Tour de Mbingo Hospital, Part 1

Here's a few sites you may see around Mbingo if you come for a visit. Sorry this isn't a comprehensive tour, but hopefully you can get a feel of the hospital.

The latest theme around Mbingo: construction. This will be our new laboratory.

Here's our operating room. In Cameroon it's called the 'theater'.

In the back of the hospital buildings, there is space for the patients caregivers to cook, wash clothes, and sleep. Every patient admitted to the hospital must have a caregiver. In the US, the hospitals serve you food, clean you, etc. In the developing world, when you are admitted to a hospital, you need to provide those services yourself since the resources are so limited. The foam mats you see to the left is where some caregivers have staked out a place to sleep at night.

I could write awhile about the identity of the hospital, what makes its heart beat, and what it stands for. But this mission statement posted in the administration building pretty much sums it up.

Here's the helicopter landing pad with a recently rescued sick person.

If you go up to the hospital on Saturday, you may even see a little nurse running around!

Medical blog # 1: Noma

I’ve hesitated to write medical blogs so far, mainly due to the fear of inadequate portrayal of the patient’s story or the conditions of this place. However, I really want to share this child’s story because her condition is not well known. She has a forgotten disease. Something that’s not taught in American medical schools. A disease that I only heard about half way through my surgical training. A disease that only affects very poor and malnourished children. DISCLAIMER: the picture below may be a bit disturbing to some people (used with permission from patient's mother).

Rejoice is a 3 year old girl. She weighs 17 pounds. She came to us severely malnourished a few months ago. She was profoundly anemic, with a huge wound of the nose and palate. We diagnosed her with noma, also known as cancrum oris. Noma only exists in very poor, malnourished children, usually aged 2-6. The child’s malnourished state leads to immunocompromise. After this, the normal flora of the mouth and/or nasal cavity cause an invasive, necrotizing infection. The children that survive noma are left with horrific facial deformities. This girl has a large defect in the palate with very little of her nasal septum left. She’s currently receiving care aimed at improving her overall nutrition, and we will address the reconstruction of her wound at a later date.

Noma is called ‘the face of poverty’. This disease particularly strikes me because despite it’s toll on many children, it is not mentioned a single time in my 3,000 page ENT textbook. I reflect on my own perception of the poor. Kelly and I often tell each other that it’s easy to forget the poor. It’s true. They often don’t have a voice to represent them, and they seemingly have little to offer society. For most of us, the poor don’t just show up on our doorstep, and they may be easy to avoid. Of course, when we consider the example of Christ, we see the exact opposite. He knew where the poor were. He did not avoid them. He knew what they needed most (Himself) and he provided for their physical needs. He loved them well. He saw the eternal value of the poor when he declared that the woman who donated two copper coins had given more than the wealthy that give out of their abundance. As I continue to treat the poor here, I’m hoping for this type of attitude.

Please pray that Rejoice would gain weight and be healed!

Word of the Month: Ashia

So my next ‘word of the month’ is a word that truly has no equivalent in the US. Ashia (Ah-SHEE-ya) literally means ‘courage’ or ‘take courage’. It transcends dozens and dozens of languages spoken in the area. I hear this word many times every single day without exception and it never seems to get old.

There are various uses of ‘ashia’. Simply, if you see someone working hard, maybe carrying a load of sticks or water up a mountain, you would say ‘ashia’. The response would be a polite ‘thank you’. Sometimes, it’s almost used as a greeting in the operating room. A nurse will poke his/her head in and say ‘ashia’. Or you could bid someone ‘ashia’ if you find out they are sick or that they are going through a difficult time. I could have told Kelly ‘ashia’ when she broke her arm (I didn’t by the way). You can also say ‘ashia for work’, to encourage someone when they’ve worked hard that day. Ashia for this woman, working with a baby on her back.

I’m almost jealous that we don’t have a word like this in the American culture. You could sometimes equate it to the camaraderie one feels when you find out someone has the same alma mater as you. Kinda like "hook ‘em" for me, being a Texas Longhorn. It’s a wonderful word that truly builds others up, encourages, shows sympathy, and brings peace. It’s the first word I teach to a visitor to Mbingo.

So the Schmedes crew bids you a sincere ‘ashia’ tonight in whatever your task is for the day.

Mback at Mbingo

We arrived at Mbingo 2 weeks ago after being in the US for 2 months. Kelly’s arm has healed! We’re so thankful for this. Literally everywhere I go.....the market, operating room, hiking......everyone asks how Kelly is doing and if she's healed up. 

It’s now the rainy season, which so far has meant about a half hour of rain in the afternoon every other day. It’s beautiful to see the clouds move in among the mountain, and the waterfalls are starting to appear. The rain moves in and cools things off. Here’s a before and after view from the hospital entrance.

A huge encouragement for us this past week was that a great friend of ours, Jay, flew back with us and worked with me at the hospital. Thank you Jay! I've also been able to spend time with one of our graduating chief residents this month, Tony. He will be serving in central Kenya next year. Here's Tony and myself performing a thyroidectomy.

Transitioning back here certainly has been difficult. We’ve had some sickness, which thankfully is improved now. However, when we cease our focus on the trial itself and shift our hearts and eyes upon God, we receive strength and peace. We’ve been so encouraged by words of support from you. The kind words of encouragement build us up and encourage us to continue pressing on. We are thankful to do good works for Christ and thankful to work alongside our brothers and sisters in the Cameroonian church.

P.S. The kids are all doing great!

Broken But Not Destroyed

Kelly plays for the women’s soccer team here at Mbingo, and they had a match this past Saturday. About 5 minutes into the match, Kelly fell after striking the ball, falling on her hand. Good news: she scored a goal, bad news: she broke her arm.

What did God provide after that? Well, our next-door neighbor happens to be an orthopedic surgeon, Dr Nana. He was able to align the bones and place a splint. Thank you Dr Nana! To complete her treatment, Kelly will need surgery. So we’ll be headed back to the US shortly, with surgery scheduled next week.

Kelly keeping her sense of humor

Needless to say, this has been quite stressful, physically painful for Kelly, and a little discouraging. My personal rock-bottom moment was the point I realized my beautiful wife would need surgery. Literally 2 minutes after this news, just when I thought, “Okay God, this is all I can handle,” the phone rang. Surely it was just another person calling to check on Kelly…..no. It was the children’s ward calling telling me that they have a 10 month old in respiratory distress with a foreign body in the airway. In all of my specialty, these are the most precarious situations. I was in disbelief at God’s timing. In the midst of Kelly’s pain and getting the kids to bed I told Kelly that I had to go or this child would die.

As I hurried up to the hospital, I simply reminded myself as I prayed, “God, you equip me for all the work you have for me to do,” knowing that both of the telescopes I use for this procedure are currently broken. Plans A and B were already used up before I even arrived. Then I saw the nurse carrying the baby as she ran down the walk into the OR. We don’t have oxygen tanks at Mbingo, so when the nurses transport children, they literally run from the children’s ward to the OR where they can re-start the flow of oxygen. By God’s grace, our team was able to remove the foreign body (a piece of plastic) from the child. The baby girl is doing just fine now.

Though I first thought I was simply being kicked while I was down, I easily see how God spoke to Kelly and I. We can hear God saying, “I have prepared good works for you here to do. You are supposed to be here. Press on toward the goal.” Kelly and I are so thankful we have the privilege to serve the poor and the sick here in Cameroon.

It’s hard to reconcile our privilege and wealth as I take Kelly back to the US for top-notch medical care, while we continue to serve the poor in a hospital that doesn’t even have oxygen tanks. While we go from one extreme to another, I continue to wonder why such disparities exist and how Christians should respond when Jesus teaches us to treat others the way we want to be treated. In a way, that’s why we’re here. I want my wife to have good medical care, therefore I’m here providing medical care to those in need. Kelly and I can’t help but feel all the more thankful and motivated to serve here.

Marlis helping out, since Kelly can't hold the baby. James is loving it!

Please pray for Kelly’s recovery, her ability to care for our 3 month old, and for a safe trip home and surgery. Thanks to an incredible support team of friends, family, James Island Christian Church, and Samaritan’s Purse. 

Word of the month: harmattan

When I first heard this word, I had no idea what it meant. The harmattan is a southerly wind that blows down from the Sahara every dry season. Kinda like El Niño, but with with lots of dust and no rain. The wind carries down very fine particles of sand all the way here, making the air pretty hazy.

The harmattan has been so thick lately, that a missionary pilot from Yaounde called me last week to check the conditions before bringing two trauma patients up here. Thankfully they landed safely and are receiving care. 

It does make for some nice sunsets though.

Missions retreat

Yesterday, we returned from several days in Bamenda at an annual retreat for missionaries. Kelly and I had a great time, as did the kids, seen here playing with their new friends.

Two things really struck me this past week. The first is the privilege of worshiping with those of your same language and same culture. It's certainly a joy to worship with believers around the globe cross-culturally, but sometimes things go missing when you don't quite understand what's going on. This then lead me to a better understanding of the HUGE need for bible translation. Imagine using God's word in your 2nd (or maybe 3rd) language. How joyful would you be to receive a bible in your heart language?

Which brings me to the second thing that spoke to me this week: other missionaries stories. We met a couple serving as the only missionaries at a rural hospital. They're in their 70's. The husband is a retired GI doctor. He retired after a full career in Colorado Springs, then moved to a hot, dusty place with lots of malaria! They specifically chose this path because they wanted to have an impact for God's kingdom in their retirement, and the place they work serves many unreached people. Wow!

We also met a few bible translators. One of them stood up and stated, "On average it takes 20 years to translate the Bible when you're starting without a written language. If God gives us health and life for that long, we're here to see that through."

We were blessed by an awesome children's program as well. One might think, "How can you get any sleep with 4 kids in a single room?" Well, they played so hard each day, they slept great every night!

One day, the kids made puppets during craft time, then used then in a show that night.