Its Party Time

December the 9^th  2011, its one year since we opened   and that is  an excuse for a party which means food and drink here in Chad. So at 12:30 we all stopped work and we enjoyed a sandwich and a soft drink together.                   

So it is time to reflect and ask what has been done in 2011 .  About 10 000 new out patients have been seen, over  300 operations performed   and a similar babies have been born.  We have sought to not only bring physical healing to people but also witness to the love of God as revealed in Jesus to them. In His name we have prayed as the occasions arise and for the past couple of months  on a Tuesday morning at the bedside of each patient, thanking God for his gift of healing.

Soon it will the biggest party of the year as we celebrate the arrival of Jesus into the world.  How should we celebrate?  Have Father Christmas arrive in a boat as in the hand painted card we found at the artisans market in town? Perhaps not. Our plan is  to stick to the real story  and act out the Nativity  with the staff miming to a sound track  pre recorded in Arabic, then party again with food and show the Jesus  film.

This year we hope to also join the party at our nearest Church, 6 miles away, where there will be a Christmas eve  event  with songs and plays to the small hours of the morning and a big party on Christmas day afternoon. We need to catch up on last year and   I am not planning on spending the day in bed with typhoid again.

Our wish for you and us this Christmas and coming year is that we will be constantly be able to celebrate the coming of Jesus into our towns and cities throughout the world.

Enjoy the party as you celebrate

80,000CFA

What can you do with 80,000CFA (around £100) in Chad?

It struck us the other day as we were reimbursed for a patients hospital fees by another missionary and then started to prepare the showing of the Jesus film in Arabic that this sum could be used for many different things.

For instance providing bread meat and sucrerie (coke and fanta) for about 60 people we hoped might turn up to watch a film,. We have just finishes building the kitchen area for the care givers village a place where they can cook and have shelter to sleep at night. So how better to celebrate than to eat and show a film.the story of Jesus told by a doctor, Luke.  Outside under the stars weather nearly guaranteed apart from the sand storm as we were clearing away. French bread barbecued meat and coke( nearly MacDonald’s) and around 100 people gathered to watch the life of Jesus projected onto a white washed wall .It was fun and seemed to be enjoyed by all we pray for its impact on lives we want to touch with his love and not just his life.

A few days previously the same sum of money had been spent in a rather different way. Ndjamena is an expensive city for luxury items. The new 1/2 price special offer rates at the Novo hotel providing a swim and a snack by the pool and a swim for 12,000 CFA each. Six of us enjoyed ourselves at the pool on a Sunday afternoon. A place that seems like a million miles away from Guinebor II and a good occasional relaxation. It seemed the afternoon would last forever until a huge storm came sending us all rushing for shelter and we hoped a drink until in true Fawlty towers style the waiter arrived and told us that everything was ‘OFF’ except orange fanta However the ice cream was a good substitute.

On a more everyday note our new tariffs at the hospital mean you can have emergency major abdominal surgery for the same price. All drugs and materials included. This might sound strange but the free emergency treatment at the government hospital often seems to include a hefty pharmacy prescription to be bought elsewhere. We have operated on quite a number of emergency cases now gun shot wounds with damaged bowel, Amoebiasis effecting the whole of the large intestine and needing a temporary ileostomy and what seems to be very common here intusception where one part of the bowel gets stuck inside the other causing bloody diarrhoea and eventual necrosis of the bowel. This last illness is half price as it occurs in children.

Finally the case which started these thoughts of this was a boy of around 12 paralysed from the waist down after a car accident he was brought to us by another missionary because of large severely infected bed sores after a rather long stay and several operations he has eventually gone home his sores nearly healed. He left just in time to get back to school in his self propelled wheelchar having spent his entire long summer break at the hospital.

I could go on but the hospital is busy as ever and so time to get back to work. I need to see another 55 out patients at 1500 per consultation to make the next 80,000CFA.

Retreat , Relaxation ,Return

Three words which sum up the last few weeks here in Chad and Mali too. We RETREATED
to Mali at the beginning of July leaving the hospital in the capable hands of two American doctors Mike and Noel , Mona and Tricia 2 nurses and Ward administrating along of course with all our Chadian nurses and midwives and other colleagues. It was a rather round about trip via Ethiopia as you can see if you look at a map This was then followed by the BMS spiritual retreat Psalm 84 5-7 Pilgrims , change-makers and visionaries were themes developed by Philip Halliday and inspired us to look again at our work in Chad .

RELAXING
surroundings a pool and fun for Ruth and Rebecca with Rebecca North and Rosemary Halliday helped as well.Then it was time for rest we spent 5 days exploring the delights of Bamako this included making new friends, a very good park with trees and grass a very strange thing , an interesting museum an ice cream parlour with 36 choices and a natural bridge that could be climbed on. Also some good supermarkets to find rarities like sausages to eat !! The trip back ended with a night in the Hilton in Ethiopia not sure which VIP the Airline confused us with but the strawberries on room service were good.

RETURN
meant back to work with a rush as a lady needed a forceps the night we arrived. Mike left on the flight we came in on and Noel the next day so a handing over ward round had to take place straight away. The next day we were operating and it wasn’t until the following weekend that things slowed a little. We have had a lot of malnourished children and this weekend has been the sugar and snake weekend .The first was a little girl gone home the day before and back in after vomiting overnight with a blood sugar of 1 she woke up quickly with some intravenous sugar and is receiving intensive feeding on our malnutrition programme now.A lady then arrived with a really high sugar level seriously unwell but thanks to our medicine in Africa book with advice on how to treat comatose diabetics in low resource situations she is beginning to stabilise, but no rest the next case through was a man who had been bitten on the finger by a snake. We thought we could treat him with our stock of 2 ampoules of anti-venom but then discovered we needed 3 more ampoules. His family could only find one more in town and has just a badly swollen arm so we are hopeful he will do well.
The only thing that has been missing is rain and whilst we were away it was very hot as it didn’t rain at all .It is still much drier than last year and although it might sound good to you on summer holidays here it is needed for the crops. We hope it comes soon.
Well the RAIN
has come now in the couple of weeks that it has taken to post this blog, lots and lots every day. The frogs nearly deafened us with their delight and the roads are interesting, even going to church is an adventure .A 180 degree swerve in the mud meant we nearly turned back but we reached the road safely if not rather slowly. Then it was time to park the car near church and

walk. Two minutes out of the car and I was on my back having slipped , (who needs ice)not deterred we continued. Next was a floating flip flop as we tried to jump over the puddles and thick mud. Mark bent down to get it and his mobile was in the puddle .(It still works) Another stuck flip flop recovered and we arrived at church to wash our feet under the pump with every one else. Church was half empty due to the rain its like snow really and the service just getting going. No rest for us though 20 minutes later we were called back to the hospital a baby with tetanus. This time I went bare feet and carried the flip flops

The baby is possibly turning the corner as we write but still very sick. All pregnant women are supposed to be vaccinated but they don’t always mange it and it’s especially hard at the moment as the Government has no vaccines which we found out when we tried to get some. That and the malaria season arriving as the free supplies of malaria treatment are difficult to come by and none available for sale in the Government pharmacies doesn’t make life very safe for women and children here. We have managed to get some in a private pharmacy not too expensively we are relieved to say.
A final progress report on our patients the diabetic lady has gone home well, also the malnourished baby did amazingly well and the snake bite man too will just lose the tip of his finger, all good news our only problem is we need some more of the second R !! The quiet August we expected with Ramadan and rain has not really happened roll on September and the return of Michaela.

What’s new at Guinebor II

The Weather?
Well now we have been here for a year so the weather reports may start to get repetitive .The heat is back again and we are sleeping out on the veranda, it seems we may be a little adapted or is it really cooler this year Still at times we are totally drenched and need seemingly gallons of water to drink.

Ward and Mona?
We have new arrivals living opposite Ward and Mona have come from the States for 6 months. Ward will work on finance and administration with Ndilmbaye and Mona is a nurse/midwife so is helping around the hospital and learning a little Arabic , it’s good to have neighbours again and to share ideas and plans.

The Nurses ?
Two are new as we have made some changes in the nurses working pattern. This means we now have a nurse anaesthetist who also oversees the wards and a fixed nurse in charge of dressings and emergencies. Two nurses consult each day and slowly but surely things are taking shape. We are still busy and had our first twins 5 days ago we were also excited to have a little boy go home today. He weighed half as much again as he did when he arrived suffering from dehydration and severe malnutrition and he walked home instead of being carried.

The President?
There were elections last month but nothing new there, the president was re-elected in the first round with 82% of the vote. Most people seem quite happy and a big celebration in town passed off peacefully.

Marching?
This time Mark managed to walk down the presidents’ road for a march for May day he even managed to wear the correct material, it went well and watermelon from the back of a cart, coke and sandwiches just rounded things off.

Our first Easter celebrations in Chad?
On Good Friday we showed the Jesus film in Arabic at the hospital it went well despite the dvd not working initially and Mark consulting until the last minute. We gave out peanuts dates and coke (narrowly avoiding giving it to the Diabetics). Easter Sunday celebrations at church started at 5.30 am with a service and then later in the day an outdoor celebration which was apparently a first- all groups were invited to sing and we sang with Ndilmbaye and a few other English speakers for the multilingual part. Later we even had some chocolate eggs which had to be eaten straight from the fridge. They were mini ones. The handmade ones for sale in the Café in town seemed a little incongruous and were out of price range especially as they risked not making it home.

Our new home?
Our house is coming on well with a roof and plastered walls and even the wood frame for the ceiling. It is fun to see our plans working out well. Mark does regular quality control checking that the plans are followed. The doors and windows are now in the right places. He spotted that the ceiling was sloping in the girls bedroom, but was inclined to let it pass as he didn’t want to be too fussy. But then Ruth spotted the same error. When measured one corner was at 2.90m and the other 3 corners at 3.00m. It looks better now.
All that is needed are windows, doors plumbing and painting so still a bit to go! All the same it’s getting exciting and we are looking forward to moving in.
Kittens and Horses?
Yes more kittens three this time, I think we need to find a vet quickly or we will be running an animal hospital. We even have a pet Chameleon who lives on the bush outside the front door and looks after himself. Ruth and Rebecca enjoyed their first horse ride in Chad last week at an open day for the French riding association in Chad, they hope to ride again at a farm owned by a Swiss lady and her Chadian husband. The bare backed riding display was impressive but I don’t think they will take it up !

Flying Doctor?
Mark has always had a secret desire to be a flying doctor and he had his chance. He didn’t get to fly the aeroplane but at least he sat in the co pilots’ seat on the flight out. He flew to Mondou in the South of Chad to accompany a sick medical student. He enjoyed the flight although it was a bit bumpy on the way back as they flew at a lower altitude. The patient subsequently went to Europe and is well.

So thats what is new with us, what about with you?

We’re singing in the sun

It’s 8am the 7th of March and for those of you who don’t recognise the date it’s the day before International Women’s Day . As usual we didn’t quite get organised, we had started several weeks before to try and get material and register the hospital to march in town but here we are no material and not registered suddenly its all action and before I know what’s happened everyone decides we can walk in our nurses uniform s and we can somehow still register.
By lunch time we have an official programme and several nurses go of to hear Madame the President speak about the right for every women to an education and training. The banner is organised and the after walk feast too. Somehow everything in Chad has to be last minute to work.




The next morning the girls are looking hassled as an endless stream of complications with uniforms that are not ready or available a banner that hasn’t arrived and Gislaine who can’t squeeze into her new dress mean they risk to be late for school ,eventually everyone is crammed into the car and we set off.


Apparently its fine to arrive at 7.30 not 5.30 am as the information said and which I was glad about , we change into our uniforms in a corridor behind the Mayors office only to be told that’ Sante’ is meeting down the road outside the new Mother and Child hospital with its 7 as yet unused ambulances parked outside ,we move on rapidly and eventually find some more nurses all ready to march- for what exactly -well maybe just to have some fun together and show that women can have qualifications too. Not a bad thing in this country where many of our patients are only allowed out of the house when fully covered and if their husband allows.


After a long wait being entertained by a man
dressed as a pregnant monkey dancing and given emergency sugar cubes to keep us standing by the Red Cross .We are off and ‘Mind you don’t take off’ is the cry as Gislaine and Beatrice struggle to hold on to the banner saying Hopital de Guinebor II eventually attached to its poles and with paint nearly dry. We parade past the Presidents wife along the smartest road in Chad finished just in time for the 50th anniversary celebrations. A never ending stream of women’s groups appear down the road in their Chadian women’s day material , the hotels, the police, the vets with chickens and eggs, the teachers singing a song which basically says without us you wouldn’t have any of the other professions (the midwives thought they came first) the women from the bank in a different material again specially made for them!! School children too all smart in uniforms .

After the march the speeches about how its good to be a woma in
Chad , well maybe we can help with that as we care for patients and show the importance of all ,but by then we are at Anastasies house for a sort of Chadian fish and chips with whole fried fish and potato salad and a French loaf each not to mention the essential coca cola much needed after the walk in the sun.

Back at the hospital the men have managed without us and there’s a kind of festive we can cope against the odds atmosphere even though they had to limit the number of patients!! Maybe next year we’ll manage to walk in the right material and be a bit more organised but for now it’s been a good day and maybe just a few more women will have heard of Guinebor Hospital now.

P.S. For more hospital news click on the link top left for an article on the BMS website

A day off at last

Ruth and Rebecca are in the midst of their mid term break . Two weeks set aside so that those who want to can go skiing! Well perhaps some of the teachers have gone. We are still in Guinebor II with temperatures slowly creeping up past 40 degrees at mid day as the hot season approaches. It not only hot but also dusty with an almost continual wind blowing off the desert to the north

To say that Andrea and I are busy would be a definite understatement as we are now the only doctors for the hospital. Since we opened two and a half months ago, the clinical work is increasing each week, up to 60 new patients to be seen each day and about a dozen inpatients. There have been about 40 babies delivered and we have one planned operating list each week during which Andrea and I give anaesthetics to each others patients. It is great to see the hospital developing a good reputation so quickly and being able to witness to the love of God as we bring affordable health care to the local population.

With the medical cover being solely our responsibility the mobile phone network is a real advantage as we can leave the hospital in the hands of the nurses and midwives and still be able to give advice and if absolutely necessary return. This means that we get to church each Sunday and then……….

We have decided to set aside one day a month when we will go out as a family and do as little hospital work as possible. Today is the day off for February and so far it has been fantastic. By ten o clock the hospital work was finished and we set off for a pottery museum on the far side of Ndjamena. I wasn’t too excited at the thought but as you can see from the pictures it was much more than that. It was a real surprise to see the whole of the centre of the village with vividly painted walls and the museum was housed in the restored Sultans palace, a mud built building that is about 3 centuries old. It was full of artefacts, photographs and documents including some very large pottery urns, that were traditionally used as coffins. I forgot to ask whether they were buried or simply left outside the front door of the house with a lid on. I am pretty sure it was the former but then again some people keep ashes on the sideboard so I can’t be for sure.

Having visited the museum we toured the village which seemed to have been given over to the production of pottery. It was amazing to see the skill as the big pots were hand made from a mixture of clay from the ground and some cow dung. They are fired for four hours in a pit covered again with cow dung as a fuel. They are then used as water jars, every home has at least one and the central aisle at church has several. They are either set in the ground or on a metal stand and being only partly glazed they are permeable and as the water gently evaporates the remaining water is cooled.





We have just returned home to check on the hospital all is quiet and if it remains so we plan to go out for a pizza at a small restaurant. It is an overgrown bungalow in the middle of town with a wood fired oven with tables arranged under a veranda in the garden. All my patients are fine and there is only one woman progressing well in labour. We will only be 15 minutes away, let’s hope we are not needed.

Hopital de Guinebor II is officially open

For up to date information and pictures please search for BMS World Mission , there is an article and pictures on the home page ( for the next week). Later can use the BMS search, put in Chad, and you will also get articles on our carbon offset eco project and other background info for Chad, including a job advert for doctors and nurses. Please feel free to apply.

A time of Jubilee is coming

The steady throb of lorries
rolling passed the hospital has now stopped.
The new road in front of the Presidential palace complete with parade ground with transplanted palm trees and triumphal arch is finished. The sound of the lorries has been replace by those of the Chadian Air Force practicing flying a flight of 5 attack helicopters in tight formation, and a pair of ground support jets pulling impressively tight turns as they arch over the city. Ruth and Rebecca were late for school yesterday stuck in a traffic jam behind some slow moving tanks. They have seen troops mounted on horses and camels parading past their school and even a military band. Next week three days of public holiday will be used to mark 50 years of Chadian Independence, with the main parade on the 11th January. The President is proud and wants to celebrate with the people and the world. We hope it will be a great day for all.

A man, Isaiah the prophet once spoke of another way of celebrating a jubilee; Jesus used his words at Nazareth to explain his ministry.

“The Spirit of the Lord is upon me,
Because he has anointed me
To preach good news to the poor.”

We too will be doing a bit to celebrate this Jubilee. The official inauguration of the hospital will be on the 4th day, Thursday 13 th January. This is purely coincidental and will give us some organisational problems but it will be good. The Minister of Health is the Patron for the day, Bert Oubre ,CEF President, is coming from the USA, many officials’ village chiefs and missionaries are invited. The American ambassador will be there, representative from Exxon Mobil; and even the British High Commissioner to Cameroon is prolonging his stay after the 50th anniversary celebrations.

So these are the plans for the coming week, but what of the past month. The hospital has been open in a low key way. About 25 outpatients a day, 8 babies delivered and a few mainly children as inpatients each night. Last night this peaked at 11 a third of our capacity, so word is getting around. We also did our first two operations yesterday and both patients are doing well one gynaecological and one general surgical.

Actually I missed most of it, having fallen ill with typhoid on the opening day, 9th December 2010, I spent most of the past month in bed and the responsibility for running the hospital and doing 80% of the on call has fallen on Andrea. She has been amazing running the home, organising Christmas for us all and looking after me it mainly in bed. The initial treatment was working well but I relapsed and required to be in one of our hospital beds on a drip for 2 days followed by 14 days of intravenous antibiotics which finished last Tuesday. I am now back at work since Wednesday working at 100% already which is amazing.

So much good news, something to celebrate.

Happy New Year to everyone.