Spelunking beneath the Jungle

There is one God, the Creator God, and His creation is amazing!

This morning I was playing soccer just after 7 am. Still warm and humid - but only in the low 80's :)

Then we went spelunking.

"Caving" in the jungles of Africa was a new concept to me, but then I was told that we were going under the hill the of the hospital...and it became quite intriguing.

We hiked, crawled, squirmed, and sweated through about 1 1/2 hours of caverns, tunnels, and crawl-spaces. Some had torches, other's head-lamps, and some no light at all.

The bats were fun to watch swooping and diving as we came into each new section. Putting your hand out to steady yourself usually sent a few dozen "cave spiders" scurring out of the way. I shined my torch on a spot just as one gal put her hand down, and there were at least two dozen spiders/insects around her hand. It was better to just not look :)

The bat guano mixed with wet clay made for a slippery floor most of the way - but easier to slither through the narrow openings on your belly. Sloshing through small streams cooled our feet, and crawling through similar parts cooled our elbows.

We made it, all without a problem. A few scrapes, bumped heads, and sore elbows later we were headed back up the hill. By the time we finished it was quite clear why they had encouraged us to use "extra" clothes prior work-teams had left behind instead of our own. It would be impossible to wash the clay and stains out. It wasn't much cooler (if any) below ground - it is always warm here! We came out soaked, covered in mud, warm, and glad to see skylight!

There was a second level, deeper, which I noted the entrance to just as we neared the exit. (I'm still not quite sure how our guide figured out where we were). Marjolaine and I crawled up through the tunnel to that section, and it dropped off about 15 feet to another ledge which led deeper and lower under the mtn. But we were informed we couldn't go any further without ropes. Something about safety measures :) If you have seen Lord of the Rings...you have an idea of what it felt like to come over the edge and see it dropping down inside. There was a deep urge to go deeper and further in. So, if I'm able to return, I have a side-trip I'm looking forward to... rock-climbing in reverse under the jungles of Africa!

It has been a good trip - and I wanted to share a bit of one side-trip just to let you know that it hasn't been ALL work and no play :)

Thanks for praying for us.

Headed back the US - leaving here Monday and should be in Indiana by Wednesday evening. I'll have a few more pictures by then.

Have a great Saturday!

John

Trauma in Gabon

So much for a quiet evening :)

I had just arrived at the evening get-together (Dessert party) for the team leaving tomorrow. When Keir informed me of a gunshot victim in the ER.

A 4 y/o boy was accidentally shot with a shotgun - to the neck.

It happened a couple of hours earlier, so I wasn't too concerned that there was a problem with the airway.

The picure you see is without any pain medications or sedation. He let me pick his head up, move his neck, and examine him. Amazing.

After an x-ray (no pellets in his skull) and a little ketamine, Jean Claude (the 2nd yr resident) and Judd (4th yr student) and I washed him out and closed the wound. Keir had told me to try - and I doubted him :) Later he told me that he didn't think it would work, but wanted me to try anyway! Nothing like a younger colleague with a little more experience to motivate you to do a better job :)

Amazing to see it come together. Hope that it drains appropriately and that the facial nerve stays fairly functional. I couldn't find any major damage to the nerves or major arteries.

God is good. The father (who had the gun) was visibly relieved when I told him in my halting French that his son would be "ok".

I have heard it said in the past, "This is Africa, the scars don't matter". My response is: "I don't work based on scars, cultural expectations, or to please people - I work to please God and honor Him with the gifts and abilities He has given me." If God gave me the training to close facial trauma, why shouldn't a little boy in the jungles of Africa benefit by it? And do some teaching in the meantime :) It is fun to be a part of the work here. And Jean Claude did a great job finishing it up.

By the way, we still made it back for middle and ends of the party :)

Having fun, working, and enjoying walking with Jesus.

I trust the same is true for you! Walk with Him. Thanks for your prayers!!!

John

In the Land of Gabon

Happy Valentines Day!!

It is warm here :-) 118 deg. F in the sun. But only 92 deg. F in the shade (I checked). Humidity = "high". And it is a GOOD day to be operating inside with the air-conditioning.

This am I awoke before my alarm, a habit which is slightly annoying because I keep going to bed late - I know I'm missing a few minutes of my sleep! But, on the other hand I pray for people till my alarm goes off, or I get up and keep going on my reading - trying to get through the Bible in 90 days. The fan is nice, keeps the air moving. That way the humidity isn't quite as bad.

This morning's cases were interesting - three teams - each with their own case: skin graft of pretty much an entire arm, above knee amputation on an 80 y/o lady, and an exploratory laparotomy on a 25 y/o gal with a mass in her pelvis.

There were the usual delays, questions, repeat blood tests, hypotension, desaturating and almost dying that occurs with the anesthetic and prep of patients, but in the end everyone started their cases. And, ended safely.

My operation was with Saskia (see above) and Marjolaine (a 3rd year resident from Canada). We operated on the 25 y/o gal. We found a mass in her retroperitoneum - and it looked "bad". We biopsied it and closed. It was too involved to hope to get it out. Her mother, whom we checked as a potential blood donor, turned out to be HIV +. It is in these cases that the impact of why we are here makes its way home. Without Jesus, both of these women will die and be separate from God forever. There is not much we can do now except alleviate the suffering as much as possible. The outcome is inevitable, physically, but there is the opportunity for them to make choices with eternal ramifications. My patient gave an emphatic "amen" when we finished praying just before starting the operation. And I am praying for her as she processes this morning's events.

A neat side-light is that John, an ER nurse from Seattle, had the same blood type as the woman, so he was the back-up option in case we got into serious bleeding. He came in to watch the operation, and had more than just a casual interest in our technique! Thankful for his willingness to be used in case we needed him. A real team effort!

My clothes are washing (!), the sun is shining, and I just finished lunch.

I'll return to the clinic at 3p to review the chapter on Breast with the residents. Then I'm headed to the pool to continue swimming lessons for Luke! Tonight is a "Dessert" night at Keir and Joanna's house - a kind of "thank you" for the team from Seattle as well as a couple more of us. We are enjoying an incredible amount of hospitality!

Thank you for your prayers, especially for wisdom in knowing how to relate and work with the patients and residents. It is a huge privilege to be here!