Shanksteps # 80Meningitis vs. SacrificeOne week ago, 13-year-old Birmé came into the hospital with a 5-day history of headache and neck pain.  She was diagnosed with meningitis (the first of the season) and started on a long course of antibiotics.  During the first two days she had convulsions and severe agitation. After several days, the agitation resolved, but unfortunately last night she again started having convulsions and vomiting. She has been in a coma of sorts since entering the hospital.   I repeated a spinal tap on her todayand it was clear, indicating that the infection is, in fact, being treated by the mediation that we are giving her.  Why then is she still in a coma and having convulsions?Medically, it’s very possible that her brain was damaged by the infection during the first 5 days that it went untreated.  To complicate things, she took many different medications from the market, including one made in Nigeria that contains dangerous drugs (including cocaine?).  She may have taken traditional potions or powders that could further damage the brain.  Much has been written about the lasting sequelae of meningitis including: blindness, deafness, paralysis, coma, and death.Although the family brought her into the hospital for medical healing, they believe that her illness is of a more spiritual nature.  For those of you who don’t believe much in the “spirit world”, this will just come across as a weird story.  For those of you who truly believe that there is a war raging between God and Satan, please read this and pray, HARD!  I assure you, living in a land where the Devil can and does work openly; I have no doubt that we are involved in spiritual warfare.  Here isher story, and the beliefs of her people, the Mafa.In Birmé’s case, she is unlucky enough to have a grandfather (father’s father) who is a sorcerer, an old one at that.  As the story goes, her grandfather is becoming more and more feeble and is afraid of dying.  Every year, for the past three years, he has sacrificed (in the spirit world) one of his grandchildren in order to “buy” more life.  Consequently, in the “real” world, each of these children has gotten sick and died.  This year it’s Birmé’s turn.  To make matters worse, her mother’s brother”knows” what has been going on, and has threatened that if Birmé dies, he will kill everyone in the grandfather’s family.  This 13-year-old girl IS a spiritual battleground.To give you a better idea of the Mafa ideas, and how one can “buy” life, you need to understand their basic spiritual beliefs.  I won’t pretend to understand most of this culture, but what I have started to understand I will share with you.  The Mafa believe in what is called a second or middle heaven.  Some Mafa Christians call this The Devil’s Heaven.  In this heaven is a grand market.  At the market, you can find almost anything you want, from special pieces of clothing, to knowledge, to longevity.You can also buy spells to harm or kill people.  Only a sorcerer can go to this market, however many people here are considered sorcerers.  My opinion is that a sorcerer here is just one who has access or is open to this spiritual world.  (I have also learned that you can indeed buy the title of sorcerer in a nearby village from a certain group of people.)  From what I understand, people go to this market all the time to get what they need.  They can also see others there, and therefore see whatthey are buying.  Sometimes if you go and you aren’t supposed to be there, or you try to steal, you will be stopped by a soldier.  If this happens in the spiritual realm, you will become sick in the physical one.  There are many stories of people who had traveled to the Devil’s Heaven and been stopped by a soldier.  After getting sick, they went to the hospital but were unable to be healed/cured.  There is the story of a student 4 years ago who was doing poorly in school, so he went to the Devil’sHeaven to buy knowledge.  For some reason he was taken captive by a soldier and held in chains on his left side.  The physical manifestation of this was that he was forced in the physical world to lie on his left side.  If he got up, his eyes would roll back in his head and he would stop breathing. He was able to do complicated assignments for school as long as he lay on the left.   As you can imagine, the doctor here didn’t know what to do to cure this kind of sickness.  He was sent 7 hours awayfor further testing, only to find nothing.  Then the neighbor saw him captive at the spiritual market, being held in chains on his left side. She told the family who employed the services of a sorcerer, who aided in the release of the prisoner, and therefore the immediate healing of the patient.Back to the story of Birmé.  Apparently her grandfather goes to this Devil’s Heaven to buy longevity, but the spell only lasts for a year.  His payment each year, for the past three years, has been the lives of his grandchildren.  I don’t know how her story will end.  I have talked with her parents, prayed with them and her each and every day, and prayed for her healing, and more importantly her parent’s understanding of the gospel, all the time throughout the day.  Her father believes that it isthe Devil’s doing that she is sick, but I don’t think he has quite understood that blood of Jesus has already defeated the power of Satan and that he needs to call on that blood.  Please pray for her healing, the true understanding of God’s love for her parents, and that despite the Mafa beliefs, that we can find a way to explain God’s love and redemption to this culture that relies so much on appeasing the evil spririts.In His Mighty Grasp, Aud and family
Shanksteps #79-Greg
She is burned from the thighs to her ankles on both legs.  It’s “cold”, 62 degrees.  She was huddling next to the fire when her cloths caught on fire.   She lives in the mountains and they brought her to the hospital after two days.  She had no sensation over the burned areas.  And her legs were contracting in a sitting position.  For a year now we have not been able to purchase antibiotic ointment but Béré Hospital in Chad gave us some burn ointments recently.   She was brought in the hospital andtreatment begun.  I explained to the family that in a few days she would need skin grafts.  We are very fortunate to have received a Zimmer dermatome as a donation.  Over the first few days she did well.  Then she started having chills and fevers.  I at first thought of infection from the burn site.  I started treatment with oral antibiotics.  She continued to have fevers.  I checked a malaria smear that was positive.  After a few days her fever abated.  We received another woman who was burned when her cloths caught fire and had a 2nd degree burn on her right side.  So I decided to graft both of them one day.  The morning I planned on doing it her father was there.  He did not want anything done.  He wanted to take her home.  I tried to explain how it was not good for her.  That without dressings she would likely die.  He said that it was because he had not done the correct sacrifices that she got burned.  So since this was the problem he was taking her home to make the right sacrifices.  I asked him if he believed in God and he said he believed in the spirits and this was why the I didn’t understand ofthe sacrifices.  It is hard to explain something to someone who believes completely opposite you in every way, medically/spiritually/physically.  Everything about this man and his thinking is different than mine.  So they paid her bill and took her home.  It is so hard to reach some people for their good.  Medically my ideas are so different than the local populations.  Theirs is based on spells and correcting the spell given.  A few people believe in modern medicine but most in traditional medicine (herbs, roots, potions)  and some in sacrifices.  Even some of our nurses use medications and if they are not working fast enough will try traditional things also.  It covers all their belief  bases.  Audrey willwrite more of their beliefs in the near future.  Please continue to pray for our work here.  In His Service, Shanks
Shanksteps #77
Shanksteps #77 Have you ever had to think of surgery on your child?  I’m sure some of you have, but I had not until recently.  Well not actually my child, but someone who I was responsible for and felt as if my close family member or child.  We had been in Béré Hospital for about 2 weeks.  The hospital is fortunate to have 4 student missionaries and a couple other temporary volunteers.   Some of the student missionaries went off on motorcycles to a town near by to purchase some things and pick up the mail.  Whiletraveling, one motorcycle had a problem and the SM (student missionary) had to wait for it to be fixed, waiting in the hot sun a few hours.  During this time she started having an upset stomach.  On her ride back to Béré she was feeling worse.  We saw her that evening after we got back from the hospital and she was having a lot of cramps. “Are you feeling OK?”  My wife asked her.  “Not to well!”  She stood to go into the bathroom.  Audrey was prompted to follow her.  Just as she entered the door she collapsed.  Audrey caught her before she hit the floor.  She came to and sat up in a few seconds.  As she sat up she passed out again.  This time for a long period.  We figured she was dehydrated or hypoglycemic so we ran to the hospital and got an IV and started it.  She didn’t move.  We gave her some medications.  Slowly she becameconscious.  She complained of a headache and abdominal cramps.  All of us were huddling around trying to take care of her.  We put her in a bed.  After examining her, her pain was all across the lower abdomen. As you may know by now, there are not many diagnostic tests available here in the bush.  We did an ultrasound and found a couple ovarian cysts.  We decided to treat her for typhoid and other intestinal bacteria so prevalent in our surroundings. Later that night she was in more pain.  Her exam was the same.  It’s 3AM and I’m thinking what would I do if it were my daughter?  I guess if this continues I would want her out of Chad and to Europe or the US.  By morning she was feeling a little better and was hungry.  Since she was still was having bowl functions I let her eat.  I decided to call James Appel telling him that it would be nice if he and the plane with Gary could come our way in case we needed to evacuate her out to the capitalof Chad and Europe.  They immediately left and would be with us in about 6 hours.  During the day she felt better till about 2PM. She had gone without pain medicine for a while and then she started having more intense pain again.  This time it gradually got worse and worse.  James and Gary finally arrived.  We discussed the different options.  The capital of Chad, N’djamena was not in a good choice.  So it was either treatment in Béré or in Europe.  At this point we felt she needed surgery based on her abdominal exam.  The student missionary was able to talk to her parents in the US and it was decided to stay at Béré. We went to the operating room with a fully volunteer, Caucasian staff.  The surgery went well and we found appendicitis.  We were very relieved to finally know the real source of her problem.  And I was very relieved that the operation went well and that she came through it all with only a headache. We praised God that James and Gary were able to come and that she did well!  Lack of diagnostic tools really inhibits our ability to diagnose patients here in Cameroon as well as in Chad.  Fortunately God impresses us often in what we should be doing in spite of our diagnostic and other inadequacies.  We praise God for His leading and help in every situation.  In His Service, Shanks
Shanksteps #78- Greg
Shanksteps #78- Greg
We are now in the cooler season (85-90 deg during the day). There was a case of Polio (a disease that paralyses extremities) here in the north of Cameroon. So the last three days have been designated by the government for vaccination of all children 0-5 yrs. That means that vaccinators go from house to house vaccinating all the children. As doctors of the hospital we are included in the supervision of the vaccination in our area.
When they are vaccinated they are given the oral polio vaccine and then marked on their finger with a mark to show they were vaccinated. Then we can tell who has been vaccinated or not. Also the house is marked in a way to know how many of the children were vaccinated.
So I go to houses and check and make sure they were vaccinated. Some houses are done well; others have missed some children because they were out with their mothers in the fields or at school or elsewhere. So they get vaccinated the next day.
In walking around I get to see more of the community.  I greet many people sitting under trees shelling out peanuts, grinding up food on a hollow rock, or threshing millet. Other old men or women are watching small children at home. This consists of letting the children wander all over while the grandpa sleeps under a tree or shade of the hanger (a “roof” on posts that is there to store millet and other things out of reach of the goats and other animals).
I decided to go up the hill and check some houses that were out of the way. One group of huts was perched on a large rock. An old man lay sleeping on a “bed” of sticks with a rock as his pillow. A small boy was playing with a scrap of cloth a few inches in length. After waking the grandpa we found out that there were three children in the age range. They hadn’t been vaccinated.
Walking further we came upon two huts with one dirty old woman who walked with a stick as a cane. She lived there by herself. She had one relative in the valley but didn’t want to live in the valley. When asked where she got water, she said that she would go down to the valley and about a mile away pull up water from the well. Then she would carry it back to her house. I can see why many of these people don’t bathe very often. Life for her looked very hard, but she preferred it to the valley.
Moving on to the last house. It was also half way up the mountain and perched on a large rock.  After scrambling up the rock path we arrived at the group of huts. Two old men sat face to face with a chicken on one’s lap. A little boy of about 7 couldn’t decide to run and hide or stay and watch the strangers. His mother was near by nursing a little newborn. She had a torn shirt and skirt that didn’t cover much. But then again, women’s chests are not private here. They greeted us warmly with
the usual shaking of hands. They had been to the valley and were vaccinated. I saw the man pulling something off the chickens’ legs as it lay on his lap. I asked him if he was preparing it to eat. Then the other old man of the house decided it was time for us to go. The guy translating for me said he was a “fettisher” traditional witchdoctor that was getting ready to do a sacrifice. He is the one people come to see to cast spells on people, find out how a journey will go, or foretell the future.
My translator asked him what he saw for the coming year as far as disease was concerned. He said it would be a very difficult year and more disease than last year, with many deaths. Shaking his hand I agreed with him that the Bible says times would get worse and worse until Jesus comes. The “fettisher” asked me to pray to my God and he would pray to his gods about this. I said I would pray to my God and also hope that someday he would know my God that loves him and sacrificed for him. He smiled
and we parted ways. After scrambling down the rock we prayed for him and his family that they would come to know Jesus that died for them. It is a strange feeling to know that you were in the presence of someone that communicates with the devil in a direct way. Please remember us as we try to reach people like this that do not know God and haven’t had a chance to yet.
In His Service, Shanks
