The Big Surprise... [drum roll, please]

Dr. Emilee Flynn Arrives

On Monday night, Emilee arrived in Guyana.  Emilee has been trying to come to Mercy Hospital for about a decade to see and work with me.   Yet for one reason or another, could never get here.   Now she is so important, a distinguished senior paediatric resident at St. Christopher's Hospital for Children in Philadelphia, that I am really just helping her.   I have known Emilee ever since she was born.  She is the oldest child of my sister Monica and her husband John Flynn (I think he's also a doctor  ).   It has been many years since I actually have seen Emilee in person, so it has been a great time to catch up with her life and living... and get some new and embarrassing stories about my sister which I'll be able to use the next time the clan gets together.

Emilee has matured into a wonderful woman and sensitive paediatrician -- and she has been on the go ever since she arrived.   Emilee is interested in practicing medicine in some developing country after she finishes her residency this year, so is here to look at how children are cared for here and has accompanied a local paediatrician Dr. Malika Mootoo on her rounds and clinics for a couple of days.  When she returns she will team up with Dr. Rohan Jabour another long-time paediatrician here, as well as a new (to Mercy) Cuban Paediatrician Dr. Rosa.   

In the middle week she is travelling to Linden and then back to GT to lead a programme on Helping Babies Breathe -- a course in neonatal resuscitation.   

Emilee is walking around the Bourda Market.

with Dolly  Karran
who has a stall at the market
 and is an old friend of mine. 

I have gotten her out in the city walking around. Don't worry, Monica: she had me and my awesome strength to ward off any muggers.   As well, she has been helpful with the PBL course and other classes.  In fact, I was going to cancel my afternoon class and walk Emilee around the city; however, the students so wanted the chance to talk with her about her life and becoming a paediatrician that they begged me not to cancel.   I did not realize how much of an embodiment of their dreams Emilee represents; she is a symbol of the kind of person they wish to be.  Emilee gave them a chance to see themselves in the future .....  and for a few moments it was close enough for them to taste.  

Of course we went to St Ann's (see slide show at upper left); she also met my friend Dr. Bhiro Harry and attended several planning meetings at the Everest Cricket Club where she enjoyed some Banga and Shark as well as Plantain Chips.   She watched Bhiro and me imbibe a few drinks and she stuck to water.   Georgia, Bhiro's wife, invited her to their home for dinner.  She met Indira who is Bhiro's and Georgia's favourite daughter and a doctor who is pursuing further education in psychiatry to be able to help cure her father ..... and their favourite son Pravesh who is a dentist.

Emilee came to a Mental Health and Suicide Prevention meeting with the local press corps and the Minister of Public Health, Dr. Norton.  She was introduced as part of the team of technical specialists working for the Ministry!

It is good to have her here; I have been honoured by her wanting to visit me and see my life here.   I am sure she will be in more of these blog posts, but for now - enough.

My Health

I have been recovering from my cough etc., and now feel only about a decade older than I actually am .....  I went of my own accord to see Doctor Devi who lives in the flat next door and who has been checking on me every time she comes or goes.   She put me on a bag-load of pills and tonics and home-squeezed fruit juice! Now I do feel well -- and I hope this means that I won't get my usual bronchitis after I get home.

A New Ambulance for Mercy

A colleague, Chris Klaffs, who has been coming to Guyana for many years and is from the Florida Synod of the Lutheran Church has assisted her friend, Pastor Mike Mielke who lives about 30 miles from her in Florida and has the great Wilderness Lake Church.  He has friends/family at Banks Distributing -- my beer company, eh?  He loves Guyana, and several of his congregation are Guyanese.  He and his church raised money for two ambulances -- and one of them is for Mercy!  This is a great service for the hospital and its patients.  Thanks!!

Some Thoughts on Receiving Donations

Here are parts of a recent email from Dennis LeBlanc who has been down for the last two years and is planning on being here again in October.   He had a reflection on asking and giving that I want to share.

Hi Jo'c,

Yesterday you wrote "I am always humbled by donations" . . . that is a word I have always felt and used myself. I carry all sorts of baggage about asking for money, but a couple people have pushed me beyond my self-imposed limits around "fund raising" over the past few years. I can't say it's gotten any easier, but I have tried to be a little more bold and creative (the tin cup routine never worked well for me) in asking for money for causes important to me.

This is the outdoor "playground" at St Ann's we are trying to improve.

When people give, I am still truly humbled by their care, concern, generosity and support. Well, I've had a lot of practice in humility lately! Today at the nursing home, three staff people came up to me (separately) and talked about the newspaper article and how they "wanted to help out a little". One hundred and fifty dollars ($150) later, I staggered back to my desk, overwhelmed by their words and gifts. It has truly been "a wonderfully humbling day"!  The total amount raised now is $704 (that's good 'ole U S of A dollars, not Guyana dollar value)!

Thanks for reading... More next week. John

except .....  does anyone know what this is?

"Light Dawns in a Weary World"

This post is written by Peter Kuhnert, a Lutheran pastor and medical doctor and Guyanese colleague.    He was a leader with both the 2013 exploratory mission and the 2014 Mental Health Team which worked in Guyana for ten days in October-November.  [They have a wonderful FaceBook page, "Transforming Guyana's Mental Health System".  Peter's message serves as an excellent reflection on giving flesh to the incarnating Christian Christmas message.   

Peter bends low to listen to a girl at St. Ann's 

********************************************

Three years ago, shortly after my first ever visit to Guyana, I was contacted by John.  He asked me if I thought we might do any kind of work together in Guyana.  I told John, emphatically, that I did not think there was any opportunity to do any work in Guyana.  There was no will, no energy, no finances, and no manpower.  There was no Spirit.  I suggested perhaps we talk again in one year.

Two years ago, a dimly burning wick began to splutter to life.  Perhaps a opportunity did exist for some partnership work to strengthen and support existing mental health services in Guyana.  John was now living locally in Ayr.  I had started working at Freeport Hospital.  We had met a couple of local psychiatrists who wanted to explore international mental health care in a culturally and religiously diverse context.  Perhaps this opportunity might bridge the partnership and development work of the ELCiC with that of mental health services, for the betterment of life for the whole people of Guyana.  Perhaps.  Certainly, there was enough enthusiasm to plan a needs assessment visit and begin some relationship development.

One year ago, October 2013, Ram and Brenna and Sujay and I joined John in Guyana for a week of site visits and meetings and discernment. We were graciously received by Dr. Bhiro Harry (Georgetown) and Dr. Mayda ( New Amsterdam), and by the minister of health, Dr. Ramsarran. We saw much and heard much and clearly saw the need for a sustained mental health initiative to support good people and hard work already being done with absolutely minimal resources.  Few in-patient beds.  Few trained staff.  No budgets.  Limited medications with only variable availability.   The needs seemed overwhelming. Yet the Spirit began to blow.  The candle burned brighter.  We knew we would come back.

The past year has been a year of planning and preparation.  An excellent slide show about our 2013 trip, courtesy of Sujay and Brenna, began to peak interest in this initiative amongst the local mental health staff at Grand River hospital, Homewood health centre, and the Kitchener Downtown CHC. Who would have expected that when we called a planning meeting, in March,  for those interested in a self-funded mental health trip to Guyana in October 2014, over 40 people would attend!  And over 20 would commit to this 10 day project!

The Canadian Mental Health Team at the Farewell reception
hosted by the Minister of Health

The project itself was a huge success.  19 individuals divided into two teams, working in both Georgetown and New Amsterdam.  The number of initiatives for  this 10 day trip was astounding. The re-introduction of life-saving ECT technology to the New Amsterdam hospital.  Clinical visits to community hospitals in Linden and Suddie ( including an awesome speedboat ride across the Essequibo river).   Opportunities to teach physicians and nursing staff at both Georgetown and New Amsterdam.  Community education initiatives about mental health during each of our community tours.  Relationship building opportunities with the ministry of health, the University of Guyana medical school, and the schools of nursing in both Georgetown and New Amsterdam.

Dr Bhiro Harry continued with his
on the ground leadership for our team.

Dr. Bheri Ramsaran, the Minister of Health provided
excellent direction and support for our team.

Perhaps most impressive, has been the high level work that John has participated in, to help create a national mental health strategy for Guyana.  This is coupled with an ambitious strategy for the creation of a bilateral university partnership to bring bring post-graduate psychiatric training to Guyana.  This would be a first step to creating a national human resources strategy for mental health that might eventually include nurses, social workers, occupational therapists, and chaplains.  The wheels of future possibility have already begun to turn.

Chaplain Ram Kalap was a leader
on both the 2013 and 2014 teams.

Sujay Patel and Peter celebrate the fulfilment
of all their hard work over the last two years.

What a difference a couple of years has made!  Initially, there was no hope.  There was no kairotic time- no time for illumination and transformation.  But slowly, ever so slowly,  light has dawned.  A dimly burning wick has begun to burn brightly.  Hope is being reborn and a spirit of possibility  is beginning to take hold. What began with the question of one, " What can we do in  Guyana?" has been echoed by the voices of 19 others and the possibility of systemic change is becoming real.  Systemic change for the betterment of care for the whole

people of Guyana.

What is more Christmas?

...than bringing Joy to children.

Thanks, John, for risking asking the initial  question.  Thanks, John, for nurturing hope in your own unique manner.  You have helped open our eyes to the possible.  You have inspired us.  We are grateful.

John amazing the Cuban Psychiatrists
 with his command of Spanish.

Thanks for being a blessing. Looking forward to being your partner into the future.

Peter Kuhnert MD MDiv 

***********************************************

Thanks, Peter.  I am humbled by your kind words.

PS: I have a few more themes for this blog, but I have returned from Guyana to develop my usual cough and cold. I am feeling better today.  I especially want to post the pictures and stories from the "2nd  Annual Father John's Photo Contest.'

Have a Blessed Christmas and let you light shine...

Peter Puts Pen to Keyboard ...and Remembers Guyana

The Difference a Year Makes

Just over one year ago, I knew about Rev. John O'Connor by reputation alone.  I knew he was an ordained Lutheran pastor and a former chaplain.  I knew that he had an interest in doing ministry in Guyana- some kind of ministry.  But the one time we communicated by email, he was in the process of moving back to Ayr, ON from Nova Scotia.  We agreed to get in contact with each other when things were more settled.

About one year ago, John and I finally met for coffee.  He shared about his chaplaincy work in the past and about his annual teaching experiences at St. Joseph Mercy Hospital in Guyana.  About three months every year for the past 10 years!  I shared about my one trip to Guyana, representing the ELCiC at the 2011 annual church convention of the ELCG.  I also shared about being in ministry at Maranatha Lutheran in Waterloo and about being a family physician working on the Specialized Mental Health Unit at Freeport Hospital.  I tried, somewhat ineffectively, to explain my odd dual calling to both ministry and medicine.  We talked briefly thereafter about the possibility of doing some work together in Guyana.  My response was muted -- where was the possibility to make a lasting difference??

In February, John and Anne joined Maranatha for our annual Black History celebration.  We didn't have much time to connect in person that day, but I believe that you can tell a lot about a person by how they lead a service and by how they preach.  Wasn't sure what John thought after that day, but was pleased to be invited to go for coffee again...

By spring, 2012, conversations with medical colleagues at Freeport led to a first meeting of our current Guyana group- Sujay Patel( Freeport psychiatrist), Ram Kalap ( Guyanese born chaplain at Homewood), John, and myself.  We talked about the idea of a medical contact-making trip to Guyana sometime in the next year- most likely when John would be back in Guyana between Sept. and November.  We talked about a needs assessment and we talked about meeting people.  We talked about who might support a trip like this with more than kind words and best wishes.  We talked about the realities of family life in Canada and the need to plan a trip only if we would truly follow through on a commitment to go.   We were blessed to receive concrete support for this trip both from Bishop Michael Pryse of the Eastern Synod and from Homewood Health Centre in Guelph.

In September, Sujay and I booked our tickets together.  Within a week or so, Brenna and Ram had also committed to an October trip to Guyana.  The Fellowship was established!  But what would we find and what might possibly develop?    Read on!

If you have followed this blog over the past two weeks, you will know exactly how much has been accomplished between Oct 23 and Oct. 30.  Thanks to John and to Dr. Bhiro Harry, we have safely explored Georgetown, Suddie, New Amsterdam, and the village of Fyrish.  We have visited the Georgetown Public Hospital,, St. Joseph Mercy Hospital, the Suddie Hospital, and the National Psychiatric Hospital.

Brenna brought her Second Year
Class's Mascot - Flat Stanley 

Can you find Flat Stanley?

 We have met and shared in mutual reflections on mental health care in Guyana with the first year nursing class at St. Joseph Mercy hospital.  We have connected with Pastor Moses, president of the ELCG at Calvary, and with Pr. Vivian  (and her husband, Eric, fellow Canucks from Lunenburg, NS) at Ebenezer Lutheran in New Amsterdam.  We worshipped at Ebenezer on Reformation Sunday in the 270th year of the existence of the ELCG!  And we learned that it was at the 2012 Closing Service of the ES Biennial Convention ( hosted by Maranatha at Waterloo Lutheran Seminary with guest preacher, Pr. Paul Moonu, president of the ELCG) that Pr. Vivian first heard her call to serve in Guyana!

Do Ministers of Health Give Official blessings?

Canadians [plus a lone American] meet with Minister of Health Hon Dr. Bheri S. Ramsaran.  [l-r Dr. Bhiro Harry, John, Rev. Dr. Dennis LeBlanc, Brenna Patel, Dr. Sujay Patel, Minister, Rev. Ram Kalap, Dr. Shanti Singh, Director for the National AIDS Programme Secretariat and Rev. Dr. Peter Kuhnert  

Today, our final full day in Guyana, we met with the Minister of Health, Minister Ramsarran.  He talked passionately about his hopes for developing the mental health care system in Guyana.  He talked about the opportunity of having 100 medical graduates repatriating to Guyana within the next year after training in Cuba, and the need for someone to guide them in nurturing a passion for and skill in providing excellent mental health care.  He talked about the possibility of future partnerships  and invited us to contact him when we had more details to provide.  This afternoon, we met with a reporter from the national television channel, NCN, Ms. Samuels.  She had first approached us with the idea of an interview after worship at Ebenezer!  The ministry gave its blessing and the interview occurred today.  Sujay spoke eloquently about opportunities for partnership and for training family physicians and nurse practitioners and for bringing allied health professionals to train local trainers in Guyana.

Following the meeting with the Minister, the team was still exchanging ideas
in the waiting room of the Ministry of Health

Autographs are now $100 each.

Tonight, we enjoyed our final meal together with Dr. Bhiro Harry, with John and his old classmate Dennis, and as the Fellowship quartet. We reminisced about the amazing and blessed events of the week and we began to dream about what might yet be.

TV Stars in the making.  We all gathered
to see the Canadians on the Six O'Clock NCN News

If you can't wait till the full length movie comes to a theater near you:  Click Here.

Good bye... till we meet again.

What difference can a year make?  A mere 365 days?  Some would say not a lot.  Of course, others would say the entire world can change.  It certainly has for us.  How will this adventure continue?  Today, I can hardly say.  But then, of course, that's the story for next year.

Thanks to you, John, for the opportunity to guest-blog for you.  You and Bhiro have been gracious and thoughtful hosts and exceptional planners.  I am grateful.  Our team is grateful.  

Thanks for being a blessing.    Peter Kuhnert

Peter Kuhnert is a Medical Doctor and Lutheran Pastor.  Back in Ontario he is the pastor of Maranatha Lutheran Church in Kitchener and the medical doctor on a specialized geriatric mental health programme at Grand River Hospital. 


"Some Unknown Reason"
A student reflects on her visit to the "Berbice Madhouse"

Upon entering, I saw several persons going about their daily routine as they talked to themselves, which at first seemed very amusing until it actually hit me that these people are really ill and society has shunned them because of an illness which is beyond anyone’s control.   As my tutors and fellow batchmates enter the first ward on the hospital ground, I started to panic for some unknown reason.   Rev Dennis, introduced me to a patient by the name of xxxx who was very wonderful, she told me about her morning and was packing to leave the premises  as she indicated that her relatives are coming to take her home.  When xxx left me, I stood in the corner and observed every detail of each patient within my view and tears came to my eyes as I stood helpless just looking on, how these patients lost their husbands, siblings, children and friends all because of a mental disorder.