Willy

Thanks for all your prayers for Willy and his family. For those of you who don't know Willy.. he is an 8 year old boy that lives in the mountains of El Cercado. He has been in the program for about 10 months however he started to decline in December according to his mother.
Last Tuesday when I saw him he weighed 33 lbs and he could hardly talk or lift up his head.  He was sent to the children's hospital in January and they told his parents that he had parasites. They came home and after taking the medicine he still wasn't getting better so they took him to a brujo (traditional healer or witch doctor). They were persuaded to let us take him to the clinic in San Juan because we had two pediatricians and a pediatric surgeon coming.
While in San Juan it was noted that he ate huge amounts but was not gaining weight and also that he had the signs and symptoms of diabetes. We did his blood sugar and it was elevated. He also had a huge abdomen and his large intestine was full according to a CT scan. The pediatric surgeon thinks that he has partial segment Hirschsprung disease. This is where part of the intestine does not have enough nerves so he cannot fully empty and this leads to poor absorption.
So now what... we are giving him insulin and trying to get his blood sugars down. The problem is that insulin is not readily available in this country and if it is .. very costly. His mother cannot read or write but she is very intelligent and she can be taught how to give it to him. The other problem is a fridge to keep the insulin in. Hopefully we can find one for him.
The second part is getting him well enough to have surgery. Right now he is getting three enemas a day and we will have to keep doing that and teach his mom also.
How do we tell a Domincan child that he can't eat rice? He could eat 10 plates a day and never feel full.
So please pray for all these things as we work together to help this family and Willy.

Blessings

Cora

We made it!

Spartanburg First Presbyterian is here! Working hard to get things ready for the week!

Madeline's Post

My first day and I already know that I want to come back next year. I'm in 8th grade and I'm here with my Dad. Today is our first day of actual doctor bussiness and I'm super excited!!!

Yoder Team - Day 4 & 5

Well, it's been a long 2 days. Wednesday we went to the market first time. Did you know that dogs can run loose, but cats...you have to keep tied up?! It was interesting to say the least. We then went to the work site at the school; despite the heat, we got ALOT of work done. A few of us, onto bible school in the afternoon. Wednesday's lesson was about praying to God no matter what is going. Shorter day because we left early to go to El Cercado and visit Pastor Morales and families we have worked with previously. Great dinner and the pastor's house, great re-connecting with old friends and a great service.




Thursday was a day of completion. We completed everything assigned at the worksite and it is ready for the next crew to pour forms and finish up.



 (All by noon.) Bible school ended with a story/skit about David and Goliath. The kids loved it! They love to color, play games, sing and scream out their memory verses.

It is amazing the relationships you make. With the translators, with one another, with kids. There is no doubt....God created each one of us in His image to bring Him glory in all we do and say. All of us. Our next challenge is to take what we have experienced and continue our mission work, but in our own backyards.

Yoder Team - Day 3 ??

I know it doesn't make sense how I could possibly lose track of days yet; I can't believe its just Tuesday! Today was a Community Day of Service at a school Solid Rock sponsors (CCED). At first, the plan (HA!), was to rotate kids all day through 9 different groups and activities. They were expecting, oh, around 500! Well, that last about 15 minutes. :) Flexibility is key here. Face painting, games, and just playing with the kids; as well as, continuing to build walls on second floor of school for new classrooms. What a great day! The kids were incredible and fun. We were able to donate 200 Spanish New Testament bibles, 150 bracelets and over 100 cross necklaces and faith "trinkets" for the principal to hand out as needed. She was ever so grateful. The best story of her day was that a gentleman accepted Christ!! And, for a Dominican, that is a big deal. He stripped (not completely naked) to rid himself of his old life and got new clothes and a haircut (through services offered there at the school) to start his new life. Now that is what I am talking  about. The principal had such a great perspective about her "job". The day was beyond a success.

Yoder Team- Day 2

What a day!

The work crew left at 8 am to start building second floor classrooms on the school. The VBS crew stayed back and did some planning with our translators; as well as cleaning in medical supply room for the clinic.

The work crew came back all "redneck" and the VBS crew returned for the evening exhausted after working with over 150 kids! We started with 15 or so in the church, but then they started up the music and HERE THEY CAME! We split into 3 groups- bible lesson, crafts and games. The bible lesson was about Jesus loving children. I shared pics of my own daughter and how much I love her and will always love her. Then talked about how Jesus is just the same. The kids loved the coloring and we ran out of pages for them. The craft was making salvation bracelets and salvation books. Games- duck, duck, goose was the fave. Our translators led them in singing and teaching them our memory verse - Matthew 19:14. Pastor Wilson has done a great job reaching out in this community and it appears alot of the kids were well versed.

Its onto baseball game tonight and day of service at the school tomorrow. Keep praying for us and for the people we are meeting each day.

Yoder Team in San Juan - Day 1

After leaving Shipshewana, IN at 1:30 am saturday morning....WE FINALLY ARRIVED!! Although we left unusually warm weather for northern Indiana, we have no complaints about the warmth here. Today we spent about 4 hrs or so traveling from Santo Domingo to San Juan, unpacked and organized all of our stuff, went through orientation and ended our day with an incredible worship service. For many of us, this is our first time to the DR. I, Jamelle, am one of them. I have been told that despite the language barrier, I would love church. AND THEY WERE RIGHT! Music was loud :); I knew alot of the praise songs and could sing them in English; and the best was the girls dancing to praise songs. I could not help but think of my 6 yr old daughter who takes dance class and just loves to dance - all the time!

We start our "real" work tomorrow. The work crew heads out at 8 am, the bible school team heads out after lunch. (YAY! We get the morning to finalize all of our plans.) Check tomorrow for more pictures and updates. Continue to pray for all of us, including the medical team that met us here who will be serving in the barrios.

And so it begins!!!

Yay!  We've had an awesome first week with VIMM and Danville, heading out to take care of patients in the barrios!   We've been also blessed to have Terry Wellman here working in the clinic, organizing and basically saving my hide in every way!  It looks AMAZING!  Thanks Terry!

After a run-through of the clinic today, our NEEDS LIST for the OR/Surgical Groups/Anesthesia is as follows:

4 and 4 1/2 size cuffed ET tubes
sterile towels/gowns/drapes/lap sponges/raytex
20 cc syringes
suction canisters
vented Yankeurs
round canister sodasorbs
CO2 water trap for a DRE Spectra AGS machine
any specialty instruments that you may require
twin size sheets/non sterile patient gowns
any small fleece blankets to keep patients warm
OR hats
Sevoflurane
Ephedrine (dire need)
Decadron (esp for ENT surg)
Size 7 sterile gloves
suction bovies
Avagard scrub soap
Foley bags
gel pads for Debib machine without wires:  3M Reference #2345N
chucks

Please DO NOT bring:
LMAs (any size)
Needles (any size)
IV angiocaths (any size)
staplers
spinal needles
marcaine or lidocaine
Isoflurane
mesh
alcohol swabs
circuits
masks
OR masks
nonsterile tubing
bovie pads

YAY for the OR looking great!

Now, onto the Med Room......  Here are the needed/suggested meds:

Permethryn creams (for scabies)
Antifungal creams (dire need)
albuterol MDI (please do NOT bring neb meds)
Ibuprofen (and lots of it!  :))
Children's cough meds
81 mg ASA (NOT 325 mg dose please)
Enalapril
Lisinopril
Atenolol
HCTZ
Clindamycin
Chewable Amox for kids
Augmentin
Vitamins (adult, children's, prenatals, infant drops)
Lubricating eyedrops (like Visine)
nonsterile gloves
manual BP cuffs (this is an URGENT need)
baggies to put your meds in
labels to put on your meds
Zyrtec/Claritin/Clarinex

Please DO NOT bring: (at this time anyway...:))))))
Bandaids
Lice shampoo
Nebulizer solution
Benadryl
Adult cough medicines
ASA 325 mg
Antidiarrheal meds
Stool softeners
Tums
Fiber
Diabetic lancets or alcohol swabs
tongue depressors
needles
scrubs (unless they are small)
otoscope covers

Thanks so much for everything you are doing!  How amazing it is to see the teams serving God through serving the Dominican people here!

Nik

the next season...

Okay we are still full of turkey from yesterday but onward we go at the Guesthouse in San Juan.   It's been awesome having our fall teams in town and now we are preparing for the Winter Season/team arrivals.

I've heard from many of you asking which supplies you should bring and I'm excited to hear from and see every one of you.   We have teams back to back to back from December 31st to the first week in April this year so.....the list will change FREQUENTLY based on what the team before YOURS brings, uses and replenishes.  :)    After eyeballing the pharmacy here, I'm going to ask for some things that we may already HAVE but which I know we will use great amounts of...and the same for the OR supplies.    Some of these things will ALWAYS be on the list.    We are aware that not everyone can bring every medication- these are suggestions.

Medications
Ibuprofen (each barrio team should bring at least 6000-10,000 pills of 200 mg strength)
Adult Vitamins (at least 8000 to 10,000 multivits)
Child Vitamins (at least 10,000 chewables.   Gummies are okay but chewables are better)
Child vitamins drops (at least 50-100 with iron if possible)
Antifungals creams (50-200)
Hydrocortizone creams
Vaseline (5-10 per team)
BP meds (beta blockers, ACE, calcium channel blockers- we always have a need for these.  Many of the patients in the barrios are taking enalapril, amlodopine, lisinopril, or nifidipine)
Children's tylenol/ibuprofen suspension/drops (at least 50-100 per team)
Children's cough medicine suspension
Singulair/Clarinex/Claritin- You will see a lot of asthma/allergies in the barrios
Inhalers-  We do not have ANY in stock.  We do, however, have a lot of albuterol for nebulizers.
Toothbrushes/toothpaste- These are excellent to hand out in the barrios.
Diflucan- There are always complaints of yeast infections  in the barrios.  You can bring diflucan or vaginal creams but the diflucan is a lot easier.  
Hygeine products- It is a good idea to hand out soaps/lotions/small shampoos in the barrios as well.  You will then want to bring at least 300-400 to hand out.
Shampoo for "hongos"- There is often a large amount of tinea capitis noted in the barrios.   We can treat with antifungal creams but bringing medicated shampoos would also be a good idea.
Permethrin cream for scabies:  bring at least 10-30.
Small plastic baggies for meds:  Barrio teams should plan on prebagging most medications BEFORE going out to the barrios (this is often how you will spend your Sunday afternoon or evening).   Your vitamins, ibuprofen, tylenol, etc should DEFINITELY be prebagged.     You will need at least 2000-5000 small baggies to put your medications in.   It's also a good idea to bring brown paper bags to put the medications, toothbrushes/toothpaste, and hygeine products in for the patients in the barrios.    You should prebag a month's supply of most of the medications (30 vitamins, tylenol, ibuprofen, BP meds, etc).  Antibiotics are bagged differently based on type and prescription.
Antibiotics- This is obviously dependent on which antibiotics the doctors like to prescribe.  However, we recommend Amoxicillin, Doxy, Cipro, Flagyl, Augmentin, Keflex, Azithro...to start.  :)
Glucometers-  this is a very tricky request- because I probably have at least 100 glucometers in the med room.  However- most of them DO NOT HAVE test strips orrrr they have test strips that will last one month..orrrrr the test strips are expired......orrrr there is no way to do quality control on them.   My recommendation would be that you bring a glucometer with plenty of test strips to use while you are here    or bring one with at least a years worth of test strips.   We do NOT need lancets or alcohol wipes or insulin syringes.  We do not have insulin here, nor will we give out insulin in the barrio clinics.
BP cuffs/stethoscopes:  for triaging patient in the barrios.
Small measuring cups for water/cough syrup, etc.  Dixie cups for handing out water with the albendazole.

OR supplies:
* This is based on assessment at this moment.  We have a month before the first surgical team arrives but there are Dominican doctors operating in the clinic during this month and using some of these supplies. Therefore- this supply list CAN and will fluctuate/change.
Instruments:  There are many many basic instruments here.  However, any specialty instruments should come with your group.
Blades:  We have some 10s,11s, 15s but please plan to bring what you would like to use.
Foley catheters:  There is an abundance of straight caths but NO Foley catheters in stock.
JP drains- we have a few (very old) drains but no bulbs.  
Gloves: sterile AND clean
OR packs/drapes
Sterile Bovies
Sterile suction tubing
Sterile spinal needles if you plan to use them.
IV tubing of your preference (but not insytes- we have a lot of IV insytes at this moment)
STERILE Laps/sponges/ratex/ towels:  We will always have a need for these.
Wrapping material for your instruments/packs
Anesthesia- it's a good idea to bring your own laryngoscopes/bulbs.
Pain meds:  Most of the post-op patients will go home with tylenol or ibuprofen.  If you would like your patients to have anything else at discharge- you'll probably want to bring it.  :)  We can order Fentanyl (IV) and Morphine (but only in 0.2 mg IV dosage form) here a few days before your arrival if you would like.
Circuits:  We have an abundance of anesthesia circuits at this time.  I will update this if we start to run low.
ET tubes:  There is a variety of ET tubes available, however- we do not have many small sizes/ children sizes.
O2 tubing/masks/oral airways:  There is an abundance of tubing/masks/oral airways at this time.  I will continue to update if we start to run low.
Anesthesia meds:  We have sevo/iso/propy/succs in stock.   HOWEVER, there is surgery in the clinic in December so I cannot guarantee quantities at this time.   You may want to bring what you would like to use...or call me at 829-982-1136 to check in closer to your arrival time.  We can order ketamine but Ephedrine is in VERY SHORT SUPPLY here and very very difficult to obtain.   Please bring it if you can.  

Well- here is a start. As I stated previously, because we have patients in our clinic at this time, the lists above can fluctuate greatly.   Please let me know if you have any questions or feel free to email me at phillynic@gmail.com.   I am sooooooo looking forward to working with all of you and can't wait til you get here!

Nicole Eby
829-982-1136

Greeting From New Community Church

This week New Community Church from Elizabeth City, NC is staying at the guesthouse.  You can follow our journey here!   http://www.newcommunitychurchmissions.blogspot.com/