Saturday, February 10, 2018

Gone Walkin’

Gone Walking…

Well, we’ve never been your typical family. Our kids have never had a typical childhood. Danae and I would rarely be called normal anyway. So it would be a pity to break our streak.

We have an opportunity.

Dr Christian Stoletniy and his wife, Sabrina, arrived here in November. He’s an oncological surgeon. Dr Sarah Belensky showed up in January. She’s a family practitioner with a little obstetrics training. So for the first time in seven years, we are in a place where we could leave the hospital and still have more than one single doctor here. And we are taking advantage of it.

For a while now, we’ve had some ideas cooking, but we didn’t really know if Christian and Sarah would be competent and capable or not. Well, after having spent some time with them, Christian is a great surgeon with a nose for administration and Sarah is one of the more caring doctors you will ever find. They can cover all the specialties with some overlap between them, and they didn’t feel burned out in January, our busiest month. All this made us feel very comfortable leaving things in their hands from March to November, our slow season.

Sarah is a church employee and will be here for years and Christian is a volunteer and will be here until November. So we have about eight months on our hands!!! We’ve been cooking up all manner of crazy ideas to occupy ourselves, and we’ve settled on the most harebrained.

We are leaving Chad on an eight-month vacation, starting in a few weeks. We will spend a week in Southern California, and then we will return to Washington, DC… to hike the Appalachian Trail! Or at least a few miles. We honestly have no clue how far we will go. It’s said less than 10% of those who start out complete it, and we will be tasked with doing it with four children under age 10, which I doubt has ever been done before, and probably for very good reason. We are going to need to carry one child, and probably two, most of the way. We’re hoping the boys can carry themselves at least! And we will probably ask the boys to carry 4-5 pounds each. But Danae and I will be carrying the rest. I anticipate I will be lugging 90 pounds, equipment + baby.

So we will see if the kids enjoy it. If we can keep them dry and warm and slept and fed. If they can do six miles a day or twelve. We have no clue. We will see if we can keep up with them carrying so much weight! If our old knees and feet and shoulders can keep up. If we make it a week or if we make it eight months.

Odds are incredibly long that we actually finish the whole trail. Walking 2200 miles with four children under ten, all while carrying your tents and food and water and clothes and cookware and… it’s pretty unlikely. But that isn’t really our goal. Our goal is rather to have fun as a family and get closer. The last seven years of being on call 24/7 has been pretty brutal. There is always somebody knocking on our door, either a nurse or somebody needing money or… there’s always something. We look forward to not being distracted by knocks on the tent and being able to get to know our kids better. And introduce them to some of American nature and history! And if the trail is miserable, well, then we will find something else to do. Together. As a family.

And we hope to return to Tchad refreshed and ready for the next few years.

I should also mention that we are PROFESSIONAL backpackers now! We actually found an organization who will help us out with food, which would probably be our greatest expense otherwise, feeding a family of six for eight months! We are feeling so fortunate and blessed. Blessed to have a little savings to allow this unpaid leave. Blessed that the church is allowing us to take this time off without considering it the end of our ministry, and also providing our health insurance during our time away. Blessed to have four healthy children and personal health that allows us to even dream of this craziness. Blessed to have a family who’s used to us enough to not really find this crazy at all anymore. Blessed to have a company that thinks we’re a worthwhile investment to feed us! So very blessed.

Friday, February 9, 2018



Huh? This started out as such a normal morning. I woke up and went to the hospital for morning worship. I told myself I’d come back right after worship for a shower and breakfast, since it had been a while since the last time soap had hit anything besides my hands, but I’m on a run of making it to worship and I don’t want to break my streak. There was only one employee there when I showed up, like 20 minutes late. The boss isn’t really setting a good example. But the boss is tired. Worship was cool, led by two women, which isn’t such a normal thing here.

After worship, I did a few random administration tasks with Fabiene, who helps me keep track of everything, then headed back home a couple hours later so Danae could come up to the hospital for a quick fistula surgery. On my way home, there were a million people at the fence separating the hospital and our house, which isn’t unusual, but is still annoying. I went over and scolded people for having nothing better to do than to watch my children breathe. Through the gate, I saw more people walking around our housing. They were my employees and others I didn’t know. I asked them what business they had at my housing. They replied none, they just came to watch what was going on at the Adventist church school next door to my house.

At this point, the kids come running up blurting out their disjointed bits of news. ‘They were holding sticks and throwing bricks and throwing rocks and banging on gates and…’ I couldn’t really follow what was going on, but our personal guard came up, looking the slightest bit out of sorts, which is always an encouraging expression for your personal guard to wear, like a guy with stomach cramps, unsure where the nearest bathroom is. He told me there were ‘manifestations’ at the school. People were on ‘strike’. Things were slowly being pieced together.

Up until then, I had heard rumors the government was slashing salaries in the public sector 55%, while raising income tax from 10.5% to 20%. But nobody had been paid for six months, so nobody was exactly sure. And so many rumors fly hither and thither, you never have any clue what’s actually true. All I knew is I had heard no news about minimum wage being decreased in the private sector, and we have been getting killed financially at the hospital. 

The story goes that the price of oil has dropped internationally, and the quality of oil in Tchad isn’t great, not to mention the price of bribes and the expense of pumping it out of a landlocked country. So no more oil exports means trouble in Tchad, a country with a financial portfolio about as diverse as the list of ingredients in salt. Not to mention, being a socialist country, everybody’s dream is to be employed by the government. Once employed by the government, you have to be a whole ‘nother level of atrocious before anybody can ever fire you. Their union is amazing. So like 10% of the country is employed by the government, and the rest are hoping to become government employees. All sounds well and good until the government cow dies and everybody who was completely dependent on that milk starves. Capitalism is a bit of a vague notion. There’s very little privatized interests. And then when the union of government employees gets upset and decides to strike, since everybody works for the government, absolutely everybody goes on strike and nothing gets done.

The other real drag of having everybody employed by the government is that when the government coffers dry up, the entire country has no money. The government slashes government salaries, so there’s less income to purchase stuff from everybody else. We’ve certainly noticed this at the hospital as absolutely nobody has any money to pay their medical bills. We’ve been losing tons of money.

Anyway, the government employees aren’t taking their cuts in pay laying down, so they do what any employee in a former French colony would do, they go on strike. The strike started Tuesday and is schedule to go on until they get what they want. (And what they want is for the government to miraculously have income to pay them their salaries, so I'm not holding my breath.) The strike in the health sector is to treat only emergent cases and is only scheduled for a week. In the past, they have completely locked the hospital doors. Selfishly, I’m kinda hoping the strike continues so patients will come here! My employees are awesome and have never gone on strike. I believe we are the only hospital in the country that can say that. Even during war, when everybody else is closed, my employees still show up. They are dedicated.

The reason for the ruckus at our school is because young men got bored. The public school teachers are, of course, on strike, as happens at least once every year or two. So the public school students got sent home. However, instead of going home, they heard that our school was still open, and they didn’t find that to be acceptable, so they came to our school to insist our private church school be closed also. After throwing bricks at the school (and our housing gate), and at the church, and after ripping down all the temporary overflow classrooms we had built with donor money, and after damaging the walls of the school and the roof of the church, the police showed up and forced our school to close in a ‘strike of solidarity and support’. 

What? So private schools where the teachers want to teach and the students want to learn get shut down by the police of the government? Hang on. The police, whom represent the government who is being striked (struck?) against, is forcing private enterprise to go along with the private syndicate union of public government employees in a strike against them. Huh?

Anyway, they disperse the crowd right before I walk on to the scene, and this is roughly the story as it is relayed to me by my guard, who now looks like he just got driving directions from Bugs Bunny on crack and needs a moment to process. I kinda feel the same way as Abel. I could use some coffee, but we’re good missionaries and only drink the stuff when we’re not writing blogs.

The kids and I explain the disturbance to the other expats and head back inside. Apparently kids were throwing bricks at Christian and Sabrina’s house while Sabrina was inside. Being as how they have a tin roof, it made quite a disturbing racket. Ok, the kids and I head over to inspect the roof. Seems ok. Back home, I start doing some cleaning and hear the voices start screaming and running past our wall again, back toward the school.

‘Daddy, is the mob back?’ Mob? Dude, you’re like eight years old. Don’t worry about a mob. Go play with sticks and dirt or something. Hmm… no, actually, don’t go outside for a while. ‘Why?’ Well, because the mob is back and I’d hate for you to get struck in the head by a brick. Dang. Mob.

I head out to our fence adjoining the school. Sure enough, kids and teachers are then pulling down the flag and throwing bricks about. (This is Tchad and everybody builds everything with mud bricks, usually unfired, which break really easily. So a brick or some morsel thereof is always within arm's reach.) Some bricks are hitting the school and the church and our compound, and some are probably hitting the kids milling about. Some of our church members and students and teachers are also around, just kinda hanging out on the perimeter observing. I start talking to the young men passing by and we start chatting about what’s going on and why. Then more and more young men come up as we discuss. And as we discuss, I create for them a better entertainment than throwing rocks, and they gradually forget about the school. In fact, they get frustrated with the knot on the flagpole and decide to leave it and start yelling at me.

There are some young ruffians who are clearly intelligent and we’re having a good conversation:
So why are you trashing this school?
‘Well, they were continuing to have class and we weren’t.’
Um, ok… like, so?
‘It’s not good! They will get ahead while we stay behind!’
So you don’t want them to get ahead?
‘It’s just not good for some people to get ahead.’
Ok, so why didn’t you register at this school?
‘It’s not a good school. They don’t teach good.’
Well, clearly from your French, you aren’t being taught well either. So if they’re not teaching well, then they don’t really pose a threat to you, right? So let them keep on not teaching well. If your teachers are so much better, you’ll easily catch up after the strike. Right?
‘It's just not good for some people to be ahead of us!!!’
Ok, let’s change topics… Do you want to work for the government some day?
‘Yes! Of course! Why not?’
Well, for one, they do things like not pay you. If you have your own private enterprise, then you aren’t a slave to the state at their mercy for everything. You could be your own king, master of your own domain, controller of your own destiny. You could be like Zelda or something.
‘No. Why would I want to do that? That’s work. I want to be a government employee.’

This was the more productive of the conversations I had. Then came the less-productive young men:
‘White man! You’re the cause of all this!’
Huh? Excuse me? What did I do?
‘You took all of our money!’
How, pray tell, did I do that?
‘I don’t know, but you took it!’
Who paid me?
‘The hospital!’ (They were using exclamation marks at the end of each sentence, you’ll just need to take my word on that.)
Dude, the hospital ain’t never given me a franc. You have no clue how many tens of thousands of my own dollars I’ve paid to the hospital.
‘The government!’
You really should cool it on the exclamation points. The government has never paid me either. Patients have never paid me. Patients’ families have never paid me. Even the Adventist church in Tchad has never paid me. My church in America pays me. The hospital brought in a little over $300,000 last year, before any expenses. Even if I stole all of that and never paid a single expense, I’d make more money in America. I assure you I’m not here for money.
‘Well, then what are you doing here?! You must be here for the money! You do nothing but steal from us! All you do is bring us suffering! You’ve never done anything for us!’
Uh… huh? So… like when you’re sick and stuff… like, where do you go and who takes care of you?
‘You’re taking our money!’
Dude, you are clearly drunk.
‘Yeah, we tore down a lady’s bar and drank all the booze in the bar before we came!’
And your point is…
‘But it’s the white guy who drinks!’
Dude, you just told me you’re drunk.
‘Yeah, but nobody drinks more than the white guy! YOU’RE drunk!!!’
Uh, yeah, no. Sorry, no I’m not.

Then we got less productive. Then people started throwing bricks at me, going by on either side of my head, landing in the branches overhead, flashing their sticks, flashing their hammers. I just stood there. My employees tried to get me to move, but at least the kids weren’t throwing bricks at the school and church any more. Eventually, the kids saw I wasn’t going away and they got bored of me. But also bored of the school and church.

‘Hey! Let’s go throw stuff at the prefecture!’

I thought about going with them, but hung back to chat with the little kids hanging around. We found mutual boredom in each other and I headed back inside.

Soon enough, my kids couldn’t stay inside and curiosity drew them out, so I figured I should be responsible and join them, even if it drew me away from productivity. Outside, I saw the pastor and we got to chatting about the school, the church, evangelism, lots of stuff. The school principal came up and we kept trying to find ways to make lemonade out of out lemons. Or at least Crystal Light.

Suddenly the screaming came back full strength toward the hospital. I was told somebody had been shot and they were in the operating room. Danae hadn’t come back yet from her surgery, so I knew all four doctors were at the hospital, Danae and Rollin, along with our Argentinian surgeon Christian and our American FP/OB Sarah. Everything would be fine.

But internally, an emergency doctor is not fine when he knows somebody has been shot and he is not with them. This is my specialty, my job, this is what I do. I kept glancing furtively, well, ok, staring, longing for any sign at all that I should run up, torn between the desire for everything to be ok and the desire to be needed. I saw Sarah carrying a baby and called.

‘Sarah!’ Nothing. ‘Belensky!’ Nothing. ‘Dr Sarah Belensky!’ She didn’t hear me, even though I was walking toward her. She walked away. Oh, how that hurts an emergency doctor.

Lately, I really haven’t been helping out much in the hospital. Sarah picked up medicine and pediatrics so quickly, I’ve turned things over to her and I’ve been helping out more at home and continuing to fill the role of administrator, while trying to take some of her evening and night duties on pediatrics and medicine. Dolores has been packing up her house and hasn’t had time to watch our kids anymore. Don’t get me wrong, I love our kids and I like being with them. But a patient with a bullet hole is a pitching wedge away from me and… and I’m not helping. Any emergency doctor will start twitching at that point.

To busy myself, I take the kids and walk away from the hospital. At the far corner of the compound, the kids and I play a bit, but I continue to wrestle with my meager thoughts. ‘Will I feel more guilty if I leave the kids, 8, 6, 4 and 2, all alone, when they’re already a little stressed by the screaming mob that was here a couple minutes ago? Or will I feel more guilty if I leave a shot patient alone?’ No, that’s silly. She’s not alone. She's surrounded by four of the best doctors in the country.

Mercifully, I see a nurse walking toward me.

‘Kids, go to Nana’s house! I’m needed in the hospital!’ The nurse hasn’t even made it to me yet, but I’m walking toward her and past her. She doesn’t need to tell me anything. My right brain fist-bumps my left brain.

I walk into the operating room and they have no IV access. Christian is trying for a subclavian. They say she’s 13 years old, but she looks much smaller. The closest vein to where I’m standing is her femoral vein. She’s breathing agonally, she’s bleeding, she’s out of it. She needs surgery and we aren’t operating without a vein. Philippe has her on oxygen and she’s breathing, her sat is holding despite her lousy efforts. I decide that’s good enough for now. My fingers go to her groin and feel her pulse. Check. 

‘Give me a 16.’

A normal IV is slapped into my hand and I slip it into her femoral vein. It may be a normal peripheral IV catheter, but we will use it like a central line. Think of it as a pediatric cordis. We have access. ‘Go prep for surgery.’ I plug the blood draining out of her IV with my ungloved thumb while somebody hooks up the IV fluids. Taped in place. Good to go. A second later, Christian nails his subclavian vein. It feels good to be surrounded by competent physicians, something I’ve been blessed with for the past seven years. 

I hang blood and fluids and squeeze. She’s still maintaining her airway and breathing on her own. Philippe gives ketamine. Dunno if she even needed it, but whatever. She doesn’t drop her sat. She does well. We get her some antibiotics. The surgeons drape her and open. There’s a lot of blood. Everywhere. Gushing out. Too much.

‘Dear, put gloves on.’ 

Danae scrubs her arms while I open one of our precious disposable gowns. A third set of hands is imperative, despite the tiny size of this girl’s pelvis. For the next three to four hours, my best surgeons, whom I might be willing to put up against any in the world, they fight for this girl. She is shot through the abdominal wall, through the colon, through the small intestine, through the uterus, through the bladder, through the iliac vessels, seemingly through every other vessel in her abdomen, and out the pelvis. She is bleeding profusely.

The girl fights to live and my surgeons fight for her. Hysterectomy. Tie off iliacs. Open bladder and stop bleeding. Stop all the intestinal bleeds. Stop all the abdominal wall bleeds. 

Her 16 gauge subclavian is wide open ringers the whole time. Her 16 gauge femoral is wide open blood the whole time. Seven bags of blood. At least that much in Ringers. I’ve certainly replaced her entire blood volume by now and then some. 

Despite the hours of surgery, she never needed a repeat dose of ketamine. This is not good. All the bleeding arteries and veins have been tied off. All the holes have been closed. But she bleeds from everywhere.

Klappette Angeline is in DIC, Disseminated Intravascular Coagulation. Oh yeah, she has a name. I had an attending in medical school tell me that DIC really stands for ‘Death Is Coming’. He was not wrong.

We kept her in our prep room for hours as we did other surgeries and saw other patients. I never did get a chance to change out of the basketball shorts I had been wearing when the nurse came for me. It was a busy day I wasn’t even planning on going to the hospital. Hydrocele, hernia, hernia, anal fistula, curetage, hernia, hernia, hydrocele, clostridium abscess from collarbone to top of head, fourth degree tear, laparotomy, cervical cancer, a few other cancers and abscesses… all either to operate on or to be scheduled for surgery or to be consulted on and sent home. 

On the one hand, it was an emergency doctor’s dream. I had two surgeons, an OB/gyn and an FP in the room with me. I just grabbed the stack of medical booklets, glanced at the chief complaint, called them in, handed them off to the proper consultant and then helped the consultant do the paper work. Yeah, and I saw a few myself too.

On the other hand, it was a total mess. In a room maybe 200 square feet, we had a guy laying on the floor awaiting his laparotomy (he ended up having a perforated gastric ulcer and probably would have died within hours had we waited), an elderly woman being stabbed in the face to drain her clostrium abscess, which stunk horribly, a woman having a miscarriage and awaiting her curetage, an endless parade of men dropping their drawers for us to see their hernias and hydroceles, everybody’s family members, a steady stream of women going to the dark back room to have a pelvic exam… and Klappette, lying on a stretcher off to the side of the room… bleeding… just oozing… everywhere. Out her bullet hole. Out her incision. Around her IV sites. And almost certainly inside. The floor under her bed is a pool. A deep pool. We could reopen her. But she’s in DIC. It won’t help. Her blood has no more clotting factors in it to stop the bleeding. She will just continue to ooze. We’ve explained it to the family.

We catch up with all the consults. I see a few ultrasounds with Bernard. I come back. And she’s on her way out. There’s just nothing to do. We let her go in peace.

So how does a 13-year-old girl come to be shot? I’m glad you asked.

She lives next door to the military camp in town. The rapscallions ran to the government offices and to the police. Then they figured they needed a purpose. Ok, so in Bere in rural Tandjile region, we’re going to have a strike that changes the government’s mind and magically gives them money. So the demands are to end the strike. Well, the government isn’t on strike. Government employees are. Ok, so the demands are to increase wages so the employees go back to work. Uh huh. ‘Cause our local authorities can do that. Ok, and the other demand is to free all the prisoners. Really? You want to free all the prisoners? Yes. Why? Well, ummm… Do you know any of the prisoners? No. Do you know why they’re in jail? No. So why do you want them freed? Well,… that’s what people on strike do, right?

Tensions mount. Things escalate. Stupid youth binged on booze throw stuff. Drunk and nervous military pull a trigger.

‘But it was just a blank!’ ‘But he shot straight up!’

Malarky. I’ve seen the entrance and exit wounds. This was not straight up. This was firing flat into a crowd. And caught a 13-year-old girl. These are the good guys with guns. This is senseless in the truest of definitions of the word. Senseless.

Klappette dies. She’s at rest. She feels no more pain. It’s horrific. Especially knowing she probably could have been saved by American medicine. Five doctors. All day. Can’t save her from one, 2-ounce bullet to the pelvis encouraged out of the muzzle of a gun by some liquid courage. All she did was come out of her house to see what the excitement was about and got caught up with the crowd. 


She doesn’t. even. go. to. school.

This was not her fight. But she lost anyway.

We are broken. But we press on.

I head home back to my fatherly duties. My superheroes, dressed up in scrubs… they labor on.

(P.S. Please don’t worry for us. We will be fine. We found out later that as soon as they heard fighting had broken out, our two off-duty personal guards came running to our house. All three were here, spread out across our compound. One was even on vacation! They are good guys, but they were not needed. Really, they’re employed to keep people from knocking on our door 24/7, not for security. But you should pray for Tchad. No economy. People not getting paid. Government bankrupt. People on strike. People don’t have money for food. They don’t have money for medicines. Tchad is a tinderbox. We are one bad crop-year away from a match.)

Thursday, December 21, 2017

Only Ten Days Left!!!

Bere Adventist Hospital first opened its doors in 1974. It now serves as the only hospital for a district of 200,000 people. Despite it’s location 42 kilometers from the nearest paved road, and far away from publicly-available electricity and running water, patients come to Bere Adventist Hospital from every corner of Tchad. The majority of our patients come from outside of the Bere Health District. In fact, during the last couple years, Bere Adventist Hospital has treated citizens from every neighboring country (Niger, Nigeria, Cameroon, Central African Republic, Sudan and Libya), and also those from every inhabited continent who find themselves ill while working or living in Chad.

Bere Adventist Hospital is known for many things. We perform more surgeries than any other hospital in Chad. We were the only hospital to remain open during the civil war. We are the only hospital to never have gone on strike. Our commitment to patient care is unparalleled. Recognizing our service, the International Healthcare Commission awarded Bere Adventist Hospital the title of Best International Hospital in the country of Chad.

In the last few years, Bere Adventist Hospital has seen impressive sustainable growth. Income has tripled with patient volume doubling to tripling on all services. In addition, fenced-in acreage has tripled, square footage under roofs and with concrete has tripled, patient beds have increased dramatically, staffing has more than doubled and we have installed the first electronic medical record system in the country of Chad. Most of this unprecedented physical growth is in large part due to a group of volunteers who came via ‘Maranatha’, a faith-based non-governmental organization. They sent five containers of materials and built prefabricated structures, which are currently being used as a pediatric ward, a maternity ward, a labor and delivery unit, a prenatal consultation unit, two other patient wards, a public health building treating mostly malnourished children and HIV-positive or tuberculosis-positive patients, a laboratory, a pharmacy, a cashier’s office, to patient-family sleeping quarters, a kitchen, a meeting area, housing, several storage sites and our one-year-old nursing school! We have been incredibly blessed.

However, ‘Maranatha’ is not a medical organization and was not able to acquire medical supplies. So we still have an intensive care unit, an outpatient center, an ophthalmology office, a dental office, a pre-operative waiting area and two surgical operating theaters yet completely and entirely unfurnished. It is with the funding we receive that we have been able to accomplish what we have done and the patient-generated income that we pay all our bills. However, the price of medical equipment prevents us from being able to realize our dream of completing our intensive care unit and our operating theaters.

As we stand, we are a fully functioning hospital and we current perform over 1200 major surgeries each year, all cycled through one single operating room. It is sadly all-too common for one surgeon the push his surgical table to the side slightly while another surgeon is required to bring a second emergency patient into the same operating room on a stretcher. They then operate side-by-side, the routine surgery which had started and has already been anesthetized, with the emergency surgery right next to them. This is obviously far from ideal, for reasons from anesthesia and monitoring to lighting and suction and supplies to surgeon freedom of movement to patient sterility and infection prevention and bleeding cessation, not to mention privacy. Supplying our two new operating theaters will allow us to provide high quality care in a safe and comfortable manner. In addition, during busier months our operating room will process through 200 surgeries or more. Being that there is only one theater in which the surgeons can work, the logistics often require the surgeons to operate from six o'clock in the morning until eight o’clock at night, taxing the team in a way that would be completely unnecessary were all three operating rooms functional.

Lastly, we have noticed the severe and desperate need for quality surgical care in Chad specifically, but also in Africa in general. We are hoping to become the first Adventist hospital in West and Central Africa to be accredited as a Pan-African Academy of Christian Surgeons (PAACS) surgical training center. With the medical equipment, we will be able to do just that, training the next generation of African surgeons to care for patients and save lives.

Adventist Health International - Tchad, our managing body, is committed to educating Africans. As it is, just last week we approved supporting five Chadians through medical school, as well as all the Chadian nurses we are supporting through Master’s programs. The addition of a surgical training center to our already existing nursing school, along with our unwavering commitment to seeing Chadian doctors and doctors-in-training succeed, would lift the country of Chad from the lower echelons of medical care on the continent.

In various recent years from various sources, Chad has been credited with the world’s worst maternal mortality rate, the world's worst neonatal mortality rate, the world’s worst under-5 mortality rate and was named both The Worst Country in the World to be a Woman (due in no minor part to the atrocious maternal mortality rate) and The Worst Place in the World for a Child to Fall Sick. These are the reasons we are here. These are the reasons we work. These are the reasons we serve. With a little outside material help, we can train surgeons and we can change the reality for hundreds of thousands of Chadians, and the continent at large.

Of note, we have agreements with two different Chadian government ministries, including one with the Ministry of Health, allowing us to import medical equipment duty free.

Bere Adventist Hospital has a decades-long track record of success and service. But when we perform all deliveries, Cesareans, ectopic pregnancies, gastric and intestinal perforations, incarcerated and strangulated hernias and bowel resections, laparotomies and appendectomies, trauma surgeries and all other emergency surgeries completely free of charge, along with all the non-surgical care and medicines and supplies we give for free to emergency patients or those in challenging social and economic situations, and when elective surgeries such as hysterectomies are done for less than $100, it is impossible to make the leaps and bounds required to provide sophisticated and modern medical care that new equipment would allow.

The infrastructure is solid. The buildings are built. The buildings have electricity. The buildings have plumbing. But the buildings are empty inside. We are ready to go. We simply need the medical equipment. Our intensive care unit and our operating theaters are vacant, calling for completion and eager to treat patients.

Our staff are ready. And more of our people are in nursing school, master’s programs and medical school ready to come and serve. And outfitting our hospital with medical equipment would not only allow excellent quality care, it would give our well-placed team the opportunity to train the country’s best nurses and some of the greatest surgeons on the continent.

We know there are many great organizations doing good work across the world, and all eager to have your prayers and support. We thank you for considering the small effort we give here as worthy of your consideration. We look forward to working hand-in-hand and side-by-side with you to make this world we live in a little better.

If you feel called to help us out financially, you can click on the link on the top right of this blog, or go to Just make sure to zip an email to AHI or write in the Memo line that it’s for ‘Bere’. All the instructions are right there. Fax numbers, phone numbers, addresses for checks, PayPay, you name it.

If you have any more questions about what we do, what we spend money on, what we’ve done, what we will do, etc, (or if you want to volunteer!!!) just email us at and we’ll be happy to reply.

Saturday, December 9, 2017

Traversing Water

Traversing Water

‘Il était condamné à traverser l’eau!’

He’s condemned to what? Traverse water?


What does that mean, exactly?

‘Il était condamné à traverser l’eau!’

Yeah, ok. I got that the first time. So like, he has to swim across the river?

‘Non! Pas nager. Se promener!’

Walk? He has to walk on water? Like, Jesus-style?

‘Non! Ce n’est pas profond! Même pas aux genoux!’

Ummm… ok, so this teenage boy needs to walk through knee-deep water without drowning to prove he’s not a liar. I have this right?


Oh, mercy. I mean, Merci.


So here’s the story…

A young man buys a plot of land. Let’s call him Joe. The next day, the previous landowner's son, we’ll call him Tom, comes to the new owner and asks to be paid. Joe asks what for. Tom says he planted three trees on his father’s property, which have now grown into big, productive, fruit-bearing trees. Joe kinda assumed they were included in the deal when he bought the land. Tom begs to differ. Joe says phooey, I’m ain’t paying for no stinking trees. I already bought the land.

Well, the next day Joe goes out to his new land and finds the three trees chopped down. He goes to Tom and asks Tom why he chopped down the trees. Tom insists he didn’t touch them. So Joe takes Tom to court for the three trees he chopped down on Joe’s newly-owned land.

In court, Tom continues to deny he ever chopped down the trees.

‘Well, let’s make him traverse water!’ comes a voice from the back of the room, the voice of Joe’s father.

Apparently, everybody in the room already knows what this entails and the judge thinks it’s a good idea too. So the official court ruling is the boy needs to traverse water. This is in the year 2017. In one of 20 or so regional courts in the country.

Now the deal is that Tom must go to a certain special bend in the river, not just any place. Then somebody must pay the person who manages/owns that part of the river for permission to use his super-special part of the river. And then, wait for it, Tom must walk through knee-deep water to the other side of the river to prove he is telling the truth. If he makes it alive, he’s telling the truth. If he dies trying, he was a big, fat teenage liar liar pants on fire.

I find out about this and I am shocked. I start talking to people and they are shocked too. I am shocked by the stupidity. They are shocked by the gravity of the condemnation. Everybody here has a story of knowing somebody who witnessed somebody drown while crossing the river to prove their innocence.

I express to them, you know, I used to swim kilometers every day in college. I am willing to tell you a nice, juicy lie right now, something that you know is false, then I’ll go swim across any section of river you want. I’ll tell you my name is Huckleberry, show you my passport so you know it isn’t true, then go for a nice swim. I will disprove this right now. Then we can stop the shenanigans and stop this kid from being condemned to traverse water. I mean, come on. The river isn’t more than like 30 yards at its widest. The river is flat and calm and slow.

‘No, no. It’s not like that. As you start crossing, the river starts whipping up into waves. The waves develop hands and fingers and pull you down under.’

Ummm… It pulls me under so I drown in knee-deep water?


I’m still willing to go for a swim. So do you think the river naturally does this?

‘Non! It’s supernatural!’

Ok, do we agree there are good and evil supernatural agencies?


Are there any neutral supernatural agencies, neither good nor evil?


Ok, so tell me, are these good or evil spirits pulling the liar liar pants on fire under the water?

‘Oh, they’re evil!’

Ok, so you want to tell me that we are relying on evil spirits to reveal to us the truth? They couldn’t lie to us? We want Satan to tell us what’s true and what isn’t? Why wouldn’t he lie to us? Why wouldn’t he just want to kill the boy? Is Satan beholden to a code of honesty toward us? Relying on Satan for truth??? How’s that worked out for humanity so far?

*stunned silence*

So should we condemn people to traverse water?


Ok, then.


You will be happy to know, the boy crossed the river, shockingly. So apparently, it’s true that this boy did not cut down the trees, the same day he got into a fight with the new owner over payment for the trees. Yeah, right. And everybody believes him. They truly believe he could not have crossed the river had he been lying. These are highly educated people with Master’s degrees and spiritual training outside the country, pastors and chaplains. They believe justice has been served and the truth has been found out. And while Adventists by and large denounce this version of justice as sorcery, it was in fact a high-ranking church employee who proposed the condemnation!


In the Market for a Hippo

There are two beliefs here centered on hippopotami. 

The first and far less interesting belief, is that hippos and black horses are the same creature. Not sure which is the original and which is the bastardization. Either hippos are just black horses that walk into water and are magically transformed into hippos. Or black horses are just hippos that walk out of water and are magically transformed into black horses.

The second is both more elegant and much more nefarious. On Saturdays, our big market day, hippos come out of the water, turn into humans, and go to the market. Which makes Saturdays also quite dangerous. Because you never can tell if the person you are doing business with is an actual person, or an evil hippo.

To us this sounds absolutely ridiculous. To a believer, this is terrifying. Folks know to say they don’t believe this. Or to at least downplay their beliefs. But the fear is real.

One of Danae’s employees, who I deeply respect as one of my dearest friends and a very hard worker and a great human being and man of God to whom I entrust my children… Well, we were driving by the hippos once and he was with us. We were telling this story to one of our visitors who didn’t believe us. So I asked my friend. 

He said, ‘That’s not true. (pregnant pause) At least, I don’t think that’s true. (pregnant pause) I know the hippos used to become people and go to the market here in Bere on Saturdays, but I don’t think they do anymore. (pregnant pause) I know they still do in my father’s village. Yes, the hippos still become people and go to market in my father’s village today. (pregnant pause) But I don’t think they do any more in Bere. That's just in the past here or out in other villages. Yes, it’s quite safe here now at the market on Saturdays without hippos. (pregnant pause) I think. But you know, you never can be sure. Better to be safe.’

We talk to other people, people who have traveled to America. They know to say it isn’t true. But then quickly add that they wouldn’t chance it anyway. No reason to tempt fate.


Animism and superstition have such a strong hold here. People are hostages of their own fear. I’ve written several blogs on the topic. Now I know there are people who chalk up all religion to superstition. And that’s ok. It’s their right to have a differing opinion. Just like the folks around me have a right to their superstitions.

We all search for what we believe is truth. It gives us a sense of safety, security, comfort. Some find that in science and evolution and whatever else. Some find that in alcohol and drugs and debauchery. Some find that in nationalism and constitutionalism and guns. Some find that in organized religion and traditions and going through certain rituals. And here, some find that in their traditional tribal beliefs and customs and witchdoctors. So who am I to judge which is right?

Well, we can’t all be right, can we? Can we all be wrong?

As a missionary, there is certainly a set of things I believe in that bring me that sense of comfort. But as a feeble human, I also recognize there are things I can’t possibly comprehend. I believe God controls the universe. But I don’t know what rules there are, if any. So much I’m not privy to.

Could Satan whip up ankle-deep water to drown somebody? I guess. Why not. Could he tell the truth sometimes and give a righteous verdict to a liar or clear the name of an honest person? I dunno.

Could Satan turn hippos into human or horses? I dunno. Maybe. He turned himself into a flying snake.

In a place where absolutely NOBODY denies the supernatural, would Satan stand to gain by doing these things and forcing people to turn to their fetishes and trinkets to protect them, instead of placing their faith in an omnipotent and all-loving God? Probably.

So while I’m so quick to jump to my conclusions of hogwash and heresy, and my judgements of ignorance and immorality… who am I? Why do I have more spiritual light? I believe God has given people certain spiritual lights. I believe what I believe. It makes sense to me and improves my life. It gives me joy and purpose. It gives me a life of love and a love of life.

So I’m a missionary. Here to tell people what I believe, what makes sense to me, what I feel God has revealed to humanity and what His will is for their lives, both mortal and immortal. And to love people.

And for now, I guess that’s good enough for me. I’ll get my answers. Someday.

But I’m still willing to tell you my name is John Jacob Jingleheimerschmidt and go jump in a lake.