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Shanksteps #78- Greg

We are now in the cooler season (85-90 deg during the day).  There was a case of Polio (a disease that paralyses extremities) here in the north of Cameroon.  So the last three days have been designated by the government for vaccination of all children 0-5 yrs.  That means that vaccinators go from house to house vaccinating all the children.  As doctors of the hospital we are included in the supervision of the vaccination in our area.

When they are vaccinated they are given the oral polio vaccine and then marked on their finger with a mark to show they were vaccinated.  Then we can tell who has been vaccinated or not.  Also the house is marked in a way to know how many of the children were vaccinated.

So I go to houses and check and make sure they were vaccinated.  Some houses are done well; others have missed some children because they were out with their mothers in the fields or at school or elsewhere.  So they get vaccinated the next day.

In walking around I get to see more of the community.   I greet many people sitting under trees shelling out peanuts, grinding up food on a hollow rock, or threshing millet.  Other old men or women are watching small children at home.  This consists of letting the children wander all over while the grandpa sleeps under a tree or shade of the hanger (a “roof” on posts that is there to store millet and other things out of reach of the goats and other animals).

I decided to go up the hill and check some houses that were out of the way.  One group of huts was perched on a large rock.  An old man lay sleeping on a “bed” of sticks with a rock as his pillow.  A small boy was playing with a scrap of cloth a few inches in length.  After waking the grandpa we found out that there were three children in the age range.  They hadn’t been vaccinated.

Walking further we came upon two huts with one dirty old woman who walked with a stick as a cane.  She lived there by herself.  She had one relative in the valley but didn’t want to live in the valley.  When asked where she got water, she said that she would go down to the valley and about a mile away pull up water from the well.  Then she would carry it back to her house.  I can see why many of these people don’t bathe very often.  Life for her looked very hard, but she preferred it to the valley.

Moving on to the last house.  It was also half way up the mountain and perched on a large rock.   After scrambling up the rock path we arrived at the group of huts.  Two old men sat face to face with a chicken on one’s lap.  A little boy of about 7 couldn’t decide to run and hide or stay and watch the strangers.  His mother was near by nursing a little newborn.  She had a torn shirt and skirt that didn’t cover much.  But then again, women’s chests are not private here.  They greeted us warmly with
the usual shaking of hands.  They had been to the valley and were vaccinated.  I saw the man pulling something off the chickens’ legs as it lay on his lap.  I asked him if he was preparing it to eat.  Then the other old man of the house decided it was time for us to go.  The guy translating for me said he was a “fettisher” traditional witchdoctor that was getting ready to do a sacrifice.  He is the one people come to see to cast spells on people, find out how a journey will go, or foretell the future.
My translator asked him what he saw for the coming year as far as disease was concerned.  He said it would be a very difficult year and more disease than last year, with many deaths.  Shaking his hand I agreed with him that the Bible says times would get worse and worse until Jesus comes.  The “fettisher” asked me to pray to my God and he would pray to his gods about this.  I said I would pray to my God and also hope that someday he would know my God that loves him and sacrificed for him.  He smiled
and we parted ways.  After scrambling down the rock we prayed for him and his family that they would come to know Jesus that died for them.  It is a strange feeling to know that you were in the presence of someone that communicates with the devil in a direct way.  Please remember us as we try to reach people like this that do not know God and haven’t had a chance to yet.
In His Service, Shanks

So here we are!  Back in Koza!  As my dad probably told you, we spent a month in Tchad.  The hospital there  was always busy; and Dad was always at the hospital; and Mom, being the devoted wife and doctor that she is, was always in the hospital with Dad.  So naturally, they were always worn out when the finished work.    I never went into the hospital.  I avoided it like the plague, so I don’t know their side of the story.  My side of the story was filled with lazy days and horse-back riding.  I wish I could tell you I went from house to house proclaiming the word of God and converting the whole town, but I can’t.  Neither did I cure the entire village of sickness.  My time there was spent with the animals and the plants.  You would be amazed about how much you can learn about God by just sitting and watching! When did time get so endangered that we must chase after it always?  We are always, always moving!  So now I have a message for all you workaholics out there.  This is it:  SIT DOWN!  DON’T MOVE!  That’s the message.      So often we just need the kick off our shoes, slip on our cute little bunny slippers, and sit down.  You need to watch the plants grow.  I could fill up this page with all I learned from just sitting and watching in Tchad, but I’m not going to.  The things I learned mean nothing in words!  You have to go out and experience God’s peace yourself.      And if you want to use that I-CAN’T-SPEND-TIME-WITH-GOD-BECAUSE-I-HAVE-TOO-MUCH-WORK excuse, you can just save your breath!  If God wants to spend time with you (which He does) then there will be a way to find peace and quiet.      It’s there that you will always find God.  He wants desperately to talk to you, but He won’t force you to talk.  You have to go to Him yourself.  I promise you that if you go to Him in the quiet you will never regret it.                                                                                                                                              Sarah 

 There are constantly new ways of doing things when one lives in a rural situation without many supplies.  We order medications and only half of our order arrives.  So we do without medications a long time.  We are forced to make due with what’s available at the time.  There are other medications available through pharmacies in town but the cost is prohibitive to the local population.  Our prices are already to high compared to the health clinics in the area.  Our prices have remained the same formany years but we are still just existing financially.  Even with our “high” prices we can barely pay our workers each month.  The government dictates the salaries of workers and unfortunately as of yet we have not received any financial help from the government to help purchase medications∑  In addition, in rural areas we use what is available out of necessity.  Here are a few examples: This hernia is to difficult to close with only sutures.  ”Well we have mesh!” “Mesh?”  ”Yes we sterilized it yesterday.”  To my mindset this sounds very strange.  I have repaired all hernias here with only suture since coming to Cameroon.  Now I’m in a hospital in Chad, and they have mesh?  After asking further questions I discovered that the “mesh” was a cut up mosquito net.  I thought, what! a mosquito net?  I guess there have been studies done with using mosquito nets as mesh in impoverishedareas.  So I tried it.  It lay very nicely in the repair.  After the surgery the man was healing well and went home in a couple days.   Another was in prostatectomies.  We have many old guys whose prostates are so large that they cannot urinate well and get urine infections.  And as we do not have sufficient supplies of medications for this disease, in general we treat them for a few weeks and then operate on them.  Well after the prostate is removed they usually bleed a lot and need continuous bladder irrigation.  Some people can afford the regular saline flushs and others cannot.  We have heard in the past some surgeons have usedplane water irrigations.  So we have done this at times out of necessity.  And it appears to work well.  Also the family can add water and if the nurse is busy and doesn’t do it, then at least there is still irrigation running. Another is our treatment of meningitis.  IN the US this is generally treated for a few weeks with intravenous antibiotics.  Here the people cannot afford it.  It takes a great deal to even convince them of a few days.  As soon as the person is awake again they want to take them home.  We generally do 5 days IV and then 2 weeks of oral antibiotics. I think the most important part of our patients health is Gods healing them.  In spite of our inadequacies and in spite if our lack of appropriate medications, people get well at the hospital.  We try to encourage our patients that it’s God that heals them at to look to Him.  Thanks for your prayers and please continue to pray for all those we care for.  We are all His children whether we know it or not. 

 

Shanksteps #75

“I need you to come to the hospital now, he is not breathing well!” As we went to the hospital I found out that a drunk man was run over by an ox cart. It has an axle and wheels from a car or large metal wheels with spokes. On top of that is a wooden box and a “tree” coming out of the front to tie two bulls to, to pull it. He wa sitting on the floor with a lot of difficulty breathing. I listened to his lungs and heard breath sounds on the left but none on the right. He had a tension pneumothorax
(collapsed lung). His right chest slopped of to his arm pit at a weird angle, kind of flat. They said the wheel had come up on his chest. His left side looked OK. I went to the OR and was able to find a chest-tube to put in him. A bit of blood came out but it appeared he would be all right.

Just after that they asked me to see someone that had just come in. They said he was bleeding from his foot. I went to see a man that had been his with a knife 2 weeks ago around the ankle. It had gotten infected and he had gone to a local clinic the day before who refered him to us. Walking in the room, I knew what I would see when I took off the cloth covering his foot. It stunk real bad, and had a puddle of liquid under his foot. After taking off the cloth I saw that he had dead skin from
the base of his toes up to above his ankle. Here things are paid for in advance before treatment is started or given. So he left an ox-cart as collateral on the operation. We debreeded all the dead tissue and basically he had no skin left over this area.

Weve now been in Bere, Chad 2 weeks. I have done about 30 surgeries and don’t know how James Appel can do it alone. Audrey and I are keeping very busy. I hear that he is doing well in Koza since we changed hospitals for a few weeks. We have about 45 patients in beds and about 8 outside under trees because all the beds are filled and some have 2 different children in them. The nurse sees about 30 outpatients a day and we see about 15-20 of those. There are a number of student missionaries and
an Australian couple doing maintenance temporarily. It’s nice to have other missionaries around and speak English. Electricity is on 2 hours a day in the evening via generator. There is running water from a water tower. Food seems to be more expensive. We have two weeks left before returning to Koza, and are looking forward to it but enjoying aspects of life here also. Please pray for James and Sarah Appel as they work in a very difficult situation for one doctor. In His Service, Shanks