Central supports Dok Elma Jocson, a missionary surgeon from the Philippines now serving at Ganta Hospital in Liberia.
September News…
Can you tell how long the missionary has been in the field by the way they drink their coffee? First year: fly accidentally dives into the coffee cup. The missionary throws out the coffee and make a fresh cup. After a couple of years: fly dives in, missionary spoons out the fly and drinks the coffee anyway. More years later: missionary doesn’t spare the fly, but drinks the coffee (plus the extra protein.) If however, the missionary spoons the fly out and instructs it to cough-out the coffee, then you know they have been in the field for too long!
There have been many variations to this joke, depending on what the preferred hot drink is in the place of service. The truth of the matter is, degrees of tolerance are achieved over time. Objects and situation that shock, disturb, or affect you early on seem to lose their novelty. During my first months here, I was a bit surprised at the inhibitions of women patients who readily disrobe in front of a doctor. Mind you, I still find it amusing that under ware is worn as is. I guess it does the job of covering what has to be covered, so maybe they got it right and I’m the backward thinking outsider.
During my first month’s working in the OR, I would stop the operation because I could hear noises from above. Much as I’d like it to be heavenly music, I discovered that the noise was coming from the ceiling—it being the hospitable place for creatures like rodents, bats & other winged varieties, termites, and other small creepy- crawlies. The local staff found it odd that I should be disturbed by the noise. I often go to the storage room on the 2nd floor of the OR. Here one needs to step cautiously as the floor boards are termite-infested. One wrong step and you might find yourself dropping down straight onto the OR table, together with the other creatures who might like to tag along!
The hospital structure was built in the 1980’s, but partly burned and looted [in 2003] during the civil unrest. It has been on my mind to renovate the OR. If you hear the term “Operating Room”, the image of a clean and sanitized area comes to mind. And your mind can even inhale the sterile whiff. Well, not our OR! It’s only by God’s grace that patients benefit and survive exposure to our OR environment. And before I start tolerating the present less than satisfactory situation, I have taken it upon myself to spear-head the OR renovation project.
This project will entail changing the roof and ceiling, replacing the broken window glass and closing off numerous public access areas. The project is expected to cost $28,000. We have seed money of $15,000 and we can perform the renovation in stages, starting in December when the rainy season is over. I would like to give you this opportunity to help the people ofWest Africa, not justLiberia. Please help us. Details on how your gifts can reach us are below. Ganta Hospital is strategically situated to serve three neighboring countries—Liberia,GuineaandIvory Coast. Security situation in all three countries seem volatile.
But war or peace, we have Ivorian and Guinean patients. Like the Ivorian boy in the picture with me. He was brought by an NGO working in one of the Refugee camps. He has chronic wounds from multiple bone infections (osteomyelitis). He has had the infection a long time and it had only been treated by a “bush doctor.” This boy doesn’t speak English and I don’t speak French, but we had fun communicating by signs and smiles. The area where we are seated is the OR veranda—cum staff lounge. It’s also where we fire up coals to sterilize our sets if the generator fails.
Now, about generators: there’s a big generator in this mission station that supplies the mission house with electricity—three hours in the morning and three hours at night. From Sept. 1 until the time of this writing, we had no electricity; the generator is decommissioned. I am pressing my clothes in the hospital and may soon be camping out in the doctor’s office! I crave for cold water time and again but I’m getting better at moving in the dark. No! I light only one candle by choice.
So here is my own version of the joke at the beginning. I was hungry so I’m making myself a cheese sandwich. I took the cheese out of a Ziploc bag and sliced off a piece and made the sandwich. I was putting the cheese back when I noticed some small, white, wriggly creatures on the cutting board. Hmm… what are those, protein on protein???? I tried to inspect the cheese in the dark. I didn’t see any of the creatures, which was comforting. I couldn’t see any in the sandwich either. So what did I do? I washed the cheese, patted it dry and put it in a different bag. I made a strong cup of Columbian coffee and enjoyed my high-protein cheese sandwich. It tasted a little different. What do you think? Have I been here too long? Hee Hee Hee .
I will go home next month for a “sanity break.” I will be in the Philippines during the Liberia National election; I think it’s safer that I’m not here. I will also have the chance to participate in a surgical mission in the south island, and then attend the Philippine College of Surgeons’ annual convention. But the highlight will be my mother’s 77th-birthday. I will return toLiberia on Dec. 12, Insha’Allah.
With regards to that boy who had artery and vein transection I wrote about last month. After days of agonizing, I decide to amputate his leg rather than lose him to severe infection. It was a sad day for our OR team. But we had to focus on the fact that he was going home alive. Praise God, Handicap International is here in Liberiaand can help provide a walking frame and, later on, a prosthesis.
I pray that you can help us with the OR renovation.
August News …
At 7:30 GMT, BBC Network Africa comes on my short wave radio. It features, as part of its program structure, Wise Word of the Day, which is contributed to by listeners from all over the reaches of the airwaves. At the Ganta Hospital Operating Room, I’ve heard of some “wise words” that were both funny at that moment and insightful in a bigger sense.
I was called to do an emergency Caesarean section on a woman who had prolonged labor. The baby just wasn’t able to pass normally through the birth canal. It was a natural, expected and welcome sound to hear the first cry of the baby. But this baby wasn’t just crying, he was bawling! The nurse-anesthetist, Saye Waylaun, said aloud, “Welcome to the world, brother. You have joined the struggle.” After the operation I went to check on the baby who was continuously bawling. “Hey, what’s wrong baby?” I said. The midwife who was doing the umbilical cord care chimed in and started reassuring the newborn babe. “Don’t cry so, its going to be all right. You can make it. It’s not hard. Life is not hard. You will make it. Don’t cry.” It’s wonderful to witness demonstrations of kindness.
Wednesday Chapel service is when people give their testimonies. It’s very common to hear Liberians thanking God for being “able to see this day” or “to be counted among the living.” After years of civil conflict and the ever present threat of diseases, Liberians are often heard to say, “It’s not easy-oh!” It is true, life here is not easy.
I am reading a book written by a Pediatrician turned Psycho Oncologist (Kitchen Table Wisdom by Rachel Naomi Remen). She talks about us doctors being trained to deal with loss “with strength.” We are to show that we are in control of the situation and not show tears—tears being a sign of weakness. It is true—it’s not a formal training but I sort of learned it. Maybe not well enough because I still cry. But another unofficial motto is “on to the next.” You can’t dwell on one patient because there are others waiting. So on to the next we shall go.
I have a 13-year-old boy who came with a big wound behind his right knee. It was bleeding so profusely that his blood pressure was dropping. I was just starting a big case so this boy had to wait while the bleeding area was controlled by surgical clamps. Finally, I was able to assess him. I alerted the OR staff that it was a possible vessel injury. (Popliteal artery and vein running behind the knee.) The story was that he fell onto a blade and sustained the cut. Months before a covenant supporter fromFulks Run,VAsent her father’s left-over medicine here hoping it might be of help. It was Heparin, a blood thinner to prevent clotting. It is not available in the whole ofLiberia. Although Heparin has lots of uses in surgery, I never thought I could actually use it! Indeed, both artery and vein were completely cut and we had to join it back together (anastomosis) and the big nerves were damaged too. Prayers goes to this boy because if the anastomosis doesn’t work, or our timing was late than the muscle damage setting in, he is going to lose his leg. After the operation, his right leg remained colder than the left leg and I can’t feel a pulse….waiting and more prayers: For two days now, the leg is showing signs of surviving; it is warm, pink and not swelling up. Saye the anesthetist told me that he prays God will bless me and the boy. The real story was that the stepfather of the boy threw a just-sharpened blade while trying to get hold of the boy. The blade hit the boy’s leg causing the cut. Life is not easy! There is no law on domestic abuse here, no family court or social service. The police don’t interfere with domestic disputes, and there’s not even a complaint from the mother.
Now I’m not saying that you should send your unused medicine here. What I am saying is that we need to be sensitive to what the Holy Spirit prompts us to do and then to obey. In this week’s Lectionary Old Testament reading (Exodus 1), the two Egyptian midwives weren’t asked to become something that they weren’t in order to make a difference. Shiprah and Puah have encouraged me today to just carry on with what God wants me to do. Death or life, God will grant that and it’s not for me to decide. I can cry all I need, for He loves me enough to record it and keep it in a bottle (Psalms 56:8 KJV). And don’t you go worrying about me. God is giving me more than enough reason to laugh. I was seriously planning to have my hair plaid like the African braid. You know how my hair gets the brunt of my distress. But the braiders don’t want to do it and my friend strongly opposed it. So I will just color-streak my hair red. It’s the only color available here anyway. Something to look forward to!
Thank you for standing behind me and kneeling for me. I really appreciate your partnership.
- Please pray for the boy, that he might keep his leg and that he will not suffer more from the stepfather.
- Pray that we will be able to help newborn babies with simple birth defects. May we become better equipped to care for them.
- Pray for our plan to renovate the Operating Room after the rainy season. The roof is leaking and the ceiling is termite infested (also by rats & birds). Pray about how you can help us bring this about.
- Pray for peace inLiberia. There will be a Referendum on August 24, and a national election in either October or November.
Thank you for all your love and prayers.
May News…
Doctors make the worst patients. And I am no exception. I thought of myself as being quick and decisive. But I was wrong. (Again!) My insides are hurting, my muscles are sore and I’m feeling really tired. At the beginning I had dismissed these as just stress-related. But the pain is real and persistent. You think I would go straight to the lab for some tests? I self medicated with antibiotic. When it wasn’t working, I was convinced I should go for a malaria test. I almost went. But I was afraid to find out if I have malaria- not when I’m taking prophylaxis tablets. I don’t want to be proven wrong. Dumb, really!
It’s always been busy here. May passed by so quickly and significantly. My sister came for a very short visit, basically to bring our mother back to the Philippines. Thankfully, my good friend visited at a very opportune time. As always, babies are steadily being delivered, not so many sets of twins as March though. There also had been a series of bereavements. In one funeral service, it took me awhile to adjust to the different way of going about the service. There was a person acting like she is off her senses, talking about the dead at the top of her voice. True or made up stories – people were laughing. And at the same time there’s blaring music and dancing. What went on in that funeral is a bit confusing to me.
During the course of all these comings and goings, there were 59 operated cases performed. Too many! As was the situation in Nepal, we do what we can when we feel confident to do it (or we feel we can help). There was a 3-day-old boy who was born with his urinary bladder exposed in his abdominal wall. Risk over benefit, with the parents’ consent we went ahead. Successful operation, dead patient! Makes the surgeon very weak!
You know I’m also the so-so bone doctor here. The usual practice here is to bring the closed fractures (broken bones without open wound) to the bush doctor. If there’s a wound the patient comes to our hospital and gets several doses of antibiotic after debridement (removing dirt & dead tissues), then will go home against our advice to go to the bush. In times when the bush doctor fails, Dr. Elma returns. Ta-dah! Amputation time…..I’m not kidding. You can smell them a mile away! Last December I brought with me two pieces of medical gigli saw wires for amputation. Both have been broken since April. I said no more amputation until I get my new wires. That can’t be because there’s sure to be one or two surgeries every month. I could have insisted I’d only use gigli wire – it’s easier and cleaner to use. I finish much quicker with less strength required.
But we had to use what is available. This patient has gone home. I thought it’s a wood saw but John Veazey, [my e-musings helper,] identified it as a common hacksaw, used to cut metal bolts, tubing, etc. Among surgeons, we sort of joke about the Orthopedic surgeons’ work as like carpentry. Naturally, I didn’t want to actually be a ‘carpenter-surgeon’, but there’s no escaping it. First the Black & Decker drill, now a hacksaw! What’s next????
Back to my malaria saga! I finally went to the lab. I tested negative and was disappointed. What is wrong??? After consulting a Liberian MD (therefore an expert in Malaria), I was advised to start treatment anyway. He says its sub clinical malaria. The tablets taste awful and are giving me gastritis! I’m being a baby – a baby with no mother, huhuhuhu. I’ll get over this, and I, myself, will be wiser. Now I can really suffer with my patients! Thank you very much. I am confident that you pray for us. God bless you more!
April News…
April 1st, I was designated as Acting CMO (Chief Medical Officer) because Dr. Willicor is taking his month-long vacation leave. I knew the challenge was even greater than just being the surgeon. My first act as the CMO was to buy cleaning supplies! Yes- soap, Clorox, disinfectant solution and isopropyl alcohol. Was that really part of my job? NO, but I don’t want to work in a dirty, smelly place. And I can’t (won’t) wait until the hospital provides us our supply, it might take days. It’s the same with surgical gloves, sutures, tubes and catheters.
Then, there were staffing issues that needed resolving. And so I asked myself was I an April Fool? I really don’t need more work or responsibility.
I did encourage Dr. Willicor to have his vacation- he hasn’t had one since he joined the hospital in 2000. I have enlisted the help of Dr. Ron Deirwechter from Iowa. Dr. Ron first came to Liberia in the 60’s, fresh out of med school. He has worked in different countries. In fact, we first met in Kathmandu in 2001 while I was still in language school and he was on his way to Okhaldungha Hospital northeast of Nepal. Imagine how surprised we were when we met here last October. Before he left, he told me that if I needed help, that I’m to give him sufficient time to prepare. I did send smoke signals and he came- not empty handed.
Looking at Dr. Ron, I can’t help asking what people might be thinking of him. Not just from his home but also here. Dr. Ron is 76 yrs old, a grandfather, a husband, a retired surgeon, has a farm, and has Parkinson’s disease. Is he another fool to be traveling across the globe to help out here for six weeks? Maybe not a fool but some people would think that he could have a nice holiday somewhere. This man, an old papa, has blessed this hospital in so many wonderful ways. He has blessed me! Aside from being a doctor, he is also an expert mechanic.
He brought his tools and gadgets. He spends all his spare time outside the Operating Room repairing broken equipment. Because of him, I now use an electrocautery machine to lessen blood loss during surgery. The overhead Operating Room light that never worked, I now enjoy. I complained about burned-out machines because of confusing outlets for 220 v and 110 v- he corrected the problem with several well marked outlets! (photo of Dr. Ron holding the overhead PR light, the power outlets are behind him.) The best of all, I have someone I can discuss patients with, and we both work through the OR list quickly and smoothly. No hassle! He doesn’t sing though, I haven’t heard him yet. Pity.
Why am I going on about Dr. Ron? Because I’m so encouraged by his life.
When I became a general surgeon in 2000, I told myself I’m giving 10 years to become rich and famous, and then I will retire. I have long abandoned that ‘rich and famous’ dream, and to stop after 10 years will just be a waste of God’s gift. Recall the parable of the talents- use it or lose it. Dr. Ron has encouraged me and I hope you too will be encouraged. It’s never too late to serve, no work too menial nor talent that’s not useable. Don’t you want to hear God tell you, “Well done! Good and faithful servant.” I do.
As for hospital work, the load remains heavy. But God sends lots of help: Friends visiting, medical professionals planning to come, and supplies that are refilled in God’s time. There are two MDs from Congo whom the hospital will employ. Pray that their arrangements will be quick and their transition smooth. The Ivory Coast crisis continues despite former President Gbagbo’s capture. We continue to get refugee patients.
Please pray for the Ivorians, their situation is dire. With so many nations needing help, Ivory Coast seems to be at the bottom of the list. I need an instrument for amputation, the one I bought last October broke- too many limbs severed. Please pray for a reliable channel to get it to here. There are four ward nurses with Malaria; snakes and scorpions are coming out- please pray for protection.
Praise God for Dr. Ron and his very productive life. Please pray for his trip home on May 1. I pray that we all have a meaningful Lent and that We will truly experience and live out Christ’s Easter victory.
Dok Elma
January News…
New year, new beginning! A lot of people, especially us Asians, believe that decisions and actions set the direction for the rest of the year. I like January because it’s my period of assessment and planning. No, you did not hear from me last month because I wasn’t able to compose my prayer bulletin. I was home for 2.5 weeks and returned to Liberia Dec 16, with my mother! Yes, she is here. She enjoyed the long travel though confessed feeling as though we won’t ever get to Ganta. What with 27 Hours of flying through 5 countries then five hours on rough roads. She always thanks God and me for the opportunity of being with people she prays for using the UMW Prayer Calendar. She keeps busy looking for small work she can help at the mission, like scrub-cleaning all signboards. She has begun her ministry with the people she encounters by praying with and laying hands on them. But her main task is keeping me clean and fed. As for me, it is good to have my mother here. I have somebody to talk with at the close of day. It has been extra difficult since returning.
There are just two of us MDs managing this 150 bed capacity hospital because the third doctor went AWOL. Later we came to know he has been employed in a big hospital in Monrovia. These last tw oweeks were particularly trying. Each of us does a straight week of night calls aside from our usual Monday-to-Saturday work schedule. It’s common to be called to do at least two Caesarean Sections in the middle of the night. After successive nights of C Sections, I was called for a tiny 18-year-old premature birth who had been in labor for three days. It took them three days to finally decide to get her to a hospital. But her uterus was so fatigued that it just won’t contract despite a maximum dose of available medicines. The choice was between bleeding to death or living without the uterus. The choice was easy, but to live with the consequence of that choice is a different matter.
Thankfully her baby was born strong and she has at least a child. This patient was followed by a 19-year-old whose baby died in the womb, because they delayed coming to the hospital. I thought I would be doing another hysterectomy. In my moment of despair I cried out, “I hate the uterus! I don’t want to see another one!” God is good. I didn’t see any others for three days. But this week I had daily hysterectomies for older women with tumor growth in their uteri. My Pediatric Surgeon-Boss was offended when I told him I was doing hysterectomies here. Maybe he believes we Pediatric surgeons are trained for a higher calling. My mother, on the other hand, told me how wonderful that God has called me and put me in a place where people are in dire need of surgeons. Mothers are God’s special blessing!
At the close of 2010, we here were praying for the country of Guinea because of danger of post-election violence developing into civil war. Ganta hospital is just 15 minutes from the Guinea border and war or not we get Guinean patients. Praise God the situation was resolved and peace restored.
Now it’s another neighbor on the verge of civil war. Ivory Coast is 2.5 hours away and the Liberia border towns have had refugees crossing over since the start of 2011. Of last report there are 5000 Ivorian refugees registered. I was a member of the reconnaissance group from Ganta that went to the border to assess the health facility from the border to us. This is in preparation for an escalation. There were at least four small health clinics manned by nurses along the main road and Ganta hospital is the only and nearest hospital with the capability of receiving spill-over casualties. We have put together an emergency plan. Although the media reports have not been encouraging, we continue to pray for peaceful resolution. Understandably, Liberians are wary of rumors of wars because their own country has been ravaged by several civil wars. As if our present workload isn’t heavy, we prepare to receive more.
Monday, Jan 17, I had a long OR list (11 cases operated) by the afternoon I was already planning on how I can manage Tuesday. There was to be five scheduled cases and it was my out-patient clinic day. I was the only doctor in the hospital for four days. By Tuesday morning I have developed some kind of plan. But God had a better plan. In His perfect time, He sent a group from Ohio. Late Monday night UM Pastor Cathy Dekreide, husband Daniel and two medical students arrived. They minister in another mission point in southeastern Liberia. Daniel is a Medical doctor who worked here two years ago. And seeing the need, he immediately filled in and took the out-patient clinic duty! I was able to do nine operations that day. One of the medical students was tailing me and was exposed to a lot of medical mission stuff. Pray with me that she will keep a heart for mission burning in her. But isn’t God great? The “11:59″ God- His help is never late.
January is definitely eventful. If beginnings do set the tempo for how the year is going to be, it sure is gonna be challenging. But even surer is God’s very present help in every situation. Please pray for strength and stamina for me. Patience too, because it seems to be in short supply after several busy nights. Pray for peace in West Africa region, specifically Ivory Coast. Pray also for the Liberia Annual Conference happening in Ganta on Feb 7-13. Thank you for blessing me with your love, prayers and graces.
Till next time, Elma
November News…
Today is a great day! There’s water flowing from the faucet! But we still need to fill the drum because flowing water is unusual and, therefore, short-lived. There hasn’t been electricity in the houses for three days now. My refrigerator’s use is to keep the ants out. The hospital, however, is kept supplied by a small generator. (Maybe I should start living in the hospital.)
No cold drink in a very warm climate is the excuse to enjoy a cold Coke when we go walking in the market in the evening. Still a great day! What about you, praying friends? Are you having a great day?
There is a mother hen sitting on her nest outside my house. She has been sitting on her 9 egss for over ten days now. Daily we check to see if the chicks have hatched, observing the mother hen to see if she needs something. Just finished a Caesarian section to a 15-year-old mom, delivering a healthy baby boy who got stuck on his way out. While closing, I asked how many children she plans to have. “Three,” she said. I congratulated her on her baby and her three-child plan. The best “thank you” is when the patient smiles.
I don’t always get a smile from my patients. Patients who keep my faith muscles strengthened … Greeyah, a 19-year-old, came to Ganta with a perforated uterus. She became pregnant, went for an abortion in which she had several holes in her uterus while the fetus remained. She was toxic when she came. Because she was so young we decided to salvage what was left of her uterus; my colleagues said it might recover. But the uterus didn’t recover and Greeyah went in for a total hysterectomy. Sad! After a week she developed a severe infection. She breaks my heart! I wake up in the middle of the night and she comes to mind and I pray for her. Every morning I expect a smile or to hear that she is feeling better. But she isn’t. She now has infection in her chest as well as in her belly. She is thin and weak and not happy.
As one radio program always says, “Life is not a series of chances but a series of choices.” With the overwhelming infection, I am thankful that Greeyah is still alive. This goes for me as well. Greeyah’s situation would have been different if I just went ahead and took out her uterus. Yesterday I took her back to the operating theatre to wash up her belly and irrigate her lungs. She was holding on for dear life. This morning I was blessed to see her sitting up, looking better. Please, please pray for Greeyah.
My hair–though the dye has not passed its used-by date–did not get my blond streaks. Just as well or I might look like a half-baked zebra. Maybe I should try purple. I’m going to the Philippines Thanksgiving weekend for a surgical conference and to get my mother. We will be back here by Dec. 16. Mother is looking forward to staying here with me as a new ministry.
Thanks for praying! Dok Elma
October News…
Dear praying friend,
To see a Black Mamba snake or a Scorpion during a visit to the zoo or in movie can give me goosebumps. But to actually see one in-person along the walking path is a different experience all together. Well, this is Africa, and she is introducing her natural wonders to me. I walk around here wearing my hiking sandals (floaters) all the time so I figure I better get serious and get myself a pair of rubber boots and strong flashlight. Who knows what I’ll step on during night calls. Sorry I cant show you photos, my laptop is sick.
Do you know somebody in your church or neighborhood to have been ill of Typhoid Fever? Here every patient with fever either have Malaria or Typhoid Fever. TyF is caused by the Salmonella bacteria acquired by eating contaminated food. The bacteria is easily killed by a course of antibiotics. But patients when they feel better, dont finish the whole treatment course. (I confess I dont ever finish a week of antibiotic myself, and I am a doctor!) So the seemingly getting-better patient becomes very ill with severe tummy ache. A frequent complication of TyF is perforated bowel.The small intestine becomes red and develops holes. The contents leaks out and poisons the whole tummy, then the blood.
My youngest patient ever is a 3-yr-old girl weighing 9 kg (19.8 lbs). She was brought here because of high fever, big painful tummy and she refused to eat. Medical textbook says doctors should arrive at a diagnosis 80% based on history and physical exam, 20% on laboratories to confirm the diagnosis. Our laboratory is very limited, even less than the very basic tests. Anyway, this girl needed surgery clearly and so was prepared. She had 2 holes in her intestine and a belly-full of muck. A portion of the diseased bowel was cut and sewn back together and her whole belly washed. Sounds simple enough. But this 3yr old only weighed 20 pounds! For a chronically malnourished patient, wound healing and recovery takes much longer. And she wont be able to start eating untill after 3days, when the bowel is healed.
But God is gracious! His mercies are new every morning. As I check on her everyday I watch out for early signs of complications. I always come back rejoicing because she was recovering well and free of complications. She cries when she see me. Praise God for answered prayers! She has gone home, with oral antibiotic to complete the treatment. I just pray she is better than her doctor and finishes her treatment.
Thank you for always praying for me. I have enough supply of gloves, my power drill is on its way; thank you Trinity UMC (Pomona, CA). Im still nagging people so we can have running water in the operating theater. Central UMC (Matthews, VA) is ready to help us get the water flowing, thank you very much. Electricity is still dicey in the middle of the night. Once I was doing my 3rd C-section at 2 am when they switched generators. We were standing in pitch darkness for 12 minutes. It felt like forever when one is supposed to be closing the belly!
To fight off frustrations I have color-streaked my hair blond. Thats because I cant find blue color. I like green but not for hair! I’m sure you are smiling. That’s great! Just don’t forget to pray for me and my patients. God be with us.
Elma
September News…
Dear praying friends,
In the candle-lit bathroom I was sitting like a queen when saw something black moving. I calmly went out and asked my fellow missionary, “what kind of spiders should I be worried about here in Africa?” Of course they got all excited and decided to kill it. Kill it but document the big hairy visitor first. This was my first night in Ganta. Good thing I’m not afraid of spiders, only frogs!
Part of my preparation in coming here is taking anti-malarial tablets 2 weeks before arrival, and make sure I have my own supply to last for a year. Malaria here is no joke. It’s the kind that is not killed easily and it goes straight to your brain. And I thought HIV was my problem to beware of as a surgeon.
Ganta United Methodist Hospital is a 150-bed capacity hospital that serves as a referral center for other hospitals nearby and from Guinea. There are four doctors - a Liberian GP/surgeon, a Congolese obstetrician, a Liberian eye doctor and me.
Electricity is run by generators, there is no running water and no telephones – only mobile phones. But there is internet! Of the very short time that I’ve been here I have repaired five hernias, delivered by C-section a baby girl, amputated a leg, dealt with an ectopic pregnancy and perforated intestine due to typhoid, and the usual appendicitis. By the way, I function as GP here and you must pray for me on this. This is new to me.
With all the patients that I have opened, I noted they all have big liver and spleen. This is again due to malaria! From birth each person has been repeatedly infected – it’s like having a cold! Almost all have anemia. You see, the malaria parasite lives in the red blood cells, destroys it and gets sequestered by the spleen. The liver is slowly destroyed by the strong medicine, other bugs that infect it, alcohol, or fungus.
Maybe we shouldn’t have killed that big hairy spider. It could help control the mosquito population!
I have a 16 y/o girl who came in because she can’t breathe well, when she eats she feels nauseous, her legs are getting fatter. Ohh, her tummy is growing, too. Clearly she doesn’t need surgery but what’s making her swell? Praise God for the donor of the portable ultrasound. Yes, I need to learn how to use this, too. I did a quick scan to make sure there isn’t a tumor, then stuck a needle in to drain fluid from her abdomen (paracentesis). We drained 3.2 liters intermittently and she is feeling so much better. But I needed to explain to her and her family that this is temporary measure, that she needs to eat well and fight whatever is destroying her liver. She appreciates your prayers.
Two churches have expressed intention to support my need of surgical gloves. Thank you for your generosity. I’m good for now, but really my wish list is growing. Just today (Saturday) I spoke aloud, “My God shall supply all my needs according to his riches and glory!” Indeed, it hasn’t been two days since I verbalized my urgent need of a power drill (for fixing bone fracture) and a covenant church has answered the need.
I have been truly blessed by so many covenant churches who love the Lord and his worldwide church. I thank God for all of you. If you have been praying for me when I was in Nepal, you need to double the effort. Please! I need your prayers. This place is so frustrating, but I’m also suffering from culture shock. What emergency room has no O2 (oxygen) support, penlight, suction machine and some provisions to elevate the head of an injured child? These frustrations shall pass, but I need to raise the bar so we can serve better. Please pray for me more. Thanks.
Bye for now.
Elma
