So this is Christmas

And what have you done ……... It is a busy and a special time, waiting for the dawning of the light, the turning of the year. So what does it mean to people in Chad?

Lycee Montaigne, Rebecca’s school being secular completely ignores it and just carries on with normal lessons. This year Rebecca’s didn’t have any tests but the year below had a 2 hour Maths test, making counting down to Christmas take on a new meaning (Baah hoomboog –Sharl Deekens,  si je ne me trompe pas).

The Christmas lights around the city, the tree in the place des nations, occasional young men in shirts and Santa hats hawking inflatable reindeer and minions, add a western consumerist touch

This year is a busy time for the security services. As we drove Ruth to the airport at midnight on Tuesday for her flight back to the UK, we were stopped 4 times. A hospital car and the fact that we have been on the radio and TV recently means we are easily recognised and the last policeman even wished us ''Joyeux Noel Docteur''. Normally our church along with many others has an all night vigil, but this is not recommended this year given the security situation, so there is a service from 4-8 pm tonight, Christmas Eve and a service between 6-8am tomorrow morning. We all pray for peace at Christmas each morning.

This year I have been making sure, along with Alan and Ndilmbaye, that the staff get paid on time. Some still get paid in cash whilst others have been waiting anxiously for the bank to process the payments, placed rather late on Friday 18^th and eventually in the accounts for Tuesday 22^nd evening. Yesterday, the 23rd , was a bank holiday for Maalud, the birthday of the Prophet Mohammed; all the bank ATM machines ran out of money causing quite some anxiety.

So what do people spend their money on? Most people get new clothes which means that Jonas and Honore (lab technicians) Raha (midwife) and Helen (sterilisation dept) are busy as they are all part time tailors.  Working in the evenings must be difficult, its dark at 6pm and most people don’t have electric lights. Just as well that the sewing machines are pedal power. Holidays are also celebrated with special meals at home and at church. Ruth, Dr Isaacs daughter, who will be coming to Christmas dinner commented that our tortoise has grown a lot (about 10kg now) and wondered when we are going to eat him. We are sticking with tradition and having roast chicken.

For Rebecca our cook it is an especially busy time. Cooking for the hospital Christmas celebration on Tuesday afternoon, only a couple of weeks after the fete to open the maternity with food once again for 200 people. Its  more or less the same menu as before which makes the timing easier. Then its  more cooking for church . It’s all rather tiring and she is also  a seamstress and has recently started baking biscuits to sell to friends as well. At least she won’t be helping to feed the church at midnight this year.

And so amidst all the business of the season, I have to give the ‘mot de Directeur Medical’ for all our guests and colleagues assembled to hear the story of Christmas. Its the 5th time and  I guess that makes it a tradition. As usual it was translated into Arabic by Ndilmbaye. This year , sadly, will be his last time as he is leaving for a new job at the end of the month. Perhaps this time next year I will be able to speak in a local language and won't need a translator? The times they are a changin.

So what would you say to a gathering of local Muslims, and visiting Christians from elsewhere in the city. It is good that they continue to come, some have been every year so they must know the story by now, perhaps they even like it, I hope so.

‘’Village chiefs, faith leaders, invited guests, friends and colleagues, once again I have the pleasure of inviting you to our Hospital at Guinebor II. A couple of weeks ago we all gathered together for the opening of our new maternity unit. We thought of the thousands of mothers and babies that had been helped in our old facilities and gave thanks for the fact that even more can be helped in the new unit. In the final week before the move was made a baby was born that was given the name Emmanuel which means ‘God with us’. It is an ancient name that was first used over 2500 years ago, a special name to bring hope in a time of trouble. Today I want to look briefly at the first baby to be called Emmanuel in the Bible.

King Ahaz was certainly in trouble, he was besieged in his city of Jerusalem whilst all around his country was being ravaged by two kings and their armies who sought to overthrow him. He didn’t know what to do and was seeking an alliance with another stronger king so that he might receive relief. Isaiah the prophet came to him, with a message,-'' put your confidence in God not men or kings''. It was not a message that Ahaz wanted to hear, he wanted to be strong and active and when he expressed doubt that God would help, Isaiah offered a sign, a young woman would become pregnant and once her child was weaned the trouble would be past. The child was to be named Emmanuel ‘God with us’ a prophetic sign. It was a sign that King Ahaz chose to ignore, he  made his alliance and later everyone regreted it.  God organised the deliverance of the city and its people all the same.

What about us, how does this story have meaning today? We too live in troubled times, there is much insecurity in the world and even here in Ndjamena. There are financial problems as well and life is hard as the price of petrol falls and prices rise, and then each of us have our own particular difficulties at work in our families. What can we do? Do we behave like King Ahaz and seek to make compromises and alliances with others disregarding the both cost and what is right? Or do we rather decide to put our trust in God, as Isaiah recommended. A baby, appropriately for here, could be a reminder that God is with us even in all our difficulties and trials, a sign of hope. Can we see it?

We are here today because the ultimate sign of hope, in a magnified echo of this prophetic story, was born of a virgin at Bethlehem 2000 years ago, Jesus also called Emmanuel. God with us in a new way. We can learn more about him and his birth in the play that will follow, pay attention to him and his story, let us try not to be like the ancient king who didn’t want to see the sign that God had given.

Jesus, born at Bethlehem,  Emmanuel, God with us.

May God richly bless you, your families and Chad at this time and in the year to come with peace and joy.



The new maternity a sign of hope for the New Year




 

Here’s to the babies in a brand new world




The first baby born in the new unit on the 2nd December 2015

 

The Official opening of the

 

Guinebor II Maternity Centre

and the

 5^th anniversary of the hospital

 

                                                      9th December 2015 

                                                                Let the day begin  : The Call   

                                                                                   (Control right 4 music)

 

Here's to the ladies who prepared the food 

6:00 am Rebecca, Odette and their team arrive early, but there is plenty to do. They plan to cut, boil and then pan fry 35kg of meat purchased the evening before in a huge upon an open fire in the back garden. The potatoes, and prawn crackers will be cooked in our kitchen. The savoury donuts were made in advance. Will it all be ready in time? 10:30

Here’s to the team who made the plan

7:00 Pastor Djibrine has already organised the canopy and chairs for 200 people and has gone in search of blocks of ice (20X20X80cm) for the soft drinks ice buckets.

7:30 Helen and Andrea work with the midwives to make the maternity tidy and get one room ready for viewing with the CTG, oxygen concentrator, oximeter and BP machine.

08:00 Ndilmbaye arrives and confirms that the Minister will attend in person, in collaboration with their secretaries, he has written the speeches for the officials. The sound system has arrived with a friend from church who runs a small business that has also supplied the polo shirts, banners and he will be the master of ceremonies, whilst Ndilmabaye will receive the guests and make sure everything goes to plan.

Here’s to the police who help keep the peace

08:00 The eight armed police from a team who are specially trained for this role arrive, along with a couple of local policemen. They are on the gates along with our usual unarmed guards and also around the perimeter of the new unit. A sad necessity for    these days of heightened security.

Here’s to the staff with healing hands

08:00 The staff come for work as usual as the work of the hospital must go on. Outpatients are always less on a Wednesday, and the only change from normal is that the morning operating and the antenatal clinic are cancelled. A bit of extra cleaning is required, and everyone helps out. Staff who are day off or on holiday come in for the fete as well, and all except emergency staff will pause and take their places just before the Minister arrives.

09:00 The maternity is not busy but one baby is born, ready to be a star on TV later in the day

Here’s to the guests who shared our joy

09:00: The first guests arrive and are shown to their seats, by half past nine the District and Regional Medical Officers are here plus representatives from the government hospitals, national and regional pharmacies, and the W.H.O. The TV crew arrives in the hospital ambulance with all their equipment.

.09:30 The mayor of Ndjamena North arrive with his personal body guard who is wearing a surgical mask against the dust.

09:45 We heard by phone that the minister has been busy in meetings and has not yet arrived at the Ministry on the far side of the city and will let us know when he sets off. This is very good news as the food is not ready, but will be in half an hour or so. Also people are still arriving including many local chiefs and Imams and many women who help with the maternity outreach program in the villages. There are representatives from the Evangelical alliance of missions and churches and our own home church EET no2 Francophone at Farcha. There is a real buzz about the place the music is playing and last minute preparations are underway.

Here’s to the Minister lending his support

10:30 The Minister arrives, and his route is lined by staff looking smart in their Maternite Sans Risque shirts and the midwives in their special outfits for the day. The speeches are delivered by the Mayor, Mark, Andrea and the District Medical Officer. The latter gives a very positive speech telling the Minisiter how we are well integrated into the local health services and that we could do with some help, notably with personnel and an all terrain 4X4 ambulance. The Minister replied saying that Maternal/Child health is the number one priority both of the President and himself and that the doors of his office are open wide to us and he will help anyway he can.

 

Here’s to all who worked so hard

 

Thanks were expressed to Aaron and his team of builders, the architects and everyone who contributed time and gifts to the project

 

Here’s to the party and the fun we had

After the cutting of the ribbon, tour of the unit and the inevitable politician with baby pictures for the TV (and there isn’t even an election on) we shared a meal, the meat cooked to perfection. As I escorted the Minister back to the car I found that we share a common language, English. He had studied at an Arabic University in Jordan and is more at ease in English than French.

Here’s to the babies in the brand new world



There have been 4200 babies born at Guinebor in the first 5 years, the conditions were cramped and inadequate, some women had to labour on a mattress on the floor, and only one delivery room. Now thanks to your generosity we have a new spacious unit with 4 labour ward beds and 4 equipped delivery rooms. It really is a brand new world for an expected further 10 000 babies that will be born here over the next 5 years. A real cause for celebration and a dance.



                                       Here’s to you my little loves

                                        With blessings from above,

                                              Now let the day begin,

                                                   The day begin,

Let the day start.    

 



The first baby born in the new unit on the 2nd December 2015



 

 



Smile

 

 

What is it that makes you laugh, is it Charlie Chaplain, Monty Python or someone else’s silly walk.  Anyway it’s best to   ''always look on the bright side of life'' so here we go

We had a good laugh this week when we decided to buy a star light for the veranda. It was in the local supermarket and we had all agreed it would be fun and a tasteful addition to our Christmas decorations. Arriving home we unwrapped it and excitedly plugged, and burst out laughing, it was multi-coloured and flashing quite a disco experience and not quite the white subtle look we had hoped for but probably much more to Chadian taste.

 

Crickets (insects plural and not the singular game) have also featured strongly in making us smile this week. They are a popular and apparently very tasty fried snack. At the management meeting being British we prefer to offer locally made roast peanuts bought in old coke bottles.  I offered some around saying the problem with these is once you start you can’t stop –yes says Pastor Djibrine just like crickets mmm I said not quite what I meant.

Different people different tastes. In a similar vein, Ruth Gwan, the daughter of Dr Isaac our Cameroonian colleague, told Rebecca that she was wondering how on earth any one could live on honey like John the Baptist as it was so sweet. We too have problems with his diet but it’s the locusts that stand out rather than the quite palatable wild honey!

Anyway what’s really making us smile this week is the opening of the new maternity unit. It is looking great with all the equipment in place and the new curtains and furniture. We moved in a week ago and tomorrow is the opening ceremony we will have all the local dignitaries and will officially cut the ribbon. But nothing ever goes completely smoothly round here. Yesterday we checked a shirt at the team meeting and discovered that the 80 newly arrived T-shirts were misprinted. They had the same message front and back.

                       CEF Hôpital de Guinebor II,

                    Pour une  Maternity Sans Risque

The health education message for the back encouraging antenatal visits was missing.

Disappointed we decided that Ndilmbaye would have to take them back and ask that a further message be quickly added. The printer was surprised and pointed out that only one was misprinted, so he had put it on the top of the pile. Naturally it was the one that Ndilmbaye had pulled. The 79 underneath were as planned and perfect!!  Whoops! Good news and so they were distributed as planned to the staff today ready for tomorrow. And so, the donuts are ready, meat is in the fridge, there are piles of drinks and boxes of prawn crackers ready to be cooked. We will need to start early as official time for opening is 9 am.

We had better go and write our speeches.

 

Spot the spelling mistake and don't forget to smile.

Images moving out onto space- picture links

Here is a link to download our November Prayer Letter and direct links to the relevant works of art in the exhibition at Tate St Ives Images moving out onto space.

 

Bridget Riley Op art
 

Lilian Lijn Koans
 

Bryan Wynter IMOOS VI


Rivane Neuenschwander  I wish your wish

 

We hope you enjoy the pictures

Changes

 

 

It’s arrived! At last, ten days ago, a small lorry drew up with the new equipment for the maternity unit. Using quite a lot of man power and a few coca-colas the pallets were transferred to the unit and Helen and I set about unpacking .

''It’s like Christmas'' said Helen

 ''Better'' I replied.

 

Then it was time to test our Ikea skills as we put together the flat pack normal beds and delivery beds, drip stands and wheeled support for the baby bed. Everything seems to be fine and just what we need. It fits well in the space we have and begins to make it all seem a reality.

 

 

 

There are a few final touches to be made to the building and then we can distribute all the equipment around, plan for the opening and get ready for the rush. This month has already been busy and with around 4 babies a day we always looked likely to pass our previous maximal number of deliveries, 120. 

 

In our cramped and basic existing unit we have managed to assist even more women than we expected with a safe delivery. Today with 15 hours of the month left there have been 142 births with 3 women currently in labour! Looking at the graph puts it in context and it looks a little less amazing and  more like a logical trend, helped this year by the community outreach project. However it is more difficult to predict the quantum leap that may well happen once the new maternity unit with its shiny new beds and spacious rooms is opened.

 

Hopefully with the new equipment we can now provide even better care. We have more of all the basic tools and also a new oxygen concentrator/small surgical lamp/pulse oximeter/electronic baby scales/electric blood pressure machine and most exciting of all a CTG machine to enable us to monitor a difficult labour and see when the baby is in distress. We hope this will help us to avoid some still births especially when the women have come with other signs that the baby may be having problems and up till now we only had very basic ways of checking all was well. It will remain to be seen if the women will accept a caesarean under these circumstances but we can only hope and pray.

As you know our work in Chad will be changing over the coming months. This gives us plenty to think about as we unpack and organise, make local purchases and get the final touches done before opening the new unit. There is the potential for a further big increase in the number of women and babies helped and plans for the future need to be carefully laid so that all goes well during this time of transition and beyond. The hospital needs to  be well prepared to meet the challenge of the numbers whilst maintaining quality of care. Please pray for wisdom and Gods guidance.

One rule for you, one rule for me.

Last Tuesday, our day off after the weekend at work, we were at the house trying to sort out hospital statistics and I popped over to the hospital to speak to Dia our head midwife. ‘Oh’ said Sarah another midwife and laughed ‘She’s gone to see about adopting a baby!!’ Well it was the first I’d heard but yes it was true 2 babies were available for adoption at the main maternity hospital and as Dia had shown some interest before her friend had rung her to ask if she still wanted one .

Two days later and Dia has a baby girl, to the delight of her son Richard who’s 12, she’s called her Divine. Her husband chose the one who wasn’t as light skinned he didn’t want a white baby! I’m sure Dia will make a great mother and Richard a doting brother as he was big softy with the kitten they have. My initial concern was also how this would work as Dia is at work all week and we weren’t aware she was about to have a baby! Fortunately this is not a problem and she’s found someone to look after the baby while she’s at work-according to her she’s much better than Dia herself. It all feels rather strange to me I’m used to hearing about all the difficulties associated with adopting in the UK .The idea that then you would hand the baby over to someone else to look after all day and are able to simply say  we don’t want the whiter baby just doesn’t sound normal!

Many apparently strange things happen here and they still take us by surprise even after 5 years. Last Saturday was Sarahs wedding, we didn’t make it as the hospital was rather busy .She already has 2 children and had her engagement party last year after the second was born. It’s considered best here, in certain ethnic groups, to be sure things are working out before you get married! Ahmat who works in Admin has a ‘wife and a baby’ and is just trying to get money together to pay the bride price. It’s all rather back to front.

Yesterday we went for a swim it’s hot and sticky and Rebecca started her half term so a good excuse -the notice near the childrens pool said    ‘’Unsupervised area, all children to be under their parents supervision,’’ a good idea it seemed. As we looked over sitting on the bench next to the sign were a policeman and soldier with a Kalashnikov employed for increased security and surveillance at the pool who needs parents! Hard to imagine at the Lido in Plymouth. ( the picture is a few months old and shows just the blue sign without the new attendants).

All this is just every-day in Chad where sheep ride on motorbikes as the easiest way to get your celebration dinner home and everyone wears the same dress to the party in fact you feel left out if you’re wearing something different.  Life here is played by a different set of rules

Good things (part II)

We wrote earlier about our concerns for the medical cover at the hospital during our time in the UK this summer. For a moment it looked like we might have to close for inpatient patient services which would have been very sad for the people round here.
 

 All my well intentioned efforts, trying to find Chadian and Cameroonian doctors, came to nothing. Despite that, thankfully, a solution has been found and in the end it had nothing to do with me.  

A week ago, on Saturday morning we received a phone call from a friend who said she had a doctor, James Appel, staying with her. He wanted to visit the hospital and might be able to help out sometime.

He came that morning and Andrea showed him round, and as she spoke to him she could hardly believing what was happening.

James has been working as a missionary in Chad since 2004 at a couple of hospital projects in the south of Chad. He has been preparing a new hospital work at Abeche in the east but it is not yet ready and he had just flown back into Chad from the USA and was at a loose end for a couple of months. He has been praying that God would find him some medical work to do.

So now we have an experienced surgeon to work alongside Isaac and provide a full emergency service over the summer for the full 2 months of our absence.  He has moved in to the guest house with his wife Sarah, a nurse, and their family. He will start work next week. Their two friendly dogs have already chased our cats up the trees.

It is amazing and can only be seen as a response to prayer, so thank you, what would you like to pray for next?

''Is there a man among you who would offer his son a stone if he asked for bread?

No.

A snake if he asked for fish?
No.

How much more will your heavenly Father give you
Good things, Good things, Good things.
Yeah, yeah, yeah.''

A serious business

A few weeks ago we went to a Chadian wedding, well actually we managed to squeeze in going whilst covering the hospital as Isaac is away on holiday. It was one of our midwives, Il Djima, who was marrying at the rather old age of 28. As friends of the bride we were invited to go and visit and eat in the afternoon, before the husbands family would come and take her away in the evening.

Having waited for the midwives to finish their shift and thankfully the women in labour to deliver including our head of labs second wife we thought we could leave. We drove up to the hospital gate, lent out the window to make sure the nurses had our phone number, and were told we had a flat tyre. No problem we said, it will only take 10 minutes to change, but then found the spare on our new car was also flat.  Already running late we called Dogo, our driver who came in the ambulance, loaded the 2 tyres in the back along with the midwives, and happily within 20 minutes we set off.  Dogo was glad to be able to come too.  On the way we dropped the tyres off for repair, and then set off to find the house. No road names, no numbers just try to find where you went last time and look for signs of a party.

On arrival we passed through the yard and were ushered into a room when we arrived given the obligatory coca cola. We were looking round for the bride, when in came someone all covered up in a laffee greeting us coyly, yes it was the bride a far cry from her engagement party when all had been laughing and dancing, this was a serious affair .She was to be a married women. In fact she had started wearing black socks to work the week before clearly preparing for her new status. We did however have the same delicious meal and then made our way back in the ambulance to a quiet hospital and time to pick up repaired tyres on the way.

It was interesting to see the difference and to see how serious marriage is taken to be. In our area the community survey done as part of our outreach project has shown that 20% of marriages are polygamous (as was this one)  but obviously still a serious commitment. We see many couples who  relate well despite the arranged marriage system here. This is important where results of the survey showed when it comes to child birth, 50 % of women it’s the husband who decides where they deliver.

 The  survey results are helping us understand more about our local area. For example

1.    Amongst the 320 women surveyed 27 had had a sister who died in pregnancy

2.    That women don’t know who’s at risk of having problems in labour,

3.     18% had had babies who died just after birth,

4.     Many women also thought they should avoid eggs and milk in pregnancy and that cow’s milk and water from cooking the boule were good for the baby.

 Hopefully through the outreach groups in the area they know a little more now, but I think we need to keep on with them. We recently had a drama group in the village too, to get over the message about the need for antenatal care and we will be painting a mural on the  wall at the hospital where everyone sits to wait.

The drama group

The new maternity building, as you can see below is still making steady progress. We are placing the equipment orders and hopefully will get them through in time. I am hoping that the much better environment will also encourage women to come and deliver with us and avoid some of the many complications possible and help to add the blessing of a healthy baby to their families.

 

 

 

PS: we leave for home assignment on 28^th June our program is below.

Sunday   19/7/2015     Huddersfield  10.30  am

           Wakefield Baptist Church  18.30 pm TBC

Sunday    26/7/2015    Macclesfield All Saints C of E     9.30am

                                         Hyde Baptist Church    19.00pm

Sunday     2/8/2015      Kettering, 10.30am

Tuesday    4/8/2015      High Wycombe Evening meeting

Sunday      9/8/2015      Perth Baptist Church 10.30am and 18.15 pm

Saturday   15/8/2015    Penzance Chapel Street Methodist Church                                      X                                         Coffee morning  10:30 am

Sunday      23/8/2015    Wakefield Baptist Church  10:30am TBC