Sunday, December 6, 2015

“Tomorrow will be the best day of my life”

I’ve often thought that these blog entries tend to be more like a string of updates, a list of activities, a mere recounting of things past.  Not a true space for reflection and meditation, insight and epiphany.  Perhaps this is because lack of time allows for only one blog entry every two or three months, and by then so much has transpired that the urge to cram everything into a small space of one blog is inevitable.  Perhaps I’ll blame my children – having 2 kids, one and three years old, is always a great excuse for most shortfalls.  In addition, perhaps I’ll blame our busy schedules.  This is often the case with two-doctor families where both parents work full-time and are both directors of their respective institutions.  Excuses aside, what I’m trying to say is, “Please bear with us for yet another string of updates.”  

1.  “No coverage.”  This is how we refer to a period like the last few months in which no grandparent is living with us to help with our kids.  Since my parents left Zambia at the end of September, we have felt a great void in our lives.  Thankfully, we had a nice home photo session with them the day before their departure.   
And we do chat with them daily on Facetime.  Nonetheless, we look forward to the end of this month when Paul’s mom will come back to join us in Zambia, and we shall once again have "coverage." 

2.  On my operating theatre table, I heard these words from my thin, quiet, 13-year-old patient: “Tomorrow will be the best day of my life.”  “Why?” I gently, but curiously, inquired.  She explained that she has spent her whole life being teased for her squint, or crossing of eyes.  With more than 100 prism diopters of very large angle, congenital esotropia, she did have a conspicuous stigma, indeed.  
But this opportunity was a chance at liberation, at pursuing a normal adulthood of the near future.  I decided to do an “R&R” on just one eye under local anesthesia. Because her numbers were off the typical charts for strabismus surgery, I decided to perform a large recession and resection (10 mm each) in one eye under local anesthesia, with the idea that the residual deviation could be measured and subsequent surgery done on the other eye in the future.  The surgery went beautifully, and her comment about “tomorrow” touched my heart.  I was so grateful for the opportunity to be used of God to help this brave, young lady, who by her one month postop visit was almost perfectly ortho (straight)!

3. Chipwenupwenu Road:  At last!  After years of waiting, hoping, and politicking for a paved road to Lusaka Eye Hospital, it finally happened.  Exactly two weeks after the caterpillars arrived on the scene, Chipwenupwenu Road was finally paved on 29 September 2015.  We can look forward to the rainy season this year, now that the patients will have no difficulty coming to our facility.
Before: Chipwenupwenu Road during rainy season 
During: At the start of road works
During: First layer
After: Road paved!
4.  A new dentist.  Dr. JoyJoy Falia, a dentist from Bangladesh who trained in the Philippines, arrived in Zambia on 2 October 2015 to work with Paul as a missionary dentist at Lusaka Adventist Dental Services.  She also works part of the time for International Caring Hands, with the mobile dental clinic based at Riverside Farm Institute, in which she is able to serve a more rural community in a dental outreach setting.  
We are so happy that she has come to serve in Zambia for at least the next 2 years, and our children really love her!  Last night, Jaycee’s dinner prayer solely focused on thanking Jesus for JoyJoy. 
Jaycee & Zach having fun with JoyJoy's camera
5.  Dental Outreach.  From 8 – 9 October 2015, Paul, JoyJoy and some dentists from International Caring Hands traveled west of Lusaka for anther dental outreach with the mobile dental clinic.  They were able to serve a truly needy community with much-needed dental treatments.
6.  A viral illness.  All of October 2015 seemed to be one big blur, after Jaycee came home from school one day with a nasty bug.  We assumed it was a viral infection (probably Coxsackivirus or something similar) which caused the fever, diarrhea, and flu-like symptoms (cough, sore throat, runny nose) first in Jaycee, Zachariah, then mommy and daddy.  It took two rounds through our family, knocking each member down and out for several days before moving on to the next victim.  It took my voice away completely for several days.   
Jaycee, going to Lusaka Adventist Clinic to be examined by Dr. Mubanga
Since that time, we have not taken Jaycee back to school.  This round of illness was a powerful reminder that we should not take our health for granted, that we should make our health a priority.  There is a saying that time and health are two things that we don’t appreciate until they are gone.  This is so very true.  And we thank the Lord that we are all happy and healthy again.

7.  MMED students.  I am happy to be an honorary lecturer once again for the Masters in Medicine (MMED) students of Ophthalmology at the University of Zambia (UNZA).  The University has just had an intake of 4 new ophthalmology MMED students (what we call residents), and they have been coming to Lusaka Eye Hospital on Friday afternoons for our Ocular Pathology sessions.  It has been an honor and a joy to be able interact with my favorite group of people to teach – those who are at the very beginning of the rewarding road to becoming an ophthalmologist.  

8.  Royal Livingstone, Independence Day weekend, and Janie’s birthday.  As 23 October is my birthday and 24 October is Zambia’s national holiday (Independence Day), we decided to take advantage of the weekend to celebrate in Livingstone.  It was a lovely weekend, which we spent with the Minor family. 
Distributing children's magazines at a church in Livingstone

9.  ZOS Congress.  The Zambian Ophthalmology Society recently organized a Congress, during which ophthalmologists and other workers in eye care gathered together for a scientific meeting from 29 – 30 October 2015.  I had the opportunity to present two topics: Corneal grafting at Lusaka Eye Hospital (Fresh, Glycerol-, and Alcohol-preserved corneas) and Challenges of running a private eye hospital in Zambia.   

Overall, it was a very interesting meeting, and marked a significant leap forward in encouraging research and academic interest amongst our ophthalmology colleagues in the country.

10.  Kaizer’s concert.  Although I was a music minor in college, my musical activity was subsequently stunted by an abnormally heavy focus on academics during medical school, residency, and on.  Even during our four years in Zambia, I am ashamed to say that I can only count on one hand the number of times I dusted off my violin to perform for any group of people.  So when Kaizer, an amazing vocalist, asked me to join his band for his album release concert, I was more than excited to accept.  We had several rehearsals before the actual concert, which took place on 31 October 2015 at the UNZA chapel.  It was a truly liberating feeling to jam with talented musicians during rehearsals, and it felt wonderful to be making music again.

One of the rehearsals
The flyer for Kaizer's concert
11.  Potential partners.  Over the last month or two, we have had preliminary discussions from two of the founding partners of Lusaka Eye Hospital to re-enter into a partnership.  Operation Eyesight Universal (OEU) and CBM, both key players in the founding of our eye hospital back in 2001, have approached us to consider reviving our partnership.  Although OEU’s budget constraints are preventing them from jumping into a partnership with us, CBM seems quite interested after their visit to our Eye Hospital on 1 November 2015.  We are excited to see what God has in store for us in terms of new partnerships.

With Peter Borchert from CBM Germany, standing in front of the bus they donated >13 years ago
12.  Early Christmas.  Every year, either the Dental family or the Medical Auxiliary from Loma Linda University will send us a Christmas gift care package.  This is so special, as we rarely receive mail from the U.S.  So on 5 November 2015, we received the Medical Auxiliary’s care package, stamped on December 2014!  So you can help me decide whether this was a late Christmas present for last year,…or an early Christmas present for this year.  Of course, the kids didn't care.  They were very excited about the parcel and its contents
13.  Late rains, load shedding and kwacha devaluation.  The situation with electricity here in Zambia has gone from bad to worse.  Last year, the rains were sparse.  This led to a very dry season and a shortage in hydropower due to low water levels in the Kariba Dam.  ZESCO, Zambia’s power company, has implemented “load shedding” on a national level since June, where scheduled power cuts in different regions allow the country to manage its shortage in power.  Although some parts of Lusaka have 3 or 4 days of the week without electricity for 8 hour stretches in the middle of the day, our area in Makeni is fortunate to have the power outages occur mostly during the night.  Our scheduled outages used to occur from 10 pm – 6 am, but they have recently shifted to 12 am – 8 am; in addition, there are often unscheduled power outages.  Unfortunately, running the generator during the power cuts has proven to be super expensive, so we have been trying to ensure that the generator is turned off on nights and weekends, which makes for interesting refrigerator and freezer contents. The rains have come late again this year, and we hope this is not a foreshadowing of worse load shedding schedules next year.
Rains have been so sparse that Vic Falls is at its driest point!  Just a trickle in October 2015.
Our handy solar-powered lamp at work during power outages
The lapses in electric power have negatively affected the country and its economy, with major copper mining companies (Mopani, Glencore) deciding to lay off thousands of workers.  Lower copper prices are not good for an economy that is so dependent on copper as its major export product. 

To make matters worse, the Zambian kwacha has taken a huge hit in terms of depreciation.  In 2011, when Paul and I stepped foot into the Zambia, the foreign exchange rate was 4.8 kwacha per 1 US dollar.  From 2012 to early 2015, the kwacha began to devalue slowly, to about 6 kwacha/dollar.  From August to date, the kwacha has gone for a wild ride, with rates quickly rising to 8, then 10, even to 14.6 at some point.  Today, it lies (albeit unstable) at about 10.5.  The cost of almost everything at the shops has gone up, even doubled, in a matter of a few months!  All our consumables for use at the hospital have sky-rocketed, since most of the drugs are imported and purchased with the almighty dollar.  We can only hope for the best in this struggling economy, but things don’t look too promising in the near or distant future. 

14.  Jeff Jones and Zimba Eye Camp.  From 2 – 21 November 2015, Jeffrey Jones, a senior ophthalmology resident from Loma Linda, joined our team for his international ophthalmology rotation.  
He even got to come down to Zimba for an eye camp (15 – 20 November), during which our team was able to screen 244 patients and successfully perform 58 surgeries.  What a great experience it was for all of us to work together with the Zimba team.  We look forward to many more collaborations and eye camps together.

15. Marine Corps 240th birthday ball. On 14 Nov 2015, the U.S. Embassy hosted its annual Marine Corps birthday ball at Ananda’s Wedding and Conference Center.  The Minor family was kind enough to invite us to this regal event.  It was interesting to see four men in uniform march in with the birthday cake, a few pieces of which were cut with a real sword and fed to the U.S. Ambassador for Zambia, the oldest marine present, and the youngest marine present.

On a rare night out without the kids
16. Thanksgiving & Paul’s 40th birthday.  We were lucky enough to be invited to the Minors’ home for Thanksgiving dinner on 26 Nov 2015.  Although we are far from home, it was lovely to be able to enjoy the camaraderie and friendship of those present.  It was a true feast, and we were even able to celebrate Paul’s birthday briefly with a birthday cake.  
Celebrating Paul's 40th birthday (27 Nov 2015) at home with cupcakes
Happy 40th birthday, love!  You're the best husband and father anyone could ask for!

17.  The kids. Jaycee & Zachariah continue to grow and learn.   
Zach just turned 15 months old.  He is now walking, talking (vocabulary of about 25 words), and climbing everything and anything he can get a foothold on.  
Jaycee loves books and is learning how to read by sounding out the letters for a select few basic words. 
We enjoy baking together!
She is also able to tell me the first letter of certain words after sounding them out.  Watching these two munchkins grow and learn is so fulfilling and rewarding.  

And that’s all for this latest update.

Monday, September 21, 2015

Baby Zachariah Turns One...and More News

There are times when so much has happened in a space of time that one doesn’t know where to start when asked to share.  This is the overwhelming feeling I experience even now, as I sit down to articulate all that has transpired in the last 4 months.  Below is my feeble attempt to reflect and record some of the important memories.

1. Eye Camps:  In mid-May, Lusaka Eye Hospital had another eye camp, during which we operated on a number of blind cataract patients. Because of the funds donated by my home church (Thank you, again, Loma Linda Korean SDA Church!), we have been able to provide free cataract surgeries for more than 260 of the most vulnerable patients in the last several months.  We have also been able to completely sponsor several cornea transplant surgeries with the donor funding.

Happy patients

This is one of our patients from just across the border in Zimbabwe who heard about Lusaka Eye Hospital from another former patient while attending an evangelistic crusade in Zambia.   
She is a 43-year-old woman who had lost her son 3 years earlier, developed depression and diabetes, and became blind (Light Perceptions vision in both eyes) in just a matter of two months.  She had both eyes operated on under the LLKSDA church sponsorship, and she is ever grateful for her newfound sight!

2.  Stanford Shin:  The last memory I had of Stanford was probably of when he was about 2 years old.  Eighteen years later, who knew that he would show up at our doorstep in Lusaka as a student volunteer.  The first week of June, he accompanied me to Botswana for our second annual eye camp at Kanye Adventist Hospital, during which we operated successfully on 110 patients. 

The hard-working theatre crew at Kanye Adventist Hospital

3. Brian Fischer:  Brian was a direct answer to a blog plea made earlier in March for a “computer-literate, task-oriented, organized individual, especially anyone familiar with accounting or business management, to help these institutions bounce back, to help inspire and train, to help model strong work ethic and organizational skills, and to help with administrative needs.”  During his three months at Lusaka Eye Hospital, he helped assess our financial situation, gave constructive feedback and suggestions, worked hand in hand with our brand new accountant, and helped change the way we think about our finance department.  It was such a breath of fresh air to have a mature, financially-adept volunteer with us to help our institution in more ways than he will ever realize. 

With my parents, Brian, Lorna, Kim, and Sam

4.  Lilayi Lodge:  Everyone needs a little getaway, sometimes.  On the weekend of 23 May 2015, we took Mom and the kids for a weekend trip to Lilayi Lodge, a cute little lodge about 14 km down the road from us.  Although the place is just on the outskirts of Lusaka, we felt like we were a million miles away from the cares of the world. 

Ready to have tea
5.  Dubai:  18 June 2015 was the long-anticipated date of the start of our annual leave.  For at least the last four months prior to this date, one of the standard lines used on Jaycee was, “If you want to go to Dubai with us, you have to be a good girl.”  Our five days exploring a city that so many times previously had been simply a layover – only this time as a destination – were absolutely enjoyable.  

Zach, trying to get some shut eye in the bassinet
Dubai is definitely a city that overdid itself.  From a barren desert to a bustling city and tourist destination.  
The biggest mall in the world.  The tallest building in the world.  Hotels and resorts that are over the top.   
Burj Khalifa, standing high with 163 floors at 2717 feet
All in all, we spent good family time, visiting the aquarium, going to the water park, exploring the city, and even attending church.  
The only interesting part was visiting Dubai during the month of Ramadan, during which restaurants and public places prohibited eating or drinking in public from sunrise to sunset.  This is a view of our restaurant table at Cheesecake Factory, as all the customers anxiously waited for 7:15 pm, which is when the waiters would begin serving food. 

6.  California:  The next leg of our vacation was not really a vacation, at least not for me.  I spent the next few days officially becoming a per diem employee of Loma Linda University’s Department of Ophthalmology.  Two days of orientation and electronic medical records training, combined with three full days working in the eye clinic left me ready to restart my vacation.  I had the opportunity to speak at Grand Rounds.  I also saw this poster in the waiting area of the Department of Ophthalmolgy!   
We have successfully performed several cataract surgeries, sponsored under the See it Forward program, in which proceeds from patients who had their refractive surgery done at Loma Linda go directly to sponsoring a cataract surgery patient at Lusaka Eye Hospital!  Special thanks to my friend and colleague, Dr. Enoch Nam, for spearheading this initiative.

While I was busy at work, the rest of the family attempted to relax and recover from jet lag.   
 Jaycee even got in a day on the golf course.  The video below shows her in action.  =)
7.  Texas:  2 – 12 July 2015 marked a historic conference for our church – the 60th General Conference Session of the Seventh-day Adventist world church.  
It was our first time attending a GC session, which was held in San Antonio, TX.  What a wonderful time it was to spend time with our family, meet up with old friends, meet new ones, listen in on some important business meetings, worship with more than 70,000 people in the Alamodome, and hang out in the family-friendly city of San Antonio. 
First Sabbath at the Henry B. Gonzalez Convention Center
Photo op with Danny Shelton, newly elected 3ABN president
Getting autograph and picture with artist, Nathan Greene
Cruising down the Rio San Antonio

Visiting the San Antonio Children's Museum, the Do-seum, with Kaylee & Kenan
Jaycee & Kaylee were like long-lost twins, similar in appearance and mannerisms
Hanging out with Piersons and Ngs at the San Antonio Zoo
Oh, hello, Carlos!
Ava & Jaycee sharing gazpacho soup by the Riverwalk
Jaycee loves hanging out with Grandma
Visiting the Alamo
Seeing Juan Iago for the first time in ages (and meeting his beautiful wife)
Dressed in our chitenge outfits for Sabbath

8.  Hawaii:  Our next stop for the following ten days was to Paul’s old stomping grounds – Honolulu, Hawaii.  There, we hung out with family and friends, took the kids to the beach and the pool, and enjoyed multiple sessions of authentic Vietnamese pho.

Visiting the Lego store
Spending the day at Bellows Field Beach Park in Waimanalo
Going to church with Christian
Eating out with Christian and Veronica
Zach meeting Uncle Jin for the first time
Hanging out at Magic Island with the Boys
Swimming at the hotel
Can't beat playing in the sand with Grandma
9.  California:  The last week of our leave was spent back in Loma Linda, CA.  That was a busy time, with me speaking at one church one weekend and Paul speaking at another the following weekend.   
Loma Linda Korean SDA Church English Ministry
Hello, Miles and Oliver!
Celebrating Grandpa's birthday one week early
Jaycee loves her cousin, Oliver
Hanging out with Jihye & family

Meeting Enoch's kids
 And in between, poor Zachariah underwent his surgery (circumcision).   
A trooper
Frantic packing ensued, as we tried to fill 13 suitcases with things for our personal use in Zambia as well as for hospital use.  Why thirteen suitcases?  Because my parents somehow agreed to come back to Zambia with us for two months. 
Celebrating Grandpa's 74th birthday in Zambia

10.  Zambia:  On 2 August 2015, we all boarded the plane to head back home to Zambia.  During our short time back, we've already had several guests coming through.   
Gemini, Verna, and Biboy
Love in a basket
Singing hymns on a Friday night
All the visitors were so thankful to be around to enjoy my mom’s home cooking.  One weekend, we took a trip down to Riverside Farms, where we took part in a campmeeting service and hung out with the Busl family. 

Campmeeting for the entire Mazabuka district
Coloring with Makena
Checking out the wheat fields
Basking in the sun with Michelle and the kids
11.  Kimberly Chan & Sam Ko:  A few days after we landed in Zambia, before we had time to settle back into our routine, we received another set of guests.  Kimberly and Sam are a two-physician couple.  Kimberly is a senior ophthalmology resident from Loma Linda who came out for her three week rotation.  Sam is an ER physician who decided to accompany his wife as well as see a bit of Africa.  We enjoyed spending time with this beautiful couple.

12.  Corneas:  On 24 August 2015, we received another set of corneal donor tissues from Eversight, so we were able to perform cornea transplants on six more patients.  By the grace of God, we are now able to bring in these tissues without a hitch (i.e. they did not end up in Zimbabwe this time)!  
And the patients are so happy with their newfound sight.  In fact, we just received another set of corneal tissues, this time donated by Miracles in Sight, an eye bank in North Carolina, and just today we have done another four corneal transplants!  Indeed, due to these generous eye banks in the U.S., patients here have the opportunity for miracles in sight. 

13.  Zachariah:  In celebration of Zachariah’s first birthday 1 September 2015 (“dohl”), we hosted a birthday party – mainly for our staff and their kids – the day before his actual birthday.  
Zachariah, sitting at the head table
Preparations began weeks before, with Paul making one batch of homemade ice cream every other day.  
Cupcakes were also baked with love.  In fact, 120 of them. 
Jaycee, Mommy's little helper
The party was a huge success, with at least 50 children in attendance.  
The kids loved the jumping castle
A proud Grandpa
Jaycee, feeding baby Anderson
During his “dohljabi,” he picked (1) the Bible – meaning he may be a pastor or evangelist one day – and then (2) a toothbrush – meaning he may be a dentist like Daddy.  We thank God for his life and for the joy he brings us. 
Smile, cutie!
14.  Jaycee: Speaking of birthdays, Jaycee also celebrated her 3rd birthday!  Since she just started school on 1 September 2015, we decided it would be meaningful to have a party with her schoolmates. Paul, Grandma, and Grandpa did a great job throwing the pizza, popcorn, and cupcake party for the overly excited school kids. 
Waiting for the schoolbus
Make a wish!
Jaycee's schoolmates
Some of the older kids adore Jaycee

Happy birthday, Jaycee!  You are growing up to be such a cute, spunky little girl.  We love you!
15.  Global Healthcare Conference:  From 2 – 5 September 2015, Adventist Health International hosted a regional Global Healthcare Conference in Lusaka for healthcare providers, administrators, business managers of our Adventist healthcare institutions in the entire eastern and southern African region.  This historic event, the first of its kind in this part of Africa, was well-attended by about 120 individuals from all over – the U.S., Zambia, Malawi, Rwanda, Lesotho, South Africa, Botswana, Kenya, etc. 

Panel with: Dr. Don Pursley, Dr. Peter Landless, Elder Lowell Cooper, Rod Neal, Dr. Hart
With Pastor Ratsara, president of SID, and his beautiful wife, Joanne
With Dr. Dick Hart
With other missionaries across southern Africa
With other missionaries (from Malawi)
Visiting the Chalala plot for a special dedication service

The Friday evening vespers was held in our backyard, and it was a special event with an amazing male a cappella group, Jasper Sea.
Jaycee, hanging out with her pal, Uncle Jerry

Mo, Jerry, and my mom - busy making the fruit salad
A bigger tent was set up in our back yard
Jasper Sea gave us a very special musical vespers
Cheryl & Erin on a small excursion to celebrate the completion of a successful conference
Paul, with the elephants
16.  National Prevention of Blindness Committee (NPBC):  Immediately following the Global Healthcare Conference, I headed down to Livingstone from 6  – 12 September 2015 for a week-long meeting for our NPBC.  During that time, we sat to brainstorm, plan, and revise our National Eye Health Strategic Plan (NEHSP) for 2016 – 2020, since our old one that we drafted at the end of 2011 is coming to an end at the end of this year.  By the end of the week, we successfully came up with the first draft of our new NEHSP for Zambia.  One item that was near and dear to my heart was the inclusion of a section on corneal diseases and our goal to set up an eye bank in Zambia by the year 2020. 


17. STAND study:  Dr. Celestin and I are excited to be taking part in a clinical trial called STAND as the consultant ophthalmologists examining all the study eyes recruited in Zambia.  This study, “A Phase 3 Open-Label Partially Randomized Trial to Evaluate the Efficacy, Safety and Tolerability of the Combination of Moxifloxacin plus PA-824 plus Pyrazinamide after 4 and 6 months of Treatment in Adult Participants with Drug-Sensitive Smear-Positive Pulmonary Tuberculosis and after 6 months of Treatment in Adult Participants with Multi-Drug Resistant, Smear-Positive Pulmonary Tuberculosis” is basically a huge clinical trial spread over 50 sites in 15 countries studying a new TB drug, Pretomanid (PA-824).  Rat models developed cataracts after use of this drug, but monkeys did not.  So special care will be taken to document the safety of Pretomanid, and one of the many paramaters will be the safety in human eyes.  Lusaka Eye Hospital ophthalmologists will be taking charge of performing a full eye exam before, during and after cessation of this drug.  Hopefully, Zambia will start recruiting patients this week, which means we should start examining the eyes of these subjects very soon.

At the Site Initiation Visit for the STAND study, CIDRZ TB clinic, Kabulonga

18.  The Road:  One thing that we have learned while living in Africa is the importance of patience (and how little we have of this virtue).  We have heard promise after promise in regards to paving the road to Lusaka Eye Hospital.  We saw progress more than one year ago, where the tarring began at the turn off, heading to the Eye Hospital.  But our dreams were shattered when the work literally stopped before our eyes (leaving the small stretch immediately in front of LEH unpaved and extra hilly).  In the time of our last blog entry (May 2015), we again saw activity after the “presidential directive.”  But we were again disappointed with 4 months of inactivity. Well, our patience (and prayers) have finally paid off!  On 18 September 2015, the road works began again (widening the street in preparation for paving).  And the Chinese contractors state that they are expected to finish the road works within two weeks.  Hallelujah! 

Chipwenupwenu Road, being worked on as we speak
19.  Elephants:  As a special appreciation to my parents, who have been such an amazing help and support to us over these last two months, we decided to take a small trip out on Sunday.  The kids enjoyed swimming in the pool.  Our final stop was a visit some local wildlife.   
Jaycee and Zach didn't quite know what to make of this experience
As my parents return to the U.S. in a week, we will pray for their traveling mercies and safety.  Thank you so much for everything!  Jaycee and Zach will certainly miss you!