Saturday, January 10, 2015

Holiday Festivities and Family Fun

1.  The months of November and December were positively packed with not just the holiday spirit, but also a flurry activity and visitors.  November 20 -21, 2014, we hosted three AHI (Adventist Health International) board members from the U.S. for our yearly AHI board meetings – Dr. Dick Hart, Rod Neal, and Danjuma Daniel.  
One of the main agenda items was what to do about what we refer to as the “Chalala plot.”  More than a decade ago, back when Lusaka Eye Hospital (LEH) was being built, the founders (i.e. Dr. Boateng Wiafe) had applied for a piece of property in Lusaka meant to be for staff housing for LEH’s employees.  However, by the time the property was gifted to Lusaka Eye Hospital, the donor funding was no longer available, and the Chalala plot was left undeveloped. 

The area at Chalala has now become a plot of land in prime real estate.  It is a thriving, developing residential area, with hundreds of surrounding middle- to upper-class homes.  It is such a valuable piece of real estate that political cadres (aka thugs affiliated with the current political party who use unethical methods to obtain desirable items for monetary gain) were trying to get it by any means.  Papers were served to us, some fake, stating that the property did not belong to us.  Or that it was going to be taken from us.  At one point, some cadres came onto the property in the middle of the night to put dividing markers on the land, subdividing it so they could attempt to sell it off.  We immediately notified the police, but the cadres thankfully did not return.  After meetings with the Ministry of Lands and the Lusaka City Council, the advice was given for us to develop the land (by at least building a structure to roof level) so that we could secure the title and maintain ownership.  Thus, the task that was given to us last year was to build a 4 bedroom, 3 bath single story home at the corner of the property.  Funding was provided by a combination of AHI, Loma Linda University’s National Auxiliary, Lusaka Adventist Dental Services, and Lusaka Eye Hospital.  We are happy to say that the house is almost complete.  

The big picture vision and dream for that property is to develop a high-standard, western-style multispecialty medical clinic and eventually hospital on that land.  The initial funding is to be provided by a recently matured trust from a former Loma Linda University student who passed away.  But if this becomes a reality, many prayers and donations will be needed to bring the project to fruition.  More to come in the future regarding the Chalala plot.

2.  On November 22, we had the honor of having Michael & Celeste Chen over at our house.  They are a wonderful missionary couple who has served at Tenwek Hospital in Kenya for the last year.  Michael is an ophthalmologist and cornea specialist who last year jumped into the world of international ophthalmology head on, much as I did 3 years ago.  The Chens were in Zambia for the COECSA (College of Ophthalmology of Eastern, Central, and Southern Africa) conference in Livingstone, after which they decided to drop by Lusaka and see us.  After a delightful day together, Paul and I felt like we were meeting up with old friends, rather than with complete strangers that we had just met earlier that day.  

3.  Every few years, Thanksgiving will fall on November 27.  This makes Thanksgiving extra special, as that day also happens to be the birthdays my husband shares with my mom!  This year, on November 27, we got to celebrate both birthdays in a spirit of thanksgiving at the house of our dear friends, the Minor family. 

4.  The day after Thanksgiving, our family went down to Riverside Farm Institute for a Thanksgiving lunch with other fellow Americans.  
It was another feast, another time of sharing, and a time for Jaycee to play with her little friends. We're so thankful for the newest family in town - welcome to the Busls, especially the littlest addition and bundle of joy, Anderson! 

5.  From Riverside Farm Institute, our family proceeded further south to Mukuyu Outreach to visit our friends, Hein, Melissa, and Inge.  As Melissa is expecting a baby girl and was planning to return to South Africa for the delivery, it was our last opportunity to see them as a family of three.  Despite the suffocating heat, for which only 2 hours of generator-run air conditioning was able to relieve, it was, as always, a joy to spend time with this beautiful family.

 6. We had another ophthalmology resident from Loma Linda University rotate with us in the month of December.  He was the first resident to come out from this new senior class, and this elective was packed with pathology, surgery, and even corneas.  It was great having you here, David Sierpina! 

David helped me with this strabismus case.  Great job!
Preop photo - large angle congenital esotropia
Postop day 1 - ortho!
7.  During David’s rotation, a set of 5 corneas arrived from Midwest Eye Bank.  The tissues were supposed to arrive Monday, December 1, 2014, so five cornea transplant patients were scheduled for Tuesday and Wednesday.  Aboard Emirates Airlines, the 5 precious tissues made their way from the JFK International Airport in New York to Dubai and ultimately on to Lusaka on Flight #713.  However, on December 1, when our driver arrived at the International Airport in Lusaka to pick up the package, he was told that although the paperwork had arrived, the box itself was nowhere to be found!  Imaging the flurry of activity that occurred at that point…trying to find out exactly where the tissues went, calling the patients to reschedule them for an unknown time in the future once the tissues were found.  But it wasn’t until Tuesday afternoon that we were given some new information about the whereabouts of the parcel – the box had gone to Harare, Zimbabwe!   Somehow, the box never made its way off the plane during the flight’s short layover in Lusaka, en route to Lusaka.  We were assured that the box would be put on the Emirates flight from Harare to Lusaka on Tuesday night.  So once again the next day, our driver made the hour-long trek to the airport only to find that the box still had not arrived!  He was told that customs in Zimbabwe was having a hard time clearing the human tissues, which should never have entered into Zimbabwe in the first place!  Again, I called my patients, assuring them that I would keep them posted.  I assured them that by God’s grace they would still get their cornea transplants.  Finally, on Wednesday afternoon, we were assured that Zimbabwean customs had managed to clear the parcel, and that it would arrive in Lusaka Wednesday night.  Third time’s a charm, and with much jubilation the driver (along with David, our visiting resident) returned from the airport with the goods in hand.  My greatest concern was whether the refrigeration of the tissues was adequate, and it was cause for rejoicing when a chunk of ice remained intact inside the ice pack of the Styrofoam box.  With a sigh of relief, I knew the tissues had survived the journey.  All the patients had successful cornea transplants on Thursday, December 4, and Friday, December 5.  But, wow, what an emotional journey this was. 

Patient #1 was a 37-year-old female with a history of vernal keratoconjunctivitis and dense lipid keratopathy of the left eye.  
I just saw her on Thursday, and her graft is looking great. 

Patient #2 was a 23-year-old female with history of keratoconus.  I grafted her right eye 3 years ago.  And so she wanted her left eye done.   
The first day after surgery she looked great.  But her postop week 1 visit had me extremely discouraged.  The anterior chamber was shallow, the graft had 3-4+ stromal edema, sterile infiltrates were at the edge of each suture, all the sutures were loosening up, and the vision was horrible.  I was afraid she was experiencing acute graft rejection, so I gave her an injection of subtenon’s kenalog, upped the ante on her topical steroid drops, and asked her to return in a few days.  No better.  Graft still super swollen.  I gave her a second subtenon’s kenalog injection and asked her to return after 5 days, preparing her for the worst and stating that we might have to repeat the graft in the very near future.  Apparently that weekend at church, before her next visit, the elders laid hands on her to pray for healing of the eye.  When I saw her again 2 days before Christmas, her AC was deep and the graft had cleared up remarkably!  When I told her and her mother that miraculously the graft had turned a corner and it was unlikely that she’d need a re-graft, the mother knelt on the floor of my exam room to praise and thank God.  Because all her sutures had become significantly loosened from the ordeal, I took her to the operating theatre that very day, removed most of the old sutures, and placed new sutures to secure her miracle tissue to her host cornea.  At her last postop visit 3 days ago, she was thrilled; her vision in her left eye that day was better than her right eye!  Praise God!

Patient #3 was my typical 18-year-old patient with history of allergic conjunctivitis, and visually impairing keratoconus.


Patient #4 was the same monocular 16-year-old boy from my previous blog entry in July who had a glycerol-preserved corneal transplant.  He underwent a successful fresh cornea transplant, and I pray that this will give him the sight necessary to get around. 


Patient #5 was a 56-year-old female with history of measles keratopathy.  Visual acuity of CF@1/2 meter OS pre-op.  She was thrilled on Postop day #1. 


8.  Also during David’s rotation, we held a local eye camp at Lusaka Eye Hospital.  This particular eye camp was sponsored by the English Ministry (EM) of the Loma Linda Korean SDA Church.   
When I was back in Loma Linda for maternity leave, my home church did some major fundraising to raise funds for eye care.  The EM specifically took up a project to raise money to sponsor 54 patients for cataract surgery, and as a result 54 patients were granted the gift of sight.  My mom helped out a few days as circulating nurse during her time in Zambia, especially during the eye camp, so it was great to work side by side with her at LEH. 


9.  December 10 marked a milestone for our baby boy.  Zachariah turned 100 days old.  In the Korean culture, the “Baek il,” or 100 day birthday is significant, celebrating the survival of an infant during the most crucial early period when infant mortality rates were sky high in the once underdeveloped South Korea.  Happy Baek il, Zachariah.  

10.  Enter, Mom.  On December 21, we made another airport run to welcome Paul’s mom back to Zambia.   
My parents were still here in Zambia at this point, so this is the first time both sets of parents have spent time in Africa together.  It was a blast.  What a treat to be able to spend Christmas and New Year’s together with all the parents.  They loved hanging out with both Jaycee and Zachariah, and it was one big party every day.   On December 28, all 7 of us packed ourselves into our trusty Toyota Hilux to make the ritualized trip down to Livingstone.   
Five glorious days of swimming (Jaycee’s daily mantra and highlight), relaxing, eating at the buffet, and seeing the Falls.  
Paul and I even squeezed in another day of whitewater rafting. The first part of the trip started hiking down the “Boiling Pot” route to the base of Victoria Falls. The whitewater rafting experience started under Victoria Falls, then we headed 30 kilometers down the gorge of the majestic Zambezi River (seeing the Zimbabwean cliffs on our right and the lofty Zambian river bank on our left). Out of the 25 rapids that we bravely traversed on our red inflatable raft, a good 75% of them were categorized as Class 5 rapids.  In other words, very fast-moving water and high chance of overturning or getting ejected from the raft.  Although our raft never flipped, we had multiple opportunities to get ejected.  What a thrilling experience.  

It was even nicer that we had the chance to stay at the same hotel as some of our student missionaries from Riverside Farms.  Michelle Suekert's family came out to spend the holidays with her, so it was great getting to know them as well. 

11.  On January 5, we bid a sad farewell to my parents, Jennifer and Edward, who had to return to Zambia. Their constant support with the kids, especially during the first 4 months of Zachariah’s life, was so amazing.  My father is an unbelievably gifted babysitter.  And my mom would be the hero who came to rescue me in the middle of the night when Zach was crying and I needed a few hours of sleep.  They definitely deserve an award for their hard work as missionary grandparents. 

Jaycee had grown especially attached to “Loma Linda grandma and grandpa” after spending the last 5 months (3 months back in Loma Linda and 2 months here in Zambia) day in and day out with them.  Watching her shed crocodile tears as they left for the airport broke my heart, and I, myself, had to fight back tears as the vehicle turned out of the parking lot.  Now that my parents are back safely in California, Jaycee has quickly adjusted back to communicating with them via Facetime.  

Speaking of Jaycee, she has grown to be an amazing little toddler.  Her vocabulary seems to double every day, and I’m always amazed at her level of language acquisition.  She is officially bilingual (English and Korean), although she speaks Korean with an Americanized accent and occasionally speaks English with a Korean flare.  She loves to kiss baby Zachariah, go to church, sing songs, play the piano, color, and explore the world around her.  

Her favorite songs to sing are: "Jesus Loves Me," "Twinkle Twinkle Little Star," "ABCs," "My God Loves Me," "If You're Happy and You Know It," "Sahn Tohki Tohki-ah," and "Gohm seh mah ri."  It's amazing that just 3 months ago, the girl couldn't even hold a tune.  Now, she's starting to get the concept!  =)  
One of my parents' biggest accomplishments was fully potty training her by the age of 27 months old.  
12.  Now it’s back to the grind, as we prepare for another phase – the phase of many visitors.  We expect a volunteer to come soon for 3 months.  Two more ophthalmology residents are scheduled to come out in February and April.  Two medical students are scheduled to arrive in February and April.  And one dental student is planning to spend a month with Paul in April as well.  Since in the month of April we will potentially have an overlap of all 5 volunteers (and our current guesthouse only has two rooms), we are in the process of renovating two patient rooms to accommodate the students.  Party on.