Things I'll Miss about Shell, Hospital Vozandes and Ecuador

• · Everything within walking distance.
• · Living across the street from the hospital.
• · Getting into a car maybe once a week or less.
• · Little kiosks where you can interact with a human when you buy something.
• · Serving the very poor.
• · Shaking hands with everyone you meet.
• · Saying hello to everyone every morning and again in the afternoon.
• · So little car traffic that you can walk or jog in the middle of the street.
• · The big crime wave: some lawn chairs stolen from a porch.
• · $1 lunch, $1.30 if you go to the expensive place.
• · Knowing most everyone I deal with daily.
• · Praying at the start of every work day and whenever a patient has a crisis.
• · NO INSURANCE FORMS
• · No malpractice claims, lawyers, or threats.

Big Urine, Little Urine

In Ecuador, especially among indigenous people, big urine is stool, and little urine (la orina chiquita, la orina pequeña) is urine. When people complain of problems urinating, the doctor has to be sure to specify which one.

Humorous story to remember this by: One doctor had an elderly gentleman who came in repeatedly saying, “I can’t urinate.”

The doctor gave him Hytrin, a medicine to help men with prostate trouble pee. He still couldn’t go. Finally, the doctor took him to the Emergency Room to put a Foley catheter in him. He starts to scream, “NO! I just can’t pee!”

The doctor remembered big urine vs. little urine and asked how many days since the gentleman pooped. It had been about 4 days. Milk of Magnesia cured him when a Foley catheter put into his bladder couldn’t.

Something about me

Elizabeth tells her story

I grew up in a nominally Catholic home. I also grew up as an expatriate in South America, my father was a businessman, and in my youth I met a number of children of missionaries. I first heard the gospel in an understandable way from missionaries when I was fifteen years old. When I went to college in the US, God brought me to a church where I could learn and grow in my faith.

In college I decided to study nursing specifically so I could do mission work anywhere in the world. A few years out of college I joined a church planting team to start a Hispanic church in Miami, Florida. I began graduate school to become a Nurse Midwife, when I met Jerry at the University of Miami. We married and moved to Tampa for him to start medical school. During the following years I entered a time of serious questioning and exploration of my faith, and at the same time we began having our children. I thank God for this time, as it helped sharpen and mature me, and prepare me for service.

We moved to Tucson AZ in 1996, so Jerry could work at a community health center and help pay back the student loans he owed. We became involved in leading a marriage ministry (and worked on our own marriage as well!). By 2002 all our student debt was paid. We applied to HCJB World Radio after exploring other medical mission’s options at the Yearly Global Medical Missions conference in Kentucky. I remember seeing the tremendous medical need in Africa, yet feeling that we fit better with South America. As I was struggling with that idea, I spoke with a representative of HCJB World Radio Inc. who told me of a great place to work for in Ecuador, but that they were opening doors to Africa, and looking at options in Malawi! I thought, “What a perfect fit, we could get our missionary feet wet in ‘comfortable’ South America, and yet Africa could be in our future some day!”

We have been in Ecuador for four wonderful years. I’ve worked part time in the hospital, begun a health education and community outreach program and started and a pre and post test counseling program for our HIV. I also lead an evangelical Bible study for Ecuadorian women who have had little or no background in the Bible. We have loved living and serving our awesome God here, and don’t feel our time for serving in missions is anywhere near up. Perhaps, If God allows we can continue to serve Him with the needs He puts before us in Malawi.

“My Father is glorified by this, that you bear much fruit…” John 15:8

Elizabeth Koleski

Each Heart Knows It's Own Bitterness

What do you do when there are three patients who need a ventilator, and your little hospital in the jungle only has two ventilators? You pray, you put the intern and resident to work ventilating by hand the patient most likely to die, and in a sad way, you hope that the sickest one passes to his final destination before the poor intern and resident stay up all night trying to keep alive a man who lost his pancreas.

What happened to his pancreas? It died. It was dead and black, except for the areas that were filled with abscesses. He survived about a month with a dying pancreas, but he passed away tonight. We went way beyond the call. He came in near death. We saw that he had air in the parts of his abdomen that should not have had air. He was taken to the operating room with the understanding might die during the surgery, but the surgery represented his only hope, as slim as his hope was. When the surgeon found that there was dead tissue and pus where his pancreas should have been, he closed the man's abdomen and took him back to his room.

As soon as the man returned to his hospital room after the "open and close" surgery, his heart stopped. After three minutes of work and medicines, his heart started again. The resident and intern did the work of a breathing machine for about 30 minutes until he started breathing again, but 2 hours later, his heart stopped and did not start again. His wife did nothing for about five minutes, then she started to cry and cry and cry without ceasing.

King Solomon wrote in the book of Proverbs:
Each heart knows its own bitterness,
and no one else can share its joy. (Proverb 14:10)

The husband and wife and their two sons had many moments of joy in their lives together, and everyone's life ends in sadness for those left behind. Tonight the couple's life together ended. She and the boys will know bitterness for a while, and loss forever, but they will have many moments of joy in the future.

After seeing a number of deaths here on the edge of the jungle, I think that we should work at making more joyful moments and work at remembering them more. Bitterness comes pretty easily; joy takes some work.

Standing on the Shoulders of Giants

Hospital Vozandes del Oriente has been here in Shell for 49 years. We do some great work with very little, and have a great reputation. We have patients who come 11 hours to see us. People seem partly to trust us because we are gringos, but mostly because we are Christians. We don't recommend surgery because we want the money but because we think it is best for the patient.

We are reaping the good reputation built up over years by great doctors who came here when there was nothing here. Everett Fuller was the first doctor here, even before the hospital existed. He was a surgeon. His wife Dorothy was a nurse. Dr. Fuller had a operating room and a clinic. Before he had completed the hospital, all the patients that needed to be hospitalized were placed on the first floor of a small hotel down the road. After surgery, the patient would be wheeled down the road on a gurney. One of the people pushing the gurney would hold an umbrella over the patients face to shield them from the sun or the rain. It's either sunny or rainy here in Shell.

Dorothy Fuller was Everett's scrub nurse in the Operating Room. In most hospitals, the custodians or the nurses are responsible for cleaning the Operating Room, but not in the early days of Hospital Vozandes del Oriente. Dr. Fuller loves telling the story that when his wife was his "assistant" and he had a particularly bloody surgery, Mrs. Fuller would hand Dr. Fuller a mop and say, "You put the blood on the floor. You need to clean it up!" Dr. Fuller is sure that he is the only surgeon who ever had to mop his own Operating Room floor.

We are living the words of Jesus from the Gospel of John, "Thus the saying 'One sows and another reaps' is true. I sent you to reap what you have not worked for. Others have done the hard work, and you have reaped the benefits of their labor." (John 4:37 & 38)

Jerry