Hello friends and family

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Hello friends and family,
As you know, Ebola is afflicting many people in Liberia, Sierra Leone, and Guinea. At the current time in Monrovia the capital of Liberia all hospitals have been closed except 2 or 3. One mission hospital, Cooper Adventist Hospital, and ELWA and JFK. The last two I believe have been designated Ebola hospitals. I have been asked to help fill in at Cooper hospital. Many patients who are sick try to get into any hospital they can. Daily decisions are made by the medical staff there as to who to accept in and who to reject. it is often a life and death decision both for the patient and the staff, that may be exposed to Ebola.

I am writing to ask for your urgent prayers right now! Pray that those workers will be protected from this evil disease. And pray for me that I will know God’s will for me and whether I should go and help out there. May God’s will be done in my life and in Cooper hospital. Greg

Shanksteps #1 Malawi 2013

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Audrey and I arrived yesterday to Malawi. It started as an eventful trip. We arrived at the airport in Portland. As we were getting up to check in at 4:45PM we checked our passports. Wouldn?t you know it?my passport had expired three months ago, and I have to have it to travel to Malawi. I was stumped. What to do? I called an online passport agency and they said turn around was three days at the soonest. But they said if I was able to go to the passport agency that they can sometimes turn it around in a day. So at 4:55 I was able to get a person in the one in Seattle. They said it was possible if I had proof of a flight, and was there at 08:00am. So we rented a car and started driving. The next morning I arrived at their office when they opened and ended up 10th in line. But with lots of prayer and redoing passport photos, I was able to get a new passport that afternoon. That evening we took the 4 and 1/2 hr flight from Seattle to Washington DC. After a couple hour layover, flew 14 hours from DC to Addis Ababa, Ethiopia, and ate injgera and Chiru (tasted great). Then from there to Blantyre Malawi, about 4 hours. Audrey and I hit the sack early at 7PM and slept the whole night through.
Today I had 5 surgeries scheduled for me and ended up doing 8. The first was unable to urinate and had a bladder catheter through his abdominal wall the past month so that urine could pass that way. I talked to him with one of the nurses translating, answered his questions. He lay on the operating table, exposed to the world. Nurses, nursing students, anesthetist and scrub tech, milled around the room making preparations. After the spinal anesthetic was in, his abdomen was prepped. I placed the blue towels in place and the drape. With one cut of the knife, I was through the skin and non-existent fatty layers. Following the catheter into the bladder, I cut through the scar tissue by the catheter. Finally identifying the bladder. I opened the bladder and then stopped the bleeding. The prostate was huge. I shelled out the prostate from its place. The urethra (bladder emptying tube) was narrowed and I couldn?t get the next catheter in. So I put a small catheter from the bladder out the urethra then attached the other one to the end and pulled it in. Closed the bladder, put a drain in place and then closed the skin. Later I was told his catheter wasn?t working. Nursing students were all over the place but a nurse was nowhere to be found. After two episodes of this I finally told the clinical officer and he will watch him this night.
Next was a young woman with HIV that had an empyema (infected fluid around the lung). I placed a chest tube and got milky yellow fluid.
Back in the operating room, an older man lay on the table. He had a swelling in his scrotum for a long time. It was about 11 inches long and 4 inches wide. A hydrocele, a collection of fluid around the testicle, was what I would take care of next. After spinal anesthetic he was numb below his umbilicus (belly button). I opened the scrotum and released the tissues around the sack of fluid. I opened the sac and resected most of it, everting what was left. Placing the testicle back in the scrotum I closed the layers, leaving a drain in place if any blood collected in the area.
I did 4 EGDs (esophagogastroduodenoscopy- that?s a mouth full). Scoping the esophagus and stomach is rather simple, but requires sedation for most people to tolerate the gagging sensation. I think it ended up being a combination of sedation and gagging today. The anesthetist gave less than I preferred, but all tolerated it quite well in spite of it. I diagnosed esophageal cancer, gastritis, gastric ulcers, esophageal Candida- in these patients.
Last was an older man with an infected gall bladder. The infection had resolved on his lab work, so I wondered if the diagnosis was correct. I repeated an ultrasound. I could see the gallbladder wall was thin, I couldn?t see any stones, but there was sludge (like sand inside). I saw a collection of fluid I couldn?t explain. So I decided to take out the gallbladder anyway. Since laparoscopy isn?t really feasible, I did it open. (thus large incision verses small incisions with a camera). I opened the skin, fat, muscle, into the abdomen. Upon entering the abdomen, I got dark bloody fluid. After freeing up adhesions to the gallbladder(gb), I saw a black necrotic gb. So the difficulty of taking out the gb started. It was falling apart as I retracted it. I soon realized I couldn?t get off the liver. So I took off the front wall of the gb. Down at the base I was able to find the duct draining the gb and tie it off with a stitch. I irrigated the whole area and then closed.
After that I went and checked on my post-op patients again. Walking ?home? about dusk, I heard the college students having evening songs at their worship, and observed a beautiful sunset.
The first day of surgery at a rural mission hospital, it was a good day!

Missionary Retreat #2 as a followup to message of June 24, 2013

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Hello Friends and Family,
We are doing well and would like your prayers for the missionary retreat idea.  The three of us feel that this is the direction our family should go.  As you know we are excited about missions.  Audrey and I are preparing for volunteering a few weeks to cover the Malamulo Hospital both in FP and in Surgery for part of their surgeons vacation.  We have purchased tickets and now gathering some hospital supplies to take over in our luggage.  We may be volunteering on another medical mission trip in January.
As mentioned in our last message, we long for a mission here while we are in the US.  As detailed in that message we hope to create a missionary retreat that will be supported by our work and provide free lodging, food and relaxation and renewal to missionaries that are on furlough (vacation) or just returned from their mission service.  As missionaries provide service to people in other lands with little or no remuneration, we would like to provide a place of renewal for them when needed.  This would allow them to rejuvenate in preparation for returning to their area of mission work.  Our idea is that they would only need to arrive at the retreat then they would be fully taken care of (food, lodging, counseling, activities, rest).  At our last email we had seen what we considered a perfect location on a lake with two houses.  It was near the lake, ocean, sand dunes, and a host of outdoor activities.  It was also close enough to work that we could run the retreat and work as well, because it would be within my call range.  The day Audrey went to look at it someone offered the full asking price of $699,000.  So that is not an option.
Now we see another potential location that meets the same criteria in one large house.  The link to it is as follows:
http://www.zillow.com/homedetails/351-Council-Hill-Rd-Lakeside-OR-97449/2116521299_zpid/
We will be seeing this house next week.  As we plan on providing food/lodging… To missionaries free of charge, and have huge student loans of our own that remains, and the price of the house is expensive due to location and style, we do not feel we can afford to purchase it.  So we ask for your aid in praying!  We believe if this is God’s plan for our family that He, through others, will provide a way.  When going to Cameroon, you may remember that we waited many months for God’s will to be made known to us, then it clearly was.  We now wait for His guidance again.  We are excited about starting a new mission here.  I plan on contacting a local lawyer and CPA soon to discuss the different options for creating this non-profit.  If you have thoughts or recommendations, please contact me.  Please pray for God’s clear leading in our lives and for us to follow His lead.

Shanksteps Re-entry institute of world missions/ Retreat for missionaries dream

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We have just spent the past week at Andrews University in Michigan. Since returning to the US as missionaries we have been asked to attend the re-entry program for returning missionaries. In our ignorance we thought it was not needed. As we have been here for more than 2.5 years now, we have come to realize that our time in Cameroon has had more lasting effects than we had thought. So this year we decided to attend. It was a blessing that we had been missing.

Over the past months and years, we have realized that our time in western Africa had affected many ways of our lives. Effected our goals for the future, changed our outlook on the world, and deepened our spiritual lives, made friends, challenged our beliefs, expanded our medical knowledge, increased our dependence on Jesus, increased the challenges of living day to day, helped us learn French, educated us in the spiritual and physical ways of the Mafa people and or the northern Cameroon and north eastern Nigerian people and their differences.

Having dealt with these changes while overseas, and then readapting back into North American culture and customs, we felt we had adapted well. Yes there are many times we are still wondering what is appropriate. For example, when a Cameroonian invites me over I know what is expected. When a neighbor or friend invites me over I don’t. If we are going to eat: Do I bring a dish? Do I bring dessert? If someone invites us to stay at their house when we are near by: Does that mean they want us to truly stay? Or is it just being nice? And I know the answer to these questions changes depending on the background of the person your encountering and also the region of the US that you are talking about.

As we’ve been through the re-entry program, it as been nice to share mission experiences with people that understand what we’ve been through. We all have had different difficulties. Some have been in fear of their lives, some have been saved miraculously, some have had losses in their families, some have had emotional strain, some terrible diseases, some have been witness to many miracles. Each has their individual experience but we are able to understand because of shared experiences. They and we have been involved in the spiritual battle. We have seen direct evidences of the enemy. In the power that Jesus has given His followers, we have seen the enemy flee from Him. It has been a great week associating with other missionaries.

As we have talked, prayed, consoled, learned, and dealt with our past, with other missionaries- it has revived our dream of having a place of rest and restoration for missionary families. Audrey attended “Women of the Harvest” for missionary women while we were on furlough from Cameroon. It was a great time of restoration for her. Since that time we have dreamed of having a place, in a beautiful surrounding, where missionary families can come for free and rest and spend time being renewed, before returning to their mission field. We envision a place near the ocean, or on a lake or river. A place where we live in the home and have space to have other families with us. A place where we have work to be able to be able to provide this free to missionaries. A place where food is plentiful, for those who have not had much. An internal library were there are books of education, missions, anthropology, science, and religious, humor… A place of safety, and rest where they can feel they are at home. While here in the US we want to support those doing foreign missions, and this seems to the way God is leading us. If this interests you, please pray to know how God would have you minister with us to missionaries.