Kudjip has been my home for the last two months, where I am working as a medical doctor at this 120-bed hospital. As well as a lot of learning and growing medically, I’ve enjoyed grappling with a different way of seeing the world and particularly illness. These experiences have challenged some of my own ideas, as well as provided opportunities for me to challenge others’ beliefs and speak Christ into difficult situations.
One experience that will stay with me for a long time was Baby of Katherine.* Babies here are not named until they are several months old, as the chances of babies dying in the first few months is so high, so all nursery babies are just Baby of ".....". This baby was born at 1.7kg and progressed well for a few weeks before suddenly becoming very unwell with a presumed infection. After starting antibiotics, I was called in later that night as the baby stopped breathing. While we can breathe for the baby for a short time, apnoea is usually the end stage of overwhelming infection and the baby will soon die. However, the nurses were not as busy as usual, and so kept breathing for the baby as long as they were able to. Miraculously, I arrived the next morning to find Baby of Katherine still alive and starting to breathe on its own again after our nurses ventilated the baby by hand all night. Baby continued to improve as the antibiotics worked, hit the 2kg mark a few weeks later and was recently discharged.
As I marvelled over this baby’s miraculous survival and our staff’s dedication, one of the midwives stated that the baby had, of course, improved as a longstanding disagreement between the parents had just been sorted out. I was taken aback with her understanding of this baby’s illness, and her attribution of the cause. But this is not an isolated case. I’ve seen time and again similar links made.
Traditionally in PNG, there is always someone or something to blame for death and illness – a curse placed, bad spirits, something put inside the body by someone else or trouble between family members. As I start off in this context, I’m still learning, trying to understand where these beliefs come from as best I can. Where the safety of a patient is at risk, I will try to challenge these beliefs, but respect them where I’m able to do so safely.
The addition of Christianity to the animistic culture of PNG sometimes just changes the attribution to someone’s sin. This can be hard to argue with biblically, with many examples of illness and death caused by sin, such as David and Bathsheba’s first son. Yet we are not held captive by fear of other spirits, and through Jesus’ blood we have the forgiveness of sins and power over the darkness.
One powerful example of challenging these beliefs was demonstrated to me as I watched one of our long-term doctors counsel a mother whose baby had been born blind. Often when a baby dies or has an abnormality, the mother is blamed for the outcome. She could have had bad thoughts about this baby, could have slept with her husband during the pregnancy, or simply worked too hard. In this case Scott explained to this mum that the baby had its own “plan” (Tok Pisin’s best explanation of genetics), that were likely responsible for the blindness. He then went on to explain that in the same way that people might blame her and ask what she had done wrong, so too the Jews wondered why a man was born blind in the Bible. But Jesus told them no one had sinned, it wasn’t anyone’s fault, but an opportunity for God’s power to be demonstrated (John 9, below). He challenged her that this baby’s disability provided their family an opportunity to rely on God, and to see where He was working in their lives. The relief on this mother’s face was obvious, and for me brought this story and God’s good news to life.
Walking down the street, Jesus saw a man blind from birth. His disciples asked, “Rabbi, who sinned: this man or his parents, causing him to be born blind?” Jesus said, “You’re asking the wrong question. You’re looking for someone to blame. There is no such cause-effect here. Look instead for what God can do. We need to be energetically at work for the One who sent me here, working while the sun shines. When night falls, the workday is over. For as long as I am in the world, there is plenty of light. I am the world’s Light.” John 9:1-5 The Message
On the other hand, the broad view of health can be beneficial as it means that Papua New Guineans are very open to factors other than the physical affecting their health. It reminds me of a Māori view of health or hauora, represented in one form by Te Whare Tapa Whā, the four walled house. This acknowledges not only the physical determinants of health, but the emotional, spiritual and family components. This is important teaching in medical school, but from a Western cultural and medical perspective it is often counter intuitive. We so often want a concrete scientific explanation. Seeing relationships and spirituality clearly active, relevant, and at work in people’s health certainly challenges some of my views of health and illness.
Sometimes this broader picture identifies factors affecting someone’s health and provides real benefit for the patient when considered and treated. One afternoon on the labour ward I heard one of the midwives praying with a teenager who was pregnant after a rape. She had been in early labour for some days and hadn’t established into active labour yet. Neither her nor her mother wanted this pregnancy, and so Sister Meti was praying that they could accept what had already happened. She prayed the family would be able to “lusim rong bilong em” (Tok Pisin phrase for forgiveness, literally meaning to lose the wrong of the one who has hurt you) and welcome this baby regardless of the situation. This was a really important component of this young woman’s care that I likely would have completely missed as I skimmed through her chart.
A common presentation at Kudjip is collapses, faints or non-epileptic seizures. These can be hard to differentiate from epileptic seizures, cardiac events causing collapse or other medically identifiable causes, but once we have excluded these the most likely explanation is psychological. The mind is a very powerful thing and affects our bodies in ways that we don’t fully understand. Nervous diarrhoea, palpitations when you feel stressed, and ‘butterflies in your stomach’ are all common ways that people experience this. It can come across as ‘all in your head’ or ‘made-up,’ but is far from this. This is a hard-enough concept to explain in New Zealand, where English is my first language, and I imagined it to be even more difficult cross-culturally.
Reality proved quite different as I saw several patients in this situation. One woman who came in with a possible collapse or seizure was described as having episodes where she went ‘starry-eyed’ and blank. She had had a lot going on recently – a grandson killed in a car accident and then her son in-law had murdered someone. As these thoughts turned over and over in her head, she told me it just became too much and overcame her, leading to this episode. Similarly, another woman found collapsed on the ground was a widow with four children, struggling with school fees at the beginning of the year that she just couldn’t cope with.
The Tok Pisin word for a problems or concern – hevi – is one of those I like better than the English. It describes the weight of some of the issues we carry, the way they can drag a spirit down and be such a burden. These women were both so open to the idea that their hevis had caused their collapses, which opened the door to talk about the One who offers to carry our burdens. Such a great example and a beautiful picture of not only God at work, but also a broad view of health!
To sign off, a Psalm I shared with these ladies that has stuck with me over the last few weeks as I carry my hevis.
Psalm 55:22 – Olgeta hevi yu karim, em yu mas putim long han bilong Bikpela, bai em i karim na bai em i strongim yu. Bai em i no larim wanpela samting i bagarapim ol stretpela man.
Psalm 55:22 The Passion Translation (TPT) So here’s what I’ve learned through it all: Leave all your cares and anxieties at the feet of the Lord, and measureless grace will strengthen you.
Rebekah | Day 31, GC3 Daily Prayer Guide
* Name changed for privacy.