The Longest Commute

My twelve-year-old Toyota pickup truck only has 63,000 miles on it, mostly because my commute for the past 12 years has been a half-mile from my house to my office.  Then it was a mile from my office to the hospital. Then a half-mile back home from the hospital. Typically I would drive about 2 miles a day. I filled the gas tank of my truck once a month, and generally lived my life inside a one-mile radius.

Then, last January, after selling my ob/gyn practice, my commute changed from a half-mile to thousands of miles.  This coming January I will once more commute to West Africa, to teach African surgeons how to do the surgeries that I do, and to help them use their medical and surgical skills as their ministry to their patients.

If you are reading this, then you have likely helped to support me with these endeavors, and I am extremely grateful to you. This year I am scheduled to make at least three, and possibly four extended trips to three (or four) different hospitals in West and Central Africa. Inside my luggage for the first trip are three complete surgical trays, two for doing cesarean sections, and one for doing abdominal and pelvic surgery. These are brand new German stainless steel surgical instruments, of the highest quality, that will be used for decades. 

I'm extremely grateful to each of you who have helped me to go and to serve and to teach. Know that you are making a difference in the world, one patient at a time. The education that I will provide to these doctors, and the surgical instruments that I will bring, will continue to serve these communities long after I have left. 

If you would like to be a part of my team, you can follow the directions on the left side of this blog. I would welcome you to vicariously be a part of my work in developing countries. 

Thank you, and blessings to each of you, and Merry Christmas!

Mango Trees & Motorcycles

Mango Tree with Ripe Mangos

Mango Trees and motorcycles just don't seem to belong in the same sentence, unless you are reading an article about things that motorcycles crash into, in which case mango trees would likely be on the list, at least here in Cameroon.

As you might imagine, if you were at a mission hospital joining the surgical team on morning rounds, you would expect to hear about what the on-call team had done the night before.  And so it is here at Mbingo Baptist Hospital.

But after a month here of listening each morning to surgical rounds, and also enjoying the incredibly delicious ripe mangos that are grown here, there seemed to be a connection between the ubiquitous presence of motorcycles and the tasty mangos that were being devoured at mealtimes.

Nearly every day surgical rounds go something like this.  The intern would show a series of  PowerPoint slides and discuss each admission:

Case #1: 12 year old boy with broken arm after falling from mango tree
Case #2: 42 year old male with spinal cord injury after motorcycle accident
Case #3: 14 year old girl with broken leg after falling from mango tree
Case #4: 49 year old woman with diabetic ulcer
Case #5: 24 year old male with depressed skull fraction after motorcycle accident
Case #6: 27 year old male with broken leg after motorcycle accident (hit Case #5)
Case #7: 8 year old boy with laceration after falling from mango tree.

This list is fictional, but still representative of the types of admissions that come in every night at Mbingo Baptist Hospital in Cameroon.

So, finally I raised my hand and asked the surgical team, "Are mango tree injuries seasonal?"  The room erupted in chuckles as everyone agreed that, yes, indeed, when mangos are in season, mango tree injuries increase in frequency.

I knew that motorcycles were dangerous, but I never imagined that morbidity from mango trees could occur with as much frequency and regularity as motorcycle accidents, at least during mango season.

And now you know how mango tress and motorocycles are related!  

Saving Lives One Image at a Time

Doctors need good information in a timely fashion to make decisions.  In obstetrics, general surgery, and critical care, even minutes can make a difference in determining whether a life is saved or not.  The availability of bedside ultrasound for rapid assessment in critical areas such as the ICU, emergency departments and labor & delivery units has become more of the norm now than the exception.  Obstetricians certainly rely more on ultrasound than on a stethoscope!

Over the past year over 150 people contributed toward this beautiful, brand new, Sonosite M-Turbo ultrasound machine with two probes.  One probe is for doing obstetric and abdominal ultrasounds, and the other probe is a critical care cardiac probe which allows bedside cardiac, arterial and venous assessments.

Finally, after the efforts and generosity of so many people, this ultrasound has found a home in the ICU at Mbingo Baptist Hospital in Cameroon, West Africa.  Here is has easy rapid access to the doctors working in the ICU, surgery and obstetric wards and is available 24 hours a day!

As of a few weeks ago, the ultrasound was 88% funded, and I will receive an update on June 1st to find out if it is fully funded.  [Based on the initial response of so many donors, we proceeded with the purchase even though all of the funding had not come in.]  The ultrasound itself is the size of a laptop computer, and I brought it on the plane to Cameroon as my carry-on.

Truly this ultrasound will aid physicians here to make better and quicker decisions, and it is appropriate to claim that lives will be saved "one image at a time."

Thank you to everyone who helped to make this happen.  You have made a difference in the world!

If anyone would like to still make a contribution toward this project, or towards the work that I do with Samaritan's Purse in developing countries, you can do so at the link below this paragraph (you may need to copy and paste it) and then scroll down to FIND DR./MEDICAL PROFESSIONAL and type my name "SAWYER, ALLAN" in the box.  All funds are placed in my ministry account and will be used for supporting my work in mission hospitals around the world through Samaritan's Purse.  Thank you.  Bless you! You have made a difference in the world!

https://www.samaritanspurse.org/medical/wmm-doctors/

Thank You is the only Payment Accepted

Who would have thought that a computer network engineer, a wound care nurse practitioner, an infectious disease physician, a cardiac anesthesiologist, and a obstetrician/gynecologist could be such a great combination to bring to a mission hospital?!

Last year I invited (or challenged) these friends to come with me to Mbingo Baptist Hospital to experience Africa from a new vantage point and to give freely of their time and talents to the work at the hospital.  Their respective skills were all very important at the hospital.

We were very grateful to have a cardiac anesthesiologist here to teach the nurse anesthetists how to care for their patients.  In this particular case, his involvement and expertise were especially appreciated by everyone.

Each team member not only utilized their skills and knowledge, but also took the time to teach others.  Here the internal medicine residents are listening to our infectious disease physician giving a lecture; however, she also attended their conferences and attended patient ward rounds to discuss the infections that they saw.

Mbingo Baptist Hospital is also the referral center for the entire country of Cameroon for care of chronic wounds, leprosy wound care, and rehabilitation from amputations.  The wound care department is extremely busy, and our wound care nurse practitioner helped to educate on new techniques, and also helped to relieve the workload.

The hospital is also nearly ready to open a new building which will hold the entire outpatient department.  It is also nearly ready to implement a computerized medical record system.  With these two tasks on their agenda, the timing of bringing a computer network expert was incredibly helpful.  Fortunately, thanks to the Internet, he will be able to continue to assist remotely as the hospital moves forward.

Personally it has been great to have these friends with me here on this trip.  Not only have they been great to have here from a professional standpoint, they have been a lot of fun as we have explored the mountains around the hospital and have spent many hours together at meals and in the evenings.

[Their names have been purposefully omitted out of a security concern.]

Finishing well in Togo.

The Hospital of Hope is the Mayo Clinic of the northern part of Togo, serving people throughout this region, including Togo, Burkino Faso, Ghana, Niger, Nigera and beyond.  As many as 28 languages are spoken daily at the hospital, requiring an entire department of translators.  The translators seem at times to be in bigger demand than the doctors, nurse practitioners and nurses.

The challenges of communicating can sometimes be more demanding than the art of medicine.  As my nurse and physician colleages can see on this vital sign temperature graph, the diagnosis could be a bacterial infection, or a viral infection, or perhaps a parasitic infection.  Well, in this case it is all three.  Post op infection plus malaria plus chicken pox.  And yet, because of language barriers, I am completely dependent on the nursing staff to communicate with this patient, because the only gestures she understands from me is the smile on my face, perhaps a nod, and a gentle touch.  

Although lately it seems as if the diagnosis is always either just malaria or malaria plus pregnancy or malaria plus pneumonia.  Even though we are in the dry season and malaria is "less" common now than during the rainy season, it seems that we are treating malaria on nearly every patient.  I actually thought I was getting pretty good at diagnosing malaria until one of my surgeon colleagues here laughed out loud and remarked, "that's because everyone has malaria." My ego was quickly deflated with the realization that he was absolutely correct.

As for wait times to be seen at the hospital, could you imagine going to a hospital that is a long way from home and then camping out in front of the hospital to hold your place in line?  If you leave your place in line then you have to go to the back of the line.  And then, depending on how serious your problem is, if it is not so serious, having to wait for several days camped out in front of the hospital?

This reality reminded me of when a Chick-fil-a restaurant recently was opening near our home at 59th Avenue and Thunderbird Road in Glendale, Arizona, and they announced that the first 100 people through the door on opening day would receive free Chick-fil-a for a year.  People started camping out for two or three days before the restaurant opened.  But that is a restaurant and not a hospital.  But as word of the excellence of this hospital spreads across the region, people are coming to the hospital in buses and vans and bring dropped off in front of the hospital in hopes that they can be seen by a doctor here.  The needs are overwhelming.

We just continue to see patients; caring for the patient that is in front of us at the moment; loving them and serving them.  We strive to bring not only physical, but also emotional and spiritual healing as well.  We treat the whole patient and not just their physical needs.  Often these appointments end in tears, not only for the patient and their family or friends, but often also for our own team members.  No tears were held back recently when a young child had lost it's mother due to an acute viral syndrome, leaving this child without a source of breast milk, and the challenges that such a problem creates in a society such as this.  This was a difficult situation to fathom, and struck a blow to the hearts of the health care team members caring for this young mother and her baby.

Behind me in this last picture is the "waiting area" by the front gate of the hospital where people camp out for days waiting for their chance to be seen.

This is the front entrance of the hospital.  The patient waiting area is behind me to the right.  This is a dry and dusty place during the dry season, and then green and muddy during the rainy season.  It has been my pleasure to serve here and to try to bring health and healing to these people and to serve my colleagues who work here full time.

In just a few short weeks I will be returning home to my family. It has been difficult being away from them for the past month, and I still have a few more weeks to go.  However, I have cherished the opportunity to serve here for this season, and pray that I have served here well.

He heals the brokenhearted and binds up their wounds.

In the middle of the night during the first week that I had arrived in Togo, the phone rang next to my head.  Delirous I answered the phone, and the voice on the other end of the phone beckoned me to come to the operating room.  A woman had arrived from another hospital, having suffered horrible complications from childbirth.  Our team worked on her until the early hours of the morning, pouring blood into her veins, and suturing her injuries.  Her baby had died even before arriving at our hospital, and the lifeless body of her little baby was brought out to her family.

The next morning, as sunlight lit up my room and hot coffee waited in the dining area, I wondered if she had even survived the night.  Even if she did survive, surely she would have a horrible infection or have other serious and potentially life-threatening complications.  But when I arrived at the hospital she was sitting up in bed asking for something to eat.  Not even 6 hours had passed since she had come out of surgery!  

Over the course of the next week, she didn't even get a fever.  Her kidneys were working just fine, and her laboratory tests and vital signs were completely normal.  

Eight days later she was discharged from the hospital.  Going through multiple translators, I explained her discharge instructions, her home care, and her follow up appointment to return in a week.  

When we were nearly finished, she was told through the translators that God had saved her life.  This message was translated from English to French and then to her language.  She smiled, looked at me, and said back through the translators that yes, God had saved her life, but that she was also grateful to me and the other doctors who had helped to save her life.  Her eyes were bright, and her near toothless smile was precious.  She then said to me, in English, "Thank you!"

 This would not be the first time that the degree of gratitude expressed by a patient caused my eyes to flood with tears, nor will it be the last.  What was particularly touching, however, was that she had made such an incredible recovery, and yet her body had sustained such trauma.  The explanation could not be in the skill of her physicians and nurses, but clearly she had been healed of her wounds.  Her obvious gratitude was worth far more than any Hallmark card could ever convey. 

One of the last items to be packed prior to my departure from Arizona to Togo was a set of navy blue scrubs gifted to me by a patient.  She had embroidered Psalms 147:3 below my name on the scrubs.  It was even more fitting that on the day that this patient was discharged from the hospital that the embroidered scrubs reminded me of this psalm. 

Psalm 147:3

"He heals the brokenhearted and binds up their wounds."  

This woman's baby had not survived the birth, and for this she was brokenhearted.  Her wounds had been divinely healed.  Indeed He had healed the brokenhearted and bound and healed her wounds.  

Making a Difference...One Life at at Time...

A midwife working so hard that she has barely left the hospital for weeks. A woman who comes into the hospital clinic a week past her due date and has hardly any water left around her baby.  A young physician, new to the hospital, is orienting to the hospital, clinics and life here in Togo.  A woman, who after over ten pregnancies comes into the clinic with her insides literally falling out.  The phone rings and a there are twins being delivered; can you please come now?

As the first week here at the Hospital of Hope in Mango, Togo, has unfolded, these opportunities to serve have all been presented to me.  To the overworked midwife I asked if I could assume her responsibilities for a week next week so that she could take some time away with family who is visiting.  There was immediately joy visible in her eyes, followed by tears of gratitude.

For the woman who presented to the clinic past her due date, we admitted her to the hospital and delivered a healthy baby boy for her.

For the new physician, offering time to teach, encourage and mentor were met with gratitude and appreciation.

For the woman who had carried many pregnancies and now her body was showing the wear and tear from these pregnancies, a surgery is planned for next week to repair the long term damage.  When she heard this was the plan, there was joy on her face.

And when the phone rings, and help is needed STAT, just being available to go and help is a blessing.

When Jesus was asked what was the most important law in Judaic Law, Jesus replied, “Love the Lord your God with all your heart and with all your soul and with all your mind.”  He went on to say, “This is the first and greatest commandment.  And the second is like it: Love your neighbor as yourself.”

Commandments or laws are often perceived as constraints imposed on us which impinge on our freedom; however, the command to love your neighbor as yourself brings forth joy, not only for your neighbor, but also for yourself.  Being in a situation where I can bring reprieve for someone who is weary; healing to someone who is ailing; mentoring to one who needs to be mentored; or delivering a healthy baby to a mother who is not progressing normally on her own; each of the opportunities to serve and to love brings joy for both the giver and the recipient.

Each of these have brought joy not only to the one who is the object of the action of love; but to me, the one who has been  commanded to love.  The command to love is not a rule that limits freedom or imposes hardship; but rather, the commandment to love thy neighbor has become a source of great joy.

As the weeks unfold here in Togo, I look forward to sharing not only the stories of the experiences here, but more so about the rich relationships that are being formed.

Yesterday on a white board in the common dining area here someone wrote a quote by Francis Chan which says, “Our greatest fear should not be of failure, but of succeeding at things in life that don’t really matter.”  My hope is to share the richness of the experience of doing things here that really do matter.