Two weeks is a very long time in mission

They say that you have to be polyvalent to practice medicine in Africa, but there are some things that you just can’t get training in. Mark is now trying his hand as a used car salesman, not an easy task at the best of times but the vehicle in question, an old Toyota that is surplus to our requirements, poses one or two extra problems. It has been parked for 3 years as it has a broken automatic gearbox which cannot be fixed or replaced and will need to be switched to a manual box by any purchaser . We wanted a picture of him in action, complete with large smile and firm reassuring handshake but sadly the guy who said he was interested if he could hear the motor run didn’t turn up today .
So what does this have to do with being a medical director? The answer is money. We are hoping for a good price as it’s not a cheap business setting up a hospital. We are now at the stage where we have sorted and counted all the equipment and supplies that have been sent as donations in the containers from the USA and know what essential equipment still needs procuring so that we can open in November. In addition we need a stock of drugs and a financial reserve to pay the salaries for the first few months. In the current economic climate any source of funds needs to be explored.

Chad, as you know, is a landlocked country so any importing drugs will be even more difficult than it was in Guinea. Therefore we will be trying to get our pharmacy supplies locally. There is a National Central Pharmacy Warehouse in Ndjamena and we have been encouraged by our first order which was for emergency room and operating theatre drugs. There were only 3 or 4 items not in stock but as they are the only suppliers for these in the country and they are essential for anaesthetics and childbirth we will have to hope that they have some for next month. If not we have to commence the difficult process of importing controlled drugs. For tablets although they do not have all the stock there is also a private Indian company who have a good supply of bulk generic medicines ( in boxes of a 1000) at a comparable price. Otherwise there is an expensive private wholesaler that sells medicines in individual patient boxes at a much higher unit cost that will be difficult for the poor to afford. This is worth praying about.

Despite the rain we are still managing to build as most of the work is internal alterations. With a bit of imagination the building which was first planned as a Lab and X ray block, and then built as an operating theatre with a very large recovery area is now being modified by the addition of a few walls and shelves and work surfaces to be a good operating theatre and maternity delivery ward . As many drugs should be stocked below 25C and nearly all below 40C we were pleased to find an air conditioning unit in a container and have installed it in a pharmacy stock room. The room also has shelves for our drugs made out of concrete to discourage termite attack. The laboratory now has work surfaces awaiting tiling.
In accordance with local practice an advert to recruit staff has been placed at the National Employment Agency and they have diffused this by radio and applications arrive daily. Soon we will begin selecting and training we’ll need wisdom and discernment as there is plenty of choice .
A visit to Meskine, Cameroon has provided a good insight into how to run a financially self sufficient hospital. CEF president, Bert Oubre, was one of the founders, hence the visit. It has many systems that we may want to use or adapt. We have already visited 2 local Chadian hospitals so ideas are coming together.

Whilst in Cameroon we had a great weekend walking in a land of extinct volcanoes and passing through a wildlife park with glimpses of warthogs and giraffes despite it being rainy season, Ruth and Rebecca have more on their blog.

That’s the second time we’ve mentioned rain and its still coming providing fun slipping on the wet clay to the main road. Apparently the rain was late again this year and then so heavy that the Sahel has both droughts and floods in different places. The consequences of further poor crops in villages that have little reserves can be catastrophic. We are sheltered from this in the capital and prices just alter a little but they do naturally with the seasons too. Please find time to look up and pray for those struggling with the climate in Chad and across the Sahel .