Tuesday, August 5, 2014

Finishing up the work

Sunrise in Long Island (by my apartment)

When I was out jogging, I took this picture of the sunrise

This is where a member lived who had lost a leg.  Missionaries would wheel him to church each week

At one time there were houses here but they were all torn down
Rariok Elementary
Children waiting for school

School children at Rairock Elementary.  Each school wears a different color uniform  Children are not required to attend school and so you often see many of them just playing in their neighborhoods or beach.  Some come around selling coconuts, shells, crafts or other items.
Touring the Copra Plant  Brother Levi in my ward took us on a tour

Copra is one of the only industries in the Marshall Islands.  There are hundreds and thousands of coconut trees.  People on the outer islands and some in the rural areas gather coconuts and husk them and put the meat into bags to be taken to the copra plant.  Coconut oil is made along with soap

Elder Holman and Elder B  working with copra on Ebon

Brother Levi works for the Copra Company and took us on the tour

Sisters Gardner, Barlow, and Wayas

Boat that brings in bags of coconut meat

Mounds of coconut meat

Farewell to Elder and Sister Barlow. 

Sister Wayas, Sister Barlow and Me

Elder and Sister Barlow and me. 

Elder Barlow, Elder Wayas and Jefferson
Ruby and I at the airport seeing the Barlows off

Rutha's grave

Grave Sight
My good friend Rutha Amsa passed away from complications of diabetes and kidney failure.  She and her husband and family were dilligent and wonderful members.  Rutha had served as the YW president and counselor and Herbino served as the mission leader and the YM president.  Rutha  suffered from diabetes and she came to a class I helped with and I  was able to help her learn how to use her glycometer.  I also helped her with a few other health problems she had.and tried to keep her in some strips.  As she got worse, Ruby and I went to see her at the hospital and she wanted to talk to her daughters who live in Utah.  We were able to help them talk through skype and she died shortly after talking to them.
Rutha's burial sight

In the Marshall Islands, the caskets are often above ground or partially above ground.  Many people place these graves right in their yard or in a family area.  They are buried with their belongings.  First there was a traditional Marshallese service in the home, where different groups of people come in and sit on the floor and someone from their group speaks (like LDS or friends etc.) Everyone walks past the casket and leaves a dollar.  After the group goes out the family provides food such as rice, chicken, etc.
Rutha's Casket

Dedication of the grave
After the traditional services, Rutha had a traditional LDS funeral and  it was nice with singing, talks by the Bishop, Stake president etc.  Then the family lines up by the casket and the people go by and speak to the family and the casket and then the family handed out more food.

Then everyone drove to Ajeltake where the burial was in a small cemetary.  After the grave was dedicated, the family again served food.

There was a lot to do to finish up the work.  I was not going to be immediately replaced so I needed to write up a lot of information to leave for the nurse who would eventually be called.  They promised me at missionary medical that an RN would be called soon.  Some things I had been trying to get done was to organize all the medical files which I did.  I kept a hard copy of each missionaries medical chart as well as an online one for missionary medical.  I updated all the outer island protocols, and first aide kits, ordered medications, wrote  up intake and release protocols, and instructions as well as updating all my protocols.  I had also wanted to get some pictures of the medical equipment that had come in the container along with the evaluations by hospital staff.  I continued to pursue getting these, but due to the fraud scandal going on at the hospital, I didn't get as much information as I would have liked and most of the medical equipment was still left in the container. I plan to pursue it with the new nurse who comes.  I also was very busy with sick missionaries.  TB became an issue with two missionaries requiring further testing after having been exposed to an active case of TB.  I also had to cover for Sister Cassita who left Kiribati for a few weeks to take care of some health problems.  I handled several hard infections, Zika Fever,  leg infections, and respiratory infection by phone from Kiribati and Kirimati .

 Another episode of King Tides:  The damage was especially bad in Rita.  Some of the missionaries in those areas were able to help with the clean up

The tides came up over the road causing a lot of damage to homes and roads

Areas had to be built up to prevent more damage

Damage from the flooding

Medical Issues

A cyst on the top of a lady's head. 
 There are many medical issues in the Marshall Islands.  I read that the Marshall Islands has the highest rates of TB in the Pacific.  Type II Diabetes Mellitus is very high also.  Many of the people are caught between two worlds...the old world where they just lived off the land and the new world that has rice brought in from Asia, and sweets and candy and ice cream brought in by modern world.  There are little man wiias everywhere (stores) that carry a few things like bags of rice, canned spam and corned beef, oil, candy, doughnuts, and ice cream.  There are two major Ameican type grocery stores and a bunch of smaller Asian type stores with food.
Another view of the lady's cyst.  The senior missionaries that saw her on the outer island tried to get some help for her by having Dr Pinano call eht
 This is a cyst that is located on the top of  a lady's head.  She is diabetic and according to Dr Pinano, it is common in diabetics, especially when the health care is limited.

Sores  on  a baby's legs on the outer island Dr Pinano was able to prescribe medication for it.

Other major medical issues among the people  are: ambeosis like entomeoeba histolytica, and giridia, dengue fever, blindness, kidney problems, amputations (due to diabetes) dehydration, infections

Missionaries biggest health problems include: dehydration, diarrhea and GI problems, infections, P Day injuries, stress, and mental health issues.  Dengue Fever or Zika Fever  can be a problem but we didn't have any cases in the Marshall Islands while I was there.  They had several cases among the missionaries in Kiribati

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