Re-entry across our American borders went smoothly, and we realized we were relieved to be past the risk of being stopped by Mexican police who want bribes. After dropping Bertha at a sister’s house in Austin, Texas, we headed on to Texarkana, Memphis, and Cincinnati. Wednesday we had lunch with a good friend in Medina, Ohio and then drove home.
We were greeted at home by a family from church who had prepared our room and posted a welcoming banner. After a day of rest and unpacking, we drove to VT to be with our daughters and their families and to celebrate a granddaughter’s 6th birthday. Sadly, we also celebrated the passing of their grand old (13 years) English black lab. Dogs can show us all how to be appreciative and trusting in all situations.
Now that we are back from Vermont, we have begun our work with Migrant Health, practicing our meager gains in speaking Spanish. On Easter, we returned to our home church and celebrated the amazing gift that Jesus gave us, and are ready to reflect, “What now?”
After our departure from Roca Blanca, a tremendous youth revival (reports of 3000-5000 young people) occurred with lots of music and international speakers. Many were baptized in the Pacific Ocean. We have also heard about plans to gather tons of corn, beans and rice from Mexican churches for the impending famine in Yucuya’a and Pueblo Viejo, villages in the mountains.
We had a joyous reunion with the Elim students, who are in their final few weeks. Several of them have been able to make decisions about receiving further training in nursing, medicine or psychology as a result of their experience at Roca Blanca. We are considering inviting a team down next year, sometime in Jan-Mar for 9-12 days with 2-4 days of travel. We anticipate it would not be exclusively medical, but could include children’s workers, construction projects, perhaps even agricultural projects.
We do have some ongoing prayer requests:
1.That the Elim students will be launched by the Holy Spirit into the next phase that God is calling them to, whether it be immediate mission work, or more equipping.
2. That all the salvations over the past 4 months at Roca Blanca receive the discipleship they need.
3. That the Mexicans themselves will rescue (by their own efforts) the hungry people of Yucuya’a and Pueblo Viejo.
4. That the Base at Roca Blanca receive the funding needed to accomplish God’s desires for His kingdom there.
Elim students, Bertha, Dave, Mary Kay, Saul and Lorena in El Mosco
Que Dio les bendiga! Dave and Mary Kay Ness
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Lupe (far right) several years ago with the Corban Clinic staff.
Her large stroke brought to light some of the obstacles to medical care here. The nearest hospital with a CAT scanner was in Oaxaca City, a difficult 7 hour drive away. First, she needed to be taken to Centro de Salud in the nearby town to get a referral. Then she was driven by our Mexican Doctor Eder, along with Laura and Bertha, to Oaxaca General Hospital. As the hospital’s scanner was down, she was transported to a private office. The scan showed a very large hemorrhagic stroke involving the right side of her brain. She remained unresponsive, but with stable vital signs. Lupe had made her wishes known over the previous year-if she had another stroke (especially a large one), she wanted to be allowed to pass on to be with Jesus.
Lupe, laughing with friends in El Mosco.
Laura, Lupe, and Lorena in the pharmacy during an outreach to El Mosco.
But hospitals in Mexico do not provide hospice care, or recognize DNR (do not resuscitate) orders. So ultimately, she was returned via ambulance back to the Base, where Laura and Bertha and her family from Pinotepa provided compassionate, expert nursing care. After 10 days, Lupita peacefully passed on to the other side at age 35, creating a void where she had been such a pivotal person in outreaches to her people, and a special daughter to Laura and Dave Nelson.
Lupe at nurses' station during Jamiltepec outreach.
Watching the immediate rallying of Base personnel and family was a stunning cultural event. People just dropped what they were doing, and calling hours started within a half an hour. Within 2 ½ hours, the body was being transported to her parents home 3 hours away. Laura and Dave, Dr. Eder, and Jesus and his wife Marisol went also to participate in the 24 hour vigil (through the night) that is customary here. Food was ready for them, and sleeping places had been found. The next morning about 20 of us went up to join them. Normally, the body would be interred right after 24 hours, but relatives were coming from Guadalajara (1 day of travel away), so it was postponed to Sunday morning. Several of us left the base at 5:30 am to be there for the interment.
Lupe and Laura during festivities preceding Laura's wedding.
There were about 300 people in attendance, walking up and down hills, with two teams of pallbearers, and a band leading the procession to the church, and then to the cemetery where the interment took place.
We were all back at the Base later that afternoon where a new week of work awaits us. We are richer for the inspiration Lupe was, poorer for not having her beside us now. But God honored her wish to be in a new and glorious body in His company, and to be finished with the troubles this earth brought upon her.
Lupe and Mary Kay at prewedding festivities.
We thank her family in Don Luis for bringing her up; we thank especially Laura for believing in her and and richly blessing her with the tools and equipment to serve her people as she did.
Que Dios les bendiga- David and Mary Kay Ness
]]>Dave’s sickest patients on day one came from outlying villages. One was a man of 70 years who was very wasted. His face was gaunt and his abdomen dipped down almost to his back when he was lying down. He had been losing weight for over four months and the half tortilla he hate morning and mid- afternoon would come up; then he would repeat the cycle the following day. He likely had gastric outlet obstruction, possibly from ulcer disease, possibly from cancer. We determined first that he wanted to live. So we gave him a liter of fluid iv. And his brother agreed to take him back to his sons to discuss the option of traveling the 3-4 hours down to the hospital.
Patients waiting at El Mosco.
Dave’s other sick patient was a 35 year old pregnant woman in her seventh month. She had had 6 children born at home. She was unregistered for prenatal care, was losing weight, urinating and drinking a lot. Her blood sugar was over 550. Her baby was moving. We talked her into going to the hospital that day, supplying her with a brief note of referral.
Morning devotions and coffee.
But returning to the tiny village of Yucuya’a was heartrending. Most patients there, often a mother with 2-4 children, complained of loss of appetite, with other common symptoms being headache, stomach ache, fatigue and lack of strength. Most had only a few tortillas, and possibly a few beans, to eat every day. They are in need of another food dispensing. Midway through the day we broke for lunch, just a little tuna salad on tostadas. The children especially just stared at us through the door and windows. Their eyes told it all. We felt so guilty eating anything; several of us cried. More tears flowed at debriefing that night. Not only do they not have adequate food; they don’t have adequate water, let alone clean water. Most of the women drink only 8-16 oz of fluid a day. But they were hungry for God, and of the 67 patients we saw, 47 asked Jesus into their lives.
Patients gathered around a tree at YuCuYa'a/
Children at YuCuYa'a
The land is bleak and not yielding much to eat.
Outreaches such as this irrevocably change our perspective on our life, and reinforce the calling that God has on our lives. Jesus appeared clearly to many of us. Some of the students from Elim are speaking of a more certain calling and commitment. The land there is promised to His Kingdom by God, but just as Israel came into the Promised Land, so this land is being subdued a little bit by a little bit.
We are in our last month here, and the Elim students are leaving soon. We are wrapping up our lectures, but continue to precept in the clinic.
Que Dios te Bendiga! Mary Kay and Dave Ness
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Injury with "spurter" pinched off.
Student dressing the injury.
When I arrived, there was an 11 year old girl on the examining table, struggling to get her breath, and only intermittently responsive. A 3 year old girl was asleep, and the others seemed pretty groggy. The room reeked of gasoline. As I walked over to the clinic, I was wondering if this was going to be situation of carbon monoxide poisoning, or toxicity from gas fumes, or both. We quickly got 0xygen saturation readings (Thank you Wisconsin team for the oximeters) on all of them and they ranged from 72% to 84%-for children, these readings should be more like 98%. We had only one oxygen tank, and only an adult mask, so we played “musical oxygen masks”, giving O2 and holding masks on a child until the saturation came up, and then we would switch to the next child. We had to go about 3-4 rounds before everyone’s 02 sat was holding above 96%.
Thankfully, nurses and students from the Elim team were present and each one held a groggy child as the oxygen was administered. Their clothing reeked of gasoline, so we stripped them all down and found a suitcase with mostly kids’ clothing that had been left behind. They were all quite pleased with their new duds.
We talked with the parents about safety in using a generator in the house, but were not totally confident that they understood the gravity of the situation. The next day, several of us and a visiting “engineer/can fix anything” man all went to visit them. The kids were all bright-eyed and playful, with no complaints of headaches or dizziness. We checked out the generator situation and discovered it would not be possible to vent it to the outdoors. Leaving it outside was apparently out of the question for fear it would be stolen. There was a small gasoline leak in one of the hoses that we fixed with some tape. Truly, the fumes in the room were very strong and the generator had not been run for many hours. So even though they seemed to understand they should run the generator early in the day with no people in the room, I am still concerned that the room is their sleeping room, and it has no ventilation.
So, we will try to stop by on a “casual” basis now and then, so as not to appear to be prying. (We will, however, continue to be praying for them!). We walked by yesterday, and the two little girls waved very enthusiastically.
Dave discussing a case with students and a clinic nurse. In this room, we see patients, do procedures such as minor surgeries and IV therapy, and take care of multiple members of a family as in this story.
Que Dios te Bendiga! Mary Kay
]]>We have done some lectures about common health problems. We have shown some videos. But most importantly they are shadowing us and then learning to take a history and do an examination, identify the problem and then work toward a solution. Next weekend we travel to El Mosco where our mountain base for outreach is located.
Classes are held in the Clinic Commodore.
Saul and Lorena, key workers in the Clinic.
Students do the initial intake on the patients in the Clinic.
Next weekend the students will have the opportunity to shadow, to check in patients, to distribute medicines, and to do children’s ministry in the mountains.
Que Dios te Bendiga! David Ness
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It seems as if every outreach has one or more medical themes- maybe diabetes, maybe diarrhea and worms, maybe malnutrition- and this outreach was no exception. We saw a whole range of vision problems, everything from cataracts to corneal injuries related to prior injuries that were not taken care of, to the need for glasses for near or far vision, to conjunctivitis related to the smoke and dust in their environment. Loss of near vision, which happens as many of us reach 40 or more, is especially critical to the women whose livelihood often depends on weaving and embroidery. There are no nearby Walmart’s to buy a cheap pair of reading glasses. Abdela is a 32 year old woman who came in with the chief complaint of greatly diminished vision, both near and far, that had come on quite suddenly. After a few questions, it was clear that this history was not making sense. So we asked her exactly what happened the day she lost her vision. I was not prepared for her answer (I knew I would not be). She had been standing on their porch with her family, watching as her mother walked down the street to visit them. It was raining hard, and suddenly, water roared down the street and swept her mother up and carried her away. Though they were nearby, they were unable to help her. They found her mother’s body about ¼ mile away. She had seen something so terrible that she “lost her vision”. She was devastated, and as we found out as we talked more, she felt guilty that she had not been able to save her. She was having dreams where her mother would be calling her to “come to her”, and she wanted to go- creating more guilt for wanting to leave her young family. She had had prayer for “return of her vision”, but not for release from her tremendous sense of loss and sense of guilt. She accepted (it seemed) our explanation of why she could not see well, and expressed hope that her vision would return over time as she was able to release her guilt.
We were fortunate to have a dental team with us, but these were too far gone to save.
We have never seen this in our 35 years of practice. Help!
We were hosted by Pastor Eduardo, his family and the members of the church. Since there were 30 of us, that was no mean feat! They gave us a spot to erect 5 tents and to keep our vehicles, and housed the rest in 3 different homes. They served 4 different meals a day to us. I can’t begin to count the number of tortillas they made, and the soups and stews were simmered in huge washtubs. The women cooked in a communal type kitchen, and served us all with graciousness and generosity. Sunday evening was their worship service, and our group was asked to do most of it. It was a pleasure for us to see the worship team (led by a Mixteco man from the base) lead worship, and then to hear one of the young Bible school graduates preach a simple, core message: God is Love. Subsequently the Mixteco worship team began to play and sing, and the tempo and the decibel level really ratcheted up, and there was a lot of dancing by young and old. The music, the dancing, the shared smiles dissolved the language barrier. It was one of the highlights of the outreach.
Two chronologically enriched Mixteco women.
Read on.
He came to the base clinic from 2 hours away. About a third of his left foot was gone. He had diabetes, but denied it until gangrene forced him to go to the hospital for this procedure. He forbade the surgeons from doing the recommended higher amputation. As he lay there, he had a vacant stare. His sister-in-law spoke for him. Then we saw his sister-in-law and her husband, the patient’s brother. The only other relatives have dropped out of the picture, leaving this couple to care for him. His brother had not worked for a month. He was holding the patient’s hospital bills in his hand; he had been helping him with the daily necessities. More than respite care is necessary. What could we do? We counseled him to resume work, and try to get a neighboring youth to help in the personal care. Then it became clear that the patient, with the partially amputated foot (with bones showing and without skin covering) understood the undue toll on his brother and his family. He was choosing his own way to die. The church had helped a little, but that was now gone.
Work, a meal, and now relaxing.
It seems as though personnel on the Base are under attack. Right now respiratory illness is prevalent. An important worker has been sidelined with kidney stones. Another leader has been weakened by physical health problems. Others are facing challenging personal problems. Some short term teams have cancelled, causing chronic revenue shortfalls (problem began with the crash of the market in the USA and has not corrected). Please intercede in prayer as the Spirit within you directs that the work being done here will continue through these obstacles, and that we will be strengthened by His grace to overcome them. It is after all His work and His battle.
Que Dios les Bendiga! Dave and Mary Kay Ness
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Bertha, surrounded by children
We learned on Wednesday morning that we had just made it through to Atotonilco before a road block was erected in San Gabriel to the road between Oaxaca and Puerto Escondido to protest the defeated mayor’s refusal to hand over the town seal to the new mayor of the same political party. Many truckloads of people had gone down to San Gabriel to participate in the demonstration. As a result, we had many fewer patients than we had anticipated on Wednesday morning. By 1 pm, we had seen everyone, including two house calls, and were packing the truck for departure. One house call was a pregnant woman, near term, who had developed headache with high blood pressure; we gave initial treatment and referred her on to the Central Salud (local government health clinic). The other was to a man who had sprained his knee a month earlier and it had not gotten any better. He had a significant amount of fluid on his knee, and he was referred for an x-ray and offered an appointment at the Base to try to drain the knee.
Mary Kay examining a robust 7 month old.
Ordinarily, we offer spiritual care to each patient after he has been seen and is waiting for medicine. Usually the local pastor or church members provide this. However, they were busy with other tasks, so each team of physician, Spanish translator, and Chatino translator offered prayer at the end of the consultation. As is the custom here, everyone (including the patient) prays simultaneously-3 different languages at once. At first this was a little disconcerting and distracting, but then it began to feel very natural and appropriate. At one point, a 70 year old wizened woman, with a bit of a sharp edge to her manner, came in for a consult. Our translator advised that she was well-known as a vocal opponent to the church and its activities. We dealt patiently with each problem she presented and she seemed to warm up slightly. We were briefly interrupted during which time the translator (17 year old girl) and the woman spoke in Chatino. When we returned, we asked her about her sleeping, was it restful and restorative? Finally, the dam broke, and she started describing that she was unable to sleep because she would see children, all dressed in black, in menacing and threatening postures. She was unable to make them go away, and was exhausted and terrified. We gently presented the Gospel (not new to her), and suggested He could help her with her fear, and she accepted Christ into her life. We taught her some simple prayers to repeat when these night-time terrors appeared and told her that others would be praying for her as well. The encounter ended with her smiling and weeping at the same time, and the exchange of many hugs. About an hour later, while we were with another patient, she burst into the area to give us a present-a big bag of frijoles (black beans). Again, smiles and hugs, and also a photo.
Consulting team with beaming Fortunata.
With the road block not expected to lift for 5 or more hours, we prayerfully accepted the suggestion that we return to the Base by another dirt road in the opposite direction, over the mountains. Pastor Clemente accompanied us, for he was expected at a conference back at the base that evening. Since he had never traveled this route, we stopped at several settlements to confirm we were going the right way. It took 4 hours to drive 31 miles, over bumpy and curvy mountain roads; despite that, we all enjoyed the gorgeous vistas, and trees of coffee, bananas, and palm. Clemente brought his 5 year old son who proved to be a fierce and persistent teacher of Spanish.
Two sisters-they really take care of each other.
Grinding the cooked corn into Tortilla dough, a daily task.
And a praise report! We drove 2 vehicles the 2 ½ hours to the airport and picked up the Elim students last Friday. They soaked up the warmth and sunshine and enjoyed the beach and a visit to Puerto Escondido, before starting classes on CHE (Community Health Evangelism) being taught by an American pediatrician who has lived in Mexico for >10 years and is involved in training people for this program, which concentrates on people learning to identify needs in their communities and develop plans to help themselves. It is an integral ministry that includes ministering to the spiritual, physical and social needs of communities. Next week a dentist will come to give a week of classes, culminating in a 3 day outreach to a Mixteco community.
Que Dios te Bendiga! Mary Kay and Dave
]]>Later in the afternoon, we were served a delicious meal by the pastor’s wife and some women in the church. There were 19 of us as well as about 6-8 Mixteco translators supplied by the village. Preparing meals for this size group is no mean feat (remember, no modern stoves, sinks, dishwashers, etc), but they did so generously, with joy and a spirit of service in their hearts. In the evening there was a lively service during which we were introduced. Following that, there was an even more lively birthday fiesta for one of the parishioners, with food, loud music and dancing, and a cake.
Almuerzo, or 10 am meal
Children at the birthday party
The birthday celebrant and her spouse. She danced a lot!
We slept in a tent set up on the porch of one of the houses, while others slept in rooms graciously vacated by the family. Two puppies managed to find the side wall of our tent-a good place for warmth, comfort, and a sentinel post from which to bark occasionally. A pig patrolled the courtyard with his own cadence of grunts. We arose relatively early, there being no dearth of local alarm clocks like roosters, pigs, dogs, etc. Some arose in time to see clearly the alignment of the moon with several planets. After devotions, coffee and “Marias” (a kind of cookie), we again set up the clinic, teams of providers and translators, the pharmacy, and the spiritual care area, anticipating a brisk day of seeing patients.
Spiritual care team
Children engrossed in drawing scenes from the Christmas Story
From Sunday 2 pm to Monday 7 pm we saw about 115 patients, 35 of whom chose to accept Jesus as their Lord and Savior. Pastor Balthazar will follow up with them. From our perspective as physicians, there was much pathology. A cachectic 15 year old girl presented with fever, cough, blood-tinged sputum, weight loss, poor appetite, night sweats – tuberculosis until proven otherwise. A referral letter to the local hospital was written to facilitate her evaluation and treatment. A 44 year old woman presented with a blood sugar of 600 (normal <120), on no medicines now, having failed on various regimens of oral diabetic medicines. Insulin had not been tried, and it is problematic in this area because of a lack of refrigeration in many homes. We wrote another referral letter to the local hospital, suggesting a trial of insulin to get her diabetes under control. A 24 year old woman presented with a complaint of headache; additional history revealed symptoms suggestive of early pregnancy: prenatal vitamins and general advice was given. We saw a 68 year old man, still working in the fields, with marked evidence of emphysema (had smoked for many years, though had stopped some time ago). He had the most abnormal lung exam (wheezes, ronchi, and rales in all lung fields. It was a good teaching moment for the students. We visited his home the next morning, and as suspected, there was smoke from the cooking fire and dust. We had chosen to give him an evening dose of furosemide (a water pill), as his sleep was troubled by coughing. That next morning he reported less cough and better sleep, so we gave him more furosemide. We made the house call to see his wife who is bed and chair bound due to a long affliction with rheumatoid arthritis. His love and compassion for her was evident in his eyes and in the way he carried her from chair to bed. For what the family said was the first time, she accepted medicine to ease the pain. And also, there were no bed sores!
One memorable patient was a young woman, very slight, looking more like a child, and obviously anxious and easily distractible. Her chief complaint was “mareo”, or dizziness. Now this is an extremely common complaint, especially among women, and is often secondary to low blood pressure because of inadequate fluid intake (maybe 8 oz. a day). So it is tempting, especially towards the end of a long day, to do a perfunctory history and exam, recommend increased fluids and be done with it. However, in her case, we learned that she would often “fall down” when she became dizzy. More than once this has been the presenting description of seizures, so we continued. These spells had begun at the age of 1 ½ years of age. Eventually, they took her to a doctor and she was diagnosed with “spells”. They do not call them “seizures” because those are attributed to Satanic influence. She was seeing a specialist in Oaxaca City (8 hours away), who had her on a very reasonable,” American-style” regimen of medications. She reported that if she did not forget any doses of pills, she did not have spells. She was visibly distressed and sad when we said the regimen was a good one and she should stay on it. Further history revealed evidence that she was treated differently in her family, and denied opportunities such as attending high school. We tried to encourage her that she could live a perfectly normal life, with a career if she wished it, marriage, family etc. By now, she was on the verge of tears. We finally asked her directly, “When you came here today, were you expecting and hoping that we would have a cure for you and you would not have to take medicine again?”- a tearful nod of the head. Such an amazing, innocent expression of hope! She then went to spiritual care, where she eventually broke down crying and was embraced by Marisol (our pastor’s wife) and accepted Jesus as her Lord and Savior. Perhaps out of that will grow acceptance of her condition and mature care of herself. Who knows? Perhaps more.
Family team that was so hospitable to us.
Mother, infant daughter, grandmother, great grandmother
God bless you! Que Dios te bendiga! Dio nasoka chu’u! (Mixteco).
Dave and Mary Kay Ness
]]>Besides the family contact, the other overriding consideration was the weather. It seemed as if we were riding a tidal wave of cold and snow as we rushed southward. From church on Sunday we had snow and snowy roads until Rte. 17 joins Rte. 15. We had snow and freezing weather through PA. There was snow on the ground into southern VA. We drove through flurries in Tennessee. In Birmingham it was still 15 degrees, but the snow on the ground was gone. Not until we were about 100 miles from the Gulf, near New Orleans, did it climb above freezing. Houston was below freezing when we arose to leave Wednesday morning. It was chilly in Monterrey, MX, and the day after we left there and ascended past Saltillo to the central plateau, the road was closed due to snow and freezing temperatures. Others behind us destined for Roca Blanca were unable to get through, but hopefully will arrive in a day or two. A friend called from Kansas Thursday night and said truly frigid conditions are coming upon you up north, so we will believe and pray for your safe travel and warm homes. But as we write this, a coolish breeze (maybe 78) is coming off the ocean and we have overcast skies. But finally, the sandals and shorts are out.
Crossing the border is always an adventure, and this year was no different. Our preparation was a bit different in that we have obtained our FM3 visas, which legitimizes the work we do down here. We had also obtained a letter from the President of the village where Roca Blanca is located; he invited us down to do medical work and to bring in the necessary supplies and medicines-not a fully proper importation document, but better than nothing. We packed all the medicines into 3 very large suitcases as instructed by him. We had an inventory list of both supplies and medicines. As we approached the customs booths, we prayed for a green light, but instead the red light appeared and we were pulled over for further inspection. They took more than a cursory look and asked a lot of questions about where we were going and what we would be doing. They looked at the papers and we had to unload about half the truck. Ultimately, we ended up having to pay duty on the supplies (accepting our list and prices), but they allowed all the medications a free pass (after we reminded them of the regulation that each person was allowed to bring in a suitcase full of medicine). The final bill of $90.00 seemed like a gift. Once across the border, we were stopped by federal police within half an hour. It all seemed like an inauspicious beginning to our travel in Mexico.
Today we are continuing to unpack and organize. Tomorrow we go out on a 3 day outreach to the mountains. From our perspective our prayer needs are: 1) Good health and rest for us after our travel. 2) Safety in travel for the several parties coming and going this weekend, including our medical outreach. 3) Preparation of all our hearts and minds to perceive every bit of goodness in His will as we seek to be obedient to His calling.
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