Share on Facebook

90 seconds: Doctor has moments to save gunshot victim
By Bill McCoy

“Kapal hadn’t come to fight, but he walked into the middle of one. Worried about his sister, the 23-year-old Domil villager crossed the boundary between his tribe and the next, where a battle had been flaring for weeks.

He walked with purpose toward his brother-in-law’s house, despite gunshots ringing nearby. The fight didn’t involve him so he thought he’d probably be safe. I imagine he didn’t even quicken his pace. I’ve seen dozens like him over the years, young men who treat tribal war as a matter of course.

As he approached the house, suddenly a burning chunk of lead slammed into his left jaw between his eye and ear. A fragment of it lodged near the point of entry, the remainder sailed on through his head and neck, leaving his throat an swelling muddle of angry tissue. He dropped like a dead man.

Kapal knew the danger and devastation of war. His own education had ended after the third grade when fighting closed his community school and scattered his village. Near his home a cluster of graves serves as a reminder of enemies to be vanquished and grievances that will never be satisfied.

Kudjip Hospital, located in the PNG Highlands

The dominant aspiration of many boys, if not Kapal’s, is to become a leader of the tribe, or in local speak, a “Big Man.” Nothing catapults one’s status faster than the demonstration of prowess on the battlefield. When opportunities arise, and they often do for trivial reasons, teens and young men suppress their fears, sharpen their knives, load their weapons, paint their faces and gather for the fight.

Every fight is part of a war that extends back beyond the cherished memories of gray and wrinkled elders. I’ve heard the stories rehearsed and embellished around fires in darkened, smoke filled huts, but I’ve never understood them. Over 16 years as a missionary doctor in Papua New Guinea, I’ve seen these wars erupt again and again, surging at intervals for reasons mysterious to nearly everyone but the combatants.

Tomorrow’s battle is as fresh and exciting as the imaginations of the adolescents, who don’t think about things like tracheostomies, or the fact that there’s sometimes only one good surgeon in the Waghi Valley, and I am not him.

The screech of brakes and skid of tires outside our emergency room suggested that a critically injured patient was on the way in. It was evening on a busy Friday at the tail of a full week. The last patients in the outpatient department had been seen. A few others in the emergency room were waiting to be moved into the wards. I was getting ready to take a break when six young men from the village burst through the double doors.

They laid Kapal on the center bed while we learned what had happened.

Moments after Kapal had gone down, his sister and in-laws gathered around him. Blood flowed from the hole in his head. He writhed. He breathed, but just barely.

Kapal’s sister thought she was watching her brother die. His in-laws had other concerns on their minds. They were worried, they said, they had just started another war.

His sister’s assessment was correct. Kapal was dying. The critical issue was Kapal’s threatened ability to breath. The trajectory of the bullet through his neck — incredibly missing the major arteries — had wrecked his airway. His voice was gone, swallowing was impossible, and his airway was rapidly swelling shut. When it did, he would be dead within a few minutes.

We provided suction, oxygen, intravenous access, and a pressure dressing, but Kapal wasn’t getting enough air. He needed surgery.

For 25 years, Nazarene Hospital has been the most reliable surgical center in the highlands, due largely to a missionary surgeon named Jim Radcliffe. But Jim was away that Friday night.

Tracheostomy isn’t the most complicated or highly technical surgery. In fact, I had a good reference on my computer that described the procedure in four straight-forward steps. First, find the right spot in the neck. Second, stab a knife in that spot. Third, put a hook on the trachea. Fourth, put a tube in the hole.

Four steps, 90 seconds to complete them. If done correctly, the patient will breath. Fail and the patient dies. I hadn’t done this before. I’d seen it attempted once, and had watched a man die as our team tried mightily to save him. The memory remains firmly etched and hauntingly painful.

I told Kapal I needed to cut a hole in his neck to help him breathe and asked him to sign a consent. I didn’t tell him I had never done it before. I tried not to let on that a large part of me was terrified. I didn’t tell him that his refusal, while lethal for him, might leave my conscience less guilty. I simply told him he needed the surgery and that it wasn’t going to be easy. “Yumi no gat wanpela isi rot. Dispela wok em i hat tru.” Our eyes fmet and I was sure we both understood.

He signed the consent form, “Kapal, God bless.” We prayed, and I would venture to say it was one of the most sincere and desperate prayers ever lifted by patient and doctor together.

I needed help, so I asked Dr. Erin Meier, young but already well-seasoned in critical situations, to join me, along with anesthetist David Wan and nurse Vero Pilga from our surgical team.

As we set up, Kapal was straining for every breath. I put him to sleep with intravenous medication and the desperation melted from his face. As planned, David made one attempt to place a tube down Kapal’s mouth into the trachea but it didn’t work. The passage was obstructed.

Vero handed me the scalpel. I stabbed the blade into Kapal’s neck. Blood pooled quickly. I pushed deeper and bubbles rose from the wound, evidence that we were in the trachea.

I tried to hook the lower trachea while Erin inserted the tube. The hole was too small. Time was running out. Kapal’s pulse was slowing. I stretched the hole with an instrument, and Erin tried the tube again. This time, there was a whoosh of air from the lungs, then a sudden cough and a clot of blood shot up from the tube, splattering on the overhead light.

Kapal breathed.

Kapal recovering after surgery

The hours after the procedure required intense effort by nurses and doctors to support Kapal and protect his newly-fashioned airway. It was hard work, but not especially burdensome. Kapal recovered and six days later the swelling subsided. Jim removed the tracheal tube. Kapal gave his life to Christ and returned home to his wife and three children.

The highland battlefield is a contradiction. Fertile mountains, flowing streams, lush vegetation and exotic birds provide an Eden in which Kapal lives, unemployed but not impoverished, with good weather, an OK home, and a lush garden. If men truly lived according to God’s divine plan, Papua New Guinea would offer no reason for a fight and no need for young men’s graves.

Instead, the beautiful rainforest is haunted by men’s fears and accommodates their violence. Creation’s melodies are drowned out by the cries of injured men, and the rich topsoil offers a cover for their lifeless bodies.

But not for Kapal.”

Dr Bill McCoy is a missionary doctor at Kudjip Nazarene Hospital, in Papua New Guinea.

Share on Facebook

Becky & the Three Sister's at Katoomba

We arrived late in the afternoon and it was encouraging to see my Nan doing well physically. She really wanted us to have a good time, so we had a busy week seeing things in the area. Many places I had not been since being a little kid, but good to show Becky where I spent some of my child hood and have some fond memories. We drove around Wellington, Becky & I went for a walk up on Mt Arthur, Anzac Day service, went to Dubbo for the day, Lake Burrendong State Park and Wellington Caves to name a few things.

Becky, Nanny & I

Come Saturday morning we left Wellington, grateful for our time with my Grandmother. We stopped by Orange to visit our relatives David and Ann and for them to meet Becky for the first time. Followed by lunch at Lithgow we made it back to Sydney late in the afternoon. It was a blessing for us to spend time with my Nan and we are grateful for how well she is doing.

Share on Facebook

Furlough - April 2012 photos

Places we went and people we saw during April in Australia

135 Photos

Share on Facebook

Sydney Opera House

We went to the famous Opera House first. I love seeing this iconic building and taking in the area. It is really beautiful on the water with the city as its background. We took pictures there of the Opera House and of the Harbour Bridge just across the water from it. It was a decently warm and sunny day, in contrast to the torrential rain the day before, for which we were so grateful. Then we had lunch there at the Opera House with a view of the harbour and the bridge. After that we took a tour inside the Opera House. This was so interesting. We learned the history of it (16 years to build and 102 million dollars!), and my favorite part was that we got to see a few minutes of the Australian Ballet Company rehearsing for their next show—just beautiful! (but Matt didn’t appreciate their dancing like I did! Haha).

Enjoying the Harbour view

After the hour tour, we walked all around the area and over to the bridge itself. We climbed up the pylon and viewed the whole city from there. It was really lovely and so interesting to learn the history of the bridge. It is now 80 years old and built entirely with rivets, no bolts.

On top of the Harbour Bridge pylon

We walked back to where we started and then caught a ferry ride to Darling Harbour. This is basically the next alcove over from the Opera House. It was very pretty there also. Here they have the maritime museum, with a few ships in the harbour, but we got there too late to go inside. So instead we walked around this area, which has lots of parks and water features. Finally we decided we should have dinner. So we headed towards home. It was a nice day in the big city, but we were glad to be home in the suburbs.

Share on Facebook

PNG photos by Katie

Photos taken by my sister Katie that captures some of Papua New Guinea.

24 Photos

Share on Facebook

“Why would you go there?” was the question I got when I told people where I was travelling. My brother Matt has worked and lived in PNG for over three years and was getting married. He works as an aircraft engineer for a not for profit organisation called MAF.

MAF provide flights to over 250 remote bush communities with essentials like medical evacuations and community development. Because of the harsh terrain many villages are only accessible by either plane or foot. Over 80% of Papuans live a traditional life off the land with little or no money, so this service is life saving.

While at work he managed to get a piece of wire through his finger. Being a third world country the local hospital doesn’t have the best medical facilities. So he travelled to Kudjip Nazarene Hospital, a not for profit hospital which has a reputation for being the best hospital in PNG. Once there he was treated by Dr Becky, a volunteer from America, and that’s how two very important people to me met.

Matt and Becky are perfect for each other, in so many ways, but especially because they both love what they do and they do it well. They even help when they can at the local orphanage.

Living in PNG isn’t easy. Mining has changed the culture of some people in the cities. They no longer see each other in the traditional ways as brothers and sisters, but as opponents with only the fittest to survive. This has resulted in high crime rates in the cities; it is like living in a war zone, razor wire and poverty everywhere. The challenges of living in a remote non-western country also make living hard. Necessities like water and electricity can be cut off for days and things that are the norm in Australia are rare here; a block of chocolate will cost you AU$9.

Before I visited Matt & Becky I didn’t completely understand why they loved being in PNG in such hard circumstances. It wasn’t until I saw them in their element; the work they do and the lovely people they help, that I completely appreciated why they loved it there.

The people are so happy and friendly; everyone waves and smiles to each other calling gut moning (good morning) or apinun (afternoon). Children laugh and giggle when you show them their photos. The food was so good that when I came home everything tasted bland. The scenery was so beautiful it was dream-like. From the air I saw massive mountains and waterfalls, and on our approach to landing in Mt Hagen I saw countless shades of greens in all of the patches of little gardens and farms. In many ways it is paradise but unfortunately that is not always the case.

I am so proud of Matt & Becky and I hope this story will raise much needed awareness and support for the amazing organisations they work so hard for.

To find out more about MAF click here, to find out more about Kudjip Nazarene Hospital click here, to find out more about BFO Orphanage click here.

Story & photos by Katie Waddell

Share on Facebook

House of God Alliance

Share on Facebook

Some of the activities at this year’s Discovery Day:

• Forums on the role and work of Mission Aviation Fellowship, including guest speaker Bill Harding, MAF’s Director of International Development
• A new turbocharged GA8 Airvan on display
• All day sausage sizzle and PNG brewed coffee
• Free children activities including face painting, clowns, a paper plane flying competition and other activities
• Discovery joy flights giving the opportunity to experience flight
• Flight simulator
• Meet MAF pilots and staff

Don’t miss out on a good day out, especially if you want to learn more about mission aviation or Mission Aviation Fellowship. More info click here and download the brochure here.

Share on Facebook

Becky, I, Dad, Mum, Katie & Alex

Share on Facebook