Lions and Tigers and Bears, Oh My!

It’s hard to sum up my first few days at Herbertpur in a short blog entry, but I think this well-known phrase describes some of my emotions pretty well! There are a lot of new things to get used to here. Such as, the electricity goes out all of the time- at least several times per day! There is no hot water, so I was given an immersion stick to put in a bucket for at least 30 minutes in order to heat it up and bathe with (although this doesn’t work so well when the power is out…). The food also takes getting used to- definitely not the American-style portion size and array of choices! Ex: dinner tonight was bananas and roti (basically a fried tortilla). I’ve been praising my jar of peanut butter! =) There are, of course, many other little things that are taking me out of my comfort zone- but that’s not what I want to focus on.

Far beyond all of these little daily challenges, is a group of people who are so dedicated to serving the Lord and serving the people in this community. I am humbled by their hard work, joy for service, and contentment. The first case I saw in the hospital was a 22 y/o female with eclampsia who had an intra-uterine fetal demise due to her seizures; she had not received any prenatal care, and the family had sought out traditional medicine when she started becoming delirious and having seizures. She was finally brought to Herbertpur, but the fetus was found dead. In only two days, I had seen 3 intra-uterine fetal demises due to preeclampsia/eclampsia. Soon after seeing this woman, we walked into the newborn area to see a premature little girl who had been abandoned at the hospital gate earlier that morning. She weighed only 1500 grams, but she was beautiful! We can only guess at the reasons for abandonment – female baby, unmarried mother, poverty? But thankfully she will receive good care at the hospital and hopefully find a family to live with.

Today, I saw something I never could have imagined. A man had disseminated tuberculosis causing a severe bowel obstruction. He had been constipated for 5 months. The man was SO emanciated, it was dreadful. They took him to the operating theater (what they call their OR here), and the man couldn't straighten his right knee on the table. He screamed and cried with the effort- they said he had a "TB joint". When they opened his bowel- I was shocked at how distended and angry-looking it was. Unfortunately, as they were operating on him he crashed. He had no cardiac rhythm so they started doing CPR. Here I was looking at a frail man with his small and large bowel hanging out of his stomach while a doctor was doing chest compressions. They couldn't save him so they attempted to decompress his bowel through an incision (such a foul smell!) and they sewed him back up. I've learned about disseminated TB back home, but it is everywhere here.

A little more about the compound: Although Herbertpur is a 100-bed hospital, basically each ward is made up of a large room containing 20+ beds in them. It is crowded so patient privacy is difficult, sanitation is far from what I’m used to in the states, and the practices of the midwives, nursing staff, and some physicians is very different. I’m realizing that not only can I learn a lot from what is happening here, but maybe I can also share some ideas from my own practice with medicine and patient care.

I want to end with a verse from Philippians. A couple of nights ago, I was exhausted after a very long and very cold day at the hospital. I came back to my room around 9:30 pm and just wanted to turn on my space heater and immersion heater in order to put a hot water bottle in my bed and then go to sleep. As soon as I walk in the door, the power went out. It stayed out for about 45 minutes. I was cold and exhausted and just thought- please God turn on the power, I need warmth! I need sleep! I got my headlamp out and started reading in the book of Philippians and this was the verse I stumbled upon:

“Rejoice in the Lord always…, The Lord is at hand; do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peaces of God, which surpasses all understanding, will guard your heart and your minds in Christ Jesus”
Philippians 4:4-7

I just stopped- how quickly I can get discouraged and upset! But Paul reminds us in this letter that we don’t have to be anxious about anything because God is in control and He will provide for us. I think I will need to come back to this verse many times over the next 6 weeks, but I really am thankful for a chance to learn what it means to really depend on Him for strength!

Prayer Requests:
- Dependence on God for contentment, joy, and strength. Please pray that I will have a good attitude about the things that don't go as planned, and that I will be able to see God at work in all situations.
- Continued good health. I came down with an icky cold, but nothing worse so far! Just some sniffles.
- For the staff and students at Herbertpur: Renewal, rest, and joy in their work here. Also, that in the midst of their hectic schedules they would remember to minister to not only the health needs of the people here, but their spiritual needs as well.

Praises:
- I met two really wonderful nurses here that will hopefully provide some companionship while I’m here.
- There was a visiting OB from Texas this week, and a husband and wife from Maine who represent an organization called “Grace Babies” – a great organization aimed at educating mothers and midwifes about prenatal and postnatal care. These 3 people have been a great resource for questions and support as well as encouragement. They left today, but it was great meeting them!

A New World

It amazes me to think that in less than 24 hours I left the subzero temperatures of Wisconsin and entered the busy streets of New Delhi where I was woken up throughout the night by a Sikh guru chanting meditations from the next-door Sikh temple! It's another world! Although I only saw a glimpse of Delhi today, I was surprised by some of the impressive development and the well-paved roads. The driving is of course scary, with Rickshaws and mopeds zooming in between larger cars regardless of lanes, but there are some spectacular sights.

I did some shopping today to outfit myself in the traditional Salwar Kameez that women in Northern India wear. I am required to wear these outfits whenever I'm on the hospital campus seeing patients. Zarema (a really great woman from EHA who met me today) took me to a few shops and I tried on a bunch until I picked my favorite patterns and scarves!

Zarema spent a lot of time today telling me what to expect at the hospital during my experience. We talked about some of the cultural beliefs and practices here in India that effect health care, as well as common things I will likely run across that might surprise me. There is one cultural practice particularly that I know I will find very difficult to face; this is the mourning placed on the birth of a girl vs. the celebration associated with the birth of a male. Males bring prosperity and wealth, so their birth is celebrated. Female births, on the other hand, are looked upon as punishment to the family, a burden for the father, a useless addition to the household. A father needs to give a dowry in order to "marry away" his daughter. Many mothers who give birth to a female will refuse to feed her daughter in the hospital, or else they will abandon them somewhere. Many mothers are threatened by their husbands or in-laws if they don't give birth to sons, so they abandon their child instead of taking her home to someone who might kill her. Can you imagine growing up as a female in a culture that views you as so unworthy? The worth of the woman becomes her ability to bear sons for her husband.

If practices such as these break my heart, I can't even imagine the heartbreak and righteous anger of our Heavenly Father, who created these girls in His image, and whose compassion for humanity is so much greater than mine! I pray that I can demonstrate this love through my actions and service to these people, so that they might glimpse His love for them.

Tomorrow morning I will catch a train that will take me to Dehradun, and I'm off to Herbertpur from there!

Prayer Requests:
- Please pray that I would have compassion for the people I will be serving, regardless of whether I agree with their practices or not.
- Something I struggle with constantly is giving up my own ambitions and desires (specifically my exercise routine and diet). I will not have control over these here and I really don't want that to get in the way of my what I will be doing here and learning. Please pray that I can let go of these things, and allow God to teach me and use me.
- Continue to pray for safety and good weather

Praises:
- I'm here! and so far travels have ran smoothly and safely!
- I feel very well taken care of my the staff from EHA
- I've gotten a few emails from people saying they are praying/thinking of me, and this is a huge encouragement! I want to praise God for all of you supporting me! =)

Namaste!

Apparently I already knew one Hindi word! Actually two I guess, because "Namaste" is used to say "hello" and "goodbye" in Hindi. I guess my recent yoga practice is useful in more ways than I thought =) I just didn't realize that every time I said this word at the end of the class I was speaking Hindi! (I stopped by Barnes and Noble today to pick up an English-Hindi dictionary and phrase book, so hopefully I can up a few key phrases before I leave). I've learned that India has 14 official languages, although Hindi is the most widely spoken. English is also spoken in many of the cities in India, especially by the more educated people. However, I will be working in a rural hospital so I've been told that most of the patients I'm going to see will not speak English. Thankfully, all of the doctors at the hospital are fluent in English.

The language barrier is a little frightening, especially entering into a medical setting where I'll be seeing a lot of non-English-speaking patients, and feeling helpless to communicate with them. However, I've realized during my years in medical school that communication is something that God has gifted me with. So I trust that He will teach me ways to communicate with people that don't involve language!

Next time I write to you I will be in India! I'm a little bummed to be missing the infamous Packer vs. Bears game on Sunday!, but I think I'll get over that =) Although I know its not possible to be completely prepared for a trip like this, everyone who has talked with me about India and about medical missions has been a huge encouragement. I'm so thankful for their leadership! I even had a well-traveled friend tell me it was okay to bring a couple more t-shirts and pants (thanks Kristin!).

I treasure all of you and can't wait to hear from you! Thanks for everything.
Namaste!!
Katie

Jeremiah 29: 11-13 "'For I know the plans I have for you', declares the Lord, 'plans to prosper you and not to harm you, plans to give you hope and a future. Then you will call on me and come and pray to me, and I will listen to you. You will see me and find me when you seek me with all of you heart'"

Prayer Requests:
- Safe travels to Delhi and then on to Herbertpur (I'm arriving in Delhi on Sunday, spending all day Monday in Delhi, and then traveling by train to Dehradun and taxi to Herbertpur Hospital on Tuesday)
- Communication: I realize that I connect with people through conversation- sharing stories, emotions, etc. I am praying that the language barrier doesn't prevent me from creating meaningful connections with patients and families.

Praises:
- My Dad looked up the weather at Herbertpur this week and it got up to 70 degrees!! Although temps drop to below freezing at night, without central heating, I think the cold weather situation will be better than I feared =)

Geography Lesson!

I thought it would be nice to show all of you a map of where I'll be going! As I mentioned in my first post, I'm working in a hospital called "Herbertpur Christian Hospital". It is located just 25 miles outside of Dehradun (labeled on the map) in the northern Indian State of "Uttarakhand" (otherwise known as "Uttaranchal as shown in this map). So I will be along the borders of Nepal and China. I wonder if there will be a lot of Chinese/Nepalese influence in this state? I'll let you know!

Preparations

Almost a year ago I was seeking out organizations to do a medical missions trip with when Tom Keppeler (missions pastor at Elmbrook Church), recommended Emmanuel Hospital Association (EHA). Many of you recieved a letter from me talking a bit about EHA, but for those of you who don't know, EHA is a non-profit, faith-based organization that seeks to provide care regardless of race, caste, creed or religion, focusing primarily on the poor. Their website is: http://www.eha-health.org. I'll be working at Herbpertpur Christian Hospital, a 100-bed hospital serving the hill-tribe people of Doon Valley. Herbertpur is located in the north (province called Uttarakhand) in the foothills of the Himalayas. For reference- I'll be fairly close to the border of Nepal.

Now, with less than 3 weeks until I leave (I leave on January 22nd), I'm experiencing a mix of excitement and a little trepidation! What will the weather be like? What will the culture be like? Will I get sick while I'm there? I know there will be many unknowns and unexpected turns, but I'm in the Lord's hands! I've heard so many wonderful things about the culture and people of India, and I'm really looking forward to working with the physicians and staff at Herbertpur Hospital.

I've been doing a little preparation for my trip and I thought I would share with you a few things that I've learned about India:
- Population is 1,181,412,000 people! (By comparison, the US population is 311,666,000)
- Hinduism is the primary religion (80.5%), which brings a large cultural caste system that divides people into "priestly" castes, lower castes, and even people who are below the caste system, called "untouchables".
- In rural areas, infant mortality is 75 deaths per 1000 live births. There is a large disparity between rural and urban populations, as the infant mortality rate in urban areas is much less at 27 deaths per 1000 births. (By comparison, the US infant mortality rate is 8 deaths per 1000).
- Literacy rate is 61% in India, but significantly different between men (73.4%) and women (47.8%).
- India is one of the world's largest economies, and has one of the fastest growing economies, but also harbors a very large group of poor people.
- HIV prevalence is only 0.3% of the population, but the actual number of people infected is 2.4 million, making India #4 in the world in the number of people infected.

For those of you who have said you would like to support me in prayer - thank you! At the end of each of my blogs, I will provide specific prayer requests and praises. I know that this experience is going to be a challenge emotionally, physically, and spiritually, but I am so excited to see what God is doing in India through EHA and what He has in store to teach me.

Prayer Requests:
- Safe travels to Delhi and on to Herbertpur
- Health
- Weather! Some of you know that I am a wimp with cold weather! =) I've been told that it will be very cold where I'm going (with no central heating system). Honestly, this is my biggest fear right now! So please pray that this will not distract me from my mission there.
- Please also pray that I would be able to find friendship and support while at Herbertpur. I'm sure I will see and experience things that will be really difficult and it would be great to have someone to share them with there.
- Pray for the staff at EHA and the patients there; for perseverance, health, healing, and faith. I know this is general, but I will be able to provide more specific requests once I get there!

Praises:
- I'm so excited for this opportunity, the time I can take to do it during my 4th year of medical school, and that logistics have worked out so far!
- For all my support from faithful family and friends!