Settling in

21 July, Wednesday
Bebalem, Chad

We thank God every time we remember you and pray you continue to grow in Hislove and mercy. Yesterday is gone, tomorrow isn’t yet, how will we worship,honor, and serve Him today? The last two days have been extremes here in Chad. Yesterday was mybirthday. The day started similar to Monday, rounding on Pediatrics. Thiswas my second day in a row so I was actually starting to feel a little bitcomfortable with the routine (watch out when that happens!). The pediatricward consists of three sections, separated by partial walls, 12-13 beds persection. Usually there is one patient per bed (or one bed per patient) butsince we’ve had more than 40 hospitalized peds patients I actually saw twokids on bed 11 and three kids on bed 12 (and for whatever reason, there areno beds 18 and 25, and there is a bed 21b). I saw 29 patients before lunchand then another 8 or so after lunch. Numerous kids are severelymalnourished, but some parents don’t want to stay for the prolonged refeedingprogram because they don’t have money. Lots of malaria, diarrhea,dysentery, rashes, and coughing. Several kids with severe mouth ulcers.One kid with heart failure. Bed 14 took a swing at me, the scary white guy,(now we call him “le boxeur”) which made everyone laugh. It was quite nice,actually, because it meant he had some strength and vigor, which many of thekids had long since lost. It seemed like a fairly ordinary work day. Ofcourse, being so busy meant I haven’t had time to visit the other wards(OB/maternity, men, women, private, surgical). Dr. Ann sees the patients inour “ICU” (more about that below) and then has been doing administrativework, so I’m kind of on my own, but at least today things went ok. I got home around 4pm.
Cari had invited our small missions team over fordinner (Dr. Ann and the two lads, Phil and Thom – Dr. Elizabeth fromSwitzerland couldn’t make it). She spent the day making shepherd’s pie andbrownies. Drew, Tony and I walked down to the local store for coca-cola.We had a regular party! It was good fun. Topped off with a game of Ark ofthe Covenant which Thom won (guess English lads don’t believe in letting thebirthday boy win J). Even more impressive considering there weren’ttemperature settings on the oven and the baking pan didn’t fit in itproperly. Oh, and our battery blew a fuse so we only had lights from 7 to8pm. I got to open presents which included some amazing cards, personalizedplacemats, and even a treasure hunt. Considering where we are, it was one ofmy most memorable birthdays. Thanks to a great family.
Today was about as different as possible. Dr. Ann interrupted morningrounds (we had moved backwards from bed 39, and were about half way done)with some additional tasks. Now that I’m here, Dr. Ann suggested to theclinic nurses that see all the outpatients, that they could send the moredifficult cases down to the ward to see me. Dr. Ann thought there were twowaiting but that quickly multiplied into five. While we were trying to seethese patients, we got called to a private room where a child was starting todevelop respiratory distress from measles pneumonia. We transferred to the“ICU” but that was full. As lunchtime came and went, Dr. Ann asked me to seea couple of ICU patients with her. One 12 year old seemed to have a septicarthritis of the left hip, spreading now to include abdominal pain anddifficulty breathing. When she asked what I thought, I mentioned wanting toget an xray, ultrasound of the hip, surgical consult, lab tests, and startIV antibiotics. Of course, the only thing available to us here were the IVantibiotics, and even these are too expensive for many families. We did take a short lunch break around 2:30, and when we returned there wasa new baby in the next bed over. This baby had fever and difficultybreathing and probably had severe malaria, but as we were getting herinitial weight and discussing what to do, she got worse and died. Right infront of us. It was so sad and discouraging to be so helpless, probably themost discouraging thing I’ve ever experienced. I brought resuscitation bagswith us, but there isn’t any oxygen in the “ICU”. And no quick way to startIVs (we have to write a script, including what size IV needle to use, thenthe family goes and purchases the supplies, then the staff starts the IV, ifthey are good or lucky with the one IV needle). There wasn’t anything wecould do to stop it. And there was only one nursing assistant staffing the“ICU” at the time (13 beds), pretty typical I guess, because of the limitedresources. There are often nursing students around, but their classes areover in August. SO different from even Togo, where four nurses would’vejumped to the bedside, started IVs, gotten an xray, started antibiotics andmalaria meds, all before we even turned to the family to talk about historyor cost. Over 7 kids have died since I’ve been here, and we think the 12year old will die in the next day or two. It’s a little overwhelming. Carireminded me there’s a reason Chad is in the top ten for infant mortality(and Togo isn’t). And that’s part of the reason we felt called here this summer and not there. Hmm………
We’ve had two special prayer times, one with Dr. Ann and three localpastors/hospital chaplains, and one with the AIM team (Dr. Ann, Thom, andPhil). The missionary community here is definitely small, but times ofprayer are uplifting, and it was also nice to be encouraged by the kind wordsand support of the Chadian pastors. Our appliance breakdowns have all been fixed rather quickly. Daily soccer games on the all purpose court (soccer,basketball, tennis even) with local kids have been helping Drew adjust. Cari is figuring out the cooking despite the different kitchen circumstances.
We could still use your prayers and encouragements. We wouldn’t mind havingthe rechargeable battery back again (a little light after 6pm makes dinner,clean up and bedtime so much smoother). We haven’t figured out how to outsmart the rat yet. Cari has been cooped up with the boys quite a bit and is looking for ways to get out and meet Chadian ladies. The boys are stilladjusting to not having at least a few other white kids around. And Dr. Annwill be leaving for several days next week leaving Andy “in charge” of the“ICU” and pediatric wards (and feeling very alone)(I’m still trying tofigure out when Dr. Ann sleeps, considering all the things she does). We hope everyone is well. We pray you are walking humbly with your savior.Love from the other side of the world.
The Robertsons