Tuesday, September 27, 2016

...And One More

Family picture at the Lower Zambezi National Park

These last several months have been chock full of travels and visitors/volunteers.  Usually, our family will just make one trip per year back home for our annual leave, but this has been an especially unusual year in that both Paul and I have had to make several trips back to the U.S. independently, sans kids.  This is partly due to the fact that we have been slowly planning our move back to the U.S.  Believe it or not, we have now clocked 5 years out of our six-year commitment to serve in Zambia, which means we needed to figure out where we will live/work next year.  This also means we are actively looking for individuals to replace us when we depart.  We are so excited that Wesley and Brianna Arnold have made the commitment to serve in Zambia; they should be arriving in the next few months, with Wesley getting oriented to eventually take over the dental practice once we leave.  However, we have yet to find an ophthalmologist to serve at Lusaka Eye Hospital!  If anyone knows an eye surgeon who is interested in serving out here, please forward this blog to him/her!

1.  April and May 2016 travels.  At the end of April, Paul hopped on a plane to take a course and dental exam in Florida.   
Students hard at work in a dental prep course
One of his stops at the end of his trip ended up being the abode of our dear friends Kar-Yee & Mervyn Ng!  Thanks for taking care of my husband on his tiring trip to Florida.
Kar-Yee with cute Kenan
A few days later after Paul left for the U.S., I, too, boarded a flight to California for a CME trip.  Seeing that I had some Emirates miles to spend, and thinking that I may not have an opportunity to fly alone (without kids) again, I decided to use my miles to upgrade to Business Class for the Lusaka to Dubai leg.  
 It was the first time in my life flying anything other than Economy, and I must say that it felt quite luxurious to be able to sleep completely horizontally in a reclined chair.  The only downside is that I feel I have been forever tainted after having had a taste of Business class! 

Dubai's Business Lounge

Once in California, I spent a few days at Loma Linda University’s Eye Institute seeing patients in clinic, then had a full OR day with my chairman and mentor, Dr. Michael Rauser, who was kind enough to proctor me for 10 surgical cases.  New Orleans was my next stop, as the American Society of Cataract and Refractive Surgery (ASCRS) meetings were going on.  This conference was great educationally as well as socially.  An entire Cornea Day was so fulfilling for my mind, and it was great to run into Gargi Vora and Alyssa Bowen, among others there.  During the meetings, I had the privilege of rooming with 2 amazing ophthalmologist colleagues – Joyce Choe & Patricia Ferrell.  
Hanging out in the French Quarter
They even joined in on the Run for Sight 5K event.   
Before the race
We attended church together with other ophthalmology friends 
Paul Chung, me, Joyce Choe, Patrica Ferrell, Linda & Paul Row
Jackson Square
and bumped into other ophthalmology colleagues like Dr. Kim from Korea and co-fellow from MEEI!   
Lloyd Williams, me, Paul Chung, Gene Kim, Dong-Hae Kim, Joyce Choe
Lunch with Richard Townley
Super thanks to my mother-in-law who held down the fort watching our kids while both Paul and I were traipsing around the U.S. independently.

2.  Kabulonga SDA Church Health Day.  Once Paul and I were both back in Zambia and almost over jet lag, our family was invited to the Kabulonga SDA Church for their Health Day on 28 May 2016.  Paul gave the main sermon, focusing on all aspects of health – physical, mental, social, and financial.  
Then, for the afternoon session, I presented on eye health, and Paul gave a dental health presentation.   
Thanks to Elder Wesley Beene and his family for inviting us to their church.
Our kids enjoyed an afternoon of running around outside with the church kids
3.  New equipment.  We have had reason to celebrate in the last several months with the arrival of some new equipment that has been either purchased or donated.  Lusaka Eye Hospital has realized its need to upgrade its equipment in order to keep up with the technology and the times.  Earlier in the year, we purchased quite a few electronic visual acuity charts from Aurolab, which we have been installing into the different areas of our hospital.   
Aurochart Digital Vision Chart - with fixation images for children
Our retinal laser machine broke several months back, and we were excited to be able to purchase a brand new Alcon Purepoint laser, which was successfully installed on 24 May 2016.   
In addition, a generous $30,000 donation from AIMS (Association of International Missions Services, Inc.) allowed us to purchase 3 new Reliance ophthalmic chair/stand sets.   
One new Reliance ophthalmic chair/stand set
Lusaka Eye Hospital also purchased our first corneal topographer in addition to 13 new computers and accessories to get prepared for getting onto an electronic health record system! 
Topcon CA-800 Corneal Analyzer
These all arrived in a container on 15 June 2016.  
Opening the container
The most recent equipment that arrived just this month included a used Humphrey Visual Field (funds donated by the LLUSM Medical Auxiliary) as well as a Dell server, donated by Dr. and Mrs. Derek Leung.   
Humphrey visual field, model 750i
So we have had a steady stream of new assets coming our way.  In order to protect some of our newly acquired assets, we have had to install sturdy grill gates on the outer doors to some of the office blocks.  Also, of note, we have completed work on our new optical shop and display rack.   
What a blessing it is to see continued growth at our institution.

4.  SID Health Ministries Advisory.  From 31 May to 3 June 2016, I was invited to attend a health advisory for the Southern African Indian Ocean Division (SID), which was held in Johannesburg, South Africa.  Dr. Bangwato Sikwa was in charge of the conference, and it was a blessing to attend.   
Great leaders of the health ministry within our church system, including Dr. Peter Landless and Dr. Zeno Charles-Marcel, gave inspiring talks.  We received reports from the various health institutions and unions across the SID region regarding the health work that was going on.  Unfortunately, it was during the very week that Pastor Paul Ratsara resigned as the President of the SID, so he was unable to attend the function.  The executive secretary, Solomon Maphosa, only stayed with us for one day, as he had to take over as the acting (and eventually as the actual) president of the Division.  Nonetheless, it was a blessed time of fellowship and prayer. 

5.  International Vision Volunteers (IVV).  From 19 – 22 June 2016, Drs. Yen Jean & Ivan Hwang as well as Dr. Bud Tysinger, all part of the IVV board, spent a few days in Lusaka before heading down to their project in Zimba (Zimba Eye Clinic).  During this time, I was able to teach Ivan (an oculoplastics surgeon based in Northern California) a thing or two about SICS (manual small incision cataract surgery); in return, he taught me a thing or two about ptosis repair.  Thanks, Yen Jean, for the gifts and cute SF shirts for the kids!

6.  MMED Ophthalmology Student Exams.  On 24 June 2016, I was asked to help participate in administering of final exams for the MMED students in ophthalmology at the University Teaching Hospital/University of Zambia.  We had a special guest, Professor Karimurio, join us as the external examiner from the University of Nairobi.  I teamed up with Dr. Zulfia Sultanova in one of the rooms for the OSCE exams in the morning and the “Viva” exams in the afternoon.  It was a long day, but good to be able to participate in the assessment for these aspiring young students. 

Anton Vurdaft, Chileshe Mboni, Prof Karimurio, Felida Mwachalimba, Grace Mutati, and Zulfia Sultanova

7. Kaizer’s wedding.  On 26 June 2016, my friend and musician, Kaizer Kasanga, tied the knot to his beautiful bride!  The wedding was outdoors in a lovely garden.  I was honored that such a talented musician should ask me to play for the prelude and parts of his wedding.  He sang a moving song to his bride, which, of course, caused me to tear up (I literally cry in every single wedding).   
Congratulations to the new couple.  And a Happy Anniversary to Paul and me, as we clocked 9 years on 24 June 2016! 

The traditional Korean Pae-Baek cermony after our wedding - 9 years ago!

8.  AHI IT visit.  From 27 June – 1 July 2016, we had a special visit from IT specialists from Adventist Health International.  Mike Reid and Marty Zola spent the week analyzing the day-to-day operations at Lusaka Eye Hospital as well as our information technology needs.   
Mike Reid, Marty Zola, me, Webbie Malake, and Lionnel Kayumba
They had just spent some time in Malawi doing the same research at our Adventist hospitals there.  Their goal is to have researched the various needs at many different hospitals as well as find out which integrated hospital systems are available; ultimately, they plan to have chosen one electronic health system by October 2016.  Quite a lofty goal, and they are definitely making progress on this.  We are certainly excited about going electronic, and are making preparations for the same.

9.  Kauai scouting trip.  As mentioned in the first paragraph, our family is slowly preparing for our move back to the U.S.  Back in February, I sent out a whole host of applications online, getting a feel for the job market back stateside.  Because of our interest in moving back to Paul’s home state, we decided to put out some applications in the state of Hawaii, and we got several bites!  One of the practices on Kauai seemed like a good fit, so in early July the practice flew me out to check it out.   
Breakfast at the Club, Kukui'ula
It seems like a wonderful practice, and we are so excited that things are working out for us to move back there.  
The aloha spirit - I got a lei every day I was there!
Fourth of July was spent having breakfast on the Makana Terrace at the St. Regis Hotel in Princeville with not just the practice staff, but a few special guests like Maryanne Kusaka – a former multiple term mayor of Kauai and Kauai "living treasure” – 

as well as Felipe Pomar – a professional surfer and winner of the 1965 World Surfing Championships.  

Just a week after I got back to Lusaka, Paul flew out to Hawaii as well.  He was able to visit with his cousin, Donna, and her family in New York on one layover.   
Paul, Moana, Donna, Wailea, and Mark Schroffner
He was also able to reconnect with his friends on Oahu.  This trip was a little more stressful for him than my trip, in that he actually had to take a live patient dental board exam.  Paul lucked out on his flight home, as he scored a free upgrade on Emirates into business class – now he is forever tainted by the taste of luxury as well!   
We are so glad everything went well in Hawaii and that he is slowly making progress on getting licensed in the state of Hawaii.

10.  Nicholas Norton rotation.  During that same period of trips to and from Hawaii, from 11 July – 5 August 2016, we had another 4th year medical student from LLU come for a student elective in Lusaka.  Nick spent a year in Zambia as a student missionary at Riverside Farms from 2011-12, the year that coincided with our very first year serving in Lusaka.  It was neat to have him come full circle back to Zambia, but now as a senior medical student interested in pursuing the field of ophthalmology. 

11. More volunteers.  Just one week after Nick arrived, my nephews, Christopher & Jeffrey Choi, arrived as volunteers for two months (17 July – 10 September 2016).  Chris and Jeff helped out with various projects, including the “container project,” which entailed organizing junk as well as archives from one of our packed containers out in the field. 
While not a glorifying, high profile job, they did a wonderful job helping with this.  
Among other tasks, they also helped reorganize the general stores room as well as analyze patient flow in our outpatient department.  They were active members of the Lusaka Eye Hospital football (soccer) team while here and got to become a true part of our Eye Hospital family.  We miss you already!

Chris & Jeff, helping to serve nshima to the eye camp patients

12.  Vision Care, Korea, Eye Camp:  From 25 – 29 July 2016, we had another local eye camp, in which we shuttled cataract patients from Mbosha and Kabangalala to Lusaka Eye Hospital for eye surgeries.  During the first 3 days of this week, we had a team from Korea, Vision Care, join us in doing these surgeries (headed by Dr. Dong Hae Kim).   
That week, we were able to successfully operate on nearly 100 eyes, so it was a productive eye camp.  ZNBC, a local television news agency, came to interview us, and so we were reportedly aired on television twice (although I never got to see the news report).  =) 

Receiving the certificate of appreciation from the Vision Care team
13.  Lower Zambezi.  Since 1 August 2016 was a national holiday called Farmer’s Day, we decided to take advantage of the long weekend to travel down to the Lower Zambezi National Park.  With Paul, JoyJoy, Jaycee, Zachariah, and me filling up the seats in the Hilux, Nick, Chris, and Jeff were relegated to sitting in the bed of the truck.   
Of course, it may have been fun for the first 20 minutes, but I’m sure the rest of the 7-hour drive (the last hour of which was very bumpy on horrible, untarred roads) was not very comfortable.  The boys were good sports, and we had a wonderful time enjoying the lodge alongside the Zambezi River as well as a full day of game viewing in the park.   
Zach enjoying the elephants
Jacyee watching the Cape buffalo
 The last bit of excitement came when we were literally chased by elephants as we tried to pass them on the road.  They had created sort of a blockade, which we tried to wait out for about half an hour.  But the driver decided to take a risk to move forward on the road, gunned the engine, scared the mother and baby elephant, and as a consequence led to us getting chased down.  Thankfully, we got out of that situation unscathed.  But we all developed a new respect for elephants. 

14.  Gwembe Valley Dental Camp.  As soon as we returned from the Lower Zambezi, Paul took Chris, Jeff, and JoyJoy to the Gwembe Valley from 2 – 5 August 2016 for a dental camp.  Daily, they worked hours upon hours extracting tooth after tooth.  By the end of the camp (after only 2.5 days of work), they had pulled countless teeth and seen about 200 patients.  By the last day, they even had to turn some patients away due to lack of time.  What a difference they were able to make in this poverty-stricken area of Zambia. 

Hard at work
Even past sundown

Gifted with crocodile meat!
15.  Eden Yoon rotation.  It is interesting to reflect back on how many Loma Linda University Ophthalmology residents have been able to come to Lusaka Eye Hospital to rotate.  By my count, we had 3 out of each senior class of 4 residents come to Zambia each year for the last 3 years.  From this new senior class (class of 2017), we had our first resident, Eden Yoon, come from 8 – 26 August 2016.  
Thanks to the LLU Eye Institute for sponsring these surgeries!
It has been a joy to teach each and every resident the SICS technique, to watch them get better on a daily basis, to see them grow and grasp new concepts, to watch them become better surgeons almost overnight.  Eden was especially great to have around, as we shared thoughts and views on a variety of different subjects – ranging from ophthalmology to religion to self-help books to politics and finance.  Eden is the one who got me hooked on reading the White Coat Investor blog, which I highly recommend to any medical student, resident, or attending who is interested in learning more about personal finance.  

16.  Elections.  Speaking of politics, the United States is not the only country that has a big presidential election this year.  On 11 August 2016, Zambians across the country cast their votes for the president of this country. 
It was another neck-to-neck race.  The incumbent, Mr. Edgar Lungu, leader of the Patriotic Front (PF) party, was re-elected to the office of president by narrowly beating Hakainde Hichilema (HH), of the United Party for National Development (UPND) - 50.35% to 47.63%.  
It was interesting to see the votes divided by tribal lines (Zambians from the Northern and Eastern Province generally voting for Lungu, Southern, Northwestern, and Western Province for HH).  It was also interesting to see how the search for peace prevailed over the demand for justice and fairness despite cries that the election was rigged.  Regardless, the entire nation breathed a collective sigh of relief on 13 September 2016, when President Lungu was inaugurated, signifying the end of potential violence and unrest and the beginning of another 5 year period of relative peace (albeit also of probable economic decline).

17.  Livingstone.  To avoid some of the potential chaos that the elections might bring in Lusaka, our family decided to take Eden, Chris, and Jeff on a trip to Livingstone from 11 – 14 August 2016.  
Taking a hike across the falls to Angel's Pool
 It was lovely to get away, to enjoy once again one of the Seven Natural Wonders of the World, the majestic Vic Falls.   
To enjoy hotel’s buffet breakfasts.  To hang out with the boys.  And to enjoy precious time with our children.

18.  Yuka Eye Camp.  As soon as we returned from our weekend getaway to Livingstone, Eden joined our eye team on an eye camp to Yuka Adventist Hospital in the Western Province from 15 – 19 August 2016.  This was the first time our team had been privileged to use the new road, leading from Mongu to Kalabo, which was recently completed in April 2016.   
Apparently, according to the Lusaka Times, it is “a 34 Kilometres stretch built in the Baroste plains with 26 bridges across it.”  Prior to this road being built, the only way to get to Yuka from Mongu was to take a boat across the Zambezi River (we had done that on our past 2 mission trips to Yuka).  Now it is a one-hour comfortable drive by car or bus!  It took many years to finish this project, which had many setbacks, but we were all so thrilled to drive on this beautiful new road, which basically is a step forward in connecting the Mongu region (undoubtedly one of the poorest districts in Zambia) to the rest of the country.  

 At Yuka, we had a successful eye camp, during which we operated on a number of blind, vulnerable patients.   

Our eye team: Eden Yoon, me, Argent Moonga, Mildred Kapasu
Most of the patients from the Western Province (Lozi tribe) tend to be quite stoic and expressionless when their patches are taken off and they realize they are no longer blind.  However, one patient in particular, who had been blind in both eyes prior to her surgical day, was especially thankful and expressed this in an outburst of joyful dance. 

19. Student Missionaries.  26 August 2016 was a landmark date, which marked the arrival of two student missionaries to Lusaka Eye Hospital.  Never before have we hosted student missionaries, but Pamela Acosta-Torres and Ana Aguilera, two wonderful pre-med students from Southern Adventist University, committed to spending almost a full year volunteering their time and skills at Lusaka Eye Hospital.  We are thrilled that they have joined our Eye Hospital family, and they have already shown us what help and energy they can bring to our institution.

20.  Last Set.  Because of our family’s plans to return to the U.S. next year, I made the decision to limit the number of corneal transplants that I would do this year for the sake of adequate follow up during the critical postoperative period.  Thus, on 29 August 2016, I performed my last set of six corneal transplants.  The last transplant we did was a charity case for a 20-year-old male who had a dramatic eye history.  I had done his transplant in the right eye last year for severe keratoconus.  Everything was going great and his vision was improving drastically.  However, on the day of one of his follow up visits, he fell down, hit his eye, and ruptured his graft!  I did an emergency repair on the graft.  Unfortunately, however, he developed a retinal detachment.  We asked one of the private retina services in town to repair it as a charity case.  They were able to re-attach the retina, but his sight remained poor despite complete clearing of the graft.  His sight in his left eye was so poor due to the keratoconus that we decided to help this eye and grant him a new cornea!

Pre-op: severe keratoconus with a pronounced cone
Immediate post-op: new cornea in place
 I am sad about the closure of the corneal transplant portion of our services in Zambia, but I’m happy that we have been able to help so many people with new corneas during the time that we have been providing this service.  Thanks to so many organizations and individuals who helped make our cornea service at Lusaka Eye Hospital such a success!  

Despite stopping fresh corneal transplants, we continue to do glycerol-preserved corneal transplants for emergencies.  This is a 31-year-old female who had a melted corneal ulcer that perforated.  We were able to stabilize the globe with this glycerol-preserved tissue, thus saving her eye. 

Pre-op profile: necrotic corneal ulcer
Immediate post-op profile: with new glycerol-preserved graft in place
21.  Lloyd Williams visit.  From 3 – 8 September 2016, we had another special visitor to Lusaka.  Dr. Lloyd Williams, an ophthalmologist in Salt Lake City, Utah, came out for a few days to work with us and learn some SICS techniques.  Lloyd is an incredible individual who had just attended the COECSA (College of Ophthalmology of Eastern, Central and Southern Africa) Congress in Tanzania, then climbed Mount Kilimanjaro with Dr. Geoff Tabin and an ex-Navy Seal who was paraplegic, before coming to Zambia.  Of note, the ex-Navy Seal paraplegic athlete ended up summiting, and was named the second paraplegic to ever conquer Mt. Kilimanjaro!  Can’t wait for the documentary to be released regarding this event (as the team of mountaineers included a whole camera crew).  Regardless, it was great to see Lloyd again, as we had just met in New Orleans at ASCRS.  It was a privilege to teach him, and I know he will use this skill to help many more eyes see across the world for years to come. 

22. September birthdays.  The month of September is always filled to the brim with birthdays, especially because that’s the month that both Jaycee and Zachariah (and Jaycee’s cousin, Oliver) were born!  These two kids have changed our world view and have brought so much joy into our lives!
Jaycee, showing her affection for Anderson Busl, at Riverside Farm Institute
On 1 September, we held a birthday party for Zachariah’s 2nd birthday!  With the addition of Pamela and Ana, both Mexican-American, and our craving for good Mexican food, we decided to host a burrito night for the party.  The party included an unspoken mandate that everyone participate in the creation of these tasty tortillas.   

Pamela, JoyJoy, Abraham, Chris, Jeff, Ana - hard at work making tortillas
The dinner was delicious, and the company just as wonderful.  Happy birthday, to a joy-filled, mild-tempered, well-mannered little boy.  You’re two!

Just two weeks later, on 16 September, we hosted Jaycee’s 4th birthday party.  We invited some of Jaycee’s friends from church over to our house, and they enjoyed a wonderful time together.  It’s incredible to see how much our four-year-old has grown, and we appreciate how much she has changed our lives (for the better).  Happy birthday, to our sweet, smart princess!  You’re our ray of sunshine!   
Is Zach trying to get in on the action?
And happy 5th birthday to little nephew, Oliver!  You share the same exact birthday with Jaycee, which makes it an extra special birthday in our hearts. 

Oliver celebrating his 5th birthday with Grandma in Temecula, CA
Unfortunately (or fortunately), Baby #3 will not be following the trend of September birthdays.  Instead, she will likely be born two months later – in November, the month whose birthdays belong to my husband and my mom! =)  
Yes, another bun baking….!