Pakistan Day 11

Today's village trip was extremely challenging. A small place near Battal, (Nogram) sited on a high terrace, the trail into the village was menacing and impossible to drive through but somehow, with some amazing skill on the driver's part, guidance from our guys, and a lot of pushing and laying of rocks in the right places we managed to get in.


We worked in very cramped quarters, again the women's team in a tent, and myself on a chair & table next to some donkeys! Saw 70 patients quickly and then made a hike up the mountain to see a debilitated patient trapped at the peak. This was the most challenging house-call I've ever made! Me and my translator (boh of us rather hefty, and wheezing up) trekked some 20 minutes up steep slopes until the clinic-tent was a blue spot in the landscape. The ruins that greeted us there was also humbling.


We've become quite efficient at what we do and managed to clear the village sick in three hours, making it back to Abottabad early this time. Thank God.

Hope to rest well tonight.

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Pakistan Day 10

We travelled some 3 hours to a village called Harori Bala by the Battal river. The terrain was challenging but cleverly maneuvred by our driver Sober.


The drive is always punctuated by torn houses and rubble that indicate what were once homes. I learnt that 50% of the homes have been destroyed completely - mostly mud huts - and the ones we see are the stone/brick ones that have survived. Only tents remain as protection against the winter. Temperatures are sub-zero here at night.


With a little more experience, we were faster in setting up. Quickly we set apart one tent for the women - seen by Ruth (a midwife from UK) and Faith (from Nigeria). I on the other hand saw all the men and some children at my 'clinic' - one table in the open air. Warmed by the noonday sun, the icy cold winds weren't that bad. As we worked, Wolf choppers would fly by ever so often, as eagles also circled above.


I saw some 66 patients while the other team saw 30+. OPD and Sarawak longhouse experience is proving useful here! This village seemed to have a little better standards of hygiene and sanitation. But as you can see from some of the photos - skin infections are bad. One infant I saw was bloated with worms, bleeding per rectally and eating soil.


After the long day's work, we were treated to some late lunch in a home that had a fireplace. We made good friends, gave thanks for our food and ate. Subsequently the men performed their Asar prayers just next to us.

Returning to Abottabad at about 8pm, we hastily headed for the local pharmacies to stock up for the next few days. I almost froze in the night chill.


To be honest, the first village trip was hard for me as I was very tired and nauseous from the journey. The second day was better since I ate less in the morning, slept on the way up, and spent much time meditating on the Scripture: 'Even though the mountains be removed and the hills be shaken, my covenant peace will no be removed and my unfailing love will not be shaken'. It was a promise both for the people who have literally seen mountains shake and hills stripped, as well as source of strength for me. Without the Lord's love, we have no love to give.

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Pakistan Day 9

Our team of 9 travelled 4hrs from Abbotabad to Amlok Bande, a small mountainside village north of Batgram. Surrounded by snow-laced peaks and terraced slopes, the view was breath-taking.



Seeing the many brick or clay homes reduced to rubble, on the way up, was sobering.


But nothing prepared me for the scale of infectious diseases I would see at the village. In our hastily put-together clinic, dispensary and surgery, we saw 100+ patients and did some dressings. Many patients needed better health care but being in an inaccessible area, and hospitals being completely unaffordable to the impoverished, I felt particularly helpless. Not being able to do more with our very basic medications was very distressing for me at first. But it's where I'm learning what doing your best and letting God do the rest means.


The driving plus work is particularly exhausting. This morning we tried to spend some time remembering 'Even if the mountains are shaken and hills are removed, my covenant peace will not be shaken and my unfailing love will not be removed' speaks to the people (who have seen literally mountains shaken and hills stripped down), and to us who can only give if we are ourselves overflowing with His love.


Night temperature is 5C but bearable. We have indoor heating. There have been no aftershocks so far.

Thank you again for your prayers that are holding us up. We are all small instruments in His greater work. May our work be a sweet sacrifice to Him.

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Pakistan Day 7

Leave for Abbotabad on an express bus at 4am.


Super breakfast spread of Puris, Prathas, Naans, and the srcrumptious chick-pea dhal.


Take a car to Balakot. Visited a large medical camp run jointly by Diocese of Peshawar, Hospital Christian Fellowship Pakistan, Norwegian, and Military. Huge number of tents, a tent hospital under construction. Preparing for the winter crisis. Medical coordinator Dr David wonders if they are doing the right thing, setting up a hospital rather than going out to the unreached villages who will soon be engulfed by the winter blizzards. Temperatures are already subzero at night here.


Joan gets really close to the children there who wouldn’t let her leave.


Large number of relief camps on the road alongside Kunhar river by various organizations.


Visited APMA (Alliance of Pakistan Minority) camps who provides shelter and education to children.

Reached ground zero, Balakot. Destruction is staggering. Can only wonder what people were feeling in the buildings when everything came down. Hundreds of men working against time to break down old structures and rebuild.




Rush Joan from Balakot to Islamabad, slam jam into a traffic gridlock there. Checks in by the skin of her teeth, without her luggage (still in Rawalpindi hotel room).

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Pakistan Day 6

Chapel service – Faith prays for healing for the staff and commissions them to heal others.

I share a farewell message on behalf of the team.

The staff organizes a march for World AIDS day, followed by some talks joined in by patients/relatives.



Thought I would close the clinic, but swamped by last-minute patients, so kept on seeing patients way past our departure time.

Was very saddened that I had to pick up so many cases only to tell them I cannot stay to operate for them.

Spoke to daughter of the patient I operated on. A premed student who had to give up her dream of doing medicine because of lack of funds, and no scholarships available for Christians like her.

Left for Rawalpindi at 3pm and arrived at 8pm+.

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Pakistan Day 5

Holy communion in chapel service. How definitive of the work here – a people blessed by God, broken to be given freely to the people of Bannu.

Taken on a trip to the Mission School of Bannu. Astounding setup and education provided. Students I met speak impeccable English in this illiterate Pashtun community. What a stark contradistinction – computer labs (funded by Finnish government) within the walls, and donkey carts outside. A place that will produce many visionaries and leaders, doubtless.

Giggly girls at recess


Students range from preschool to mustached young men

Performed a polypectomy for one lady whose nose was completely packed with massive nasal polyposis. Anesthetic technician gasses her with Halothane, tubed, no monitors, no capnograph. Just a hand on the pulse and another squeezing the bag while I operated!


Went on an escorted trip around Bannu town, finally. We are not allowed outside the hospital without escorts – in fear of Taliban or Al-Qaeda kidnappers. A trip back in time by a few centuries. Total chaos and confusion. A wonderful mess indeed..


At night – Joan has to transfer a child to the military hospital for respiratory distress. A child with congenital heart disease, pneumonia, and plummeting oxygen sats. We arrive at the military hospital only to learn that they have no ventilators as well. Not there, not in the whole of Bannu!! Amazingly, on hearing that, the child decides to get better and start playing with us cheekily. These Pashtun are made of steel.


The rascal!

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Pakistan Day 4

Chapel service – Faith preaches about God providing all our needs.

OPD is even busier today. Word has spread in Bannu town that there is visiting ENT and Paediatrician, so they are all coming in. Every man looks like a Taliban or Mujahideen who could run me down with a camel or riddle me with bullets. The women look like walking fortresses in their Burqas. What false preconceptions we harbour. Instead they are humble, beautiful and loving people as vulnerable and needful as any other people in the world. I am greatly humbled to be able to perform a myringotomy for one such man who is afflicted by a sleep-depriving tinnitus. What a thrill that was.

I can hear!


Sister Alice

Had tea with Sister Alice. She is the prayer woman of the hospital. Story is she was once a nurse as a young girl in the old mission hospital. Recently she was admitted in the new hospital with status asthmaticus. When she got better she was called by the nurses who recognized her to pray with them and soon she was invited to join the staff as a prayer woman. Now she goes around the hospital daily praying for all the patients and staff. It’s amazing when she comes into the OPD and starts praying there in Pashtun in full view of the patients (who, also amazingly, do not find it offensive but will bow humbly in prayer also.)

Some facts I learnt about Pennel Memorial Christian Hospital:
- first setup by Dr. Pennel 150yrs ago, a British missionary who walked among the people in Pashtun garb, and spoke fluent Pashtun. Story is after he died, a man blinded by cataracts asked to be operated by Dr Pennel. But upon learning that Pennel had departed, he said, ‘If Dr Pennel is alive, I want to be operated on by him, but if he is no longer with us, I have no need for vision.’
- The mission hospital has been defunct for 50 years
- Reconstructed over the old hospital 2 years ago with funds from Diocese of Peshawar (Anglican), government grant and Finnish support
- Now self-supported, patients are charged minimal sum for consultation/drugs/surgery
- 600,000 rupees monthly expenses, in gross deficit every month
- 4 doctors, 67 ancillary staff consisting nurses, lab technicians, translators and other workers. Visiting dentist (Reginald’s wife) and ophthalmologist (Reginald’s brother.)
- 50 bedder
- Active outreach work to remote villages in Bannu to provide vaccination and to ‘collect’ patients in need of hospitalization
- Many services not available have to be ‘contracted’ out to private labs, or to Peshawar
- 2 other hospitals in Bannu: one military hospital not accessible to civilians, and one government hospital which is in even worse shape


Doctors at work - Reginald, Faith, Joan, Julia (from Kazakhstan)


The 2 o'clock Lord's prayer in the foyer


The guard who keeps us safe from unwanted intruders, and keeps us from going out without permission!

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Pakistan Day 3

Day starts with chapel service in basement of hospital. 8am sharp, music of tabla and harmonium and voices in Urdu praise wafts through the hospital like a sweet fragrance.


Faith, who is pastor of a church in Nigeria, preaches the prayer of Jabez.

Did our rounds after breakfast of Prathas and eggs and the traditional Chay (milk-tea). Lots of TB and Malaria and an assortment of Reginald’s surgical cases.


Profile: Dr Reginald is a surgeon who had worked some 15 years in Tank Mission Hospital. He has a reputation of performing 15-20 surgeries a day, and a record holder of 31 a day! (We have witnessed him finishing a vaginal hysterectomy in 30 minutes!). He had been in private practice in Hyderabad for some years before the Diocese of Peshawar called him to setup the Bannu Mission Hospital 2 years ago. He left the lucrative practice to startup this work.

Met Rev Altaf – priest of the Anglican church in Bannu. Tells us there are 300 Christian families in whole of Bannu. Very oppressed and restricted work in this Muslim fundamentalist state ruled by MMA (our version of PAS).

Ran our OPDs – Joan saw all the children, and I saw ENT patients. My self-designed portable endoscope light source gave trouble at first but once working, worked full steam. OPD is 9am to 2pm, then 5pm to 8pm. 2-5pm is surgery time.



Prayer meeting at 8pm in the home of one of the staff. Heavenly Urdu singing accompanied by Dr Reginald on the harmonium. Faith shares about spiritual warfare.


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Pakistan Day 2

Depart for Peshawar at 6am. 3 hour drive, past Indus river. First glimpse of rural Pakistan – horse-carts, markets, etc.


Drop off Siva (CREST full-time worker) at Peshawar Mission Hospital. Siva will do logistics coordinating work for Peshawar-Balakot operations. Dr. David – UNICEF worker and Paediatrician tells us Balakot is overloaded with doctors, patients are few, clinical work lacking. Good idea for us to go to Bannu where the hardcore poor are and hospital in great need of help.


Bannu is 80km from the Afghan border, populated by some 3 million, mostly Pashtun tribes. Hardcore poor. Severely neglected, marginalized peoples.

Faith, Joan & I proceed to Bannu in another car. Drove across the Northwest Frontier Province, through the China-Pakistan Kohat Friendship Tunnel to Bannu. Another 3hr drive, through rocky mountains, ravines, and arid, pebbly roads. Drove past a township (?name) where illegal arms/ammunition is manufactured.



Car breaks down in the middle of nowhere – ran out of petrol. Stranded for a half hour while driver hitched a ride in a truck to get more diesel. Kept getting questioned by passer-bys but once people are told we are headed for Mission Hospital, no more questions asked.

Arrived in Pennel Christian Memorial Hospital, Bannnu – to be welcome by some other foreign mission workers and Dr. Reginald (director of hospital) himself. More about hospital later.


To our joy – we have private rooms, hot water, and super meals every day.

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