#96 Shanksteps – Selfishness

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#96 Shanksteps – Selfishness

 

How many times does the Holy Spirit have to scream in your ear before you finally give in?  What does it take for you to realize that you are self-centered?  For us it took the angelic face of a 12-year-old girl who appeared on our doorstep one evening.  

Her name is Dzaoda.  This courageous young girl is the very first female in her village to continue her education past elementary school.  Her mother and brother, who are from a village about one hour away by motorcycle, decided to send her to the Adventist Secondary School in Koza.   This is her first year here.  Up until now she has been living with her aunt here near here. However, last week, four weeks before the end of school, her aunt kicked her out of the house demanding that Dzaoda give her

two bags of millet or she couldn’t come back.  Dzaoda came to our house to ask if she could hide her books on our porch because she said that if she left them with her aunt, her aunt would throw them away.  (The school is right next to our house.)  She said that her mother was coming in 3 days to arrange everything with her aunt.  We offered that she could stay here until her mother came, and our guard thought it best for her to sleep on our front porch. We gave her a mat and mosquito net, and fed

her for the next several days.  

Now, at this point I know there are some of you saying, how could you leave a young girl outside like that. First, let me say that everyone here sleeps outside during the hot season.  You also have to remember that the people here live by the concept that if you “have” and I “need”, it is perfectly okay for me to “take”.  Unfortunately, the inside of our house would be too great a temptation for almost anyone, with all of the “American stuff” we have.  Even if they weren’t tempted to “borrow” any

of it, they would certainly tell all of their friends how “rich” the Americans were.  So, to avoid these and many other problems, we don’t usually invite people that we don’t know VERY well into our house. 

Several days ago we went out and she was crying. After calling our hospital chaplain over to help talk with her, we discovered that she was afraid that we would be angry with her and think she was a liar because her mother never showed up.  We assured her that we were not angry and promised to try to work things out for her.  Our Chaplain went and talked to her aunt and others who knew what was going on. Well, yesterday morning, we met the Aunt.  She said with her mouth that Dzaoda could come back

to her house, but with her tone/mannerisms, it was quite clear that she was not welcome or wanted.  So, yesterday afternoon, Greg drove Dzaoda to her village to meet with her mother and brother.  (Her father died when she was 7.)  Greg planned to drop her off, but made her promise to come by our house on Monday morning (to make sure that she was ok, and that she was planning to finish her last 3 weeks of school.)  He talked for a while with her mother and brother (all translated, as no one in the

village speaks French), and in the end, realized that she had nowhere to stay if she was to finish out the year of school.  So, Greg agreed that she could stay at our house until school ended.  

Last night, we again had Dzaoda sleep on our porch with the idea that we would try to find a good Mafa family to stay with in town.  Now, I have to tell you that for the past week as this saga has been unfolding, I have not really felt at peace about her sleeping and eating outside; despite the fact that she was okay with it; despite the fact that it was culturally appropriate; despite the fact that our guard was out there with her.  I have been continually rationalizing that it was okay, while in

my “mother’s heart” it was not.  So, after almost a week of struggling with the voice of the Holy Spirit (some would call it a conscience), we have taken her in as one of the family – rules and regulations included.   And finally, my heart is at peace with my head.  I also realized that if God wants us to take her in, then he would protect our “stuff”, or make us realize that we really don’t need it anyway.

It’s obvious that we are different from the people of Koza, but sometimes I forget how different.  I was again struck with how much we do have, and how little the people get by with.  When I was showing Dzaoda around the house, I realized that I had to teach her how to turn on the water in the sink, use the toilet, and switch on the light in the room.  We are so blessed, and yet unfortunately so selfish with our blessings.

Try not to use this reminder to point out how others are selfish, but look inside yourselves to see how you can share your blessings with those around you.

In the service of One who is completely unselfish, Audrey (and Greg and Sarah)

Shanksteps #95

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Shanksteps #95

 

There was a small hole in his upper back about 1cm from the spinal column. He was spitting up blood and otherwise felt OK. He was drunk on the local millet wine and couldn’t remember what the dispute had been about, but knew that his neighbor had done it. He said it was a thin piece of metal that was about a quarter of an inch across and imbedded about 6 inches in his back. They pulled it out immediately. He had some blood coming from the stab but it was slowing down. For me it was a diagnostic
difficulty. He needed to have a gastrograffin swallow to evaluate for esophageal injury. A CT scan with contrast to evaluate for any large vessel injury. And a bronchoscopy to evaluate for tracheal perforation. He had a normal pulse and blood pressure. I do not have the tests that he needed. And if I were to try to refer him elsewhere, they wouldn’t either. There is a CT scanner in Yaoundé (about a 3 day trip and 800km away). This is not feasible for the local population regardless of how
sick they are. It would take their years income, to just arrive down there. So I needed to treat him where we are. So I decided to treat him with antibiotics and wait and watch. If he became infected then I would have to explore his chest. That would cause other difficulties as I do not have a chest retractor, or good assistance, or general anesthesia… the list could go on and on.
We prayed for him daily and gave him IV antibiotics and he took nothing by mouth. We continued this treatment for a week. After about 5 days the spitting up blood stopped and his pulse and BP remained normal. He never developed a fever either. After a week I advanced his diet slowly and eventually he began a full diet. We praise God for healing him and that he did not get a mediastinal (central chest) infection.
We often have diagnostic difficulty in many patients we see. We have limited tests, plain xrays and ultrasound (thanks to your donations). Often I feel God prompts us on what to think about and how to treat some patients.

We are thankful for His healing. Greg

Shanksteps #94

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Shanksteps #94

How strong are your beliefs and what are you willing to give up to keep them? A young man came by the house today. And is often the case I first think who is it? If it is someone I don’t recognize I think what do they want. Often its to ask for something. Seeing someone who I didn’t know I asked what they needed. His was a request.
He is in University a full days travel away. He was brought up in a family of animists. While he was young his father didn’t take care of his family or make sure they could go to school. Everyone was for themselves. He made it to high school with the help of other family members. In grade school his father decided to become a Christian and got rid of his extra wives and their children. (Doesn’t seem entirely Christ-like to me) So since that time he has essentially had no father. A few years
ago a Peace Corps worker was here and he helped her a lot and she subsequently helped him get a small plot of land to have a house here in Koza. She has also helped him with part of the schooling for going to University. He has strong beliefs. He is a Seventh-day Adventist. Since he takes his beliefs seriously he has chosen not to go to classes or tests on Saturday, but preserves it as a day holy to God. His first year in University he was able to pass ten out of twelve credits. The two he
failed because he failed to attend the final tests which were on Saturday. The school advanced 160 students of the 400 of the first year. He was also advanced. Now in the second year he is nearing the end and has found out that five of his 13 credits are testing on the Sabbath. So he feels he will not pass this year. When I asked him how many others are in the same situation he said one other. He said most other Christians trample their beliefs while at school, whether it be Sabbath observance
for Adventists, or sexual promiscuity for others, or alcoholism for still others. Sounds similar to many Christians in the US Universities doesn’t it?
He came to see if there was any way I could help him go to a Christian school that did not require activities on Saturday. He said this school generally costs 1.2 million CFA ($2800) to attend per year. 750,000 for tuition, and the rest for rent, food and other living expenses. He thinks he can do it for 1 million CFA. He gets 400000CFA help from his friend, could get 100000 from a younger brother and is asking for help of 250000 a year for three years. This would cover his tuition. He will
work locally to cover lodging and living expenses. All of this to keep his beliefs. How strong are your beliefs? Are you willing to give up critical things in your life for your beliefs.
I hope this story encourages you in your beliefs that those who are following God need to always be firm in the time of temptation to fall to the easy way or to rationalize away your conscious. If any of you are interested in helping a young man please let me know.
In His Service, Greg

Shanksteps #93

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He was born this morning. He has six toes on each foot, six fingers on each hand. Short stubby ears, and a wrinkled forehead. He weighs 1.6kg (3.5 lbs). His parents said he was term but that’s not likely. His heart and lungs sounded normal. He was crying and had a cleft lip and palate. But the biggest problem lies at his umbilicus. There was a 3cm wide hole with all of his bowels laying on the table beside him (gastroschisis). [It is an abdominal wall defect that has 14% associated jejunaland ileal malformations, 4% have other malformations, 60% are premature, and there seems to be no associated genetic factors.] Only the grandfather and some other relatives were there. The mother was to weak to come to the hospital they said. The father was away in another village, and didn’t know he had a new baby. I explained to the grandfather that survival was unlikely but that surgery was his only option. We took the child to the operating room. He was making stool, which made me slightly hopeful. Our student missionary and I were able to take all of the edematous bowl and put it back inside. We sweated profuselyas we attempted to do the repair without air-conditioning because the child was already cold. It was 107deg F outside, and just as hot inside, with our gowns on. We have no warming apparatus in the OR. During the surgery the child vomited and desaturated (dropped his oxygen) and I had to unscrub to help the nurse bag the patient. He was not able to raise the saturation. After 30 minutes he was stable enough on max oxygen for me to reenter the operation. We finished the operation and he wasbreathing on the maximum oxygen that we could give (5L NC). We put him in the incubator donated by Parkveiw hospital and warmed him up. He would periodically stop breathing and we would have to bag him up again. We started another operation, a hysterectomy for uterine prolapse, and observed the baby in the OR while we did it. A few hours later after seeing clinic patients a man came in who was stabbed in his left upper abdomen and had omentum hanging out. Blood oozed from his side and he was drunk and talking profusely. He referred to me as a priest and explained he was stabbed with his own knife he was carrying. As we went to start his operation the baby desaturated again and I had to go between roomsto help him. Then the power cut off. We operated in the dark by headlamp donated by the head of surgery at the end of my residency. I could hear the monitor going off because of the low oxygen but could do nothing about it. They went to find someone to start the generator. Finally the generator was started about 5 minutes later and the oxygen for the baby was in single digits (normal is >92%). I was concerned then about brain death for the child. We found a spleen laceration in the stab victim,through and through stomach perforation and a liver laceration. We repaired the stomach laceration and repaired his cut rib at the entry site. The baby was being bagged more often with less success, he was wearing out. He needed to be on a ventilator, but that’s not available here. Finally I decided to stop and turn off the generator. It is often very difficult decisions that physicians have to make on a daily basis. Unfortunately many are life and death decisions. I pray daily at the beginning of each rounds, that God gives me the wisdom to treat each patient that I see, and not harm more than help. It is frustrating not to be able to diagnose problems and even more frustrating to know the problem and not have the equipment or staff to do something about it. Another along those lines is that we are having a measles outbreak now as Audrey wrote recently. We are up to 8 cases now. Children that were apparently already vaccinated against it, for the most part. Very contagious and preventable. We are thankful for our health that is holding up in spite of our surroundings. Thanks for all your prayers and emails. They are very encouraging.

Greg