The Independance Day Project- Student's Mumu

 This year the college did something different in celebration of Papua New Guinea's Independence Day.  They gave the students a pig (a very large one!) and all the other necessary items to cook it, and gave most of the kitchen staff the day off. 

Around 9:00 this morning, I walked on down to the area where they were preparing their own feast.

 Now, the college has about 100 students, and about 40 of them were there, working together to make this meal.  These students come form all over PNG and at least 10 different areas were represented today.

 I saw some great examples of team work and leadership.  By this time, the pig had been killed, and had it's little operation to remove all the "insides."  Those "insides" had been cleaned out, and were now being used in the preparation of the meal.  The stones had been heated up for the allotted time, and the blood sausage had already been made.  The greens and banana leaves were gathered.  The kaukau (sweet potato) and other vegetables were being pealed and prepped for cooking and the fire pit was being prepared for all to be placed inside. 

I did mention that the students are from at least 10 different areas, right?  Each of these areas has some slightly different ways of performing this PNG custom.  Some "heated" discussions over hot stone placements and correct way to do this and that took place.  They all kept their cool though, as many hot stones were placed in seemingly the correct spot and a only few fingers got a little too much exposure to the heat. 


I got to hear from a few different students of how this was done at their place; what they did different and what they did the same.  I also am sure I heard lots of phrases said by parents and relatives of the students while doing these same actions.  "More greens here," and "Do not put the stone there."

You all did well, your parents would be proud, I loved seeing your teamwork and I hope you all enjoy your feast!





  Happy Independence Day PNG! 

Little is much…When God is in it. (Remembering Lorrie Klem)

It has been an interesting few weeks.  Its week 4 of second semester, I still have no clue how time goes so fast here.  The days are often long, but the weeks seem so short!    

My Obstetric Complication class is going pretty well (based on the first test I'm just about finished grading.)  I've struggled a little more with it that I have the Normal Obstetric class I taught last semester.  Mainly, the struggle has been figuring out what the students actually need to know and what can we actually do about it here. 

We got some new text books from Northwest Nazarene University (thanks sooo much, they really are a great help!!)  A few of them are relevant to my class and the students are using them for their major assignment.  But then the really interesting questions come! For instance, our PNG text book, written in 2002, briefly discusses, in two paragraphs, placenta previa (condition where the placenta is attached to the uterus close to or covering the cervix) and what needs to be done here.  The US text book has pages on the condition and its treatment!  One of the pages states that the condition can resolve in many cases.  There is nothing about it resolving in the PNG text book, only treatment when the woman comes in bleeding.  First question from a student, "How can placenta previa resolve while the patient is bleeding?"  Answer from me, "Well, it can't, the book is talking about placenta previa resolving when it is diagnosed early on in pregnancy by looking at an ultrasound, and then as the uterus expands the placenta ends up not covering the cervix…" Next comes some blank stares from a few students and more explanation is given by me. 

Ultrasound is not something that is done routinely in prenatal care in PNG.  Overall, in the country, it's rarely done.  Very few places have a machine, and only a few of the patients would be deemed medically necessary to have a scan done.  So, very, very few placenta previas are getting diagnosed on ultrasound and "resolving" in PNG.  Where do you go from there?  Why can't every woman get an ultrasound in pregnancy here? Why do babies (and mothers) most likely die every day from this condition in this country and very, very few probably die yearly from it in the US?  Why do I have to teach that there is basically no treatment for hydrocephalus, when I know there is one, and the US textbook explains the treatment in detail?  Why is most of what I need to teach basically the same few steps for treatment, for such complicated conditions?  Why are there only so many steps that can be done here?  Why can't the care plan at the end of that US textbook also be in our PNG textbook?    

One of our Doctors here, Mark Crouch, shared recently about his similar feelings on the OB ward.  I totally understood his frustrations and it hit home with what I had been experiencing these last 4 weeks trying to teach all of this.  (see my Facebook page for the link to his blog)

Tonight in Fellowship, the first year students sang the song "Little is much when God is in it."  And I was holding back tears the whole time.  My frustrations with what to teach had set in again as I finished the second test this afternoon and gave it to the ladies in the printing room to print for me.  Also, a wonderful lady at my church in Illinois, a friend of mine, has just passed away after a valiant fight against cancer.  Lorrie embodied this song.  She could throw a party for a whole community with $50 or less it seemed!  She always saw a harvest field in front of her.  One of my best friends (and many other people) is a Christian today, because Lorrie witnessed to her at work, and invited her to church and showed her what being a Christian is all about.  Lorrie did much with little all the time.  So I sat there tonight, hearing the students sing the following lines, thinking about what little we have here, and what little Lorrie worked with much of the time as well. 

In the harvest field now ripened
There’s a work for all to do;
Hark! the voice of God is calling
To the harvest calling you.

Refrain

Little is much when God is in it!
Labor not for wealth or fame.
There’s a crown—and you can win it,
If you go in Jesus’ Name.

Does the place you’re called to labor
Seem too small and little known?
It is great if God is in it,
And He’ll not forget His own.

Refrain

Are you laid aside from service,
Body worn from toil and care?
You can still be in the battle,
In the sacred place of prayer.

Refrain

When the conflict here is ended
And our race on earth is run,
He will say, if we are faithful,
“Welcome home, My child—well done!”

Little is much when God is in it!
Labor not for wealth or fame.
There’s a crown—and you can win it,
If you go in Jesus’ Name.                                (Kittie L. Suffield, 1924)

If that wasn't enough to get me straightened out, Pastor Joseph then shared from 1 Samuel 16 about the time when David was chosen over his seven brothers to be King.  "The Lord does not look at the things people look at.  People look at the outward appearance, but the Lord looks at the heart."  (verse 7b)  Another wonderful message, but I wrap up with the prayer that is now on my heart. 

Oh help me Lord to see what you see, to look at what you look at when you see all that is this place Papua New Guinea and its beautiful people, and not see this place you have called me to labor as "too small and little known."  It is great because you, God, are in it, and I know you will not forget your own.

And may a little(or much) of Lorrie Klem live on in each of us, as we make the best of what little we have, with you, Papa God, always in it. 

The People of Papua New Guinea

Back in May, I shared a little about my prayer request for what I am to do the next few years.  I just couldn't come to peace with leaving and not returning after December.  I prayed about what this would mean for me, how it would work out, and if staying was really even necessary here, or what God wanted.  The answers have come and I am now planning to stay in Papua New Guinea through March of 2016.  I am not planning to come home until then.  That date was chosen because I would like to see the class of students I started teaching last year graduate and that is when they will!  These are the students I am currently teaching an Obstetric Emergencies and Newborn Complications class.  These are the students that are on my heart all the time.  I love all the students here, all three classes, but the current second year students are the ones I have taught the most, have seen the most, and who have put up with me the most!

I was thinking the other day about what I am thankful for lately and mostly it was people who came to mind.  I want to share some of them with you all. 

First, there is Angela, one of the women who works in the College printing room.  She knows I am really trying to working on my Tok Pisin.  She loves to make me laugh by starting out a conversation with me in Tok Pisin and then switching to her Tok Ples halfway through our conversation and seeing me get all confused!  As soon as I realize she switched languages, I roll my eyes and she just laughs more and more, until we are both laughing so hard others come to stare at us!  I got her the other day by asking another of the tutors a Waghi phrase (her tok ples) and saying it to her before she had a chance to talk to me! 

Next, there is Sister Grace, one of the senior tutors at the college.  She asks how my lesson plans are going and is always there if I need some input on how things work in PNG.  She also has a great laugh, and thinks I'm extremely humorous, (even though I doubt most others do!)  She and her daughter love to read and Grace has been so thankful for all the books given to her when the missionaries recently cleaned out and downsized the station Mission library.  We chat about books, obstetrics, our families, and our love for the students and love for Christ.  She shares from her garden with me, and I made a cake for her son's birthday.  You have never seen anyone happier over a simple chocolate sheet cake with "Happy 7^th Birthday Moses" written on it! 

There is Emily, and Lin, Ann Marie, Queensley, and Sylvia, my neighbor girls that love to do anything with me from weeding my garden, to taking down laundry to baking cookies.  They also like yelling "Hi, Sister Staci" as often as they can as I try to get their correct name out.

There is Moris, the woman who has come over a few times a month for the past few months to help me clean and do yard work.  Her cheerful spirit while doing these simple tasks puts me to shame and makes me smile at the same time.  She too is helping me learn Tok Pisin, and loves to find a new word or two to teach me each time I see her.  At K10 ($4) for 4 hours of work (the going rate around here), I truly get the best part of the deal just by getting to know her. 

I could go on and on; about my national friends, about the missionaries here as well, about patients I met on the ward that I think about and pray for but I'll end with sharing the names of those 38 students who now make up the second year class and are continually in my prayers.  –There is Andrew, Bruce, Chris, Danny and Dimas.  Everlyn, Elizabeth, Israel and Louis.  Jacob, John G and John M, Joshua, Jonah, Joy, Josephine, Jennifer and Jeminah.   Mata, Max, Mec, Moses, Madelyn, Mero and Michael.  Nathan, Philemon, Robina, and Rebecca.  Samson, Shedrick, and Sera. Tracy, Timothy, Tom, Thomas, Terry and Wilfred.  And there are a few that are no longer in the class that are also still in my prayers.  (And yes, I did that without looking them up, it helps that I attempt to grade their papers in alphabetical order to make it easier to record grades.)

These are many of the reasons I've had to be thankful lately and there are so many more, but I'll leave that for another day.  These are the some of the people who are my "People of Papua New Guinea." 

 

 

The Humbling Hike

So, yesterday I went on a hike with a group from Kudjip.  The 12 of us "white skins" met at 6:00 am and headed out to get our national guides for our hike to Kurumal.  We picked up Isaiah, a 3rd year Bible College student, at Tamban church and got to see a glorious sunrise there. 

I was feeling good and ready to enjoy a fun day of hiking with some friends, old and new.  Erin, my physically fit, doctor friend, had told me that the hike was more difficult than the previous one we had went on, and there would be times we would hike straight up the mountain through peoples gardens and then hike back down again, and that we would cross the river a few times. 

So I was prepared for it to be a tough hike, but that explanation doesn't do it justice by any means!!  I've seen patients in the hospital that have fallen out of their garden, and sustained major injures!  Crazy to understand for this Midwestern girl, that falling "out" of a garden is a real thing here.  I'm also not in the shape I was in college when ROTC hikes and strolls in State parks were something I could accomplish with minor aches (and Illinois, Wisconsin, and Washington are nothing like PNG!)  But I have been swimming regularly recently, getting some cardio and strength/flexibility in for my back and feeling pretty good. I also love nature and getting any excuse to be off station and enjoying it sounded great. Our last hike, with basically the same people was at a nice pace, not overly fast, not rushed and had plenty of stops for pictures and chatting with those we went by.  I guess I though this is sort of what our day would be like, just longer and a bit harder.  Little did I know what was in store for me! 

It started out easy enough, good pace, wide enough, well-used, packed dirt actual "trail."  Then our group began to grow as we went.  A few kids would join here, some ladies there, a man as we crossed his garden, till we had about 51 people in our crew.  The trail took us higher, up more narrow spots, and really wasn't a trail anymore, but worn down grass, and rocks and mud.  We got to those vertical gardens and by now I have a man in front of me who must be a trained trail guide.  I don't know at what point he decided he was going to be my personal guide but at some point he just made it clear he was. 

Now, I think of myself as a pretty easy going person, but I also am very independent, and very use to doing things for myself, and all by myself.  I'm a nurse, a former Army officer, a missionary, a first born child, an introvert, a 32 year old single woman; I've done well, just me and Jesus, making things work so far.   I kind of had a hard time accepting his "help" the whole way up.  I wanted to put my hand in one spot to push up, he would grab my hand with a death grip, and pull me up.  I'd let go, he would grab my hand again.  All of this was done in a very respectful, thoughtful manner, but I just could NOT do what I wanted to do, without this man, or some small child, or who knows who else right there to "correct" or "hinder" me!  The pace was no longer something I was in control of.  I was being dragged up a mountain I wished to climb.  I couldn't stop to breathe when I wanted to.  I had to put my foot there, and not there.  I couldn't get my hand out of his.  I couldn't stop if I wanted to without ten people crashing into me (at least it felt like this!) There was little shade at this point and I was getting very hot and thirsty.  I finally somehow was able to communicate that I had to stop and got my hand free.  I was able to get some water then, but was so hot, stressed out and claustrophobic and too many eyes were watching me that the shortness of breath I had had, quickly turned into wheezing and now I was really panicking.  Here I am on the side of a mountain, now hours from medical help, and even with a doctor, a CRNA, and 4^th year medical student in the group, I knew none of that would matter if I couldn't calm down and figure out how to make this work.

 PRAYER.  Short, and specific.  The wheezing calmed down some, the water helped and then Sid, the CRNA, a former Army man, and a dad, said the first words I heard clearly in a while, "Sometimes the lessons we learn on these things are not the ones we hoped for, humility…." I can't remember the rest now, but that one word was enough to bring Philippians 2:3 to mind, "Do nothing out of selfish ambition or vain conceit.  Rather, in humility value others above yourselves, not looking to your own interests but each of your to the interest of others." 

I had to let go of what I wanted to do.  I had it fixed in my mind that I could do this myself, but fighting for that was getting me nowhere.  I resigned to the help.  He wanted to help, I probably did need it.  Not being selfish in this instance meant relying on those around me, and one man in particular.  I still haven't sorted through all the implications that can be taken from this like I like to do, but for me yesterday, that one man, became a symbol of my pride.  That man, whose name I could never pronounce right even after three attempts and I have no clue how to spell, wanted to help and I had to let him.  I caught my breath, and then we moved again, me still struggling with the whole issue, but determined to be humble. Once we got to the top of that section, we were able to talk and worked out a plan a little better to help them understand my pace and back issues and all, but a lot of the success of the day just came from me reaching out and accepting the offered hand, or foot hold or whatever it was.  And there were many of them, and many spots I still didn't want help but it was there and I took it.  I hated having my hand held like that, but it was the lesson I needed yesterday. 

I came to Papua New Guinea to teach and to serve and go as He commanded, and I have done some of all that, but God wanted me to learn something yesterday and receive some help.  As I looked at the Philippians scripture today for my personal study, I went back to the first verse of chapter two. "Therefore if you have any encouragement from being united with Christ, if any comfort from his love, if any common sharing in the Spirit, if any tenderness and compassion, then make my joy complete by being like-minded, having the same love, being one in the spirit and of one mind.” (Emphasis added)   I received encouragement, comfort, love, shared stories of our common faith, and got lots of compassion yesterday.  Pride goes before the fall, and I fell a lot yesterday, and that pride is gone, along with the backside of my pants, which now have a significantly large hole in them.  Hard to have a lot of pride when you have to borrow a shirt to cover your backside!

 

 

 
I'll say the hike to the waterfall was worth it, even though the uphill climb was tough, and going back down wasn't much easier, crossing slippery rocks in the river was difficult, and hanging on to barely a ledge alongside the river was crazy.  I won't forget the hike, the views, the smiles, the lessons, the stress, or that hand that kept reaching back for mine. 

Not Malaria

After an exhausting 24 hours yesterday of aches, chills, fever and some GI symptoms, I called my friend Dr. Erin this morning. I'm sure she appreciated the interruption to her breakfast, with my long list of symptoms. We set up a time for me to meet her at the clinic and I then called my fellow tutor Sr. Grace to let her know I wouldn't be coming to the Maternity ward again today.

I hate missing work, and we have a good group of students on the ward I want to be working with. While the last few weeks on the ward have had their share of challenges, it's been rewarding as well and some good changes are taking place. I was excited for this week on the ward.

On Saturday I had gone swimming with Erin, Tim and Karla in our new reservoir built for the hydroelectric project. The reservoir is the new craze here at Kudjip, probably 100's of people are coming to use it weekly. Swimming, sliding down the "water-holder-backer" walls, washing clothes and bathing all takes place. It's quite a site (and probably means there are quite a few organisms in this water as well). This was my real first swim in a long time, and while it was refreshing to be in the cool water and swim some lengths, I also got a reminder of how out of shape I am! I've only gotten in a few runs and some short hikes lately and need to be doing more. We planned to get in some more swim sessions as often as we can.

Monday, two of my students informed me they had Malaria. Last Friday, one had Measles symptoms and there is a outbreak of them in the area. We gave health talks on vaccinations to all our patients on the Maternity ward and had some more talks planned for this week. Then those symptoms hit me on Tuesday. I prayed it was only food poisoning, but no clue how I could have gotten that because I know I cooked everything well and I haven't been eating anywhere else recently. When the symptoms continued on onto a second day I knew I needed to call a doctor if I wanted to get back to work as quickly as possible. I got my exam and an order for a CBC and malaria smear. I had my least painful lab draw ever and then waited for my results. One of my students with malaria was there for follow up labs, and also one of the college secretaries also had malaria symptoms. I really didn't seem to have the same symptoms they have and was just wondering what it could be. I'm just getting familiar with all these tropical diseases. (Working on the labor ward and not in a clinic or the Medical ward doesn't help too much with this.) We chatted a bit while we waited for our results and had a few laughs because of one little probably 18 month old that was waiting not so patiently with her mom. I wished I had some of her energy.

After about an hour my results came. No malaria. Pretty normal CBC, slightly decreased white cells. Back to Dr. Erin I went. The news from her, "Typhoid." Hmmmm, well at least somewhat quicker recovery than malaria! I got my antibiotics, and a new stash of Tylenol and headed home for another day of mainly sleep. 10 hours later, I'm feeling a little better, fever is controlled and I'm getting tired of myself and a little bored, so I wrote this!

Second year in PNG, second tropical disease. So glad this isn't Giardia like last year. Grateful for friends who have been there for me, concerned coworkers and students and their prayers. It was also a good experience to witness first hand the care that is given at the hospital and relate a little bit more to our patients. And I got a PNG health record book! Thanks for the continued prayers.

A day on the Maternity Ward

So I've been asked lately by a few friends what my days are like now that I'm not teaching in the classroom but working on the Maternity ward. Today might not have been a typical day but it wasn't completely out of the ordinary either. Woke up at 5:30 prior to the pig in the garden behind my house, had some Bible time and then a quick shower, breakfast and started a load of laundry before leaving at 7:25 to go to Monday morning Hospital chapel service.
8:00 attempt to listen to change of shift report (spoken in Tok Pisin. English and PNG nurse acronyms) while counting heads to see if all 17 of the assigned students are present.
8:20 assign each 2nd year student on postpartum 4-5 patients and have them work with 1-2 of the 1st year students, assign two students to work in nursery, make sure the 2 students in the delivery room aren't doing a delivery by themselves, and make sure the 3rd year student charge nurse knows what he is doing for the day.
8:30 supervise the students beginning their daily care for the moms and babies, while Doctor rounds on patients. Begin signing procedure books for all 17 students for procedures done on Friday afternoon when it was too busy to sign then books.
8:45 check on students in delivery room, no one in active labor, one student starting an admission on a multipara.
9:00 continue working on procedure books- sign Sr. Staci approximately 150's times throughout said books, wonder where my coworker that is suppose to be working on postpartum is, so I can fully supervise in the delivery room.
9:20 continue to go back and forth between labor and postpartum, watching one procedure after another, point out some things in the chart for students to pay attention to, chat with a few patients
9:45 coworker arrives, inform him of students task on postpartum and then concentrate on patient in deliver room with 2nd year student Joshua. Time contractions (using hands and wrist watch and patient reports) review labor process, assist with filling out paperwork.
10:15. John now is beginning to admit his patient in the next delivery bay, go back and forth between both bays assisting both students.
10:30 remember I need more latex free sterile gloves to do these deliveries and go to central supply and find my stash. Place gloves in both rooms so I can quickly put on when needed.
10:45 while helping John, hear Joshua's patient make a noise that basically only means one thing on a delivery ward in PNG and run back over to them (10 ft away) and put the gloves on while making sure Joshua is ready for this delivery.
10:49 help Joshua delivery baby boy, try to prevent tearing, not quite successful, big baby
11:00 bleeding controlled, give assistance with suturing but realize this is over my head as American RN's don't suture and I'm still learning, so trade places with my coworker on postpartum
11:05 begin supervising 2nd year students giving scheduled meds after the medication prayer time, avoid 3 medication errors
11:35 switch places with coworker again and assist with breast feeding on Joshua's patient and them do assessment on John's patient. Now she is 7 cm dilated, amniotic sac still intact, and its her 5th baby in 7 years. Fully get her history, it's her first time ever to come to a hospital. Has not had prenatal care, last two babies died at 11 months and 4 months. Wants to avoid another baby dying (why she came to hospital this time) but also has husbands permission to get a tubal after this delivery. Has only had girls. Last baby born 13 months ago. Not the best history, not the most common, but I've seen many similar stories here before.
12:05 let hospital staff know of our patients status, tell John to run and get some lunch fast and head home to get a quick lunch and hang up my laundry! (We are allowed to take a one hour lunch, haven't done it recently!)
12:40 back at labor ward, John is already there and monitoring contractions and fetal heart tones as needed. Amniotic sac still intact. Talk with Joshua about things we could have done better in his delivery.
1:50 Joshua begins to admit another patient, help with assessment and paperwork. Check on John and his patient periodically.
2:45 John's patient remains unchanged. Contractions are not very close together, 7-8 minutes. Decide to break her water. John performs procedure. All is looking good. Contractions pick up.
3:10 Assist with Joshua's patient. All admission done, waiting for more orders as she had prior c-section is now post-dates, not active labor
3:45 John's patient is getting closer to delivery, 9 cm, but wants to keep walking around the bed, of course, right at change of shift. All midwives on ward are at a staff meeting (not located on ward) and all CHW (community health workers, somewhat like an LPN) are in change of shift report out in the postpartum area. We remain with John's patient.
4:15 John's patient suddenly makes the same noise that Joshua's patient made earlier, except she is still walking around the bed and isn't on the side that has the step to get up into the bed. She squats before I can get out any Tok Pisin that would have gotten her to get up into the bed and that motion was enough that we know have a baby coming and no way to get the mom up to our sterile field. Quick instructions to John and we have the field under mom and I have a baby head in my gloved hands (thankful I had them ready to go a few hours ago). I've never delivered a baby this way before and John was suppose to do the delivery but no way it could happen with where we were each located in the room. Baby boy safely delivered and placed on our clean field at 4:20, followed quickly by the placenta. John gets to help at this point, cord clamps and cutting, and we then get them both up into the bed to do continued assessment. I'm still amazed nothing bad has happened but that this lady came to the hospital to deliver safely and we end up delivering on the floor!!! She is smiling though, very thankful we were there to help and loving that she got a baby boy! Some more assessment and we control bleeding and discover a prolapsed cervix to add to all our fun. John and I keep on praying!
4:30 All the nurses return from their meeting in time to help us finish putting mom together and then get her and the baby cleaned up and assessed.
5:15 All paperwork completed, patients successfully moved to postpartum ward. We informed them we would see them in the morning and to keep a close eye on her bleeding. I head home to get my laundry off the line before it really starts to rain.
5:25 Second shower of the day with my lovely heated rain water!

So just another Monday on the Maternity Ward, Kudjip Nazarene Hospital. Love it and this life God has called me to.

The Three P's

So it's been a while since I posted last. I've had computer issues and still do but I'm putting my other technology to use and writing this on the iPad. I'd been wanting to write about my obstetrics class for awhile. Classes finished 5 weeks ago but now we are working on applying those lessons in clinical. I mainly taught about the normal labor process this semester. One of the big lessons was on the three P's, power, passenger and passageway. These terms are referring to what is needed for labor to progress normally; sufficient contractions and then pushing effort from mom, a baby that is positioned correctly and isn't too large, and a passageway that allows that baby to move through it. The students did well learning the lessons and what is good and bad for each of these categories. We have a obstetric model that has helped me to demonstrate some of these lessons. I've found it quite Interesting that the model is Caucasian while the plastic baby doll that is always our "passenger" is the darkest skinned doll I've ever seen (and darker than any Melanesian baby around here). We use what's available! I've used a cloth book bag and towels to hide the baby in to help with identifying baby's position in the uterus and I've used a plastic bag coiled up to represent an umbilical cord and show cord prolapse. It's been fun and challenging to find hands on ways to engage the students, because hands on is a preferred learning method for many of them. I've also gotten to see how those lessons worked now that we are on the labor ward and are delivery babies. The Army way of "see one, do one, teach one" comes in a lot here. We try to get the students to see plenty of deliveries prior to doing a delivery and then they have to do 25 deliveries prior to graduating, but often the guys are so anxious to try their skills and teach them to the other students, that after one delivery they are feeling pretty confident and want to teach those who haven't been assigned to labor ward yet! Controlling this enthusiasm has been my struggle over that past 5 weeks. Constant reminders that two lives are in our hands works of a time! (I say guys because I've only had male students on the labor ward so far, missing my girls a lot but the guys are really doing quite well).
I've been thinking about three other P's recently as well. Presence, Prayer and Passion. Daily presence with my Heavenly Father, a lot of that being prayer and a continued passion to be here in Papua New Guinean despite all the continued challenges.
Also, over the past month our station power situation has been drastically improved because our hydroelectric power is up and running for the most part. A few kinks are still being worked out but it's amazing what having reliable power allows you to do! Like the dishes at 7:30pm, or a shower whenever it's needed, or reading a good book at night using a lamp and not a flashlight, things that rarely could happen before. That daily presence of power has really improved my overall outlook at times. Daily power outages are no longer the reality. It's also a great reminder of what the daily presence and power of God can do in our lives. Who knows what this continued passion will lead to, but I'm praying about the next few years and would also appreciate your prayers in this area.
Seven more weeks on the Maternity ward, then back for more lessons in the classroom, but never ending lessons continue with the Three P's here in Papua New Guinea.

Now a bit of my prayer recently, for my fellow coworkers here, all who are under that great commission and for myself-

But I do more than thank. I ask—ask the God of our Master, Jesus Christ, the God of glory—to make you intelligent and discerning in knowing him personally, your eyes focused and clear, so that you can see exactly what it is he is calling you to do, grasp the immensity of this glorious way of life he has for his followers, oh, the utter extravagance of his work in us who trust him—endless energy, boundless strength! (Ephesians 1:16-19 MSG)