Home Sweet Home

The Lord allowed me to return safely last night, on time, with all but one of my bags, but fortunately the gifts for Jen and the kids did arrive, and the other bag will arrive in due time. I have already Emailed a response to Dr. Jean at Hope concerning some of our patients, and will continue to work with him from the States as is necessary. He sent xrays of Modey's femur, which is well-aligned, and appears to be healing well. All other pts are thriving and soon will be able to return home. I had an opportunity to review all of my pics from the trip with Jen this am, and hope to share these with as many of you as possible.

I'm not sure how to adequately summarize this trip in a manner that does the entire experience the justice it deserves.  I suppose that is why the Lord didn't ask me to be a full-time author.  I am grateful to all of you as my blogging family for your support and prayers, and for those of you who reached out to my family while I was away. Most of all, I am grateful to God for demonstrating to me the true definition of sacrifices of love, undeniable joy, and unexplainable peace.  It would be impossible to have left Guinea the same man that I was when I left, and for that fact, I am humbled. Hope Clinic, and the faithful staff, have left a lasting impression on my life, and I will remain faithful to do whatever I can, both here and upon my return there, to serve the Lord in whatever capacity He so desires. I have many goals-- to learn French, to coordinate the opportunity to bring laparoscopy and endoscopy to Hope, to take many of you with me in the future and let God completely transform your lives as He has done mine, but most of all, to remain diligent in praying for Hope and the nation of Guinea.

I am eternally grateful to all who have read and prayed.  God bless, Jeff

It's Time For Me to Fly...

A little music trivia quiz for you bloggers-- Who sang the the title of today's blog? There will be a prize for the first correct answer--on the blog! Well, we are in Conakry, arriving safely this am after driving twelve hours yesterday, and four more this am. I have had the pleasure of staying in the Westlake's apartment for the day which is overlooking the Atlantic Ocean. We had pizza for lunch, and then did a little souvenir shopping in the market. The plan is for dinner tonight, and then they will drop me off at the airport for my 11pm flight to Paris. The plan is for me to hit PDX @ 7:30pm, Wednesday nite. The Lord has been gracious these past few days, which has been evident in many sincere "goodbyes" with patients, clinic staff, new friends, and safety on the roads. This blog has been a direct avenue by which to stay in communication with family and friends, serve as a great reminder of my experiences while in Guinea, and hopefully, it has glorified God in the manner in which his power, grace, and love have been reflected in print. I am eternally grateful to all of you who have travelled with me and to those who have cared for my family while I was absent. Our Father will reward all of you for your faithful prayers. My hope is to get a chance to visit with all of you soon after returning home to give you a good report of the Lord's work in Africa. God bless, Jeff

Grace Like Rain

Todd Agnew has always been one of my favorite artists, and tonight, as the dark clouds moved in, and the winds picked up speed, and the pouring rain finally fell, after two and a half months without rain, his song, "Grace Like Rain" came to mind. Dan and I were honored this evening by the Hope Staff with a wonderful meal and many kind words and thoughtful gifts. I have always done poorly when it comes to saying goodbye, but this was much easier knowing that my desire is to return and serve again here at Hope. I rounded for the last time this am, and am happy to report that all of the pts are doing quite well. Dan and I took the time to take pics with the pts this afternoon, which was fun for us, and equally fun for the pts. So many good pics to share, with a story to support each one. Church this am again was very enjoyable with the music and attitude of the folks who love God openly without embarrassment. A pastor from Togo shared from Acts 1 and Romans 8, and very enthusiastically urged everyone in attendance to decide to choose the Lord. I believe 4 or 5 people made commitments to Christ today. Lunch was wonderful, and then we spent the afternoon hiding from the heat and packing. Grace like rain... I have witnessed God's grace here in many ways. The staff was incredible gracious in their interactions with me despite my inability to speak French. All of the patients are provided with excellent care and loved equally despite their ethnicity, economic status, or disease process. God continues to provide medical supplies, medications, and supplies necessary to maintain the physical plant here at Hope, that are given by many generous donors and contributors. Lastly, people are bowing their knees to the King of Kings and surrendering their hearts to Him. Hallelujah, and all my shame is washed away..." We leave for Conakry at 6am tomorrow for the two day drive. My flight leaves at 11pm Tuesday evening(3pm in The Dalles), and I should arrive home, Lord willing, at 7:30 pm on Wed evening. My heart is for our pts here at Hope, however my soul longs to be reunited with my family and friends. Again, I'm unable to express my gratitude to all of you who have taken precious time to blog with me and uphold us here at Hope in your fervent prayers. I will never be the same man or physician who arrived here in N'Zao three weeks ago, and for that, I am grateful.

Reflections on God's Goodness

Today was a fun day here that began with a wonderful breakfast. Rounds were enjoyable, as we have 12 pts in house, and all are doing well. I will miss having the opportunity to meet with grateful people that want so much to be loved and cared for. Lori was kind enough to let me tag along to the market in N'Zerekore and observe some grocery shopping and enjoy the sights and smells of the scene. The people here are genuinely friendly and also quite respectful. I spent most of the afternoon organizing a long Email for Dr Jean in order to allow his transition process here go as smoothly as possible. Imagine what it would be like to return to a service with 12 pts, not a one of them you had operated on! I hope to meet with him halfway between here and Conarky to express my gratitude to him for allowing me to come and serve from his office and with the OR crew that he has diligently been mentoring and training. Specific prayers tonight could be extended for many of my new friends here in N'Zao. Stephen and Lori Albright are my host family. Stephen is the current CEO here and is currently training another man to take over his position. Lori has the gift of hospitality and has "Americanized" many meals for me and Dan. She has been so gracious when I've not been on time for meals, and they truly have an open door policy. Their daughter, Hannah, age 9, has kept me on my toes with riddles and stories, and even allowed me to repair her lip laceration just a couple of days ago. Their plans are to remain until June of 2013, and then go on furlough. As of today, they are unsure of where the Lord will lead them, thus they would appreciate your prayers for their future. Dennis and Cindy Westlake will be taking Dan and me to Conarky on Monday. Dennis is the regional director for CAMA, the governing body for Hope Clinic. The plan is for Guinean nationals to take over the administration of the clinic, thus Dennis is training folks as well during this time of transition. They also will be going on furlough in April of this year, and are also searching for where God would have them serve. Please pray for them during this transition as well Jon and Anja Erickson have been more than generous to me during my stay. Jon is one of the two co-founders of the clinic, but spends most of his time now in the local Christian schools, and with evangelism. He has a heart for mobile medical teams, and is currently hoping to organize a team to travel to a remote area and do a little surgery. Anja is the clinical administrator here at Hope and organizes the medical education program as well. She is an extensive source of medical knowledge and has taught me many valuable things about tropical diseases in Africa. Please pray for this couple as they continue to serve here at Hope and abroad. Jairus and Adelaide Bohimbo are a very energetic couple whose love for the Lord oozes from every pour! Jairus is the nurse anesthetist here who is quite skilled, works well with pts who are anxious about surgery, and has been a good friend to me during my stay. He is a converted Muslim that takes advantage of every opportunity to share Christ with anyone who will listen. Adelaide is very busy here seeing new pts and organizing nursing education as well. They have invited us over for dinner on two occasions, and I have never laughed so hard while eating dinner. They are hoping to begin raising some financial support soon, and this is a matter of prayer for them. Please pray also for Jean and Jackie Yaraduono. He is the surgeon here, and Jackie is the head nurse for the Inpatient Ward. I have only spent a few hours with Jean, but enjoyed the fruits of his labor while working in the OR. Jackie is a wonderful combination of a sweet spirit, but appropriate firmness as well. There are many other fantastic people here at Hope who would appreciate your prayers as well. This place was the brainchild of two men, but the Lord, the Great Physician, oversees the day to day healing that occurs here. In a land that prides itself on cheating, bribery, and witchcraft, these people are truly a light in the darkness. I am grateful to the Staff for their support of me, despite the difficulty with my language deficiency. I will miss them all for a time, but hope the Lord desires for me to return and serve again. God bless, Jeff

For those of you who read Jeff's last blog about his kidney stone attack, I wanted to update you.  I talked to him very briefly just a few minutes ago before he went to bed.  The connection was really bad but we typed IM for a bit.  He is feeling better than he was in the OR today, but he still feels like another stone may be working its way down.  He is very sore and very tired.  Please, keep him uplifted in prayer as he rests this weekend, that he will pass this last stone before he begins travelling on Monday (our Sunday night).  Thanks for all of your support, laughs, and prayers for him.  I know he feels like you all were are part of seeing him through this time away from  home.  Love, Jen

Scalpel down, Gloves off, The OR is Silent

It is hard to believe that three weeks of work here at Hope have been completed. All in all, 72 consults, 30 cases, and hundreds of interactions with patients and families, has now been drawn to a close. I felt a slight tug at my heart as I gathered up my belongings from the OR and walked back to my room. For those who prayed for us today in the OR, it was evident, as we were able to efficiently and safely negotiate through 6 cases. The only hiccup was a 3 hr period of time that I suffered from a kidney stone attack. I was able to drink 4 liters of fluid in between cases, and shortly after Jon prayed for my pain to be gone, the stone passed... It's nice to know I got something else from my father besides my ravishingly good looks! We have 12 surgery patients in the hospital over this weekend that are all doing well at this point. It will be good to have some time with them this weekend prior to my departure. Jairus led one of our pts to the Lord during his hernia operation today-- spinal anesthetics are amazing! It will also be sweet to have time to collect my thoughts prior to leaving Monday, catch up on lost sleep, and thank everyone here that has made my stay enjoyable. There were no times of loneliness here for me, as everyone wrapped their arms around me and made sure I was doing well. It will also take me a few days to contemplate my experiences here, and fully understand what God has done here at Hope. The OR crew expressed their gratitude to me for being willing to come and help them treat many sick folks. I will miss them dearly, and hope to be given the opportunity to serve again with them in the near future. Many of our pts are anxious about my departure, but I have assured them that Dr Yaraduono will care for them well, and that Jairus is not going anywhere, anytime soon. There is a small possibility that Dr. Yaraduono will arrive this weekend, which would smooth the transition process significantly. You might ask, "What miracles did you see today?" I can say that I observed a man turn his back on his Muslim upbringing and his beliefs, and surrender his heart to the Lord. After spending a few weeks at Hope, I understand there is nothing more dramatic or exciting than a lost soul being saved from certain death. Tonight is pizza night, and frankly, I could eat! Thank you all for your kind words, faithful prayers, and the love you demonstrated to my family during my absence. The blog will remain active for a few more days, until my return, but God's leading in my life and the strengthening of my soul will live on, for I cannot desire anything else but to be in service for the Lord. God bless, Jeff

Cuttin from Sunup to Sundown

We had another great day in the OR today! We began around 9 am after morning devotions and rounds and were able to get 5 cases done, including a repair of a wrist fracture that required us to think on the fly and modify the original plan. Almost every bed is full now on the Inpatient Ward, and we have 6 cases to do tomorrow. We didn't finish until 8:30 pm tonight, and the crew was still laughing and having a great time. Not a single complaint all day! I have been caring for a 70 yr old Muslim man for the entire three weeks I've been here. He arrived with a blood sugar of 475 and bilateral thigh abscesses with fasciitis. He was in early stages of septic shock. I remember looking around for an ICU bed when I was asked by the medicine physician to consult on his case. He required 48 hrs of resuscitation and then we took him to the OR to evaluate the extent of his infected legs. I explained to him and his wife that he may have infection into the bone, and require bilateral leg amputations to save his life. We drained over a liter of pus from each thigh and stripped most of the fascia( muscle covering) from his thighs. We were all a little solemn when we discovered the scope of his problem, and I was honest with his wife, that he may not live to see the sunrise. The next morning, I slowly walked up the hill to see if he had survived the night, and found him sitting up in bed, smiling and eating breakfast. He must have said "Thank You" a hundred times. We have taken him back to the OR four more times, and I'm pleased to say that he will be ready for skin grafting next week--Thank you, Dr. Jean-- and is walking all over the clinic grounds. I found out later, that the staff here thought I was crazy to take on his case, believing he was too sick to care for here. I had no idea that I had a choice whether to refuse him care and send him away. Of course, because of the language barrier, I was oblivious to this chatter, and I have been told by many of the staff that they are sorry for doubting God's power to heal this man. Truthfully, I probably was foolish to agree to care for him, but God was faithful even when my judgement may have been less than optimal. He doesn't need us to heal, he just needs us to trust Him. I have a few specific prayer requests for those of you who have been praying for us here at Hope. The first is for tomorrow, as we push the envelope to help many folks in the OR. The second, is that Dr. Jean will arrive here safely on Monday, and not be overwhelmed by the large Inpt census I have left in his care. The third, is for safe travel home that will begin on Monday, with a two day drive to Conakry, and then 29 hrs of flights and layovers to arrive at PDX Wed evening @7:30 pm. Lastly, despite the fact that this blog will become dormant a few days after returning home, continue to pray for the staff at Hope Clinic as they continue to treat a predominantly Muslim population of patients and witness to them about Christ. I am asking God to help me understand his will for me and whether I should return to Hope to serve or be willing to go elsewhere. Selfishly, I can't wait to return here to serve! Again, thanks to all you Blog Dogs, your prayers are reaching across the pond to this humble Clinic! Jeff

And The Lame Could Walk and the Blind Could See

Three hours into a four hour hysterectomy, Jackie, the Head Nurse on the Inpatient Ward, poked her head in the OR and asked my permission for the young girl with the arm amputation and shattered pelvis, to take a walk. Of course, I thought she was joking, for this girl hadn't walked for 8 wks, and her X-rays certainly appeared as though ambulating was only a dream. Jackie chuckled, and then explained that this girl was actually walking along the sidewalk, visiting with the other patients. I slowly stopped, laid down my pickups and scissors, and said in French, "You say What?!". All four guys in the OR were flabbergasted, and then we all noticed, there wasn't a dry eye amongst us. I had just Emailed the Mercy Ships Organization last night, and their Ortho guy is ill, and wasn't able to operate. There are no ortho folks with reliable skills in the whole country. I went to sleep last night a little discouraged for this young lady. I awoke at 5 am and was convicted to get out of bed and pray for this girl, that God would heal her and allow her pelvis to mend, allowing her to walk again. I was unaware that many others had been praying the identical prayer! All drama aside, this is only explained by God's miraculous power. You ask, why does it take four hours for me to do a hysterectomy? Well, this patient had an 8 pound uterus that was stuck to many other essential organs, and grossly distorted by benign fibroid masses. As four women came into the Recovery Room to see their friend, Jairus came out of the OR, holding her grotesquely deformed uterus for them to observe. They immediately began to sing and dance and grabbed me and hugged me and kissed me several more times than is necessary after slaying a uterus. They then explained that this women had been to 4 different hospitals, and had multiple operations to remove the uterus, but on each occasion, they closed the abdomen, stating that hysterectomy was impossible. She had been bleeding rather uncontrollably for years, and was lightheaded and dizzy all of the time. I then asked them to show me the basic moves of their dance, and joined them until we were all laughing too hard to breathe. We were able to do 2 other small cases as well, and see a few consults in between. Tomorrow, we have hernias, ortho cases, a little plastic surgery, and of course, more wound debridements! I was invited to the village, to Jairus' home, for dinner, which was excellent, after working all day. It was well over 90 today, and the humidity is now up to 65%, which should promise a big rain quite soon. I'm fairly certain that I'm sweating at the same rate at which I'm guzzling fluids. Thank the Lord for the air conditioner in the OR! I'm thinking about sneaking up there tonight and sleeping there! Thank all of you faithful blogheads for sticking with me. Off to bed I go-- I need some rest if I'm gonna keep observing miracles all of the time! Jeff

From the Hope Clinic Trauma Center

Happy Valentine's Day to all my blogging friends and family! What a long day in the OR today, but many were treated, and it's time for God to heal. We did 5 cases today including two more chronic trauma cases from the same accident as Modey. The first is a 15 yr old girl who was scooped up at the scene without parental knowledge, and taken to a nearby hospital where her right arm was amputated just below the shoulder. Fortunately they didnt recognize her other arm was broken. She was also unable to walk. She was brought here by a man who heard we had treated Modey, and knew she was being neglected. On further work up, we discovered her pelvis is shattered as well. We took her to the OR today and opened up the amputation site due to overwhelming infection, and washed several other wounds as well. We cannot address her other broken arm due to active infection, and the pelvis will require a specialist. The other boy is 19, and sustained a horrendous wound to the left side of his face and scalp. The left side of his scalp is gone with his skull exposed, and his left ear is no more. His jaw is badly broken, and we had to debride infected bone from his jaw. He cannot open his mouth very widely and has many cavities that predate the accident. We cleaned every thing up today and plan to bring him back to do it over again, and pull out all of his rotten teeth. Our goal is to contact the Mercy Ship Organization and ask them to consider taking these two kids for further repair. This is a huge prayer request, but our God knows no limitations. Tomorrow we have another full day planned in the OR, but the crew loves to work, and have been up to the challenge. The weather was hot today, and the humidity is returning, which I'm told means we should expect some big African rains soon. It would be nice to be able to walk around without my tongue being coated with dust! Dan and I had a wonderful dinner with Jon and Anja Erikson tonight in the village. I was also able to Skype my lovely bride as well, which is almost as good as going out to dinner, and much cheaper!! The Lord is faithful here at Hope, and wherever you are as well. Do not give in to doubt, fears, or your own limitations-- you will only miss out on a chance to observe Hisnpower and glory! God Bless, Jeff

Peace Within the Storm

Another unbelievable day here at Hope Clinic. We were asked to see many new consults, which has led to a request from the staff here to operate on Friday, which is not the standard. All in all, we have @ 20 cases to do in the next 4 days, which may overwhelm the holding capacity of the inpatient ward. A gentlemen who heard that we had cared for Modey and his orthopedic injuries, plucked two more teenagers out of nearby hospitals and brought them here for us to see. Their injuries are horrendous, life-changing, and heartbreaking. I havent the strength to relate to anyone the extent of their injuries, but will be bust better defining them tomorrow. Please pray for a 15 yr old girl, and a 19 yr old boy tomorrow as we operate to save them from life-threatening infections, and then better understand what reconstruction they will require. At one point this morning, we were being pulled in many different directions, and I asked Jairus and all of the people competing for our attention to stop and pray that we could work together as a team. The African culture appears never to be in too much of a hurry, until everyone wants something done now, and then there are no rules of engagement, usually allowing the louder voice to win. Once our prayer had ended, I taught my consultants the art of triaging, and before noon could pass, we had seen 20 people efficiently and thoroughly, drawing out plans for all of them. I learned a great lesson from Jon last week in the OR, and God was faithful to provide great peace within the storm that is the hectic nature of a Monday in any medical facility. The afternoon allowed me to go back and do a secondary survey of all our patients, and assure they were tucked in nicely and safely. I covet your prayers for me and the OR crew this week as the pace will be quicker than they are used to, but they are excited for the challenge, and want more than anything to treat these new pts and watch God heal them. God Bless, Jeff

We Treat, God Heals...

We were greeted by a beautiful sunrise that burned through the dust for the first time in a week. It is noon now, and the temperatures have already climbed well over ninety degrees. The day started with Rounds, and the Lord continues to bless all of the patients in the healing process. There is a lady here who has been here for the better part of two weeks that arrived very ill, but has been improving slowly. We had talked yesterday about further testing that would need to be done in the nearby city to evaluate her for rare causes of her sickness. She was transported to the city, had blood drawn, and preliminary studies demonstrate that she may be HIV positive and maybe be suffering from sequelae of AIDS. She will be sent back to the city tomorrow for further testing, and if preliminary tests are confirmed, she will remain there for treatment. I learned that most believe that there is a 20% rate of HIV positivity in Guinea, quite low when compared to eastern and central Africa, but significant, just the same. Pray for this women and the thousands of others who suffer the effects of this horrific disease. The church here in N'Zao is holding educational meetings about AIDS next weekend, and my friend Jairus will be teaching, and would appreciate your prayers. We received news today that a major workers' group has announced a working strike for tomorrow due to dissatisfaction with the government. Usually, because N'Zao is so remote from Conarky, the Clinic is rather unaffected, but there is a chance that some workers may choose to stay home if they feel it is too dangerous to travel. Fortunately, Mondays are non-operating days, and we may only be affected by several more no-shows than normal. It's just a reminder that political unrest is prevalent all over the world, but God remains in control. I learned today while at church, that the motto for Hope Clinic is " We Treat, God Heals ". This is just the simple summary of which I have been writing to many of you. I came across a book in Dr. Yaraduono's library entitled "The Hand on My Scalpel" written by Dr. David Thompson, a gentlemen who has served in Africa as a surgeon his entire career, spanning well over 30 yrs. I read it in a single sitting, and must relate to you that it is one of the best books I've ever come across. It is tragic, yet humorous, and an excellent portrayal of many of my own experiences over the last two weeks. I encourage you to get a hold of a copy, and enjoy. A visiting pastor from a nearby town spoke today from Luke 8 and described the story of Christ ordering the storm to calm, saving his disciples from certain peril. His point was to keep our eyes fixed on Jesus, which is the exact summary that my friend Jairus presented last week from Mt. 14. Both men emphasized that when life takes a turn for the worst, we must stay focused on our Lord, and not our own abilities. I shared with my wife, earlier this week, that while trying to repair Modey's femur fracture, we came to an impasse, discovering we could not get the two ends of the femur to align. Jon Erikson, one of the founders of Hope Clinic, had asked to scrub in with us that day, having taken a special liking to this boy. When I shared with the crew that day, that I was unsure of how to adjoin the ends of the femur, Jon quietly asked permission to pray. We all stopped, laid down the instruments, and bowed our heads as Jon prayed. He asked for wisdom, God's power, and healing for Modey. It was a simple prayer, but when completed, God had given me a thought to paralyze the patient who was under a spinal anesthetic only, in order for the muscles to relax. The medicine was given, and shortly thereafter, the two ends were realigned, and available for plating. After all was done, Jon credited me for my calmness, courage to take on a case outside of my training, and unwillingness to succumb to discouragement. I quietly shared with Jon that it was his willingness to stop and pray, to call upon the Mighty Creator and Great Physician that allowed us to help Modey that day. Do I think it is a coincidence that the only two sermons I have witnessed in Africa both emphasized fixing our eyes on Jesus? I know my own conclusion, and allow you to establish your own. The rest of today should allow for reading in preparation for next week's cases and some time to relax as well. I have great anticipation for what God has in store for us this week. Thank you all for your time and energy to stay in touch. God Bless, Jeff

A Day to Unwind

For the first time in 5 days we were able to observe the sunrise and sunset as the dust slowly moves on. It was warmer here today, eventually up to 90 degrees, but remains very dry. The day began for me at 5:30am with the opportunity to Skype with my family, including my parents. Everyone looks well, and fortunately it sounds as though they have few plans for the weekend which should afford itself to much needed rest. I rounded with Jairus and Dr. Simeon at 8am and then Lori, Dan and I, along with two other ladies headed for N'Zerekore, the second largest city in Guinea. After clearing a single police roadblock we entered an extremely dusty city bustling with activity. There were more motorcycles than one could possibly number headed in very direction on either side of the road. The road is in poor condition with the loss of asphalt quite some time ago, and potholes that could pulverize the front axle of even a large truck. There are no traffic lights, no stop signs, and no street signs indicating any kind of order. As we entered the market area, we found a parking spot in front of a small shop and commenced with shopping. I learned early on to keep my mouth shut to avoid mouthfuls of dust, later learning that this is a very common manner by which to acquire parasitic infections. It was a blast walking from vendor to vendor, bartering the price of several souvenirs and food items. My friend Dan is an amazing shopper and I am fairly certain he could put some of you ladies to shame who consider yourselves to be professional shoppers! In fact, he would argue that he is not a shopper, but instead, a professional buyer! I found most of the shopowners to be polite and engaging, some of them quite proud of their ability to speak English. I even recognized four people in town who I had been involved with concerning visits to Hope for medical care. After 3 hrs of wandering the market, we grabbed some beef swarmas (sandwiches) and headed home for lunch. My afternoon was rather simple. I fully intended to read for pleasure, but awoke 90 minutes later feeling refreshed. We all showered and then headed back to the big town for dinner. We ate at an establishment that is well trusted and enjoyed a time of lively discussion-- in English! The food was rather good and on average we spent @5$ per entree. As dusk approached, we quickly headed home to avoid having to drive in the dark. The sides of the roads are littered with motorcycles without functioning taillights, some with a family of four aboard! Pedestrians are at the bottom of the totem pole when it comes to the culture of travel and know to step into the bushes when cars and trucks approach. All in all, a good day to experience the sights, food, culture and friendliness of Guinea. I anticipate another fantastic worship experience in N'Zao tomorrow, and may even find time for more rest as well. Thank you all for your kind words and willingness to give of your valuable time to encourage me and my family while we are apart. You cannot know how much it means to me. Jeff

A Quiet Day at Hope

It was a peaceful day at Hope today as the dust slowly moves on and the sun returns with the heat as well. But still no no rain as yet... Folks here can't remember such a long period of time without rain. I have nothing to compare the weather to except I know it is a lot colder in The Dalles! Fridays are clinic days here, thus the OR is quiet, which is good for the staff after a long but productive week. I told the crew I am praying for a relaxing weekend for them, as we have many people to help next week. We may actually fill all of the inpatient beds depending on the ability to get others home. All postoperative pts are doing well and are very grateful. I explained to Modey today that I have 4 sons at home and that they, my wife, and all of my family and friends are earnestly praying for his recovery. Tears flowed down his face as he softly choked out a heartfelt "Thank-You". He was very worried this am that I would have to operate on him later to take out the plate we had placed to repair his leg. Once I explained that the plate would remain indefinitely to aid him with his recovery, his eyes lit up and his smile returned. God continues to soften his heart and strengthen his broken body. His spirit is beginning to regenerate and his will to succeed is evident as he works diligently to strengthen the leg that was partially amputated so that he might have the opportunity to be fit with a prosthesis and walk again. Secretly, I am grateful for a shorter day as it has been a long but profitable week. Sleep has been scarce as I share my bed with several orthopedic texts in order to be prepared for the tasks at hand. Tonight my goal is to make it to bed early, as I have plans to arise at 5:30am to Skype my family. I don't understand the technology behind Skypeing, but it has taken the sting out of being away from my family. Who knew you could communicate so freely from the jungles of Africa?! The staff here is insisting that I stop working this weekend and go to N'Zerekore, the big town nearby, and experience the market, the food, the smells, and Guinea at its finest. I look forward to worshipping again at the church in the village and listening to the children's choir. Thank you to all who blog often! You are strength for me when I have none to give. Jeff

Here are a few new pics!!

The line of folks waiting to be seen and evaluated

baby before hernia surgery

baby after surgery :)

Jairus (interpreter/nurse anesthestist) with baby

Dan Erickson - from Alaska, there doing plumbing/electrical work

More Drill, Plates, and Screws...

Hello to all of you faithful bloggers! Had a wonderful day in the OR fixing hernias and also fixed a fibula fracture as well. We found the chuck for the drill which really took all of the fun out of the case because it went so smoothly. Ok, not really, this bone stuff is pretty fun! We are quickly filling all of the inpt beds, which creates an amazing buzz around the Clinic. So far, all of our pts are healing and happy. Modey, the boy with the repaired femur, had a fair amount of pain today, and would certainly benefit from your prayers. We are officially done in the OR this week with elective schedule-- I'm hoping for emergency cases, of course-- but we have many clinic consults to see tomorrow. While I was fixing the fibula fracture today, Jairus, the anesthetist, was witnessing to the pt, who was very interested in what he had to say, and asked many questions. Spinal anesthesia is truly amazing! Thank you all for your prayers. Until the next time... Jeff

God knows exactly what we need

Today started in an interesting fashion. Two of our 4 OR pts did not arrive, and the 7 mth old with the hernia arrived with a full stomach, so we had to reschedule til tomorrow. That left us with only the femur fx to do. We did find the power drill, and then took two hours to sterilize all of the equipment. We finally made an incision at 11:17am, and by 3:15, we were finished. What transpired in the middle of those two times, is nothing short of a miracle. Once the fx was exposed, and the large bone callous was removed, we were forced to paralyze and incubate the pt in order to reduce the fracture. It required 4 people to work together in order to bring the two ends in line and then three people to hold the bone as I began to drill. However, we were unable to find the chux(sp)to tighten the drill, and despite my best efforts, the drill bit kept slipping. Eventually, we were able to use two tools that aren't normally associated with drills, and the bit held, and the plate was placed and held the femur together nicely. Even now as I write this, I'm fighting to hold back tears of joy because of the end result, and because we all felt God with us today in the OR... The dust is beginning to move on and we did see the sun for the first time in two days. We expect to receive many upper respiratory infxs this week because of the dust. The clinic was quieter today. God certainly allowed me to focus on just one boy, just one case, just one broken leg, just one young man who may get to walk again... Never will I question again whether God knows what is best for me. Thank you all for your prayers for He was close today...

A great day in the OR...

We had a very profitable day here in the OR. We were able to help a lady today who has been bleeding uncontrollably for years that has also had significant abdominal pain as well, by performing a hysterectomy. Another gentlemen had a huge mass on the back of his head for 30 yrs, and we were able to remove this well. He insisted we do it under local anesthesia, and then he tolerated this without a single complaint. Tough as nails... We were also able to see 5 new consult in b/t cases as well. Tomorrow, we have 4 cases, which may be a stretch, but should prove to be a good day. If we can locate the power drill, we plan to repair the young man's femur. We received another young man with a fibular fx that is two months old, that we hope to address on Thurs. All of our postoperative pts are doing well thus far due to consistent prayer. We awoke this morning to overcast skies, however, it wasn't due to clouds or fog, but instead, it is due to massive duststorms that are blowing in country from the Sahara, called the Hamartan(sp?). According to the staff here, it has never been this bad. We all walked around today with dust filtering into our nasal passages, coating our tongues, and filling our lungs. Someone believes there were a few raindrops today, but not the storms to which they are accustomed. We ate dinner in the village tonight which was white rice, with a spicy chicken based sauce and green salad. It was excellent. We are eating well, to the point where I'm not losing as much weight as I had hoped. The folks here are wonderful hosts and have bent over backward for us. Thanks again, for all of your prayers and heartfelt words of encouragement. Until tomorrow... Jeff

Just Another Manic Monday...

What a fantastic day here at Hope. It was a little cooler (85F) and the clinic was hopping. We were able to see 12 new consults today and do two cases on a non-operating day. I began sending some of my first few pts home today with successful results and having heard about Christ's love despite their Muslim background. Folks here are genuinely grateful for good care and a caring heart. It was hard to see them go as well as their families. As I continue to prepare for Wed's femur repair, I inherited a gentlemen who was struck by a car while riding a moto who broke both of the bones in his lower left leg. He was admitted to the "trauma service" today and hopefully we will be able to address his fractures on Thursday with the decline of some of the swelling. I also saw a women who fell and shattered both bones in her wrist on Christmas day, and decided that since it still hurt, she would come and see if we could help her. I, again, have sent pics of X-rays to my international consultant in The Dalles, and hope he can guide this poor, hapless general surgeon through these two repairs as well. Man, what I would do for a bread and butter general surgery case right now! We did actually do an emergent appendectomy today, which was the first open appy I have done in over 7 yrs. I kept looking around for someone to hand me a laparoscope. Ahhh, the good ole days! The Staff here never ceases to amaze me. They are so flexible as demonstrated by two different translators who were willing to go in two different directions with me as we walked around from office to office to see all of the new pts. The OR crew doesn't normally do cases on Monday, but we're thrilled to drop what they were doing to help. The gal in the lab who was drawing all of the blood samples, covered for the guy in Radiology who was out today, and did all of the X-rays as well, all the while laughing and singing as if she couldn't be happier. God's joy and peace are demonstrated in the middle of chaos and sickness on a minute by minute basis here. Thanks again for all of your kind words and encouragement. You are all greatly appreciated. Jeff

A refreshing weekend in Guinea

The last two days have been good for rest, study, and time to get to know the folks at Hope who God is using mightily. Saturday and Sunday mornings began with rounds on the Inpatient Ward. This has allowed me to get to know these pts more personally as we educate them concerning the healing process and share laughter together as they begin to accept my presence here as their physician. Saturday included a short trip to Lola, a nearby town, to visit a young couple with 3 small children who recently were led by God to relocate here in order to translate the Bible into one of the local dialects. Sunday allowed for a chance to worship at the church in the local village of N'Zao. The children's choir was outstanding and the drums were LOUD! It was awesome to watch people worship the Lord without concern for what others might think. A couple was presented before the church who had recently converted from Islam and had been forced to move to N'Zao because of persecution in their home town. The leaders of the church exhorted the congregation to support this couple with prayer, money, food, or whatever resources they had. My friend, Jairus, the anesthetist, gave the message from Matt 14 about Christ and Peter walking on the water. It was a powerful message, and a great example of how leaders in the church must be willing to teach. I hope this afternoon to have time to "go shopping" in the warehouse in order to identify available resources for repair of a femur fx. I have had contact with one of my ortho colleagues in The Dalles, who has provided me with valuable advice and encouragement. We hope to do the repair on Wed of this week, giving this young man ample time to heal from his amputation. This week poses to be a challenging and busy week-- which is my personal preference. It is 90 degrees and dry here, much like July in The Dalles, and I am continually grateful for the fan in my room which allows for a comfortable environment to study and sleep. Stephen and Lori Albright are my host family while here. Stephen is the Hope administrator. Lori has been feeding me well and assures that all is well. Pray for this couple and their daughter, Hannah, that God will provide strength, health, and wisdom each day. Again, I'm indebted to all of you who have been so kind to send notes of encouragement and uphold me and the Hope Staff in regular prayer. This would be a much different experience without your support. God bless, Jeff

The Internet has been resurrected!

You don't know what you've got til it's gone! The Internet has not been functioning for @24hrs here, which has caused me to remember where in the world I am and how grateful I am to be able to communicate with friends on the other side of the world. It's hard to believe that the end of the first week is coming to a close. We were able to see many new pts yesterday with plans for many surgeries next week. I just finished rounds this am with Dr. Simeon,the medicine physician, which was good for me. I have quickly been learning tropical medicine, and have had to forget about a lot of typical American diseases. I am getting to know my pts well and their families. The young boy who required the amputation is doing well. He has amazing pain tolerance. We continue to make plans for his femur repair this upcoming week. I covet your prayers for the planning process which will be crucial for success. The last couple of nights have been conducive to sleeping with the cool weather. The temps have been in the 60's, which allows me to have a few hrs when I'm not sweating continuously, but causes the folks here to arrive in the am wearing their winter jackets. it has been beautiful and sunny without a drop of rain since my arrival. I've been told that it hasn't rained here for over two months. The staff at the Clinic are incredibly generous with their time and we have had the opportunity to eat in several homes and enjoy the local cuisine. The Albright's have graciously invited me to travel to a nearby village to visit with a young couple who are attempting to start a new church. I'm excited to see a new village and mingle with the people. Sunday should be awesome, with the opportunity to go to church in the village. I'm grateful for the weekend and the rest. I'm also thankful for your prayers and correspondence, which have served as a great encouragement. God bless, Jeff

The Internet has been resurrected!

You don't know what you've got til it's gone! The Internet has not been functioning for @24hrs here, which has caused me to remember where in the world I am and how grateful I am to be able to communicate with friends on the other side of the world. It's hard to believe that the end of the first week is coming to a close. We were able to see many new pts yesterday with plans for many surgeries next week. I just finished rounds this am with Dr. Simeon,the medicine physician, which was good for me. I have quickly been learning tropical medicine, and have had to forget about a lot of typical American diseases. I am getting to know my pts well and their families. The young boy who required the amputation is doing well. He has amazing pain tolerance. We continue to make plans for his femur repair this upcoming week. I covet your prayers for the planning process which will be crucial for success. The last couple of nights have been conducive to sleeping with the cool weather. The temps have been in the 60's, which allows me to have a few hrs when I'm not sweating continuously, but causes the folks here to arrive in the am wearing their winter jackets. it has been beautiful and sunny without a drop of rain since my arrival. I've been told that it hasn't rained here for over two months. The staff at the Clinic are incredibly generous with their time and we have had the opportunity to eat in several homes and enjoy the local cuisine. The Albright's have graciously invited me to travel to a nearby village to visit with a young couple who are attempting to start a new church. I'm excited to see a new village and mingle with the people. Sunday should be awesome, with the opportunity to go to church in the village. I'm grateful for the weekend and the rest. I'm also thankful for your prayers and correspondence, which have served as a great encouragement. God bless, Jeff

Here are just a couple of pics Jeff sent.  I got his messages and am currently
trying to get a hold of the ortho surgeon Jeff always texts when one of our boys gets a fracture!  Unfortunately we've had 5 broken bones this year so we've kept him a little busy.  Hopefully, they will connect and be able to help this kid.

The antiquated x-ray equipment!

one of the xrays from the kid with the old femur fracture.  Jeff says they will wait to try to fix the femur until next week to give him time to recover from the completed amputation today.

Truly a Humbling Day

Ive always believed everyday in the OR is different, but today strengthened that conviction. We were able to do 3 fairly standard cases efficiently, however that came to a screeching halt due to our next new consult. We were asked to evaluate a 17 year old boy who was struck by a drunk driver 6 wks ago. There were approximately a dozen related fatalities at the scene. He was scooped up and taken to a nearby hospital and was found to have a badly fractured ankle. This was unfortunately treated by amputating his leg immediately above the ankle with the wound left open. His parents heard about Hope and drove him here today for help. He also has a left femur fracture that was not reduced appropriately, and the bones are not aligned. He appears to have a wrist fracture as well. We were able to convert his amputated leg to a more formal below the knee amputation, that when healed, will allow him to be fit with a prosthesis to walk again. However, there is the issue of his femur fracture... I have been attempting all day to send Jen pics of his X-rays so that she can show them to an ortho surgeon. The Internet connection has been difficult today. There are no ortho surgeons in Guinea. My hope is that he can instruct me in the best way to manage this femur fracture. I have not been involved in a femur repair for @ 15 years, thus am out of my element on this one. Fortunately, the surgeon here has two excellent ortho texts that I am currently reviewing. Some of you have asked how you can pray... Please pray that the Internet connection here will allow for transfer of these X-rays to the US for review and consultation. Also, please pray that we will be able to help this young man as best we can to allow him an opportunity to walk again. James 1:5 says, If any of you lacks wisdom, ask God... And it will be given to you. Again, thank you to all who have been sending notes of encouragement, and who have been upholding us here at Hope, in your prayers. If I miss answering any of you, please stick with me, and I will keep trying to become blog-savvy. Jeff

Here are a few new pics from Jeff...

the picture hanging above the entrance to the OR



Agnes is a very good scrub tech

OR

Recovery

 Central Clinic Courtyard

Eighty degrees and sunny again...

The people at Hope continue to amaze me with their ability to show love and concern for every individual who arrives to be evaluated. Today was a slow but profitable day in the OR, which allowed us to evaluate several walk-in pts for surgery tomorrow and next week. Some folks come from 100's of miles away, from towns that have bigger hospitals, choosing to be seen here because of the impeccable reputation of Hope Clinic. People come prepared to stay for surgery the following day in order to avoid the added expense of returning home. Some are dropped off at the clinic and instructed not to call for a ride home until they are "fixed". The OR team is a very friendly and eager group that is prepared to work longer hours in order to learn more about surgical technique. Jairus, the anesthetist, has served as my interpreter for every pt interaction since my arrival, and finds a way to keep smiling despite the quick pace that we maintain in order to see as many pts as possible. Pray for rest for him at night and renewed energy each day in order to put up with me! Guinea is currently enjoying the dry season and most days see bright sun and 80-85 temps with nighttime temps of @60 degrees. I have been promised that it will rain while I'm here, and that there is no rain comparable to an early season African downpour. I'm slowly acclimating to the heat and now able to see pts or operate without losing 5 lbs/day due to fluid losses. Thanks to all of you who have been responding on the blog or sending other Emails. We have plans to go to the village for dinner again this evening, so until tomorrow... Jeff