Tuesday, August 2, 2016

Medical Missions for the Rest of the Family

Going on a medical mission trip with the entire family adds multiple options in terms of ways to serve.  Our son Andrew and his friend Ty Nowatzki made this video that tells how the rest of the family served at Mbingo Baptist Hospital in Cameroon where we served during the month of July 2016.  Click on this link to watch the video:  Medical Missions for the Rest of the Family

Anna giving Amber anesthesia.  (Just playing doctor.)

Thursday, July 21, 2016

Bed F12

It's 3 AM and even though my body was warm and comfortable under blankets and my head resting on a nice pillow, sleep was elusive.  The sound of rain beating down on the metal roof sounds as if we were living at the base of a waterfall.  A different pitch of sound is made from the water pouring out of the downspouts.  There is no other audible sound, as the sound of the rain and the water overpowers any other sounds in the house at this hour.

At the end of a long day in the operating room, I went to check on my patient in bed F12 on the female ward. Her bed is at the end of a long ward of 24 beds, 12 on the left and 12 on the right.  Bed F12 is at the end on the left.  Each bed has a dark green modesty curtain that can be pulled, and mosquito netting dangling down in a loose knot from above.

As I entered the ward through the modest nurses station, I peered at the chart rack to read the notes that had been made that day and to check the labs.  She was on five different chemotherapy drugs to treat her cancer, called choriocarcinoma.  My hand ran down the slots to F12.  The slot was empty, which was not at all unusual.  All of the other charts seemed to be in the wooden rack, and the counters of the nurses station were uncharacteristically barren of charts.

There was a solitary nurse in the nurses station and I queried here as to the location of the missing chart. Her expression told me before her words did.  "F12 expired this morning doctor."  Our eyes locked for a moment, and then I turned and peered down the tops of my bifocal lenses to the end of the ward.  F12 was empty.  The bed was made.  No care givers were sitting at the bedside of bed F12. There were no belongings on the shelf or piled on the chairs.  Just two days ago I had stood at her bedside talking with her about the side effects she was having from the chemotherapy.  I had held her hand and prayed with her.  I had slipped her two tootsie roll lollipops to put something sweet in her mouth to replace the nasty taste of the bile that resulted from the side effects of the chemotherapy.

Then I took a deep breath, let out a long deep sigh and turned and walked out of the female ward down the corridor to the hospital circle driveway, then down the hill past the hospital chapel, down the slippery muddy road past the helipad to guest house #11 where we have been staying for the past month.  As I walked the tears that had been leaking out of the corners of my eyes dried on my face.

F12 had died.  Another patient with a cervical biopsy which had shown a rare form of cancer called a rhabodomyosarcoma had been transferred to palliative care; a place where pain management and spiritual and emotional care are provided, but where cure is no longer the goal of therapy.  A third patient with even a more rare form of cancer called a sarcoma botryoides had also been placed in palliative care that day; her tumor replacing her uterus and filling her female parts with grape-like clusters of cancer; fixing itself firmly to the bones of her pelvis.

The aroma of something delicious filled the air of guest house #11.  Debbie, the wife of the pathologist here, had "dashed" (gifted) us with a freshly butchered chicken.  I found out later that Debbie's friend had done the butchering and plucking and my wife, Teresa, cut it up.  Teresa had found a delicious recipe calling for Italian dressing and brown sugar and she had baked a delicious dinner of chicken and pasta.  We sat around the table, sharing the events of the day. I heard about the boys hiking a mountain today at sunrise, and the different ways that our family had served at the hospital today.  My spirits were lifted by game a Hearts and successfully "shooting the moon" once during the game before Teresa could celebrate her victory by "shooting the moon" herself.

The last three weeks have been filled with new relationships and touching lives of others, teaching them what I know, and sharing with them the knowledge that I have been given.  Below are pictures and captions of some of these people.

Dr. Lema is from Tanzania and is currently in the PAACS surgical training program and doing a rotation at Mbingo Baptist Hospital in Cameroon for three months.  His wife and daughter are back in Tanzania.  He always has a smile and such a great positive attitude.  It has been a pleasure to work with him, teach him and to have enjoyed several meals with him.

Dr. Laura is a physician from Cameroon who I work with daily in the women's clinic at Mbingo Baptist Hospital.  She tirelessly addresses the needs of women here in the clinic.  She speaks French, English, and the local dialects and patiently has translated often for me.  She is a sponge for knowledge and it has been a joy to invest in her life while serving here.

Ty Nowazki, aka the "Gringo at Mbingo", is like another son to us, and has traveled to be with us here at Mbingo.  He and our son Andrew don't sit still for long, and have been extremely adept at finding different ways to serve here, doing everything from entering years of pathology data into databases to helping a medical student from Stanford doing research on amputees with his research.  Today Ty and Andrew are going to give of themselves by donating blood at the hospital. It has been fun to watch the impact of this experience on Ty. 

Dr. Amir is a PAACS resident from Egypt spending three months here in Cameroon at Mbingo Baptist Hospital.  I have had the pleasure of working with him and teaching him in the operating room and in the surgical classroom.

Dr. Carol has been one of my favorite people to work with here. She and her family live in Cameroon, and once a month she commutes 3.5 hours to come and work at the hospital for a week each month.  She effortlessly slips between English, Pidgin and French and engages her patients and colleagues beautifully.  Her son Eddie guided us up the mountain to the top of a nearby waterfall.  Without Eddie I don't think I would have ever have dared to make the trip through the tall brush, knowing that some of the most poisonous snakes in the world live here.  I just tried hard not to think about it as we forged our way up the mountain!  The view of the mountains, the valleys, the waterfalls and the hospital and clinics below made the hike (and overcoming my fear of venomous snakes) worth it.

Saturday, July 16, 2016

What does TIA mean?

Robert Emmons, perhaps the world’s leading scientific expert on gratitude, argues that gratitude has two key components, which he describes in a Greater Good essay, “Why Gratitude Is Good.”
“First,” he writes, “it’s an affirmation of goodness. We affirm that there are good things in the world, gifts and benefits we’ve received.”
In the second part of gratitude, he explains, “we recognize that the sources of this goodness are outside of ourselves. … We acknowledge that other people—or even higher powers, if you’re of a spiritual mindset—gave us many gifts, big and small, to help us achieve the goodness in our lives.”
TIA is the abbreviation for transient ischemic attack, which some people refer to as a mini-stroke. However, here in Cameroon TIA means, "This Is Africa." I think of "TIA" when I think of the obstacles, or truly mountains that need to be moved, as we look at how do we move forward here with such enormous issues as prevention of cervical cancer, or early diagnosis and treatment of breast cancer here in Africa.  I think of TIA when I use a pair of surgical scissors that don't cut; indeed not performing the very function for which the scissors were designed.  
We had been made aware that many of the surgical instruments at the hospital here at Mbingo were decades old and in various states of disrepair and dysfunction.  Over the past year many of the readers of this blog had donated tens of thousands of dollars in order for us to place a special order for new surgical instruments for Mbingo Baptist Hospital in Cameroon, West Africa. 
When we arrived with extra suitcases filled to fifty pounds, and several to seventy pounds, crammed full of brand new, never used, high quality, stainless steel surgical instruments, there was a ripple effect that happened here at the hospital.  There was a buzz among the surgeons.  The operating room staff were talking.  The surgical residents were elated.  Even the CEO of the hospital was very aware and extremely grateful for this gift.  
The two components of gratitude are expressing gratefulness for the gifts received, and recognizing that we could not have done this great thing without you.  On behalf of the hundreds of people who work at Mbingo Baptist Hospital, and the thousands of patients who will benefit from your gift, thank you!  
Operating Theater Director Jackie Griffin, Nurse Beverly, Head Surgeon Dr. Jim Brown and Dr. Allan Sawyer survey the gifts of surgical instruments, gowns, drapes, sutures, surgical loupes, surgical headlights and surgical dressings brought to Mbingo Baptist Hospital in Cameroon, West Africa.

Central Sterile Director Ben and Operating Theater Director Jacqueline Griffin demonstrate the folding and unfolding of surgical drapes for a video made by Andrew Sawyer and Ty Nowatzki to be used for staff and surgeon instruction.

Surgical instruments on a Mayo stand preparing for surgery.  Note the kitchen towels being used for surgical towels. 

Removing a large ovarian tumor and cancer staging.
Left to Right: Dr. Carol Loescher, scrub tech, Dr. Sama Akanyum, Dr. Sawyer, anesthetist Mr. Gilbert

Surgical Instruments in Surgery.

More Surgical Instruments in Surgery.

Our photographers, Andrew Sawyer and Ty Nowatzki.

Left Ovary waiting to be opened by Dr. Loescher. 

Friday, July 15, 2016

Red and Yellow, Black and White

Several months ago, a friend of mine and vascular surgeon, Dr. Paul Osteen, shared a story about a patient of his that he had cared for in Zambia.  Her name was Precious.  It was a heart warming story, one that leaves you with tears ready to spill from the corners of your eyes.  At the end of his story he shared the lyrics to the children's song which is familiar to many:

"Jesus loves the little children,
all the children of the world,
red and yellow, black and white,
they are PRECIOUS in his sight,
Jesus loves the little children of the world."

Dr. Osteen's story and the lyrics of this children's song have been going through my mind as we serve here in Africa.  Being here in West Africa and reading the disturbing news events of the past week in America leaves my heart troubled and saddened.  Earlier this week I sat in the hospital chapel at 6:45 AM joined by hundreds of the hospital staff as they sang and listened to the morning message.  The hospital chapel is filled to a standing room only capacity with hundreds of people each morning, Monday through Saturday, six days a week.  In the company of my co-laborers, each of us here united in the purpose of bringing healing to the sick in the name of Jesus, I realized that I was one of only about a half-dozen white skinned people in the room.  The best part of it all was that the color of my skin didn't matter.  

Mbingo Baptist Hospital Chapel
My family met with Pastor Mbuh Julius (last names are written first here) to discuss placement of vinyl transfer Bible verses that we had brought with us.  Seventy percent of the patients here are Franco-phones rather than Anglo-phones (French speaking rather than English speaking), and in preparation for our time here we had asked Amanda George (www.etsy.com/shop/babygeorges) to make large vinyl transfers of two scripture verses; two in English and two in French.  My family went to work with Pastor Julius to find places in the hospital and chapel to place these scripture verses.

In the maternity waiting area, my family transferred Psalms 139:14.   

Above the check-in window in the surgery clinic they posted Deuteronomy 31:8.

"The Lord himself goes before you
and will be with you;
he will never leave you nor forsake you.
Do not be afraid; do not be discouraged."

We were extremely honored when Pastor Julius asked us to place the English version of Deuteronomy 31:8 in the front of the chapel where the entire hospital staff meets six mornings per week.  

Red or yellow, black or white; French speaking or English speaking, no matter how short or tall, small or large, we are all precious in God's sight.  

Indeed, when Jesus was asked what is the most important commandment, his response to the religious leaders of the time was, 

"Love the Lord your God
with all your heart and with all your soul and with all your mind,"
This is the first and greatest commandment.  
And the second is like it:
"Love your neighbor as yourself."  
Matthew 22:37-39

The problems of the United States will not be solved by decree, law, Congress, the Supreme Court, or whoever is elected as the next president.  The problems of the United States need to be solved with a change of heart of the people of our country.  These are heart issues, not political issues.  We would do well to consider what advice Jesus had to say to to the lawyers of the day in biblical times, "Love the Lord your God with all your heart and with all your soul and with all your mind" and "love your neighbor as yourself."

Sunday, July 10, 2016

Who is that surgeon?

Dr. Carol Loescher is an ob/gyn who lives in Cameroon and tries to spend a quarter of her time at Mbingo Baptist Hospital as a consultant.  Two of her children are here, Lydia and Eddie.  We have been enjoying having other kids here and today we took Lydia, Eddie, Anna and Amber to watch Dr. Loescher do a cesarean section.
Left to right: Amber, Anna, Lydia, Eddie

Dr. Carol Loescher draping her patient with the kids looking on.

Anna (left) and Amber watching Dr. Loescher operate.  No one passed out!

This little baby boy is only a minute old!

He is telling us that his lungs work very well!

Eddie and Lydia posing in front of their mom operating.

Mother and son face to face for the very first time.
A special thank you to the mother for allowing our children to watch her surgery and to take these photographs.  We are very grateful!

Inside Mbingo Baptist Hospital

Let me take you on a tour of Mbingo Baptist Hospital and introduce you to some of the people here.  Sam Nigo is one of the PAACS surgical residents that I am working with here at Mbingo.  When he told me that he was from the DRC (Democratic Republic of Congo), I asked him if he knew some of my friends who have worked at Nyankunde Hospital there.  It turns out that his father was the head laboratory technician there and that he knew all of my friends.  We operated together for several cases this week.

For those of you who know how an operating room functions, usually there is some type of a main board which tells which patients and surgeons are in which room and the type of surgery which is being performed in that room.  There is always someone in charge of "running the board."  Here is the gentleman who runs the board at Mbingo, and he takes great pride in running things efficiently.

This is one of the nurse anesthetists carrying a young child in for surgery.
During the morning the residents of the internal medicine and surgery programs take a break to enjoy chai tea and light pancakes.
Dr. Carol Loescher is an ob/gyn physician who comes to the hospital for one week a month.  She and her family lives a few hours away.  Here her daughter Lydia and her son Eddy walked with our family over to our house for a game night.  

Early this morning the phone rang before sunrise.  These twins were in the wrong position for a vaginal delivery, and so Dr. Carol and I did a cesarean section.
Jackie is the nurse in charge of the operating room.  Yesterday our children helped her to unpack all of the surgical instruments that we had brought with us, along with other donated instruments.  They arranged them on these tables and were busy making new surgical trays for various types of surgeries.  Needless to say, she was extremely grateful for the hundreds of surgical instruments that our supporters had helped to purchase and donate to the hospital.  Many of the surgical instruments that are in the current surgical trays are decades.  To have brand new surgical instruments is an incredible gift and will be a blessing to them for years to come.

Thursday, July 7, 2016

Holiday Surprise

Yesterday, July 6, 2016, turned out to be a holiday in Cameroon.  Eid al-Fitr marks the end of the fast of Ramadan, which is a national holiday here in Cameroon.  Following a busy morning of surgeries at the hospital, including removing a large benign ovarian tumor, I discovered that at noon we were done for the day.  It was a beautiful day here at Mbingo, and the hiking here is amazing.  The 16 year old son of another missionary physician offered to guide our family up into the mountains to see the waterfalls from the topside of the waterfalls!  The beauty of these lush green mountains speckled with waterfalls is an amazing contrast to our home in Arizona.  
This little chameleon wasn't too happy that we discovered him while on our hike. He blended in beautifully with the plants that he called his home.

Anna (left) and Amber didn't seem to mind at all that they were standing next to a 1,000 foot drop behind them.  
 This is one of the many waterfalls that can be seen from the front entrance to Mbingo Baptist Hospital, although from the hospital the waterfall is way off in the distance.  Let's just say that this is much more up close and personal!
In a previous blog I had mentioned that the boundary of the land of the hospital is the top of this mountain range and down into the valley below.  The man who donated the land to the hospital believed that the mountains would prevent the spread of leprosy from going over the top of them.  When we reached the top ridge line, we found this barbed wire fence that I suspect was mostly to keep the herds of long horned cattle from toppling over the cliffs, but I couldn't help but think that this was one last "barrier" for the leprosy from going over the mountain.
From left to right: Teresa, Allan, Andrew, Amber, Ty Nowatzki, Anna.