Barton - Ecuador

Paul and Kim Barton, both medical doctors and members of NSP, moved with their 4 sons to the edge of the Amazon jungle in Shell, Ecuador in 2007 to serve with Mission to the World. Paul is an anesthesiologist at Hospital Vozandes del Oriente and Kim works as a pediatrician both at the hospital's clinic and at La Casa de Fe Orphanage. You can find out more about them on their website: Barton Family

Read the Barton's latest update below:

November 8, 2011

Dear friends and family,

We have been back in the U.S. for almost 3 months now.  It has been very refreshing to us to be back in our home culture.  It has also been rather busy.  Some of the things that we have done since we have been back:

1.  Bought a car and put almost 8,000 miles on it.
2.  Visited all the grandparents and a couple of the boys' cousins and also seen some of Kim's cousins.  Made plans to see both sides of our family over the holidays - a real treat!
3.  Moved the contents of a storage locker in Dallas, a closet in San Antonio and an attic in Houston to our house in Dallas during the hottest summer on record!
4.  Attended a black tie dinner with Samuel, Paul's Mom and aunt and Kim's parents to see Paul honored as the Pillar of Citizenship by his former San Antonio school district.  http://foundation.nisd.net/pillars.html
5.  Presented our experience in Shell to several groups of San Antonio school children as well as a group of 200 pastors in our Presbytery.
6.  Processed (debriefed) our time in Ecuador with members of our mission agency, Mission to the World, and thought creatively about how to best use medicine to serve the gospel when we return to Shell.
7.  Were accepted by Mission to the World as career missionaries after a week of "Interview and Orientation" in Atlanta.
8.  Made the news by being rescued by the fire department after the monorail at the Dallas zoo stopped.  (This was the boys with Kim's parents who were graciously watching them while we were in Atlanta for our interview week with MTW.  Never a dull moment with those Barton boys.  Isaac, age 3 explains it best:  "We rode on the monorail at the zoo and it got stuck and the firemen came up and got us and helped us down.  I put my arms around his neck and my legs around his shirt." See http://www.myfoxdfw.com/dpp/news/092711-Dallas-Zoo-Monorail-Stuck-on-Elevated-Tracks-with-People-Inside  The boys are in one of the cars visible in the video - all are wearing red shits.)
9.  Rode the Texas Star Ferris wheel, ate corny dogs and fried pumpkin pie and saw the bird show at the Texas State Fair.
10.  Visited the Alamo, San Jacinto monument, Paul Revere's house, the USS Constitution and two science museums for our home school program.
11.  Drove through 12 states en route to  and from Vermont in the October.  Visited our neighbors from Shell - the Umbles in Pennsylvania, who have since returned to Shell after a successful kidney transplant for Randy.  We also saw several of Kim's college friends who live in the Northeast.
12.  Experienced Fall in Vermont by picking apples and pumpkins, jumping in piles of leaves, going on hay rides, hiking, and solving a corn maze.  We also witnessed with awe the stretches of new pavement and lingering devastation in Vermont 3 weeks after Hurricane Irene.
13.  Renewed our involvement with our home church in Dallas.  Every Sunday Paul remarks as we left, "Boy, that was a great sermon."  It sure makes a difference to be able to worship in our own language and regularly participate in church events again. 
14.  Made plans for Paul to attend a conference in Kentucky this weekend that focuses on medical missions.  We attended this conference 8 years ago and look forward to attending it from the perspective of experienced missionaries.
15.  Have marveled at clean water in the tap, mailboxes, garages, the Interstate highway system, the size and selection in groceries stores, our ice dispenser and countless other things that have already become normal.  And at times we have remembered wistfully year-round fresh strawberries and tomatoes, fresh juice, whole grilled fish and plate lunches for $2.50.

As you may have gathered, we are living in our same house in Dallas.  It feel like a time warp because everything is just as it was 4 years ago, except that there is one extra Barton boy!  Speaking of the boys, many people ask us how they are adjusting.  We hope to be sensitive to the fact that this is not their home culture as much as it is ours.  They miss their friends and their jungle life in Shell, but are enjoying the new experiences that we have had here.  It was a joy to see them reunite with the Umbles, our neighbors in Shell, whom we haven't seen in almost a year.  It was a real answer to prayer for Samuel who has been praying to see his buddy Jonny Umble before next summer.  They were also able to have a long anticipated camp out together.  Isaac, the youngest is somewhat confused.  When we first arrived he kept asking to go to the airport and take two planes back to our house in Shell, but now he talks about coming home to our "new" house with the garage (in Dallas.)  Josiah has thrived at a 2 day preschool program where school in English is a new experience for him.  He is starting to read and we are doing kindergarten subjects in home school with him.  I think the transition has been hardest on our extrovert, Nathan, who misses being around other kids in school since we are home schooling.  However, he makes friends very easily, and is enjoying new friends in our neighborhood and church.

We have enjoyed this initial time of transition and rejuvenation after 4 years in Ecuador.  Now we look forward to the next few months of raising increased support, traveling more to visit supporters, family and churches and planning our return to Shell for next summer.  Paul will also be working part time.  Our most predominant feeling during these first few months has been one of gratefulness.  Gratefulness to look back at how God has provided for us in Ecuador.  Gratefulness for our mission agency who has been a real encouragement to us.  Most of all, gratefulness to all of you who have prayed for us, encouraged us, read our letters, sent things to us, cooked for us, hosted us and made the past four years, as well as our transition to Dallas, possible.  It is such an honor and privilege to see the body of Christ at work and to see how God works through His people to advance His Kingdom.   He is answering your prayers on our behalf daily and we are deeply thankful.

We will soon have updated picture prayer cards and will send out a letter with more information about our financial needs for our next term.  God has faithfully provided for us financially the past four years and we are excited for this chance to reconnect with you as partners in our work.  If you currently support us financially, please continue if possible as we are using some support while here in the United States.  We are currently setting up a calendar of church visits and would love to present the work that God has been doing through us in Shell.  If you would like us to visit, please let us know what a good time would be for your church.

Please pray for the medical missions conference that Paul is attending this weekend.  Pray for safety in travel as well as a fruitful time learning more about different models of medical ministry.  Please also pray for the hospital in Shell who is looking for family practice doctors to fill several vacant positions.  Paul hopes to help with recruitment for the hospital while he is at the conference.

Many blessings and thanks to all of you.

Paul, Kim, Samuel, Nathan, Josiah and Isaac

July 29, 2011 

Hello friends and family,

We leave for the U.S in 10 days!  We will live in our house in Dallas and complete the training and fund-raising to be long-term missionaries with Mission to the World.  We are currently on their short-term track and the statue of limitations is running out after almost four years here.  The "short-term track" is usually two years!  We expect to be in the U.S. about a year and hope to see many of you.  We are so thankful for your support of friendship, funds, prayers and encouragement over these last four years.  From sending care packages to financial support,  from visiting with triple the luggage you would normally pack to praying because of a sense that we were traveling, we have seen first hand how the body of Christ works and we are deeply grateful for your partnership. We have seen miracles of protection and healing and changed hearts.

One of the most recent miracles we have seen is in Grace.  She came to Casa de Fe, the orphanage where Kim works, during our first months here.  She suffered from meningitis and was left with a stroke on one side affecting her arm and leg.  She lived deep in the jungle and was unable to get physical therapy.  She was also born with no thumb and several finger anomalies.  Last month, a hand surgeon who is one of Paul's friends from college visited and was able to use one of her fingers to create a thumb for her.  It was a five hour surgery and Paul scrubbed in as his assistant!  The surgeon left here very discouraged because it looked like the graft would not "take" or develop a good blood supply and would have to be amputated. However, thanks to the prayers of many, when she was taken to the O.R. in order to amputate the graft (or new thumb,) the surgeon realized that she had developed some blood supply and was hopeful that the thumb would survive.  It did and we are encouraged that God does indeed answer prayers and do miracles although not always on our schedule!  In spite of all that she has been through, Grace always has a beautiful, winning smile that endears her to anyone who meets her.  Her picture is to the right...

Paul's friend, Tim was also able to help another child at Casa de Fe, Matin, who has CP.  He moved some tendons in his hand to give him better function.  Tim also served as the on call orthopedic surgeon for the week since our usual surgeon was in Quito.  The best part of his visit was watching Paul act like a college student again!  About the same time, we hosted a pediatric resident doing an international rotation.  Debbie was a huge help to Kim at Casa de Fe in getting things ready to leave for a year.  She also helped at the hospital and went on two jungle trips to do physicals on children in the Compassion program.  One of these, Paul and I were both able to go on.  We drove to Arahuno to finish the physicals that Kim and some other doctors started in December.  It was fun to see my husband in primary care mode.  He was even able to see some of the parents for minor complaints, although I think he would have preferred to put them to sleep!

Paul and Isaac with visiting college friend Tim.Hosting short-term visitors like Tim and Debbie is truly one of the blessings of our work here.  We have met countless visitors over our four years from  many different specialties, stages of life and even countries.  It is a great encouragement to us to have people working alongside us and expanding their own God-given vision for involvement in missions.  One of the highlights of our time here in Shell has been hosting a team of short-term missionaries from our home church in Dallas.  Tomorrow, they will return for their third trip to Shell.  This is our fifth time to host a team and each time has been a new and rewarding experience.  This time, our church team will hold their third annual VBS at Casa de Fe in English for the orphanage kids (who do their schooling in English) and missionary kids.  The afternoons will be spent running a Sports Camp in Shell in conjunction with a local church.

Two days after this team leaves Shell, we will leave as well.  We look forward to time to reconnect with family and friends and live in our home culture a bit.  However, we will miss our friends and ministries here.  Thankfully Casa de Fe will have a nurse for much of the time that I am gone.  Paul also has anesthesia coverage lined up for the hospital starting in January.  However, two people that were planning to help in August are unable to come.  This is very stressful for all involved - please pray that help with be found for the fall.

Please also pray our transition to the States and the time we will spend there in preparation to return to Ecuador next summer.  Pray for our interview process with Mission to the World and for our fundraising.  If you currently support us financially, we hope that you will be able to continue doing so as God leads.  We will initially remain on support in the States and then plan for Paul to work part-time.  We are deeply grateful for your partnership in the gospel and look forward to seeing you again.

Blessings,
Paul, Kim, Samuel, Nathan, Josiah and Isaac


June 1, 2011
Hello all!

We have had a few busy months here in Shell since our last update.  We'll give you some snapshots below.

In late January a little girl came to Casa de Fe with the most severe malnutrition that I (Kim) have seen.  Karla's mom was sent to jail four months previous and she was being cared for (or not) by her grandmother.  She arrived weighing less than 9 pounds at 14 months of age.  Initially she had a hard time gaining weight and ended up with a diarrhea illness that made her extremely ill.  We Karla is doing well now!admitted her to the hospital here and when she did not improve, we transferred her to our sister hospital in Quito.  Her blood pH on arrival there was 6.8 (for our medical friends.)  We were not able to do this test (blood gas) here at our hospital and so were unable to manage her here.  My heart broke watching her deteriorate and knowing her poor prognosis in Quito, where she required full intensive care support on her arrival.  Miraculously God healed her and she is now thriving at Casa de Fe and her weight is up to 17 pounds. Diarrhea is the second of leading cause of death in children under 5 years old worldwide.  Malnutrition contributes to over half of pediatric deaths worldwide. 

March brought us visitors!  Paul's mom visited for several weeks and unexpectedly extended her trip when she suffered a pulmonary embolism.  We were thankful for the excellent medical care at our doorstep.  Our cordless phone we use as our U.S. vonage phone even reached to her hospital bed since we are so close!  We also hosted a young adult team from the church that my (Kim's) brother pastors in California.  The team completed a much needed side walk along the road in front of the hospital, painted at the hospital's "casitas" (which are available for patients living far away that require frequent medical care but do not need to be hospitalized,) taught PE and Art at the missionary school, and made shelves and a puppet theater for Josiah's Ecuadorian preschool.  It was quite a busy week and we were glad that Paul's Mom was still here for the times we dashed off to handle team logistics without giving our own kids a second thought!  We were all disappointed that my brother and niece were not able to come on the trip as planned due to illness, but that gives an excuse to do a repeat! 

At the end of March, Paul traveled back to Texas with his Mom to help transfer her medical care to her U.S. doctor.  (She is doing great and seems to be fully recovered!)  On his return, he was able to bring a blood gas machine back with him.  Since our first weeks here, we have felt like this would be a useful addition to the hospital's equipment and it was brought home even more strongly after Karla was so ill.  In the past 2 months, it has come in handy multiple times.  Managing, purchasing and at times fixing the hospital medical equipment has become his second job here.  He has done a great job getting things in working order and updating many things from IV poles in patient rooms to new equipment like ventilators and the recent blood gas machine.  He has become expert at reading manuals online and contacting companies to fix equipment that became outdated in the States years ago.  It can be frustrating, as well, since he does not have any specialized training.  Just this week God provided a short-term missionary electrician who Paul had meet in December on a trip to help a doctor on the coast.  Carl showed up at a crucial time in the hospital and was a great help and encouragement to Paul.  It served as another reminder to both of us that this is God's work and He is faithful in providing for it and for us.  Please praise God with us!

Of course, Paul continues with his main job of anesthesiologist for the hospital.  Because he is the one who manages ventilators in the ICU, he is often involved with the most difficult patients admitted to the hospital.  In March, an 7-year-old boy from Shell, Justin, was hospitalized after finding a firecracker, lighting it  and having it explode in his hands.  He suffered severe injuries to his hands, face, chest  and eyes.  In God's providence, we have an opthomologist at the hospital this year and this past month a visiting cornea specialist was able to help Justin with corneal transplants.  Paul has been involved in several of his surgeries as the anesthesia provider, including the initial surgery and the corneal transplant.  Please pray for Justin and his family as they adjust to living with his disabilities. 

April brought celebrations.  Nathan turned 7 and celebrated with a Star Wars party.  For pictures and more Barton Boy updates, including Josiah's birthday in May, see our website - www.drsbarton.blogspot.com.  We also celebrated a wonderful answer to prayer when our neighbor, Randy Umble was able to have a kidney transplant from his wife, Melanie in Pennsylvania.  You may remember prayer requests from previous updates regarding his health and unexplained kidney failure.  It is truly amazing that Melanie was a The Villacis familygood match and both are recovering well and hoping to return here this summer.  Thank you for your prayers on their behalf.  Around this time, Pastor David and Carmen Villacis from our church in Mera welcomed their third child - Ashly Elizabeth.  You can see their picture to the right although Amy, their oldest daughter was at school.  And of course, April brought the ultimate celebration of new life!  Easter always feels a bit strange here.  Good Friday is the big holiday in Ecuador and Easter does not have quite the triumphant church service and music that we associate with it.  We were glad to gather with the missionary community to eat and sing hymns in English that are special to us at this time of year.  We even had trumpet accompaniment! 

Now May has flown by.  Our thoughts have turned to making preparations for our upcoming year in the States.  We hope to return in mid-August and will live in Dallas.  In September we plan to attend a  MTW Interview and Orientation week to change officially from short-term to long-term missionaries.  Then we will develop our prayer and financial support team and plan to return to Shell the summer of 2012 to continue this ministry for another 4 year term.  Paul has had the equivalent of a part-time job searching for replacement anesthesia coverage for the hospital here in Shell for this time we will be gone.  There has been lots of interest, but it is time-consuming to follow up with everybody, answer all their questions and then schedule  those who get to the point of applying to work as a short-term missionary.  Thankfully, God has provided coverage for about half the time at this point.  I have also been preparing Casa de Fe, the orphanage where I volunteer, for my absence.  We recently learned that the nurse who would be here for the year will not be coming, so please pray for wisdom in filling this need.  A pediatric resident will be visiting in June and I hope to get all the children caught up on their physicals while she is here. 

We look forward to seeing many of you as we return to the States.  We are planning a East Coast driving trip in the fall and if it goes well, will plan more travel.  We will be looking for a van to buy, so if you know of anything available, let us know.  We also welcome outgrown boy winter clothes, since we have lived in shorts and t-shirts for three years now.  We have started to pack away books, pictures and other things we won't need in the next couple of months since others will use our house while we are gone.  Every time he sees us packing or going into the attic, Isaac asks us if it is Christmas yet.  He remembers that we stored the Christmas tree and decorations up in the attic.  Please pray for this time of transition, which is exciting, but also can be stressful.  We are grateful for the many ways you partner with us and have been privileged to truly see the body of Christ at work in this ministry the past three years.

Blessings,
The Barton family

January 20, 2011
Dear friends,

Happy New Year! Wow, December really flew by.  We will give you a whirlwind tour of our December because we are ready to move into 2011! We started December with a "Vacation under the Volcano" with Kim's parents who were visiting and spent Thanksgiving with us.  We stayed in nearby Banos for a couple days, then brought my parents to Quito for their flight, leaving Banos on a day the volcano erupted.  No wonder the man who checked us in reassured Paul that we were in the "zona de seguridad" (safe zone.)  See attached pictures of the volcano as well as the four Barton Boys.  The next week found me, Kim in the jungle for 2 days doing Mt. Tungurahua erupting!physicals on Compassion children while Paul held down the home fort and covered anesthesia for the hospital.  (see more on our blog, www.drsbarton.blogspot.com)  The next week, Paul traveled to San Lorenzo on the coast to provide anesthesia at another missionary surgery clinic.  I was kept busy with the special needs children at Casa de Fe, the orphanage where I provide pediatric care.  Four children were hospitalized this month, several other illnesses managed on an outpatient basis and one baby died.  Little Suzanna, a who was born with hydrocephalus and had a VP shunt died December 15.  It was a blessing that she was able to live at Casa de Fe most her her short life where she was a truly treasured little baby.  And it is a blessing and a comfort that now her mind and body are whole and at peace.

We enjoyed a quiet Christmas week around Shell with the kids including a picnic and swimming at a nearby river.  We attended the Christmas program at Josiah's school which turned out to be more of an outreach program of games and activities for kids in the community.  No wonder his teacher looked at me strangely when I asked about what he should wear.  We celebrated Christmas Eve with a potluck and sing-along for the missionary community.  Churches here do not have Christmas Eve or Christmas Day services Four Barton boys...so it was a joy to be able to celebrate with beloved songs from our own culture and language.  The week after Christmas Paul was back to work - on call for 2 weeks straight.  So we have played lots of games, made crafts, been swimming in the cement pond on the compound and watched all our new Christmas videos at least once!  On New Year's Eve we visited the hospital's New Year contest.  Each department made a straw figure "old man" who represents the old year and whose widow, represented by one of the staff in costume is reduced to begging at the turn of the new year.  After a winner was determined, the straw figures were burned in a bonfire.  (See pics on our blog.)

This past weekend we went to Quito to see our friends and neighbors, the Umbles.  Randy's kidneys are not improving and they are making plans to get travel to the States for further evaluation, treatment and a possible kidney transplant.  Please pray for them during this transition.  Our Missionary Aviation Fellowship colleagues recently learned that the powers that be will no longer allow non-Ecuadorian pilots to fly, so they are the process of figuring out how to adjust their ministry to this requirement.  They are in the process of transferring the ministry to Ecuadorian hands, but need a couple more years.  Please pray for wisdom for their leadership.  Nate Saint missionary school is also looking for a teacher for next year.  Pray for this need and if you or anyone you know are interested, we can give you more information.  Finally, we anticipate returning to the States this August for one school year.  We plan to change our status with our mission, Mission to the World from short-term to long-term missionaries and then return here to Shell to continue working at the hospital as long as God so leads.  Please pray for us as we prepare for this change and make many decisions regarding this time, from kids' schooling to travel plans to temporary jobs.  Please also pray that God would provide coverage for anesthesia at the hospital here.  We are looking for anesthesiologists to help at the hospital for any time period from a week to the whole 10 months that we will be gone.  

Your support and encouragement is a blessing to us.  Thank you.  May 2011 bring you much joy and may you rest in God throughout any challenges that arise.

Love,
Kim, Paul, Samuel, Nathan, Josiah and Isaac

November 19, 2010
Dear all,
Ah, November, that season of crisp air, apples and pumpkins, fall leaves and of course turkeys.  Here it is more accurately the season of thunderstorms, mortinos (tiny wild blueberries only available for a short time) and molting termites!  We will have a turkey next week, however, and are anticipating a visit from Maw-Maw and Pop to enjoy it with us.  Hopefully there will be no surgeries during our dinner since it is not a hospital holiday and Paul is on call.

Seriously, this is the season of Thanksgiving, whatever climate surrounds us and we are grateful for so many things.  First of which is you, our support team.  You all are the backbone of this work and we are immensely thankful for your e-mails, prayers, financial gifts and interest in what we are doing here.

We are thankful for our four "preciosos" who continue to thrive here. Isaac is becoming quite the toddler on this side of two.  He has strong opinions on what he wears (Thomas shirt, Buzz Lightyear PJ's), what he eats (preferable ice cream and cookies) and what WE do.  He is very precocious, having perfecting the eye roll already.  We are very proud of Josiah who has really taken to his Ecuadorian preschool.  He tells us new Spanish words daily and recently participated in a dance performance with other Shell preschools.  See attached picture of his class and the video of Josiah's performance is our most recent blog entry at: drsbarton.blogspot.com.  Nathan has the reputation in school of being very sensitive and caring.  ("Miss M, you are so beautiful!")  He misses having only a half-day of school in Kindergarten, but otherwise is thriving in first grade.  Samuel is enthusiastic about many things from carpentry (He is building a bookcase with Dad) to star gazing to optical illusions and any kind of logic puzzle. 

We have also recently celebrated the completion of some construction here in Shell,  The Nate Saint house was remodeled this summer so the next time you visit us, you don't have to worry about the floor giving way under your feet.  The historical displays regarding Nate Saint's ministry and his death at the hands of Waorani men is updated and the rest of the house has been converted to offices, an apartment and meeting space for MAF (Mission Aviation Fellowship.)  We attended the dedication ceremony conducted in three languages - English, Spanish and Waorani.  It was incredibly moving to see the grandson of one of the killers, who is now a pastor in the Waorani Chrisitian church speak and then lead a church service in the house the next day.  God alone can bring something so miraculous from something so tragic and to Him alone be the glory!

The new and improved Casa de Fe.And just a week ago, after dozens of teams and almost 2 years of construction, Casa de Fe, the orphanage where Kim helps, moved into their new property.  The three work teams that we have hosted in the past year and a half were a part of this huge undertaking. Things are chaotic and still being figured out, but it is a beautiful building and all the kids are estatic.  All the kids are under one roof and the building also houses the school until a school building can be built.

We see prayers answered so often here.  Just a couple weeks ago, I saw a precious 4 month old baby girl in the clinic.  10 months ago when I met her family,  her mother was pregnant (with her), leaking amniotic fluid and expected to miscarry.  We see much evidence of the hands of the Great Physician even when the resources of modern medicine reach a limit.  Please join us in prayer for the medical issues many of our friends are facing.  Our neighbor and a teacher at Nate Saint school, Randy Umble has been suffering from decreased kidney function for several months.  Please pray for his healing and for wisdom for his family and doctors.  Our teammates in Quito have family members suffering as well.  Please pray for Craig Pohl's brother Brent who is suffering from kidney failure and infection.  Please also pray for our team members, Mike and Robin McMahan whose newborn granddaughter died shortly after birth this week.  Further, the son of one of our Ecuadorian teammates, Jordan Anrango, in Quito was recently hit by a car and, after several days in the hospital, is recovering at home.  Finally, many of the children at Casa de Fe have complex medical problems and one had surgery today to place a feeding tube.  We are always battling the more mundane childhood infections there as well, and they become more difficult when multiplied by 54 children under one roof.  We appreciate and indeed depend on your prayers.

We wish you a blessed Thanksgiving season,
Kim, Paul, Samuel, Nathan, Josiah and Isaac


July 9, 2010
Dear friends and family,
We apologize for our silence of the past few months.  Things have returned to normal since Paul's trip to Haiti in April and we are just keeping up with day-to-day life.  Today (July 4) marks the two-year anniversary of our move to Shell (almost 3 years in Ecuador) and so we will reflect on some of the changes we have seen over the past 2 years.

1.  The boys have grown 35 inches, all told.
2.  The road to Tena (a town further into the jungle) has been paved and now takes less than 2 hours, compared to 3-4!  The very short road that leads from the hospital to the road the school is on (We call it "The shortcut road") has been paved and now has lights as well.
3.  We have said "Hello" or "Good-bye" to at least a dozen missionary families here in Shell.
4.  We have hosted 2 mission trip teams and are preparing for our third.
5.  Paul has been to Haiti twice.
6.  Paul has spent hours designing and equipping a tent hospital to be used in disaster relief.  Did you know that you can find the weight, size and cost of almost anything from surgical drapes to litter boxes on amazon?
7.  We have never lacked for financial or prayer support.
8.  Paul has done anesthesia for over 800 surgeries - 15% of them in Haiti!  He has done about 5 labor epidurals (which aren't used very often here), pulled 5 coins from the throats of small children and managed dozens of patients on a ventilator.
9.  Kim had over 700 clinic patients and 1 ICU patient (twice.) 
10.  Isaac has learned to talk, Josiah has learned his alphabet, Nathan has learned to read and Sammy has read books that we have never even tackled.  Sammy and Nathan have learned to ride 2 wheelers and Josiah has learned to ride a bike with training wheels.  Isaac rides the wagon!
11.  The boys have eaten over 1500 frozen yogurts and bon ices (popsicles.)  Isaac spends the day saying "bon ice" and today was saying "una mas" while reaching for the freezer.
12.  We have caught 5 tarantulas, bred 5000 fruit flies with our leftovers and poisoned 1000 ants.
13.  Casa de Fe orphanage has had about 20 kids come and go so that the census is roughly the same. 
14.  Kim has learned more about genetic syndromes, tracheotomies, MRSA, ADHD, parasites, malnutrition, cleft palate, congenital heart disease, ventilator management and seizures than even in residency where there were always specialists to handle these things.  (And still has much to learn!)
15.  We have learned to adapt during almost 2000 hours without Internet, 300 hours without power and 65 without water. 

We hope that the greatest changes have been in us - our trust in God, our flexibility when plans change and our world view.  God has continued to lead us and provide for us on a daily basis.  A medical team recently visited Casa de Fe with experience in special needs kids who were a tremendous help and encouragement.  Currently a visiting nutritionist is helping me evaluate their dietary needs.  Paul and I recently had a rare date night with another couple as a thank you from HCJB for all the work Paul did on the tent hospital proposal.  This was a great way for Paul to use his "behind the scenes" talents and hopefully he will be able to participate in more projects like this as well as future disaster relief projects.  Another behind-the-scenes role he has is coordinating equipment maintenance and ordering at the hospital.  He is currently ordering some much need equipment including new ventilators with some of our ministry funds.  We are thankful for a healthy support balance that allows us to help with this need.

As a family we have recently enjoyed family excursions to Quito for a week, to Ambato for grocery shopping and video games, to the Banos zoo and to the pool in Shell.  We saw Toy Story 3 (6 thumbs up!), got car maintenance done, went bowling, said good-bye to friends, were slightly intimidated by a tapir wandering around the zoo and stocked up on good lettuce, ricotta cheese and even corn on the cob! We look forward to our Dallas church's second mission trip the first week of August and then we are blessed to be able to travel back with them for a short stateside vacation.  We will visit family in Houston and San Antonio and swing through Dallas to spend several days with our favorite pediatric dentist!  Yes, dentistry is just a little different here.  Oh, and we will visit our church and friends, too!  If we miss you this time, we plan to return to the States next September 2011 for the school year.  We plan to do the training and additional support raising that MTW requires for us to change from short-term to long-term and return to Shell in summer 2012.  We are considering home schooling for the school year so we will be able to travel and visit supporters, friends and historic places.

Thank you so much for your support and prayers.  We think of you often and do hope to see most of you in the next two years.  We never quite get our blog updated as often as we like, but there are several new posts since our last e-mail update.  www.drsbarton.blogspot.com  As always, let us know if you have different preferences regarding our e-mail communications.

Happy fourth of July,
Kim, Paul and los cuatro traviesos

Prayer and Praise
1.  Casa de Fe is close to moving to the multi-use building.  Please pray that work would continue without glitches and that the transition will be smooth.
2.  We are hosting a team from our church July 31-Aug 7.  Please pray for travel, logistics, team preparation and ministry.  They will be doing a VBS and construction at Casa de Fe and helping with VBS at our church.
3.  Praise God for providing funds to buy much needed equipment for the hospital.  Pray for the logistics including customs that are involved in actually getting it here.
4.  We are thankful for the family that rented our house in Dallas the past three years.  Please pray that we find renters for this next year.


April 5, 2010
Dear all:
It has been a busier-than expected month of March!  The month began with Josiah, Nathan and I (Paul) heading to Quito to bring my mother to the airport after a great two-week visit.  The three of us got caught up on dental work and renewed my passport before our return to Shell.  Our family was reunited for a few days before Kim left with Josiah for Quito again.  This was a bit of a crazy weekend for me being on call and managing three boys as well as 2 babies in the hospital who were on a breathing machine.  It is very uncommon for us to have 2 ICU patients on the breathing machine, let alone 2 infants!  With some help from our neighbors, I managed the home front while Kim, with the help of another Princeton alumni in Quito (what are the odds?) met our team from Princeton Evangelical Fellowship (PEF.)

The PEF team consisted of a group of 14, mostly college students, who spent the week doing construction at the Casa de Fe work site.  They also helped with teaching PE and Art at the Nate Saint (missionary kids' school) and at Casa de Fe.  The last day they painted the inside and outside of our church in Mera, Cordero de Dios.  How beautiful and fresh it looked when they were done!  We really enjoyed having them with us and were truly encouraged by their vibrant lives and joy in serving the Lord through these opportunities.  Our journey back to Quito to get them on their Friday night flight was punctuated by a visit to Mitad del Mundo or "middle of the world."  This is a park and cultural center located on the equator that celebrates Ecuador's location in the middle of the world.  We dropped the team off at their flight then took a brief rest at our guest house only to be up the next morning and at the airport at five to get me, Paul, on a flight to Haiti!

HCJB disaster relief desires to be involved with the continued healing of Haiti specifically to include some follow-up with the patients we served during our first visit there.  The trip was scheduled for 2 weeks and we arrived in Haiti Saturday, March 20th.  Our hope was to take over where other teams had left off with treating more patients with earthquake related injuries and to see our former patients.  We found that many of the surgical and medical needs had been covered by previous teams and our services were much less needed than we were led to believe.  However, we did do about 15 surgeries and many cast removals and/or replacement.  Further, physical therapy is a great need now and we helped to get this started.  Some down time was filled by visiting the city of Port au Prince and taking in the earthquake destruction and observing how the people were learning to cope and recover from this  tragedy.

Later in the week we visited the town of Legane which is located very close to the epicenter of the earthquake and suffered over 80% destruction of buildings.  It reminded me of pictures and accounts of London after the air raids of World War 2.  In Legane we also visited a tent hospital staffed by the NGO Global Village and Notre Dame University in partnership with the only nursing school in Haiti.  Our tour allowed us to gain valuable knowledge about how these enterprises are run.  We hope to use this knowledge to prepare a disaster relief medical/surgical tent hospital package ready for immediate deployment in the future.  

Thursday night we accompanied the Billy Graham Evangelistic Association team to a tent refugee city for outreach with the Gospel.  This village is located on a city street and made of a tent constructed from various tarps over a wooden frame that spans half of the city block.  To us it appeared to house about 100 people and almost all of the tent square footage was covered by mattresses.  It was remarkably clean and did not smell.  I was amazed by the way they were making the best of a terrible situation.  After the presentation, several people trusted Christ as their Savior.

I have made some entries to our new blog that tells a bit about this time in Haiti at:  www.drsbarton.blogspot.com.

As I'm writing this, my team here in Haiti is packing bags and plan to leave tomorrow, Saturday, to go home to Ecuador.  I can't wait to see the familly again!  I anticipate a warm welcome upon my return while Kim "disappears" to recover!  She certainly needs a day and a half at the spa! 

Addendum from Kim:  We were overjoyed to have Paul home yesterday on Easter.  He took an early bus from Quito and we were reunited just before lunch.  Isaac keeps squealing, "Daddy, Daddy!" and all the boys got in some much needed wrestling and pillow-fighting with Daddy.  Please keep the HCJB efforts in Haiti in your prayers as well as Casa de Fe and the baby girl in the hospital in Quito.  We appreciate you so much!  Happy Easter.  He is risen indeed.

Love,
Paul, Kim, Samuel, Nathan, Josiah and Isaac Barton


March 5, 2010
Dear friends and family,
We are so appreciative of your support during Paul's trip to Haiti.  We saw so many answers to prayer for Paul and his team as well as for us here at home.  We were so thankful to have my parents here and even their passport problems that delayed them gave us a heads-up so that Paul and his teammates did not have the same problem.  After hearing many times from Paul and his teammates about their concern for tetanus, a doctor friend of ours found tetanus vaccine for purchase as well as some that was donated.  She arranged to pick it up and transport it over ice with her husband who arrived in Haiti about the time Paul was leaving.  I wasn't sure how exactly we'd pay for it, but thought we could use our ministry funds if needed.  The total came to almost $9000 and our home church, New St. Peter's Presbyterian in Dallas decided to use their monthly alms collection to help defray the cost.  God provided abundantly and our church collected more than double this amount on one Sunday.  The vaccines made an immunization campaign possible in a refugee camp a short distance from Port-au-Prince.  This will have long-reaching consequences as Haitians and especially the men are seldom vaccinated.  It is truly amazing to see how God worked even in the midst of the tragedy of the earthquake and we are honored and a bit awed to be able to serve Him in this way. 

From Paul...Over the past month I have had many people ask, "So how was Haiti"?  The best way to describe it is that it was great and horrible at the same time.  You all must have seen the copious photos from Haiti in the days following the disaster there so I won't outline that here.  What I do want to emphasize is what God has done through this tragedy!  This is what I have continued to focus upon.   Thankfully I was spared many of the difficulties other relief workers endured during their times of service.  Our base of operations was Baptist Haiti Mission (www.bhm.org) who, since their inception six decades ago, operate a 100 bed hospital, church, elementary education ministry, and artisan training, among others.

The earthquake on Tuesday afternoon, January 12 left many with broken limbs who soon filled the overflowed the hospital numbering 300 or so wounded.  All these were admitted and cared for by the only remaining physicians on staff - Dr. Bernard and a senior level medical student - Claud, (who's school was destroyed in the earthquake) with the help of a handful of nurses.  From this point, the patients waited, many with open, dirty fractures of the arms and legs, for our team.  This, I believe was one of the greatest ways I saw the Lord work miraculously through us.  We were a small team consisting of me, (an anesthesiologist) two orthopedic surgeons, a nurse, two family physicians and a water engineer.  Wow, what a great fit for this specific situation!  Almost all of the patients were victims of fractures of the arms and legs which we were prepared to surgically fix.

We arrived at the hospital on Friday, Jan. 15, in the early afternoon and went to work immediately triaging and cataloging the patients.  Several hours later we entered the operating room with our first patient and worked until after midnight.  We continued operating early the next day and continued to midnight again.  This pattern was repeated again the next day as we finally began to make a dent in the work load.  The family physicians on the team spent this time tirelessly managing wounds and other medical issues.  We were grateful for the continued arrival of other medical providers as the days went on including other anesthesiologists, nurses, general practitioners, chaplains and laboratory personnel.

Through it all I continued to be amazed by the many miracles that seemed to pop up on a daily and even hourly basis!  All praise goes to the Lord and it was fun to see Him work and provide in so many ways.  One example was my need for another anesthesia monitor.  After several days of use my anesthesia monitor suddenly went blank and would not work despite my many attempts at resuscitation.  The word was sent out to the local staff to search for an alternative.  For the first few days of our work there, the international supply lines you have heard of on the news were not yet flowing so many items we take for granted in our usual OR environments were not readily available but were often dug out from the many store rooms scattered about the Baptist Haiti Mission compound.  I became accustomed to describing what we needed to our helpers in the OR and they would diligently go search and almost always return with just what we needed.  Frequently they would say, "We just found a bunch of those around a corner in the store room."  We may have heard about the shortage of IV fluid at one point or of orthopedic supplies at another point and these things were miraculously found tucked away.  So, when our monitor went out, wouldn't you know it, the hospital director, at a conference several years prior, "just happened" to be the winner of a door prize of - you guessed it - 2 monitors that were exactly what I was looking for.  These too were stashed away, waiting for just such an occasion!  See what I mean...isn't it fun to see the Lord work!

Another small but palpable miracle was the "accidental" inclusion of a water supply hose in the portable water purification plant that was delivered to the hospital compound.  Typically it comes with one length of hose to immerse in the water to be purified and another length for the outlet side to deliver clean water.  Martin, our water engineer was unpacking the kit and wondering how he was to bridge the gap between our source of water and where it needed to go when he discovered that another length had been included "by accident" with this kit!  Yes, it's small but obvious that God was working moment by moment!

I must tell you about Madam Kafa  Madam Kafa is 83 years old and has been working in this OR at Baptist Mission Haiti literally for decades!  She would meet us in the morning when the OR schedule began and remain until we finished at a late hour.  We found out after several days that her house had been destroyed by the earthquake and she was sleeping on the streets.  What amazing dedication!  We were able to help her out with shelter materials once we learned this.  Her grandson, Stefano, a medical student in Haiti, also helped us.  His medical school was also destroyed so he practiced his English while helping translate in exchange for the opportunity to observe in the OR.

During the 11 days we were there 115 surgeries were done, most of which were orthopedic in nature.  We arrived home exhausted but blessed knowing that we were used by the Lord to minister to the people of Haiti demonstrating the love of Christ through medical service.  Our last morning briefing the chaplains attending the patients reported that over 70 people had trusted Christ to be their Savior and Lord during this time. This is the most incredible miracle of all.  God used this terrible tragedy that left people in dire circumstances to lead them to new life in Him.  To Him be the glory.

A picture is worth a thousand words, so I just finished posting some pictures on a new website for us -  www.drsbarton.blogspot.com.  Also, please pray for the specifics of a follow-up team in April.  We don't know what medical specialties will be needed, but I am willing to go if the opportunity arises.

Back to Kim...We are a little bit dazed to realize that February is over and gone.  We celebrated a big birthday for Kim, saw Quilatoa lake - a beautiful crater lake in the highlands of Ecuador - with friends from Quito, had a wonderful visit from Paul's Mom, attended Colonial Day at Samuel's school and got dental work done for half of the family.  We will post pictures, possibly on the new blogspot website since it is proving very user-friendly for pictures.  March promises to fly by as well.  We are eagerly anticipating a short-term team from Kim's college fellowship group - Princeton Evangelical Fellowship.  Four staff and ten students will visit for a week to help with construction on the new Casa de Fe multipurpose center as well as helping out at the Casa de Fe school, hospital and Nate Saint school.  This is the second team we have hosted in Shell, so we are still novices.  However, it is a role that we find extremely rewarding.  Please pray for their experience - for smooth travel and logistics, for health during their time here and for spiritual impact on them as well as the people to whom they minister.

Once again, thanks for being a part of this work - in Haiti and here in Shell. 

Many blessings,

Paul, Kim and the Barton boys


Since the January 15 update below, Paul has safely returned to Shell and rejoined Kim and the boys after 2 surgery filled weeks in Haiti...

January 15, 2010
Dear friends and family,
Please join us in praying for Paul as he is with a HCJB medical team in Haiti.  There are 2 family practice doctors, a surgeon, Paul as anesthesiologist, a water engineer and the HCJB healthcare director.  They are partnering with Samaritan's Purse (www.samaritanspurse.org) and more information is available on their website as well as www.hcjbglobal.org.  He left Wednesday night for Quito and flew to Miami Thursday.  Today they were able to fly to Haiti.  I got word that he landed safely and they had an hour or so drive up the mountains that surround Port-au-Prince to a Baptist mission hospital where they will be based.  Their main concern right now is safety as the people of Haiti are understandably quite desperate.  Please pray for their safety as well as the emotional impact of witnessing the devastation.  I will try to update our website each night, www.drsbarton.com as well as post news on Facebook.  (Paul Kim Barton on Facebook.)  If you would like to receive e-mail updates directly, please let me know.  There is also a website to see Twitter updates from another team member:  http://twitter.com/hcjbglobal.

The boys were very sad to have Paul leave, but have been very helpful to me in the past 2 days.  We are thankful for our supportive community here.  Next week my parents are due to arrive for a previously planned visit.  We are all looking forward to their visit and will especially appreciate having them here with Paul gone.

We have had a difficult three weeks since Christmas.  To fill you all in, Christmas morning at 3:30 I was called to the hospital by Patti Sue who runs the orphanage, Casa de Fe.  Steven, a baby who has had many problems since his birth on September 11 stopped breathing and they brought him to the ER.  It was not his first such episode, but was the longest.  We were able to resuscitate him and he required about 10 days on a breathing machine.  During this time, Paul and I were both involved in his care, much more so than either of us is usually involved with a hospital inpatient.  We had early mornings, late nights and many hard questions about his care.  In the process he required a tracheotomy.  We were able to send him home about 2 weeks later and since then he has done very well at Casa de Fe.  This is truly a miraculous answer to prayer.  He has been the child requiring the most complex medical care at Casa de Fe and his tracheotomy has only increased this distinction.  I believe many of the ladies who care for him are ready for nursing school now!  Continue to pray for him and for wisdom in the decisions we make regarding his care. 

We, along with our missionary community here are also deeply saddened by the drowning of the 2 1/2-year-old grandson of our fellow missionaries.  His brother is one of Nathan's classmates.  He was hospitalized in a ICU in Quito for several days and was covered by prayers from all over the world.  Although we know he is in heaven with Jesus, our hearts are heavy for his parents, siblings, and grandparents and we continue praying for them.  

We have seen so many answers to prayers in our two years here and in the past few weeks, but we also know that sometimes the answers are different than the ones we hope for.  Know that we are praying for you as well and that we appreciate your prayers on our behalf.

Blessings,
Kim, for the Bartons