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Shanksteps #56 -Audrey
I wanted to give you an update on our patient Ngossa, so I copied the beginning of her story from a previous Shanksteps.

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.)
UPDATE:
At the time of the first writing, Ngossa was conscious, but unable to talk. She was not eating very much, was unable to walk, and only seemed to understand very simple directions. Almost immediately after sending out the story about her, she started having severe vomiting, a series of seizures and fell into a coma. I was very upset, and couldn’t understand why God would let this happen to her when we were praying for her sooooo much. (He is infinitely more wise than I∑) Most of her family left wailing that she was going to die; I was unfortunately thinking the same thing. (I found out later that her neighbor (a local “traditional healer”) told the family that they should take her out of the hospital because we were trying to kill her, and were only keeping her there to get money from the family. Fortunately the family did not act rashly and left here at the hospital several more days.) Obviously her family was very discouraged. They had already paid a huge amount on he
r bill, and now she was worse. At that point I started paying her bill myself to help out in hopes that the family would allow her to stay in the hospital. They agreed. We increased our daily prayers for her and her family. After two days, she came out of the coma, but again was unable to talk, walk, eat or understand what was being said to her. I was very discouraged, but at least she was out of the coma. About three days later, when I came in to make rounds, there was Ngossa, talking, walking, and washing her dishes outside the ward with the other women. I couldn’t believe my eyes. I had thought she was going to die, and here she was, almost as if nothing had happened. We asked her if she recognized me, and she said, “No!” She was still a bit slow to respond to questions, but as far as I was concerned, I had just witnessed a miracle! After two days we let her go home. Several days later, I found out the rest of the story. When her family initially went home wail
ing after she was in the coma, they called the whole family together for her funeral. Family members from as far as Douala (3 days travel) away came to give condolences to the family. Weren’t they surprised when the day after they arrived, Ngossa came walking into the village as if nothing had happened? I believe that God wanted more than just the immediate family to witness this miracle. Now they could celebrate life together instead of death. Ngossa and her mother came back to see me last week, and I could find no problems whatsoever with her, mentally or physically. I still don’t know where she is spiritually, so please continue to pray for her. Her family however knows that they witnessed a miracle. Praise God!

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.

#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.