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#54 Shanksteps
January 9, 2007
Has the sorcerer ever eaten you? Apparently it does
here. We had a patient last week with pneumonia that
was doing OK, then one night developed difficulty
breathing. We were not called and the patient died in
the next few hours. Today we had a patient who came
into the hospital with a depressed skull fracture.
Apparently her neighbors did this. They were family
of the woman with pneumonia that died, and somehow
they ascertained that this woman had cast a spell,
become a sorcerer and “ate” the woman. I believe it’s
like eating their “spirit”. And when this happens the
person dies (physically). So the best I understand it
right now is that it is a type of a spell cast on
someone else to kill him or her. So they took
revenge. They had a large stick, about 4in. by 3ft.
and beat her over the head with it three times. When
I evaluated her she had no pupil reflexes, no gag
reflex, dolls eyes, and blood draining from the right
ear and a GCS of 3. She was breathing and the heart
was going but that’s it. When examining her head I
could feel about a 4X5in. wide depressed skull
fracture. I explained to the family the damage was
already done and that she would not survive. I do not
have any equipment to elevate skull fractures or make
burr holes, and don’t think it would help her anyway,
especially in our situation. So we are still learning
of cultural beliefs.
Have you eve had your eye burst? Has it happened to
any of your family? If you lived in Koza Cameroon it
could happen to you! Yesterday a patient came to my
office because his eye had burst in the morning. I
could not understand so I questioned further. Any
trauma to the eye, eye infection, pressure applied to
the eye, products put in the eye. The answer to all
was no. I asked what happened. I woke up this
morning with severe eye pain, when I got up it burst
and a white thing came protruding out. So I looked in
his weeping eye. It was blood shot and had what
appeared to be his eye lens, sticking through his
cornea out in front of his eye. What a sight to
behold! I was unsure what to do. What would you
ophthalmologists do in a place without any eye
equipment other than an ophthalmoscope. So I
amputated the part protruding out. He had not seen
for four years and I told him that I did not think
anything would bring back his sight now. I wanted to
refer him to Maroua before amputating the “thing”, but
he refused and said essentially to do whatever I could
and that would be it. I hope to see him back in two
days.
We are continually challenged physically,
spiritually, and medically. I must say that “never a
dull moment” seems to apply to our lives. If any of
you medical personnel or others want to ever visit us
you are always welcome. We just need at least a weeks
notice. Though as sometimes happens, the morning of
would suffice. Also we are looking for a physician to
cover our hospital while we are gone on furlough in
about 5 months. We plan to be back in the states mid
June to Mid August and the hospital needs a physician
to cover for us. If you are at all interested in
helping please write me or for a faster response call.
We check our email about every 2-4 weeks when we are
in town. Hope to hear from you. Keep us in your
prayers as we are continually challenged. In His
Service, Shanks

Shank
Hopital Adventiste de Koza
BP 53
Koza, Extrême Nord
CAMEROUN

To call from USA: 011-237-522-0278

Current Needs:
-replacement physician for our furlough mid June- mid
August
-cast cutting saw
-sterilizable drill
-equipment to make burr holes
-good needle drivers
-good scissors
-hospital repainted (half done)
-Accucheck Ascensia microfill glucose test strips
-large supply of prenatal multivitamins- our mulitvits
have 4 yes FOUR ingredients
-5 good stethoscopes
-4 dynamap blood pressure/ saturation/ pulse
rechargeable machines
-4 good blood pressure cuffs and one children’s cuff
-another portable saturation monitor machine
Larger Projects:
-medium sized generator for lab fridge, when power is
out
-hospital rewiring
-long term- a hospital pickup
-visiting friends

Shanksteps 53

Meningitis, Magic and Marriage

Quiz Question:
What are some common causes of meningitis?
Answer:
In the US, one might answer saying that the causes are
mainly infectious, caused by bacteria, viruses, or
fungi.
In Cameroon, the most common cause is magical.
We have unfortunately just started into the
meningitis season again, and it looks like it may be
another epidemic. We have seen 7 cases so far in the
past 2 weeks. The family of one young woman is
convinced that she is sick because she is ready to get
married. Let me explain. This young woman, Ngossa,
until recently had many male suitors. She had 5 or 6
men who were competing for her hand in marriage. Now
that she is marrying age (15) she has made her
decision and chosen the one she wants to marry.
Apparently all (or some) of the others were irate and
put a spell on her (or paid the sorcerer to do so),
which is why she is now sick. With this
understanding, no amount of medications is going to
solve the problem. (She remains in very serious
condition. Please pray for her recovery.)

I have been taking care of a 2 month old (also with
meningitis) who was slowly improving but not at the
rate I expected. On further examination, I realized
that he was not getting his medication as prescribed.
The nurses are in charge of giving IV meds, and the
family in charge of pills. This child had not
received the proper IV medication for several days and
now the family was demanding to change to pills.
Normally I insist on continuing the prescribed IV
treatment before converting to oral medication.
However, in this case I conceded, thinking that maybe
if the family was responsible for giving the meds, he
would at least receive them. When I examined the
child the following morning, I discovered that he had
again not received his medication. Why? You might
ask…They didn’t give him his medication because he was
sick…

On the same day in the same ward, a father asked me if
I would decrease the medication given to his daughter
(also with meningitis). Why? You ask again… Because
his wife is sick and he doesn’t want to have to pay
for both. Logical from a financial standpoint, but
not a medical one…

Too often here, the families of the sick dictate their
care. They often tell me what to prescribe, how to
prescribe it, how much to give, and how long they
should take it. Their knowledge is based on how much
money they have in their pockets at the moment, not
what is medically best for the patient. It is very
difficult here because there is such extreme poverty
and a hospital stay may mean the difference between
eating or not for weeks or months. However, patient’s
families also change the rates of their IVs (faster is
better), give twice the medication recommended (more
is better), don’t give the medication at all (less is
better). The hospital is continually accused of
trying to “just make money from the community”.

With the lack of appreciation from the community, lack
of good nursing care, lack of cooperation from
families, and sorcery to cause or heal all ailments, I
often wonder what I am doing here. I often feel like
my being here doesn’t make a bit of difference, and it
may not. But then I remember that I am not here to
work for the villagers, or the nurses, or the
hospital, or the church. We are here to work for God,
and are here because HE has called us here. Please
pray that we don’t lose sight of this bigger picture.

#52 Shanksteps

Hey ya’ll, (missin WV tok)
Christmas is past and we missed our families and
friends. We did get “snow” the last few days. We
woke up to about 55 deg F(very cold here). All our
friends are in coats and hats, and I even saw a pair
of mittens given by a previous physician. The reason
it is so cold is that the winds are coming in off the
Sahara (Hamartan winds). So everything looks foggy
outside. Though it’s not fog it’s dust in the air.
We have a soccer field next to our house and we could
barely see the other side. A few days it only got up
to 70 deg F. We were cold also. I wore my one long
sleeved shirt over my scrubs for a couple weeks now.
Didn’t bring more “warm” cloths, and don’t really need
them anyway. But long sleeves help. I walked out on
our back porch yesterday and I left footprints. I
told Sarah to go out and make a “dust angel”. We had
a little chuckle. Everything in the house and outside
is covered with dust, great for a few electronics (as
if electricity variation wasn’t enough already).
We are starting to plan our next furlough. We hope
to be coming back to the US around mid June to
beginning of August. We will spend the majority of
our time at our parents’ houses and a little time out
west.
We had a very nice Christmas. It was simple but we
had wonderful food. Audrey was able to somehow make a
nearly normal (US) meal for us here. We hung our
homemade stockings and had a small artificial pine
tree. We made paper snowflakes to hang around the
house and paper chains too. Also had some paper
angels with a star on the tree. We made some
stockings for our house-help too. They thought it was
great. We are so blessed to have their help.
New Years was like last year, but this year we knew
what was coming. We had a year-end party with the
hospital workers outside with food and a large fire
for warmth. It lasted about 4 hours, and we brought
in the New Year with goat, chicken, salad, macaroni,
and Coke and Orange Fanta. About 4AM on the morning
of the 1st, we heard the all to familiar, “Bon Anne,
OhOhOh, Bon Anne!” Repeated over and over for 5-30
minutes till candy is given. Kind of like an annoying
Halloween without costumes. It continued until around
noon then took a few hours break, and then they were
back out to try to wrap up the day with a little more.
We were long out of candy by about 8AM after about
400 children had been by. I still can’t figure out
whether this is a French tradition or a Cameroon
tradition. Either way it is strange to my American
mentality. Now we are past that and we are enjoying
more peaceful days in general.
We are now in the process of helping the local
department of health vaccinate the local population
for polio and giving the children under 5 yrs vitamin
A. So we are keeping busy. We are looking forward to
my parents visiting us soon.
We hope your Christmas was very good with friends and
family near, and the Christ was not left only in His
manger, but made it into your hearts. We are so
thankful for His gift to us and hope you all realize
it too. Merry Christmas and Happy New Year, Shanks

12-7-06
Hello friends and family,
We are sorry it has been a long time since we have
been able to send emails. It appeared like the other
ham email was going to work. But I think the devil
does not want us sending emails easily. I think my
equipment is working but propagation must be bad, and
I cannot connect like I need to. So we are still
using our other yahoo email address.
We are doing well, other than a few rounds of
malaria. Audrey and Sarah had it last month. This
month it’s me with the malaria. We are coming through
it just fine. Audrey had a tough bout with resistance
and lots of nausea and vertigo. Fortunately for me,
my symptoms are not bad with the medications. The
number of patients has dropped down to about 20 in the
hospital now. With Christmas and some Muslim holidays
coming up people are trying more than normal to save
money and therefore come in to the hospital even in
worse conditions than normal because they wait so
long. So we are getting out a little earlier these
last few weeks.
We are glad to have a Nigerian intern with us for a
few weeks. It is a new part of the internship at Ile
Ife to try to send some of the medical interns to
other sister institutions. Also recently we had my
sister, Cristy, visit us for a month. It was nice
having her here. We look forward to my parents coming
to visit in the next month also.
I want to thank all of you who continue to support
our hospital. With donations we were recently able to
make an order from Yaounde at 30% reduced rates for
some medications for the next three months. Others
meds we will still have to buy from other locations.
When we order we get about half of our order because
they do not keep all things in stock all the time. So
the other half we try to get from other sources. Also
some have donated money specifically to help patients
who were unable to pay their hospital bills. This
recently helped a woman who had been here for 6 months
of TB treatment leave, and another whose bill was $20
and she could not pay for 1.5 months. It seems so
contrary to the mission of a hospital like this to
have to keep people because of inability to pay but we
have to do that to continue to purchase medications
and salaries…keep the hospital functional. We
continue to pray for revival of missions in Christian
churches and ours specifically. There are many
hospitals that need personnel and also financing that
is lacking. So all this to say thank you so much. I
wish you could have seen the ?70 year old woman
dancing around after 6 months of being here at the
hospital knowing she was going home. She says
THANKS!!!
Please continue to pray for us and our ministry here
that we would be used, as God wants us to be. In His
Service, Shank’s