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Shanksteps of Faith
6-8-06
There is often more to the story than you expect.
Such is the case with Matakon (his name in Mafa means
sickness). He is a 15 year old boy who was brought in
to the hospital by his parents 3 days ago with
abdominal pain. He was found to have a partial bowel
obstruction and placed on IV antibiotics and told not
to take any food or drink by mouth. He was doing okay
until yesterday when he started having increasing
episodic pain. An X-ray showed many air-fluid levels
indicating that he now had a full bowel obstruction
and needed surgery to correct it. Straight forward?
NO! The nurses and Greg have spent the past 2 days
trying to convince the father that the child needed
surgery. He has completely refused. He initially
told the staff that he would go home and discuss this
with family, and perform some traditional sacrifices.
Here is the real story.
Someone in Matakon’s family did something very bad in
the past. The spirits punished severly and first took
the life of his mother several years ago (with bloated
abdomen as well). His mother’s eldest brother was
next, followed by her other brother. All died of the
same “illness” that plagues Matakon. The village
Chiefs: the Blama, the Lamido, and other elders of the
village told the family that they needed to do
something (sacrifice) for full pardon from the
spirits. The were also told that if anyone else
becomes ill within 6 months to 1 year that their
action wasn’t sufficient enough and another death
would be the punishment. Thus, the intestinal
obstruction of our patient Matakon. To this family,
this is NOT an illness needing a doctor and surgery.
This is retribution by the spirits for something done
in the past. No wonder they don’t understand our plea
for surgery to save his live. No wonder they don’t
want to hear about the pathophysiology of bowel
obstruction. No wonder they don’t want to pay for
medications. This is a VERY real spiritual battle for
the life of this child. Several of the nurses have
seen this type of thing before and when the surgeon
did a laparotomy to release the bowel obstruction,
they found nothing wrong. Don’t for one minute think
that the Devil can’t imitate (or create) a bowel
obstruction. Don’t for one minute think that there
isn’t a perpetual battle between good and evil going
on. This is the Great Controversy. There is a battle,
not only for the life of this child, but more
importantly for his soul.
So, what do we do as medical professionals??? We cry
and we PRAY. We Pray as never before. We pray for
miraculous healings. We pray for the soul and life of
this child. We pray for the understanding of the
family. We pray for God to remove the evil that
plagues this family. We are unable to do anything
medically, but spritually we have all the army of
heaven for support.
I finish this story several days later and wish with
all my heart that I could tell you about a miracle,
but the truth is, I don’t really know what happened.
As I wrote the first part of the story, our chaplain
and several nurses were talking with the boy, teaching
him about the love of God. We were also trying to
convince him that even though he was unable to choose
his own medical care, that he could make the choice to
follow a God who loves him enough to send His Son to
die so that this child could spend eternity in heaven.
His family took him home and I suspect that he died.
But… you never know what the power of the word of God
can do to change someone’s life.
Please pray that we will God can use us to win these
spiritual battles. This stuff is VERY real.
In battle for HIM, The Shanks

Shanksteps #36
So what do you do when you get a broken arm? If you lived here you would go to the local bonesetter and get it put in small wood splints like the Chinese did of old. If it is an open fracture, sometimes the local bonesetter sends the patient our way. So we had a gentleman who came here just that way. We only see the open fractures because all the others are done locally. So he arrived with his radius and ulna poking through the skin near the wrist. We were able to get an x-ray to see that that was the only place broken. Then I took him to the OR and debreded all the dead tissue and junk out of the end of the bone. Then I casted him from fingers up to his upper bicep. He came back in two days complaining of significant pain and wanting the cast off. I refused after looking him over. Every couple days there after he said I needed to take it off. I continued to refuse. After weeks of beratement I at 6 weeks shortened his cast to the forearm so he could exercise the elbow. He regained full movement in the next two weeks. He again requested it be removed. He refused any x-rays, “not having any money”. So I took off his cast finally when I thought he was healed sufficiently. I would feel much better about subsequent x-rays but can never convince anyone to get them because of the cost. Up front they want them but not later. So when I examined him without the cast I saw that he had a little deformity of one of the bones on physical exam but his function was very good at the wrist and hand. I put him in a splint and sent him home with the precautions to not fall with it or ride a bike… or it could refracture as was not completely healed. Well the interesting part is a week later he returns to return the brace. He had gone to the bonesetter and had it rebroken to change the deformity and had it in wood splints all around. The mentality is sooo different. Some don’t care at all of appearance and walk around with huge umbilical hernias and others like him seem to be bothered by slight imperfections. I guess that mentality is all over the world.
Well we sit at home without electricity for 4 days now. Another small rainstorm blew through and knocked down some power poles. They are usually weakened by termites then finished off by the wind. Things have started to green up again and starting to get pretty. The rains bring beauty and cooler weather but also the mosquitoes and worse roads. But I like this season overall.
I’ll make this short, as the generator will not be on long. Please continue to keep us in your prayers and thoughts. In His Service, Shanks

May 14, 2006

Wow, it has been a long time since we have sent out any Shanksteps. In our last note, Greg mentioned that we were praying for patients to come to the hospital.
Although I don¡¦t believe that God created a meningitis epidemic, HE did use it to bring up our census. We started receiving kids with meningitis around the end of February, and about 2 weeks ago it finally let up. I think that during med school and residency I saw 2 patients with meningitis, and did 2 or 3 spinal taps. Now¡K I could treat meningitis in my sleep ¡V which is a good thing because we were getting called every night, often several times a night to admit these kids. The hospital census increased from 25 patients to 55-60 for about 2 months. We turned the pediatrics ward into a meningitis ward, and moved the rest of the kids into a different ward. I think in all we treated over 100 cases of meningitis here. But I know for every person with meningitis we saw here, there were 2 or 3 in the villages that probably didn¡¦t survive. We lost 4 patients to the disease, 3 after having been treated with a deadly ¡§over the counter¡¨medication made up of Tylenol and cocaine, or other traditional medications.

We have finally started taking days off as a family.
From the time that Dr Hamza left, we have worked 7 days a week, 24 hours a day, and gotten very little sleep during this time. About 4 weeks ago we took our first day off with Mindy (4th year med student from
LLU) and her husband, and travelled for the day to Waza ¡V wild animal park. We left early that Wednesday morning and got to Waza about 7am. We drove around the park until about 1pm then decided to stop and eat lunch. This time of year is the hottest and dryest, so all of the animals head to 1 or 2 watering holes. We were able to see several giraffe, 1 elephant, a huge lizard, a python (thanks to Scott¡¦s good eyes) and VERY fortunately, we saw a lion chasing after a gazelle. It was a beautiful sight. We were all hot and tired and so decided to head to Maroua to drop Mindy and Scott at a hotel in preparation for their trip home (8-10 hrs by bus, 12-20 hrs by train,
12-15 hrs by plane ¡V not an easy trip). Greg and I returned home to relieve our nurse from on call duty.

The following week we had unexpected guests. James Appel and Sarah came to stay with us for a week while the political unrest, and potential problems calmed down in Chad. After Chad¡¦s presidential elections on May 3rd they were able to return home. We thoroughly enjoyed spending that time with our friends and fellow missionaries. We swapped stories, played games, did rounds together. They even gave us 2 days off. Our first day off we spent on ¡§vacation¡¨ at a hotel in Maroua, where we spent the day swimming in the pool and reading in an air conditioned room. We ate pizza and drank soda. It was pure gluttony. The AC was an added bonus, as we had just gone 4 days without electricity and water at home, which also meant no fans¡KOn Sunday, our busiest day, James and Sarah offered to man the hosptial so we could work on unpacking boxes that had come in the container. It was a true blessing, and we were able to get a bunch done. We definitely brought too many personal things, but it¡¦s like Christmas every day we open another box. We had no electricity the whole week that James and Sarah were here (I guess preparing them for returning to Chadƒº) so we all slept outside under the stars. It was much cooler, but I expect the malaria epidemic to hit our house any day now.

We are now back to a normal schedule. The hospital was full before James got here, the census decreased to 9 patients while he was here (3 docs in the hospital and only 9 patients), and now the census has picked back up a bit, so we have been a little more busy. We are now in the home stretch looking forward to coming home. We have 36 days before we leave here and are very excited about seeing family and friends and our pets, and eating good food.

We thank all of you for your prayers, gifts, donations, ideas, thoughts, notes etc. God has really taken care of us.

We have one specific prayer request we would like to make known. We are desperately in need of a western trained nurse to come out here and train our nurses.
If our nurses can have actual training, our jobs will be much easier, and the patient care will improve considerably. Because this is such a male dominated culture, we are praying for a male nurse, or nurse practitioner, with some years of experience, lots of energy, leadership skills, ability to speak French (or learn quickly), and great heart for the Lord.
Although all of our employees are Adventist in name, most have a very weak spirituality or even understanding of a relationship with God. Please keep this request in your prayers. God has already done amazing things here and I believe that he has big plans for this hospital.

Thank you for your love and prayers,
In His Hands,
Audrey and Family

Dear Family and Friends,
Its been a while since we wrote because we have been
busy, as Im sure all of you have. We just finished
our Meningitis season with 60 patients in house and
now we are down to 15. Feast then Famin. Feast was
good we finally caught up with all of our back
salaries, but now with it as slow as it is we will be
going backwards again. The local population just does
not have enough to support the prices necessary to
support a self sufficient hospital. We are praying
for other sources or ways to augment our income to
continue the quality of care we want and should give.
So now that meningitis is done we now have the
vomiting and diarrhea season starting. Now it has
rained a few times and whenever there is standing
water it is much easier to get and use that water than
to look for it a number of kilometers away from your
house and carry it in a clay pot back to your house
every day. So it is no supprise that they get the
diarrhea and vomiting. It has been especially hot up
to 110 deg F and down to 95 deg during the night.
Feels like a sauna when the fan blows that hot of air
on you. For the last week we didnt have to worry
about the fan, We had NO electricity. We attempted to
start the generator for the hospital to replenish the
water tower and recool the refrigerator with the
vaccinations… in it but it was connected to the
battery incorrectly and blew up the starter. So after
spending a few days and a bit of money we were
fortunate to get it fixed and get it started. We ran
it for 4 hours (5 liters an hour $1/liter) Wow, thats
expensive. Also didnt have long enought to get the
fridge cool or the water tower full. So we gave up on
it. Did another surgery by Petzel headlamp, a
strangulated inguinal hernia. It was terribly hot and
I couldnt keep from dripping on the patient. Terrible
sterility that night and nothing I could do about it.
We just kept on wiping our brows hoping to stop the
dipping without avail. When all done it looked as if
we had showered with our cloths on we were so wet.
We were blessed recently with a visit from the Appells
form Bere, Chad. They came here for about a week to
let the unrest in Chad die down before going back to
their hospital. We were very happy to have them with
us for a few days and James Appell helped on that
surgery as well. What a wonderful few days it was
with them.
We are still counding the time till we get to come
back to the US. Still trying to find out about
tickets, but plan on being there end of June to mid
August. We hope to see as many of you as possilbe
though our travels will be primarily limited to the
East and our families.

Please keep us and this hospital in your prayers.
There is much to do both spiritually, physically, and
financially. Thank you for all your notes and help.
In His Service, Greg