To God be the Glory

In reference to our last post, we went back to the hospital on Thursday. The first thing I did was go to the OB ward to see if the little girl and her mother were still there. I could not find them so I looked in the report book from earlier that week to figure out what happened. I discovered that the baby passed away only a short while after we left the hospital. I grieved the loss of the little girl but remembered the life that we were able to give even if just for a short time. I prayed for a miracle for the little girl but God had other plans. Maybe he did perform a miracle but just not in the way I was thinking. I live to bring glory to God in all situations, including this one. So today I remember that even though the situation didn't end up like we would have hoped, somehow God has been glorified and that will be enough. We gave that little girl and her family everything we had and gave her life for just a few short hours. I don't see the full picture of God's plan but I know that He is still in control. To God be the glory forever and ever Amen!!!

On a side note we have safely arrived in Zimba!!! Thank you for your prayers!!

Love Margaux!!!

Twins!

We have been in Choma now for almost two weeks. Our time here has been filled with many new and unexpected events. Choma General Hospital is where we spend our time for clinical three times a week. Each clinical day we are split up into groups of two or three and are sent to different wards throughout the hospital. Some of us have had very uneventful days, while others have had extremely overwhelming days. We have all been able to learn from each other’s experiences and have been very thankful for the opportunities that we have to love and care for these people.          

This past Monday I was assigned to the maternal ward with Margaux. Prior to this trip I had never seen a birth or C-section, so I was very hopeful that when we arrived at the ward a mother would be in labor and we could assist with the birth. God had so much more in mind for us than just that. Right as we walked into the ward we went to set our bags down at the nurse’s station. The nurse had just walked out of the labor room and told us that a mother just delivered twins and we could go in and help. We walked in to find the two babies wrapped in blankets on the warmer. The nurse was attempting to resuscitate one of the twins, who at that point was not breathing and was beginning to turn shades of blue. The mother was still lying on the table and the nurse asked if we knew how to deliver the placenta. We told her we did not, but we could continue to ampu-bag the baby in attempt to help him start breathing. Before we left for Africa our team learned a technique called “helping babies breathe”. The purpose for learning this was so that we could take kits over here with us and teach the technique to the traditional birth assistants. I think neither Margaux nor I thought we would have to actually use those techniques by ourselves. I am very thankful that we were educated on resuscitating new born babies. It enabled us to jump right in with confidence and begin bagging the baby. We were both praying and hoping that this little boy would begin to breathe. After about 15 minutes he started responding and began to breathe on his own! What a miracle! By the end of our clinical the little boy was with his mother feeding and still breathing well. Praise God.                                                                                              

After the emotions of that experience,  I expected the rest of our day to be a little less eventful, but I was very wrong. During the time that we were working on resuscitating that little boy there was another woman lying in the labor room. She was only 6 or 7 months pregnant and was in premature labor. Her pain began to obviously increase while she was lying there and we were waiting hoping the Dr. would arrive soon. However, the Dr. did not arrive and she began to give birth… another set of twins! The first baby was born and was not breathing. Margaux and Kristin took the baby over to the warmer and immediately began ampu-bagging him. The next baby, a girl, came a few minutes later and was also not breathing. We were all three working on stimulated and resuscitating these babies. Because resources are very limited, we only had one ampu-bag that had a mask that properly fit over the babies faces. We tried to make due with a bigger mask so we could bag both babies at the same time but we ended up having to take turns bagging and giving oxygen. I was primarily working on the first born baby that was a boy. The Dr. and nursing staff allowed us to continue our resuscitation efforts despite informing us that our efforts were futile. At that point we could still feel a pulse in each baby so we were not going to stop. After over an hour of trying to resuscitate the little boy his pulse faded away and he passed on. I will never forget the feeling of holding that little boy after he passed away. It was hard to believe that the excitement of his life beginning had already ended so quickly. My next task was to go and tell his mother that he did not make it. Walking down the short hallway to where she was laying felt like a mile walk as I dreaded what I had to tell her. She responded as well as you can in a situation like that and was very concerned about her other child. I informed her that we were still trying and would do the best we can. When I returned back to the labor room I sat and held the baby boy and just cried and prayed that God would allow for the little girl to survive. I wanted the mother to have at least one child.            

Margaux, Kristin and I continued to work on resuscitating the little girl. The mother at first was not interested in coming and holding either of the children and just wanted us to keep doing what we were doing. When the father arrived they came in to the room and he took pictures of both his children. The boy that had passed on was still lying next to his twin sister. The father’s only comment about the boy was that he looked just like their first child. Then he and the mother left the room. We had been trying on the little girl for over two hours now. She still had a pulse and was starting to have more frequent spontaneous breaths. Finally she began to have even more frequent breaths to the point where she would fight us when we tried to give her breaths with the ampu-bag. Her color began to come back and her eyes even opened a couple of times. We secured oxygen to her nose and informed the parents that she was now breathing. I think we were all in shock that this little girl was actually breathing. It was always our hope but after two hours, our already low chance of successfully resuscitating her seemed to have almost hit rock bottom. But God allowed us to witness two miracles that day…                                                                                                                                                                                                     When it was time for us to leave, the baby was stabilized on oxygen and the nurse informed us that she was going to try to start feeding her. It has been two days since we have been back to the hospital. When we return to the hospital  tomorrow I know that Margaux, Kristin and I will head straight to the maternity ward in hope of seeing this precious miracle thriving.                                                     

 

Over my time here I have been reminded that God is good all the time. All the time God is good. It is easy to become overwhelmed by life’s circumstances and lose sight of God’s goodness. But he really is always good and is so faithful. After clinical that day we came back to our house for lunch. Sometimes before eating instead of praying we sing a song. That day Dr. Bee led us in singing “this is the day the Lord has made, we will rejoice and be glad in it”. That song really hit us as we were still processing everything that had just happened. Often as we have heard local Zambian’s pray they end their prayers with “in the MIGHTY name of Jesus Christ” really emphasizing the “mighty”. Our God is undoubtedly mighty and powerful. Each day is truly the Lord’s day and with his power and might his will for our lives will always prevail.

On a lighter note, our group will be leaving Choma on Friday to return to Zimba. Our two weeks in Choma has been filled with clinical time, class work, visiting Hannah’s home town, having our own “Zambia Olympics”, and many nights of homemade popcorn, thanks to Dr. Bee. Each day holds many unknowns but I think it has been a very good challenge for all of us to let go of a little control and just patiently wait for what God has in store for us next.

Written by: Jaimee Cichowitz

Here is the picture of us up front at church on Sunday. We had just begun to sing "Lord I Life Your Name on High".

Choma

Hey everyone!

Last Friday we drove 1 ½ hours from Zimba to Choma. It ‘s been fun moving to different places, and it is neat to see how unique each place is that we are staying. The place that we are staying at now is called the Fortress, and it is a neat area that has lots of open space for us to be in. One of the unique features is that there is a pretty inside courtyard area that has green grass and an open area where we often eat our lunch or do homework.

On Sunday we went to church at Choma Central, and during the morning service all 12 of us students along with our RD got up in front of the church to sing a special song. We sang a song complete with clapping and hand motions. There was a time of testimony where a young lady gave a powerful testimony of how her mother was diagnosed with cancer, and after months of treatment she passed away. This young lady is the oldest of five children. Her testimony was that even though God did not answer her prayers the way she wanted Him to by healing her mother from cancer, God is still God. She encouraged us by saying that God knows our individual circumstances, and He has a plan for our lives, even through the difficult times.

After the restful weekend we jumped into clinicals for Monday and Tuesday. We have been at Choma General Hospital, which is quite a bit larger than the hospital at Zimba. On Monday we started out with a tour of the hospital, and then we were sent to our various clinical assignments.  I was in the ARV (anti-retroviral) clinic during the morning. The hospital provides free ARV medications to patients with HIV, and it was neat to see how many people were eager to get help and complying with the treatment—the clinic sees about HIV positive 80 patients a day!

Tuesday Andie and I spent the day on the Maternity Ward. Since there were six babies delivered the night before, most of the moms were discharged this morning (they usually discharge new moms 6 hours after delivery). We spent most of the day following the gynecologist while he did rounds, and while he saw patients for the women’s health clinic. Some common problems seen in that clinic were PID (pelvic inflammatory disease), uterine fibroids, infertility, and UTIs. The doctor was great at asking questions, and he would often say what the symptoms were, and ask us what we thought the diagnosis would be. He also let us help with calculating gestational age, measuring fundal height, and using the fundoscope to hear the fetal heart rate.

The past two days have been full of good learning experiences. Some girls on the team have gotten to help with procedures like dressing changes, Foley catheters and suctioning. We have each had unique experiences in the hospital because each ward is quite different. Tomorrow is Wednesday, and that means we’ll have a full day of class. We are all looking forward to having a chance to sit down and take a break from the more strenuous and draining hospital environment.

On a personal note, this time in Choma has been a really neat time of reminiscing for me. My parents lived in Choma for 4 years when they first became missionaries in to Zambia (I was 2 years old when we first moved here). I’ve been able to see quite a few people that I knew from my childhood, and it is totally awesome to have the opportunity to be back here again.

Thanks for reading and keeping up with us! We appreciate your prayers for us and all the new things we are experiencing here.

Love,

Hannah 

Here Come Clinicals!

Hello everyone! Mwapona buti!

It has started off as a busy and exciting week here in Zimba as we started our clinicals at Zimba Mission Hospital on Monday.  This week we have different groups in the hospital and some out in the communities doing a Measles campaign.  On Monday I was able to spend my day in the male and female wards.  The first day of clinical at a new hospital is always a hard adjustment trying to become accustomed to the protocols of the hospital and the roles of the nurses and nursing students.  The census for Monday morning included seven males and eleven females.  The male and female wards are separate with one nurse in each ward.  The hospital is very different compared to American hospitals with the beds right next to one another and no patient privacy. However, this allows for some good laughs with us practicing our Tonga with the patients and families.  The morning consisted of me following the nurse on the doctor’s rounds.  The nurses and doctors at the hospital are extremely beneficial and really take the time to explain everything and get the nursing students involved.  Their intelligence is very inspiring.  Think about in the United States how we have specific doctors and physicians in specialized areas.  For example, if someone has a heart problem they would be sent to a cardiologist.  But the doctors here are the ones taking care of everyone and know how to process through the next steps for the care of patients. 

A few of us were able to practice some of our nursing skills for the first time on actual patients.  I attempted to put in a NG (nasogastric) tube in a patient who previously had a stroke.  It was hard working with him because he was not oriented to his surroundings.  The bed siders were a big help.  It is always exciting and scary the first time doing a skill in the hospital setting compared to the nursing skills lab.  The nurse came along side of me and finished up the procedure since I couldn’t get it all the way in.  Even though I couldn’t quite accomplish the procedure, I was so thankful to get past that first experience mark and know more of what to expect. 

Nursing care looks very different here in Zambia.  The bed siders (the families of the patients) play a huge role in caring for the patients.  They are the ones who bathe the patients, clean the patient’s bed, and even hold their medications for them if the patients are gone from their beds.  I will take a safe guess and say that we all wanted to come to Zambia to be a source of help, but it was very important for us to understand the roles of the nurses in Zambia.  Even though we are used to cleaning and bathing patients in the U.S. , we cannot change the expectations of nurses here.  Working the hospital made me truly appreciate the role and help of the bed siders. 

  

Today, four of us including one of our professors, Carol went out in the community for the Measles campaign.  Since we went out into the community we had to wear our skirts and our sneakers-great look (picture included!) We were definitely out in the bush and people walked from all over to get their measles vaccine along with Vitamin A and Mebendazole (a medication to get rid of worms).  We treated children from 6 months to 15 years.  The four of us students along with some Zimba nurses vaccinated a little over 350 people!  We definitely got our practice in for giving shots.  It was a great experience and I’m so thankful we were able to be a part of this campaign for the community.   

Most of us have experienced more in the past 2 days than over a couple of weeks at clinicals in the U.S.  It excites me knowing this is just the beginning!  God continues to reveal his faithfulness and give us His strength to learn and grow each day we are here.  He truly knows how much we can handle each day and helps us through! 

Enjoy reading! 

    

Love,

Jamie Aardema

Zambian Wedding!

     Saturday afternoon, we were privileged to attend a Zambian wedding! The bride is the daughter of a local pastor and we were graciously received as part of the town “family”. Most of the students chose to attend and we began the afternoon by lathering on sunscreen and packing up our group wedding gift including pots, pans, and bowls that we purchased at the local market earlier that morning. After a dusty three mile walk, we arrived at the celebration!

    The pastor gave a message to the couple and wedding attendants that included  most of the Biblical passages that reference marriage. He placed an special emphasis on the man and woman leaving their families and being united as one. As per tradition, the bride and groom hang their heads low and do not show any emotion of gladness throughout the entire wedding ceremony and reception. (In this culture, to rejoice as bride and groom would be to bring shame upon their family by inferring that they are happy to say “goodbye”). From time to time, an attendant would lift the bride and groom's head and stretch it from side to side followed by gently lowering the head of the bride and groom back down into the solemn posture.

     At the conclusion of the ceremony, the couple did not kiss but left with the attendants to sign the marriage documents. While the bride and groom slowly exited with heads bowed, the rest of the wedding attendants began to sing, dance, and celebrate freely inviting us to join along in the celebration! Surprisingly the singing was supplemented by a wired AV system with recorded music and we noted flashing colored lights from one of the speakers! The celebration died down only after the bridal party returned with the officiators and the signed marriage documents. The signed documents were lifted high and the attendants cheered and the women chimed in with high-pitched shrills of approval. It was time for the reception!

     We made our way out to the huts and were introduced to the traditional Zambian drink pronounced “chibwantu”. It is made from boiled corn and rice flavored by a particular tree bark. The missionary couple explained with a smile, “It is known as the drink that you can chew”. Mmm-mm. Everyone gave it a try, a few even had seconds!

     As everyone gathered for the reception, we practiced the Tonga greeting phrases we learned and smiled and laughed with children. We were seated as guests of honor right next to chairs reserved for the bride and groom. It is uncomfortable to be treated with such hospitality but the smiling demeanor of the hosts and their graciousness only implied that our presence was a delight. To say it was humbling would be an understatement.

     Several dances ensued at this point, including several from the bridal party which ended with a surprise throw of hard butterscotch candies and gum. Let me tell you, these gals did not throw underhand – a few of us got caught off guard, especially when the first row ducked! The one disadvantage to having a front row seat of honor! Finally, the newly-weds followed them in – yes, heads still bowed! (If they are caught with a smile on their wedding day, they are punished with a small fine payable to the master of ceremonies - we were assured it was small.) Mercifully, after another head stretch, they were each brought some orange soda to take as refreshment, but even still, the newly-weds were very reserved and methodical in movement.

    Several cakes were brought before the couple, but before they could cut the cake, one last dance was in order: the knife-girl dance! A young preteen girl danced her way to the couple bringing the long-awaited utensil. The married couple cut a piece of cake together, the groom fed his bride, and finally they kissed! (...but still no smile! Too bad for the MC!)

     Each attendant individually presented their gift while the crowd peered on and many sang and danced. Traditionally, when all the gifts are collected, the cash amount and total number of each utensil, bowl, and item is announced. We missed this part as we were invited to dine so we could and make it back home before dark. We were given bowls of N'shima (Zambian corn-based staple) and beef with broth – it was so good!

     It was a lovely 3 mile walk back home. The temperature was comfortable and we all talked and processed through the happenings of the day and continued appreciating the stark silhouettes as they formed on the Zambian horizon.

     In case you are wondering, the married couple is allowed to smile...the next day. :) 

Posted by RD - Kristin

p.s. just in case you were dying to know, our fantastic round-about-navigating, traffic-squeezing bus driver's name is Potiphar! (inspired by Genesis 39)                                          ~elisabeth

The Bus Trip from Lusaka to Zimba

“For he shall command his angels concerning  you to guard you in all your ways.  “ Psalm 91:11

It is probably best that a team leader describe this day in our Zambian adventures. We were up at our usual early time for breakfast in Lusaka.  We then had to find a place for twenty passengers, twenty-two 50-pound suitcases and another 18 carryon bags on the bus!  No way!   The bus driver (thinking ahead) had hired several welders to come and construct a trailer hitch that would fit on the back of the bus.  He located a small closed trailer and between the trailer and several seats in the back of the bus, we were all scrunched in for what they said would be the five hour drive to Zimba.   For the first two hours Mrs. Bence taught her Leadership class on the bus, with students working in small teams and giving reports while we jounced along.

About two and a half hours out of Lusaka, we entered the hill country.  The bus was struggling to pull all the passengers and trailer up the grades and finally the engine over-heated.  We pulled off the side of the road and waited about 60 minutes while the engine cooled. Fortunately, the driver had plenty of water to re-fill the radiator.  The students were great---playing group games, singing and improvising a “restroom” of sorts with those wonderful long dresses (chitenges).

Back on the bus and down the road.  We had a nice rest-stop and ordered lunch at a “fast food” restaurant.  One of the students (Samantha) ordered “fish and chips” and sure enough, she was handed a complete deep-fried fish---fins, tails, eyes and all along with her French fries!

The trip seemed to be going on forever, since the bus had to drive rather slowly to avoid overheating.  About a half hour out of Zimba, we heard a loud “bang” and pulled off the highway. The driver assumed we had experienced a blow-out, but all the tires looked fine.  While we were waiting a car slowed down and stopped to see if we needed help.  A Zambesian and  American walked back. The Zambesian recognized one of the students (Hannah) who had grown up in Zambia as a missionary kid.  The American turned out to be a former student of Dr. Bee’s a  Rob Murphy who is now a missionary in a nearby orphanage!   Small world!

Back in the bus and down the road.  Only now the bus was really straining and the engine was smelling a bit hot.  Finally, the bus conked out altogether just on the edge of the town of Zimba.  Ahead of where we stopped –about 50 yards—was the gate to the mission house.  It turns out that the loud bang was the radiator hose exploding into smithereens.  Nearest replacement part?  50 miles away in Livingstone.  But we were able to walk the few steps to the mission house, the hosts there used their Land Rover to bring the trailer to the front door and the adventure comes to a wonderful end.

Parents, your daughters were troopers! The “five hour” trip took over 9 hours!  What a great team of women to have on this trip.

So do I believe in Divine protection?  You bet!  Your prayers and God’s lovingkindness have brought us safely to our new home for the coming week.  We thank him for his goodness tonight.

Dr. Bee (Bud Bence)

September 5, 2012

Yesterday (September 4, 2012) we spent our day touring some local hospitals in Lusaka.  The University Teaching Hospital is the largest hospital in Zambia.  It has 1800 beds but is very understaffed.  We had a meeting with the charge nurses of each unit in the hospital and they briefly informed us of what their job was like.  At this meeting, we sat in a large conference room and we were served coffee/tea and some pastry type things and biscuits.    It was obvious that they were excited to have us there!   The nurses at UTH reported that at times the nurse to patient ratio is 1:100!  This is unheard of in the states!  In the U.S. the nurse to patient ratio is 1:4 or 1:5.   At UTH there were many nursing students and it was very interesting to talk with them.  Nurses in Zambia do not get to choose where they work.  After they graduate nursing school, the government places them wherever there is need meaning that they might be forced to leave their families.  This would definitely be really hard for me and it would make me think twice about becoming a nurse in Zambia!  After touring UTH we had lunch and then went to Levy General Hospital.  We also went on a tour here.  It was much newer than UTH but much smaller.  Overall, our day was successful but also very tiring!  I was impressed with the nurses at both hospitals we toured. 

Today (September 5, 2012) we started our day at the Beit Cure Hospital.  Right when we walked in, all of us were overcome with positive feelings and good vibes.  This hospital was awesome!  It was like the Riley Children’s Hospital of Zambia.  The staff was very happy to have us there and greeted us with open arms.  The Cure hospital focuses on treating children with neurological or orthopedic disabilities.  Some of the main disorders that they treat are hydrocephalus, Myelomeningoceles, spina bifida, club foot, and cleft palate (just to list a few).  While we were there, we saw many children in casts and with hydrocephalus.  The woman that led our tour was adamant that we all come back after we graduate and volunteer at this hospital for a year.  It was really funny because each staff member that she introduced us to, she introduced us as American nursing students that were coming back after graduation to volunteer for a year.  Personally, I would to have the opportunity to work in the Cure Hospital.  The government does not fund the Cure Organization so they have a hard time keeping nurses and doctors on staff.  The government in Zambia provides great benefits to those in the healthcare system so it is definitely a sacrifice to work for a non-government hospital like Cure.  The hospital had a few different units and each unit was a separate building.  It was open air and on an absolutely beautiful compound.  There was a place for the children to play, a place for the mothers to do laundry, a garden, and a cafeteria.  There was another group of volunteers there that made booster seats, bookshelves, chairs, and toy boxes out of recycled materials and uses a sealer that makes the items feel very solid.  These items are then sold or used in the hospital for the children there.  This group then teaches some of the children at Cure how to make these items so that they will have a job in the future. 

Overall, we were all extremely impressed with the Cure Organization.  It was a kid-friendly hospital and seemed like an ideal place to work.  Cure is a Christian based organization and the staff has the opportunity to provide holistic care for each patient by sharing the love of Christ with them.  This is something that all of us were encouraged by.  The Cure organization definitely needs donations and anyone can make a donation and learn more about this organization at www.cure.org!  So please visit the site and see what you can do to help!  It is definitely worth your time : )  They have a program where you sponsor a child that needs surgery and track their progress.   I have not had a chance to check out the website yet but I am confident that all donations are for a great cause! 

After we left the Cure Hospital we went to a nearby mall.  The mall was very Americanized and it had some great shopping!  Most of us just shopped at the grocery store and mainly bought chocolate!  They have Cadbury chocolate here and it is delish!  We then went back to the compound and had lunch.

After lunch we had two meetings scheduled.  One with CHAZ (Churches Health Association of Zambia) and World Vision of Zambia. 

On a side note: we brought a bag of Bibles to give out while we are here in Zambia.  We have gotten to know our cook and housekeeper very well, and while we were gone they noticed the stack of Bibles in the corner.  They asked what we were doing with them and one of our leaders (Dr. Bee) told them we were planning to give them out to whoever needed one.  They asked if they could have one, Dr. Bee said “of course,” and told them they could pick out whichever one they wanted.  Esther, the housekeeper was so pleased to finally have her own Bible, that it brought tears to her eyes!  We were all very touched by this story and it brought tears to many of our eyes!

It is our last night in Lusaka and we are leaving for Zimba at 9am tomorrow!  It is a 5-6 hour drive and for 2 of the hours, we are having seat time for our leadership and management course.  It should be an interesting drive!  We will update you all again in Zimba.  Please continue to pray for us!  We will definitely need your prayers in the weeks to come!  God is so good and we are being reminded daily of this in our devotionals!  We love and miss all of you!

Love,

Haley 

Hello all!!!

We have a few days under our belt now. Yesterday, (Sunday), we attended the John Howard Pilgrim Wesleyan Church. It was a very lively service full of singing and dancing. It was one of our first emersions into the Zambian culture. One of our team members, Mim, actually got up front and danced with some of the Zambians. One of our team leaders Dr. Bee (Bud Bence) preached the sermon at church on Sunday. Church lasted about two and a half hours. After church we went back to the guest house that most of us are staying at and ate lunch. Following lunch we had a meeting with a lady named Sarah. Sarah is the Chief nursing officer of nursing education, management, and practice for the country of Zambia. She shared with us about how community health centers and health care in Zambia work. We were able to ask her several questions about how health care is provided here in Zambia as well as cultural views on different aspects of nursing. She was very insightful. After that we had some free time where some of us took naps and others of us went on a walk around the compound. In the evening we all gathered around the piano as Lily/Elisabeth played and we sang worship songs. It was such a great time of fellowship.

Today we had class with Dr. Bee. In the afternoon we were able to go to a cultural village market and buy a few gifts and souvenirs. Many of us got purses and chitenges and some African jewelry. Chitenges are basically 2 yards of very colorful fabric that Zambians wear over their skirts or just as wrap around skirts. The market looked like a traditional African village complete with thatched huts. The huts were all filled with lots of different things like giraffe statues, little wooden chairs, bowls and wooden spoons. Many of us were asked to trade things that we had on us for objects in the market.  After some persuasion, Ashley actually ended up trading the skirt she was wearing for a chitenge in the village. After the market we attempted to be studious and read our nursing textbooks out loud together as a group. So far I have really enjoyed my time here. I am still trying to take in all of the cultural differences but enjoying my time here getting to know the other members of the team. We will spend the rest of this week having tours of local hospitals and meeting with some of non-governmental organizations including World Vision here in Lusaka (the capital) and seeing how they work and what they do.

Love
Margaux

All of us dressed in our Sunday best getting ready to head to church on the bus

WE MADE IT!

We made it safely! Trying to get adjusted to the time difference.  Had an awesome time in London during our layover.  We got to see the changing of the guard at Buckingham Palace, Big Ben, Westminster Abbey, and many other attractions.  This week we will be in Luska visiting different health care facilities and getting a feel for the health care system here.  Thanks for all of your prayers! We love and miss all of you at home!