We Keep a Shotgun in Our Broom Closet (By Hannah McDowell)

That’s right! There it stands, double barrels propped against the wall in the far left corner, sharing floor space with a couple of brooms, two bottles of bleach and an assortment of empty gallon jugs that we use to safely dispose of used needles. I discovered it the morning I needed to sweep the floor when I arrived for my 7:00 to 3:00 shift. The clinic here in Honduras has a wonderful janitress who comes in six days a week and does a superb job of keeping things spick and span. Believe me, that is no small task, given our location at the edge of town, on a dirt road which is alternately either very dusty or very muddy, depending on when it last rained. It takes several-times-daily sweeping and mopping to keep the tile floors adequately clean, and on her day off that job falls to whichever nurse is on duty at that time.

Naturally I was a bit startled at the odd addition to the normal arsenal of cleaning equipment that one might expect in a broom closet. Upon my inquiry to the day guard on duty, he smiled, assured me it was never loaded, and that it has only been used a few times when one or another of the guards has carried it as a not so subtle deterrent to any would-be trouble maker who came around.

That’s not the only difference in stateside vs. Honduran nursing. Something that never ceases to amaze me is the cost of clinic care here. The five pound eight ounce beautiful little girl whom I most recently welcomed into the world at 4:48 a.m. had a non-complicated arrival, and she and her mommy were both able to go home 24 hours later. Their entire bill was 500. “Not too bad,” you say? You’re right, especially considering that we are talking about 500 lempiras, not dollars. At the current exchange rate of 18.9 lempiras for each dollar, that comes to $26.46. Of course, when either mother or baby needs extra attention, the bill goes up: if a bag of IV fluids is used, it costs $3.65, and oxygen at 3 liters a minute for an hour comes to an additional 95 cents. Intensive care for a newborn is another 110 lempiras, or $5.82.

If your child is dehydrated due to several days of diarrhea and vomiting because you failed to boil his drinking water, you can bring him to our clinic for IV rehydration and medication to get rid of whatever bad “bug” he got from the water. We will give him excellent nursing care for $4.23/day plus the cost of his medications and IV fluids. Quite reasonable, especially compared to the $10.58 per five minute visit our collaborating physician charges to stop by and see how he is getting along, and make any necessary changes to his treatment plan.

If you are unfortunate enough to chop your hand instead of the tree limb you were trying to cut up for your wife’s cooking fire, drop your machete, wrap the wound in a rag (hopefully a clean one) and hurry on in to us. We can inject it with a local anesthetic so the thorough cleaning it needs won’t hurt, and you can lie back and close your eyes while one of our nurses expertly puts in the stitches necessary to neatly draw the gaping edges closed. If it’s a small cut requiring only one package of suture, you will be charged $4.76 for the repair job and bandaging. If your machete was well sharpened and you were swinging vigorously, your wound will probably require two packages of suture, but in that case you will get a bargain: instead of paying double, your bill will only be $9.26. If you need a tetanus booster the fee will be 21 cents for the syringe and 11 cents for one of us to give you the shot, since the Health Department supplies us with the vaccine itself free of charge.

Do be careful not to slow down too much at the crest of the hill on your way into town. I’m told it’s a prime spot for gangs of hoodlums to leap from their roadside place of concealment, stop your car and rob you. Just a week or so ago, that very thing happened to a 60 year old gentleman on his way to visit his elderly father. He arrived at the clinic mid-morning, clutching a blood soaked towel to his shoulder. “I wasn’t scared when they jumped out, I was mad!” he blustered, as I kept pressure on the wound while he eased down onto the exam table in our treatment room. “There were three of them. One fellow tried to grab my door, and when I swerved to run him down, another one pulled a rifle and shot me through the window!”

I gingerly slipped his bullet-shredded shirt over his head and carefully peeled away the towel. Pleased to find that the bleeding had stopped, I adjusted the brilliant overhead light to better examine the three inch long and quarter inch wide blue-black tunnel that extended from his shoulder to his collar bone. With infinite care I extracted one small and two rather significant sized chunks of mangled bullet, and tightly bandaged the gaping hole that was left. Twenty minutes later, his younger brother driving, he was on his way to a larger medical center for the x-ray he needed to see if his collar bone had been nicked, and to investigate the suspicious looking bulge on his neck that I suspected might be another piece of bullet. And he didn’t quibble a bit about the $2.65 he had to pay for my care!

There are a few occasions when we don’t charge full price for our services. Twice now I’ve been on duty when the extremely deaf, 96 year old man who can’t afford the surgery he has needed for two years, comes tottering in for his every-week-to-ten-days Foley catheter change. Rheumy eyes blinking, he peers up at me and grins cheerfully as I give him a welcoming pat on the shoulder, then squat down to help him undo the thick black shoestring that he uses to tie the urine collection bag to his leg. When the pus clogged, filth encrusted tube and bag have been replaced, and his dirt and sweat stained clothing readjusted, he reaches into his pocket for the money he has tucked away, and painstakingly counts out his stash. The normal cost of such a procedure is 80 lempiras, or $4.23. I accept the 40 lempiras his trembling fingers slide across the counter, smile, and loudly wish him a good day and God’s blessing. He shakes my hand and thanks me before slowly shuffling out the door and up the dirt road. I turn to the sink to wash my hands, blinking back tears. How very blessed I am with so much that I take for granted! I silently thank the Lord for allowing me the privilege of ministering to “one of the least of these my brothers,” and pray that His love will continue to shine into he lives of the many who walk through our doors.

A Wonderful Time

We are in the middle of a very action packed, two week tour, and I must say that we have been having a wonderful time. I have tons of pictures, but most of them will have to wait until we get home this coming Friday (this is the first that we have had internet service since we left). For now, here is a little glimpse of what has been happening.

We left last Saturday, and on our way up to a camp in Michigan we stopped at Cracker Barrel and Cabelas. That was the first time that Missy had been to a Cracker Barrel, and we both enjoyed the food and the store. We didn't know that we would be going by Cabelas until we got to it, but of course I had to stop.

The Wesleyan Holiness Camp in Remus, Michigan was outstanding. God came in our missionary service, and a number of the people closed with a good time of prayer asking God to help them develop more of a passion for missions. The people at the camp were the friendliest that you can find anywhere. We were planning on leaving on Monday, but we ended up staying an extra day because we enjoyed the services and the fellowship so much.

On our drive to our next service location on Tuesday we came across a huge petting zoo which Devin absolutely loved. We stayed from Tuesday until Friday at an empty parsonage in OH, and had a nice little break. One of the church families gave us some money after the Wednesday night service and told us to do something special as a family. So on Thursday we went to a zoo, and again we absolutely loved it. On Friday we drove to Port Huron, MI to stay with my cousin and his wife. Yesterday they took us to watch some boat races on the St. Claire River, and again we absolutely loved it. Last night I went paintballing for the first time, and I absolutely loved it (getting the picture?). This morning we enjoyed a good service, after which we enjoyed a delicious lunch. In a little while we will be heading to Br. Rick Maloyed's church.

This has just been a brief sketch of our activities, but it will have to do for now. I promise that I will share more pictures ASAP.

Sis. Betty Derscheid was the district missionary president for the camp in Michigan. She has such a heart for missions, and went out of her way to make our stay at the camp both enjoyable and encouraging. Thank you, Sis. Derscheid.

In closing, I love this picture which I took at the Michigan camp. Missy didn't know that I had taken it until the next morning.

What do you see...

...when you rent from horse and buggy Mennonites? We have a big, beautiful pond right in front of our trailer, and our landlords take advantage of it quite often. Last night a bunch of their grandchildren (the Hornings have 14 kids and piles of grandkids) went camping.

The boy clapping his hands in the middle is staying with his grandparents all summer. How many of you parents would send your young child to stay with their grandparents that long? It must be a cultural thing.

Of course you have to go swimming the next morning. Notice the little guy swinging off the rope. You can go way up that ladder and swing way out, dropping into about 10 feet of water. I'm thankful for the pond; there is nothing like a good swim after a hot day. Now you can see why it will be quite and adjustment for us to live in the city in Costa Rica; neither one of us are really looking forward to that.

We are leaving for a two-week trip to Michigan and Ohio in a little while, and would appreciate your prayers.

Another Exciting Update

Once again my mother has sent me a very interesting e-mail, once again I am very impressed with her writing skills, once again I am going to post it for you all to enjoy, and once again it is pretty long for a blog post. So if you don't feel like taking the time to read it I understand, but I'm sure you will enjoy it if you do. And if you haven't read the post before this one, I would encourage you to do so (it is quite enlightening).

Hello Again!

It’s 11:28 p.m., and so far the night has been pretty quiet. Maybe I’ll have a chance to both start and finish an entire letter this time, instead of spreading it out over several days! We had a thunder storm earlier this evening, but the only sounds now are an occasional drop of water from the tile clinic roof hitting a puddle on the gravel path below, the ceaseless croaking of hundreds of frogs rejoicing at those puddles, and the periodic harsh clicking call of a lizard who is perched somewhere close by in an overhanging tree.

My lone pediatric patient is peacefully asleep, one leg draped over her mother, lying beside her in the crib. Now that the little one is being treated with IV fluids and antibiotics, her frequent diarrhea and vomiting have stopped, and the mommie is gratefully catching up on rest as well.

Sometime tonight I need to wrap for sterilization in our small steam autoclave the washed and air-drying instruments that Maribel used to suture the nasty wounds of the 18 year old young man whose uncle violently attacked him with a machete this afternoon. The scars he will forever wear from the deep cuts on his shoulder, arm and leg may well fade sooner than the marks of the emotional trauma he is sure to carry inside, buried from sight but never from his mind. Oh, the tragedy that can be avoided by knowing and living for God!

The peaceful calm is a far cry from the happenings of this same shift slightly over a week ago! I was tired to start, having worked 24 out of the previous 40 hours (eight hours on, eight hours off, eight hours back on, etc.,). Our 28th wedding anniversary on July 4th had come and gone. It wasn’t exactly the most romantic we’ve ever had, since Rex was miles away that weekend, teaching a missiology course to national pastors, and I was spending every spare minute between clinic shifts finishing the preparations for the talk on menopause I was scheduled the give here to the women of the local church the evening of the 4th. (That service ended up being cancelled 15 minutes before it was to have started, due to a terrific storm with subsequent power outage all over town. I didn’t mind not having to do my presentation by flashlight!)

The evening of my scheduled 12 hour shift on the 5th and 6th passed quickly with the usual assortment of people coming in to buy medications, receive shots, and seek medical advice. The lights weren’t working in the post partum ward again, but by the light from the hall through the open doorway, the not-quite-six-pounds baby girl whose delivery I’d helped with that morning and who’d had a bit of trouble getting started with breathing appeared to be doing fine. I didn’t need a light to listen with my stethoscope and hear that her lung and heart sounds were nice and clean, and she was nursing well. By 11:00 p.m. the steady stream of walk-in patients had stopped, and mother and baby were sound asleep.

A few minutes before 2:00 a.m. little Miss Newborn woke up hungry and got another meal, but this time she kept crying even after she’d eaten well and should have been satisfied. Her mother had been in labor for 3 days at home before coming to the clinic, and I knew she was exhausted. She gratefully accepted my offer to take her baby for a little while so she could sleep, and I carried the tiny girl back to our linen room for the diaper change my investigating finger had discovered she needed. Imagine if you can the heart-stopping shock I received upon unwrapping her blanket to discover that her face was a deep, dark, ghastly shade of purple! Rapidly unsnapping her sleeper, I found to my further dismay that her entire body was the same horrible color.

Snatching her back up in my arms, I ran down the hall to the delivery room, stripped off her sleeper and diaper and laid her in the infant warmer, quickly throwing the lever to start the powerful bulbs glowing with heat, and pulling the oxygen tank over so I could fit a tiny mask to her face and start a rich flow of oxygen to her lungs. A hurried phone call to Dr. Maldonado elicited orders for a STAT injection of steroid and the oxygen which I’d already started, plus the promise that he was on his way.

By the time he arrived 5 minutes later, the deep purple color had gradually lighted to a dusky blue-grey, and in a few minutes more, she had almost returned to the much more becoming shade of pink that little girls look so good in. Although it was obvious that she was struggling to breathe, surprisingly, her heart and lungs sounded clear. The doctor left me with an order to gradually wean her to room air, but to keep a close watch on her (which I certainly planned to do anyhow!) and reapply the oxygen if necessary. He also wanted her referred to a pediatric specialist as soon as her parents could take her.

Over the next three hours I discovered that as long as she was not crying, her color would hover around an unhealthy looking pasty, pale pink, but that the moment she even started to fuss, she’d turn blue and mottled. I was kept constantly busy, trying to keep her from crying (stroking her gently, singing and talking to her, and giving her glucose water to keep her blood sugars at the very acceptable level they were when I checked them after the doctor left), and turning on and off the oxygen in response to her color. She looked much better in pink rather than purple, believe me!

I had early on told the mother what was happening, and when a woman in labor arrived at 5:00 a.m., I hurried to the mother’s room and asked her to come be with her baby, showing her how to adjust the oxygen and hold the mask in place, while I checked the status of my new patient. From that point until the day shift nurse arrived at 7:00 a.m., it got really interesting as I juggled care of the newborn with support and monitoring of the laboring woman.

With the reinforcement of another nurse, things got a lot easier. I stayed an extra three hours with the baby while her parents made arrangements for her transfer, and Rosmery took over care of the labor patient. However, my shift, which had by now stretched into 15 hours, was not to be over yet.

During the snatches of time that I’d given support to the expectant mother, she’d somehow gotten attached to me, and wanted me to stay to do her delivery. I assured her that I would, but told her I needed to go home and eat something first, since she was not too far along and it was safe for me to leave and get back in time.

After having breakfast with Rex and Jeffrey, I headed back to the clinic once more and was delighted At Rosmery’s report that mama-to-be was 8 cms. dilated and likely to deliver within the next hour or two as this was her third baby. “Wonderful!” I thought. “I’ll soon be able to go home and get some sleep.”

So much for that optimistic idea! Another hour passed…and another…and another. And still the poor woman stayed persistently at the same stage of dilation, in spite of strong contractions three to five minutes apart, and every position change, comfort measure, reasonable intervention, prayer, and whatever else we could think of to help things along. Finally, shortly before the afternoon shift nurse arrived, things started progressing again, to the point that delivery seemed imminent.

But she pushed…and pushed… and pushed, for over an hour and a half and still no baby. By this point, her labor progress had fallen way off the “normal/average” chart and was definitely into the “Let’s do something!” stage. A phone call to the good doctor and his subsequent exam and decision to have her transferred to a larger hospital was not too surprising. What did startle me was the way he urgently motioned for Maribel (who’d taken Rosmery’s place at 3:00 p.m.) and me to follow him into our tiny pharmacy, the only good place for a private conversation.

“Get her out of here as soon as you possibly can!” He hissed. “She and her husband are bad news! They never pay their bills. That woman has been into everything: she was a former prostitute, a police officer, a nurse and who knows what else. If things don’t turn out here as she wants, they’re likely to sue the clinic!”

I gulped and glanced over at Maribel, who looked as shocked as I felt. She hurried to make the phone call requesting an ambulance, while I headed back to explain to the couple what would be happening next. “PLEASE go with me!” the woman begged, grabbing my hand in both of hers and kissing it. “You’re my angel!” Mindful of the doctor’s dire warning, I figured there was no other choice if I wanted to keep her happy with our services and prevent the trouble he’d predicted. So once again I found myself bouncing out of the clinic yard in the back of the ambulance, fervently hoping this ride would not be as hair-raising as my last.

This time I managed to keep the contents of my stomach intact, to my great relief. I could both sympathize and totally empathize with the poor husband who, half an hour of jolting and jostling later, abruptly thrust his head out the hastily opened window behind him, and miserably kept it there for the rest of the journey, periodically heaving his offerings into the roadside bushes.

We did make it safely and on time to the Santa Barbara Hospital. We also made it safely back home, where I stumbled wearily to bed, VERY thankful to have finally ended my 26 ½ hour shift. Just remembering it makes me tired! So, “Buenas Noches, todos.” May we all sleep well!

Hannah

Breaking News! Drilling Finally Permitted in ANWR

That's right, I just heard on the radio that congress has finally voted to allow drilling in the Alaska National Wildlife Reserve! Many would no doubt agree with me that it is about time (sorry Mr. Moose and Mr. Bear). Congress quietly gave permission for the drilling to begin. From what I understand, the drilling has already started, with 150 drills having taken place in an area about the size of one and a half football fields. Oh yes, did I mention that the drilling is not for oil? The environmentalists have started drilling to see what affect heat has on ice. Brilliant! And of course, this has something to do with global warming. Now I am not a rocket scientist, but for a small fee I would be happy to tell these guys what affect heat has on ice. Hey, maybe this would be a way for us to raise support.

A Wonderful Day

If we were writing a book on our deputation travels, the chapter entitled "July 13th" would be one of its highlights. We had two services yesterday, and both of them went very well. The first one was in the afternoon at the Oakland Mills Evangelical Methodist Camp. Since we had recently been in three Evangelical Methodist churches, I had developed a completely different presentation. I felt God's help while I was speaking, and the congregation responded very well. At the close of the service, an offering was lifted that totalled over $1,500 for EFM!

Our evening service was at the Lewistown God's Missionary Church. Again, God came in the service and the people responded very well. And again EFM was blessed with a good offering. The congregation of about 25 gave over $500. In addition to receiving two good offerings, we also received three and a half support pledges from the two services. I have been praying that God will help meet EFM's financial needs through our ministry, and He is answering that prayer.

After the evening service we had a fun time of fellowship with Pastor Donahey and his wife and son. Devin loved all the exciting things he found in the parsonage, including the "magic" air conditioner, the dog that barked, the dog that breathed, the dog that sat in the basket, and especially the dog Hairy. In fact, Devin liked Hairy so much that Dwight Donahey gave Hairy to Devin. I do believe that Devin is becoming quite attached to his new little buddy. (If you click on either Dwight's or Br. Donahey's blog in the next couple of days, you will probably see some pictures of our time there).

Devin enjoys cuddling with his new friend, and he even is willing to share his cereal.

The Nightmare

I know this is rather lengthy for a blog post, but it is very interesting. My parents are in Honduras for ten weeks this summer, and my mother shared one of her nights at the EFM clinic. I do believe that she is the most interesting newsletter writer I know.

Diary of a Nightmare

Saturday, June 28, 2008

1:37 a.m. – “¡Hermana Ana! ¡Hermana Ana!” The night guard’s voice on the walkie-talkie startles me from a sound sleep and I leap out of bed, stumble over to the dresser and fumble in the dark to find the button on the radio to answer him. He doesn’t give any details, just that I’m needed at the clinic.

1:42 a.m. – “Pray for me, please!” I beg Rex as I run out the door. “I know they wouldn’t call at this time of night unless it’s an emergency.”

1:44 a.m. – No question about the emergency part! I’m greeted by the sight of a woman lying on her back in one of our labor beds - along with five inches of pale blue umbilical cord. “It’s a breech presentation,” Maribel the night nurse informs me, as she hurries to call the ambulance.

1:46 a.m. – Quickly gloving up, I gently check the position of the baby who is doing his best to enter the world knee first: definitely the wrong way. Then I help the mother to turn over and kneel, chest on the bed, to take the weight of the baby off the cord, while I anxiously listen for a heartbeat. The little one is still alive, but his heart is beating too slowly. I explain to the mother what we have to do and why, and have prayer with her, asking God in His mercy to spare the life of her baby so she can raise it to serve Him.

2:38 a.m. – “Where is that ambulance?!” Oxygen mask fitted to her face, IV fluids rapidly running into her vein, the mother has been ready to go for a while. The Red Cross Toyota Land Cruiser finally pulls up to the porch, the attendant apologetically explaining why they couldn’t get here sooner. “The ambulance wouldn’t start. We had to push it to get it going.”

3:06 a.m. – We bump across the rocks and out of the yard on our way to the large maternity hospital in San Pedro Sula, normally a two and a quarter hour trip. I brace my feet and fight to keep my seat on the narrow bench where I sit next to the stretcher, my hand still in place on the baby’s leg, firmly keeping him inside and off his umbilical cord until we can get to the operating room for the Cesarean delivery that will save his life. The woman’s husband sits beside me, holding aloft the bag of IV fluid in one hand and gripping his wife’s hand with the other. With the portable tank of oxygen and large garbage bag with emergency supplies that Maribel packed and sent “just in case,” there’s no room for anyone else in the back. The ambulance itself carries absolutely nothing except a vinyl covered stretcher, without even a sheet to cover the threadbare spots that have worn through with long use.

3:17 a.m. – I glance again at the tube feeding into the mother’s arm. This time instead of a clear stream of fluid, there is dark red blood backing up the line. Briefly letting go of the baby, who has been staying up where he is not pressing on the cord, I grab the IV bag and work to get the fluid running properly again.

3:18 a.m. – Glove on once more, I check the mother and discover with horror 2 inches of leg and knee that have insisted on being born. I ease things back inside with one hand, stretching with the other to slide open the tiny window opening into the driver’s compartment. “The baby’s trying to come! Please hurry all you can!!!” Instantly I feel a change as the driver accelerates. “Dear, Lord, please keep us from having a wreck!” I silently plead. At least it’s not raining, so we don’t have the hazard of slick mud added to the danger as we barrel along through the darkness.

3:34 a.m. – I’m still praying, but the words are different now. “Oh, God, don’t let me throw up, PLEASE don’t let me throw up, please, God, help me...BLAAH!!!” I lose everything in my stomach, thanks to the rocking motion of the speeding ambulance over curvy dirt mountain roads. I’m thankful that at least I’ve not eaten since 6:00 the evening before, so it’s mostly liquid.

3:39 a.m. – The woman’s husband follows suit, and I grab for the IV bag he can no longer hold as he miserably empties his stomach as well.

4:03 a.m. – We’ve been jouncing and bouncing for nearly an hour and have finally gotten to the paved section of road. The smells of sweat, diesel fuel and amniotic fluid swirl around me as the driver accelerates even more. I discover that I can drape the bag of IV fluid over my shoulder and hold it there with my cheek, giving one arm a rest. The other hand has started to cramp, but I grimly bend over and keep the baby pressed up inside as its mother coughs repeatedly. I gently rub her leg and smile at her. I can’t imagine the agony she must be feeling. All this time she’s been lying helpless, thrown from side to side and a few times banging her head against the back door as the ambulance careens down the mountain. Off and on she feels the urge to bear down but valiantly grits her teeth and obeys my commands to “Breathe, don’t push!” She’s doing incredibly well. I greatly admire her courage; the only evidence of her trauma is an occasional groan.

4:23 a.m. – I thought my stomach was empty. With both hands again occupied, all I can do is bend over and let the rest of what’s in there splat on the floor. At least that’s only two times for me, compared to the husband’s four. The siren wails as we fly along, swerving back and forth to miss the cars that don’t readily yield the right of way.

4:30 a.m. – We whip around a corner and pull up to the hospital’s emergency entrance, making the trip in slightly less than one and a half hours. I count at least five people lying asleep on the ground, with many others standing around outside as they wait for word from the staff on a loved one’s outcome. No such thing here as a husband or mother giving support to a laboring woman. No one is allowed to accompany her inside the hospital. But I trot determinedly beside my patient as she is wheeled through the doors, persistently keeping the baby’s leg in and off the cord until we get into an exam room and a troop of doctors and nurses converges, one of them taking my place. Another glides an ultrasound wand quickly and briefly over the mother’s abdomen. With relief I notice that the baby’s tiny heart is still beating. Thank God, we have made it in time! I follow the stretcher around a corner and down a short hall, stopping outside the operating room with the ambulance attendant to wait for our equipment to be returned.

6:57 a.m. – The ambulance pulls up once again to the front porch of our clinic. I stiffly step down to the ground, clutching my aching back, thankful to have the nightmare over and to have arrived back home in one piece. I want nothing more in life at the moment than a hug from my husband and a hot shower. Oh yes, and don’t forget to take a picture to go with the article for the mission paper!

(I found out a week later, July 6, that we made it to the hospital in time for a successful surgical delivery. Mother and son arrived safely home yesterday. I’m so grateful to God for His help, and for the part He allowed me to have in the drama. Such is a day in the life of an EFM clinic nurse!)

Please Pray

I just found out a couple of days ago that the mother of Carmen Meneses passed away from cancer (Carmen is the pastor's wife of our main church in Costa Rica). I'm not sure where the lady stood spiritually, although I do know she attended the church. Please pray for the family and especially Carmen during this time of loss.

Sis. Carmen

Carmen's husband and father

July 4th and SIMO Slide Show

Happy July 4th, everyone! I'm always proud to be an American, but today I am more proud than ever. I only hope that God will somehow work to bring America back to Him. Tonight we will be going to watch the Penn State fireworks in State College, PA. This show is ranked third in the nation. It lasts 45 minutes, and averages 4 fireworks per second throughout the main part of the show, and 49 per second during the grand finalle. In addition, the fireworks show is set up to music played on a local radio station. The whole thing is completely amazing!

I was planning on sharing more pictures from SIMO, but fellow EFM missionary Kristin Duncan put together a very nice slide show with a lot of good shots. So instead of reinventing the wheel, I will just give you the link to her presentation. Enjoy!