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Bongolo Anesthetists

It's good to be back home with the family.  What a great trip!  It was a pleasure to help educate and train clinically the anesthetists and surgery residents.  Even greater was the continued deepening of relationships with them and the rest of the missionary staff.

Traveling and getting to know Jack Ewig was an added benefit to this trip.  He is a wonderful man of God.  I hope to return with him sometime.

Next planned trip is in late January with the Welkers.  It will be another blessing.

Thank you all again for your prayers and support.

Worms Part 2

We had a very busy last day at the hospital--multiple cases and finishing up the education series.  Just when I thought the day was over and ready to head back to my place to pack, along came an emergency case.  It was a 19 month little boy with a bowel obstruction.  He was pretty sick and needed surgery soon.  So, we took him to the operating room around 5pm and started the case.  Come to find out his obstruction was due to worms.  Again, no pictures for the squeamish, but the largest one was about 8 inches long.  Crazy!!  The unfortunate thing is this is preventable with public health, clean water, and medicine.  He did well during the case and immediately in recovery.  The next few days will be critical as he will likely get sicker before getting better.  Pray for his recovery and healing.

We had dinner with a few of the missionaries and said our goodbyes to others.  Off to pack for the return home on Saturday.

PAACS

It is quite a joy to work alongside the PAACS residents training here in Bongolo.  PAACS stands for Pan African Academy of Christian Surgeons and was started here at Bongolo Hospital.  It has expanded to many more hospitals throughout Africa and is a wonderful model of training and discipleship (see link above for more information).  Christian physicians who graduate from medical schools all across Africa apply for the PAACS surgical residency.  Once accepted they are assigned to one of the PAACS locations.  They are either sponsored by a hospital in an under served area in one of the African countries or the PAACS program will sponsor them.  After they complete the surgical residency (5 years), they are required to return to their sponsored hospital or the PAACS program will place them in an under served area.  Upon returning, they not only provide much needed health care, but they are looked upon as Christian leaders in the community as well.

Where does anesthesia fit in all this.  Well, many of the locations where the surgeons will be working after graduation have very little or poor anesthesia services.  Many times, the surgeon is not only doing the surgery, but also doing or overseeing the anesthesia.  A lot of my time spent here is devoted to training the residents in basic anesthesia skills through lectures and clinical teaching.  Aside from the medical education, it has been a joy to develop relationships with these wonderful men of God.  They have taught me some things!!

Thanks again for your prayers and support.

Tough Day

Today was very busy.  Once again I was thrust out of my comfort zone by taking care of newborns and small children.  My anesthesia practice in the US is essentially limited to the big people and not the every so tiny ones.  Well today we had a 2 month old with hydrocephalus for a VP shunt and then a 3 year old for a tonsillectomy.  All went well as I recalled my days of rotating at Riley Hospital for Children during my anesthesia residency.  I do believe God had His hand in it though.

On a sad note, we finished the day with the other end of the spectrum.  It was an 80 year old woman with a hip fracture for repair.  She fractured it about a week ago and due to varied delays both medically and socially, her case was delayed to this week.  We did a spinal anesthetic and all was going well with the procedure.  Then all of the sudden she arrested.  We "coded" her for about 30 minutes but could not save her.  It was tough.  For those who may not know, these are very high risk procedures on sick patients.  In the US, while rare, older patients do arrest during this procedure.  My assumption was she had a clot move to her lungs and she arrested immediately.  The surgeon talked with the family and he believes they are all Christians, including the patient.  Pray for her family as they grieve the loss of their loved one.

Thanks again for all your prayers and support.

Restful Weekend???

We had a restful weekend with no surgical cases, at least not at the time of this writing.  Saturday we took a walk down to the river with a few of the missionaries and walked across it.  It is very low at present as it is dry season.  Soon the rains will come and the river will rise about 8-10 feet.  It was actually a bit challenging and many of the rocks were slippery and not very flat.  We banged up our shins pretty good.

Later Saturday afternoon we (Jack, Justin and I) borrowed one of the vehicles and took a drive into town.  "Town" is Lebamba where there is a market and some tiny convenience stores.  There is one grocery store and also a market.  Not a whole lot to do so we just poked around and bought some food.

Saturday evening came along and I had a worm pulled out of my back.  For those weak in the stomach, I will not gross you out with the details or pictures.  Ask me about it when I return.  It's all good.....

Today we went to the local church and worshiped the same Almighty God as in the USA.  While I do not speak the language and could not understand the sermon, it was still a wonderful experience sharing this time with my brothers and sisters in Christ.

This afternoon we played some basketball with a few of the local youth and missionary kids.  It was a good time.

Restful Weekend???

It's Still About the Patient

We had a very busy week of surgical cases and now that it is Friday, I am exhausted.  It will be good to have a few days rest.  That is if there are no emergencies.  Most of the week, I found myself running between 3 different operating rooms managing and supervising 2 anesthetists, an anesthetist in training, and a surgical resident on the anesthesia rotation.  On occasion I did my own cases as well.  It was a great week with plenty of opportunities to teach and interact with trainees.  Sometimes I did find myself so busy and so focused on "getting the cases done" that I forgot about the patients.  Frequently this happens in the US where the "big machine" of healthcare gets in the way and we find ourselves simply moving the cases along without any connection to the patients.  Well, at times this is true here in Gabon.  Compounding this is the fact that I speak a different language and it is difficult to relate and show compassion through a translator.  That said, we do need to be efficient and move through the day or we would never get done.  There needs to be balance.

One such case helped gave me a quick reminder of why God has given me the opportunity to be a physician and how it all needs to be about the patient, wherever I serve.  I was called in to help my resident do a spinal block for a hernia repair on a young adult male.  I could tell when I entered the room that the patient was very anxious about this procedure.  On top of that, when he found out it was going to be done under spinal he got really nervous and started to verbalize his fright.  I helped the resident get prepared and then went around to the other side of the table to assist positioning the seated man for the spinal.  He immediately grabbed my hand and arm very tightly and started to pray.  I prayed with him.  He calmed down but did not let go of his tight grip on my arm.  After the resident completed the spinal, the man let go and thanked me.

A reminder that it is about the patient.

Trauma

Not unlike at the hospital I work at in the US, we had a late night trauma case.  It was a motorcycle/moped versus pedestrian collision and I believe alcohol was involved.  In Gabon they are seeing more and more trauma as the roads begin to get paved.  The drivers of cars and motorcycles now feel they can go faster because of the paving.  Of course, alcohol involvement doesn't help.

The pedestrian's leg was pretty banged up.  He had a compound fracture (bone sticking out) of his tibia and multiple lacerations of his face and head.  We took him to the operating room emergently to clean up and stabilize his leg--very similar to the US.  All went well.  God is good.

The motorcycle operator has multiple facial fractures and will likely need to go to the operating room for repair.  As you know, I am here with an oral surgeon, Jack Ewig, who sees and repairs facial trauma routinely.  He asked Keir, the lead missionary surgeon, if they see a lot of facial trauma like this and quite honestly he stated, "none over the past year or so."  While I wouldn't wish this trauma on anyone, isn't it like God to have an expert in place when it does happen.  It will afford the patient great care and it will be an excellent opportunity for teaching of the missionary surgeons and residents.  God is good.

Checklists

Jack and I left the Guest House in Libreville this morning and took a flight on the mission plane down to Bongolo this afternoon.  It was good to get settled in and meet new friends while reacquainting with old friends.  We had a wonderful dinner with the Thelanders followed by some much needed rest ahead of a busy week.

After we boarded the small, single engine plane and prior to take-off, the pilot ran through his checklist making sure the equipment was functioning and we were safe to travel to Bongolo.  I am sure he has done this checklist many, many times yet I could tell he took each step seriously and was not skipping any of them.  In my world of anesthesia we also have similar checklists, making sure our equipment is properly functioning and that we have all the various drugs and backup supplies needed in case of emergency.  While the pilot's checklist is more robust (probably because he is getting on the plane), the similarities are there.  It may seem ridiculous at times to go thru these checklists as it rarely uncovers a problem, but they are necessary to avoid serious events. It's like getting back to the basics for each flight or each case.

I wonder what life would be like if each of us ran through a mental checklist in the morning prior to heading out for the day. We may be able to handle better the "stuff" that life throws at us. Part of my morning checklist is spending time in prayer and reading my Bible. Helps me get focused. What's on yours?

Libreville Guest House

We had an uneventful trip from Cincinnati-Paris and Paris-Libreville.  All our bags and equipment made it without a problem.  Thanks for your prayers for safe and smooth travels.  We are staying at the Guest House (pictured above) in Libreville tonight and tomorrow we take a small plane down to the mission hospital in Bongolo.  That's a good reminder that we are guests on this trip.

We are looking forward to getting settled in, reconnecting with the missionary physicians, missionaries, nurses, anesthetists and surgery residents.  Thanks again for all your prayers.  I hope to update frequently.

Jeff

Whose Stuff is Important?

Well, tomorrow we set out for Bongolo.  As is the case with these trips, there is usually more stuff to pack than capacity will allow.  Over the years I have come to realize that I need less stuff, making more room for the needs of the mission trip and the missionaries.  I am reminded that this is a good life application and really not just about mission trips.  We should continually strive to simplify our lives and weed out the unnecessary "my stuff" (material possessions, mindless media, etc) and replace it with "God stuff".  Matthew 6:19-21

Getting Ready for Another Trip

God has given me another opportunity to serve Him and the people of Bongolo Hospital.  On September 20, I will be returning for a two-week visit to Gabon with Jack Ewig, an oral surgeon from Dayton, Ohio.  We will be helping support the mission of the hospital by teaching and training the PAACS residents and other health care workers as well as taking care of the patients with love and compassion.  It is exciting to return to Bongolo again.  Please pray for us.  Click on the above tabs for specific prayer requests and our itinerary.  To God be the glory.