Saturday 29 September 2007

September 28



Canoe



House in Kikori



Paralysing a crab



PNG Diet: Potato, sago, banana



Smoked python



The last couple of days were hard and horrible emotionally. I was really, really missing Ingo. Strange now that we are married, we are indeed one. I just don’t feel complete without Ingo. So there goes the very independent Chie after all!

Had to do a couple of ultrasounds because of huge livers. One of the guys liver goes all the way down to nearly his right groin. I have never seen such a huge liver before. The ultrasound showed a mass prob arising from the liver but difficult to tell. I’m kinda enjoying the ultrasound though I wish I knew more.

The whole team from New Zealand has left today. I had lots of cleaning up and washing up to do. So spent a couple of hours doing that. Now the house is clean for the first time since I’ve arrived. It hasn’t rained the last couple of days so laundry should be able to dry. It hasn’t been too hot as it has been raining up until a couple of days ago. Two girls from the single girls quarters came to visit. So we had a good time sharing and ‘talk stories’. I had a lovely time with them. The staff speaks quite good English so there isn’t much problem communicating. The PNG people are not confrontational and gentle, polite like the Japanese. I was told the northern coast of PNG was a place where many Japanese soldiers died so many Japanese have come over the years to pay respect. I didn’t know about that part of Japanese history. I didn’t know Germany had a go in trying to colonize PNG as well. There is definitely a difference between the coastal and highlands people. Apparently the coastal people are more peaceful which is where Kikori is. Even with the staff here, the highlands people are more aggressive and harder to get along with compared to the coastal people. Most of the staff here are Coastal people anyways.

September 25

Busy day today. Lots of little problems. Had a woman who was screaming with pain and looked pale that I thought she had either ruptured appendicitis or ruptured ectopic pregnancy. In the end I think it’s another cancer. Then we had a leprosy guy who came in with a gangrenous toe. I learned how to amputate a toe from Dr.Scottt. Actually it’s not that hard as the toe is already dead.

The oil company helicopter landed on hospital site yesterday bringing a lady with three weeks history of bloody diarrhoea with mucous and blood—prob amoebic dysentery. She was also pregnant. Turned out this morning she delivered the baby. They called me for delayed second stage labor and thought we need to do vacuum (air pressure to pull baby out). I was not looking forward to it. So I made the woman push harder and pop the baby came. Phew!

September 24

Another week has come. This would be my 4th week here. In some ways it is going by fast but also slow at the same time. It’s still raining quite a bit here so it’s not too hot. I believe there’s about 1month left of the rainy season. When the dry season comes, it is very hot as this area has lots of limestone as roads. Today two girls from the team have left for New Zealand. At the end of the week the rest of team will leave as well. I will be left on my own then. A bit scary really. One of the PNG health care workers will move into the house to keep me company. I’m glad for many reasons because of safety reason, also if someone calls me for emergency and I don’t wake up she may be able to hear them. Also I’ll be able to learn more about the PNG culture from her.

Papua New Guinea is indeed a linguist paradise. I cannot believe how many languages are out there and they are not even related—completely diff languages all together. Pidgin is still the main language but I must say I still need the staff to translate for me. The local coastal language is called ‘Motu’. So I’m picking up medical vocabulary for Pidgin and Motu. Pidgin is mostly from English words but there are some German words as well as Germans use to colonize PNG long time ago. So most PNG people speak 3-4 languages. I believe they are quite good in languages.

Over the weekend I had a scary case. I was called to a vaginal bleed 1 day after delivery. They had sutured her and she was bleeding overnight. Funnily the patient didn’t think to tell the nurse and thought it was normal. Life is hard here and so they tolerate a lot more things than we do in the western world. Her towel was soaked with blood and by the time the nurse examine her, she had a continuous bleeding. When I came I undid the stitch. I couldn’t find the source of bleed, it was just pouring. I stitched her up but it didn’t stop it, so I opened it up again and stitched again. It again didn’t stop the bleeding. So I again opened it up and when I was about to give up (problem is I can’t give up because then she would just bleed to death). So by the third time she finally stopped bleeding. I must say it was a bit scary. God was good though, because before I started I had prayed with patient. So I didn’t panic at all. I know God will not give me cases I cannot handle so this was a good experience and given me a bit of confidence. I know it was a simple case but with horrible consequences if bleeding was not stopped.

There’s a continuous flow of TB patients as usual. We have about 50-60 T B patients I think.

Please pray
1. I don’t develop TB
2. Simple joys every day to keep me going
3. Wisdom and discernment to know what to do with medical, surgical and obstetric cases
4. They are waiting for a PNG doctor to arrive, so please pray that the doctor will come ASAP

Friday 21 September 2007

September 21

Today the Emergency bell went off. There was a case of stab wound from domestic violence. The husband was under the influence of alcohol and drugs. If it wasn’t for the other people who stopped the husband, the wife may have died. She had two stab wounds in her upper back but he missed any essential parts ie lungs, heart..etc… The husband then came into the emergency theatre with the knife which he probably stabbed her with and if it wasn’t for Dr. Scott and another nurse being there, I’m sure he would have stabbed the wife to death. Very thankful that nothing happened. There’s no security in the hospital during the day, but someone else had already notified the police and they were there right after we prayed. This is the second case of stab wound from domestic violence since I’ve been here. I’ve been told that right after payday which happens quarterly, domestic violence increases.

September 20

This was definitely a much better week. I’m more settled and there’s a team of people from New Zealand, Australia and Germany. It’s been such a blessing having them. I can’t remember if I’ve told you already as I’m emailing all blog entry to Ingo to paste onto the website as the oil company internet has blocked the blog and I don’t have access to it. Ingo has been kind to send me comments from people as well. So the people on the team are doctor, pharmacist, radiographer, carpenter, hair dresser, and an occupational therapist. One of them cooks really well so I’ve been well fed recently. It’s just so nice having people to talk to, another doctor to discuss cases with…etc… Dr.Valerie has left yesterday but at least Dr.Scott is here until next week. Dr.Scott used to work here for a 2 years so he is quite experienced. However, he leaves next Friday I think. Dr. Scott said that the hospital here has had times when they had no doctor at all. So I have to tell myself that having me here is better than no doctor at all.

The x-ray is not working again. Not sure why. The maintenance guy is trying to sort it out but who knows. Well this week the cases are once again TB cases. We have about one fitting case per week. Most of them are due to TB I think. This week we had a sad case. I examine a lady (not sure of her age, most of the people don’t know their age—you ask them how many Christmases have they had or look at their hair colour to determine their age). She may be in her late 30s. I examined her and discovered she has cervical cancer—late stage. We did an ultrasound on her and discovered a lump in her pelvis compressing her bladder. I had to break bad news to her husband and he started to weep. He later on told me he paid $25,000 Kina (£7,500) as bride price. Don’t know where they get the money. I was able to pray with the husband and the family. Then the chaplain came and talked with them and I’m told that the wife said the sinner’s prayer. She actually does not look very ill anymore since all the prayers. A couple of days ago I thought she would not last a few days or weeks. She has been bleeding from this cancer continuously the last 3 months and has become so pale. There is only one oncology centre in the whole of PNG, it’s in Lae and their radiotherapy does not work always as well. I’m probably going to send this patient home to her village and give morphine to her husband who can inject it when the pain becomes worse. She will probably die from anaemia (as no blood transfusion available) or infection. Her name is Tibere if you would like to pray for her.

I’ve moved room in the house and it’s a quieter room. So I don’t hear this crazy, noisy rooster as much now. I do enjoy listening to the frogs, crickets, cicadas. It’s very noisy at night actually. Last night, we had a few hours of thunderstorm which roared and trembled the earth. It’s like a ‘rolling thunder’. Tonight is fellowship night. This place has so many opportunities for Christian activities. It’s great and I’m loving it. I love being able to pray with patients. People seemed quite open. I found out that at the mouth of the river that runs in front of the house is where the missionaries that first arrived about 100 years ago were killed and eaten. Apparently, they had never seen westerners before and thought the leather boots the missionaries wore were part of them, so they boiled the leather shoes for several months and manage to eat the boots as well.

September 16

Today is Papua New Guinea Independence Day so the hospital is quiet. The newly elected Gulf Province governor visited the hospital this morning. This is the first time any governor took an interest in the hospital. I wish I had my camera with me. The governor and his right hand man dressed really nice, they had digital cameras and even mobile phones (there is no signal here). The ‘sound’ man that recorded all the speeches with a small battery operated recorder. He was barefoot. A lot of PNG likes to go barefoot. So you see all these kids without shoes running around and all of them have multiple inguinal lymph nodes. Talking about PNG politicians, I have already heard about how corrupted they are, and this person running off with this money and that. The country is really rich with their natural resources (gold, oil, logging etc….) but somehow the people don’t actually see it. Makes you wonder where the money is all going. The newly elected government has to clean up the mess of previous governments leaving lots of debt which makes it difficult apparently.

Today is also my birthday. I share the same birthday as PNG’s Independence Day. I didn’t tell anyone so I quietly celebrated on my own. I’m not big on birthday celebrations anyways so it doesn’t bother me. Tomorrow is a public holiday and they are having sports day to celebrate and I am told some traditional dancing.

Please pray for another doctor here at Kikori. Last week they put in an advertisement in their paper for a doctor to come work at Kikori. Please pray that the right person comes here and ideally before I leave. Preferably soon as it would be nice to have another locally trained doctor here to share experiences and workload.

Saturday 15 September 2007

Saturday, September, 15

A few days ago one of the doctors that was here for a couple of years returned with his fiancé and a team of workers including a occupational therapist, radiologist, pharmacist and a German carpenter. Today they left for Kapuna (about 10 hours by the slow canoe). The faster the boat, the more expensive the trip. The faster boat takes about 4-5 hours. Kapuna is where the other hospital is. They will be coming back to Kikori and staying for another week or so. The pharmacist was sorting out the dispensary and found many out of date drugs. We still use the out of date drugs as that is better than no drugs. With this team of people, they brought with them food and so this week we have been well fed. Yesterday at the market we bought a pig’s leg and eel. The pork was nice but the eel was a bit tough.

I have not been sleeping well. Not used to the stupid rooster crowing all the time. I’m using ear plugs now but when Dr.Valerie leaves, I’m going to have to come up with another plan. With my ear plugs I would not hear the door knock. Maybe a string tied to my toe and hanging out the window so the nurses can pull the string and I would feel my toe move and wake up. I’m sure by the time I’m done here I would sleep in exhaustion and won’t even need ear plugs.

In the middle of the week I was missing Ingo very much. I have learned my lesson, I won’t be apart from him for more than two weeks ever again. I don’t think I can handle it. Marriage does do that to you, I suppose.

Well my wonderful mom sent me a birthday card and I got it a couple of days ago. It was just so nice to get something from somebody. It only took a bit over a week to get here from Japan. So any of you fancy to send me a card or letter, that would be nice. My address is: Kikori District Hospital, Gulf Province, Papua New Guinea.

Please pray that the hospital find a Papua New Guinean doctor to fill this place before I leave at the end of December. The hospital has just put an advertisement for a vacant doctor post in the national paper. Please pray that the right doctor comes. It would be nice to have one while I’m here for support and help. It’s a busy hospital and could do with two really. So the sooner they get a doctor the better. Then I can leave in peace as well knowing that this place will be taken care of. Plus a Papua New Guinean doctor would know how to deal with things in rural areas as they are trained for it.

September 14

Another busy week. It tends to be very busy from Monday until Thursday then it gets better. However, this morning we had two big cases. While trying to reduce a girl’s arm fracture, the emergency bell went off. There was a woman in labour who delivered and lost 1 litre of blood. Thank goodness Dr.Valerie was there so that we were able to control the bleed. It’s scary looking at the gush of blood coming out. In about 10 days I will be on my own and I have to deal with all emergencies. I’m thankful that I had some time with an experienced doctor to learn from her. During the week we had a clinic and boy, it was like an ophthalmic (eye) clinic. All these people have something wrong with their eyes. There were a number of them who have this white/cloudy speckles covering part of their cornea. I have no clue what it is. It could be herpes infection but I saw like 3 patients like that and not entirely sure what it is. One of my babies died this week. The child was not as sick as the child I was worried about last week so I had hopes for this little one. The other child got dramatically better after putting him on TB medicine. Well, this one had oxygen like the other one, and also a tube into his stomach so that mom can express milk and we can pour medicine and milk down this tube. Well, mom did not listen to the nurses and decided to feed the expressed milk by mouth. Well the baby basically choked to death gasping for air I was told. The day when I admitted the baby I prayed for mom and baby so I thought she is now going to blame God for the death of her child. After wailing for a few hours over her dead baby, we moved her to a different room, and offered to pray for her and she accepted. I was very humbled. In the Western world, maybe the health professionals would have been blamed for the death.

I have learned to use the x-ray machine and the portable ultrasound. It's quite useful. The x-ray machine was broken for a while but now there's a new battery so it works. I can even process the x-ray films after taking it. The doctor here does everything.
It will be very useful for all fractures which we had two of last week. I'm quite happy putting someone in a cast now.
We have some rubbish plaster so this poor baby which I've been trying to straighten the foot, I had to try 7-8 different plasters before we got one to harden into a cast. Somehow the humidity had ruined some of these plasters. The humidity does amazing things. It has melted most of the contraceptive pills.
Oh, another thing I have learned this week is to anaesthetize a patient to fix a fracture. The drug we use is ketamine and it's one that is no longer used in the western world because it may cause nasty hallucination and disturbance when they awake from it. But it's quick and does not affect the breathing. They don't close their eyes on this anaesthetic and it looks very strange. A bit eerie I suppose. But works wonderfully

September 9


Death Adder's head

A man came in with a snake bite today. He brought the culprit. After looking at a book we have called Venomous bites and stings in Papua New Guinea, we identified the snake to be a Death Adder. Most of the venomous snake bites in this area are from Death Adders. We’re lucky in that we have antivenom if we needed it. The man is ok and we are keeping him in observation. Don’t think he was envenomated. Death Adders cause neurological symptoms instead of blood symptoms. Then the rest of medical cases are more TB cases. I would say about 90% of patients are TB cases. All the complications I’ve read in books, we have—such as TB spine, loads and loads of TB glands, TB joints, TB lungs, TB meningitis, TB abdomen…..etc….

The weather is very pleasant recently—cloudy and breezy. The rain has stopped which is nice as the clothes are getting dry instead of damp and mouldy. I’m getting used to not having electricity all the time. Here everything is recycled and used in all sorts of ways. No bottles, cans, papers are thrown away. All syringes used for patient’s medicine are recycled (of course the needles are thrown away). They’re very innovative and can think of ways to reuse things. Empty drug bottles are used to collect patient’s urine when we need it. We have to be economical in many ways. They stuff their food inside a bamboo to cook over a wood fire, empty bottles are used as asthma pump spacer…etc….

This weekend has been very restful. For me going to the oil company base camp to do emails is wonderful. So nice to hear from people, to know how family is doing and to know that people are praying for me. Also it is so nice to be eating vegetables at the camp canteen.



Christian Life Centre

Church is nice too. Nothing like seeing beautiful butterflies flying around the pulpit. Today we had a sermon on Father’s Day as last week was Father’s day. Apparently, in the past there has been a fair number of missionaries from the Pacific islands to PNG so you can see their influence. One of them is that in church, the men sit on one side and the woman the other side. In the middle aisle, if married couples want to sit, they can sit together in the middle. The other influences of the pacific islands probably is the language and music. I saw this guy playing these small guitars that I’ve seen Hawaiians play. They also use words like ‘talk stories’ which I know the Hawaiians use. They sing beautifully here. One of these days I will record their singing and put it on the blog. There are fellowship meetings twice a week and also a prayer meeting. So spiritually I am not deprived at all.

Saturday 8 September 2007

September 7



House in Kikori

Well it’s been one week since I’ve been here and it feels like a very long time. Thank goodness the hospital hasn’t been too busy which helps. I can practice on certain things. Like today I tried to put a cast on this little 4 month old because he has a talipes foot (crooked foot). All the cast don’t work once humidity gets to it so I had to try 3-4 different times before we found one that was working (meaning one that would actually harden into a cast). I had to give away about 8 different cast thing (for kids to play with) as they don’t work anymore. The humidity is incredible. I don’t have to use body lotion at all as it’s so humid. My backpack was covered with mold in less than one week. The clothes smells damp. Not very nice. Nothing stays white. It just looks dirty even if it’s not that dirty.

I don’t know how I’m going to last until December. It is definitely harder than I anticipated. It’s one thing if I was doing just clinics which I can handle but hospital is another thing. Yesterday Dr. Valerie had to do incision and drainage on a guy and about 50ml of pus drained out. We had to fix a fracture of an 8 year old girl. There haven’t been many obstetric cases. I am told there are about 20-30 deliveries per month.

Language is more of a problem than I thought. I guess about 50% of people understand basic English. But the other 50% don’t really understand English. They speak their own language and Pigin. I am learning to use different Pigin words like urine is pis pis, stool is pek pek, diarrhoea is pek pek wara, stomach is bel, see you later is lookin behind you…etc….. there are a lot of English words in Pigin which makes it easier but I was not anticipating to learning a different language at all.

This week every plane or boat that came by, I was wishing so hard that I could get on it and get away. I am missing Ingo more than I anticipated. I suppose that is what marriage does to you, you do become one. I do feel incomplete without Ingo. I am sleeping better only because I am tired. Eating a lot of brown rice with tinned fish and bread—so fairly healthy I suppose. There are lots of crabs too if you can get to the market. At the market, it’s not a bargaining culture (which is nice) so what the price is fixed by the seller. Things are not cheap, i.e. one carrot is about 30pence (60cents USD). Crabs are cheap, one small crab cost the same as a carrot. Cabbage comes from the highlands and it’s more expensive, about £2 ($4 USD). So it’s a real treat.

The neck stiffness baby is finally improving after one week here, and only 4 days of TB drugs. The neck is not as stiff. Yesterday I admitted two patients from clinic again for TB treatment. There is a chaplain at the hospital and he comes in to preach to the patients on the ward at times. There is a fellowship meeting twice a week and they sing beautifully. Most of the nurses are quite good here. They run the clinics and in fact I don’t see much malaria as they are treated from there most of the time.

Please continue to pray for me as I have been quite homesick (which is very unlike me—perhaps I’m getting older) and it’s only been one week here. As usual, pray that I won’t get any difficult deliveries, difficult fractures or difficult medical cases. Pray that I will be able to pick up the language faster so that I can communicate with patients better.

Please send emails as I look forward to them.

*Lidka, I tried to email you but it won’t let me. Sorry! But thinking of you and your family.

September 2



Ward at Kikori Hospital



Local kids

A fairly quiet day—started mini ward round around 7am, finally managed to go to church. It takes about 45min walk each way on bumpy road. Because this area has a lime stone quarry, the roads have lime stone so when it rains, there are not mud everywhere which makes walking easier. Church was good. It’s in the open space with a roof on top. There are trees all around, i.c. banana trees. There are so many butterflies here and so many different kinds too. My favourite are the turquoise blue ones. They are so beautiful.

Nice to have Dr.Valerie around. She showed me how to cut and scrabed my first coconut to get coconut milk. Then we made sago pancake (main staples here in Kikori)—basically made from a type of palm tree. Kinda has the same texture as tapioca. They cook sago with everything. We had that with tinned mackerel in tomato sauce.

On the medical side for my medical friends—the 4 month old baby with the meningism isn’t improving but not worsening, after 3 days of penicillin, we switched her to TB drugs. So we’ll see if she improves in the next few days. One gentleman has what we think amoebic dysentery. He is still vomiting. He is jaundice as well. Difficulty is that we don’t have a lab to send for bloods so difficult to ascertain what is going on. Learning that TB is so rampant that some of the early signs is just enlarged lymph nodes in kids esp in submental, cervical lymphadenopathy. They are completely well, with no pulmonary symptoms. This afternoon had a child who was having a partial fit with smacking of lips, twitching, starring into space—he is having it with a mild fever. He has had a fit about 1 month ago, then they put him also on TB drugs and he improved. The question is if he has epilepsy or if this is related to an infection. As now he has respiratory signs. We decided to put him on antibiotics first, if no better to start him on antiepileptic drugs. One sad case last night, a new born about 12hours old just died for no apparent reason. I wasn’t there but the baby was completely well, no complications during birth, wasn’t blue, was sucking well and then died like that. Still not sure what happened there. To tell you the truth, I’m glad Dr.Valerie was there as I would have been completely devastated even though I would not have been able to do anything really.

Electricity from the generator comes on about 6:30am until 8am. Then at noon until 1:30pm, and then at 6:30pm until 10pm. Sometimes the electricity goes longer which is nice. It all depends if the person who switches it on or off needs it. I bet he was watching a movie or something last night so it was turned off around 11:30pm. So we kinda adjust to that. I don’t mind if it turns off later. We cook when the electricity comes on. Laundry is basically handwashing our clothes.

P.S.: This is an extract from an e-mail conversation between Chie and myself (Ingo) and I thought it might be interesting to all of you:

Ingo: The picture from the ward looks pretty basic. Did I see this right that there are no matresses and that patience need to sleep on the wooden bed structure?

Chie: The hospital used to have mattresses but they went walking. Basically patients stole them so now the patients have to bring whatever they have. It is very basic. The patient's toilets are disgusting. See, these patients all live in simple huts made from natural materials so they are not used to cleaning..etc...

Saturday 1 September 2007

First news from Kikori




2nd day at Kikori Hospital. Well, I’m practically unpacked and settled in my room (see above). It has a beautiful view of the Kikori River (second picture). Dr.Valerie met me with handful of patients, nurses, nursing students awaiting my arrival. They gave me a small bouquet of flowers and the girls sang a song about welcome to the family. It was very nice.

Ward round today was about 5 hours long. Majority of the patients has TB. In fact a couple of them have TB meningitis. In London, they would have been the biggest concern and all but here, it’s almost the norm. The ward looks like a 3rd world hospital. Very dirty looking, making most NHS hospital look 5 star. We even have a marasmus-kwashiokor patient (malnourished kid). All the stuff we learnt in the trop med course, we have here. Amazing. I am glad that I am here. I made the right choice. I know I will be busy which would help in my moments of missing Ingo. Dr.Valerie is very good. She was raised in Kapuna so she speaks some Pidgin and Motu (which is the known language of the area).

It’s going to be very busy. It’s only my 2nd day yet I feel like I’ve already been here forever. I got up at 6am today, started ward round around 7am. Finished ward round at 12:30pm, had lunch, then had TB clinic from 2-5pm. Then went back to wards around 6pm until 8:30pm. Came home cooked, ate. Rechecked on patients at 9:30-10pm to make sure everything is ok. I have also learned to use the ultrasound to try to see what the womb is like and also how the baby and placenta is doing. One of the mothers has a fairly low-lying placenta, and in London, I know they would have done frequent ultrasound and monitor her closely by the specialist. Well, here I’m the specialist. Dr.Valerie has a great ultrasound book so we have been referring to it. I’m quite impressed with Dr.Valerie’s traction making for this little girl who had broken her thigh bone last week. When she is gone in a couple of weeks, I would have to be in charge. It’s quite nice having her and because of her upbringing in PNG, I have learned a lot about their food, culture, people and language.

Dr.Valerie took me to the market --Not as much variety as I anticipated—people just scrunched around their back garden or fish and bring it to the market to shop. They use leaves to weave into a basket and that is their shopping bag. They sell lots of betel nut, crab, coconut. Not much tropical fruit and the fish had been all sold out. Here hygiene is not exactly there so you have to make sure you cook everything. Drinking water is basically rain water. That has been ok. There is one store that sells basics and it is really interesting, I have to take a picture one of these days. Basically all items are behind this wooden counter with metal bars, you speak through an opening and tell them what you want. Apparently, if they had stores like what we have, things would go walking. In Port Moresby, the capital, they have supermarkets but lots of things go walking, so they have security guards and you get your bags searched every time. They are so poor here. They wear clothes with holes, and it looks like they had the same shirt or pants for years. Dr.Valerie had to lecture them how to use these western toilets, as they throw whatever they like in it, which has caused plumbing problems. She went around giving them bits of toilet paper.

The PNG people are lovely. Some of them have the most amazing smiles. The weather is great. I was anticipating the worse—humid heat like Malaysia and summers in Japan. But it’s still rainy season and their ‘winter’, so it rains 3-4X a day and rains in the night. It’s overcast a lot so it’s not too bad. I mean it’s hot but not unbearable. I have been able to sleep ok. I am told the heat will come in the summer which is around Dec time. So hopefully it will be ok until I leave.

Looks like I will be able to do internet at least once a week where I’ll go to the oil company and they let us use their computers and feed us. Now I understand why the oil company people emphasised several times how I would appreciate some different food. With the limited food available, I think I will really enjoy the time I can get away to the oil company for some nice meal and using internet.

Please pray for the following
1. Wisdom in all medical cases but particularly obstetrics and orthopaedic cases
2. My health
3. Favour among staff and patients
4. Wisdom to discern how to help the people here (ie educate on hygiene…etc..)
5. Energy to continue with a good attitude

P.S.: This is a message from Ingo. This has been posted via me as Chie has no access to the blog directly in Kikori. She is e-mailing these posts to me and I put them on the blog. This also means that she is not able to see your comments. Therefore, please e-mail any remarks to Chie directly - I am sure any news will be much appreciated!