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)