Medical

Health Clinics by the Numbers

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We’re 5 months into the trial of the 4 new clinics, with a total of 12 operational months between the health centres – the halfway point in the trial. Cetkana has been running for 5 months, and our most recent Obanga pe Wany. only 1 month. We’re aiming for ‘operationally sustainability’, which means the patient fees cover running costs. The new clinics have already treated 2293 patients combined which is impressive. YAY stats – here goes…

The patients

Here’s the graph of the number of patients seen by each clinic every month. Note Obanga Pe wany only has one dot – the clinic has only been running for a month. I’m not currently collating the data for conditions seen (its available at the health centres), but over 60% of these patients had malaria.

Two Thirds of our patients are kids under 12, which is great from a saving lives perspective, but not so good for our sustainability as they pay less money.

The money

Patients pay a flat fee which covers Consultation + Test + drugs. This means someone knows before they walk 2 hours to the health centre exactly how much money they need. Patients 0-4 years old pay USD 0.70c. 5-12 pay US $1. 13+ pay $1.50. Even in Uganda where people have very little, this is a relatively small amount of money, and always less than transport to the nearest other health facility. You won’t find cheaper healthcare in Northern Uganda outside the hopeless government system.

Over 90% of our running cost are drugs + the nurse’s salary + rent, and from our current experience it takes around 235 patients a month to raise the money required to pay for this. Here’s the graph showing how much money our health centres are losing/gaining each month. The line in the middle is the “sustainability line”, which the health centre has to stay above on average to be viable. Keep in mind a couple of really good months can offset 4-6 not so good ones (see Ocim) If you’re wondering why its US rather than NZ dollars, its because the New Zealand Dollar is a backwater currency and we want to be taken seriously. A beautiful backwater though…

As a side note, we also give some stuff out for free, like condoms, family planning and mama kits for pregnant mothers. Nurse Naume at Ocim gave out 300 free condoms one month. Awesome.

Take away points

Around 235 patients a month is what’s needed for sustainability Even after only 4 months, Ocim is doing well enough for us to say they can continue indefinitely. Sustainability win and compounded good! Obanga Pe wany had a fantastic first month, if this continues it should also become sustainable. Cetkana is doing a great job, but is unlikely to become sustainable,. Elegu has started very slowly and is losing a lot of money, but its early days. Stats alone don’t show the good these places are doing. Stay tuned for the non evidence based stories to pull the heartstrings and give the majority of people who didn’t read this blog a warped view of how awesome these health centres are… 2/3 of our patients are kids, which is great for their health and their future.

PS: We’ve decided to extend Cetkana’s trial another 3 months to 9 months. Despite their currently unsustainably low number of patients, they’ve actually lost very little money. Unfortunately I doubt they will reach the magical 235 number to be able to continue, but we wanted to give them every chance. Their deficit is only USD $40 a month. You might say, why don’t we just fund that shortfall? That’s so little money to help provide healthcare for 150-200 really poor people a month. People have already offered. Maybe in future we will run centres with small subsidies. For now though lets shoot for the moon and go for 100% local sustainability. It may hurt to shut places down, but we can always go back and through this approach we’ll find the areas which desperately need quality health care, rather than just a lot.

If you got to the end my respect for you is immense. More exciting and inspiring stories coming soon.

21 Days

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A few weeks ago Miriam Tillman shared that the Hospital of Hope was once again facing Lassa Fever season in northern Togo. They were going to remain on high alert until they hadn’t seen any new cases for 21 days. She wrote the following update last Thursday.

We finally reached day 21 but are holding our breath… Lassa Fever is an acute viral haemorrhagic illness that is endemic in many countries around West Africa but was not believed to be in Togo until last year. One of our Missionaries became sick and died from an undiagnosed disease but it was not until a second Missionary got sick that we found out they both had Lassa Fever. Last year these were the only two cases that were discovered in Togo.

In February this year, as I was preparing to return back from furlough in New Zealand, I found out that our hospital was treating a patient with Lassa who had arrived from a neighbouring country. Since then the Hospital of Hope has treated five Lassa Fever patients from Togo and the surrounding countries. We are taking precautions to limit the risk of exposure to our team and medical staff. Until further notice we are limiting our clinic services to follow-up and urgent cases. We are also washing our hands with bleach water when we return from market or visiting and not meeting in large groups (which restricts playing sports and going to church). We will remain on high alert until we have not seen or heard of any new cases for 21 days.

Which brings us to today… day 21… Unfortunately we had a patient die over the weekend who is a potential Lassa Fever patient and so we must wait until the blood test results come back from Lomé tomorrow before we can know if we are at day 2 or 22.

 

Unfortunately the tests confirmed that the patient had Lassa, meaning they were at day 2. Please pray that no further cases will occur so that the hospital can resume it’s normal functioning as soon as possible.

Clinic No. 3 – Borderline

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Elegu is a “post-apocalyptic shanty town”, explained my wise anthropologist friend. If you only had four words and a hyphen, I don’t think anyone could do better. Arabic music floats out of Shisha bars. Rainbows of money flap in the wind held by flimsy rubber bands. A different language every 10 meters. Refugee intake point with a broken swing. And despite all this hustle and bustle there’s no health clinic – only drug shops. Until now. New clinic number 3: Elegu.

Just three years ago the Border Post between South Sudan was moved 10 km to sit on the actual border, and within those ]three years a bustling ‘gold rush’ town sprung up. Gold, oil and high quality rice is smuggled in from South Sudan. Food is sold at exorbitant prices across the border. NGOs buy up large to look after those the evil war has displaced both in South Sudan itself and the refugee camps nearby in Uganda.

Elegu is a racial melting pot, although as a white person you wouldn’t guess it immediately. We’ll be serving refugees from South Sudan who are making their way outside the camps. The local Maadi tribe. Traders from the East, West, North and South who are trying to escape poverty through the trading gold rush. We asked our waiter Prossy:

Me: “Where do you come from” Prossy “Mbale, Eastern Uganda” Me: “Why did you come to Elegu” Prossy: (Shrugs) “Work, money” Me: “Did you know anyone here before you came?” Prossy: “Not even one person”

The abode we’re renting would not quite meet New Zealand building regulations, but it will do the job. You wouldn’t want to be there in an earthquake that’s for sure! Our nurse Walter is humble, cheerful chap who has moved in with his wife and small child. If anyone can make it work in a weird place like this, he can. He’ll be in Church today, welcoming resurrection and new life. That’s what we’re looking for in Elegu.

This post was originally posted on Nick & Tessa’s blog, Ugandapanda.com

Will it work?

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As the rickety pickup rolled in on the narrow village track, I had two thoughts bumping around. One, the nerves and excitement of starting our second clinic. Did we bring all the equipment? Is our young nurse going to be OK? Is the door even going to be unlocked?

And Two. Who is OJ Maxswel?  The picture above is of the hut right next to the clinic.

Don’t worry, this blog is not about OJ Maxswel.

I try to be objective and use head over heart when selecting new clinic sites, but my heart has broken a bit for this place. Ocim needs a clinic, it really does. If you get sick there, even accessing bad quality health care is difficult. And the place is gorgeous. It’s the closest you’ll get to an idyllic village, with pigeon houses, traditional granaries, and decorated huts. Even in dry season I was captivated.

But my heart breaking doesn’t mean that the clinic is going to become sustainable. It’s a 6 month trial, to see whether the demand from the community will be enough to keep the place going. There’s a whole lot of reasons the thing should work. But there are almost as many why it won’t.

 

Why Ocim Outreach Clinic will work 1) When I assessed Ocim, I asked a bunch of locals how many hours it took to walk to the nearest health centre. I couldn’t get a number, but some people said “We leave to go there just after the sun rises, and we get back just before it sets” 2) It costs $5  for transport alone to access any medical care. Our clinic costs $2 at most 3) Reverend Ojok, the local Anglican minister is an publicity machine. On the way back from the clinic he taped 3 posters promoting the health centre on the walls of shops and talked to everyone he saw about it. Legend. 4) The community is proud of their new clinic. They want to make it work. 5) The clinic has got instant cred and trust by being  run by the Church of Uganda. Our nurse Naume is a Christian, and the community knows she’ll pray with them if they want that. 6) My heart says it will 7) Because “OJ Maxswel, king of the king” is there. What more do you need?

 

Why it won’t 1) People are very poor. Nearly everybody there is a subsistence farmer. One dollar for kids and two dollars for adults may not seem like much to be treated for serious diseases, but for Ocim, it still might be too much. 2) The population is relatively sparse compared to around other clinics 3) It’s not on a main road, or in trade hub. We’re using the only available iron roof building in the area. This means the clinic is not very public and visible, and we can only treat locals, not people who are passing through. 4) The day to day existence of a small clinic like this is fragile. One robbery, one fire, and one aberrant guy harassing our nurse and it could be enough to sink the ship. 5) My heart is often wrong

 

From huts within sight of the health centre, two mothers came with their kids while we were still unpacking the truck. Both had high fevers. One had malaria, and had a seizure in the morning. The other had a large skin infection on their right butt cheek. Both mothers had been trying to wait out their child’s illness, unable or unwilling to pay the large transport cost to the nearest health centre. Both if the kids will now be fine. That’s why we’re here.

And the second thing on my mind? Here he is, OJ Maxwell himself. “King of the King”.

It begins – New Health Center 1.0

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Narrow road, burnt grass, full load. We breathed a sigh of relief as our small pickup  arrived at Cet Kana, laden with all things required to start a new health clinic. The place is gorgeous, with one of the better views in Gulu overlooking thousands of palm trees on an open, sparsely populated plain. The clinic is next to the current and future church. Current is a skeleton of palm tree timbers, covered every Sunday with tarpaulins. Future is the brick building, with half-walls only.

We were a bit shocked to find that the rooms hadn’t been opened for months. After thirty minutes of sweeping and rearranging, Felix our nurse, and Fiona our assistant co-ordinator unpacked the drugs and equipment. Desks and chairs were moved into the clinic room. The blood pressure machine was unboxed. Within a couple of hours, two dusty unused rooms had been transformed into a nice wee health clinic.

There are two big advantages to the health clinic location.

The church owns the building so we don’t pay rent The Pastor and other church members have already been involved in weekly family planning clinics run from the building, so the church/health connection is already rolling.

But we are yet to see whether this will fly. Are there enough people in the area to justify a clinic (my biggest concern)? Can adults afford the 2500 Ugandan shillings (1 New Zealand dollar) we are asking to treat a child? Or the 5000 shillings (you do the math) to treat an adult? Can our nurse juggle the responsibilities of organising the facility, seeing patients and managing the money? After 3 months we’ll have some idea. After 6 months we’ll make the decision whether to continue or not. Taking a risk like this isn’t easy on the nerves, as it’s a big money and time investment. I keep reminding myself that even if the clinic “fails” to become sustainable, we still will have treated around 1000 patients more efficiently than most NGOs could manage. I also can’t help thinking that Jesus is into this kind of risk.

And its exciting. Seeing the first child handed over to nurse Felix to test for malaria was a small victory in itself. I’ll keep you updated with how things are tracking.

We are starting up 3 clinics like this with money already raised, and are aiming to start 2 more. If you’re keen to donate money towards starting the last 2, then message me at ugandapanda.com/contact-us/

A huge thanks to those of you in New Zealand, Australia and beyond who made this possible. You know who you are.

Saving a life, or two

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Our wonderful midwife Gloria ‘in the bush’ at Oberabic Health Centre had a hard night recently. She’s the only midwife there, so has to do most the work that involves mothers and babies, and make all the calls under really difficult circumstances. A miscarriage and a tricky delivery led to a long, intense evening which ended up really well for the mothers and newborn baby. Its hard to overstate what a fantastic job she did under the circumstances.

Apart from being a great story, and example of the great work that goes on at our health centres, this story is a microcosm of the struggles our patients and staff face all the time. Amongst other things Gloria and the patient faced these challenges. Feel free to add your own after watching the video.

The Patients: – No access to transport to get to a higher level facility – Poor knowledge of problems around birth, which led to the mother coming in late and not telling Gloria her waters had broke. – Lack of social support

Gloria – Working in the uncomfortable zone above your level of medical expertise – Having to do everything yourself (sterilise the equipment yourself, after you’ve already completed the delivery) – Understaffing

Opening St Philip Mini-Hospital

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It seems there are ‘wins’ all round for Nick and Tessa Laing. You’ve just seen the amazing progress Tessa’s group has made in bringing new alcohol regulations to their region. Nick has also been hard at work as you’ll see in this video.

As part of our Bishop’s seven years on the job celebration, we officially opened the monstrous 25 room St Philip mini-hospital. Some people, schools and churches reading this article gave money to this cause so a huge thank you. In the video above you can get a glimpse of the outcome!

Important people were everywhere. The Minister of Primary Healthcare was supposed to open it, but in her absence the minister of foreign affairs did the honours instead. He even made a comment about the Christchurch earthquake! Tessa videod my mini-speech. I was supposed to get 2 minutes but I was cut to 30 seconds due to time constraints.

 

To see some more photos from the event click here.

The Hospital

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The following is a blog written by Beth Goodwin who volunteered with Anne McCormick in Cambodia for a month. Here she shares her reflections from her time with Anne. The original blog can be read here (and includes many more photos).

The World Mate Emergency Hospital in Battambang – this is where I’ve been for most of the last month [ending in April], helping Anne McCormick with her activities programme. It’s a lovely hospital, with restful greenery and bougainvillaea gardens. There are two big wards of about 32 beds each, one for men, one for women and children. Then an infection ward, and ICU, plus a few rooms for private patients. The main cases that come here are amputees and broken bones. Cambodia still struggles with unexploded landmines, so there are more amputees. It wasn’t too gory, mostly things were nicely bandaged up.

It’s a Japanese funded hospital (Handa Foundation) – though minimally. There are a few expat staff in there, which apparently means fewer mis-diagnoses, because their qualifications were most probably a lot more in-depth, their degrees earned not purchased. Cambodia is still suffering significantly from the Pol Pot regime, and education has a long way still to go.

Nurses didn’t seem to have much to do! Surprisingly. Same as restaurant staff. How do we find so much to do in New Zealand. Surely there are the same tasks? Nurses here were usually congregated at the end of the ward, on their phones. They blocked facebook on staff wifi for obvious reasons. But the ward was clean, wounds dressed, nobody died last month (I think). Maybe there’s less paperwork and peer pressure. They get US$1 an hour. Rent is upwards from about $50 per month as far as I can tell. I find myself thinking, well, if you’re in a DINK situation, that’s just enough for eating, maybe, you can survive. But then, all it takes is one emergency, a broken leg, a stolen motorcycle/bicycle, a funeral or wedding. What then? Not to mention kids at school, needing clothes etc. It’s tough.

Every patient at the hospital had a family member or a friend there 24/7 to help them with bathroom tasks, food etc. Its tough on the family member if they had to stop work! They sleep on the floor by the patients’ beds, but apparently they’d mostly sleep on a mat on the floor at home anyway, so its no different.

Anthony & Anne – so lovely to stay with a kiwi couple. They have been so kind, helping me with how to get around, lots of lifts, some ice-creams, and the loan of some useful items like a kettle and chilly bin to help when I moved into a guesthouse in town. Thank you both.

Anthony’s role there has been to start a Social Work department. This has had challenges, since social work isn’t really a ‘thing’ in Cambodia. It is now! I don’t know too much about what’s involved, but it’s such a helpful and necessary gap being filled! He’s been training up a fantastic team, who have benefited from all his NZ Social work training and experience. The department is practically running itself now, which is a huge achievement. It’s the funny role of most mission work – to make yourself redundant. I’ve so enjoyed Anthony’s humour, good sense, cheeky grin, and strong faith.

I’ve spent most of the time with Anne with her activities program at the hospital. I’m so impressed that she’s built it up so much over the years. There’s now a room with cupboards, heaps of books and resources, and one paid staff member to help. A few years ago, it had no walls even. I can’t imagine it with no aircon, and no cupboards to lock, trolleys to push etc. Thanks to all overseas suppliers and fundraisers of good things.

Anne is a librarian by trade, so unsurprisingly, everything works highly efficiently, and is well-categorised, numbered and labelled. She used to lend the books out for a few days at a time, but found many were going missing, hence the trolley system. It takes 1-1.5 hours to take the books round in the morning, let them choose, write down the number. They are collected after 4pm. Patients definitely perk up when the books and puzzles trolleys come round. We do games in the afternoons 1-3 times a week.

You might think it doesn’t sound like much, taking round books and puzzles. From a western perspective, maybe it seems unnecessary. But here, when there are no libraries and games are unaffordable, it’s a huge blessing to have these things to pass the time, get your thinking away from your pain, and also it helps bonding between patients and their family caregivers. It’s helping them to heal faster, I reckon. Plus, they get to know Anne and Sokhim, and often will share struggles. It’s easier talk to the ones with the books than the ones with the needles…

I would really have loved to get to know the patients more. There’s time to banter with them, ask them how the day’s going, how they enjoyed the book, what sort they’d like next, what they do for a job, how they broke their arm, the list goes on. I felt very restricted by the language barrier. I managed a few stock phrases by the end, but that’s not enough. If I do decide to stay overseas longterm, language is top priority – I didn’t realise just how vital it really is.

It was heartbreaking to see adults and children needing to be shown what a puzzle is, how you do it. They all loved them once they got going, but didn’t have the reflexes of looking for matching colours, straight edge pieces, and matching the puzzle to the picture. It’s just practice. Reminds me of me trying to play a computer game last year. My flatmates challenged me to ‘judge not’ without trying them. So I tried a few for the experience. They were fairly patient with me, but I could see the frustration – can’t she see, the score’s right there, so’s the map, so’s the treasure count or whatever, she’s going right into the danger zone! From my perspective, I found it took all my concentration to focus on one part of the screen, and try to walk and not to get eaten (which I never managed to avoid). I didn’t have the visual clues and trillions of hours of practice.

I began to wonder, all these things we take for granted like puzzles, are they all actually learning tools? Learning not only colour matching, and little pieces forming a whole picture, but even critical thinking. The thought processes of – what if I turn this round, will it fit? Critical thinking is hugely important in life (in my opinion), and I just started to wonder if it’s taught in more subtle ways than we think, like through puzzles, for instance.

Probably my favourite day was when we realised some of them were saying no to books because they couldn’t read. I am beginning to realise Anne has everything! She even has a box of pairs of cheap long-sighted glasses, which we brought out, and they were SO happy! The laughter and disbelief of suddenly being able to see clearly and read again! Their kids found it hilarious too, watching their mums suddenly sporting a pair of glasses.

My most terrifying day was the last day, when I played some viola to two of the wards. I really, really don’t enjoy playing solo to people. I’m a viola player for goodness sake, which is a group harmony instrument, gregarious even, enjoys safety in numbers. I don’t even like practicing when anyone’s in the house! I have learned to play with 4 pegs on my bridge to dampen the sound somewhat. BUT, I am here for reasons other than just what I feel like doing, and I thought it might be fun for them, you definitely don’t see violas every day here. So, I braced myself, and played some appalling renditions of Bach suites and Monti’s Czardas. Thankfully, I have no idea what they thought – language barriers have positive moments, too. Some of the kids enjoyed trying it afterwards.

We made paper! To buy more books, expand the activities for the patients, Anne has been making paper to sell, and to make into cards and books. The paper is made with a machine built by Mark Lander in Amberley, Christchurch (see http://marklander.org/hollander-beaters). It works like a dream, on paper, cloth, and natural fibres. After home attempts with substandard equipment in my childhood, I was so impressed at how Anne and Sokhim managed to easily do 50 large A3 sheets of beautiful paper in a day. Sure, the occasional one wrinkled, but by and large they were all beautiful!

Melodies, Paper and Checkers

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Here’s an article by Caleb Holland from Alaska. He was part of a recent YWAM team from Honolulu who worked with Anne McCormick at the World Mate Hospital in Cambodia for five weeks.

The word ‘love’ is often misused if you ask me. If I had a dollar for every time I’ve heard a friend of mine say “Goodness! I love iced tea,” I would be a very wealthy man. They don’t actually ‘love’ iced tea. I understand words can change meaning as time progresses and culture changes, but something about ‘love’ is to be revered. It’s a precious word; a word that should be preserved for when it has the most meaning and impact. It can restore the broken. It can bring joy. It saves and creates life.

I love this hospital. The team I travelled to Cambodia with loves this hospital. The volunteers love this hospital. And this hospital has loved us. They say if you live in a place long enough, the building or house will adopt some of your characteristics. Though I have only been here a short time, it has become very clear to me that this place has been filled with loving people. When you enter, you’re greeted with compassion, and when you depart, it sends you away with a longing to return.

Melodies

Most days, we sing. When I heard we were singing, I was giddy. Christmas carolling is one of my favourite things back home; spreading joy and all of those niceties. Little did I know that we were singing in Khmer. Learning second languages has always been especially difficult for me (singing makes it a bit easier I admit), so long story short, this wasn’t going to be anything like Christmas carolling.

We walked down to the wards for the first time and I was nervous. I didn’t want to mispronounce some words and mistakenly belt out profanities. The team all readied our voices and waited patiently for the waving hands that meant “start singing”. Suddenly, the hands began to wave, and before I could think, Khmer songs flew from my mouth. I looked at the patients/visitors and they seemed pleased. Whether they were pleased because of our mispronunciations, or because we sounded angelic, didn’t matter to me anymore; if they were pleased, we were doing something right.

Being able to make people smile is probably one of the biggest things we take for granted. Every human being has the capability of brightening someone’s day. With a song, a joke, or an encouraging word, we can make painful circumstances more bearable. You don’t know what people are going through in their heads or their hearts. Who knows, perhaps you making them smile was exactly what they needed to keep on pushing.

Paper

Being able to create things is pretty spectacular if you stop and think about it. You’re taking things that are already their own separate entities, repurposing those things, and combining those things to make a singular thing. It’s astonishing, and we got to do that here with making paper. Essentially, you take whatever paper-like substances you have, throw it into a machine, get some mushy stuff, and one tray later you’ve got paper! It doesn’t sound very exciting written down, but that’s perhaps because I haven’t told you that you can throw coconut husks and old sheets into the paper mix. Got an ugly shirt for your birthday without a return receipt? Don’t re-gift it! Turn that thing into paper. The possibilities are quite literally limitless. And there’s so much more that comes out of it than fun. There’s a lot that separates man from beast, and creativity is among that lot. For me, and I’d say most of humanity, being able to create is an essential part of being human. It can provide therapy, it can entertain, and it can create civilizations.

Games and Puzzles and Such

There’s a certain chapter of our time here at the hospital that I would consider being my favourite. All of the chapters are good, of course, but I thrive in board games and puzzles, and if I thrive in something it’s going to be my favourite. You take this cart full of an assortment of games and keep your eyes peeled for those who look in need of some competition. Once you’ve found your competitor, let the sparks fly. The best part is teaching them how to play. Warning: they’re quick learners.

I specifically recall this one time when I was playing some checkers with a thirteen year old boy. The boy had what appeared to be a broken leg, and an even worse case of “Man, I wish I could get out of this bed and play some games.” I gestured the game of checkers, and through some persistence, he agreed to do battle with me. As I taught him the rules of the game using charades, I told myself “Caleb, take it easy on the guy; he’s new and no match for your chess expertise.” As the game began to pick up speed, I noticed I was taking it a bit too easy. I stepped up my game and put on the most intense looking checkers face I could. It wasn’t enough. He was still taking out my pieces. And with every piece he’d take, his grin grew closer and closer to his ears. “Fine,” I said, “no more training wheels.” I took my foot off the brakes and put the pedal to the metal. It was then when I realized a very sad, humbling fact. I’m not good at this game, and this kid was an expert. My last piece was taken and the boy’s right eyebrow was raised, paired with a smile that said “Easy.” I was defeated, but my pride wouldn’t let me leave on that note. So I lost two more times. And though the losses haunted me, the fun and joy from the boy outweighs anything else. And that’s the attitude you get from all of the patients here; fun, joy, and that powerful word I spoke of, ‘love.’ Without love, this hospital wouldn’t exist. Without love one may argue that nothing would exist.

Thanks

The team cannot express how thankful we are for the compassion and kindness the staff and patients have shown us. Without them, none of this would be possible. They’ve taught us so much through the way they’ve acted around us. And a bit more of a specific, focused beam of thankfulness goes out to Anne McCormick. She has consistently guided us through our afternoons and has been so willing to help and talk with us. I have met very few people in my life who are willing to commit so much of their lives and time to helping others. She and her husband are astounding examples of how to be a blessing to the world. The amount of work they put into creating opportunities for patients to be entertained through their trials is inspiring, and they’ve inspired me and my team to be better people. I could not stress enough how amazing of a place this is. If you’re in Battambang, you should most certainly volunteer here. I’m saying this from personal experience. You’ll learn lessons as long lasting as gold, and far more precious.

The photo above is a picture of Anne with Caleb’s YWAM team.

Evening dental clinics

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We’re excited about a group of male dental students who responded to request to trial Saturday night church-based dental clinics east and north of Phnom Penh. Factory workers in Cambodia work long hours 6 days a week and are unable to access the care Phil has been offering during regular hours. The video is a short clip which Phil took at the new Saturday evening church clinic trial. It has been going really well so far but we would appreciate prayers for wise decisions to be made as this progresses.

The fear that his female dental students expressed about travelling at night was underlined last month when a 16 year old previous neighbour was stabbed in an attempt to take her bag from her as she rode her motorbike at 8pm only 100m from home. Her wounds were not life threatening and she is back at Hope school now. Please pray for her as she has to pass the place it happened every day and for her mother as they consider whether they should move house. Phil and Becky value your ongoing prayers for safety.

The prison work is going well each Wednesday. Please pray for Phil as he leads this team. Often there are different students each week so it takes time to train them all and get routines going. But, overall it has been very encouraging to have a good number of students who are committed to volunteering in this work and are keen to learn and gain experience. They are a mixture of Christian and non-Christian so please pray that the Christian students and dentists will have opportunities to share their faith and witness through their actions. The prisoners are very grateful for the treatment that they are receiving and the conversations that they are able to have while being treated.

The children and I are into the last 5 weeks of our school year so things are getting very busy. Please pray for us as we work our way through deadlines and towards farewells.

Lastly, but very importantly, the hot season is intense and the current drought situation is looking very serious. Drinking water is becoming very low in many areas and in some, it is simply running out. Animals and fish are dying as lakes and rivers are critically low. Here’s an interesting article which gives details of the situation: Animals die as Cambodia is gripped by worst drought in decades. Please be praying for this whole situation!