Silent moments…

We all need them sometimes. I love those moments when all of sudden everybody is quiet and the busyness comes to a full stop.

One of those moments is our prayer moments in the Operating Theatre before surgery. Before we start surgery we pray with the patient or over the patient if the patient is already asleep. For people who know what working in an Operating Theatre is like, you know that there is a lot to be done and prepared before a surgery can begin. You hear people talking, giving orders and instructions. You hear the noises from opening sterile items (plastic packages), you hear the noise of running water from the people scrubbing, and you hear the beeping from the monitors. Then all of sudden there is silence, only the beeping continues… time for prayer. A moment in which we realise its not us bringing healing, it’s not by our wisdom, its God, the ultimate Healer whom we need to come down and help us. We are the instruments in His Hands.

2 weeks ago I had another one of these silent moments in a whole different setting. With our devotional group from Cure Hospital we went to visit the prison in Thyolo, to reach out to the prisoners, to share the gospel, to sing songs and to bring gifts like plastic plates, cutlery, and cups, soap, sugar, bread and books. The Thyolo prison keeps about 200 prisoners for all kind of offenses but only for a maximum of 7 years. Offenses are ranging from stealing, to rape to murder and everything in between. I was a bit nervous before going, but actually it wasn’t scary at all. We were welcomed by the officers and led into the courtyard. There the prisoner sang us a welcome song. 200 man singing… amazing! What a voices! Better than any choir I’ve ever heard! But then… silence! A moment of prayer. It was quiet, so quiet; you could almost hear the silence. After the prayer, people started worshipping the Lord. From a moment of silence into a moment where a lot of voices were worshipping together in their own language, in their own words! After this one of my collegues shared the gospel with them. Most of the prisoners responded to the Word and it’s my prayer they will stand firm when temptation comes. It’s my prayer they will one day not only be physically free but also spiritually free!

Sorry, no pricture of the meeting in the courtyard: NO CAMERA'S ALLOWED. This is a picture after the meeting. Some of the prisoners were appointed to receive the gifts.

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Visiting the sick

4 more weeks and WE’ll be in Holland!!! Yes, WE, Kenneth and I are planning to travel together this year! And finally spend time together in Holland with my amazing family! And… hold our newly born precious little nephew, Lucas! Being in Malawi made me realise even more what a miracle new life is! Here in Malawi everyday 8 women and 46 children die due to pregnancy and childbirth complications…

YOU, Friends (supporters) of OperatieAfrica , the charity I set up and represent here in Malawi, have sponsored the surgery of 2 children. And I got the opportunity to be involved in their surgery, to visit them in the ward and to visit one of the children at home. Let me introduce them to you:

This is Shamimu, 6 years old. She is coming from a poor, Muslim family. Shamimu started treatment for bilateral clubfeet years ago at the CURE infant clubfoot clinic. But her parents left to travel to South Africa in search of work and Shamimu was left in the care of her older sister. Her older sister didn’t continue to bring Shamimu to the infant clubfoot clinic and her condition worsened. When Shamimu’s parents came back to Malawi and they sought treatment again. Her father also had clubfoot as a child, and he doesn’t want to see his daughter struggling with it anymore.

3 weeks ago she had her big surgery. And this went well. A week later she came back to Theatre for inspection of the wound and a new cast. She is now discharged and home. She will be in cast for 6 weeks. She is a cute little girl with a big smile. Although she is 6 years old she hasn’t been to school yet, because of her bilateral clubfeet. Now her life will be completely changed and she’ll be able to live life as a normal child!

Big smile and 2 straight feet in cast!



And this is Daniel. Daniel is a 3 year old boy. Daniel arrived into this world as a normal, healthy baby boy. It wasn’t until his first birthday that his mother first noticed his legs starting to bow. This is common for the bow leg condition; it often doesn’t show up until the 1st or 2nd year of a child’s development. His mother sought treatment but was told that there was nothing to be done. Daniel is a plump little boy and his mother was told that was the reason for the bowing. His weight was putting pressure on the legs and forcing them to bow to support his weight. Fortunately, his mother knew that didn’t sound correct so she was referred to CURE after she continued to take Daniel to different facilities. Daniel and his family live locally here in Blantyre.

Daniel in the Operating Theatre


His left leg was corrected 3 weeks ago and he will be casts for 6 weeks. After complete recovery he’ll come back to have surgery on his right leg.
Last Saturday Kenneth and I went to visit Daniel at home. We had a nice time with the family and Daniel is coping really well. He is hobbling around and not having any pain, just the itching of the cast.

Careful and concentrated!

On behalf of Shamimu and Daniel, a BIG THANK YOU!!!

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Chickens and worms

Last Friday we had a fun and busy day in the village. Joshua headquarters in the UK wants to do some fundraising around Easter time and for this reason we had to find a family with chickens! The first house with free ranging chickens we saw, we stopped the car and greeted the family. We agreed we could take pictures and meet the mother, the business woman of the family, later in the day. So we carried on to the feeding centre for the morning clinic.
This weeks’ clinic was at the centre where we, when we started the clinics in October, had lots of children complaining about abdominal pain, a symptom of a worm infection. This problem was caused by their water source; a water well. The water from a well is not treated, but their safe water source had been broken for some time. After securing their water source, (repairing the water bore holes) it was now time to treat the children for the worm infections. This week I was on my own with a translator and so had to see all the children myself. 61 children showed up; a very busy clinic! Fortunately there weren’t many serious problems with the children. After weighing and assessing them, we gave them the Albendazole tablets. Except for 2 or 3 children all the children chewed and swallowed them without trouble, followed by a cup of clean drinking water!

2 big tablets for a little child... but it kills the worms!


a nice cup of clean water!



After the clinic we dropped one child and her mom of at the nearest Health Centre. She presented with a fever and symptoms of malaria. We quickly had some local lunch, before we started the adult clinic in the afternoon. During the adult clinic we checked the Blood Pressure and gave the adults some diet advise to lower the risks of getting an high blood pressure.

On our way home, we stopped at the house with the free ranging chickens to have short interview with the mother, the business lady. I decided to stay in the car, as other people were responsible for this interview and the pictures. As I was sitting in the car, relaxing after a busy day, the 15yr old daughter of this family came up to the car, and started chatting with me. Her English was surprisingly good. After she found out that I was medical and working in the hospital, she told me she had a little accident 2 days before, and the nail of the big toe had come of completely! The big wound on the big toe didn’t look clean at all. So I got her to sit in the boot of the car, got the first aid box out and cleaned the wound right there, on the side of the road! After cleaning, I dressed the toe with the little we had with us and provided her with some extra band aids and sticky tape. Oh and advised her to keep the toe as clean as possible (and that in a dusty country without proper shoes…). She was so happy with the simple first aid we provided!

A great, surprising and blessed day out in the village!

Oh and I finished the day with a Youth meeting at the City Pentecostal Church where we talked about the value of life and issue of abortion. “Thank you Father for our lives and providing for us in every need we have! Amen”

Beautiful piece of Gods creation in Malawi

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Feeding the hungry

Friday, is my so called ‘village day’! And I’m always looking forward to the Fridays! Last Friday, I saw 33 children during the clinic in the morning. Most of them were doing well, we only had to refer 3 children to the hospital for treatment of minor skin rashes. Unfortunately 7 of the 33 children were underweight. This doesn’t mean they are malnourished yet, but they are at risk of becoming malnourished. We give the mothers (or care-givers) advice regarding nutrition, variety in meals, importance of snacks and the risks of malnutrition. One of the main causes for underweight in this community is poverty. The mother simply doesn’t have food to give the children. Joshua (the charity I work for on Friday – Orphan and Community Care) therefore started about 15 years ago with feeding programmes and feeding centres. These centres are for preschool age children (1,5-6years). There is time for playing ánd learning. For example the children will learn the English A,B,C, counting in English, simple verbs in English, but they will also sing songs and play (group) games. And they will get a free nutritious meal! After the clinic I went around to different villages and feeding centres to deliver the Likuni Phala, the nutritious flour they use for making the meal. It was great to see the kids smiling, eating and enjoying their free meal!

Delivering the Likuni Phala


Enjoying the Likuni Phala, next to the new bags!


Big smiles!


'Yes, a full stomach again!'

Over the last year I’ve been seeing one family with 3 underweight children over and over again. The children are slowly putting on weight, but are still underweight and tiny. The mum told me, almost in tears, that she simply couldn’t feed the children as she and her husband didn’t have a job and there simply was no money. Through Joshua I’m now financially supporting this family with part of the money, that YOU have been (and still are) donating to me regularly. A big THANK YOU from this family to ALL of YOU!

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2013…an exciting and rainy start!

Hi Everyone,

The first blog entry for this New Year! Sorry it has been so quiet for a while. During the month of Dec, things are a bit slow in Malawi; it’s the Festive Season! I also had some time off during this month and was really blessed to spend some time with 2 really good friends that came over to visit me, Marianne and Grace. They joined me in the hospital, came along to the village and we managed to spend a week travelling through the beautiful country of Malawi.

In theatre


Travelling in Malawi

But… it’s 2013 and back to work now!
Last Friday I went to Mulanje Mission Hospital. As you might remember, this is the hospital I was initially planning to go and work. But due to circumstances, things didn’t work out with them 2 years ago. 4 months ago I visited the hospital, because I needed a letter from them. I met the new hospital director, who told me that they were planning on improving and building a new Operating Theatre. And she asked for my input and help.
So, last Friday I went down to Mulanje to see the new building, to give some advice regarding the building and to discuss a teaching plan with the nurse-in-charge in the Operating Theatres. It is really a privilege to work with the ideas I had when I initially came to Malawi: improving the patient care in the operating theatres.
Mulanje is about 1 hr drive from Blantyre. But as we are in rainy season now, it took me 1,5hr with lots of heavy rain on route. The scenery between Blantyre and Mulanje is amazing, but unfortunately I didn’t see any of that as the rain was so heavy and what I saw was people walking to their fields or working in their field, getting soaked. I saw fields flooded, kids getting soaked walking to and from school, women walking long distances in the rain carrying buckets of water, buckets of laundry etc on their head and women washing their clothes in pools on the side of the road.

The road to Mulanje in dry weather…
A good rainy season is what Malawi really needs. Last year lots of the crops failed due to weather conditions. So far we have had good rains, but unfortunately in some area’s the rainfall has been too heavy and in at least 4 districts thousands of people are homeless and starving due to floods that washed their house, food stored and fields away. Lets pray that God in His wisdom and power will give us the weather we need for good crops and enough food!

God sometimes really surprises me with things I didn’t expect to happen (anymore). Like this one: there was a letter in Mulanje Mission Hospital waiting for me from the Medical Council of Malawi. After 2 years I’m finally officially registered as Operating Theatre Technician. I received a beautiful, very official certificate. Minor detail: the position of Operating Theatre Technician doesn’t really exist in any of the hospitals here… Ah well, we’re in Africa!!!

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Teaching and touching.

Teaching outside in the burning sun or in a ‘knokkie-knokkie’ full (crammed) brick stone building with sweat dripping of your face. Checking the blood pressures of adults outside in the rain… the surprising ingredients of a job as community health teacher! And I love it!
And just to let you know, since this week I’ve an imaginary 2 year old son. Just this week he was suffering from diarrhoea ánd malaria, but… with the help of the communities he’s cured!

Last Friday I was teaching in Chigwaja, a village on the outskirts of Blantyre. 95(!) people attended the teaching! The room was so full that about 15 people had to sit in the door opening and outside on the veranda underneath the windows! An overwhelming eagerness to see what’s going on and to learn!


The only little problem… Malawian time! People tend to never show up in time, but at least half an hour to an hour late. Even though I’ve been working in the different communities for more than a year, I’m still not really getting used to it.
The teaching was about diarrhoea. We talked about the causes, the symptoms, the dehydration that so often come with it, how to make Oral Rehydration Solution and PREVENTION! The big problem in this village is the drinking water. The boreholes in the village are both broken and they are currently using water from a well. This water is not treated and looks very, very dirty!


There is no way, I could get myself to swallow that water! Friday morning we followed some school kids to the well as they told us they were getting some drinking water in their break… shocking! BUT… with the help of Joshua Organisation the boreholes should be fixed by the end of this week! The boreholes will provide safe drinking water! A lot of people here are suffering from worm infections, therefore soon after the boreholes are fixed, we’ll provide de-worming tablets for the community!
Safe drinking water is an important way to prevent diarrhoea. For now we’ve told and advised the people to boil the water before drinking. Another very important way of prevention is the handwashing WITH soap and we’ve handed out a piece of soap to everyone that was there.
To check if the people really paid attention and learned something, I told them about my imaginary 2 yr old son! And yes… they cured him!

The next day, Saturday, we had our big Health and Hygiene Day at ‘the village on the other side of the bridge’, Mwandika! The bridge is finished, the road to the bridge is fixed and it’s just amazing. This bridge is really opening up the world to them.
Appr 210-230 people showed up. We had a whole day ‘walk-in’ clinic for the 1,5yr-6yr olds. At the same time there was teaching going on. We talked about diarrhoea, malaria and high blood pressure and we checked the blood pressures of the adults. We found some really young, 18yr and 20yr olds, with a real high blood pressure. We referred everybody with a high blood pressure to the nearest by health centre for a proper health check-up and for the others we left them with a diet advise. And to serve the people, we provided a lunch and a drink! It was a real success! Besides coordinating this day I also had to teach on Malaria. It was great to teach here. Again people were really eager to learn and it was very interactive!


A job as community health teacher is surprising, challenging and never the same. Love it!

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Yes, it’s weekend!

This week I’ve got to know the real life of a Theatre Nurse/Technician in Cure Hospital! The first  weeks were an easy introduction to the real life in the Operating Theatre. But… you won’t hear me complaining… I really like my new job! Normal working days start at 7.30am end finishes around 4.30pm. But anything can happen, sometimes you’re running late with a surgery and you’ve to stay till it’s finished, or sometimes you’ve to come early to switch on the machines to make sure the instruments will be sterile for the surgeries that day. Lunch breaks don’t really exist, if you’re lucky you’ve 10 minutes in between cases or you eat after you’re finished. This means I often get to eat lunch around 2.30pm. The good thing is, 2 meals a day are enough for me now; breakfast and late lunch!

This week we did 3 knee replacements and 2 hip replacements! Isn’t that amazing that we’re able to provide these surgeries in the middle of Africa! And on Thursday, an arthroscopy knee… it almost feels like being home, back in the Maartenskliniek in Woerden!
As Operating Theatre Nurses/Technicians, after surgery we sometimes need to clean, the instruments, pack the sets and even sterilize them ourselves. Therefore sometimes the days are really long and tiring, but still happy! I love it, my collegues ánd the patients are all singing and if they can they even dance during work or in the ward! One older Zimbabwean lady came singing into theatre this week, to undergo a total knee replacement, isn’t that amazing!
After finishing in the theatres, I’ve gone to the ward to visit my patients this week, and meeting the patients post operative has been really good. It really made me happy! 

After 4 days in Cure, it was time for my village day today! A new village! About 45 minutes out of town, with only dirt road and scary, scary bridges! It has been such a good day, but very busy! During the clinic we saw 69 children! This is the biggest clinic we’ve ever done! It lasted till 2.15pm, 4 hrs! I was supposed to start teaching at 2, and surprisingly there were already 20+ people waiting outside the building! I felt so guilty that we couldn’t make it in time, but they allowed us to go and have a quick break. The mother of one of the translators offered us a great lunch, what a blessing. By the time we came back for the teaching there were almost 50 people and… half way the teaching there were 76!!! people! The people in this village are really eager to learn and even the chief came to attend the teaching. The chief is a very good man and a very good leader, ánd he clearly cares for his people; their health, but also their education! And he has set a great example, by attending the teaching himself! I haven’t met many chiefs like him, but good to know there are good chiefs out there! 

And now… it’s time for weekend! Enjoy a good weekend! Weekend yabwino!

(PS: I struggle with my internet at the moment, will try to upload some pictures next week!)

The children waiting outside, with their mums.

Esther weighing and measuring the childrenOne of the HIV+ families. They are doing so well!

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A new job!

Hi everyone,
It has been a while since I updated my weblog, but everything is going well! The last month has been quite busy, chaotic and challenging.
Due to Immigration issues, I needed a new work permit. Although Queen Elisabeth Central Hospital really would have liked to keep me working there, I still couldn’t get an official job with them. At this time someone told me there was a job opening in the Operating Theatres in Beit Cure International Hospital. This is a Christian Mission hospital, here in Blantyre, specialized in orthopaedics and plastics. I applied, had a successful interview and was accepted for the job! And… since yesterday I’m part of the staff of Beit Cure Blantyre! So far, I’m really enjoying it. I enjoy being back in Orthopedics (as that was also my specialty back home) and I really enjoy working in a Christian mission environment. The staff is very passionate and the patient is really cared for! It brings back lots of memories from my time on board the Africa Mercy, Mercy Ships.
Although the management of Cure was looking for a full time staff member, we agreed on a part time job for 4 days a week as I really wanted to keep working in the village for one day a week.

In the midst of all this, my parents ánd brother came to visit me. We had a wonderful time together. They joined me for the clinic and the teaching in the village. I showed them around the hospitals and we spend one week enjoying the beauty of Malawi and the fellowship with each other! I think they got a good impression of what living in Malawi is like.

During our first clinic in Kasinje, one of the small communities we’re serving with our village project, we met Brian, a 7yr old boy. This young boy has great difficulties with walking. When he was little he had surgery performed on his left leg, but the surgery went wrong. Since then he isn’t able to walk without pain, discomfort and struggle. We referred him to Cure Hospital, but unfortunately, his condition is inoperable.
Till last year, both Brian and his brother were going to school. Brian to a private school in the village and Hope, his brother, to the government school, about 2km from Kasinje. Unfortunately the father of the boys left the family and the mum couldn’t afford the private school for Brian any more. Brian tried to walk all the way to the government school, but he couldn’t make it. When I heard his story, it just touched me and I wondered how I could help. I emailed my brother and asked him if he, or together with his friends, wanted to sponsor Brian through school.
So last month Arjan and Brian got to meet each other! And it was a good meeting! Brian is a bright young boy, who will never be able to join his friends in playing football, but who now can finish his school!


The group villagers that came out for the teaching when my parents were visiting!

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My ‘Sunday’ job

Street kids ministry, one of my extra ‘jobs’ in Malawi! A very different ministry, and still medical! I’m not teaching them the love of Jesus in words, but in deeds! I try to show Jesus’ love for them by cleaning and caring for their dirty wounds or providing them a meal. And just to be there for them. Sometimes there are more serious medical needs like malaria, eye problems or stab wounds. For these kids we provide first aid, and organise transport to the hospital and a guardian to go with them. But mostly it is bruises from minor fights or falls and superficial dirty and/or infected wounds, headaches or diarrhoea.

   

When I was home in May-June I was looking for a smart phone. At one point I got an offer from someone, but I needed to pay €80. My younger brother offered to pay for the phone and transferred the money into my account. But couple days later someone offered me a phone for free! So I told my brother and wanted to transfer the money back. ‘No’, he said, ‘you can have it’.
Back in Malawi and back with the street kids I realised that one of the things these children are missing, is proper meals.  And you know, I love cooking, baking and also enjoy a good meal. So what is better than to share my brother’s gift with the street kids, who don’t even have 1 proper meal a day?! The least I can do is help providing them with some meals! So my brother, your money is going into the stomachs of my friends from the street!

  

And you know, another thing I love about this ministry… I can do it together with Kenneth. Together we can spend time helping these kids!

At the moment we’re making a short documentary about the street kids ministry for the youth from church in Holland. If it’s possible I’ll try to upload the video clip when it’s finished.

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Milo Bridge Launching Ceremony

Today I was invited to attend the Launching Ceremony for the Milo Bridge. Milo is the name of a rural and remote village just about 30 min drive outside of Blantyre. To get to the village you always had to jump from rock to rock to cross the river. In dry season you were lucky as there was only little water in the river, but in raining season it was a real struggle to cross this river.

Welcomed by the ladies from the village

Children have to cross this river everyday to get to school as there is no school in the village or anywhere close. So there is always the risk of falling and drowning or being bitten by the crocodiles! There is also no health centre or clinic on their side of the river. Imagine being a pregnant lady with complication during giving birth… but before you can get help you first need to cross the river! Or any other emergency situation. And because of the lack of a bridge it has never been possible to drill water holes for fresh water. There was no way to get the machine to drill the holes on the other side of the river. So up till now the people are using river water which leads to a lot of sicknesses.

This bridge really is the bridge to development; education, healthcare, water and sanitation and trade! 

Crossing the 'red sea' by improvising. In the distance you see the foundations of the bridge

I’m planning to visit this area again when the bridge is finished. In October or November we’re planning to organise a day full of health talks, hygiene lessons, medical check-ups for kids and blood pressure checks for adults. I’m already excited!

The MP (member of Parliament) is giving a speech.

Today there were lots of important people. The Bridge project is initiated by Joshua, the UK organisation reaching out to poor communities and orphans. The money is raised by and through Rotary UK. So there were many speeches by chiefs, the district commisioner, the traditional authority, Joshua director Sylvia, the spokesman of Rotary Malawi and the MP, member of Parliament responsible for this area.

An interesting afternoon!

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