Happy Birthday Tim!

 

  So, yesterday was Tim's birthday. It was a day similar to most days, with Tim waking up early to go to work, but with a few surprises. We also woke up early and made him breakfast. Tim was able to come home from work around 2pm for lunch, and he was able to stay home for the rest of the day:) We had a good dinner together, Red Red and watermelon. We were even able to have cake and ice cream, or actually an ice cream cake. I like to make something a little different for birthday cakes, so I attempted my first ice cream cake. We received a package from family with a few birthday gifts for Tim. Since we couldn't find what we wanted to give to Tim for his birthday, it was very nice that Tim had something to open. Hopefully, we can find it when we go to the city this weekend. To top it all of, Tim was on call for OB last night and he never received any calls! Thank you for all your happy birthdays and well wishes. It is wonderful to know that we are thought about and prayed for.

First Week in an African Mission Hospital

            Our prayers were finally answered regarding my Ghanaian medical license. Praise Jesus! I was granted my license last Friday, and I began work at the hospital on Saturday morning. It has been a steep learning curve. I begin my rounds most days in the isolation ward, where there are several patients with chronic wounds, a couple patients being treated for or ruled out for tuberculosis, and a smattering of other patients with infectious diseases. After finishing there, I usually go to either the pediatrics ward (children <5yo) or Ward 5 (mostly older children/adolescents, but occasionally there will be adults if the other adult wards are full). After I have seen those patients, I go to make sure that there are no more patients to be seen in the other wards. I start rounds around 7:30 AM Monday through Friday and 8 AM on Saturday and Sunday. Monday, Wednesday, and Friday are clinic days (where clinic starts around 10 AM), and Tuesday and Thursday are procedure/surgery days.

            There are a total of 8 wards in the hospital: maternity, men's medical, men's surgical, women's medical, women's surgical, Ward 5 (as I described above), pediatrics, and isolation. The hospital administration had just brought two new doctors onto the staff a couple days before I started, one Ghanaian surgeon and one Nigerian ER doctor. They then added another two Ghanaian doctors a couple days ago. There is also one American OB/Gyn that has been here for almost a year. That brings the doctor count to 6 now, which is much better than what I thought that it was going to be, which was 2. It helps out tremendously on morning rounds when we have to see all of the patients in the hospital, which can potentially be around 120 patients when all beds are full. Not all of the beds are full right now, but they are starting to fill up as we enter rainy season and the cases of severe malaria start to increase.

            Just to give you all a sense of what working at the hospital is like, I will share about a few of the cases that I have seen this week. I saw a teenager present to clinic with elevated blood pressure (180s/130s; normal is 120/80), anasarca (whole body swelling), including fluid in the lungs (pulmonary edema) and shortness of breath. We gave her some oxygen and some medicine to decrease the amount of fluid in her body and to help her breath better. Then after some basic workup, including a heart ultrasound and urine analysis (blood tests are very limited here), it appeared that she had a condition called acute glomerulonephritis (essentially injury to the kidneys) in addition to heart failure. I placed her on all of the medicines to help treat these conditions, and she has improved greatly. She is no longer on oxygen, her lungs are clear, her blood pressure has normalized, and her swelling has almost gone completely away. Thank you God for your healing of this woman! Please pray for her continued healing and recovery, as she has some residual right-sided weakness that started before she came to the hospital, probably secondary to her severely elevated blood pressures.

            I have also assisted on a couple C-sections and a bowel perforation (hole in the intestines) from a typhoid infection (a common infection in this area that comes from consuming contaminated water). I have done a few paracenteses (draining fluid from the abdomen of people with liver disease) and lumbar punctures (collecting samples of the fluid around the spinal cord to look for infections like meningitis). Additionally, there was a young man who presented with an abscess of his thigh, but this was no ordinary abscess. It was as big as half of his thigh, and after cutting into it to drain the infection, it appeared that the abscess had actually spread between different layers of his muscles (a condition called pyomyositis).

            Lastly, the most memorable experience of the first week of work at Baptist Medical Centre was getting to be an anesthetist for an emergency surgery. There was a pregnant woman that had come in with a ruptured uterus and had blood in her abdomen, so she needed to go to surgery right away. The Ob/Gyn approached me on rounds that morning and told me that the anesthetist on-call was not available and asked if I could be the anesthetist for the surgery. We agreed to use ketamine (a type of anesthetic) so that the patient did not have to be intubated (tube placed in her windpipe for breathing). Plus, if she were intubated, I was going to have to manage the anesthetic gases, with which I practically have no experience. I read up quickly on ketamine use, prayed, and then went to the operating room. Everyone worked together as a team, the surgery went well, and the patient did well. All glory to God!

            Those are just a few of the cases that I saw this week that I wanted to share. Please continue to pray for the hospital, healing for the patients, wisdom for the doctors and medical assistants, endurance and joy for all workers at the hospital, and that Christ would be glorified through all of the work being done here.

My First African Sermon

            We had planned on checking out a different church this Sunday, one that one of the other missionary families had told us they attended. They had said that it met under a big tree by the TB village. The TB village is associated with the Baptist Medical Centre, and it is where patients and their families stay as they are finishing 6 months of treatment for tuberculosis. It is about a 10-15 minute walk from our house. We tried to contact the missionary family to meet up with them before going, but we were unable to reach them (we found out later that one of them was not feeling well, so they didn't go this morning). So we decided to try and find the church ourselves.

             Even at 9 AM, it was already in the high 80s to low 90s, but God blessed us with occasional breezes to cool us off as we walked. We arrived at the TB village and were not seeing any gathering of people under a tree. We were about to turn around and go back home when one of the people sitting on the front steps of her small house got our attention and said "church?" in her best English. We nodded and said "yes", and she pointed us towards the direction of a big shea tree where a group of people were starting to gather and set up benches. We said the usual good morning greetings ("Dasuba") and sat down to wait for the pastor to arrive. After a good amount of time, it was apparent that the pastor would not be coming. Shortly after that, a young man who spoke good English came up to the group and confirmed that the pastor would not be coming. He then proceeded to ask me if I was going to preach. After some slight hesitation, I agreed.

            The service started out with some singing accompanied by a djembe. The guy leading the singing was someone we knew from the hospital grounds. He seemed to want to incorporate us in the singing, so he sang a song in English that went like this: Alleluia, 1-2-3-4-5, Alleluia. This repeated over and over again, and sometimes he would sing 6-7-8-9-10. After the singing was over, it was time for the sermon. The young man that had come translated into Mampruli for me. It was probably not the most well organized sermon ever since I did not have any time to prepare, but I talked about trusting God and shared the Gospel.

            So from what was almost a failed search for a church this morning, God turned it into an opportunity to trust Him and share about Christ with some of the local people. Alleluia! 1-2-3-4-5!

 

Proverbs 3:5-6 "Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge Him, and He will make straight your paths."

Ghana at Last!

            I would like to start this blog by mentioning several ways that God has blessed us since we have left the US. First, none of our checked bags (we had 9 large bags, 1 car seat in a box, and 1 stroller) were lost, delayed, or damaged on any of our flights (and we unloaded in the country where the missionary conference was, in Accra, and again in Tamale, and there was a total of 3 layovers). Second, we have been charged much less for excess baggage than what we were anticipating. Third, we received abundant help from flight attendants, airport personnel, and perfect strangers as we have traveled with two little children, 3 bookbags, 1 diaper bag, 1 car seat, and 3 duffle bags through airports and on and off airplanes multiple times. Fourth, we found a car (details below). Fifth, a new acquaintance that we met in Accra the first night we arrived offered to drive our large amount of luggage up to Tamale the next morning, which saved us hundreds of dollars of excess baggage fees. Other missionaries on the hospital compound then picked up all of the luggage from Tamale and brought it up to Nalerigu so that it was all there when we arrived. Sixth, our house went under contract 3-4 days before we left the US, and the closing papers were signed a few days ago. Seventh, our passports were stamped by the immigration department in Ghana within 1 week (it usually takes 3-4 months, and we would have been without our passports for that period of time). Eighth, our youngest, Abigail, developed a fever of >102 degrees within a day of arriving in Nalerigu, and we could not figure out a source for it. After much prayer, by us and people back in the States, the fever disappeared without treatment, and she has been well since. Abigail has also started to sit up on her own. These are just a few of the big ways, among many others, that God has blessed us in the past few weeks.

            So we arrived in Ghana during the first part of May, and we spent nearly a week in the capital, Accra. During that time, we met many missionaries at the guesthouse where we were staying. Some were from the US, some from Nigeria, and others were from Ghana. Rebekah also made several new friends during the few days we were there. We also spent a couple of days with the mother of one of our Ghanaian friends from the US, and she showed us around Accra and helped us to meet some of the people involved in health services within Ghana. Since the International Mission Board just recently gave control of the Baptist Medical Centre over to the local Ghana Baptist Convention (GBC), we also met with one of the leaders of the GBC to just say hello and start to form a relationship.

               

                

            We had been told that having a car in Nalerigu, where the Baptist Medical Centre is, is practically essential. Nalerigu has a limited supply of groceries and other miscellaneous items, so the missionaries on the BMC compound make a trip to either Tamale (3 hours away) or Bolgatanga (2 hours away) to stock up on items every 4-6 weeks. Because of that information, we had been communicating with a person in Accra for the past few months regarding purchasing a car. We had mainly looked at SUVs and trucks, but after awhile, we settled on looking only for trucks. The terrain in the Northern Region where we were heading is not very conducive to cars (many dirt roads with large potholes), so a truck would be a perfect vehicle in our situation. The dilemma that we were facing was that the trucks were all outside of our price range. However, God, in His perfect timing, provided a truck one or two days before we arrived in Ghana. It was within our price range, in good shape (except for some minor problems, which were fixed), and had good mileage. I was able to test-drive it when we arrived in Accra, and it drove great. That was actually my first time driving a car in a city in Africa...quite an adventure, but that is another story for another day! The person that helped us find it drove it up to Tamale after he had registered and purchased car insurance for it. I met him there a couple days ago and drove it the rest of the way to Nalerigu. This is only the third car that I have owned, but it is the first car that I have had to purchase (the first one was my dad's old car that I inherited when I turned 16, and the second one belonged to my late grandma, and my uncle gave it to me after my first one was totaled in a crash a few years ago).

                                   

            After spending about a week in Accra, we flew up to Tamale, where someone picked us up at the airport and drove us to Nalerigu. We were assigned to the house where one of the previous long-term missionaries had stayed. The other missionaries on the compound have made our transition much smoother by providing us with some basic foods and supplies as we were unpacking, organizing our house, and getting used to shopping in the local market. Many things were left behind by the missionary family for us, and several of the items have come in very handy. Two items that have been a special treat are a yogurt maker (Lori brought some yogurt starter) and and an ice cream maker that doesn't require ice (we have already made 3 batches).

                                                              

            There is a lot to which we need to become acclimated: the hot weather, the limited local food selection, the unpredictability of the electricity and internet, the daily (and sometimes multiple times a day) encounters with visitors at our front door, the local customs, the common and almost expected use of house help (a local person you pay to help cook, clean, and/or take care of your children) and the more intense preparation of foods that is needed, among many other things. God has been gracious in allowing us to feel more at home each and every day that we are here. Both Rebekah and Abigail are adjusting well to all of the change.

            One final story for this post: we found out the day after we arrived in Ghana that we actually did not have our medical licenses due to unforseen circumstances, so we had to resubmit the application. Unfortunately, it usually takes 6-8 weeks for the license to be granted after submission of the paperwork. Therefore, I am not currently working at the hospital, and there is only one long-term medical doctor (an OB-Gyn) that is running the entire 120-bed hospital. It has been a blessing to get to spend more time with my wife and kids, to get the house a little more organized before I start working long hours, to brush up on tropical diseases, and to just be more flexible with my time. However, I would like to start working soon and start reaching into the lives of the patients I treat, for the glory of God. I know that it will be on God's timing, but please pray that my medical license will be processed quickly (we will be obtaining Lori's medical license later, probably after Abigail is weaned).