Laceration repair

Nothing like being called names by a 4 year old - especially in a different language!!

Just finished suturing a laceration on the forehead of said 4 year old.

He alternated between calling me loco (crazy) and malo (bad).

He was not happy.

The above is a picture of this child a week after the repair. His grandmother was so embarrassed. She said he never says words like that.

Scorpions II

Swatted our second baby scorpion yesterday.

Still waiting for the mother and/or father, or at least the third of the three!

Thanksgiving

We are not in America, and so Thanksgiving is not a holiday here.

That didn't stop the American missionaries plus a few local friends from celebrating around all the fixings, although one day later than friends and family back home. To make sure things felt like home, we ate many of the same foods and even the sweet potatoes were color-dyed so that they appeared their familiar color.

We began with a couple of songs, For the Beauty of Earth and then Give Thanks, this second one in English and then Spanish. My favorite renditions of these songs can be found here and here.

We were then reminded of the importance of prayer that contains thanksgiving, and not just petitions (Colossians 4:2).

And then we ate - and felt satisfied.

n.b. the turkey, indian and pilgrim decorations were made from toilet rolls and by our boys along with some neighborhood kids.

Scorpions

Charity used a fly swatter to smash this one.

It had been "lurking" underneath our kitchen garbage pail - unfortunately, Athan tends to hang out there!



A few other things, ...

I have been telling the boys to shake out their shoes before they put them on - maybe now they will listen.


This one doesn't seem so threatening, but I am curious where his mother and/or father are. Full-sized scorpions here are 4-6 inches in length.

And this leads me to my final point.

We have been told repeatedly that scorpions travel in threes - and this is only the first :(

LoC III - Cleaning

Cleaning is pretty much the same as at home. Except for the following, ...

Everyday you have to sweep the floors. Well at least I do because it is one less bath for Athan, and there are little sawdust piles from termite-like ants plus all the bugs that died over night. Oh, and sometimes there is gecko poop - nasty!

You also have to clean the bugs off the table before you eat. Though we always seem to miss some.

I should be cleaning the squished mosquitoes off the wall, but I felt like it might serve as a warning to the others - it didn't seem to work. What may be working is these things you plug into the wall (I may need those for home). Mosquitoes are just as bad by our home in Huntsville in the summer but as you can see from prior post, these are huge though easier to kill. We saw ants carrying a dead one - it was very funny. I wish I had the camera - I think Shane had it, (what a surprise).

Dishes are washed the good old fashion way - in the sink, and then dried on a rack. The only difference is we don’t have hot water at the sink. Now that we figured out that a slower shower stream leads to warm water, I might get water to wash dishes from there. Also, sometimes I use a few drops of bleach, which most of the time ends up on my clothes.

I have had a woman who cleans at the clinic clean my house twice now - it was very nice! I actually got to sit & read to the boys.
It was $30 Belize - that is $15 U.S.
Her name is Marsela and she mostly speaks Spanish. So she gives us a Spanish lesson as well! You can see her picture above with Athan and Grattan.

Running adventures

I am typically out the door by 6am to run 4-5 miles, maybe a few more than that on Saturday.

You can see some of the "friends" I have encountered thus far on my runs.

Also, across from the clinic there is a park. It takes Hudson and Bram about a minute to run the loop around it. We have had several races with the neighborhood kids thus far. No 5k's yet, though :(

Photos

I have been asked a couple of times about our photos ...

If you want to view the slideshow, left-click once on the pictures.

If you want to see larger images of the pictures, left-click twice.

Finally, if you do go to the larger photos, some have comments on them.

Why we are here IV

We came to Belize knowing we would have many adventures - exciting, scary, and humorous (these last sometimes only in hindsight).

We came to Belize knowing that we would have a lot of time to spend as a family.

We came to Belize knowing that we would be stretched in many ways forseen and unknown.

We came to Belize knowing that we would get to escape part of the frigid Alabama winter!

But most of all, we came to Belize knowing that we would be a part of serving the local people through showing them kindness, healing/preventing some illness and being used by God to draw them to Him.

Most (all?) of our posts have dealt with the first three reasons listed above. This post has a picture book of some of the people we have helped in the clinic thus far.

Enjoy.

Altun Ha

As mentioned, we had the chance to go Altun Ha on Thursday.

We took a road called the Old Northern Highway (OLH). It looked to save us a half-hours driving (can you have an idea where this is going?). On the map, the road looked the same caliber as the New Northern Highway (ONH is the one that heads east just south of Orange Walk). No one here mentioned any difference - though of course, we didn't ask. Picture 1 from above gives you an idea of what it was like - and the road got worse from there. We drove on it for over an hour. We saw ONE vehicle.

I may have mentioned before that Belize is a very multi-cultural country. Our area is primarily of Mayan descent, though the local shops are run by the Chinese (huh?). There are large pockets of Creole folk, mostly in the South and Belize City. There are several Mennonite settlements. They fled Canada and America to avoid military service and now have established a nice little home for themselves. More on them later. There are also "East" Indians. And finally, there are many Americans and Canadians who are here vacationing, retiring or escaping.

Back to our Mayans. There are scores of excavated Mayan settlements throughout Belize (it is a major tourist attraction here, besides scuba diving), and indeed throughout Central America. Though their descendants still exist, the civilization largely fell apart several hundred years ago. Theories are numerous as to why this happened - the only we can know for certain is that God directs the rise and fall of civilizations and He had His reasons concerning this one. Hudson thought maybe it was because they didn't worship the one, true God - but then, what does he know, he is no theologian :)

As excavated sites go, Altun Ha is relatively small. But it is in close proximity to Belize City, the docking site for cruise ships. So tourists can get from their ship to the site, have a short tour and then back on their boat in less than half a day.

Our boys had a good time running and climbing.

The history of the presbyterian ministry amongst the people Mayan descendants in Northern Belize can be found here.

Garifuna Settlement Day

Today is Garifuna Settlement Day - ie. MLK Day for Belize, sort of.

Information about them can be found here.

The festivities celebrating today would be interesting but the Garifuna and their festivities are in Dangriga (we are near Corozal in North, Dangriga is south of Belize City), about a 4 hour drive.

So we will not be going.

For us, and you blog readers, it mostly means a national holiday - the clinic is therefore closed.

We will, however, be going to Altun Ha. This is an old Mayan site - pictures to follow!

Transport

As I have mentioned, we are located in a small town and the people live a mostly agrarian lifestyle.

Above you can see some of the typical ways the people here get around.

This is not photo-shopped

He may not have teeth, but he is over 10 ft. long!!

Notice where his tail is when the man is feeding him.

Musings

So we know that God is the Creator of all men, and we know that the good news of Christ is for all, or else we would not be here.
However, a couple of events over the last few days reminded me of these facts.

First at church.
We were contrasting the allure of the world as depicted by the Great Prostitute in Revelation 17 and that of Christ and His majesty.
We talked about how prone we are to be short-sighted and trust her riches and not Christs', even though we know how the story ends.
Anyway, the discussion sounded exactly like one we would have back home, only some of the specifics were different.

And then yesterday, a husband and wife came for some counseling.
As in most counseling, the parties involved tried to hide their respective culpabilities.
And then there were language barriers and cultural barriers too.
But based on what I could determine and what the staff also picked up, nothing short of repentance and turning towards God would provide them with hope.

Just like home.

So pray for the people here and the people at home.
That we would see the riches of Christ, and what He has to offer and turn towards Him.

A First

We have four boys.

So far, only one cut that needed stitching.

So far, only one broken bone.

Before today, nothing that needed to be taken out of a nose or ear.

Grattan proudly displays our first nasal foreign body - a balloon!

Church

We go to church twice on Sunday, once at 9.30am and then again at 6.00pm.

At our church in Alabama, Redeemer, we only have one service on Sunday.

This frees us up to either have a time of family worship (very important), or spend time with my family (also, very important).

However, I also miss having church twice on Sunday and we get to experience that here.

If only I could understand more than 25% (10%?) of what they were saying!

p.s. Charity says the picture only makes it look like women's bible study is in a dungeon
p.p.s. Charity also says to remember these photos next time you complain about your bathroom. We even bring our own T.P.

LoC II - Food

Menu for our days are as follows ...

Breakfast - cereal, eggs, pb & toast or oatmeal. The chickens in the picture are not who I get my eggs from - but I do get them from their neighbors. Twice I have bought pancake mix that contained bugs - there will not be a third time, but I did find a recipe.

Lunch - Get to eat at clinic for $7 U.S that pays for me and my four boys. This is good Belizean food, fellowship & I don’t have to do dishes!

Dinner - spaghetti, chicken tortilla soup, shepherd's pie, mac & cheese, and others to follow.

Misc. - I go to the market once a week with the clinic cook.
- I have to bleach the veggies so we all don't get sick
- There are ants in the fridge so things have to be sealed.
- Things are very expensive except staples (ie. rice, beans, flour).
- The oven works most of the time.
- We get red and green apples, bananas and watermelons for fruit.
- I get my eggs, some veggies and tortillas delivered to my door.

p.s. I am now using fabric softener. Cloth diapers are going great. I have 6-ply cloth diaper & a little flannel insert for extra absorbency - they both dry great. I use the thirsties diaper cover that dries fast. I added another line to dry more –it has helped a lot. I just have to remember to start a load at night so that I can hang for the early morning sun.

Trivia

A nickle for whoever can guess why this bird, the Jacana, is referred to as "the Jesus bird".

Came across this one this evening when we were out for dinner.

Clinic life

A little about the clinic.

Hours are 8am-12n, and 1p-4p. No appointments so it is first come, first serve.
This explains why some folks show up before 6:30am.

Currently we are seeing between 10 and 30 patients a day. Some days have been slow because the clinic has been without a consistent doctor for several months and so people are not aware that someone is there full-time. The slow days have been nice to get adjusted to life here - but we are here to work, so I would like to see it get busier.

Our lab is limited to spun hematocrits (to check for anemia), urinalysis, pregnancy tests and a finger-prick blood test for H. pylori. Patients are sent to the local hospital if any other labs are desired. This includes the third positive dengue test we ordered earlier this week.

We do have an ultrasound machine. The image is a little hazy but I have looked for gallbladder and aorta disease, dated a couple of pregnancies and located a foreign body.

We do have an ECG machine. I use it to determine if someone needs to be on aspirin or not :)

In a town called Orange Walk, about a 45 minute drive, there are a couple of surgeons and a variety of other specialists. Some people, when they really want to get something done, travel north about 30 minutes to Mexico – how weird is that to say good quality medical care can be had in Mexico?

We have a pharmacy that is fairly well stocked.

So far lots of diabetes and hypertension management. Many older patients are fixated on their cholesterol – we think there was some sort of government education program sometime back. We wish they would be more fixated on their diabetes! Lots of arthritis - most people work hard labor, either around their home or on the sugarcane fields. Most everyone has congestion – either from the dust or their open-air fires in their huts/homes. Some parents want vitamins and/or worm medicine for their kids – I say OK.

I have had three ER cases so far. First, removed a bead from one kids ear- three people to hold him down. Second, took an inch long piece of metal out of the base of one guys foot – it had been there for 5 months. He had had frequent infections but didn’t know why. They forgot to X-ray despite his repeated problems!! He said only sometimes he could barely feel something in there. Walking barefoot your whole life takes a lot of the sensation out of your sole. Finally, patient had a vagal event in our waiting room - though this was only determined after am intense, quick evaluation. Things like heart arrhythmia's, stroke and low blood sugar were at the top of my list initially. Maybe he just wanted out of the waiting room and back to a bed :)

Our patient population is primarily Mayan – most speak Spanish, a few speak only a dialect. Some of our patients are a mix of Creole. Some are Americans or Canadians down to visit or live. And we also have a few Mennonites - they make up around 1/7th of the total population, but mostly keep to themselves.

Click here for a link to the clinic's website. It has some interesting information, including how the clinic got started.

Mosquitos

The coin is the Belize equivalent of an American quarter.

The size of this mosquito is something I would expect from the time of Noah, not the 21st century.

Why we are here II

John Piper, a minister of a church in Minneapolis, has had a significant influence on our life. He has authored many books, most notably Desiring God, and has a library of sermons that can be easily accessed here when you click on his resource library.

Below are links to two different sermons that I have listened to over the past few months. They have either directed us in our decision to come to Belize or have confirmed our choice to do so.

Boasting only in the Cross

What is the Recession For?

Hope they encourage you.

Village animals

We live in close contact with a wide variety of animals.

Here are just a few ...

Life of Charity (LoC) I - Laundry

The first week I had to wash at the clinic.

It was a challenge getting the laundry & 4 kids to the clinic plus timing to go back & get it & put it on the line.

Then one night I had a surprise - I came home and found my very own washing machine. Small pleasures!

I have to wash practically everyday because I hang the clothes on the porch & it takes forever to dry.

There are frequent rain showers (we are near the end of the rainy season) plus the mosquitoes eat me up just hanging laundry so that is why I hang it on the screened porch.

I brought some Charlie soap which is fragrance free but when you hang your clothes out they just don’t smell so sweet, depending on how long it takes for them to dry. So I have resorted to buying soap here plus something you put in on the rinse cycle.

The word is out

One of the benefits of our house location is the work commute (haha), and the ease with which I can see my family throughout the day.
However, it is also "understood" that if I am around, I am here to help.
Until today, I had yet to be "bothered" during after-clinic hours.
This morning, I was called to visit an elderly lady with "la lombriz" - parasites.
And then this evening I took care of a young adult with an URI, and then placed 7 stitches in the base of 4 year old's foot.
Patchacan knows that a doctor is again living in "la casa azul" - the blue house.

Remarkable

We are now here two weeks.

Until yesterday, nearly all the people in the village were polite towards us but definitely kept to themselves.
They seemed friendly with their “Dias” or “Tardes” or “Noches” – short for good day, good afternoon and good night. But this was as far as it went.

This was in spite of me working in the clinic, us not being the first gringos in the area and our aforementioned walks through the village.

Yesterday, as mentioned, we celebrated Hudson’s 6th birthday and were pleased to have close to two dozen people come over for the festivities.

Within 10 minutes of ending his party, 8 of the children showed up at our door to play.
Today, we were joined by 10 others in a pick-up soccer game – two prior attempts to include some local kids in this affair had failed.
And now we have two different children at our house playing with our soldiers and cars.

Remarkable.

Why we are here

We came to Belize for a variety of reasons.
Some noble, some selfish.
We may or may not go into more of "our" why later.
However, today I came across an article that mentions some reasons why we came, or at least some of the reasons why we would like to think we came, or at the very least some of the reasons why we would aspire to do something like this in the future.
Enjoy ...

WHAT'S THE ALLURE OF INTERNATIONAL MEDICINE?
Nicholas Comninellis, MD, MPH
"I've lost three more patients today," writes Ben Cavilla, MD, from the Lubango Evangelical Medical Center in Angola, southern Africa. "One had terminal AIDS. Another had a liter of puss in her belly. And the third was a young child with typhoid fever." Dr. Cavilla gave up the comforts of British Columbia, paid his own expenses, entered into a foreign culture, and learned a new language - all for the privilege of volunteering his time and talent.
Consider also Rick Donlon, founder of Christ Community Health Services in South Memphis. "We took a dramatic pay cut to help the poor," says Dr. Donlon with all humility. "Some of us mortgaged our houses to pay bills and salaries so we could impact the most largely underserved part of the city."
Why did these individuals make such sacrifices? What is the genesis of this allure; the allure of international medicine?
Let's begin by defining just what we mean by the words international medicine. While various interpretations are in use, most fundamentally international medicine means healthcare for all people - especially those on the margins.
And here begins the first allure of international medicine: We want to care for those who are most marginalized. As I read applications for the INMED International Medicine Certificate, I encounter professionals inspired over the prospect of investing their time, talent and treasure for which their only likely recompense will be a "Thank you" and a sense of satisfaction. In an age of economic crisis, why is this so attractive? Because, first of all, it is consistent with the ethics we most admire; also, because it resonates with the faith possessed by many; and because we realize that somehow this kind of self-sacrifice is intensely good for our souls.
But caring for those most poor presents daunting obstacles. And here originates the second allure of international medicine: We like a challenge, something difficult; something that demands innovation and often brings out the very best in us. Those who are truly poor, whether in the United States or in other nations, are often separated by divergent culture and low-resources. Providing effective health intervention requires mature skills in crossing cultural divides - skills in language, worldview, and health beliefs that are infrequently addressed in formal education. For this reason, INMED is offering the upcoming Cross-Cultural Competency in Healthcare Symposium. Successful health intervention with limited resources also demands unique abilities in community health assessment, managing diseases of poverty, and health leadership. The INMED International Medicine Intensive Course is an invaluable opportunity to gain these skills. So equipped, we are better prepared to be fueled by the challenge.
The third allure of international medicine touches on a deeply personal note: We want a healthy legacy. I am struck by the frequency with which healthcare professionals reflect on their experience in medical missions or free health clinics or community health centers, even years removed. Though their service was often difficult and marked by failures, it also created intense personal meaning and deep significance. And while pride did not prompt the service, they are intensely gratified that it became part of their personal history.
So how shall we respond to the allure of international medicine? For those new to the field, I would first recommend volunteering in your current community. Displaced people, minorities, and neglected citizens are almost ubiquitous. Also, seek out like-hearted individuals for collaboration and encouragement. The meld of similar conviction produces success unthinkable by those working alone. Strengthen your understanding and skills in the field. It is for this very reason that INMED exists: to so equip healthcare professionals. Finally, realize that the allure is not simply intellectual, but one that originates in our souls, and happy are those who permit themselves to be lured on behalf of those who are least served.

Hudson - through the years

Hudson turned 6 today

We had the privilege to celebrate his birthday with some of our neighbors this afternoon.
Water-balloons, balloon-popping, cake and piñatas.
Lots o’ fun.

Roseola

Athan is now in the rash stage of an infection called Roseola.
This is a viral illness affecting children between the ages of approximately 6 months and 3 years of age.
The difficult thing about this viral infection is that you are really not sure what is causing the fever until the rash develops – anywhere between 2 and 8 days after the fever starts.
Athan had a fever and was irritable and had some lymphadenopathy, but nothing else to clue us into why he was febrile and irritable.
Then, as is typical, the fever subsided and a characteristic rash appeared.
It is really remarkable as he then had this diffuse rash, so he appeared worse, but the fever and irritability went away.
In a normal scenario, it is somewhat disconcerting to have an irritable child with fever.
Add in the inability to test for meningitis.
Add in further concerns for tropical illnesses – even if we have only been here for a couple of weeks.
We are thankful to God that he is on the mend – now if those mosquito’s would only stop biting!

Ida

Click here for
Ida's projected path

This could get interesting.

Dengue fever

Diagnosed my first two cases of dengue fever yesterday. Seemed indistinguishable from influenza - I wonder how many cases of dengue fever I have missed in Huntsville :).

Per the CDC, dengue fever is characterized by ... "high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash, and mild bleeding (e.g., nose or gums bleed, easy bruising)." It can also be associated with liver test abnormalities (I can order a urinalysis in our lab - one girl had bilirubin in her urine) and a relative bradycardia (ie. patient has a high fever and so an elevated heart rate is expected, but heart rate is often normal).

These two facts and the presence of dengue fever in the area made us think of it.

Treatment is the same except no nsaid's for dengue - I guess in case it progresses to the hemorrhagic type.

Not much difference between influenza and dengue, and malaria for that matter - makes for lots of fun for healthcare workers with limited resources.

Extra DEET for the kids!!

A typical day in Shane's life

4:30a-5:00 – roosters and birds are up – and so am I, on and off
5:30a – sun is up
6:00a–6:45 I am out to run 4-6 miles. I would like to run the Boston Marathon in April and will need to run 20-30 miles/week (regular training would be >50 miles/week) while here to make that worth the effort. My gear (visor, shorts and asics ds trainer’s) is courtesy of FleetFeet.
6:45a-7:00 – stop sweating
7:00a-7:29 – shower, dress, eat. Menu includes pancakes, eggs, peanut butter and toast, bananas, cereal with powdered milk - yum.
7:29a—7:30 – work commute
7:30a-8:00 – singing, bible reading, prayer with office staff. Arturo Ku delivers a short message of good news to waiting patients.
8:00a-noon – Patient care. Some come as far as 2 hours to receive my expertise!
Noon-1:00p – lunch. Our cook, Lucy, makes some local fair for the whole staff. As predicted, it is some form of chicken and rice and beans – but everyday is a variation and every day is very good. Charity and the boys join me for lunch.
1:00p-4 – Afternoon clinic hours.
4p-4:15 – wrestling/karate with my kids
4:15p-5:30 – some sort of afternoon stroll or trip to the local soccer field. The length of the town is 1mile (I know this thanks to my Garmin101) and so it is easy for us to get around on foot.
5:30p-6:30 – Dinner
6:30p-6:35 – I strangle one of my kids
6:35p-7:15 – games (Hudson has gotten quite good at Jenga, Grattan at Perfection), reading, singing, etc.
7:15p-7:20 – I strangle another one of my kids
7:20p-7:45 – showers
7:45p-8:15 – we listen to two chapters from the “Story of the World”
8:15p – bed – eary, very early, but we are up early and lack of A/C just saps you of all energy
11p – I am awakened by something outside – I hope it won’t eat me!

Prayer request

A child who needed the medicine, indocin, died on Saturday. This was a premature baby who had an prenatal artery stay open that was supposed to close - a condition called patent ductus areteriosus (PDA). In utero, this artery shunts blood away from the lungs to the rest of the body - not a problem as the blood is all oxygenated from the Mom. At birth, this artery closes and the blood then goes to the lung as it should. In some infants, this artery stays open and so the blood going to the body does not go to the lungs first - so they get hypoxic, which leads to progressive heart failure.
This condition is fairly treatable in the U.S. with either an I.V. medicine or surgery. Neither of these options are available in Belize - or in most of the world for that matter.
Anyway, we brought some medicine down to close this artery. It was expensive medicine and also time-dependent - ie. the baby needed it within a short time-window or it would not survive.
We were excited to be used by God to be involved in the helping of this child and their family.
We were saddened to hear of the dying of this child, as the timing of our arrival and the ability to get this medicine seemed providential.
God's judgments are unsearchable and His ways past finding out, and so the O'Neill's will trust that He has other things in mind besides the preserving of this one life.
Pray for the parents of this child that they would seek Him amongst their sorrow.

Spanish

I really want to learn more Spanish.
It would definitely aid in taking care of patients in the clinic – usually a family member or office staff can translate, but it is not the same.
It would be helpful to form relationships with neighbors and church members.
But most of all, I would like to learn more Spanish so I could understand the peoples prayers.
Their prayers are earnest, so I wish I knew what they were asking our Father.
They are lengthy, though I don’t get the sense that they contain vein repetitions.
There is also a melodious tone to them, that is music to the ears.
So pray for me that my ability to understand Spanish would increase.

Weather

This is the 10-day forecast.
I am curious to see what critters will be flushed out of their home and into ours!
I am curious to see how Charity deals with five boys being cooped up!
Charity is curious to see how the laundry will dry!