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.

Back to Log Index

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).

Back to Log Index

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+.

Back to Log Index

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!

Back to Log Index

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!

Back to Log Index

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.


Back to Log Index

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.

Back to Log Index

Pakistan Day 1

CREST Team Malaysia leaves for Karachi 755am. Courtesy of Pakistan International Airlines, all our relief supplies accommodated except for 12kgs. In total 14 cartons of blankets, winter clothing and children’s toys.


In-flight service by full-grown bearded male stewards! Great service, abundant food.

Team tired and slept most of the way.

Towards end of flight, all team members seen to be doing planning, writing notes on tasks, learning essential Urdu, brushing up medical skills, and meditating on the Word.

Joan and I read Psalm 23 to each other – especially struck by ‘valley of the shadow of death’ as we pictured Balakot in all its destruction.

Arrived Karachi, harassed a little bit by airport officials and touts, but finally cleared to Islamabad. Lost one piece of luggage there – mostly our medical supplies and equipment!

Received by Chaman Nadeem, national coordinator of HCF (Hospital Christian Fellowship) who is our guide for the next few days.


Unloaded all our supplies at a house in Islamabad and caught 4 hrs sleep in Skyway hotel in Rawalpindi (twin city of Islamabad).

Back to Log Index

Pakistan calls

Newsflash: Joan and I have signed up to join CREST in a medical mission trip to Balakot, Pakistan for the earthquake relief efforts. We are going from 26 November till 10 December 2005.

Since the earthquake in October, many communities in the mountain ranges around Balakot have been left homeless to fend for themselves against the cold. The death-toll stands above 80,000 and threatens to rise in the winter. Water-borne diseases, skin infection, and psychological trauma are the commonest medical problems apart from the need for shelter and warmth.



We have been informed that we will fly into Islamabad or Peshawar, and proceed to our base camp at Mushafarrabad at the foothills. We will make daily trips into the mountains, part by road and part on foothills to go into villages where we setup medical camps. After our ‘virgin entry’ into these villages, most of which have not had any aid, much less encounters with Christians, other teams may follow up with shelter and reconstruction work. From reports of a team gone before us, the needs are overwhelming but the people are highly receptive. Apart from landslides and the occasional aftershock, our safety seems to be quite assured as the Pakistani have high regard for Chinese and the military is very protective of aid workers. Praise God for that.

We ask for your prayer support for the entire mission team, our safety and wisdom in interacting with the people. Please pray also for our parents, who we know will be very anxious. If you would like to commit yourself to being a prayer partner for this mission trip, please do reply to us as we will be much encouraged to know of the people praying for us while we are up there.

I hope to bring back lots of photos/videos, and information on how we can contribute if you are interested. There is an adoption program also where sponsors can adopt families and sponsor their rehabilitation.

Addicted to work?

I hadn't realised how addicted I am to my job until this long Deepa-Raya break. It was a week of celebration for me - of NO TRAFFIC, GOOD FOOD and all the TV I could watch without my eyes popping out.

Let me see - I watched 3 episodes of HOUSE (the TV series), House of Wax, Guess Who, and The Longest Yard. All were fun. In fact HOUSE has made me want to study medicine all over again; this time not to pass exams but for the sheer pleasure of grappling with the mysteries of human life and disease. House of Wax was,...well, overrated and under-horrored. Guess Who was surprisingly more interesting and engaging than most romantic comedies of late. And The Longest Yard was simply hilarious. By the end of the week, I was going out of my mind, rearranging furniture and making my own cables!

Anyway, I was only too glad to get back to work yesterday and be in operating theatre again. The north-pole chill of OT and the musical beeps and hums of machines makes for a second home. Am I addicted to work? Is this a good thing or a bad thing? I'm sure it's a bit of both. Tomorrow the students will be back in class for more torture and my clinic should be in full swing on Thursday...

Sigh... The joys of work.

Education for the soul

My Scripture reading today was Numbers 20. The tragic chapter where Moses & Aaron are sentenced from ever entering the Promised Land. Next to Adam & Eve getting banished from Eden, this must be the second most heart-wrenching moment in the Pentateuch. Moses venting his frustration, Aaron following suit, both of them receiving their sentence, Aaron degarbed... There is a pained silence in that chapter that shrieks of a tragedy too grave to put in words.

But the lesson is so clear. In this journey, on this side of heaven, God is interested most in my faith. And by faith I don't mean a mental approbration of a set of doctrines, but a deep visceral belief that God saves and provides. I'm beginning to see that wilderness periods are potentially the most precious of times. They make or break us. Sometimes I choose rightly, sometimes I don't. But my faith is being built from the ground up.

Do I believe enough to do just as He says, and only as He says - no more, no less. No need to give God a helping hand or take extra precautionary measures, just in case?

A couple of days ago, while trying to repeat some Scripture to myself, I found I couldn't say 'In God I trust, whose word I praise' with any amount of sincerity. There is way too much unbelief within. Does God really meet all my emotional, vocational, financial needs?

How much of my decisions and actions are predicated on this unbelief? There is much unbelief to repent of, and much transforming work to be done in my heart. A work accomplished only by receiving His love in the deepest recesses of my soul. This 'wilderness' I'm in isn't the first and certainly not the last. But in each episode, I pray that the soul-education that God is offering is not lost on me.

Career Wilderness

My current university job has been a great trial for me in a paradoxical sense - I am under-worked. I feel my research talents are wasted, opportunities to develop surgical skill is denied, and overall I have little to contribute in my current capacity. My hope of moving to our designated hospital where I may have the freedom and opportunity to fluorish has been dashed over and over again.

And all this, over the past year and a half, has plunged me into pits of depression - doubting my own worth and progress in life. I am only in my mid-30s and I feel like I'm ready for retirement!

In that context, I read today something from Rachel Remen. She says, 'Many times we can put them (suffering) behind us and get on with the rest of our lives. But.. some things are too big or too deep to do this, and we will have to leave important parts of ourselves behind if we treat them in this way. These are the places where wisdom begins to grow in us. It begins with suffering that we do not avoid or rationalize or put behind us. It starts with the realization that our loss, whatever it is, has become a part of us and has altered our lives so profoundly that we cannot go back to the way it was before.'

I am beginning to move from denial to acceptance. Life needs rebuilding and redefining. I want to believe that this period of career wilderness is refining me in ways I can't see. That God is chiseling ruthlessly away at my ambition, my drivenness and my restlesness. I am forced to ask, what IS really important to me and to God? Am I what I do, or do I do what I am? I am forced to face my deep unbelief that God could be in control and pry my controlling fingers into open hands. I am forced to confront my fears of becoming obsolete, irrelevant, useless, a vocational failure.

I believe that suffering/hunger is grace. I believe this wilderness is a gift to embrace. It is the panting without which the deer would not seek a stream. It is in my wilderness that I am compelled to ask the most important questions: who am I and who is my God?

My soul, find rest!

My soul, find rest!
Find rest in God alone.

Alone,
Not with your thoughts

Alone,
Not with your ambitions

Alone,
Not with your books
or PC
or projects

Alone,
Not clawing at things to achieve
Things to hold
People to impress

Alone,
It's so hard isn't it?
Are you afraid,
There is nothing there?

Do not fear
Being alone
For alone is where I am
And where you are is where God is

Mary and Martha slugs it out

I see so much of myself in the Martha depicted here – craving for attention, exhausted without it, presenting my best work, vying for merit. And then appaled to have Jesus point a finger at Mary, not in condemnation, but to show me that it is the ‘better way’ Oh man, had I known...

The Mary within continues to wage war with the Martha in me. Or rather my inner Mary continues to be bashed by my type-A, engine-driven Martha, accusing: Why do you sit around and do nothing? What have you achieved today, this week, this month? Are you getting anywhere? How can you be so inactive when there are so many needs around you? Don't just sit there, do something already! With that kind of inner drivenness playing out all day, it's no wonder I exhaust myself so easily. On the other hand, even when I am drained, I do not know how to rest.

I journaled on Saturday:
'If not for the discipline of a weekend review, I won't even have realised how much and why I am in severe unrest and plummetting into unhealthy habits.

Here I am at the end of the week, insomniac and weighed down by false guilt. And I'm not letting up - I still feel like I need to do more, find more to do, feel so unaccomplished...

But look at the week:
- you operated on a mycetoma
- you ran a busy clinic
- you've written 2 chapters of your book
- you've read a few papers
- you met with and counseled 2 people
- you took two bedside teachings
- you ran once in the morning
- traffic has been murderous
- you brought your parents to Serdang

You are so driven and so addicted to the adrenaline, your insight/memory is clouded. All you can feel/see is your need to DO SOMETHING. You are not how many articles you write, how many classes you take, how many poeple you meet, or how much weight you lose. These are the guidelines I use to live a healthy life, but they do not constitute who I am. I am who I am. And God loves me as I am.

If there is a time you need to STOP and DO NOTHING - IT IS NOW!

COME AWAY. STOP FROM YOUR WORK. FIND YOURSELF AND GOD IN YOU.'

Jesus says to the Martha in me: "Yoke Yeow, Yoke Yeow, you are worried and upset about many things, but only one thing is needed. Choose what is better, and it will not be taken away from you."

There comes a point every day, and at the end of every week, that I must hear that firm voice and cease. Disengage my gears, detach from the work, and declare a time of Sabbath rest. A time to just BE. Reaffirm I am who I am, apart from and before the work.

Lincoln was depressed?

Soo Inn writes in Learning from Lincoln that the great president of the US of A struggled all his life with depression, but that depression gave him clarity, creativity, and humility.

SI also shares: 'as one who has made his own short sojourn into clinical depression I cannot see how I would wish that experience on any one... The reality is that we now live in a fallen world where pain is a given. Quoting Eugene O'Neil, Shenk reminds us that “Man is born broken.” Post Fall, pain is a given. A wise and loving God now uses that brokenness for His higher purposes. Today, we live in a society that sees pain as an enemy to be removed as quickly and as efficiently as possible. I understand this desire. Pain is no fun. It's just that sometimes we remove pain too quickly, before it can deliver its message.'

Thank you for that, Soo Inn. As someone who suffers recurrent low-grade depression, I couldn't agree more. I am constantly faced with a choice: to fight the pain or to embrace it. To pour my energies into palliating it, or do the surgical work of dealing with its root causes.

I accept that on this side of heaven, the agony of living cannot possibly be eradicated. Instead pain can show me my greatest needs/weaknesses and keep driving me forward in my journey to God. Befriend your pain, Nouwen would say. Let it show the way.

As surgeons, we understand that more than anyone else. Pain brings the patient to us. The nature of pain guides us to the pathology. And the goals of treatment is not mere pain-relief but cure, by surgical removal if necessary. There are instances, even, where pain-relief is cruelly deprived of the patient - in fear of 'masking' the disease process. In the same spirit, I read yesterday Yancey's summation of the book of Job: 'God is more interested in our faith than our pleasure.'

Lincoln was depressed? It's good to know we're in good company!