Hello Again from PNG

Hello again from Papua New Guinea It is raining again as I write this note. I believe it has rained every evening and night for the past two weeks, probably 15-20 inches in that time. It seldom rains during the day, so I expect sunshine tomorrow. The rain is actually a good thing as it keeps our cisterns full. All the drinking water is filtered, but we wash the clothes and bathe in rain water. It is really very clear and clean.

Medicine is much the same as at last report. I have finally convinced the nurses on Labor and Delivery that every patient needs to be seen and reviewed by the doctor every day. When I first came I would sometimes find a patient that had had ruptured membranes for several days and was not being induced. All things happen in their own time around here, but that was more than I could stand. Last evening, I had a patient come in from the Jimmi Valley (about 25-30 miles away - but many hours by car, or days on foot). She reported being in labor for six days, but the mud slides had kept her from coming in and the baby delivered on the way to the hospital. When she arrived the baby was in respiratory arrest, and was too far gone to bring back. I had another baby earlier in the day that our nurses had delivered and were trying to resuscitate with an adult mask. I intubated the baby and with a little oxygen he was doing fine in short order. I guess some in-service training is needed. I also received a woman yesterday afternoon that had delivered "in the bush." She had a retained placenta. No bottles or banana fronds hanging from this one, but the mother had lost a lot of blood and required two units and a bottle of fluid to bring her back around. No wonder maternal mortality is the worst on the planet here in Papua New Guinea and according to the missionary physicians, it is getting worse. Gynecology is going strong. I see a lot of advanced pelvic tumors and pelvic inflammatory disease that has progressed much further than I am use to. I currently have two women on the ward that had the most horrible abscesses I have ever seen. Folks here must be a lot tougher than in Missouri, I thought both might die, but drains and chloramphenocol works wonders. I have also been helping Jim Radcliffe, a general surgeon, on some of his cases. Today, we had a small child that fell out of a guava tree. He was impaled through the chest. We cleaned a bunch of splinters out of his pericardial sac, but his heart was untouched. What a miracle! My 1300 gram baby is doing very well. He is still in the nursery but feeding and growing well. Last night,  I delivered a 1000 gram baby who is still alive, but the other doctors feel she has only a very small chance of survival. Enough from me. I hope and pray you are all well. Tyronza and I are fine and experiencing all we can from this new culture. See you in another five weeks or so. God Bless, Dr. P Pictures can be seen on: http://www.facebook.com/album.php?aid=19428&id=100001961413037&l=a20582723c