"I have but one candle of life to burn, and I would rather burn it out in a land filled with darkness than in a land flooded with light." --- JK Falconer

Wednesday, August 26, 2009

"However, I consider my life worth nothing to me, if only I may finish the race and complete the task the Lord Jesus has given me -- the task of testifying to the gospel of God's grace." Acts 20:24

We're home. God has been incredibly faithful and we are incredibly grateful. We leave behind in Togo good friends, great memories, and a wonderful ministry. We have completed this task and look forward to the next one!

The trip was long -- about 36 hours (3.5 hours and 7 separate passport checks in the first airport, just to board the first plane) but very smooth, with easy changeovers and an early arrival in NY. We experienced no ill effects of the reported Royal Air Moroc pilots' strike; quite the opposite, actually. Our transfers and layover in Casablanca were remarkably pleasant (unlike our one trip through Paris two years ago). The kids did great, sleeping sans Benadryl everywhere we needed them to. In fact the only one who caused trouble was Andy, getting reprimanded by an airport worker at JFK for wrestling with the boys on the carpet in front of the Club Lounge. ("I'm sorry sir, you can't do that here!" What, wrestle with my kids? "I'm just trying to be nice and warn you, security will be here soon..." And do what? Am I packing heat? Did someone mistake joy and laughter for the cries of a whuppin'? Oh well, welcome home to America....) Our skin and noses immediately dried out. Our air conditioned home felt COLD. We'll finish out our malaria and worm pills just to make sure no little friends survive.

We'd like to thank everyone for supporting our trip, hopefully in person if possible. We have pictures and stories, of course, for those who would like to see. And we pray each of you has been strengthened and encouraged and comforted by the work being done not just in Togo but here as well. God's Spirit is moving through the land, and we pray you are tasting and seeing that the LORD is good!

Your faithful co-workers in Christ,
CADT - the Robertsons

August 22, 2009

22 Aout 2009 – Day 73

“Though the fig tree does not bud and there are no grapes on the vines, though the olive crop fails and the fields produce no food, though there are no sheep in the pen and no cattle in the stalls, yet I will rejoice in the LORD, I will be joyful in God my Savior.” Habakkuk 3:17-18

We spent morning devotions Monday talking about worshiping God for who He is, not what he does. It was challenging. Would we still praise him in all the circumstances that Paul was able to praise Him, or the persecuted church (in jail with every possession taken)? Along with Proverbs 30:8 – that we might rely on our amazing God, not ourselves. I half-jokingly called it the “anti-prosperity” gospel. Not as popular with the masses, I’m guessing, but seeing the circumstances in which people praise him here is humbling.

Had a great walk to the waterfall last Saturday. Drew was a trooper and made it all the way. We had misty drizzle from time to time but that kept the temperatures down. Mauwli and Dan (Stoner) jumped in the small pond at the base of the falls and both boys were clamoring to get wet so Cari and I jumped in too. All the rain we’ve had made the falls pretty powerful. On the way Drew was complaining about the rain (“why does it have to rain?” so the plants can grow “but why now, cause we’re getting wet” I don’t know, Drew, but God wanted the plants to get a drink, you’ll have to take it up with Him……). Once we went swimming? What do you think about the rain, now, Drew, and the big waterfall? “Great!”

The Italians have been here a week now and with all the arrivals (Bonts, Summerfields, Ken and Terry Crowe, their friend Angie an ultrasound tech) and returns (Steve and Mary Jo Mills) the place is fairly hopping. We’ve had almost rowdy mealtimes (for Baptists, I mean). Dr. Sam has requested Italian food for meals so we’ve had spaghetti and lasagna and Dr. Sam even played Pavarotti off his computer! The lady with the pelvic fracture is recuperating well. Last night we had a movie night – The Los Ban~os Raid in WWII. Russ’ mom and uncle were interred at that camp and were rescued. It was pretty amazing.

Hard to believe it’s my last call. One lady almost dead from a botched abortion 2 weeks ago and another young mademoiselle from gay Paris, here for 4 weeks teaching AIDS education, fell and broke her wrist sightseeing at a waterfall. Amazing what walks (or is carried) through our doors. I’m definitely going to miss sitting in Russ’ command chair, getting toys for the kids, and hearing the moms of premies who’ve been here two months smile and yell “wezalo!” when I come in.

Thank you to everyone for supporting us in this endeavor. We look forward to sharing our stories and encouraging others who might wish to do something similar in the future.

May you seek the LORD while he may yet be found. And may you praise though there are no sheep in the pen or cattle in the stalls!

Mawu ne no kpuli wo (May God go with you).

Yours in the service of our LORD,

CADT (The Robertsons)

August 16, 2009

16 Aout 2009 – Day 67

“My name will be great among the nations, from the rising to the setting of the sun. In every place incense and pure offerings will be brought to my name, because my name will be great among the nations,” says the LORD Almighty. – Malachi 1:11

Trying out new phrases in Eve is a lot of fun. I’ve mentioned before how I like to laugh and hear others laugh and stumbling through a new Eve phrase is one of the quicker ways to do that. The downside to trying out a new phrase at the hospital is that the Africans are very community oriented (this actually is a very positive aspect of the culture, they do everything together, the good and the difficult, the joys of recovery and the sadness of death). Once I speak Eve (Devi effwo? = How is your child?) to one family I must repeat it to every family! The moms start laughing before I even get to their child, anticipating my weak stumbling Eve phrases. Right now we have about 15 pediatric patients. That’s a lot of laughter……

Its been a crazy last 24 hours. The Bonts have arrived – a family physician, his wife and 15 year old daughter. Their traveling companions, the Summerfields, are in Lome and should arrive today. They were all diverted through Paris because of the Royal Air Moroc pilot strike (have I mentioned that we heard the Royal Air Moroc pilots have gone on strike? ………getting home next Tuesday should be interesting). They got separated by luggage problems and their stories are incredible – including stolen passports and lost credit cards. We’re all glad they’re here.

Several baby emergencies during my day and night on call – including a 32 week placental abruption (treatment is emergent delivery – are we sure of her dates? Who did her ultrasound last week? Oh! I guess that was me!). She presented at 10:15, about 5 minutes after our surgeon, Dr. Sam Williams, told me “Well, Andy, everything looks calm here, I’m going to head to church in Tsiko if that’s ok.” Surgeons often do that because few surgeries are that urgent, and most of the surgeons have cell phones. Sam doesn’t have one of course, so after stalling for a few moments hoping it really wasn’t THAT critical, (“please doctor?”) we realized her labor wasn’t progressing, her BP was dropping, the fetal heart tones were dropping, so yes, please send the guard to the Tsiko church and fetch Dr. Sam. Sam thanked me later for being kind enough to arrange for his first moto ride in Togo (he’s been here 9 times). Baby got delivered “Toot Suite” and both mom and baby are fine.
Around 6 pm we had another stressful birth with a sick baby. Then this morning we had a baby try to come out hand first (the name for that would be MAL-presentation with obvious emphasis on MAL). Another Dr. Sam C-Section Toot Suite, another stressed baby, probably the worst yet, including an umbilical catheter for IV access. In between there were several sick malaria kids and one piece of corn up the nose (don’t do that again!). But the big news was our emergency call at 11pm………

Todd drove up the mountain last night in the ambulance (one of the minivans) to rescue 4 people from a car accident. They turned out to be Italians! From Naples. All of them high school teachers. They were on holiday touring Benin, Togo, and Ghana, somewhere up our road the brakes went out and they careened off the cliff, rolling several times about 20 yards down the slope (in the middle of the night). 3 of them walked away. 1 very nice lady has a broken pelvis but is otherwise well. The driver has bruises and one laceration but is also ok. Considering what we’ve seen and what can happen its pretty amazing they’re not worse off (that they’re even alive?!). We had an interesting time getting to know one another, one man spoke good French, 3 of them spoke a little English. Je na parl pa Francois, Je na parl pa Italian, for that matter. I’m sure their first impression was NOT that they’ve been brought to the best hospital in Togo (personal bias inserted here). In fact, the second lady MUST have had a concussion because her first question to me was could she have some Perrier? It was an interesting pantomime trying to explain that no, I’m sorry, but we don’t have any Perrier in the hospital, any bottled water at all for that matter, but yes, it’s perfectly safe to drink out of the tap, see here (me drinking) I’ve been drinking it fine for three months. I hope she had a concussion, because she asked me to look at her scalp numerous times, it was fine (just a bruise, no bleeding, no you don’t need stitches, yes you can have some pain medicine), and after a while I wondered if she maybe couldn’t tell that there some REALLY sick patients all around her – including her travel mate with the broken pelvis and the driver and all my 10 premature infants and …….Yes, I will check back on you in a minute, but for right now, S’il voux plait, your scalp is fine, I’m BUSY.
I did feel really bad for them. Apparently some of their bags went missing after the crash. I even offered pelvis lady some of Cari’s clothes (Cari doesn’t know yet, nice of me, eh?) which she declined. I walked back and forth to the guesthouse several times getting clean glasses then some muffins. (I don’t know how they’ll eat while they stay here – the Togolese make fufu). The dirt-floored, no running water cuisine may work for the Togolese but they probably won’t feel comfortable there. On my last trip back (around 1am) the guard waved me down to tell me ……something (my French just isn’t that good!). Finally I recognized a word – “serpen” Serpent! SNAKE! Probably 6 feet long right along the hospital path! I used the flashlight and chanted “no snake, no snake” (Tony style) the rest of the way in. Todd told me in the morning that it was dead, the guard had killed it and thrown it over the wall, but apparently told everyone he saw, including me. Somehow I missed the part of the explanation where the serpent was dead. The next morning our intrepid hospital administrators swooped in and the Italians (the 3 without pelvic fractures) are put up in style at our Guesthouse now. I just finished having lunch with them!

I think we have more pediatric patients – at least 15 – then ICU, women’s and men’s put together! YEAH!! We have eight isolettes (two of which still work) – all full. The hand presentation this morning had nowhere to go, we played musical isolettes again. Not included in the last 24 hours but adding to the craziness – we admitted another oomphalocele 3 days ago (the first oomphalocele baby died), and 2 days ago a baby with a vagina but no connection for stool (anal atresia) or urine (epispadias). That surgery was amazing. We’re trying to keep her alive until the pediatric surgeon comes in September. Russ is going to be way jealous (and sorry he left for his daughter’s wedding in the States?)!

People are coming even as we are thinking about returning home. I will be so very sad not to be here. Could you please pray for our flights?

God is calling us to the nations (Malachi). Are we listening?

May you seek the LORD while he may yet be found. And mawu ne no kpuli wo (May God go with you).

Yours in the service of our LORD,

CADT (The Robertsons)

August 13

13 Aout 2009 – Day 64

I will give you a new heart and put a new spirit in you; I will remove from you your heart of stone and give you a heart of flesh. And I will put my Spirit in you and move you to follow my decrees and be careful to follow my laws. – Ezekiel 36: 26-27

More joys and sorrows, more hills and valley (…..and many many days on call!) I’ve been on call every other day for 2 weeks now and I’m counting the hours until Dr. Bont arrives on Sunday!

One of great joys here is seeing very sick patients get better. The ones that arrive in a coma, with troubled breathing patterns, where we explain to the family that the patient might not survive, we might pray with the family and try a few (the typical) medicines, but really their life is in God’s hands. The Pediatric ward was like that today. I was up much of the night trying to keep one of our 28 week premies alive, he died around 4am. But during rounds three of our comatose-seizing-with-malaria-one-vomit/aspiration-away-from-death children woke up! Yes, THREE. Synchronized healing. It was wonderful.
PE-5, a 2-year old, had only been deathly sick for one day – he was sitting up acting normal asking for food (I love when Quinine works that fast!).
PE-4 is the patient I mentioned last letter – 2 year old girl with malaria and seizures – the Moslem family I almost didn’t pray for because I was angry at faker-guy, but ended up praying with them later, with the echoes of “amen” from around the room. She has been in a coma ever since arrival (1 week). Her breathing had improved, her seizures had stopped, her kidney failure had reversed, but she just hadn’t woken up from her coma. Things had been looking dismal (the longer coma lasts the worse the prognosis), we had started tube feedings with water and then bouille (porridge) in preparation for having the family take her home. (Because of the absence of specialized rehabilitation facilities and the relatively steep cost of inpatient care, we try to get patients home as soon as we can. This often means families are responsible for Foley catheters, NG tube feedings, range of motion physical therapy and dressing changes. It involves a bit of teaching and lots of wishful thinking but works out well more often than I would expect. Luv is a good example of a positive outcome.) Well yesterday she opened her eyes for the first time and this morning the family called out to me (“Yovo! Yovo!”) to show she had pulled her NG tube out herself, was trying to sit up, and was looking around! I think she even had enough strength to glare at me (scary white person). I started clapping and praising God (akpe na mawu!) and we were all having a joyful time. (And I really mean “all”, the whole room grieved with the mom of the 28 weeker who died in the night, and the whole room celebrates with families when things go well.)
While we were standing there having joy, the mom of PE-3 started slapping me on the arm. “Yovo, Yovo!” PE-3 was another 2 year old girl in a coma from malaria and seizures. She arrived two days ago, so not as worrisome as PE-4 (but who am I kidding? If the kid’s in a coma, I’m worried! 2 days, 7 days, coma is coma!). PE-4 heard all the commotion, opened her eyes and was staring right at me! Sometimes a little joy is a good thing. It was refreshing after a tough week.

With Drs. Briggs and Ebersole gone I’ve tried my hand at ultrasounds to take the burden off Todd a little. Monday was my call day and I think we did six. Often they are fairly straightforward -- check pregnant moms for accurate dates, confirm twins and check women with fibroids in preparation for surgery. Fibroids are masses of muscle in the uterus that can be HUGE here, and very painful, and definitely decrease fertility. The surgeons try to remove them for infertile women who desire to become pregnant. Once we see one on ultrasound the next question is “Do you want to be pregnant?” Most do, of course, which makes the surgery more technical. If not, the treatment is just a hysterectomy. One of the ladies was in her mid-thirties and had no children. So I was a bit surprised when she said, “No” she did NOT want pregnancy. For the first time (it was a busy day) I turned and really looked at her and noticed how sad she appeared. Was she married? “Yes” What did her husband think? (The men have the money) (Now we get the real story….) She had been diagnosed with this fibroid 8 years ago at another hospital, had been told it would make pregnancy difficult, so the husband left her. Just left. No baby, no commitment. Gone. No wonder she looked so sad. What was different now? Now the fibroid was so painful she wanted it out. How very sad. Thanks be to God His faithfulness is true and His promises are forever……UN-like ours, yes?

Sunday night Cari and I shared our testimonies at the evening worship time. It was nice. We shared our slideshow from two years ago and I shared several life verses including the one above. Cari shared what God’s been teaching her about hospitality (did you know the word “hospital” comes from the Latin root?) Dan and Rachael Stoner arrived Sunday for a survey visit and gave their testimonies Tuesday at prayer meeting. They are pilots and have committed to the mission here. They are in the final phase – just need to raise support. It was great to hear about that part of the ministry – a plane here could open up all kinds of doors. We walked down to the hanger Tuesday and the boys got to sit inside the plane – a little 6 seater. Speaking of missionaries who could use our financial support (!) there is a surgeon and his wife in MI who are committed to a career here, but they still need to raise over half their support. The hospital could desperately use them, we’ve been without a full-time surgeon since Bob Cropsey left 7 years ago.

Anyone looking for a career missionary to support – to get magnet family pictures for the fridge, monthly prayer letters, and once-every-four-years visits from fatigued missionaries home on furlough? 
(Besides us, I mean?)

While I’m thinking about that, visits from friends and family back home can be an incredible encouragement to the missionaries out here. Anyone want to visit us while we’re on the field next summer? Your letters and messages have been a blessing for sure, thank you again to everyone who prays for us and writes to us, please don’t stop (but just in case some of you were feeling a prompting about international travel………)

We hope you are also well. The summer is winding down and school is near. We pray you find rest and peace solace in the presence of our LORD. Thankfully he has promised to save us from all our uncleanness! (Ez 36)

May you seek the LORD while he may yet be found. And mawu ne no kpuli wo (May God go with you).

Yours in the service of our LORD,

CADT (The Robertsons)

Tuesday, August 4, 2009

July 30

30 Jul 2009 – Day 50

Greetings in the name of Jehovah, the LORD who heals us! (Ex 15:26, Ps 103:3, Ps 147:3)
We pray that all of you are well, and walking in the knowledge and strength of the LORD.

Today was one of those days. Some days I wonder about Psalm 84:10. Who did I pick medicine? I wonder if David might have been having a day like mine. Of course, no one has with vengeance sought my life the way Saul chased David. But today was one of those days…….

Call was long, but God was watching over (was someone praying specifically for me last night around 9-10pm?). The late afternoon was filled with odd patient after patient (involuntary sticking out of the tongue?). I arrived late for Cari’s special African missionary dinner. Then I was called back before it was over. Around 1am a difficult pregnancy came in and at the same time I was also informed our 28-30 week twin mom was having early labor. But before I knew it the difficult pregnancy was delivered and the premature mom was settling down and not progressing! I slept a few half winks and woke up in the morning to a zoo……..

Walked in on semi-comatose 70 year old abdominal pain, distention, small bowel obstruction, difficulty rehydrating took to OR to vomit and aspirate, pus in the abdomen, coding during recovery now on Dopamine. 6 month old with incarcerated hernia. Sent home the 70 year old with prostate hypertrophy/urinary retention who got knocked off his moto trying to get here, femoral contusion, pelvis xrays negative, sent home to rest and follow-up. Also sent home the 70 year old chief of his village whose best friend/secretary died, had dysarthria after returning from the funeral home (and a few drinks), rehydrated, told to rest (does one rest if you’re chief and your best friend is dead?); And the 40 year old encephalitis NG feed dependent lady in infection. Heart failure lady was better, as was 20 year old HIV pneumonia lady, but SI2 old man with wicked pneumonia was still touch and go and getting a standing CXR was an experience not just once but twice (first no good, did they really try three times?). One of our 30 weekers was vomiting blood. Then 20 year old in coma, completely unresponsive and breathing 6 times a minute (not good), he died while I was away at lunch.

Russ let me away for lunch. We all hiked to Jeremy and Elise’s in Tsiko. FuFu and chicken in a peanut sauce. Cari took a (short) turn at the FuFu pounder. (Have we mentioned FuFu is eaten by hand?) Washed down with sweets and a Coke. Very proud of Drew who tried it and found he liked the sweet biscuits best (ate 4). They explained that inviting us into their home to eat African was their way of accepting us! It was very sweet and VERY much appreciated on our end. And so different from eating Western food at the Guest House surrounded by typical Western amenities. Of course, found out later we were almost African, they set us each plates and true Togolese dip into a community pot of FuFu. (As I watched John, their 3 year old son scoop and slurp his FuFu down with not quite clean hands, I couldn’t help but think about Amebiasis and all those other fecal-oral infectious disease and said a quick prayer of thanks that our hosts were so thoughtful. Then a pang of regret and self-criticism as I realized how far from African I still am). A lovely time of fellowship …..shattered by the piercing screams of a 2 year old boy splitting his lower lip open …..followed by gurgles as the blood poured down his shirt and legs. At first we thought it was the darn nose again but a quick exam by Doctor mom (confirmed by a pediatrician) identified a GAPING lower lip. He had fallen onto a big wooden FuFu pounder of all things. Long hike home considerably shortened by a fortuitous encounter with returning missionaries in their Land Rover. So the afternoon started with 2 stitches, Tony papoosed between two parents. Fortunately the surgeon was still waiting for his next case so Andy didn’t have to gown up!

Cari took the boys home….. I turned back toward the hospital……And the next thing I knew I had entered a zoo. The afternoon went all to pieces. The first 70 year old’s surgery went all to pot, then the 28 week twin mom went into real labor and delivered, one vaginally, the other by C-Section. Meanwhile the 20 year old died. And another 20 year old who had severed off the tip of his finger waited patiently for an open OR as arterial blood continued to pump out of his finger. Another 20 year old with a fractured clavicle and small holes in his side waiting in the hall for someone, anyone, to be free to patch him up so he could go home. He must have wondered why I passed him >20 times without ever stopping to fix him. We played musical isolettes without the music for the ever-increasing number of premies in our “NICU” because now we only have two functional heater units; and with two new 28 weekers, three (four?) 30 weekers, and a (I can’t believe he’s still alive) five week old former 28 weeker – well, sorry but sickest baby gets the working unit. If you’re unlucky enough to be doing well you get a broken down unit with a hot lamp and a few extra blankets. Did I mention we only have four functional IV pumps? Yes, we still count drops per minute here! Here come some more……..Kid with typhoid, 4 weeker with fever rule out sepsis, boy with hemoglobin of 4 (thank goodness for something simple!), 8-10 getting-more-frustrated-ladies waiting (with their angry husbands) for pregnancy ultrasounds (most come 3 hours from Lome, where wealthy people are used to demanding and getting, and they come up here because we’re cheaper and offer better quality, but their lack of patience really gets to Russ sometimes, and this was one of those times!). Then the family of the really sick man in SI2 asked to be discharged so he could die at home. Another man (where did he come from?) asking Russ then me to sign an insurance form (are you serious? Right now? Can’t you see I’m coding a 28 week twin here and that man over there is dying, too? Please come back later!!!!). And all the family members, friends, and general rubber-neckers inching closer and closer to the chaos around the nurses’ station/makeshift NICU. At one point we had to yell to get the 15-20 some people who didn’t belong there to step outside (only kinda worked), reminding me how lovely those NICU double doors were, you know, the ones with the big sign NICU -- NO ENTRY PAST THIS POINT, next to the security guard, the big sterilize-up-to-your-armpits-like-a-surgeon sink, and the ONLY PARENTS ALLOWED sign. At one point Russ turned to me and asked “What are you still doing here? Aren’t you post call?” But I know he’s exhausted. He’s trying to schedule umpteen ortho and complicated pediatric surgery cases for September before leaving in 3 days and has been up til 3am several nights in a row. Am I really prepared for him to leave? Then I remembered I WAS post call and it would all start again in 14 hours. So I left the zoo………

I found out later they also found a scorpion in the pharmacy……

I want to talk about the persecuted church….I read Tortured for Christ by Richard Wurmbrand…..no time to think today……

Tony’s doing well.
I love that they feel free to run around the compound – the whole place is like a big backyard. Drew even bikes the loop and they both ride down to the tennis court to play. But the downside – we have no idea where Tony scraped up his face.
We’ve moved into the Guest House apartments now as the DeKrygers return tomorrow. Sad and happy – it’ll be different but there will be four more young boys. Bye to the toad and tears for the former farm mouse. And unfortunately we’re now quite some distance from the (4am) crowing roosters.

May you seek the LORD while he may yet be found. And mawu ne no kpuli wo (May God go with you).

Yours in the service of our LORD,

CADT (The Robertsons)

July 29 - from Cari

July 29th A quick peek from Cari:

Since I don’t have any photos, I decided to describe a few scenes to you of Togo.

Scene 1: the local grocery store
Take a peek in and you will see large sacks stacked on the floor of rice, flour, corn flour. Sort of like Sam’s Club, but these bags are seriously huge! One small counter straight ahead where the sale is transacted. Make sure to stop and say hello to the workers there (happens to be a Moslem family). Behind the counter is an incredibly large network of shelves where every space is filled with something. Straight ahead are the cigarettes, batteries and soap. To the right and up is the pantry – tomato paste, canned corn, canned fish, pasta and powdered milk. To the far right are shelves of biscuits (a sweet cracker) and cookies. Down toward the floor are shampoos, hair ointments, and the like. To the left are smaller sacks of flours, sugar, corn meal. And finally, in a closed case, are a collection of cell phones. And there you have the typical Togolese grocery store!

Scene 2: the street
Walking along the road by the hospital is never dull! First the road itself has its own obstacles such as large potholes and roaming animals (goats, dogs and chickens). Sometimes the holes are filled in with dirt – I especially like it when the dirt includes patches of weeds or grasses! It is important to be aware of the road as there are often motos (motorcycles) and large van taxis which come zipping down the mountain and honk to you to get out of the way. There are always people walking the road – bringing clean water home from the hospital well or large bowls filled with firewood for the outside stoves the cooks use. Oh – and all of this is carried on the head. There are a few stalls, as well, where bananas, soap, fabric, bread and tomatoes are sold. At this time of year the grass can get quite high, so it’s important not to move off the road too far or you might spook a snake! And all of this is to the tune of “yuovo, yuovo” a chant the kids call when wanting to get your attention (meaning “white person, white person”).

Scene 3: the small church
There are several church plants in small villages near the hospital. These churches are unlike anything one can see in the states. They meet under payouts – grass covered roofs held up by large wooden poles. Inside, families carry their own chairs and benches for seating. The floor is packed earth (or not so packed as Tony found one Sunday which led to a lot of dirt in his socks and in his Bible). There are a couple members near the front who play their instruments for music. Behind the pastor is an open view of a valley and a mountain – all lush vegetation. There is nothing hanging on the wall – they are glad to even have a wall! (Usually of bamboo nailed to poles) There is no sound system – easy to hear in such a small space, and electricity? Out here? But there are strong voices raised in worship and in prayer. There are children smiling and laughing when shaking hands. There are coins dropped in the offering bag as it passes around. There is truth in the message as the Pastor opens his Bible and preaches.

Tomorrow we move out of the home we have been staying in – into the guest house where we will be in two large bedrooms which have and adjoining door. Please pray that the boys adjust well – they will have to say goodbye to the toys, space and bikes which have been their’s to use while in this home. We are happy to know, though, that it is because our friends will be returning to their home, and we look forward to seeing them. In case we have not mentioned it – the DeKryger family has four boys – ages 2, 5, 7 and 9. I think my boys will be happy to enjoy these new playmates.

In Christ,

July 26

26 Jul 2009 – Sunday, Day 46

Hello friends and family. We thank God every time we remember you. Our internet has been down for four days but is back on!!! Yeah!!!

The compound is quieting down. The Briggs left for a year’s furlough yesterday. They’ve been here for two years. There were lots of tearful goodbyes from Togolese and American friends. It was neat. Dr. Martin leaves tomorrow and the Ebersoles head back next weekend. Our busiest two weeks have just begun.

I wanted to remind everyone how important your support is to us. We truly appreciate everyone who prays for us and for those who’ve blessed us through financial support. My last night on call two pregnant women arrived in labor. One had a prolapsed cord and lost the baby. The other had shoulder dystocia and was a very difficult delivery. Fortunately, Dr. Martin rushed in and helped with both, so I’m praising God for his assistance. I’m also looking to the next couple weeks with no OB-GYN backup and asking for your prayers! So many times patients come in with difficult diseases and we need providential wisdom and discernment (to cover my huge gap in knowledge of adult conditions). We need to decide quickly if they have a problem we can help with medicine, or if they have an untreatable condition and need to hear the gospel and then be sent home to die. It’s much better for the family if we can make decisions quickly before exhausting their meager resources on futile care.

There are joys to share as well. Your support helps us bless the Togolese if many small ways. Cari brings the boys up every Friday and we sing songs in Eve and English, then pass out small treats (Hershey’s kisses, tennis balls, coloring books, stickers, stuffed animals, etc..). The patients and their families love the boys and really appreciate even the smallest gifts. Also this week we were able to share some eggs and coca-cola with boy who drank lye and is on a G-tube. He desperately needs protein to build up his strength (one of the best sources of protein but very expensive) and the coca-cola actually cleans the sludge and debris out of his G-tube to keep it working. Such a small gift, a bottle of soda, but the mom has been thanking me every day for the past three days and I’m overwhelmed at her gratitude. I have to keep reminding her “akpe na Mawu” (thanks be to God, not Andy) - and explaining about all of my friends and family back home in the States who made the gift possible (you guys!). Again, just another soda to me, but Wow……

Come to Africa! Missionary advantage #4: You become part of the missionary family and suddenly everyone is an Aunt or an Uncle. The kids have relatives all over the place!

May you seek the LORD while he may yet be found. And may you love him more than anything else in your life (hammocks and air conditioning included). And mawu ne no kpuli wo (May God go with you).

Yours in the service of our LORD,

CADT (The Robertsons)

July 23

23 Jul 2009 – Day 43

Greetings in the name of Jehovah , the LORD who heals us! (Ex 15:26, Ps 103:3, Ps 147:3)

I should never have mentioned how quiet the hospital was! Things are busy again. Please pray for us. This Monday the Briggs family and Dr. Martin both return to the States leaving two pediatricians and a surgeon. It means every other night call for a while and leaves a real gap in OB coverage. I’m learning as much as I can before Monday!

Cari the farmwife is sad. We discovered that our pet mouse was actually living in one of the kitchen drawers, curling up in a dishtowel. We couldn’t tell if the poop was fresh but then we found two fresh urine puddles. The drawer looked so much like a home I was worried I was in a Disney movie. We moved the unmolested traps into its home and they quickly did their duty (I guess African mice do like peanut butter after all). ATsuTse helped us get rid of it (talk about “chickens”!). Definitely NOT a Disney movie.

Speaking of animals, we have a toad problem. Or rather, a problem toad. He must be a former tenant who thinks he still lives here. There are many toads, often sitting out on the path at night practically begging to get stepped on. Maybe there is an upside to the snakes after all. I was sitting on the kids’ bed and felt something move under my leg. I was worried about snakes but didn’t dare check for fear of getting bit, but then checked for fear of the kids getting bit, but didn’t find anything. But later that day I was sitting in the rocker and felt the same thing behind my back. Now I was quite freaked out and jumped up, something moved……just a gecko. Never had that happen before.

The Briggs family volunteered to watch the boys so Cari and I took a romantic 3 hour hike up the mountain. It was nice to walk at an adult’s pace. We met several people on the road including a man who spoke Spanish as well as French and Eve and a spattering of English. We practiced our greetings numerous times in response to the cries of “yovo”. We saw and heard more army ants. After 1.5 hours I was just pooped. We had been told the first village was only 45 minutes away, and our Spanish speaking friend kept saying “almost there”, “just around the next bend”, but after two or three false alarms (and numerous chuckles about the similarity to picking out the perfect Christmas tree) we decided to head back. The next morning we went to church that way and discovered we had indeed been just one more bend from the village.

Rounds continue to be challenging.…a mixture of joy and heartache:
A 6 year old girl admitted this afternoon unconscious. She was started on malaria treatment since that is by far the #1 cause in children. When the grandmother finally arrived we got a completely different history. She was with a friend somewhere else, they grabbed a bottle from atop the cupboard and drank most of it! She slowly woke up through the course of the afternoon but reeked of alcohol. I’ve never seen that before.
The boy who drank lye came back. It ended up scarring his esophagus after all. He’s lost 5 pounds and can’t eat or drink well so he got a G-tube this morning and will need surgery down the road.
We always ask why people come to the hospital (“chief complaint”), or why they have brought their child to be seen. Russ was on call and heard a chief complaint that neither he nor I have ever heard before – “What’s wrong with your child?” ….. “He’s dead.” Turns out he had supposedly died that afternoon at the grandparents, but by nightfall when the parents arrived to start funeral arrangements someone noticed that he was still breathing. He ended up dying anyway, not surprisingly.
We sent a 40 year old lady home to die earlier this week. She had been sick for several months, losing weight, coughing blood – her HIV test was positive so she probably had TB as well. After our lightning rounds I went back in to talk to her some more. 10 kids, three had died. A husband who was also wasting and sick (and also ended up testing positive for HIV). When I asked if she was eating ok the family responded no, she hasn’t eaten in two months! I started to scold her (trying to do it in a good way if that’s possible), telling her that if she doesn’t eat, then our medicines aren’t going to be able to help her. Then I felt bad about scolding her and realized she probably already knows our medicines can’t help her now. My heart changed. Feeling compassion now, I realized I should be sharing the gospel with her instead of scolding her. I remembered how the Bible says Jesus loved the rich young ruler even though the rich man ultimately went away sad, and I tried to see her with Jesus’ eyes of love. Daniel, the nurse, and I talked about when Jesus healed the paralytic, first forgiving his sins, then healing his disease. And we shared about the two thieves on the cross, one of whom believed in Jesus during his last moments on earth and Jesus promised him a place in paradise. She accepted Christ. Then we sent her home to die. She will leave behind 7 kids.
We sent a second lady home to die this afternoon, young lady, only 20. She had something incredibly complicated, with kidney and liver failure and we think probably adrenal failure as well – she had hyperpigmentation, truncal obesity, moon facies, and profound weakness. It had been going on for 9 months and she was very sick, but we still always hope we can do something. I feel like a failure even though I know she’d have gotten a gazillion tests and scans back in the States. Medicine in the dark with a blindfold on, I guess. Today we sent her home to die before it got dark and while she could still get into a taxi. We also broke mom’s heart as it was her only daughter.
Our 28 week premie is still alive. It’s not on full feeds yet so every two or three days when we lose the IV its touch and go – she’s one failed IV from death. But she’s otherwise doing great. The two miracle 30 week twins both died within 24 hours of each other (Mom came in for persistent bleeding after giving birth at home. We took her back to the OR to stop the bleeding in the uterus, only to discover another baby inside! Born over four hours apart, but both very premature). We also lost a 3 day old to oomphalitis (infection of the umbilical cord that spreads to the whole body causing sepsis (blood poisoning) probably from unsterile birth conditions). I’ve only read about it, never seen it, but here we really do see everything.

Thank you again and again and again for your support – your prayers and good wishes. I think today I have hit a wall, a bit homesick. I was dreaming of air conditioning, the hammock, dinner out, taking a nap on the couch, chips and salsa in front of a football game..……no ants……..Five more weeks seems like a long time…… (I’m wallowing a bit today)

Come to Africa! Missionary advantage #3: CHARTING is unbelievably simple, like back in the good old days. (No Dictating, and No Joint Commission.)

God humor #3. I walked into the doctor’s lounge and found my backup pair of glasses I had left here two years ago, a little moldy but otherwise unharmed. Good thing we came back!

May you seek the LORD while he may yet be found. And may you love him more than anything else in your life (hammocks and air conditioning included). And mawu ne no kpuli wo (May God go with you).

Yours in the service of our LORD,

CADT (The Robertsons)

July 16

16 Jul 2009 – Day 36

Greetings in the name of Jehovah , the LORD who heals us! (Ex 15:26, Ps 103:3, Ps 147:3)

O da deviah ma? (What is the child’s weight?)
Deviah Nanoh-a? (Is the child breastfeeding well?)
Meba-NAH-dee. Babuya de-KAH. (Please, I have one question.)
May lay nada dim. Fica srronye? Fica vinye-wo. (I am looking for something. Where is my wife? Where are my children?)

Those last two are on my favorites list. The last usually gets laughs, especially when I say it for practice and Cari is right beside me. I can get even more laughs by adding a “-wo” to the end of “srronye” to make it plural. (“May lay srronye-wo dim.” = I am looking for all my many wives!) Meba-NAH-dee is a fun word, too. It’s like please in French (S’il vous plait) but literally interpreted it’s not please. “Please” in Eve is “Medakuku” which no one ever uses. Meba-NAH-dee literally means “I want to tell you something”… and it comes out sounding like “Hey you!”

There is something wonderful about learning someone else’s language. It’s a rapid rapport builder with staff and patients. And it’s definitely the quickest way for me to generate laughter (a favorite thing of mine). The hospital staff all seem keen to teach me a new word or phrase every day, and the patients and their families often enjoy teaching the “yovo” (if they aren’t staring at me blankly not understanding a word). The other day a lady called out to me on my way home and asked where I was going – after a couple seconds for processing, I was able to respond back “Me le yi apeme” (I am going home) – I learned this phrase quickly and enjoy using it at the hospital as often as possible!

Tuesday night we have prayer meetings. One of the women that come to help Bea Ward teach the teachers is a worship leader back home. This was her last Tuesday so they asked her lead us in song and we had a jamming guitar/African drum/ukulele time of praise. We sang many favorites including Days of Elijah.

Things have been quieter at the hospital. The complicated follow-up surgicals from the Mercy Ship have mostly been seen. The pediatric ward was empty the other night for the first time in a while and the hospital census has been down in general for a couple days. Our new surgeon is here, Dr. Saloam and his wife Dianne. He’ll be here for three weeks. He was here 5 years ago and I gave him a tour to get reacquainted. We shared call last night, his first night here, and we put him to work right away. We had a 10 year old hit by a moto with a lacerated Achilles tendon (not good) that he put back together lickety split. And then around midnight a classis typhoid perforation (severe abdominal pain for several days, very tender abdomen, and free air under the diaphragm on x-ray) that he fixed no problem. Typhoid is so common here that we’ve banned eating raw cookie dough (very sad for the boys and I).

I bought three flashlights before we left, none of which work reliably. And the two we bought here (for a buck) stopped working so walks back to the house at night are interesting. We still chant “no snakes” a lot. And with supplies somewhat hard to come by we economize quite a bit. The other day I actually used the soap until it completely disappeared – something I’ve never done before.

Good quiet time out of Mark 10 – the rich young man. I love this passage for many reasons.
1) Because it’s the only place in the Bible someone left Jesus’ presence SAD (happy, joyful, thankful, angry, furious, etc, yes….but never SAD ---I think….correct me if I’m off all you Bible quizzers out there). 2) Verse 18, God alone is good. So often I fall into the trap of thinking that being a medical missionary makes me a “good” person. When people say we’re good people for coming here it just inflames the pride. But here Jesus himself rejects the label “Good teacher”!!
3) And I may be following most of the Christian “rules”, but what one thing do I lack – what one thing do I have a hard time surrendering completely to the LORD? I actually came up with several things that would be hard to part with (starting with M&M cookie dough!!): favorite foods, carpeting, no ants in the house/bathroom/kitchen/bedroom/incubators, football in the fall (high school games Fri evening, college, NFL on Sunday, fantasy football), favorite books and movies, going out to eat at local restaurants….
4) Its wonderful promises! Jesus loves us (v21), treasure in heaven (v21), all things are possible (v27), a hundred times family members (v30), and most of all eternal life (v30).

Thank you again and again for your prayers and support. We couldn’t be here without you. May you wrestle with God and with your own “one thing” and overcome like Jacob overcame.

Mawu ne no kpuli wo (May God go with you)

Yours in the service of our LORD,

CADT (The Robertsons)

July 11

11 Jul 2009 – Day 31

How beautiful are the feet of him who brings good news! Dirty and pierced for us. Akpe na Mawu!

Hello to all of you. We hope all of you are well. And your family as well. We’ve been reading through “Don’t waste your life.” One of the last chapters is a call to be a missionary. Not just overseas but also at home. And to be thinking about the partnership between senders and goers, as both are critical to the sharing of the gospel. He comments how important it is that sending churches and sending believers have hearts and minds excited about missions, active missionary mindsets at work, with family and community, with finances, time and property -- so that those who are sent have an authentic message. We want them to love the same Jesus we love, the radical life-surrendering Son of God…….We don’t want the Togolese to love America.

July 8th. Wednesday. Melody Ebersole is away. Have I mentioned before how much she and Cari are alike? Her last week was filled with ministry. Despite her numerous exclamations about how much packing she had left to do, she put it off to the last night so she could spend one last time of fellowship with so many of the Togolese kids she’s pouring her heart into. Yao – the amputee that gets around on crutches who she’s leading through the book of John; the 60 kids that come over three times a week for praise and worship and Bible teaching; even a party for all the kids who made decisions for Christ this past year (how could she NOT do these things!). Last minute packing kept her up the entire night so Russ was worried she would fall asleep in Paris and miss her connection. When I stopped by to say goodbye she was lamenting all the non-people tasks left unfinished, like writing some thank you notes. I encouragingly said she could write those on the 3 hour drive to Lome. She said, “Oh no, I’m going to spend that precious time talking with my boys. I’m hoping to get them written on the plane.” “Melody, you won’t write them on the plane, either, you’ll end up sitting next to someone and talking the whole flight!” She smiled and groaned, “Oh I will, won’t I. Please, God, let me sit next to someone who doesn’t want to talk.” We got a good laugh out of that one. I don’t know what happened on the flights, but Russ said she made her connection – she spent her whole layover in Paris talking to a nice gentleman and sharing the gospel with him!

July 9th. Thursday. John and Betty Teusink invited us for dinner. It was nice. They have been here a LONG time, raising their kids here. Two years ago they were wanting to return from furlough but struggled with fund-raising. We’re glad they’re back. He’s the maintenance guy and jack-of-all-trades handyman. He even fixed the ice maker in the guesthouse to the boys’ delight. The place wouldn’t go without him – I think I’ve mentioned before how the hospital can’t function without hot water. All it takes is a faulty boiler to shut down our entire ministry. So again, we’re definitely glad they’re back. Which reminds me, THANK YOU again to everyone who is supporting our trip here and praying for us. We wouldn’t be here without you, either!
Betty saw a cobra in her yard – they still visit from time to time although it is much less often since the wall was built around the compound. I guess it was a small one, but still big enough to stick its head up out of the grass and hiss at her (poor thing, it was probably lost and scared and just looking for its mommy…...). Cari took advantage of Betty’s library to borrow the Janette Oke books and videos, apparently this is considered a real treat? She is enjoying them so much (How much is she enjoying them?) just minutes ago she flatly refused a back rub to keep reading one!

July 10th. Friday. Lively discussions at the guest house! Our newest arrivals here are Barb and Bob Adolf from Cincinnati. They retired from 45 years of full-time missions in Bangladesh not long ago but still manage to come to Togo – they’re here for 4 months. He’s helping fix old and install new lab equipment. They have great stories and love conversation. They also brought their 16 year old grandson.
They came in through Ghana and had quite the journey. Apparently President Obama is visiting Ghana this week? (Nobody knew this….we don’t get much news here) The Adolfs had funny stories about the newly painted airport and signs about not touching anything! His visit happens to coincide with a nationwide gas shortage – not a single gas station in Ghana was open. They made it back on fumes, I guess the car has just enough gas to make a roundtrip from the Togo border. Theories abounded, conspiracy ones included, because none of us knew the real reason. I guess when you’re the dictator you really don’t need a reason to shut off gas nationwide. The most popular theory was crowd control – it’s hard to mobilize for protests and rebellions when there’s no gas. President Obama will think Accra is a nice, quiet city (with a beautiful new paint job, as well!)
And Hillary Harris (the anesthesiologist from South Africa) was supposed to leave this morning for Benin - 3 weeks volunteering on the Mercy Ship. But hot off the email presses was a warning from the US Embassy to stay off the streets of Lome this weekend (her route goes right through the capital). Apparently the main opposition party in Togo scheduled demonstrations this weekend – usually peaceful but always with the potential to turn ugly and violent (the missionaries that were here in 2003 still vividly remember the shootings, stabbings and injuries that followed the national elections – HBB was overwhelmed with patients and refugees). So she elected to stay here until Monday.
With Melody Ebersole gone to the States, Cari has taken on her role as HBB “child life therapist” (child visitation and general amusement). The four of us visited the pediatric ward, sang a couple songs in Eve and English, handed out some toys and candy, then Cari walked around and read Bible stories to the kids (while Andy quickly cancelled NPO orders on two boys so they could eat their chocolate kisses). (Speaking of Cari being like Melody, she’s still debating whether or not to continue having kids club at our house – it would only be about 60 kids three days a week…….in French……..)

July 11th. Saturday. Interesting day, not too busy. Saw a 20 year old French mademoiselle for abdominal pain and dysentery – positive Entoemeba in the stool = amebiasis. Nasty little critter (yet another reminder how blessed we are in the States for such an incredibly clean public water supply). How odd it was to go up to the outpatient clinic and see a white face!
This morning we said goodbye to the other Harrises (David and the boys Steven and Robert) who will return to South Africa without their mom. Drew will certainly miss his Settler’s/pingpong/card game buddies who’ve been so good about including him in things.

For those who were interested in the chalk story, I counted again and found 23 pieces. And the “hand towel” at the nurses’ station sink was an old hospital gown, which they pull out when the 2 ratty old towels get too wet. To clarify, though, the towel shortage may be the result of thievery more than finances -- good towels tend to “walk away” (just like nice pens always walking away from the OB floor back home). In fact, one of the missionaries saw one of our really nice OB towels on the back of a moto at the market one time and she chased the guy down and wrestled it back from him!

Ps. A note from Cari – Apologies to the Peterson family. It was Rebecca Peterson, not Laura, who was at Black Forest – Andy had a momentary memory lapse as he wrote the last email

Mawu ne no kpuli wo (May God go with you)

Yours in the service of our LORD,

CADT (The Robertsons)

July 9

Akpe, akpe, akpe Jesus, akpe July 9th
Nusiwo ne wonam madakpe nawu
Akpe, akpe, akpe Jesus, akpe

Thank you Jesus for all your good gifts to us! A new Ewe song that we learned from the only female surgical technician here, Patricia. There’s something fairly incredible about being able to thank the Lord in a different language – to know that his children thank him from almost every space on Earth. And to think of what it would mean to know “thank yous” come from every language spoken…a prayer for the many unreached peoples of this world.

Life continues to go well for us here in Togo. As I write, Andy is at the hospital dealing with “accident” victims. At this time of night, that is never a good thing. I am sure he will write about the details in one of his emails. Suffice it to say that God is certainly using him and his skills here. And I have enjoyed seeing how excited Andy has gotten about sharing his faith with the patients – and seeing God answer prayers for these people.

Drew has been enjoying spending time with one of the boys of another short-term mission family – Robert is 11 and from South Africa. The two of them have played the longest Settler games every afternoon all week! (Settlers is a strategy board game) They like to play to 30 or so points (instead of the normal 12). It’s been fun to see Drew mature as he hangs around with these older youth.

Tony has made many friends – everywhere we go someone is calling his name. He has learned to say “akpe”, “ca va” and “evivi” (thank you, how are you, yum yum) which always gets great reactions from the Togolese. His biggest thrill is still the time he spends feeding the chickens.

Both boys will accompany me tomorrow to the hospital to spend some time with the kids –giving small gifts, singing songs, reading stories. They seem excited to do it. I have taken on the visits as Melody Ebersole (the other pediatrician’s wife) has now left for the states and has transferred all her small gifts to me to pass out. It was hard to see her go – she has been an inspiration to me. And Andy has pointed out many times how similar we are – from misplacing things to spending all night packing before a trip (she had to fit in a couple parties and ministry – so much more important than packing!)

Many of the people who were here when we first came are now leaving or getting ready to leave. It will be a time of transition for us and for the compound. Please pray for Andy, especially for stamina, and for Drew who will really miss some of the kids he’s gotten to know. We are glad our friends Jeremie and Elise are still here as Drew has enjoyed being with their son and nephew.

Thank you for your continued prayers. We have definitely seen it in the hospital – I am sure Andy will share more about how God has been working there to save souls and not just lives. God is good! Akpe Mawu!

July 6

6 Jul 2009 – Day 26

Ok, here is a somewhat typical morning greeting:
nDee! Apemathoe?
Olee. eChobedo.
Do cho. Deveearay?
Wo fwo. Apemathoe?
Wo fo. sRoe wo fwa?
Ehh. O fwo.
This is accompanied by a handshake and repeated with unending variations to everyone you meet at work (remember there is quite a bit of French influence here!). Sometimes it even continues as the two parties finish their handshakes and start walking away from each other! And other times they’ll be finishing the verbal exchange with one person while starting the handshake with another. When I’m joining in, this exchange is usually followed by peals of laughter. There’s a French version as well, of course. And ambitious missionaries can even learn the Kabiye version!

Well, internet’s been down for a week now. We were told Saturday it would be repaired today. Today, we were told it would be ready tomorrow. Who knows what tomorrow will bring?

To be honest, while some things remain vague and unpredictable like phones, internet, and electricity, the one thing we do know about tomorrow is that there will be sickness and disease, surgery and malaria, wonderful recoveries and the finality of death….and I’ve been working so much lately I don’t have much time to think about internet.

July 4th. A wonderful evening of fellowship. One of the celebrations that bring the missionaries together. Though it rained a bit, we had independence-related Cari-led games in the Payute (like a pavilion), a delicious barbecue/potluck, tons of desserts, ‘smores over a campfire, fireworks (bottle rockets from a coke bottle to the pediatricians’ dismay and Togolese pipe bombs), and a time of singing and praising God. Our Canadian and South African colleagues joined in for most of the party.
Earlier in the day I got to see Luve in follow-up. He’s the 5 year old hero that pushed a 2 year old girl out of the path of a moto, was struck and in a coma for several days, and is now recovered enough to go home. He’s eating and using his right arm, but not talking or walking yet. His heel cords are tight so Dr. Briggs and I fashioned some AFOs (ankle-foot orthotics) for him to wear at night to try to stretch out the muscles. (As we sometimes joke about here, we referred him to physical, occupational, and speech therapy while he was in the hospital, but apparently there is a HUGE backlog of referrals and they never stopped by….typical!….and there was such a LONG wait list for appointments at the office they couldn’t get in…….) We did the best we could but it sure would be nice to have real therapists here with us! (Hint,Hint, Andrea……. : )

July 5th. Sunday. On call (3rd Sunday in a row). Cari and the boys rode up the mountain with the Ebersoles for church. 60 year old man who was so drunk the night before he drank insecticide (not good), in a coma getting gastric lavage and atropine. 40 year old man who broke his ribs 4 days prior to arrival, has a gallon of blood in his chest and a flail chest (the broken rib pieces bulge out with each breath), and his kidneys have shut down, no urine for 2 days (because we don’t have true ICU care, his only real hope is to pay 100,000 a week for dialysis in Lome, usually prohibitively expensive. 40 year old lady with extreme hypertension (finally controlled with four meds, one of which is so old it is no longer sold in the US and we had to go back to a 1994 Drug Reference Book to even find it listed in the dosing guidelines, under the qualifier “Rarely used”!), pancreatitis, and kidney failure (yes, very common here), actually doing a little better. Premies doing well. Sick newborn seizing. Malaria kids recovering.
Late in the evening I returned to the hospital to treat a child with severe malaria and seizures. While I was there I stopped to chat with the 60 year old because of some abdominal pain. He was awake now, and talking, and looking so much better. We talked about how I could give him pain medicine but it will soon wear off. The bigger problem was his bad decision to get drunk and drink insecticide. I didn’t have any medicine for the pain of that sin. But we believe in and follow the God who created us and sent his Son Jesus to die for us. Jesus says he came to take away our pain for good, he died for our sins, so we could be forgiven and have a new life. We at HBB were all very thankful to God he was still alive. He could’ve died because of his bad decision. While he was here I wanted him to hear about this Jesus and think about following Him. No one else could make this decision for him, not us doctors, not his family, just him and God. Then I briefly shared my testimony with him, like I did with the youth at the lock-in, how before I followed Jesus I used to drink a lot and one night drank so much I couldn’t remember what I did – just like him. That was the night that changed my life, and started me on the path to listening to Jesus and following him. Would he think about that? Akpe na mawu! But of course he was Kabiye and he didn’t understand. So after the laughter at the yovo stopped my nurse translator who knows Eve, Kabiye, English and French translated -- We thank God! I found out the next morning that he gave his life to Christ while talking with the chaplain during morning rounds!

July 6th. Long night. The child with malaria had seizures all night and things look bad. Then they brought in a 5 year old with tetanus spasms – whole body, including the trismus (locked jaw) that is so classic. The old studies report a 50-50 chance of dying from tetanus, but here at HBB they’ve started putting the anti-toxin directly in the spinal cord so I did that for the first time ever -- by lumbar puncture. We’ll know in two weeks if he’s going to make it. The 60 year old man and 40 year old lady are much better. The 40 year old man’s kidneys have not recovered any function and we sent him home to die. After morning rounds I took a long nap.
Jade, a college student here checking out missions, has had a wonderful time. She has tons of energy and jumps in everywhere, especially up at the hospital. She’s helped out a lot in the surgery sterilization room, cleaning and organizing supplies and folding drape after drape. The work is tedious but I guess the staff is a lot of fun so she really enjoys it. They sing a lot of songs, in Eve, French and English, and Bible quiz each other. She did Bible Quizzing at her home church so she fits right it (plug for Bible quizzing!!). The other night at the Ebersoles she taught us an Eve praise song (akpe, akpe, akpe, Jesu, akpe) and stumped us – name the two books of the Bible that end in a question mark?
Tomorrow Dr. Martin finally arrives. We’ll have two weeks of four docs on the call schedule then everyone starts leaving and it’ll every other night on call for much of the remainder.

Come to Africa!!!! Missionary advantage #2 – you don’t have to be embarrassed about picking your nose in public, everyone does it here and it’s no big deal !!

Crazy God-humor #1. I was born in the same Gerber hospital that Dr. John Briggs worked at back in Freemont, Michigan. One of his kids, Ryan, was also born there. We had a good laugh about that.

Crazy God-humor #2. Several of the Briggs’s kids attended Black Forest Academy while they were studying language in France, where Laura Peterson is a dorm mother. We had a good laugh about that as well. During our last stay we talked about Laura as well - one of the Gayle kids, Nathaniel, also attended Black Forest Academy and knew her.

Mawu ne no kpuli wo (May God go with you)

Yours in the service of our LORD,

CADT (The Robertsons)

July 4 - Happy Fourth!

4 Jul 2009 – Day 24

Apematho! (eh, wo fo)

We thank God for you because of his grace given you in Christ Jesus. We’re reminded again how important your prayers are to us. This Friday we talked about perseverance -- Remember, “We have come to share in Christ if we hold firmly till the end the confidence we had at first.” “We want you to show the same diligence to the very end, in order to make your hope sure. We do not want you to become lazy, but to imitate those who through faith and patience inherit what has been promised!” And, “So do not throw away your confidence; it will be richly rewarded. You need to persevere so that when you have done the will of God, you will receive what he has promised!” Run the race for the prize that lasts!

The teacher team goes home today. Sounds like it went well again. Cari was a bit sad it didn’t work out for her to help, but……she has managed to pick up a long-term substitute teaching position! Turns out three of the homeschoolers need a crash British Literature course before returning to the States in August. Cari’s taking them through Canterbury Tales right now. Melody Ebersole mentioned to me the other day how wonderful it was that Cari could do this, how grateful, etc… She and Russ are surprised to see how much their son, Nate, has enjoyed writing poetry! I commented that if anyone could get teens excited about iambic pentameter it would have to be Cari (then we had a brief chuckle at Cari’s expense). I saw her lesson plan on the dining room table and they’re in for a treat. Whenever I see the boys now (playing soccer, ping pong, etc.) I make sure to warn them (how tough a teacher she is, how she fails more students than she passes, shouldn’t you be home studying?, etc.).

We’ve eaten out twice this week. Thursday we were invited over to the Ebersoles for a Togolese barbecue. Several Togolese and the Ebersole boys, Steven and Nate, cooked up local cuisine, including fu-fu (like mashed potatoes but sooooo starchy it’s eaten with the fingers), beef, pork, and snake. We sat around the barbecue fires, lit the tiki torches, and had a good time of fellowship. Cari and I both tried the snake (puff adder), and sure enough, it tastes just like chicken. Ironically, Russ was late because he was at the hospital taking care of a snake bite victim. The patient ended up dying. (Our general approach to snake bites is to admit everyone for observation. If they start to develop signs of poisoning then we start the anti-toxin, but it’s too expensive and precious to give to everyone who comes in with a bite. As Michael Gayle laconically informed me two years ago – “only about 1/3 of the bites are actually poisonous”…..comforting thought, Michael, thanks). Anyway, the family brought this man in 3 days after the bite and in full cardiac arrest, so we tried to help but there really wasn’t much we could do for him at that point.

Then last night we were invited over to the Harris’ for dinner. Again, traditional African fare plus a pot of spaghetti for the boys (and Andy?). The Harris’ are from South Africa so we had a mix of tastes. It was delicious again. No snake this time. They are considering joining staff at the new hospital up in Mango (the outreach project to predominantly Muslims in the north). He’s a surgeon and she’s an anesthesiologist so they would be a great asset to the medical work. It was fun to hear their story, especially as we’ve just returned from our April trip to eSikhawini. Drew has really enjoyed their two boys, Peter and Robert, who are gracious enough to let him in on ping pong, tether ball, and Settlers games.

Another Cari farm-girl story! The other day I heard a piercing scream from the kitchen. For its character and decibel level and the gasps for air that succeeded it, the best I could surmise was that she was cornered by a python, or a viper, or at least one of the little sand snakes. Fearing for our lives, I glanced around for a weapon to fight the beast as I leapt from the sofa and quickly ran thither. Alas, no snake was found. No scorpion or other beast either. Instead, a wee poor field mouse she had frightened. Trapped in a kitchen drawer it was, now paralyzed with fear by the pitch of her screams. Since then we’ve learned two things: 1) Cari, lover of mice and one-time owner of a pet mouse whose name escapes me at the moment, apparently doesn’t think they belong in the kitchen; and 2) Togolese mice aren’t very fond of peanut butter, at least when used as bait (but the ants love it).

Come to Africa!!!! Missionary advantage #1 – you can go to work in flip flops and shorts!!!

Mawu ne no kpuli wo (May God go with you)

Yours in the service of our LORD,

CADT (The Robertsons)

July 2

2 Jul 2009 – Day 22

Greetings in the name of the LORD, a strong tower.

With Russ gone to the Mercy Ship in Benin and Dr. Martin still not here yet from his one week airline delay, its been a busy week of every other day on call again. But last night I slept the night through with no phone calls! The last several have been filled with moto/car accidents and death so to have everyone doing well is truly a blessing.
An interesting experience Monday night on call. We had admitted a sick, sick old man in the morning. Severe pnueumonia and diarrhea, as well as several months of wasting. The story was typical for AIDS so we ordered the HIV test as well. It was positive which meant his pneumonia was likely TB so we ordered that as well. Ephraim and I talked with the old man mid afternoon about his HIV test and his prognosis (slow recovery, enter government AIDS treatment program, etc..) and he expressed his fear about this diagnosis. Apparently a man in his village also received this diagnosis and died. We shared some hope that our IV fluids and medicines could treat his current sickness and he could get help from the government. Then we talked of Jesus and his frequent reminders (commands?admonitions?) to “fear not” and “take heart” (I have overcome the world). The man was a Christian so we prayed together. It was actually a brief but sweet time of fellowship.
Numerous times throughout the rest of the afternoon the two daughters asked to take him home to die. I talked with them at length about giving the medicines time to work (at least more than 4 hours, please…….). Well, sure enough, around 2am, the nurse called because he was much worse. When I arrived he was near death and the daughters were visibly upset (because he was dying or because the yovo doctor was so stubborn?). It is a terrible thing to die in a hospital, I think partly because taxi drivers charge exorbitant fees to transport dead people (40,000-50,000 cfa ($80-$100) versus 3,500($7) – the average income is about $1 a day (500 cfa) so the regular fare is about a week’s wages!). I asked about transport options now but because it was the middle of the night it would also cost a lot more. The nurses called around and we found a taxi driver willing to take the family for 18,000 cfa ($36). I volunteered to pay the fare, we asked him to come quickly. We disconnected the oxygen and carried the man (quickly) out the door and up the steps to the taxi – as he gasped for air I sensed the Togolese nurses actually quicken their pace to a near run. We got him in the taxi alive and off they went. The family was exceedingly grateful and thankful – and here I was feeling bad about keeping him. I found out later he died not 15 minutes into the 2 hour trip – but considered here to be a successful evacuation. I’ve been thinking about him a lot. I was glad we had a chance to pray together, and I was glad we could serve the family and help them avoid a monster bill, but how different from medical ministry in the States! One could make a compassion ministry out of paying cab fare for families of deceased patients.

Akpe na Mawu (We thank God)

Yours in the service of our LORD,

CADT (The Robertsons)

more from Togo

Hello friends and family!
The internet has been down for quite a few days here, so apologies for the sporadic news.

25.Jun.2009 -- Day 15

Heartache. Lost a 3 year old tonight and I’m not sure why (stroke? Cerebral malarial coma?). Malaria this morning, routine resuscitation, had a brief seizure early but responded to valium. Also had blackwater urine after starting treatment (G6PD vs malaria vs quinine). Then this evening his kidneys shut down, no urine since about 5pm. I saw him at 9 and even wrote a few orders. He seemed quite stable. Sats were good. Around 11pm he arrested. They called, and when I arrived, no pulse, no respirations, teeth clenched as though a seizure (although extremities flaccid). Pupils already fixed and dilated. Short stay – what is there to do? Sad, sad. Can’t really focus or talk to anyone. What happened?

28 Jun.2009 – Day 18

Long three days. Lots of ortho the last two calls. Dr. Harris, the surgeon, has been a blessing. Tuesday night around midnight they brought in a young girl who had been struck by a moto – broken right femur and open fracture of the tibia and fibula (lower right leg). Poor thing. I got the x-rays then called Dr. Harris. He was so smooth, “sure, that’ll be no problem, this will go quite nicely” (in a South African accent, of course). We found out the next morning during rounds that he had been a front line surgeon during the Angola War (I’ll need to look that one up), kind of like M*A*S*H. He’s a whiz at ortho, which is nice. Many of the general surgeons that come here struggle a bit with it (and I guarantee you the pediatricians that come here are CLUELESS in the OR).
Good thing, too, because last night around midnight they brought in more heartbreak. Two survivors of a motor vehicle accident – car went off the cliff down 20 feet, burst into flames, three deaths). The lady had about 30% second and third degree burns, broken left arm, broken right leg, and 3 or 4 broken ribs. The guy had two broken arms. They had been evacuated by some other missionaries to a hospital about an hour south of us. The hospital started IVs and sewed up the lacerations, but refused to release them to come to us until family showed up to pay the bill! So the accident occurred around 3 pm and they didn’t get to us until 11pm. (It really feels like a trauma ED/ICU most of the time …my skills looking in ears and interpreting strep tests are quite useless and getting a bit rusty.) I spend most of my call nights with my nose in a book. And I’m pretty sure there’s nowhere else for patients to go. We’ve only evacuated one patient to Lome since I’ve been here – that was today when we sent a patient in renal failure for dialysis. Most can’t afford it but he’s the brother of one of our lab techs so the family has more money than most.
There have been more joys and positives, of course (so I best share some of them lest Cari consider me a pessimist!) Several desperately sick malaria kids have recovered and gone home. We have several premies sailing along well and getting ready to go home. The child who swallowed lye and burned his esophagus has recovered enough to go home. The 4 year old who was hit by a moto and in a coma for several days has had an amazing turn -- Wednesday started grabbing things purposefully and yesterday fed himself a biscuit (his name is “Luv” and I’ll be sad when he’s well enough to go home – ironically – for the past two weeks I’ve enjoyed rounding in Pediatriae because we get to see each day’s small improvements!).
And Wednesday, one of the nurses, Virgine, asked me to share the gospel with a patient from her village. I quickly and nervously looked for one of the hospital chaplains (hoping I might persuade them to intervene) but none were nearby. So after rounds were finished we went back and I shared a brief gospel message (trying hard to emphasize the “good news” and not my anxiety). Because it’s an open ward, everyone was privy to our conversation, and those who wanted to could and did come closer. So by the end, where we talked about how no one could make a decision about following Jesus for her, it was up to her alone to decide to accept Jesus’ sacrifice and reconciliation with God or reject it and go her own way., there were about 10 people listening (or more). I have become quite accustomed to this during medical rounds, and by now I had brought to mind Matthew 10:19-20 and I Peter 3:15 about twenty times so we just cruised through. And she accepted Jesus! Just like that! It was way cool.
Drew and I went to a soccer game today – the local Tsiko team. The two Briggs boys play on it. They won. We’ve had quite the week for snakes as well – a sand snake (only a little poisonous), two puff adders (watch out!), and a python. The python was brought in alive so Drew got to pet it. A little confusing for the boys because we’ve been chanting “no snakes, no snakes” every night as we walk in the dark. The oldest Ebersole boy, Steven, has quite the snake collection and has become quite a local celebrity. Folks come from as far as three villages away because they know he’ll buy them, he skins them, and his collection has been very helpful when snake bite patients come to the hospital very sick. He brings it to the ward so the patient or family can identify what we’re up against!
We were hoping to have a fourth doc here this week, but Dr. Martin missed his flight from the States and the word we’ve gotten is Royal Air Moroc can’t get him here for another week! With Russ in Benin visiting the Mercy Ship until Tuesday it’s back to every other night call for a bit.
Message from I Samuel tonight at Missionary Devotions – God calls us each by name. We pray you are listening and hearing His sweet voice!

Yours in the service of our LORD,

CADT (The Robertsons)