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.

No news is good news?

Two weeks is a long time to wait for news especially when something momentous is happening. So here it is an update on our news, is it good news? We’ll leave you to decide.

The rest of the staff training went well, and a really encouraging 15-20 people at each mornings pre work prayer meeting ( 20 mins before the staff meeting) We did start to see patients on the Thursday morning but actually not quite as planned. The Wednesday evening the staff decided that they were unhappy with their lack of bonus on top of their salary. We were unable to reach agreement and so separated for the night with an uncertain future. Next morning we found a compromise, a profit sharing bonus will be paid, it was always planned for the future but as there are not yet any profits and none likely for a few months,. Anyway as a short term solution we will have a low flat rate start up bonus for 3 months after which time it will be truly linked to profits. A good outcome especially as the works reps have signed to agree that it will be an equal shares for all, irrespective of hierarchy, gardener to head nurse all the same. Also although it sounds horrible all the discussions were conducted in a very amicable manner. All these things are good principals for a Christian hospital.

So 2 hours later than planned we opened , and it was as if nothing had happened, everyone as nice as usual. Between us we saw 25 patients, I mainly went around organising as did Andrea, and then we mucked in at the end to help our Roy and Michaela who were flagging. It was 2 pm, I was shattered, couldn't see why, had a sandwich and then an inhabitual siesta.

Next morning I had slept very badly, woke up vomited and got back into bed. Had to get up at 9 am to go and see the local Health Director. He decided it was time for him to visit especially as we were open, and so we drove him back and showed him round. He was most impressed, he had never been before! despite being in post for 4 years and yes I did invite him previously, in May, but you can't be chasing up people all the time. I went back to bed, not vomiting but unable to eat and by now had a low fever. I have been in bed ever since eventually as the fever mounted Andrea diagnosed Typhoid. Since last Wednesday I am on treatment am responding and convalescing

Any way thank God for his guidance to Andrea to the diagnosis in he minimum of time, and for the fact that though still convalescing I am now well enough to write this.

The hospital is seeing 20-30 patients a day and has a steady trickle of emergencies. We still await our first baby, will it come on Christmas day? There are plenty of antenatal patients so it shouldn’t be too long.


At least we are ready now The freight arrived in
Ndjamena eventually 2 weeks ago. It then took 9 days
before being cleared for release by customs but all 175 kg arrived 4 days ago and that's great. It is unpacked, Andrea finished it on Saturday morning.

One perspective on the news from Mark, Andrea's would be different. I hope that was worth waiting for but was it good news?, Next time we will try to have even more Good News, it is after all what we are here for.

A Time of Waiting

As I write the sun is shining from a clear blue sky and although at the moment it is a pleasant 24 degrees by lunch time it will be in the high 30s and too hot to work outside. It is hard to believe that there is ice and snow in England and shops full of Christmas decorations. Advent is however here and we wait the coming of Jesus again and consider which of the many ways of celebrating Christmas we are used to we will have here .It somehow seems inappropriate to fill the house with more things when so many around have so little but we do need to celebrate this great event.

For Mark just back from England after an urgent visit for medical tests we are glad to say that the time of waiting was short and the outcome good. Keep taking the tablets is the answer now and he is well. Marks unexpected visit to the UK delayed things by 2 weeks and has caused the official inauguration to be postponed the to the New Year

Tomorrow the waiting for the hospital starts to be over. The nurses and midwives laboratory and pharmacy staff begin their induction training. There are about 20 of them. It is exciting, after all we have been here since April, but also slightly daunting. Despite the delays, there are still things to be done, sterilisation building to finish-nearly there but our mason that knows how to tile has just had to go off to his village for a visit -so more waiting. Toilets and triage room and entrance walkway also to finish.

In addition contracts, paperwork and ministry visits need to be organised soon now Mark is back

Finally equipment and drugs that have been ordered for a few weeks need to arrive by air from Europe- It is unclear why they have not yet been dispatched. More waiting and praying that it arrives soon before our opening date of the 9th of December.
We need patience, we need enthusiasm, we need energy and we need wisdom we need as we wait on God to fulfil all our needs Psalm 138 v “The Lord will fulfil his purpose for me; your love, O Lord, endures forever- do not abandon the works of your hands.”

Pitures showing the changes in the

operating theatre/maternity

Moving ahead

I wonder what wakes you up in the morning? Maybe it’s the same as us, the steady rumble of heavy lorries outside the window ; hopefully it’s not quite as early as it is here, about 4.45am. They are searching for sand and gravel to build the new road and parade ground in front of the presidential palace. It has to be finished by January to celebrate 50 years of Independence. It is unclear whether this was delayed from the actual date in August because at that time of year it was likely to rain or because of the building works, perhaps a bit of both. The early start is to make sure its ready on time even working Sundays which is a day off for most.
We too are working to a deadline for the official opening the hospital in 3 1/2 weeks . There seems to be plenty to do before this can happen but invitations are being sent and mats and chairs ordered and menus decided on, we may be glad we are being woken at 5 am and kept awake by the call to prayer and sunrise which follows.
Through all of this we have been aware of Gods hand on us we have been able to find nurses and other staff who have a good level of training for us to work with and who are keen to show the love of God in their work. We have had good contacts with local authorities and seen His guidance as we place our orders and make plans as to how the hospital will function. Finally we suddenly received the money we needed just as the bank account was empty and we were considering whether we could really open on time.
So now there are just a few things left to do

1)Finish the sterilisation buildings-windows and doors / mosquito nets/concrete shelves and tiles /paint inside and out

2)Other small building works/ a triage room and new pedestrian gate for the out patients / toilets for the outside carers area /waste disposal area and incinerator.

3)Wait for two consignments of essential equipment and drugs to arrive from Europe by air and clear customs to complete what we have.

4)Run induction courses for the nurses, midwives, pharmacy and lab staff.
Wait for tables and chairs and drip stands to be made locally and buy some other local equipment.

5)Have a final review of the infrastructure and equipment by the Ministry of Development and renew our agreement and contract with the Ministry of Health

It all seems a lot to do so …….we took a break and had a weekend away at the end of half term staying beside the river in a small hotel with swimming pool and visiting some more volcanic rocks this time weirdly eroded into the form of a family of elephants- great fun having a boat ride up stream, now we are fully charged and ready to move with God working together to meet our deadline.

Green is the colour

As we look out from the hospital our part of the Sahel is a verdant green colour, you can see it on Google earth if you like, the image is from this time last year. Green is the colour but it won’t last ; the 4 month rainy season is coming to an end and we will soon be in the 8 month of dryness and all the low vegetation will be eaten by the livestock or catch fire and burn leaving the desert like baked mud that we saw when we first arrived. Every tree is precious in order to maintain the fertility of the ground and avoid true desertification and as such wood burning is actively discouraged by the government and instead they do something quite amazing, they subsidise the small bottles of gas for the simple gas burners of the poor whilst the larger bottles that we need for our fridge and cooker are actually more expensive per kilogram of gas. Robin Hood would be proud of the policy on two
accounts.

There was a conference in N’djamena June 2010 where they planned the creation of a 15km wide ‘Great wall of trees’ (BBC news 17/06/10) to block the advance of the Sahara. Seems like a good idea, apart from the big traffic jams caused by having 10 heads of state here at the same time

Sometimes it seems like we as BMS Mission partners not doing our bit to help, emitting greenhouse gasses as we fly around the world, and a couple of weeks ago setting an recruitment test for 200 nurses and midwives that used what I hope was imported sustainable forest or recycled paper or we’re done for. Adding another couple of degrees to the usual 45C and occasional midday peaks of 50C of the hot season would finish us off.


So we are pleased to say that we are planting trees, BMS have given us money to plant 150 trees to offset a part of the missions international travel carbon emissions. There are other BMS projects elsewhere around the world. Our trees will need protecting from goats and camels for the first couple e of years and also a bucket of water each day of the dry season but they will soon develop deep roots and be able to cope as those next to our house which are now 5 years old. In addition to photosynthesizing they will also give much needed shade in the care givers village and discourage the transit of cars and lorries across our land which is always a potential danger for us and the neighbouring school.

PS. this post got delayed by a week due to technical difficulties. We have now marked the above mentioned recruitement tests and will be holding interviews with 30 candidates for 15 posts later this week. We will need lots of wisdom to select those who will best enable to serve the people of Ndjamena.