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Shanksteps #75

“I need you to come to the hospital now, he is not breathing well!” As we went to the hospital I found out that a drunk man was run over by an ox cart. It has an axle and wheels from a car or large metal wheels with spokes. On top of that is a wooden box and a “tree” coming out of the front to tie two bulls to, to pull it. He wa sitting on the floor with a lot of difficulty breathing. I listened to his lungs and heard breath sounds on the left but none on the right. He had a tension pneumothorax
(collapsed lung). His right chest slopped of to his arm pit at a weird angle, kind of flat. They said the wheel had come up on his chest. His left side looked OK. I went to the OR and was able to find a chest-tube to put in him. A bit of blood came out but it appeared he would be all right.

Just after that they asked me to see someone that had just come in. They said he was bleeding from his foot. I went to see a man that had been his with a knife 2 weeks ago around the ankle. It had gotten infected and he had gone to a local clinic the day before who refered him to us. Walking in the room, I knew what I would see when I took off the cloth covering his foot. It stunk real bad, and had a puddle of liquid under his foot. After taking off the cloth I saw that he had dead skin from
the base of his toes up to above his ankle. Here things are paid for in advance before treatment is started or given. So he left an ox-cart as collateral on the operation. We debreeded all the dead tissue and basically he had no skin left over this area.

Weve now been in Bere, Chad 2 weeks. I have done about 30 surgeries and don’t know how James Appel can do it alone. Audrey and I are keeping very busy. I hear that he is doing well in Koza since we changed hospitals for a few weeks. We have about 45 patients in beds and about 8 outside under trees because all the beds are filled and some have 2 different children in them. The nurse sees about 30 outpatients a day and we see about 15-20 of those. There are a number of student missionaries and
an Australian couple doing maintenance temporarily. It’s nice to have other missionaries around and speak English. Electricity is on 2 hours a day in the evening via generator. There is running water from a water tower. Food seems to be more expensive. We have two weeks left before returning to Koza, and are looking forward to it but enjoying aspects of life here also. Please pray for James and Sarah Appel as they work in a very difficult situation for one doctor. In His Service, Shanks

Shanksteps Job description of a medical missionary (and hospital director)

The longer we are here, the more involved the job description of my husband: general surgeon and hospital director. When a 35-year-old man comes to the hospital with a painful inguinal hernia, he is a general surgeon. When a pregnant woman comes in need of a Cesarean, he is an OB/GYN. When during the C-section, the baby refuses to breath, he is a neonatologist. When a 5-year-old comes in with a skull fracture after an accident, he is both neurologist and neurosurgeon. When Bouba, a 18 year old
boy, comes in after being stabbed through the diaphragm for calling his cousin a donkey stealer, he is a cardiothoracic surgeon and then pulmonologist. When a 70-year-old man comes in with a huge prostate and inability to urinate, he is an urologist. When a 6 month old comes in with severe anemia from malaria, he is a pediatrician. When a 45-year-old comes in with hypertension and irregular heartbeat, he is a cardiologist/internist. When a 45-year-old woman comes in with VERY advanced breast cancer,
he is both surgeon and oncologist. When the minister of health comes to the hospital to discuss how to prevent another meningitis epidemic, he is a Preventive Medicine doc. When a 2 year old comes in and weighs only 9 pounds, he is a dietician. When our medication is running low, he is a pharmacist. When a 20-year-old comes in with renal failure and our lab tech is away at a meeting, he is a laboratory technician.
When there are employee disputes, financial difficulties, fist-fights between nurses and patients, theft of money and medications, committee meetings, difficulties with the police and army, and new nurses to hire, he is the hospital director. (He is often also a psychologist/counselor in these situations.) When one of our maintenance guys was having problems with his girlfriend, he gave advice and support and acted as surrogate father. When asked to preach, he is preacher (much outside of his
comfort zone).
When our male cat needed to be neutered, he was the veterinarian (on the middle of the living room floor). When the female cat started spraying and needed to be spayed, he was assistant to a visiting American vet. Any time large items need to be picked up for the hospital, he is the driver/chauffer. When electricity goes off in the hospital (but not in the village) he is digging up buried electrical lines and patching them back together, and is an electrician. (He is also an electrician when the
oxygen machine blows up in the ER.) When the voltage regulator catches fire in the lab, he is a fireman. When the oxygen concentrator (a different one) refuses to work, he is a mechanic. When car stops running, he is an auto mechanic. When I’m away or sick, he’s a Jr High Teacher. Every morning he fixes breakfast, and is therefore our cook. When we needed curtains to cover the windows, he was, yes, even a tailor. When the newly opened airstrip in Koza needs to have trees uprooted and holes
filled in, he is a landscaper. When the Acacia trees lining the entrance to the hospital need to be cut down, he is a lumberjack, followed by landscaper, replanting new trees. When the metal grate covering the windows is sawed off by the thief, and needs to be repaired, he is a welder. When the roof is blowing off in the high winds, he is a roofer. When we discovered that there were boxes upon boxes of things donated over the years, all hidden in the garage, he spent hours pouring over equipment
and was a cleaning service. When we suspect that someone has been breaking into one of the houses on the compound, he is the “assistant” guard (armed with machete). When the sink springs a BIG leak, he is a plumber (even when it is fixed with an old bike inner tube). When the hospital latrine falls in, he is in there helping clean up; afterward manually digging a new hole with the other maintenance guys. When our toilet stops working 2 weeks before vacation in the US, and the replacement doc is
staying at our house, he is again the plumber. When he finds out that it has stopped up because the septic tank is full, he is out there manually scooping out 15 years worth of waste. What would you call that? I call him a saint.
At the end of the day, he comes home and is the spiritual leader of our home; and the best father and husband anyone could dream of. Please pray for Greg and the “many hats” that he wears. It is a very difficult position that he holds, but God is supporting him moment by moment, day by day. —Audrey
(Every one of these situations is true :})

Shanksteps #72

Local cultural beliefs are very different from ours. Today I was able to get a glimpse of the beliefs of a tribe called Mineau. There was a child from near this area that was anemic and the mother was HIV positive. No other donors could be found, so I gave blood to the child. While giving I found out some interesting beliefs about this tribe.
They believe that two people CANNOT be buried in the same grave. While I was in the US a pregnant woman who was anemic came to the hospital for treatment but unfortunately died. One of the hospital workers gave blood but she didn’t make it. When they took this woman back to the village apparently they “couldn’t” bury this woman with the dead child inside. The people of this village believe that you have to be buried separately in order to meet god separately. So they opened the cadaver and removed
the fetus and buried them in separate graves. Upon questioning further about burial practices by this tribe I found out that in a few cases, when someone is really old and unable to care for himself any longer and demented, that they sometimes euthanize them. Apparently the way this is done is the family starts crying of their “death” once the decision has been made. Family and friends come to the home and they bury the person alive! How different from our culture! Oh how these people need to
know more of Gods love! I think of my own American culture and how much we need to know of Gods love too. We have a very cerebral knowledge of Him and His interest in our lives but do we really live like we KNOW Him and feel His love on a daily basis? Our culture in the US is “Christian”, but there is a wide variety of beliefs and thoughts of God and what His interest in our life is.
I believe that God is interested in every aspect of our lives. He created us and sacrificed His Son for us so we could be with Him someday. We often think of what we have sacrificed by coming here to Cameroon. But our “sacrifice” pales in comparison to the real sacrifice of Jesus in our behalf. Our Bible says that even if I were the only one here, that Christ would have come for me, or you! It is hard to comprehend this never-ending and all encompassing love of God! I want to know Him better
and understand better His love for you and me. I believe you need to know His love better too. And of course the people here need to know and understand His love also. Please continue to pray for us as we serve HIM in a very different culture and with His help withstand the barrage of attacks by the devil! In His Service, Greg, Audrey and Sarah Shank

Shanksteps

Neonatal Tetanus

Watching him in full tetanic spasm was probably the worst thing I have ever seen in my life. Kaldoussa came to us at 8 days of age. He had been born at home with the help of a family member. Mom had not had any prenatal visits or counseling, and therefore also not received her tetanus vaccine. At 7 days old the spasms started. The family brought him to a nearby clinic that immediately referred him to our hospital. Tetanus is a horrible disease. The sooner after the “injury” the spasms start,
the higher the mortality. I suspect his “injury” was cutting the umbilical cord with something dirty. Anyhow, when he arrived, we had some of the necessary medications, but not all. So we did the best we could, and prayed, and prayed, and prayed. After three days in the hospital, his mother was extremely discouraged and decided to take him home. She said that he wasn’t getting any better, and she had no money to pay for his treatment. When someone comes in with tetanus, we immediately explain
to the family that their disease will take a long time to recover (sometimes up to several months) and the medications will be very expensive. We explained all this to the mother, but after three days she decided to give up. I sat down with her and explained that stopping now would probably be a death sentence, and that she would have wasted the first three days for nothing. I explained that since he would most likely be in the hospital for at least a month that she would have some time to come
up with the money. This dear woman responded that she wanted more than anything to be able to continue treatment for her son, but that she didn’t want to promise that she would come up with the money for the bill when she wasn’t sure she would be able to. She explained that she had nothing to sell (goats, chickens, millet, onions etc), and hardly any food until the next harvest season. My heart went out to her.
While we were home on furlough, we spoke at several churches and camp meetings. At one church in WV, a woman gave us a donation specifically to be used to help children whose parents couldn’t afford treatment (Thanks Susan A!). Usually if we consider helping someone financially, they have to come up with a good portion themselves, however I truly believed that this woman had nothing. So, I told her that I love children, and God loves children. Neither of us (myself or God) wanted to let Kaldoussa
return home without doing everything we could for his survival. I told her that we would take care of the rest of the bill and for her not to worry about finances. She broke down. She said that that was her responsibility as a mother, and yet here we were helping a family we didn’t even know. She truly had no words to express her gratitude.
So, we continued to treat this little fella. Every morning in my personal worship I prayed for him. In our prayer group every morning we prayed. Eliza (peds nurse) and I prayed for him before making rounds, and then we prayed with him and his mother every day when we checked on him. From a medical standpoint I was very worried that he wasn’t going to survive, but I had an impression that God was going to make something out of this experience. As of today he has survived 10 days and is almost
spasm free. He had a high fever for several days, but after the right cocktail of antibiotics he has now been 24 hours fever free. I believe that he just might survive this ordeal. Perhaps more importantly thought, his mother has experienced love from a stranger and the love of Christ working through this experience. Kaldoussa will probably be with us for at least several more weeks during which time we can also minister to his mom. Please continue to pray for this itty bitty guy and his mom.
Thanks to everyone who has given donations, love and prayers. We need all three.
In His Hands, Aud
PS: Unfortunately for this small child, he was not able to support the spasms. We expect to someday see him in Heaven when Jesus comes to raise the dead who fell asleep in Him. Greg