Six-Year-Old Update

David Santi went home a couple of days ago. He is the six-year-old who kept thwarting our efforts to change his bandages. He wore donated clothes as he left because he came to the hospital without a stitch on.

As you can see in the photo, he went home with quite a haul of goodies. He has two cars, each about 4 to 5 inches long, plus a coloring book. Not bad for a naked little boy from the jungle The last few days he was in the hospital, David made himself quite at home. He would sit with the nurses at the nurses' station. He always had candy or gum. He went from a frightened boy in pain to a little pistol.

David's home life is sad. He is an orphan, and his twelve-year-old sister takes care of him and his younger siblings. We can't change everything here, but we can do what we do very well and with great love.

We already miss David.

Blessings,
Jerry and Elizabeth Koleski

Outwitted by a Six-Year-Old

We have been trying to change little David Santi’s bandages for the last two days. David burned himself by spilling hot soup on his back four days ago. Because David is only six and in our hospital all alone from the jungle, we don’t expect him to grin and bear it when we change the bandages, we do it under anesthesia.

There is only one drawback to anesthesia; you can’t eat for a few hours before you get it. That is where one little six-year-old from the jungle has defeated six doctors from the big city. Yesterday the resident wrote the order “Do not feed until after lunch.” The nurses thought that David was to get lunch, then nothing else. David, being a hungry little boy in a strange place, ate what the grown ups gave him. He was finishing lunch just as they were going to take him to the Operating Room to change his bandages. The dressing change had to be put off, because if David vomits from the anesthesia, he could inhale the vomit and give himself a nasty pneumonia.

Today, everyone was told that David was not to eat breakfast, so that the bandages could be changed. Everyone was with the plan, except David. As they were about to take the little guy to the Operating Room, he was finishing the apple he had begged from the nice man across the hall. The doctor asked, “Why did you eat an apple? You weren’t supposed to eat anything.” With brilliant six-year-old logic, David replied, “Nobody gave me any breakfast and I was hungry, so I asked the man for some food and he gave me an apple.”

David will be fine. The burns aren’t very deep and cover less than 10% of his body. He would be fine faster if we could change his bandages and clean his burns more often, but he will be fine anyway. He’s really cute, so when he does what he wants, which is the exact opposite of what we want, it’s impossible to be angry with him. Still, getting outwitted by a six-year-old is embarrassing and frustrating.

Blessings,
Jerry

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.

Malawi, Here We Come

Our son Andrew will finish eighth grade in June 2008. After that date, we will need to look for other ways to educate our children.

We took a trip to Malawi in April. We liked it a lot. We prayed and were convinced that God wants us to go to Malawi. There is a clinic there called Partners in Hope founded by Dr. Perry Jansen. The needs are huge, but God is alive there.

The life expectancy at birth in Malawi is 37 years. 1 in 4 children die by age 5. 15% of adults and 30% of the population is HIV positive. One half of a million children have lost one or both parents to AIDS. There are 2 doctors per 100,000 Malawians. That is 1% of the rate in the United States. There is a joke, that is half funny and half true that there are more Malawian doctors in England than is Malawi.

We pray we will make a difference.

Blessings,
Jerry for the Koleski family

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

Mud Slide Slim

Since children in the jungle don't get to go sledding on snow, they still can slide down hills. Here, they go mud sliding.

The day started with the kids trying to slide on a large sheet of plastic wet down with spay water. They quickly discovered that the plastic wanted to slide down the hill with them. Since the first try was not fun enough, fast enough or dirty enough for the kids, the kids decided just to slide on the mud. It made a huge mess, grinding mud into their clothes. After they were done, they turned the bathroom into a new mud pit.

The great thing about kids is that they will make their own fun, and are usually more creative than the adults around them.

Blessings,
Jerry and Elizabeth

Premature Baby - It's Good to be Wrong Sometimes

It's good to be wrong sometimes. I thought the premature baby admitted two weeks ago was going to die. Shows how much I know. The baby at first lost weight and needed antibiotics, but now she is growing and getting ready to leave the hospital in the next few days.

Her birth weight and her Bilirubin, the chemical that makes people with Hepatitis look yellow, were horrible. She was born at 32 weeks. We have had babies 33 weeks of age die here. This tiny girl doesn't think much of numbers and statistics, she just keeps on growing and eating. When she was born, she weighed 1900 grams (4 lb 3 oz). During her first week of life, she dropped all the way to 1580 grams (3 lb 7 oz). Now she's almost back to her birth weight. She never developed any of the problems most premies develop, like pneumonia or other infections. She never ended up on a ventilator. I'm amazed.

If she can keep gaining weight and clear up her jaundice, she might get to go home to the jungle in a few days. That would be a great surprise and a time when I'll be very happy I was wrong.

Blessings,
Jerry