Eight-two days ago, I left home and while that time away from home is nothing compared to some of our men in the military, missionaries and many others who are heroes to me, I can still state unequivocally that I am glad to be home again. During this trip, I flew 37,000 miles (one and a half times around the world) and have passed the three-quarters of a million mile mark for air-miles since beginning work in medical missions in 1998. Too bad that I didn’t get frequent flier miles for many of those! On this trip, I spent time in six countries (some two or three times) and I trust I accomplished a fair bit for PAACS and the CMDA-CMDE as well as for the missionaries I interfaced with. Most importantly, I hope I accomplished what God wanted me to accomplish.
This week’s surgical case list fell apart a couple of times but we stayed busy with the non-scheduled cases. Sunday’s schedule became disrupted when, at the end of clinic, a multi-trauma accident occurred nearby on the highway. Creating instant chaos as wailing patients and families mixed, 18 people were dragged into the outpatient department by the mini-taxis and other vehicles. I shuddered at the way that bystanders helped to transfer the patients – praise God there were no broken necks in the group! Fortunately, with everyone still at the hospital and nearly finished with the day’s tasks, personnel were there in short order. Because of lack of beds and facilities, two victims were stabilized and eventually sent on to other hospitals in the region. The rest were given outpatient treatment and released. Three required surgery including one woman with a depressed skull fracture and a severe and complex scalping injury with lacerations of the face, ear and shoulder. Praise God, she ultimately did well and recovered from her coma. The run of children with imperforate anus continued. I was able to do the definite repair on the 3 year old upon whom we had performed a colostomy last week and then we did another diverting colostomy on a newborn who not only had an imperforate anus but also had ambiguous genitalia. In fact, the baby was referred to as a boy in the clinic and we weren’t sure at first either, but after examination on the table and doing a laparotomy, it was definitely a girl. She will have to have surgery on her genitalia to restore the vaginal opening as well as have her rectal continuity restored. They will wait until she gains some size for that.
Gallstones are common in Asia – as common as they are uncommon in Africa. With any gallstones, there is always the risk that they will get down into the main drainage duct and cause blockage. In the US, the development of invasive radiologic techniques and the use of ERCP (endoscopic retrograde cholangiopancreatography – a scope to go from the duodenum into the duct) have made surgery on the common bile duct uncommon. So much so that what was a standard procedure during my training is now so rare that surgeons are graduating from excellent US programs without knowing how to do them at all. We had such a patient this week – and I still remembered how to do it. It went well. Amazing how things that worked before technology still work!
One afternoon, I gave the OR crew, nurse Nancie Dellaganna, Dr. Kelley and Dr. Tripura the talk on the WHO program for the surgical checklist. It was well received and in fact, we used the checklist all day on Thursday.
On afternoon, I met with Dr. Tripura, the PAACS resident, and with Dr. Kelley, Dr. Weirman and Ms. Dellaganna to discuss his progress and our feeling that he would need one more year of teaching to be the surgeon we know he can be. Unfortunately, Dr. Kelley will be on furlough next year, so we have come up with a two year program of planned reading and self-study. I also hope to have him spend a three month rotation next year at one of the PAACS programs in Africa. He has three children under seven and one in the oven, so that will all have to be worked out.
Friday was the first day of a three-day Field Council meeting. All the ABWE missionaries from this area came together for prayer, for worship, for friendship and for ministry meetings. Friday was spent in worship and prayer. It was fascinating to get a glimpse of all the aspects of ministry here. One thing that I was unaware of was the great spread of the AWANA ministry (a Christian children’s program analogous to scouting) in Bangladesh. They have 450 separate clubs with another 150 planning to start in the next six months. The Bangladeshi church has just appointed their second AWANA missionary and he is supported entirely by the national churches.
One thing I noticed in looking around the room full of missionaries was that the women outnumbered the men 3 to 1. It is not that women can’t serve the Lord effectively, because they can. What is sad is that young Christian men in particular and maybe all ages of men in general are not willing to listen to God’s call on their life. There are roles, especially in male-dominated societies, that must be filled by men if they are to be effectively accomplished. Shame on us men for our failure to serve Christ as we should.
Saying good-bye was not easy. I had thanked all the people in the OR Thursday and Friday evening and Saturday morning, I said good-bye to the others. I particularly found it hard to say good-bye to Steve. I truly admire him and his dedication to the King. I had come here wondering if I still had anything to offer since it had been so long since I had practiced all-comers general surgery. As usual, I learned more than I taught, but I also did learn that I am not completely useless yet and that my hands still work.
I left the hospital in Malumghat, Bangladesh Saturday at noon (2:00 AM EDST Saturday morning), drove an hour to Cox’s Bazar and then caught a flight to Dhaka. After a rest in the guesthouse there, I went to the airport in the wee hours of the morning. At 4:05 AM (6:05 PM Saturday EDST), I left Dhaka and flew home through Doha (Qatar), Washington DC and landed in Raleigh-Durham at 7:38 PM. I was home shortly after 9:00 PM tonight. I was definitely ready for a shower and a soft bed. It was a long trip.
Praise and Prayer Requests:
- Praise God for traveling safety, for protection of Micky, Sean and me while we were apart and for what He has accomplished in the past 82 days. Thank you all for your prayers on our behalf.
- Friday, March 23 was my father’s 86th birthday. Thanks to God for cell phone technology that allowed me to talk to him on that day. He recently was diagnosed with idiopathic pulmonary fibrosis and has had to adjust to wearing oxygen all the time. This week, he again was hit with the bad news that the bladder cancer has returned and they are recommending intra-bladder treatment with chemotherapy because he cannot tolerate the major operation for removal of his bladder. Please pray for wisdom for the right decision and for peace of mind for him and my mother. I am so blessed to have had him as my father and I thank God for each day we have with him. I am looking forward to seeing Mom and him in April.
- Pray for me as I recover from this trip, catch up on all the backed-up work and begin to prepare for the spring business meetings for both the Continuing Medical and Dental Education and the PAACS commission to be held in Chicago hotels two adjacent weekends in April. I had hopes of taking a full sabbatical from May until August, but that seems unlikely with my commitments and my desire not to let PAACS business fall by the wayside. Please pray for wisdom, for spiritual renewal and for the Commission as we continue to attempt to remodel the way PAACS works.
King David said in 2 Samuel 22:47 (TNIV), “The Lord lives! Praise be to my Rock! Exalted be my God, the rock, my Savior!” May that be our praise as well,
Bruce, finally together with Micky and Sean