Saturday, August 20, 2016

Dragons Slayed

I guess I kinda owe everybody an update on our situation and my dragon-slaying wife.

Thursday morning, the Prefet sent word via the district medical officer that he would be calling his brother, the prime minister, and asking him to call the American ambassador, requesting we be removed from Tchad.

When my wife heard this, she went back on her strike. But she felt bad for the ladies on the maternity ward, so she went and did rounds on her 16 patients. But she kinda then felt bad for the post-op patients, so she rounded on those 12 patients too. Well, and there were two elective surgeries that where waiting, so she did those too. Well, and she was presented four more patients needing elective surgery, so she lined them up for Friday.

Then today, she rounded on maternity and surgery again and then goes and performs five surgeries and consults a million more, getting home about 6pm on her strike day. (Her last patient came from Cameroon.)

Should you ever need a labor union leader... She is not the one you want.  Her compassion, in the face of the most torrid and unfounded accusations of racism, thievery, incompetence and deceit, awes and humbles me.

Thursday, after hearing the Prefet would have the ambassador throw us out, I went rapidly to the hospital to grab my computer. Trying to make a quick escape home, I was stopped by a young man running after me.

He came from twelve hours away, taking multiple busses over dirt roads. I had been so mad, I didn't go to the hospital the day before. He had been waiting for me at the hospital for three days. I asked him what he wanted. He said, "Nothing." I've been in Tchad six years, everybody always wants something.

He had come to see me a few weeks prior. I had written some medicines for him and sent him home. He went the twelve hours home. Then he decided to come back and see me again. His chest pain, his cough, his fatigue... It was all gone. He was gaining weight again. I asked him why he had come back. He said he simply wanted to say, "Thank you." He had tried all the other hospitals, but this was the one, I was the doctor, that had cured him.

I left him and headed home again. Once again, before I could reach the safety of my front gate (we live on the hospital compound), a nurse from the ER got me. He had a fist full of medical booklets. He had patients he wanted me to see.

The first was a Muslim lady with her head covered. She had a bellyache. Literally. I wrote for some medicines. She and her husband told me they had spent twelve hours on multiple busses to come see me. They too had waited a few days to see me. The lady uncovered her head so I could see her eyes. They were welling up. Her husband began to speak. They had heard about the Prefet's threats. They wanted to personally apologize for the words of another and beg me not to leave Tchad. Who would take care of them? They thanked me repeatedly.

The next patient was the same story. Another twelve hour trip on multiple busses. Sorry about the grief the authorities are giving you. Please don't leave.

When I finished in the ER, the nurse from medicine caught me and begged me to see her patients. I have never said no to a nurse asking me to see a patient, so I suppose I shouldn't start now.

I rounded on medicine. Patient after patient grabbed my hand and thanked me and asked me to stay.

By the time rounds were finished, all I could do was to nod my head and grunt, afraid anything more and my voice might betray my emotions.

Later last night, my church elder came to my door to beg me not to leave. While speaking with the church elder, Danae went up to check on a patient. (She's the world's worst striker.)

Danae came back and said a nurse took her in private and begged her to stay. That wasn't surprising. What's surprising is it was the nurse we thought didn't even like us!

So while we remain threatened by silly people for silly and unfounded things, we have been sent encouragers. We have been told that we matter. We have been told we make a difference. We have been told we help. We have been told we are wanted.

And while we don't work for human accolades... It helps.

So we don't know yet what will become of us... But it's Friday night here, which is our Sabbath, our day of rest. Our day to put all our troubles behind us.

Why worry about tomorrow, what I will eat or what I will drink? Sufficient were the troubles of today.

For those of you who are the praying type, feel free to keep us in your prayers as things play out this next week.

Saturday, August 6, 2016


My wife is a dragon-slayer. Let me tell you why...

Yesterday was a bad day. Our leading local authority accused us publicly of killing patients with expired medicines, accused our surgeon of killing patients because he's too old (anybody who's spent a day in the OR with him would scoff at the thought) and that our surgeon could be replaced with somebody two years out of high school who could do a better job, accused us of being here for the money, and accused us of being racist, using the local equivalent of "nigger". Then he lectured us on the Ten Commandments.

My wife was distraught. We fought, built, sent people to school, sacrificed paycheck and status and professional advancement, time with family. We have seen all four of our kids suffer from malaria. We have watched our son seize with malaria. We have stayed up innumerable nights watching our kids get IV quinine. We have vomited more in the last six years than in the first 31. We have sobbed, we have bled, we have sweat. We live in a tiny house, rarely less than 95 degrees inside. Our electricity and our plumbing is spotty. None of this will ever make us leave the mission field.

But now to be accused of this, my wife was done. We talked about packing up and leaving last night. We talked about going on strike and only treating the urgent cases that arrive. We were at our lowest. We prayed.

This morning I woke up to my wife cuddling hard against me, despite the heat. I thought maybe she needed some emotional reassurance. It turned out she needed to feel warm. She began to shiver violently. She was burning up. She has malaria. She is nauseated, but she is taking her pills. She is dizzy, but she is drinking a little water and eating canned peaches.

We prayed. We read Luke 12. My wife went back to bed.

A nurse knocked on the door. The midwife. I told Danae. Danae said she was on strike. I got the story of a woman who delivered at home three days ago, was bleeding from multiple vaginal lacerations and one torn into her urethra, and the nurse couldn't fix it. Her hemoglobin was three.

I relayed the story to Danae, who told them to apply pressure. The midwife went back to work.

Minutes later, Danae came out of the bedroom. She didn't even put on her scrubs. She went up to the hospital. She stopped the bleeding. She saved a life.

She came home and put on her scrubs. I asked her what happened to the strike. She explained to me there was a man with a non-urgent hernia waiting for surgery. But he had been waiting for three days. She felt badly for him.

Then there was an older woman needing a hysterectomy. It's a big surgery. My wife has malaria. And an extremely heavy heart. The sickness is causing the old woman to be in pain. It's nothing that will ever kill her. But Danae sees her. Danae agrees to do the surgery today. Another non-urgent surgery. While Danae has malaria. And while people are saying she's a racist. And while people are saying she's here for the money, she is off doing a hysterectomy for $80, 100% of which goes to the hospital. Not a single dime from this surgery will ever end up in Danae's pocket. And while people are saying she's killing patients. She doesn't care. She knows the truth.

And she knows this woman is innocent. Just another old woman in pain. From something Danae can fix. If they are in pain, and Danae can fix it, Danae will fix it, regardless how the world may be falling around her.

This is my wife. This is my hero. From the first day I met her. She has not changed.

I don't know if we will stay in Tchad or not. But it doesn't really matter. If people want us here, we will stay. If they don't, we won't.

It doesn't matter because my wife has already proven that her love beats the pants off whatever it is you have.

She has slain your dragon. And she will slay them all.

Because that's what she is.

My wife is a dragon-slayer.

Thursday, May 26, 2016

A hoot

(no pictures of owls… or any pictures on this blog)

It’s been a hectic last couple of weeks.  We’ve had a slew of complicated OB cases come in.  Dad’s also been sick with vestibular dysfunction (rock in his ear), so I’ve had more on my plate than normal too.  With everything that’s been going on I think God knew I needed a good laugh.  

A few days earlier I delivered a preeclamptic who was refusing to push.  She was just straight up acting like a baby.  But as some of us know, it’s just hard to deliver sometimes.  It hurts.  Especially your first time.  She ended up with a vacuum delivery and postpartum hemorrhage with uterine packing for atony.  Both her and her baby were doing well.  

Two days later… it had been a long day at the hospital.  In the evening I came home, took a nice cold shower, and put on a long relaxing sundress.  

A knock on the door.  

It was my evening maternity nurse, Fideline.  She said one of my patients (the same lady above) was ‘agitated’ and thrashing about.  The family was demanding to leave.  

Oh no you don’t leave!  My hair was still wet and unbrushed, but I left to go have a look at my patient.  

The patient was thrashing about on a mat outside of maternity.  Her mom and sister were holding her down.  Every once in a while she would scream out or cry and continue thrashing.  I observed for a few seconds. 

It seemed she was faking it.  But rather than calling her out, I decided to go with the flow.  If I called her out, the family would go to the witch doctor.  

I explained to everyone watching this happens sometimes with her sickness.  (She could have swelling of her brain that would cause some lapse of judgment).  I called out the husband because he had not given blood (like I had asked in the morning), and had not bought the anti-malaria drugs I had prescribed in the morning.  How dare they ask to leave when they hadn’t even done what I had requested that morning!  

As I was doing this I asked the family to not hold her.  She tried to thrash about, but I kneeled calmly and grasped my arms around her arms and body.  The whole time she would intermittently let out bursts of thrashing.  Each time she did, I squeezed and held her in place.  

The family seemed unusually attentive, hanging on my every word and nodding their heads most sincerely.  I spoke softly in her ear (though she only spoke arabic, sometimes they speak a little french), and loudly to those watching explaining everything.  I was pretty certain all the people around didn’t speak French, but they were really intensely listening.  I’m used to being the center of attention, but this was above and beyond anything I had ever experienced before.  There must have been a good 60 people staring at me by now, really into my lecture.  So I decided to explain at lengthy detail what was going on with her.  She was sick.  She could not go.  We would give her blood.  We would give her malaria medicines.  She had to stay.  

I kept talking.  It wasn’t her fault.  This happens sometimes.  I explained cerebral edema with preeclampsia/eclampsia.  I explained anemia.  She thrashed.  The onlookers/family seemed to accept this.  Something told me they would have earnestly accepted anything I fed them.  

I looked down after my lengthy discussion.  


One of ‘the sisters’ had come out for some fresh air.  My boob was hanging out.  One titty just flappin’ around in the breeze.  

Awesome.  My strap had broken on my dress during her thrashing about and that right tata was open for all to see, staring unblinkingly back at the throng.  

I calmly explained to everyone that because of her sickness, she had broken my clothes.  The family definitely had to stay to make sure she was better.  I figured I had spent enough time playing it cool like nothing was wrong and decided it was time to return the sweater puppy to the sweater.  I asked for a scarf and her sister tied it around the top of my dress.  

We carried my patient into a private room and she sat up and asked for some water.  

Ya, most likely had faked everything.  (Don’t get me wrong, the rack is 100% real.  Her ‘seizures’ were fake.)

Which makes it worse that she exposed my melon!  Although, anyone who has breastfed exclusively for 6 months knows that at 5 ½ months along, your boobies are no longer your own.  So why not expose them for all to see?!  (The one benefit is that at six months of breastfeeding, at least the cans are 12-ouncers and not 5-ounces.)

Now I realize that the crowd probably wasn’t really listening to me.  They were all just interested what this crazy white lady was doing with her sisters all hanging out.  Though it’s the culture here to let your hooters hang, it’s not normal to see white jugs out on display.  

It sure gave me a good laugh afterwards.  

The patient had no more problems with agitations.  I made her stay an extra day with no more occurrences.  Her and her baby left in good health.  Her husband was very grateful.  He said thank you over and over and over.  And over.  While giving me a creepy smile.  And his phone number.  

Friday, April 29, 2016


We celebrated Valentine’s right this year. Lyol woke up early (as usual) and started making 20+ valentines for everybody on the compound. Pretty cool that he’s learning to write.

And we had a big ole goat feast at Naomie’s too. Good stuff.

And we have other big news for Valentine’s.

We are adding to our family.

Kinda quick right after having a baby and potentially dangerous, but… we’ve never really shown good judgement in the past. No reason to start now.

It was actually all Danae’s idea. She was the one who wanted it. Not me.

In fact, this may be a sign of the end, conforming to local customs to too extensive of a degree, losing touch with what would be normalcy in America.

It may be time to notify the church General Conference and inform them Danae has ‘gone native’ and it’s time to bring her back home.

I give you Val…

Val is unsure of her new home

Danae leads her new Valentine gift

Friday, April 1, 2016

Just Sick

The house is asleep. I am awake. It’s midnight. And it’s my shift. I can’t sleep. I don’t want to.

Four children, two dogs and one wife. All peacefully sleeping. (Well, the wife isn’t sleeping peacefully. She’s just taking a break.)

I’m at the dining room table and six feet to my right is Juniper, sleeping like… well, like a baby.

But there’s the all-too-familiar green board strapped to her arm. Zane has worn it often. Now Juniper.

She’s just three months old for crying out loud. And it’s dry season. Couldn’t we have waited a bit longer?


This afternoon she puked. Not baby spit up. She doesn’t do that anymore. Real puke. Soaked everything. And she felt hot. Danae noticed it too. 101.4. Fever. Puked again. And again. And again. A lot. And shot it several feet.

Sabine came over and poked her right hand. Then her left. Then her left foot. Then her right foot. Then her left hand again. And again.

Sabine is amazing. Her patience and hands blow me away. She found the slightest thread of a vein in the wrist and the ever-familiar sugar solution is dripping into Juniper’s tiny, but still chubby, arm.

I look at her. Did she twitch? Is she breathing enough? Is she breathing too fast? Is that a respiratory alkalosis to compensate for a metabolic acidosis? Is she breathing at all now?

We’ve been down this road enough. It’s tiring. It wears on you. Nerves, shot. We have no right to be immune. We live in the same place as the other Tchadians who lose 21% of their children before age 5. But misery doesn’t love company in this case.

The last two Adventist missionary families trying to raise kids under the age of 12 here, some of my best friends in the world, some of the people I respect the most… lost a kid each. Can’t we be different? Can’t we be the exception?

And the all-too-familiar flashbacks start…

I cannot forget them. Doing CPR on one of my best friend’s children, born the same day as my son. His skin turning cold right under my palms. Turning over the care of my own son to the same friend who happened to be in the room when my son started seizing. The certainty he was dead before he finally took another breath. The blue skin.

I look back at my daughter? Is she getting ready to vomit? Is it the light or does she look pale? Could she have malaria-induced hemolytic anemia? Am I sure this is malaria?

There are new flashbacks to process for the first time…

I lost my nurse on Wednesday, five days ago. He was younger than me. He left behind his wife and five children. Is there any good reason I am alive and he isn’t? Did he suffer from some disease that could never attack me? Thursday, I was asked to speak for five minutes at his funeral. What do you say? I barely made it through. We then drove him to his village and buried him.

Yesterday, we lost another patient. But it was a success. We started a postpartum patient on quinine. Her heart stopped. Danae and Stephen jumped on it and started chest compressions and sent Ndilbe to get me. By the time I got there, she had received epinephrine and her heart was beating again. I gave her a little magnesium. We don’t have calcium. Her brain had gone a bit without oxygen. Danae had JUST been at her bedside talking to her. Five minutes later, Danae noticed she wasn’t breathing. If she hadn’t been there…

I look right again. Juniper is still breathing. She’s getting the same medicine. The same medicine the lady had just started when her heart stopped. The same quinine that prolongs the QTc interval and leads to torsades de point which leads to cardiac arrest.

I just gave her some IV Tylenol and threw a wet cloth over her and stuck her under the fan. She’s not as hot to the touch now.

Why should we be the exceptions? Why should we escape unscathed? Can we… Can we?

A nurse just knocked on the door. A pregnant lady just came in and died. She came in with a hemoglobin of 3. Danae had gotten a bag from our blood bank to give to her. Abre just came to tell me she died. Abre was on the verge of tears. I was surprised. Typically, nurses don’t get us to tell us patients died. Abre is good. And he cares. He’s rare. And he’s one of my favorites for it. It’s so easy for us to lose our humanity and the value of each life. Each soul. Death is so commonplace here. How long can we keep on caring? Do we need the hard shell to protect ourselves? Calloused? Calloused missionary?

I just looked right and didn’t see her breathing. I ran over and put my hand on her chest. She of course startled. She’s fine. For now. Just sleeping.

Danae just got called up to do a Cesarean section. I’m now alone-er.

I just learned this morning that while I was on vacation, the hospital signed a statement we had received 15.000.000 CFA worth of free medications from the government. The only problem was that we accepted a 10.000.000 CFA check in lieu of the medications. The supplier gets to bill the government 15.000.000 and keep his 5.000.000. We get 10.000.000 and if we don’t play along, we get zero. The authorities called me in to explain to me as much. I told them we would never sign a false statement.

Well, I was wrong. We did. When I found out, I was so livid. I threw a child’s proper temper tantrum and stormed out. So sick of the corruption. If the hospital does it, can I blame my staff for trying to steal an extra buck, or for falsely signing they gave medications? If the hospital’s stamp doesn’t mean something is true, what good is it? If we are being like all the other hospitals, if our integrity is for sale, what are we doing here?

We actually sat on the floor of our bedroom, looked at each other, and asked, ‘Is it time?’

Is it time? Is it time to go home? When you’re just so tired of everything. Tired of all the corruption. Tired of the same old problems. Tired of the heat. Tired of the constant sickness. Tired of rice and beans, beans and rice. Tired of the dirt. When you’re this irritable, is it time to get off the battlefield? Can you still help people? Is this what burnout feels like? Can you burn out when you love so many employees, the Abres, the Sabines, the Ndilbes, so many friends, so many patients, so deeply?

For the moment, if you need anything, you know where to find me. I’ll be right here. Awake. Beside my baby. Glancing nervously. Afraid to sleep. Afraid to miss the subtlest sign. Afraid to miss a moment with my daughter. Never knowing…

I look right. Her leg shook. Again. What that rhythmic? Is she seizing? Are her breaths coming erratically? Sweet Juniper. So precious. Leave her alone. I’m tired of this. Sick of it. Just sick.

(This was written about four weeks ago. Juniper finished her quinine, but was still vomiting with fever, so we extended her treatment several extra days. She also had intense diarrhea and went days without urinating. Two days after she finished quinine, Lyol got malaria. Before Lyol finished his quinine, Zane got malaria. Before Zane finished his quinine, I got malaria. Less than a week after I started treatment on myself, Danae got malaria. Five of the six of us had malaria the month of March. Addison alone escaped unscathed. Juniper still has fevers on and off, which we blame on the heat, but no more of the lethargy and vomiting and diarrhea. So yes, we are sick of being sick.)

(As a second aside, yesterday it was discovered that two teachers at the school had stolen tuition. One stole four months’ worth of salary. The other stole three years’ worth of salary. Now there is no money to pay the other teachers their salaries for March, let alone the rest of the year until kids pay tuition for the next year. They purchased a fake receipt book to issue the students their receipts, so this was clearly premeditated. And yet, they tried to justify themselves. These were the same teachers who publicly accused me of stealing their money last year and called me a colonialist, despite the evidence that for the first time in history the cash drawer had 100% of tuition for all students at the school. And these same teachers insist they can’t repay a dime for their colleagues’ salaries. Some members of the church committee were leaning toward letting them off the hook, but it was finally decided to fire them last night, although we have still granted them a month to come up with the missing money before we bring them to the justice.)

(As a final aside, we do have our ups. Remember, we are only inspired to write during our downs. So our blog is a pretty depressing blog to read. If it were all downs, we wouldn’t still be here. We will try to do a better job of sharing our ups. But days like yesterday, you really do wonder what you’re doing here working at things you are untrained to do 24/7 for missionary salary when teachers like these just go about ruining all our hard work. It’s often tempting to go home, work my ER shifts and make a ton of money. Eventually, we will return home, either for our kids’ education or for our own sanity. But for the moment, we stay for the Abres, the Sabines, the Ndilbes and the others, the local people laboring right along beside us. They sweat the same sweat. The bleed the same blood. They cry the same tears. They suffer the same malaria. They make their own sacrifices. They too could make more money. They too could live closer to family. They share the same joys, the same successes, the same frustrations and the same failures. They are our friends, and they are our family. And so, for the moment, we stay.)

Monday, March 14, 2016

Tuesday, March 1, 2016

Welcome Home 2.0

Welcome Home 2.0

After being away for four months (Danae and kids, nearly three months for me), we were ready to get back to the grindstone. And to get home. While we always appreciate our time in American civilization, we are similarly eager and ready to get back.

Four A.M. wake up call and getting on the road pre-dawn to head out the airport, our kids were their normal semi-nervous bundles of energy. We had the normal 24 hours of flying uneventfully and even had a stress-free passage through immigration (last ones through, literally, as per our usual). And as usual, the porters had already collected all our bags and were waiting for us.

As a bit of a surprise, we saw James at the airport! He had even arranged lodging for us at Guinebor hospital. That was nice of him! And he and Sarah fed us too!

Then James and I went to our AHI meeting, which started at 6pm. We do these meetings rarely, so there’s usually quite a bit of ground to cover. It really went about as well as could have been expected, but didn’t finish until after 11pm. The same day after I walked off a 24-hour set of flights that morning. Welcome home.

The next day we caught the air-conditioned bus to Kelo. All went well at the beginning. Then a couple hours in, we had a flat. Jacked up the bus. Dropped the spare tire out. Changed tires. Back on the road. Welcome home.

We arrived to Bongor finally with not too much hassle. Fortunately the police at the checkpoints seemed about as engaged as valley girls at a spelling bee, which always makes it easier on us. But once in Bongor, the bus company decided the bus wasn’t behaving appropriately and we needed to get on another bus. Welcome home.

Not to worry, they said. They had already called for another bus from N’Djamena to come pick us up. Well, quite a while later, the bus showed up. Just one problem. It was already full of people. Well, not Tchad-full. Somehow, we managed to squeeze 14 of our bags under the bus and three more bags inside and found a few seats and settled in, combining our busload with the pre-existing one. Welcome home.

After a few more hours of bone-crushing potholes big enough to hide a small elephant herd, we pulled into Kelo and met Rollin and Dolores, who had been waiting patiently for us for hours. Amazingly, all our bags were still with us. We strapped them down and drove home and got in about twelve hours after leaving N’Djamena. Welcome home.

Things went smoothly until Danae started shivering violently in the middle of the night, five days after landing in the country. It’s cold season, but rigors aren’t normal under a half dozen layers. I took her temperature and it was 102.4, which somebody once taught me in medical school is abnormal. So we did what we do. We put her on malaria treatment. Strange after just five days, but not unheard of. Welcome home.

Then a few days later, right after lunch, Zane decided to throw up. An hour later, while cutting a mass out of a man’s forehead, one of our volunteers doubled over and started tossing her cookies. I didn’t feel so hot, so I went home and found Zane passed out on the couch. Our cook had cloistered himself up in our second bathroom for a significant period of time. I hoped he was still alive. Our gardener was outside fertilizing our garden, but was doing it personally. From her mouth. An hour after that, Rollin started violently upchucking while ripping out a man’s prostate. I’ve been told patients don’t find it comforting when their surgeon blows chunks during a case, but I’ve never been in that position, so I can’t be sure. Rollin collected himself and, being the proud warrior he is, carried on. Then found himself vomiting again. I wasn’t present myself, but I was assured none of the emesis made its way into the open abdomen. No, I wasn’t present because, at that very moment, I was sitting at home with passed-out Zane. Well, Zane came to, stood up, walked halfway across the living room, pulled down his pants, and proceeded to let fly on the rug. ‘Came to’ might be an exaggeration. The poor kid was really still asleep. ‘Zane! That’s not the toilet! We don’t pee on the rug! Wake up!’ He gave me a blank stare. Lights on, nobody home. To his credit, however, he was able to manage to cut himself off midstream. Urinatus interruptus. I carried him to the toilet where he finished his business. That night, around 1am, Lyol came in to inform me he had barfed in his bed. I undressed him, showered him, put sheets on the couch for him, then took the sheets and pillow cases off his bed, threw them outside, and made a mental note to increase our laundry lady’s salary from $1.60/day to maybe $1.70/day, a mental note I’ve since forgotten. At that very moment, another volunteer was vomiting in the house next to us. Pretty much everybody ralphed. The next day, we threw away those beans. Welcome home.

Friday, January 1, 2016


You still have a few hours to make a tax-deductible donation to Bere in 2015!!!

Go to...

and mark your donation 'Bere'.

Monday, December 21, 2015

I Love My Job

Something very, very good happened this year. Boko Haram set off a whole bunch of bombs in the capital of Tchad and launched many lethal raids in the north of the country, making it a deadlier terrorist group than ISIS/ISIL in 2015. Well, that’s not the good part. Our church forced us to evacuate the country, with the exception I could stay back on my own (not entirely true, James was in Moundou), if I acknowledged the risk I might not be evacuateable later if things were to deteriorate in the country further. Well, that’s still not the good part. Hang on.

Danae and the kids left Tchad not knowing if they would ever be able to return. And the thought of that shook us to our cores. It brought us to tears.

And that was something very, very good.

You see, we celebrated five years of service to Tchad December 12. Tchad is a hard place. There’s no entertainment. You’re constantly ill. You hear nonstop criticism you aren’t a good parent. The food is terrible. The quality of medicine is horrifying (which is even more depressing, since WE’RE the ones providing the bad care). We live life always on the knife edge of burnout. And the culture runs about 180 degrees contrary to American culture. At five years, we are already the second-longest tenured missionaries to Tchad, behind the Appels. And we had begun to wonder if our time was up.

We had accomplished so much in Bere. So much. And it took so much energy. And we had aged so much in five years. Perhaps it was time to step aside and let some young energetic bucks (and does, perhaps) with new vision and fresh ideas come in to take Bere to the next level. Maybe it was time for us to start a new chapter of our lives. And time for Bere to start its own chapter.

But now, being forced out, against our will, with so much left unfinished, and nobody ready to come in and take charge and finish it… It just didn’t feel right. Maybe we did have a little left in the tank. Maybe we had a lot. Maybe we weren’t done. Maybe we weren’t being called home. This just did NOT feel right. We still have more to give. We aren’t ready to throw in the towel and call it quits.

And so we prayed. We didn’t pray for somebody to come take our place. We prayed we could come back.

And after five weeks alone in Tchad, the Blands and Zach were allowed back to Bere, and I went to America to join my family and have a baby. (Well, technically, my wife had the baby. But I was in the room. That’s worth something, I’m pretty sure.)

January 18, we will be returning to Tchad. We will be going home. We will be going where we were called, and where we are still called to. And we are happy and excited about it. Our children are eager to return to their 80 square foot bedroom where all three (now four!) of them sleep together with two dogs and however many cats show up. The familiarity of their mosquito nets. The rice and beans, beans and rice. The 90 degree mornings and 110 degree afternoons. The ironically cold showers.

And that is something very, very good.

My kids’ friends are there. Their books are there. Their toys are there. My friends are there. My work is there. My calling is there.

And that is something very, very good.

We will go back. And we will do what we do best. We will try. And then we will do what we do second-best. We will fail.

We will try to offer the very best medical care to each patient who darkens our door. And we will fail. From lack of medicines to lack of blood donors to lack of medical equipment to lack of money to lack of expertise and yes, even for lack of energy sometimes. And perhaps occasionally even for lack of compassion. We will fail. I can promise it. But we will try again with the next patient. I can promise that too.

We will try to be the best spouses and parents and neighbors we can be. And we will fail. But we will try afresh each new day.

We will try to be the best preceptors we can be to the nurses and students and physicians who come by. But we will fail. It could be for lack of time or lack of knowledge or something else. But we will fail. And we will try again.

We will try to reflect the image of Christ all day every day. And you know how that will turn out. We won’t be anywhere close. But we will try again.

And we will try our hardest to love everybody we come across as best we can. And we will fail, I can assure you. We are no better at it than you are. But, just like you, we will try again with the next person we meet.

And that is something very, very good.

Perhaps you are an educator. I’d like to remind you we are sending 17 Tchadians to medical school and nursing school, both undergraduate and masters. I’d like to remind you we are in the middle of the very costly process of opening a nursing school. I’d like to remind you we also support the local primary and secondary school. None of this would happen if AHI wasn’t here doing it. This is very, very good.

Perhaps you are in public health. I’d like to remind you we have a massive public health project for the entire district of 200,000 people. We educate and treat. We provide a health education from safe sex to tuberculosis to hand hygiene to nutrition and everything in between. We provide deworming medicine for the entire district and we operate mobile clinics to find the sick where they are. We operate a nutrition center, giving healthy food to children and education to their mothers. None of this would happen if Zach Gately and AHI weren’t here doing it. This is very, very good.

Perhaps you are in the medical field. I’d like to remind you we will probably end up treating around 20,000 unique patients this year at our little bush hospital 25 miles from the nearest pavement. We will probably have operated on around 1200 patients this year, ranging from 17.4kg ovarian masses to around a dozen vaginal fistula patients to nephrectomies to goiters to amputations. We have treated patients from Niger, Nigeria, Cameroon, Central African Republic, Sudan, Libya, Egypt, Tunisia, as well as many foreign workers in the country from Asia, Europe, South and Central America, and North America, all who bypass many other hospitals to get to us. Furthermore, we provide obstetrical care for free, performing all vaginal and Cesarean deliveries without cost to the patient. We treat many children for free. And we treat all urgent cases for free. We are improving the structure of our hospital to provide better care to more patients with a new maternity ward, two new operating rooms, a new lab, a new cashier’s office, a new pharmacy, a new dental clinic, a new ophthalmology clinic and a new public health clinic. We have implemented the very first electronic medical record in the country. We have computerized all our financial transactions. And none of this would happen if AHI wasn’t here doing it. This is very, very good.

Perhaps you are in the field of evangelism. I’d like to remind you the missionaries in Bere operate no less than seven Sabbath Schools every single week, often a single missionary doing multiple Sabbath Schools each Sabbath, and occasionally running Wednesday night prayer meeting as well. This is very, very good.

And perhaps you’re my favorite type of person. Perhaps you’re just in the simple business of loving people. It’s not so simple, is it? Well, that’s exactly what we do. Or at least what we try to do. Like you, we fail and we fail with regularity. But we keep on trying. And who would love the people of Bere if it weren’t for us? Who specifically? Who would love the people of Tchad if it weren’t for the missionaries? Who would show them there is a world that cares? Is there a world that cares? I’d like to think that so long as we’re breathing, there will be a world that cares. And that is very, very good.

We live in a 65% Muslim country. We live in a country frequently attacked by the most deadly terror organization in the world, Boko Haram. I don’t know what your opinions are regarding Muslims or Islam or refugees. But I know they are people. I know they are not monsters. They are my patients. They are my employees. They are my colleagues. And they are my dearest friends. And I love them.

Regardless of whether or not you want them in America, they are human beings, created by God, of equal worth to Him as myself, my wife and my children. I am no more human than they. I am no better human than they. They deserve medical care. I provide it. The best care we have. Free to the extent we can afford.

If you don’t want them in America, then help us go to them. Help us love them. In a nerve-wracking time, it’s the best hope we have.

My job is to love.

And I love my job.

And that is very, very good.

If you want to be a part of what we do, there are many ways to help:

1. Pray. We take this seriously.

2. Come live and love with us. It’s not easy. It’s not comfortable. It is downright scary at times. You will get sick. You will hear of terrorism. You will live your life miles beyond the outermost fringes of your comfort zone. And at the end of it all, you will have a story to tell, a worldview drastically and permanently altered, and a heart full of memories and gratitude.

3. Give. If you trust us with your hard-earned money, great. If not, find a worthy organization you do trust and give to the point you feel it. It’s hard to imagine you’ll regret it.

We function thanks to the intervention of Adventist Health International ( 100% of your donation comes directly to us, where we use it for training Tchadians, building a nursing school, construction, deworming and other public health projects and so many other things. I personally am responsible for 100% of the money that is given. In the upper right of our blog, is a link marked ‘DONATION’. Just click the link and it will explain to you how to give. You can pay by PayPal, check, money order, credit card, one-time, ongoing, etc. You can send mail, email, you can call, whatever. Just send a note along saying it’s for ‘Bere’.

And it is tax-deductible, should that be something which will interest you come April 15.

Also, if you’re like my wife, you’ve been quite busy this month with Amazon. If you shop, you can choose your preferred charity as Adventist Health International and 0.5% of what you spend goes to AHI, although not specifically for Bere.

Email us any question, concerns or encouragements you may have.

909-558-4540 or
Adventist Health International
11060 Anderson Street

Loma Linda, CA 92350

Monday, December 14, 2015

2015 Year-In-Review

Year-End Wrap

Well, it’s December, time for a little 2015 year-in-review.

We kicked off January, our busiest time of year, with the implementation of an electronic medical record. I think I have a whole separate blog about this, but it’s truly incredible. Thanks to several volunteers (Dirk Wunderlich, Zachri Jensen and Adrian Sarli, and a few others too), we took our hospital from majority-of-employees-have-never-touched-a-computer to 100% implementation of an electronic medical record of orders of all medications, lab tests, imaging and surgery in less than two months. We currently track all inventory and most finances with it. We have discovered stealing in the pharmacy with this system and have fired the responsible parties. The simple fact this exists in a place where no school has a computer, where there is no library, where we are 25 miles from pavement, where there is no electric grid besides our generator, where nobody has running water in their home… It’s absolutely amazing. We even use our new network to broadcast evangelistic videos to our patients (and neighbors!) in our waiting area. And it never would have happened without Dirk and Zachri. (And it wouldn’t have gotten to the next level without Adrian.) 

Which brings us to the medical stuff. We will probably have registered 18,000 patients into our electronic medical record system by December 31. We started on January 24, our busiest time, so we will have seen close to 20,000 unique patients in a year. This is a testament to our volunteers, our support, our staff, and our God. We wish you could see the patients we treat every day. I promise volunteers they will see something new every single day they are here. Probably one of the coolest this year was a 17.4kg ovary Danae and Rollin removed. Amazing. We have a blog post on that too!

We are also actively involved in public health, thanks to Charis McClarty, who is no longer with us (She’s not dead, just her time had come. Well, that doesn’t sound better. Her term was up. She’s healthy in America. Don’t worry.) and Zach Gately, who’s still with us (He’s alive too.). These two were/are amazing. They expanded Project 21 from being the 21 neighborhoods of Bere to being the entire 200,000 habitant district of Bere! They take motorcycles out to all the surrounding villages and putting on health lectures. They are also pulling teeth and… There’s just no way I can tell you all of it. It’s an overwhelming list. One of the coolest things they do in my opinion is arrange mobile clinics. We load up the truck with nurses and go out into the villages. It’s insane how many people show up, a total zoo. We will consult on hundreds of patients in a couple hours, until it’s too dark to continue. We will take the ultrasound and do those for free. We refer patients to the local health center for their medications. And we take the acute cases back home. It’s so cool, I just can’t describe it. The last one I went on, I jumped into the back of the truck and all the kids (and adults) came around and we had a quiz on Genesis. It’s really neat because the Muslims have essentially the same knowledge of the book of Genesis (even including the genealogy of Abraham, Isaac, Jacob and Joseph). We also received a donation of Albendazole, a deworming medication. We paid a couple thousand dollars for the import tax and received millions of pills (literally). We have dewormed all the schools in the district and pass them out for free at all the mobile clinics. We hope to soon give them out for free at all the churches and mosques too. When the government came through our district and did their studies looking for worms, we were the only district in the country where they found none of the typical worms!!! The local authorities give us credit for that. And we give you credit for that.

Along the lines of public service, in partnership with Restore a Child, we have also started projects to raise goats and chickens for patients and their families and the community. To be honest, it fed a few and then petered out, mostly because we didn’t have anybody reliable to oversee the project. Also, we had a bird flu of some sort take out the chickens. There are still some goats alive and reproducing, but we honestly don’t have the infrastructure to ensure it continues its success. We did plant a bunch of trees. Some died and some are growing slowly. Some trees Maranatha had planted earlier are already giving papayas and guavas and mangos and peanuts and corn and other things. It’s really fun to walk over to the pediatric ward and hand out these foods to the hospitalized children! I wish you could be here to see the gratefulness!

Our public health branch is also operating the nutrition center. Thanks to the services of Zach and Charis and the Macombers and Mike and Chris, the nutrition center was able to serve loads of kids. Unfortunately, we will be losing Mike and Chris, the real leaders who went to visit these kids in their home villages and changed entire families. They will be missed by us and by the people they serve. That’s a couple with huge hearts.

Around the hospital, we have slowly continued our construction. We’re still really hurting from Jamie’s absence. God and family called the Parkers back to America last year and boy are we missing ! But we creep along. We have slowly put walls up in our new buildings, as well as doors and layers of paint, thanks to your generosity and the labor of some volunteers (Thanks, Miki!).

We trained four nurses in anesthesia this year. I say we, but it was really Mason. Unfortunately, we lost the Mason and his family this year too. Real life called them back to America, but their hearts will always be for missions, no matter where they are. The number of people they touched in just over a year is extraordinary. Their stay here with us was also funded by donations. Donor money is responsible for four well-trained anesthetists covering two (and soon to be three) hospitals in Tchad, providing much safer surgical care.

Speaking of training, donors have sent 17 students to training last year. Three are in Master’s of Nursing programs. Three are in medical school (and a fourth and fifth are approved). The balance are in nursing school. And speaking of nursing school, we are hoping our nursing school can be opened this next year. We would still ideally have a Francophone nurse practitioner to head it up, but we will work with who we have. There is really only one quality nursing school in Tchad, and it simply cannot generate enough graduates to keep up with demand in the country. This will be the big game-changer. And eventually we see it branching out to offer anesthesia and midwifery training, as well as other specialties.

I also had the opportunity to visit a lot of our sister hospitals and clinics in Cameroon, and the nursing school there too. Boy, were they ever inspirational. Great stuff is going on in the world and it’s so thrilling to be a small part of it.

Our biggest reason for existing is showing the world the love of our God. And we try to be active in that too. The Adventist volunteers in Bere are operating nine Sabbath Schools. This takes a lot of energy. Many people do two Sabbath Schools each Sabbath. Motorcycling on the edge of the Sahel to tell people about Jesus is really exciting stuff, and even though we are tired, it’s usually the highlight of our week. Telling Bible stories, singing and dancing, high-fiving. It’s just awesome. Something everybody should be able to experience. And perhaps the most exciting part is we have some local Adventists who go with us and can tell the Bible stories in the native tongue without translation. In fact, often they will go out by themselves on Sabbath, and even during the week, to tell these Bible stories and sing these songs about God. All we do is loan them the motorcycle. It’s really exciting when the Muslims stop by and realize how many of the same Bible stories we share!

The year hasn’t been entirely without challenges. We have had many bombings in Tchad, thanks to our local terrorist group, Boko Haram. They don’t get as much publicity, but Boko Haram has actually killed more people this year than ISIS/ISIL. This causes much angst among our family and friends. Which kinda does make us feel loved and cared for. However, Boko Haram headquarters is quite a ways away. They would need to cross multiple borders and police checkpoints to get to us. So far, all their strikes have been in the capital, 6-8 hours north of us, or in the lake region, which is even farther still. While it’s true somebody could come and kill us, I think recent events in America have shown us that can happen anywhere. The only way to truly be safe, is to be where God wants you. And we feel very strongly God still wants us in Tchad.

There was a stretch, however, that had us questioning that. In early September, the American State Department put out a warning encouraging all Americans to evacuate the country. We decided to comply with the state department and the General Conference and evacuated everyone but myself and James Appel, who would keep the Adventist Surgical Center of Moundou running. Finally, in mid October, it was agreed that necessary personnel could return. The very next week, Rollin and Dolores came back to Bere so I could head back to America for…


We have a new BABY!!! November 8, Juniper Belle Netteburg was born.

And that makes 2015, a VERY good year.

(What follows are a TON of pictures from 2015. People who have been to Bere might recognize some places and faces of locals and volunteers. All these pictures are incredibly self-indulgent. But you know what? It's my blog and I can do what I want!)

(Second parenthetical remark: The photos at the end of Juniper were taken by an incredible photographer Denise Feagans. Checker her out at