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Cameroon Shank steps # 6 8-23-05
Hello Family and Friends,
We are two weeks into things here. We have just met
the other doctor that has been covering the hospital
for the last three months. Dr. Hamza has recently
finished medical school in Yaounde and is in the
process of being placed by the government. We are now
taking call. Audrey and him are switching call each
week, and I’m always on for surgical things. So far
(two days) it’s been nice. He is from near here and
reacts very well with staff and patients.
Yesterday we sat down with the administrator and
discussed all the finances of the hospital. It is in
real bad shape financially and has been unable to pay
its workers salaries for the last 3 months. They have
received about 1/3 of what they are supposed to get.
The hospital also owes past electric bills from
1998-2000. Owes the Union for many past things. Owes
tithe to the church. And a number of other creditors.
So it is essentially living from “hand to mouth”. We
pay for medications most used and IV fluids and
laboratory bare minimum. The real issue has been the
past year without constant physicians. When this
occurred the patients go to other facilities. And now
that it’s the rainy season people are out working and
the roads are so bad that people that normally come
from Nigeria can’t make it across the rivers. So this
makes it difficult to get the needed supplies to treat
the patients like we could. We very much appreciate
all the donations that were given to us. We brought
some smaller items with us like gloves, pulse oxymeter
by Nonin, rigid proctoscope, stethoscopes….and other
small items. We anxiously await our container, which
has apparently left the US and should arrive in Douala
by the end of September. How long it will take to
clear customs and make its way up Cameroon a thousand
kilometers only God would know. We pray for rapid
transit. Please pray for the financial situation of
the hospital and also for continued spiritual growth
of the employees in this difficult time that we all
will grow closer to God and serve His children here as
best we are capable of.
At the hospital there have been more interesting
surgeries. We had a patient come in with birth of a
baby at home then retained placenta. We attempted
about an hour to remove it unsuccessfully. The
patient had a low blood pressure and fast heart rate
indicating significant blood loss. So we took her to
the operating room and took out the uterus. Her
family refused to give her blood. So I donated it to
her preoperatively. With that and the other fluid she
stabilized then we took her when things were ready in
the operating room. With much prayer we were
successful in getting the uterus out and the patient
out of the operating room alive. The next day they
would still not give her any of their blood but we
were able to give some that had been donated for
someone else who had expired before receiving it. She
seems to be doing well about 4 days postoperatively
now. I am very thankful to have Audrey help me in
these surgeries as it is very helpful to have someone
who speaks English and adheres to sterile technique.
For this and many other reasons we look forward to the
student missionaries coming here to help. Our first
one is to arrive at the end of this week. She will
stay a month then another will come for a month. I
think this is invaluable to the student as I went on a
number of student mission trips myself in the past. I
would encourage anyone considering it to pursue it, as
it will undoubtedly change your life in a positive
way. We are happy to accept student missionaries as
is Dr. Appel in Bere, Chad. If you are not
considering being a student missionary I would
encourage you to help financially support one in your
church or through AHI or directly with someone
interested in serving overseas.
Power is one thing we are very thankful for. We have
it most of the time. It went out for about 8 hours
today which put a stop to some lab work and made
rounding difficult but most got done without much
difficulty. Fortunately there were no surgical
emergencies today. As mentioned before the power
company has threatened to cut off our power but as of
yet that has not occurred. We continue to pray for
this also.
So at 2 weeks into Koza we have good days and
difficult days. But regardless of how our feelings
are at the time we are all happy to be doing what God
has called us to do. We praise Him for leading in our
lives so directly in the past that we are confident He
will continue in the future. Please continue to lift
us up in your prayers. We would love to have visitors
if anyone of you are interested.
In His Service, The Shanks

_____________________________________________________________________
Cameroon #4
Dear Family and Friends,
We are finally in Koza. We arrived on Tuesday August 9. It was quite the trip. We started by the
driver at the dental clinic dropping off our luggage (now cut down to 11 pieces) for the baggage
on the train from Yaounde up to Ngaoundere. Then we finished packing a “few” things. We each
ended up with a large backpack and a smaller backpack each and two large bags of food. It was
crazy but we thought we would be in the sleeper car, with four beds and some space to store
things. Well we didn’t end up in one. We were in first class seats. This meant in a train car with
two chairs on each side. Well leaving Yaounde was a chore. They opened the gates at 5:30 and
there was a mad rush for the train. Fortunately the first class seats are reserved. Not a first
come first serve basis like second class. There the people who get there first get seats and the
rest stand. In the first class everyone sat. We were heavily weighed down and fought our way
through the crowd to the train. Then boarded and were able to find places for our backpacks
behind us. The driver brought our extra two bags that we couldn’t carry to the train for us, so I
didn’t have to fight my way back to get them. We left on time at 6PM Sunday evening. There
was a train stop about every 20-40 km. They were long stops, I suspect as the conductor talked
with his friends.
Also the train stopped when it was the Muslim prayer times, as did the bus later. So we were
suppose to arrive around 9AM but we arrived at 2:30PM to Ngaoundere. Well we were able to
arrange a bus ride with a company represented on the train. So they said in a ½ hour we would
be ready to go once arriving and it would take 5 hours to get up to Maroua. Well the first two
buses out did leave within a ½ hour but all our luggage was not off the train yet. Finally all pieces
were brought off. Now we would go on the next bus. We finally left around 5PM. On the way up
to Maroua we had to go over a bridge that was to short to have the luggage piled on top like
before so all things had to be brought into the bus to cross the bridge with the passengers
walking. Then reload everything up top again. This was around 1AM. We finally reached
Maroua about 2AM. What a journey.
Fortunately the Conference president of this region was there to meet us and take us to a hotel
for the night. There was one bed in it and we all crashed together.
We left the next morning for Koza and arrived after about 3-hour travel because of the rough road
the last 20 km. Trucks are absolutely necessary to reach Koza.
The whole hospital staff (18) was out to meet us and welcome us “home”. It was a very nice
reception. Our house if beautiful. And Koza village is situated in the mountains. And right now
(rainy season) everything is very green and absolutely gorgeous.
They hired a cook to prepare us a fantastic meal and we ate very well in our own home. They
hired him and a guard for the nights. If we choose we can keep them on. It’s not very expensive
and real helpful to have someone able to cook and clean while Aud and I are both at work. It also
gives two people of the community employment, which, unless you work at the hospital is NONE!
So it would be helpful both ways.
They have worked here 2 days so far and it seems to be going well.
The following day was a meeting with the town mayor and chief. All the important people of the
village were there. The Union treasurer and the conference president of the church were there to
present us to the community along with the support of the mayor and chief. It was very humbling
with the way everyone was addressed and the meeting conducted. The society is very
hierarchical and their meeting showed that too.
After the meeting we went to see the hospital. The structure is very nice but very ill equipped.
We currently only have HIV, Tuberculosis, type and cross, and stool, and malaria smear, and
hemoglobin, urinalysis. No x-ray currently because they don’t have the reagents to develop it.
Wow do I wish I had an ultrasound already in the first two days. Would be very useful, as would
be an x-ray (TB and fractured femur). I guess we can get some electrolytes and transaminases
when we have those reagents also. We don’t have glucose either, which Audrey found it hard to
deal with a diabetic coming in with headache, polyuria and fevers. We also have no insulin and
no oral agents currently. Our pharmacy has a variety useful and non-useful things. A variety of
antibiotics and anti-worm medications and one NSAID for pain. The operating room has a few
non-absorbable suture but NO absorbable suture and only one size of gloves and No masks or
hats. So there are many things to obtain once the hospital makes some money, along with
paying its staff who haven’t been paid but 1/3 salary the last two months. The types of patients
we have currently are, 3yo with a femur fracture I just put in traction, many with malaria, worms,
the diabetic, pregnant patients with bleeding, some with vague complaints and pains, breast
mass, tuberculosis, and one unable to pay bill so staying here till done paying. Private rooms are
pay per day, others are one time fee for hospitalization. Our daily routine, as far as I can tell,
consists of: 7:30 worship and recount of new patients admitted overnight, rounds on the wards,
seeing patients the nurse doesn’t know what to do with, then recheck on patients. Most workers
leave by 2:30 when their 8 hours are up. There is one nurse in the hospital and 6 nurses aids
that run each ward individually. The rest of the staff are trained on the job.
Well we are very blessed because the day before we arrived the cell tower in Koza began to
work. As I mentioned in the last letter our number from the US is 011-237-522-0278. The 237 is
the country code. We have the phone on whenever we are awake. We are 5 hours ahead of
EST.
The people here seem to be very courteous and friendly and generally quiet. We are glad to
finally be here and to have a “home” once again after 4 months of roaming around North
America. We are very pleased with the administrator and his vision for the hospital and we pray
that we are able to address not only physical but also the spiritual disease. Please pray for us as
we start work here in Northern Cameroon.
And as we try to lead a hospital having never done it before. Thank you all for your prayers and
support.
In His Service, Greg, Audrey and Sarah Shank
__________________________________________________

News letter #3
08/04/05
Dear Family and Friends,
Well we are currently still in the capital, Yaounde.
We will be leaving for Koza on Sunday, 8-7-05. We have started the process for our medical
licenses here and are now able to work in Koza. We have had a good stay here but of course are
anxious to go up to Koza.
The people of Cameroon are very friendly and we are practicing our language skills out of
necessity and trying to read up on tropical medicine.
So all of you know. We have had very limited access to email while here and will not have our
ham radio permit till after the end of August. This is why if any of you have responded to our
previous emails we have not responded to them. And likely will not be able to till after the end of
August. Please pray that we get our ham radio permit soon so that we can have communication
up in Koza. We understand that the cell tower is built in Koza but there are other problems and it
will not be working for a few
months++. We do have a cell phone that works in other
surrounding towns. Our number when outside of Koza is country code 237 then 522-0278.
Incoming calls are free to us; the cost for you depends on your carrier, usually 40cents+ a minute.
We currently have two student missionaries coming out to join us. One starting in about 2 weeks
and another a month later. They are both staying about a month.
We will be looking for a student missionary to teach Sarah whenever we can find one that is
interested.
She is still in mid 5th grade. With all the language learning in Montreal and craziness since then
we have not restarted her home schooling. We plan to start very soon.
About Koza, we understand that at the hospital up there, there are many financial difficulties.
They are soon to have the electricity cut off because of past-unpaid bills within the last few years,
at least a number of months worth. We also hear that in the rainy season (now) that the patient
census is low.
Because of this the hospital workers have only been able to be paid 1/3 of their salary these past
two months. However the workers are hopeful of a recovery soon and are diligently providing
their services to the surrounding population. We are nervous and excited as we prepare to enter
service with them. We pray that with Gods help we will be able to make a significant positive
difference to the hospital and to the community. We know that God wants us in Koza and He got
us through medical school and residencies for His service. Please pray for our own personal
spiritual growth, that we will become the people that God wants us to be to serve Him!
In His Service, the Shanks
www.missiondocs.org
PS: Anyone who’s friends want to be added to the mailing list please respond to this letter with
something about being added to the mailing list in the subject line and my friend who is managing
my email and website will add you.

Dear friends and family,
We have been here for almost 2 weeks now and are hoping to get to Koza by the end of this
week. There are a lot of paperwork hassels and things are a bit more difficult to get done here.
Everyone has been very nice and helpful since we have been here though.
One specific prayer request that we have is that we found out last night that there have been
some financial problems with the Koza hospital and the electric company is turning off the
electricity until past bills are paid. I think that it is years worth of bills…Please pray that this will be
taken care of soon. We are also having trouble getting the ham radio license and can’t have
communication until we have it. Please pray for these issues as well.
Otherwise we are fine. Language is still difficult but we are managing. Love to everyone and we
will send out a more complete update when we get to Koza.
That trip ought to be an adventure in itself…
Love, Audrey, Greg, and Sarah