. They will beat their swords into plowshares and their spears into pruning hooks. Nation will not take up sword against nation, nor will they train for war anymore." Isaiah 2:2-4
The Holy Spirit reminded me of the importance of touch. In a situation where hygiene is less than optimal and diseases run rampant, the last thing I usually think to do is touch someone. Taking patients' vital signs became one of my favorite activities. Thanks to the manual blood pressure cuff and mercury thermometer I was guaranteed at least a few minutes with each patient to talk with them (usually some lay persons sign language was involved, as I am hardly fluent in Pigeon), and more importantly in my mind, to touch them. With a gentle lift of the arm to take a temperature or place a BP cuff, or a slight touch to the wrist to count a pulse I felt that I was able to communicate to people that I cared about and for them, even if I could not say so in their language. Many smiles were exchanged over the days. I have never enjoyed taking vital signs as much as I did in Porgera.
***Fast forward a week or so...
The violence in Porgera with surrounding tribes and villages continued to increase. Brad and Derek, the other 2 LLU students, had already left and had been escorted down the mountain with a protected vehicle and armed personnel. It came for our time to leave and as of the day before our departure we still had no ride down to the airport for the following morning. Dr. Granada finally came to our house and announced that we had a ride! The Catholic priest had offered up his vehicle and time to escort us down. He had a small pickup truck, no metal cages covering the windows, and there would be no armed escort to accompany us. Needless to say, we were less than thrilled and quite fearful for what this would mean for our safety. We were made aware that road blocks were occurring on the road down, we knew we were traveling through war zones, and we were going to be going down the long road covered in rocks and pot holes with no spare tire. It seemed like we were just asking for trouble. Dr. Granada tried to comfort us by saying, "You will be fine. God will protect you. You are traveling with a priest. No one will harm a priest's car." And while I would love to be able to say that my faith was as strong as his in that moment, it was not. We were terrified, and when it came down to it, we had no choice unless we were going to postpone our flight out of the country.
At 0400 the following morning we were closing up the door to our little house and we were greeted by the priest, along with 3 other gentlemen who had offered to escort us. The pickup truck was small indeed and did not have any sort of protection surrounding it like the Landcruiser did, but it was a vehicle and we were grateful for that. The should-have-been 6 hour drive took us 4 hours and 45 minutes as the priest was quite good at speeding through war zones. For 4 hours and 45 minutes my knuckles were white from squeezing Casey's hand so tight. For 4 hours and 45 minutes I asked the Lord to protect us. We drove through a few road blocks (piles of large rocks in the middle of the road, large tree trunks laying across the road), but no people were around. Thank you Jesus. Our little truck had to slow down to go over the trunks and rocks and I was cringing inside at the thought of getting a flat tire right by a road block, where you know people must be near. And we had no spare, by the way. I prayed for our tires, that they would remain strong and intact, and they did. Thank you Jesus. My eyes were scanning the sides of the road the whole drive, looking for people hiding in bushes with their guns or bush knives, waiting to steal, kill, rape, for this is the activity we had been hearing of for a few weeks at that point. I was sitting in the middle seat of the back row of the truck and I remember looking up at the rear view mirror and seeing the priest's left eye in the mirror. His eye was steady, calm. His eye was focused on his task at hand, but completely peaceful. His eye was unwaivering even when speeding through war zones. His unchanging eye was such a comfort to me. I stopped scanning the sides of the road for predators and instead focused on the eye of the priest, the constant, unchanging, faithful eye of the priest. I felt the Lord telling me "Be still, my child. I am your God", over and over. And in the midst of my terror I felt a peace. I knew we were going to be ok. More than ok. And the odd thing is that it was not in a physical sense that I knew we were going to be ok, but rather in an eternal sense. I truly had no peace at all about making it down that mountain untouched, or even alive. I was well aware of the fact that we were in the middle of nowhere where actions go unseen all the time, where innocent people are harmed and killed because of another's conflict. I honestly did not know if we would be able to escape those things. But I knew, I knew, that we were in the arms of our King and that we would be more than ok because we belong to Him.

As you know by reading this blog that I have typed myself, we made it safely down the mountain. Thank you Jesus, and thanks to all of you who prayed for our safety. We are humbled and very grateful.

Going into this trip I was very prideful, unknowingly. I liked to think that I am one who is comfortable traveling to foreign countries, one that embraces things that are different and new to me, one that particularly enjoys working in third world settings, an adventurer, and one who tries to live by the motto Carpe Diem. Needless to say I was extremely humbled when I found myself faced with danger in a way that made me want to return home immediately, to return to what was normal for me. I am not all of who I thought I was and to say that this trip offered up many lessons would be an understatement. I learned much about myself, more about how Casey and I interact with one another in very stressful situations, (like I said previously, he is a rock for me and for this I am so grateful), and where I turn when I am filled with fear.

Although we miss the people we grew close to in Porgera, we are glad to be home in our normal environment. I remember going on a walk shortly after returning to the States and it dawned on me that I was not scared. I was not scanning the bushes for people who might harm me, I wasn't walking extra fast so as to minimize my exposure time, I was just walking. And I thought about how this is normal for me, to walk without being scared. And once again, my mind returned to the people of PNG, how walking around their home area without fear is not normal. How every day you have to be on guard. There is no such thing as a stroll through the park in Porgera. My heart breaks for these people who have no escape from this, who know no difference than the violence they are surrounded by.

And so I continue to pray for their country, that violence would cease and safety would be known.

***
Some photos from the journey...
On the bird at LAX... waiting to take off!
Just landed in Sydney
Sydney sites...




Ferry boat ride!
Just a little calamari from a food stand in Chinatown!
Feeding an emu at the wild animal park



I guess this is how the airport officials of Port Moresby, PNG make foreigners feel safe...

Hagen market
Stopping at a "chicken and chips" stand on the way from Hagen to Porgera

Our ride up the mountain
Our house
Casey and Derek with two of the incredible hospital staff members. Anette on the left is a Health Executive Officer, the equivalent of our NPs here. Stephanie on the right is a nurse.
Our bathrom door would lock itself shut so Derek here is using our one and only kitchen knife to pry it open. Desperate measures...
The three docs in training... Case, Derek and Brad

Dr. Granada is a little shorter than Casey, so he frequently had to raise the operating table to Casey's height and use a stool for himself :)

Porgera market, where we bought our produce from
The grocery store. Notice the entire isle of cooking oil!

The boys with one of their patients. Notice how many fingers the gentleman has... The boys had to remove the stump of his index finger and attach the tendon from it to his middle finger so that he could point and grasp things properly. It worked!
Casey charting for the first time
Casey proudly holding the first baby he delivered. He did an amazing job...
Notice the flower vase used at church... why didn't I think of that?!
Casey was asked to preach at church and he did a beautiful job


The boys standing in front of the incinerator... a sight, for sure.
July 3rd... 6 years, babe!!! So fun...

A sweet pumpkin we fell in love with.... his skull was fractured from falling


Morning rounds with Dr. Granada



Every Saturday night became game night at our place. Casey would make his famous kettle corn on the stove, I would mix up some Milo (hot chocolate drink), the Rook cards were brought out and poof! We had hours of fun with our new friends.

Casey removing a foreign body from a child's ear

Casey and one of the missionary children folding gauze to be sent through the autoclave

At Mt. Hagen, one of the free missionary clinics
*Notice the square package on the left.... Don't all Holiday Inn hotels give complementary condoms to their guests?!? :)
Our last night in Sydney... Mom and Dad blessed us so very much by changing our 8 bed hostel room to a hotel room right on the train line. We enjoyed some much needed time together to decompress in a quiet, peaceful environment. We took the train into the city to say one last goodbye to the stunning Opera House before our departure the next morning. Sydney, we miss you already!

We were greeted at the gate in Seattle by my mom and dad... perfect. A little time was spent in Issaquah, I was able to reconnect with Lindsey after her year in Uganda, Casey had adventures with his Young Life boys, we traveled to Bainbridge for our dear friends' wedding that Casey was a part of and then we were off to the beach house to reconnect with the whole family. That's right, all 8 of us! The Wards and the Pinneos together under one roof for 2 days! It was fabulous. We had boat rides around the inlet, beach walks, bon fires, cribbage games, bbq dinners, bocci ball on the beach at low tide, and lots of great conversation. Shauna and Maeve came all the way to the beach to say hello before they were off to camp, and Amber hosted the rest of us girls at her new home in Seattle for a bbq. We also were able to meet up with our dear friends Andrew and Chandra downtown for a short while. All that to say is, what an incredible way to re-enter one's home after being and feeling so very far away. We felt absolutely surrounded by people who care for us. Thank you for this gift.

The beautiful bride on rehearsal day
Loma Linda men
Casey in his groomsman role on rehearsal day
The beautiful bride and fabulous groom

A lovely visit from Shauna and Maeve...


All eight of us together!
We went crabbing...
beach walking...
played bocci ball...
enjoyed each other's company...
went kayaking...
lounged around bon fires...
watched perfect sunsets...
ate delicious food...
and played cribbage! All in all a fabulous weekend with the two families.
We were privileged to be invited to my dad's retirement party at Horizon Air. Many people shared their memories of my dad as their leader...I simply could not be more proud of him.

***
For better or for worse, I really didn't think much about Papua New Guinea during the first few weeks back at home unless someone inquired about our trip. I was more than content to be back in my safe environment with my family and friends close by. It was not until recently that I really began to ponder all that was experienced. And I was immediately reminded of my dad warning me of this very thing over the phone when we were a half a world away. He gently told me that I was in survival mode, that I probably wouldn't even begin to process all that I was going through and learning until much later. He encouraged me to strive to live each day in Papua New Guinea to the fullest, to look for opportunities so that in 10 years when I look back I will not wish I would have spent my time there differently. What fabulous advice. And he was right, as he usually is, and I have entered the processing phase of this past summer.

I am grateful for many things. I am grateful that we had the opportunity to see another part of this beautiful earth that God has created. I am grateful for the people of Papua New Guinea that we were able to get to know and the relationships that were formed. I am grateful that Casey was able to have so much hands-on experience so early in his career, that his confidence level pertaining to interacting with patients will be that much higher going into clinicals because of this experience in Porgera. I am thankful that his love for medicine continued to grow through this experience. I am grateful for the babies he delievered. I am grateful that I was able to share some of my nursing knowledge with the nurses in Porgera, and I am so grateful for the scores of lessons I learned from them.

I am grateful for my husband and our marriage, for the incredible man that he is and for the wonderful relationship that we have. I am grateful for my parents and for how they so actively love their children. I am grateful for my brother who called me in PNG from Colorado because he wanted to check on me and say hello.

I am grateful to know my Creator who cares so deeply for His children, who gives peace that surpasses all understanding and welcomes me into His arms. I am grateful that I can talk to God any time and He hears me.

I am grateful for where we live, that I feel safe when walking the streets and going to the supermarket.

And my heart breaks for those who do not know this love, this acceptance, this support, this feeling of safety. And so my sadness moves me to prayer, and also prayer for how to act. It is easy to feel helpless when confronted with problems of such magnitude, but great feats start with a single step, right? So Lord, use my experience this summer, use my summer of fear and subsequent sadness for the country of PNG to bring about change. Positive change that would be pleasing in Your sight.