Tuesday, September 15, 2015

Under the Veil

Honestly I didn't want to know what to expect going to serve in a predomintly Muslim area of the world and in this particular area of northern Togo.  How open would these patients be seeing a male gynecologist?  Would they be open to a Christian physician praying in Jesus' name for them?  Would they talk to me?  Would they allow me to examine their most private parts?

Well, I was in for a very pleasant surprise.  Typically as soon as these veiled women walked into my examination room, the veil that covered their faces would be lifted.  Although their husbands typically answered the history questions for them, this was usually due to necessity, as frenquently their husbands could speak French and the women could not.

I was even more surprised that after I had completed the history taking and needed to do a gynecologic examination, that there was not even a hint of hesitiation.  I would turn my back to put on my headlight and my examination gloves, and would find the patient disrobed to an appropriate degree, and completely willing to allow me to examine them.

But even more remarkable to me was, at the end of the visit, I would always ask through Sylvie, my medical assistant and interpretor, if I could pray for the patient.  Not a single one refused.  It was nearly always a very simple prayer, but the effect that these prayers had on the patients was remarkable.  Often the husband would extend his hand, and do the typical regional handshake (grasping the right hand like a normal Western handshake, then reaching above the thumb to the wrist, then back down to a normal shake, then pulling hands apart down to a snap against each other's fingers, following by pulling ones' hand back to his own chest).  At this point these men always had a huge smile on their faces, and typically would say, in English, "God bless you."  These men were so grateful that I was helping their wife.  One man inparticular, after I cared for his wife, brought in his sister and his second wife to see me as well.  (Did I fail to mention that this is a polygamous society?)

On that same point, one of the women that I did a prolapse surgery on, at the time of discharge she had a huge smile on her face and said, in English, "God bless you!"  She was from Burkina Faso, and did not speak English or French, but she had memorized this phrase in English to say to me out of gratitude when I discharge her from the hospital.  I was really touched by this expression of gratitude.

Patient Patients

Togolese people have to be the most patient people, exhibiting patience rarely seen.  These patients will show up at the hospital at 6 o'clock in the morning and wait all day to see the doctor.  My day would start with rounds at 7 AM followed by surgeries sometimes filling the morning.  In between surgeries I would run over to the radiology department to do a hysterosalpingogram on an infertility patient to see if her tubes are open, then return to the operating room.  Often it would then be time for lunch, followed by ultrasound clinic starting at 1 PM and then I would finally get over to the gynecology clinic around 3 PM where the patient patients had been waiting all day to see me.  They would just be lined up on the benches outside of my room, which was room 9.

There was never ever a hint of anyone being frustrated about waiting all day to see me.  Often it was me that was feeling frustrated by a stack of charts, each representing a patient along with their family and translator sitting outside of my door.

Inside the clinic room the following scene would unfold, with Sylvie (my medical assistant and translator) translating my history from English to French and then another translator translating from French to the patients' heart language.  Fortunately much of the history had already been recorded in the paper chart, but sometimes even these notes were in English rather than French.

Word had gotten out prior to my arrival that the specialist gynecologist was coming to the Hospital of Hope.  One common problem here was the result of these women having so many babies.  The pelvic floor prolapse problems were the worst that I have ever seen.  Many women came into the clinic with their genitals completely inverted inside out.

It seems that once I did the surgery to fix the first two of these, then the word really got out.  On the last clinic Friday that I was serving in Togo, a woman came to the clinic begging to see me.  She managed to first get in to see the pediatrician and explained that she had been to the government hospital nearby and had some type of prolapse surgery three years ago.

Dr. Kelley Faber, the pediatrician, sent her immediately over to my clinic room and was the next to last patient to see me in my clinic that last Friday.  When I examined her I realized why Dr. Faber had referred her urgently to me.  This patient also had a complete genital prolapse, with her insides hanging out.

I knew that elective surgeries were not done on weekends, but I was not scheduled to leave until Monday morning.  I wondered if there was some way that I could schedule her for Saturday morning, the next day.  I spoke with the physician's assistant in charge of the hospital "Doctor" Todd DeKryger.  He made some phone calls and got the permission of everyone so that this patient would not have to wait until the next gynecologist came along.

We put her on the schedule for Saturday morning, and I did the surgery in about 90 minutes, doing a vaginal hysterectomy along with a surgery that tacks everything back up inside to a ligament called the sacrospinous ligament.  The surgery went beautifully, and when I saw this patient on Sunday morning before I went to a French speaking church service, she was all smiles and incredibly grateful.

As I reflect on my time at the hospital, I am still amazed at the degree of patience that these patients exhibited, without any tempers flaring.  Their patience was only surpassed by their gratitude.  I was humbled by both.

Tuesday, September 8, 2015

Better Late Than Never

Let me apologize for those of you trying to follow my blog posts from Togo.  The intermittent and slow internet here has made it much more difficult to post blog posts than to post on Facebook.  I will be making more blog posts after I return to the states, but in the meantime, please friend me on Facebook if you have not done so already.  I have been able to post a lot on Facebook.

Also, Jana Cunningham, an NICU nurse from Banner Good Samaritan is on our team, and she has been writing wonderful blog posts.  You can find her blog at nicunursegoestoafrica.blogspot.com.

Several months ago a doctor arrived at the Hospital of Hope for a short term assignment.  The first weekend she was here, Dr. Kelly Farber said to the short term volunteer doctor, "Go get your bathing suit and let's go for a swim in the pool."  The visiting doctor replied that she hadn't brought a bathing suit.  Dr. Farber said, "Didn't you know we have a swimming pool here?" to which the doctor replied, "I thought you were joking!"

I must admit I could just not grasp a swimming pool in northern Togo, but sure enough, there is a beautiful L-shaped swimming pool behind a 10 foot wall.  A pool company from Texas had donated all of the equipment and manpower.  Alain Niles, one of the long term missionaries here, had dug the hole in the ground with the tractor.  The only difficult task with this is that unfortunately they built the wall before he dug the hole, which made the task far more difficult.

The result, however, is this beautiful pool for the families here to gather and enjoy a chance to cool off.  It was designed so it just gradaually starts off shallow and then gets deeper and deeper and deeper.  I have especially enjoyed going out late at night and cooling off before going to bed, as the pool is just across from the guest house.
Most of my surgeries have been gynecologic surgery dealing with horrible prolapse problems.  Unfortunately the photographs and descriptions are not amenable to publishing on a blog or on Facebook, but these women are so incredibly grateful to be restored to normal anatomy.  One woman who didn't speak French or English went out of her way to learn how to tell me "thank you" in English when I discharged her home from the hospital following a successful surgery.  

Monday, August 10, 2015

Where in the World am I Going? A Sneak Peek...

If a picture is worth a thousand words, then a video is worth an entire book.  Last week one of the full time staff at the Hospital of Hope in Mango, Togo sent me this video.  You can watch it here by clicking on this link:  Hospital of Hope.  Here is a glimpse of the place I will be serving in just a few weeks.  [Please do not re-post this video on social media or other blogs.]

Sunday, August 9, 2015

20 days and counting...

In just 20 days I will be leaving for Togo.  Three airline appropriate shipping containers are filled to capacity and sticky notes and "to do" lists surround me.

Many of you have been asking if my family is going with me this time.  Anna and Amber will be starting eighth grade, and Andrew will be heading back to Westmont College.  Michael is working and Teresa will be taking Andrew back to college the same day I leave for Mango.  So, I will be traveling somewhat alone, except that I will be meeting up with an NICU nurse from Banner Good Samaritan (now called Banner University Medical Center - Phoenix), and a general surgeon volunteer and a pediatrician.  Our planes will all converge in Paris so that we can take one flight together to Togo.

As of last week over 180 people are part of my team that have helped financially so that I could purchase the necessary surgical supplies and a new ultrasound machine.  Many others are praying for me.  I am grateful to all of you.

Sunday, August 2, 2015

To Go To Togo!

 Do you know how to go to Togo?  Considering a few months ago I didn't even know where in the world Togo was, I am learning quickly!  

On August 28, 2015 I will fly to Paris where I will meet up with the rest of my team and then continue our flight to the capital city, Lome, Togo.  The next day our team will make an eleven hour drive to the northern part of the country to Mango, where the Hospital of Hope is located.  


Here are some interesting facts that I have learned about Togo and the Hospital of Hope. 

  • The Hospital of Hope opened on March 2, 2015 and on the first day they saw 200 patients BEFORE LUNCH!
  • In the first week that the hospital opened they saw patients from Togo, Ghana, Benin, Nigeria, Burkina Faso and Ivory. 
    • One patient traveled three days (from northern Burkina Faso) and then walked directly into the hospital, found an empty bed, and lay down. 
  • The ratio of doctors to patients in Togo is 4 doctors for every 100,000 patients.  
    • The ratio of doctors to patients in the United States is 256 doctors for every 100,000 patients.
  • 10% of the population in Togo is infected with HIV.
  • The infant mortality in Togo is 78 infant deaths for every 1,000 live births.
  • The infant mortality in the U.S. is 7 infant deaths for every 1,000 live births!
  • Nearly 200 donors have helped to make this trip possible.  Because of an amazing group of donors, I will be bringing:
    • A new portable Sonosite M-Turbo ultrasound machine with two probes.
    • A Designs-For-Vision Daylite surgical headlight.
    • Twelve Standard Register reusable surgical gowns with overwraps for sterilizing.
    • Ten Cook Medical Bakri Balloons (life saving treatment for postpartum hemorrhage.)
    • Eleven Kiwi obstetrical vacuum devices (for operative vaginal deliveries.)
    • Fifty-two boxes of Ethicon surgical suture.
    • Fifty-plus pounds of German stainless steel new and refurbished surgical instruments.
    • Adjustable Allyn Stirrups for the operating room (for doing gynecologic surgeries)
    • Surgical Gloves
    • Obstetric Dopplers
    • Pulse Oximeters
    • Life saving medicines
Thank you for your support and prayers.  I will be returning to Arizona on September 15, 2015.  

Friday, August 1, 2014

Asante Sana...Thank You...

In just a few hours we will be leaving Tenwek Hospital and will be on our way to Nairobi to board our plane to come home to Arizona.  I wanted to make one final blog post from Kenya to thank all of you for your prayers and contributions that have allowed us to come and to serve.

Because of the prayers and generosity of so many people, so much has been accomplished, and will continue to be done here in Bomet, Kenya at Tenwek Hospital.

When we first drove past the water towers of Tenwek Hospital, arriving nearly a month ago, we were eagerly looking forward to seeing how God would have us serve here.  We were so excited to be here.  Thank you.
Late in 2013 I sent out a letter telling you that we were raising funds for an ultrasound machine to bring with us to Tenwek, and within 60 days we had nearly enough money for this portable ultrasound.

Then in December we heard that there had been a power surge at the hospital that had wiped out all of their functioning ultrasound machines.  By February, five months before we even had arrived in Kenya, the ultrasound that you had provided was already at Tenwek Hospital working overtime in labor and delivery and frequently being borrowed by the other medical services at the hospital.  Thank you!
One of the ways that my wife Teresa and daughters Anna and Amber were able to serve was for them to go with Tabitha Ministries and help to finish the walls of a hut for a widow and her six children.  Mudding a hut is a dirty job, and they had a wonderful time helping in this way.  The widow was extremely grateful for their help.  Thank you!

We also had hoped and prayed to raise enough money to provide six widows with milk producing cows, and that we would be able to be the part of a cow dedication ceremony, also through Tabitha Ministries.  

What we saw was nothing short of amazing, as there was an outpouring of love and support for this part of the project.   Enough money was raised to pay for 30 cows!  You all contributed $9,000 to pay for 30 cows, which is such an incredible blessing.  Each month Tabitha Ministries does two cow dedications, after carefully selecting the widow and her family who will receive a cow.  Because of you they have enough cows for these dedications for the next 15 months!!!

The recipients of these cows will now have a way to provide food and money for their children, and their vocation will become the care of the cow.  This is an unbelievable life changing gift to these women and their children.  Thank you!

Two years ago you supported us to go with a medical team into the jungles of Papua New Guinea to be the first western trained physicians to go into the Hewa Tribe.  Since then a documentary has been made of that mission trip.  If you have not watched it, it is a short 30 minute documentary.  Here is the link: Healing for Hewa Documentary.

This past month, while we were here in Kenya, this documentary was released online.  We are extremely grateful to each of you who helped to send us to this remote place.  Thank you!

While we have been at Tenwek Hospital we have formed dozens of new relationships.  Most of the people that we "knew" here were only from brief introductions or by email communications.  Since then we have formed dozens of new relationships.  As we prepare to leave we reflect on the many new friends we have made here, and some of these will no doubt become lifelong relationships.

Dr. Elijah Terer has become a good friend.  Several weeks ago he invited our family to his house for dinner.  We stayed late into the evening, feasting on home grown and home cooked Kenyan food.  His wife, Emily, who also works in the Maternal Child Health (MCH) clinic at Tenwek, is such a good cook.  After dinner they served us the best chai that we have ever tasted.  They said that they had a secret spice that they grow in their garden that makes it taste so good.  (I think it was cardamom).   These kinds of relationships are invaluable as we strive to teach and support the work being done at Tenwek.  You made it possible.  Thank you!

Because of your generosity and giving hearts, we were able to bring donated medical and surgical supplies that would have cost over $200,000 at retail prices and to provide these to the hospital.  Just looking at this picture of me in this operating room, you donated the LED high tech battery powered surgical head light that I am wearing (it is much brighter than the operating room lights that are hanging from the ceiling).  You donated my hat, my scrubs, the surgical gown that I am wearing, and the gloves on my hands.  You donated the suture that I am using on this patient.  You donated the mask on my face.  You even donated the surgical scissors that I used to cut this suture after I finished tying the knot.  We arrived with thirteen trunks of supplies each weighing exactly 50 pounds, and we will leave with a few duffle bags of our clothes.

But even more so, you provided me an opportunity to come and to teach a handful of Kenyan doctors the skills that I have learned.  Because of you I was able to teach them the art of obstetric and gynecologic surgery.  And, I have been able to convey to them the importance of touching their patients as whole persons, not just addressing their physical needs, but also their spiritual needs.  My wife and daughters and I are extremely grateful to each of you.  Thank you!  God bless you.

One of my favorite quotes is attributed to John Wesley.  He was quoted to have said the following:

Do all the good you can.
By all the means you can.
In all the ways you can.
In all the places you can.
At all the times you can.
To all the people you can.
As long as ever you can.