It is always good to get back into the mission hospital setting, but I became painfully aware once again of the critical lack of supplies and drugs that are everyday realities in a mission hospital. Last Friday night, a young woman who had an abortion in the village came to the OR with a belly full of pus. There were no surgical caps and the surgeons had to scrounge the entire campus to find a clean surgical mask. Size 8 gloves are not to be found in the country. There is only one narcotic available at all in-country and the Soddo Christian Hospital pharmacist is now scrambling to find supplies for the post-op patients because the government has decided the hospital uses “too much” of the only narcotic. I found out that amazing conclusion from Paul Gray after I gave a lecture on pain control in which I gently chastised them for not using enough narcotics for the patients’ well-being. It is so easy to see what “should” be done and so amazingly difficult to do any of it here. Common lab tests are of uncertain availability, the orthopedic surgeons do not have a functioning fluoroscopic C-arm, there are no antibiotic crèmes or ointments for burns or wounds except one old type, many drugs are not available, so forth and so on. All of that exists in the face of overwhelming poverty and limited resources. Still, despite these appalling lacks in basic medical necessities, most of the patients do well as the Great Physician takes over where our ability ends. And I am thrilled to attest that at least in this mission hospital, the main thing remains the main thing – I was overwhelmed to watch our third year resident lead a Muslim in the sinner’s prayer on morning rounds. This new Christian faces certain persecution from his family and village, but this man dying of rectal carcinoma has received eternal healing even when we cannot offer him radiation therapy or chemotherapy for his advanced malignancy. Please keep your medical missionaries in your daily prayers – it is very hard to keep going from day to day with so many obstacles and frustrations. And please consider giving something extra in the next offering plate – it is so hard to see people hurt or die because of the lack of basic necessities.
On Wednesday and Thursday, Paul Gray and I drove to Addis Ababa to talk to the Korean Presbyterian Myungsung Medical Centre about their desire to become a PAACS training program. This hospital is actualy even more medically advanced than the hosiptal we visited last week in Arusha, Tanzania and yet the lack of supplies and drugs is a problem here as well. Certainly, poverty is the only thing in abundant supply. This hospital is the mission outreach of the Myungsung Presbyterian church. This Seoul church is huge with almost 100,000 members. The pastor was visiting this hospital in Addis Ababa the day we arrived, so things were a little hectic for the administration that day.
There is a new CEO who is also the new Medical Director. An Ob-Gyn by training, Dr. Chulsoo Kim arrived from Korea last September and he has his hands full. Although he has never run a project like this and has some weaknesses (don’t we all?), his heart seems to be in the right place, he wants to emphasize evagelism and he wants PAACS. It was God’s timing that allowed Paul and I to visit this week when I had been scheduled to be in the Ivory Coast and it was God’s timing that had two Korean-Americans from Detroit there to help the new CEO process the ideas behind PAACS. Dr. Chang is a recently retired general surgeon and Dr. Lee is a retired anesthesiologist, so they “got it.” They were enthusiastic about PAACS and yet asked all the right penetrating questions. They helped translate both the ideas and sometimes the language.
Paul and I proposed that this hospital become an extension of the Soddo Hospital program. That would solve several issues including some governmental issues. I believe it would create one of the strongest PAACS programs with both a high-quality urban and rural experience. Paul has already contacted a Korean-American surgeon that we both know and he is seriously considering the idea. Again, God’s timing. Please pray with us regarding this. We are waiting on some further information from the hospital and I will present this idea for consideration at the April PAACS Commission meeting.
On this trip, we went to the agency which overseas both drugs and medical licensure in this country (an interesting combination). Haileyesus Tesfaye, a December graduate of the Soddo Christian Hospital, has been turned down for his specialist license. This is part of a political and governmental snafu that we have been trying to solve for more than two years here. The first graduate was granted such a license but now they have declined two people in a row. Paul could never get to see the man who is blocking the approval but hopes to be able to get an appointment to see him next week. This man, a mid-level bureaucrat in the Ministry of Health, is offended that we didn’t have the program approved by him. We, of course, had never heard of him nor of any necessity to have him approve it. It is somewhat funny when we hear the typical bureacratic complaint that we are not following the rules and procedures. It is funny because there are no rules and procedures that apply to our unique attempt to train outside the University system. And as is true with bureaucrats everywhere, no one wants to make any decision which might come back to bite him in the future – so nothing gets decided. In the meantime, a highly qualified surgeon in this surgeon-poor country sits on his hands because he can’t get the right license – and patients suffer. Along those same lines, we are still praying that Stephanie Hail can get approval to have her year of obseved work done at Soddo under Dr. Mark Karnes. I have no problem with that requirement of a year of mentored work (because it is applied across the board) but sure wish that they would let her do it in Soddo. Certainly, Mark with his years of experience is as qualified as anyone in the country. We had hoped to hear something definite on this the end of this past week, but I haven’t heard whether they have heard.
Thursday evening, I flew to Dubai and after an 9 hour layover in that amazingly busy and rich airport, flew on to Bangkok and then on to Chiang Mai. About 30 minutes later, the Korean Air flight from Seoul landed with my precious Micky and Sean on it. I was so glad to see them. Other friends, Marvin and Mary Jane Jewell and Dr. Tina Slusher, were on the flight as well. It was good for all of us to finally get to the conference site and to get to bed well in the wee hours of the morning. As a sign of her exhaustion, Micky slept until 11:30 AM this morning. I have never known her to do that. Both Sean and I had slept in somewhat too but Sean was out exploring and making new friends and I caught up on the internet/e-mail activity while she slept.
The greatest experience here at this conference is just talking to the missionaries. I was talking last night to a young family doctor missionary in the airport. She has been teaching Chinese medical students but is going to move to Phnom Penh to work with the victims of human trafficking. The terribly sad, tragic stories are eye-opening and the amazing missionaries working throughout these situations are an honor to know.
Praise and Prayers:
- Please pray for the CMDA-CMDE conference which starts Monday here in Thailand and goes for twelve days. Pray for me and the others as we teach. Pray for safe travel for the missionaries, for rest, for rejuvenation, for refreshment of their soul and for comprehension of all the medical material. Pray that the Holy Spirit will cover all that is done.
- Please pray for God to remove the obstacles for Ethiopian licensure for both Stephanie Hail and Haileyesus Tesfaye.
Glad to be together,
Bruce, Micky and Sean