Kara comes to visit

What fun (and a bit of crazy timing!) it was for my sister, Kara, to come visit. She showed up just one week before I was scheduled to leave on Home Assignment. A week that was crazy busy as I wrapped up my responsibilities and said my see you laters to teammates and friends in Indonesia. She spent a week with me in Serukam and then we spent a week exploring the island of Lombok and its beautiful waterfalls and beaches. Here are a few pictures of our time together...

She is here! A long trip by yourself!! 

Enduring one of her many "paparazi" moments when everyone either wants to take her picture or take a picture with her.

And then we were off to enjoy some time on the island of Lombok (next to Bali)

We stayed at a lovely AirBnB with a pool and we were the only guests for most of our time. 

We also had several beaches in walking distance

And there is nothing like sunset on the beach!

We also explored the jungle and some waterfalls. 

And fed peanuts to some hungry, loud, and bossy monkeys

And then with a transit in Kuala Lumpur, Malaysia and Taipei, Taiwan (with its many fun decorated lounges) we headed home to the US

Graduation 2017

With much joy (and a sigh of relief) we have wrapped up another academic year. We celebrated at our Graduation Ceremony last Thursday as 37 new nurses graduated. They started as a class of 45 with one withdrawing, one taking a year off for financial reasons, and the remaining students have not yet passed all their classes. Some might consider having students who didn't pass a bad thing but here we have been working really hard to make sure we hold our students to a high standard and having teachers willing to fail students is a good thing. Many of these students come in with a very weak academic history and just need to take the program at a slower pace with some extra help and tutoring. 

Join us as we celebrate these 37 new graduates. The video below contains a few highlights of the singing, dancing, and speeches that make up a graduation ceremony here. Pray for them as they take their Nursing Board exam in October. We have the highest pass rate in our province but it is still far from 100%. Five of the graduates with the highest GPAs will be able to continue their education and have their bachelor degree paid for by our local government. Pray for us as we continue to strive to hold our students to a high standard in the knowledge that as a nurse they will be responsible for patient's lives. We will be having a meeting sometime this week to discuss several of our students who are struggling. 

For those reading this in your email program, videos sometimes aren't visible and you will need to click the link below to go to the blog to watch it or watch it on YouTube here (https://youtu.be/5CKwgGxAeDw) 

Ujian Akhir Program - Final Program Exam

We just wrapped up our Final Program Exam for the senior class. This is the second time I was a test examiner. This exam is a three-week process and includes a practical portion, a written paper, and oral presentation/defense. A lot of work for a diploma!

Week 1 - the students cared for a patient for three days in the hospital shadowed by an examiner and graded on their patient assessment, intervention skills, and patient teaching.

First morning - after they picked a card with their patient room number and diagnosis. Before that they didn't know what type of patient they would have. It could be anything from a pregnant woman, to a child sick with pneumonia, to an adult admitted for a medical reason or a surgical case. They had two hours to complete a full assessment and write up a nursing care plan before they were quizzed. They were not allowed to look at any books or resources during this time. 

Some were happy at their assignment :)

Others not so much :(

Phew - first day over! But before they found out how much homework they had to prepare for their shift the next day :) 

Sometimes your nursing intervention test of giving a nebulizer treatment to a young patient with pneumonia can result in cuddles. (I had permission from the patient's parents to take a picture)  

Our team of Nursing Teachers and Examiners. We can be all smiles or we can leave you searching for the right answer for many long minutes ;) Both of these teachers are leaving us next year.

Week 2 - they wrote up a nursing care plan and paper on the disease process their patient was experiencing in consultation with their assigned nursing instructor. I consulted with 7 students.

This what the final result was at the end of the second week. This is a nursing care plan and case report for an adult patient with typhoid. 

Week 3 - they did a presentation on the paper they have written and then faced questioning by three examiners for around forty-five minutes. Only after successfully passing this three-week process are they officially considered graduates of our program.

First day of oral exams.  

One of the students doing her presentation. They are limited to between 10-15 minutes. 

This is followed by answering the examiner's questions and defending their nursing care plan. 

I think we were all glad to be done with the process. Final results will be discussed and announced tomorrow morning. In the afternoon they receive an official letter stating they have officially passed the program. This letter can be used to a a position contingent on passing the nursing board exam. Graduation will be next week, on August 3rd. 

The end of the academic year is in sight! I still have a lot grading for the other three classes I taught this semester and grades are due August 2nd but am making steady progress. A big prayer request for the Nursing School... we have recently lost three teachers, leaving us with just four nursing instructors for 130 students. We do thankfully have several masters of health teachers to help out and we also work with several nurses from the hospital, but still that is a tough loss. One of the teachers will be returning though in a few years after she completes her master's degree. To my understanding, there is not a single program in all of Indonesia that allows you to get a master's degree in nursing while also working anything close to a regular schedule. All require at least partial relocation for at least several weeks at a time. Pray we can fill those vacancies with experienced nurses with a passion for teaching and serving, preferably before the new school year starts September 4th.

Going Grocery Shopping

So you want to go grocery shopping with me? Shopping is a bit different here, although probably not as different as some might expect :) So what's on your shopping list today? Many things we can get locally because although I live in a village, it is on the main road between two bigger towns and has the hospital with many employees living in the area.

Need fruit? We got several choices but probably different choices than you are use to. You can almost always find bananas in all shapes and varieties - so far have counted 16 different types. We even have ones that you are suppose to eat while they are still look green and yet are ripe. Pineapples are also frequently for sale (and we have several plants near our houses too). Oh and oranges are actually green here and have seeds, so watch out. In our village area though you can't find apples, pears, cherries, peaches, berries or grapes etc although we can buy apples in Singkawang (more on that in a minute).  There are days I really miss some of those fruits especially being from the beautiful Pacific Northwest.

Locally we also have a small canteen that sells ready-to-eat food. No McDonalds here though! For a little less than $2.00 though you can get a nasi bungkus (rice package to go) with some meat (or other proten source depending on how much you pay), vegetable, and rice. Oh and don't forget the hot sauce! You can also get fried rice and noodles here. Most of my students eat here on a daily basis. Our patient's families also buy food for themselves and the patients here.

Don't have time for a trip to the market in town. You can order many things from your motor sayur (vegetable motorcyle - although they deliver more than vegetables). These drivers head into town in the middle of the night and load up their bikes at the market and then have different areas and times when they deliver to different villages farther out. Some go to the morning market and then deliver in the late afternoon. They usually have the basic favorites like green beans, a several green vegetables, peppers, sometimes fish. Your best bet is to develop a relationship with one who you can order food from and know what time he arrives in your area. Course delivery is still hit and miss based on what he can find at the market that day.

Last shopping option near us are several smalls stores down front. Their selection has really improved in recent years, especially one Chinese family who seems to have a pretty good supply chain including things imported from Malaysia. You can buy lots of things including rice, flour, eggs, soap, noodles, umbrellas, buckets, water, liquid propane gas, sandals, towels, and the list just goes on and on. That said things are more expensive than going to town usually. I try to buy the majority of my big shopping in town but then supplement with things from here as needed both to support them and for the convenience. Most of this local shopping is done by my helper. She cooks me an Indonesian lunch daily with usually rice, some meat, eggs, or tempe, and a vegatable. Today for examples that was chicken in red sauce that she calls ketchup with some green beans.

Once a month or so though I head to the town of Singkawang, which is only about 45 km away but takes a little over an hour to get to thanks to the curves and potholes. I don't drive here (yet) so have a car and driver that takes me and I usually make a day of it, eating lunch in town and enjoying the break. Singakwang is considered a town by Indonesian standards but it has almost 200,000 people living in it. About 3 years ago they even got their own mall with a supermarket that has many things that before we would have to travel to the city 5 hours away to get. So I can now get fresh butter, milk, cheese, (although both are expensive so I don't get them very frequently or in limited quantities) and many other things. It even has a bakery that sells hot dog and hamburger buns. Things it doesn't have though include any frozen microwave meals, a good cereal selection, the normal snacks and treats you would have in America. Here are a few pictures of shopping in Singkawang...

These use to be the only supermarket type stores in town before the mall opened and selection was much more limited. They have no refridgerated section, so powdered milk and canned butter were our only options for example. They also do not have any sort of carts and so instead you fill baskets you carry in very narrow aisles stacked with stock. I make quite the spectacle as I only go shopping here about once a month and buy a lot more than the average Indonesian family as most Indonesians only buy enough supplies for a couple of days or at the most a week.

Singakwang is located on the coast of our island, so there is good supply of many types of seafood. I usually try to go to this market and bring a cooler with me to stock up on vegetables and fish. After my monthly shopping trip there is little room in my freezer :) 

And then about three years ago after long months of waiting for construction to finish, the mall finally opened. In Indonesia it is popular for a nice hotel to be attached to the mall and that is still under construction but some rooms opened early this year. At first I thought that was a strange idea but now I like the idea. Most places in Indonesia like to have a soft opening first where just a few basic services or stores are available. For this mall some of the first stores opened were the supermarket and the department store. For awhile there those were the only stores open though and there was fears the mall would fail. Then though the movie theater, KFC and a donut store opened and things started to look more hopeful. Now there is quite a good selection from a bakery to kids stores, to cell phones. Just this month several new stores opened. This place can be completely packed when they have one of their special events (like a basketball court in the center having a tournament) but I like to go on a weekday early enough in the day that kids aren't out of school yet. It is a lovely break in the AC, with some yummy food and there aren't long lines at the supermarket. 

Hypermart is the name of the supermarket and while its stock can vary a lot and they can be months where there is very little in stock, it is a refreshing change to shop here. I am actually really impressed that they can keep things like fresh butter and cheese in stock although in rather limited choices. At the most we have two different brands of butter and usually only one. Cheese here is $50 a pound. Yikes! Hence the need to put myself on a food budget once Hypermart opened :) They also have baskets and wide enough aisles to get through, although they do like to stock in the middle of the day, so sometimes if they have just gotten a shipment, it can be tricky. I definitey make quite a spectacle here and frequently despite other cashiers being open everyone will line up behind me to see what all is on my cart and commenting on it. Most days I can take it in stride but there some days I have to admit the getting stared at and all the comments can be quite frustrating. By the way even at the big Hypermart in the city 5 hours away they still don't have belts of any sort leading up to the cashier so you have load and then push forward all your purchases. 

The final stop on our way home is usually the fruit stand. The family that owns the one I like to shop at use to have a regular motor sayur route out in Serukam and we developed a good relationship with. He then stopped coming to Serukam but opened this fruit stand. It usually has a good selection, including Chinese grown apples, watermelons, papayas, and lots of other fruit in seasons. I have now developed a relationship with this man's daughter and we always enjoy catching up briefly when I stop for fruit. They frequently give me some extra oranges or a discount and it is just nice to shop where you are known and they know what I like. 

And to end up on a funny note, this was the cereal aisle at Hypermart in the not so distant past. How does the variety compare with the US? All that to say I am looking forward to my Home Assignment in a few short months and enjoying some of those things you can only get at home in the Pacific Northwest!

Capping Day 2017

It was a special Friday at the Nursing School on March 3rd as our freshmen class who had just completed their first semester had their Capping Ceremony. This is an old tradition (pretty sure it was imported somewhere along the way) where students get to wear their white uniforms for the first time. Female nurses still wear caps here and this is their first time wearing them, hence the name the of the ceremony. One of the best parts is we got to meet their parents and families. There is no parent orientation at the beginning of the school year here, so we do a meeting on Capping Day for them.

This ceremony also signifies that they will be allowed to do clinicals in the hospital this coming semester. We were talking in the office at the Nursing School this week how just wearing the white seems to give them more confidence. It was a really rough first semester with more students failing more classes than ever in recent years, so we can hope that will change this semester as they continue to mature. I don't teach them in their first semester, so I am looking forward to getting to know them and teaching them Nursing Fundamentals this semester like how to take a blood pressure and do a physical exam.

Ok time for the pictures and a couple of short videos (for those reading this in your email you might need to click the link to go to the blog to watch the videos).

Our freshmen class. The student dressed in yellow in the center represents the Florence Nightingale Pledge they take

One of the parents shares that they are entrusting their kids to the Nursing School, which is important culturally here

Dr. Paul shares some words of wisdom about surviving school and the responsibilities of being a nurse

The three students with the highest grades

This is our official Nursing School song that talks about how the school was founded by God and they want to be students here to be shaped and educated by teachers and staff who will lead well and give them lots of work so they can be professional nurses.

They then sang a second song about our motto that is from Ephesians and speaks about how we were all created by God, so that we can do the good works He has prepared for us.

The final song was for their parents. It is a classic Indonesian song that talks about how their parents raised them, loved them, and cared for them and how they are the best. As you can see, we lost "Florence Nightingale" to tears before we even finished the first verse and most of the first row and many others were crying by the end. For some of these students it was especially hard because their parents weren't present because they have passed away already.

Please be praying for us teachers and the students as we seek to not only help them become knowledgeable nurses but model a servant's heart that has compassion for others.

Field Fellowship 2017

Oh what fun it was in late January to gather with our whole team for our annual meetings! We have a growing team, which included three new arrivals - two long-term women and one short-term young man. While we serve on different islands and in different ministries it is so good to get together, share our joys and burdens, and pray together.

For those able to, we spent the first day and a half just enjoying time relaxing, shopping, and eating fun places together. Then the remaining few team members joined us and we spent three full days in meetings and wrapped up with a time sharing Communion. I didn't take a lot of pictures because I was just enjoying being with everyone but here are a few taken by other members of our team...

We spent the first evening praying for the unreached of Indonesia, each other and our ministries

We also took time to pray for our two newest long-term team members. They are settling in and tacking language and culture study. 

We also spent time with men and women meeting separately to do some more in-depth sharing where where we focused on hope. 

And I got to spend time with some of my favorite people - the young members of our team. 

Hanging out and taking selfies with Beatrice. Her big sister Annie is behind her.

Hanging out with our youngest team members. I was present at all of their births here in Indonesia. 

Please be praying for the baby I am holding in my left arm. There were concerns about his development during our time in Jakarta and further testing in Indonesia has shown what may be a major problem. He is being evacuated to Singapore in a few hours for further testing and possible surgery. His name is David and he is two and half months old. 

Christmas Celebrations with Students

 *Very late post :) *

One of my favorite parts (but also very time consuming) of the Christmas season here in Serukam is the opportunity to invite the Nursing School students to my house before they leave on Christmas vacation. This year because of the accreditation visit things had to be moved up by a week leaving me scrambling a bit to get enough food baked but in the end it was fine. So for three nights I hosted an open house at my place. Here are some of the fun pictures from those open houses... 

You can tell where the party is by finding the house with all the noise and shoes outside

A necessary requirement is a lot of food! 100s of cookies and at least one cupcake and can of soda per student required. 

And after that is all about fun, singing and eating...

I keep busy keeping food on the table and taking a lot of pictures with all the different students. By the they are ready to head home my smile is wearing a bit thin :) 

These two young ladies (Dolina in the center and Gusniati on the right) are two of my "anak PA" or students that I provide academic counseling for. In this case they are both 2nd year students. We meet regularly through the semester to make sure they are doing well physically, spiritually, emotionally, and academically. Both of these young ladies consistently get the top grades in their class. Unfortunately, my other student from this class, Nimrod, routinely receives some of the lowest grades in his class and is struggling to pass. Please pray for all of our staff and teachers as we seek to teach and mentor these young nurses-to-be.