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

Shanksteps #75

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