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

 

 

 

Good things, good things, good things.

 

Sharing bread is a symbolic mark of the new community of life in Jesus and it is God who supplies the loaf as we pray ‘Give us this day our daily bread. True sharing goes deeper than this as seen in the Acts of the apostles, after receiving the spirit at Pentecost the new community of believers shared in an unparalleled way so that no one was in need.

In Chad the government has continued with the francophone tradition of a subsidised national loaf, probably more inspired by events surrounding the French revolution than by the bible. It is imported wheat in a stick like baguette rather than local maize or millet boule which is the true national staple. I find that a baguette at 125 CFA/20p is a good way of giving to people asking for help on the streets in the city, it makes sure that the help is eaten by those asking for it. Locally produced gas is also subsidised, smaller bottles which take a burner costing less per kg of gas than larger ones that you attach to a cooker. This helps the less well off and discourages the use of wood and hence deforestation in the Sahel region. Sharing resources and meeting peoples need is a good thing whether it is the government or individuals who are doing it.

 

It is said that an army marches on its stomach, perhaps the French long loaf was even invented so that Napoleon's troops could carry it inside their trousers, which may or may not be true, but all the same is a funny image. Anyway 3 meals a day keep the troops happy and ready for action. What is the equivilant for a hospital? I guess a hospital works  through its stomach too, and th pharmacy has to meet the need for drugs. Four regular drug rounds and filled prescriptions mean that patients can take what they need to get better.

 

 

We have always prided ourselves at GII on having a much better availability of essential generic drugs at affordable prices than many other health structures. We have bought the vast majority at the Central Government pharmacy but lately that supply has become less regular and for various reasons we have been having to send more people to buy their drugs in private pharmacies at much higher prices. This is both a loss for the patient and for the hospital.

Realising the essential need for medication Elizabeth, the pharmacy technician, bought the subject up at a morning prayer meeting and prayed for an improved supply. God had already heard and answered her prayer before she spoke, I had a phone call from Campus Crusade for Christ who had a supply of essential medicines that they wished to give to us so that the hospital would be better able to serve the people of Chad and show Gods love. It was a substantial gift, about 3 months expenditure on medicines, mainly antibiotics and painkillers, but it will free up resources so that we can restock other lines too. A real blessing.

The Director for Health of Ndjamena talking to the press

The small ceremony was transmitted that evening on Chadian National TV and radio which along with an unrelated article on BBC Afrique this week will have raised again the profile of the hospital which may make us even busier than usual.

And so to the next problem, do we have the medical staff to cope? This is even more important than the pharmacy and probably more difficult to solve. Our Chadian Doctor, Antoinette, has unexpectedly been recruited by the government and is leaving at the need of the month. A joy but a mixed blessing. She will hopefully come back and help with night and weekend sessions. Andrea and I will be away from the hospital in July and August. It is a quiet time of year, with the rains impeding access and people wanting to be planting their fields but we still do need adequate cover. Dr Michaela is returning to Germany as her husband has gained a University teaching post which means that for the moment the only sure medical practitioner for July and August is Dr Isaac and that is not sustainable. We need to find new permanent and temporary staff urgently, is it possible to find a solution? We are urgently asking BMS and CEF for help in this and we have faith in our Father God, as His Son said

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.

Godspell after Matthew's gospel