Friday, March 30, 2012

#105 Alone


Crap. Why am I crying all the time in this country?

My son spiked a fever of 101.9 yesterday. Five weeks of fevers. So far he’s received five days of IV quinine, seven days of oral quinine, two weeks of primaquine, three days of malarone, seven days of artemether, one dose of fansidar, one dose of mefloquine, a week of bactrim, a week of amoxicillin and a week of azithromycin.

It’s now officially unlikely to be malaria, typhoid, urine infection, pulmonary infection... well, it’s unlikely to be any normal infection at all. Or even any abnormal one.

We’re left with leishmaniasis, brucellosis, tuberculosis, cytomegalovirus, Epstein-Barr virus, mononucleosis, mycotic infections, other parasites and even rarer things. None of this is likely. But I’m praying for one of these infections.

Because the alternative is either debilitating autoimmune disease or else cancer. Leukemia just fits so well.

Fevers with no obvious source. Weight loss. It’s all there. And I remembered last night that on one of his first peripheral blood smears, the lab guy wrote leuk+++. Lots of leukocytes. Leukemia.

Please God, no.

We decided last night to get Danae and Zane home. They don’t yet have their tickets. In fact, they don’t even have their passports yet. All our passports are in N’Djamena, waiting for the association to renew our expired visas. Hopefully she will pick up the passports this morning and bribe her way out of the country on expired visas later on today. If all goes well, Danae and Zane will arrive in Washington, DC Sabbath or Sunday. Zane will then be seen Monday.

(Can anybody get me in with the Washington, DC pediatric version of House Monday morning?)

We packed until 2am. We woke up at 4am. I carried my nine-month-old, the most precious and beautiful nine-month-old in the world out to Augustin’s car. And I held him. And I cried. And I kissed him. And I cried. I could not give him up.

Have you ever sent your nine-month-old thousands of miles away, continents away, for an unknown diagnosis and an unknown treatment. A potentially lethal diagnosis. I can’t stop crying. And I don’t feel like I ever will.

This place is too much. This place is too hard. This place breaks your heart. I can’t stop crying. My precious son.

I still can’t believe I just sent away two of the three most dear people in this world. Two-thirds of all I care about in life just drove off, leaving me standing beside the car, unsure of what state I will find them in the next time we meet. Will I see him next in perfect health? In a hospital bed in America, tied up to an IV and looking worse? Will I see him next in Heaven? I don’t know. I only know that I’ll never see him the same again. It will either be better or... not better. And I’ll see him through different eyes. I promise to never take him for granted.

I hate this. I hate all these tears. I don’t like sobbing. This should not be necessary.

Why didn’t anybody tell me about all this? Where were these missionary stories while I was growing up? Where did this fit into all the books about third-world family vacations, about baptisms, about... about everything that I’m not experiencing here. Nobody wanted to publish those books, did they? I suppose nobody wanted to read those books either.

I just can’t take this uncertainty. I’m not strong enough. I don’t want to be strong enough. It’s the not knowing that kills me. I’d trade anything just to not need to deal with the uncertainty anymore. The lack of a clear diagnosis. No. I take that back. I’d trade anything to have my son back in my arms and healthy again. I’d trade everything I own. Everything I could ever own. I’d trade my work. I’d trade my education. I’d trade my position. I’d trade my experience. God, I’d trade my life.

Next Friday will mark the one-year anniversary of losing the son I wanted to adopt. God, please don’t take this one too. We even named him Zane, because we couldn’t bring ourselves to name him Zeke. Similar, but not the same. Different ending, we hoped. God, don’t make their ending similar. Give Zane another 100 years. Just make him outlive me. After Zeke died, we made a deal. I’m the next person from this family to go. You need to hold up Your end of this deal.

Danae is now on her way to N’Djamena with Zane.

I was so strong last night for Danae. Now who will be my strength? I will go on. I will be the good missionary soldier. I will stay at my post and await further instructions. I will treat kids with malaria and watch them get better, just as I expected my son would.

I’m lying in bed, having slept two hours and unable to sleep any more. It’s just starting to get light out. My three-year-old is a room away. I’m sick to my stomach. My vision is blurry, my nose is running, my lips taste like salt and there are pools in my ears.

I’ve never been more alone in my life.

If this is not rock-bottom, I don’t want to know it.

Thursday, March 29, 2012

104 Stop with the Needles Already!!! by Zane

Ok, so I’ve got a few minutes before my parents find me and kick me off the computer. I’m at least feeling better enough to write an update. Put in a phone call to Child Protective Services now. You can read the rest of this while you wait on hold. I already have a file open in the state of New Jersey, by the way.

I finished a week of quinine pills. Terrible. Yuck. Blech. And I never vomited a pill.

So Friday, Daddy talked to a pediatrician at Children’s Hospital Boston, Harvard, who does research in malaria. He told Daddy that there isn’t much resistance to artemether, Larium, Malarone, primaquine, quinine, etc... so he didn’t think it was malaria. He was leaning toward typhoid, and explained to Daddy that amoxicillin and Bactrim no longer work as well as they used to for typhoid. He said that I should start taking azithromycin for typhoid and, if that didn’t work, then Cipro. He explained that the Achilles tendon rupture risk is less than the risk of carrying typhoid around forever. He also explained that in the US they have quinidine, but that’s riskier for my little baby heart and not as effective as quinine. So if it was indeed malaria, I’d be just as well off here in Tchad. Lastly, he discussed with Daddy all the other possibilities, like cytomegalovirus, Epstein-Barr virus, mononucleosis, the autoimmune diseases, various horrenderomas, and really rare stuff like other parasites and fungi (I’m a fun guy!) and stuff.

The doctor recommended malaria blood smears, typhoid blood tests, complete blood counts, a Foley (WHAT!!!) catheter in my penis for urine tests (No way, Jose!!!), an x-ray of my chest (radiation therapy like Gamma!!!), etc.

We don’t have a functional x-ray, I voted no on the something-going-into-my-penis test, we don’t have platelets for the CBC, etc etc etc. Mommy and Daddy tried to get the malaria, typhoid and white blood cell count with differentiation done, but try as they might, nobody could stick my vein. So they just did the malaria test... My SIXTH malaria test!!!

All-in-all, it was an awesome conversation with the doctor and I could tell that Mommy and Daddy really appreciated it. They told me that if/when we went back to the states, they’d try to convince the pediatrician to leave Children’s Hospital at Harvard for Silver Spring, MD.

So after getting off the phone with the expert specialist man, my malaria test came back... POSITIVE. So after five NEGATIVE malaria tests and treatment with arthemeter, fansidar, malarone, mefloquine, primaquine, bactrim and oral quinine, all for the treatment of five NEGATIVE malaria tests... I get my first positive malaria test. What in the Sahel?

Mommy had been threatening to take me home after that conversation. Daddy and the "HAH-vahd" doctor I think convinced her that all the medicines were in Tchad.

Sabbath, Daddy drove a few hours away to give condolences to a nurse who lost his mother to a stroke. While Daddy was out there, Mommy took me to the hospital. I finished my seven days of oral quinine and was still having fevers. She had had enough.

She told me, ‘Mommy loves you, Zane, but we need to do some pokies so we can give you some medicine so we can make your owies go away.’

I said, ‘I understand, Mother. You need to place an intravenous catheter so as to administer quinine dihydrochloride so as to treat my malaria falciparum.’

She said, ‘I’m so happy you understand.’

I said, ‘No chance. I’m never in a million years going to let you poke me with a OOOWOWWWWWWWWOWWWWOW!!!’

Mary Charles (a boy’s name here), Hamadou, Abre and Seraphin 2 (the short one) tried like at least five or six times each. I’m a pincushion here! And without success.

Mommy brought be home with no IV and sent a mildly distressed text message to Daddy. Daddy high-tailed it home and called Seraphin 1 (the tall one). He came over and found a little vein in my wrist. He put in my IV outside under the sun. IV quinine, here I come!!!

So since Sabbath, I haven’t been able to do anything except be held, sit at my high chair and sleep. Otherwise, I’m liable to knock out my IV. I’ve grabbed the IV tubing and ripped it out of the bottle. I’ve tried to pull out my IV. I’ve tried it all. No crawling, no nothing. Plus, my IV pole’s too tall to let me play on the ground anyway. This IV drip is continuous, so I can’t just get my medicine and then detach and play.

Sunday, my IV went bad and Daddy called Seraphin back to the house. This time, they cut my glorious locks and put in a scalp IV. Mommy was sure to keep the first trimmings, but she’s very sad to see my baby hair go. She doesn’t think it will ever be the same again.

Yesterday was the completion of my third day of IV quinine. I still had a fever of 101, despite all the quinine, plus six days of azithromycin. So Mommy decided for two more days. But my IV was infiltrated. Half of my face puffed out like the marshmallow man in Ghostbusters. You know the one? Anyway, it deformed my ear and everything. It was pretty cool.

So Daddy called Seraphin, who came and put in my third IV, this time causing the other half of my head to get shaved. I’m just trying to show solidarity with Gamma.

I guess I could sum up the last four days as... ouch, ouch, hey stop that, that hurts, stop with all the needles already, hey what are you strapping to my arm?, why can’t I move my right arm?, breastfeed, wet a diaper, wet a diaper, wet a diaper, wet a diaper, gracious how much fluid are they going to give me!?!?!, breastfeed, be held, push around an IV pole, breastfeed, wet six more diapers, eat some mangos, poo, sleep, wake up, sleep, wake up, breastfeed, sleep, diaper, sleep, why is that every time I wake up all night long Mommy or Janna is sitting there in front of me making sure my IV doesn’t block off or start running too fast --- it’s just creepy, sleep, wet more diapers, new IV, ouch, new IV ouch, more diapers, wrap up my head like a lobotomy patient, more diapers, breastfeed, sleep. You know how it goes, right?

Anyway, I heard you all were praying for me. That’s cool. Mommy and Daddy keep talking about how all those prayers are keeping me alive. Keep praying for me if you don’t mind. And pray that Mommy and Daddy stop looking at me like they’re afraid. It’s such a downer. They look at me like they’re trying to etch a permanent memory just in case.

Oh, and don’t forget Child Protective Services. Can they make house visits in Tchad?

Love, Zane Oliver

You will notice on our blog,, that we have a link for donations. This is through Adventist Health International’s website. We believe strongly in the mission of AHI. We feel that AHI is an organization worth supporting. By donating through AHI, you can be reassured that there is a strong measure of accountability following your donation. Just mark the donation for ‘Bere.’ And remember that your gift is 100% tax-deductible.
Olen Zain: +235 62 16 04 93
Danae Zain: +235 62 17 04 80
Olen et Danae Netteburg
Hopital Adventiste de Bere
52 Boite Postale
Kelo, Tchad
Volunteers Welcome!!!

Wednesday, March 28, 2012

#108 Zane update

Got Mango? Does this stuff come IV too?

How to stay warm when it's 110 out.

Zane rocking the lobotomy look in support of Gamma. And for 96-hour or more IV quinine drip. (Sent Monday afternoon)

Thank-you all for your continued prayers. Zane, and my family

Wednesday, March 21, 2012

#106 Zane and thanks to Sandia View Academy students

Paludisme (Malaria)

So first, I’d like to say thank you to all those praying for us. We don’t have good internet access to confirm for ourselves, but we understand that there are many of you passing around our blog address and spreading the news on Facebook to pray for Zane. We covet your prayers and believe strongly that your prayers, no matter where you are and no matter where we are, make a difference. As a child, I always imagined a giant granary-type silo, the kind you see strewn across the midwest, floating in the sky on a cloud, with white-robed winged angels, one on each side, each with a hand on the door. Then I would imagine a prayer reaching them and they fling the doors open and blessings (somehow in my child-like imagination, blessings came out like corn kernels) flooding out onto the earth below. (I think my brain mixed the movie ‘Witness’ with some Ellen G. White.) Actually, I suppose this is how I still occasionally view prayers. Child-like faith. It’s not a bad thing.

Zane still spends most of his day happily playing, crawling, babbling, putting inappropriate objects in his mouth, subjecting himself to his brother’s mischief and doing other normal eight-month-old activities. But he’s lost a couple pounds and keeps having these fevers. Today was 101.5. Yesterday was 103. Danae is threatening to take Zane home if he’s not better next week. It’s been about a month, so I suppose that’s reasonable. Although I still don’t know what they’d do differently. I can’t imagine too many US pediatricians being willing to start an eight-month-old on IV quinine.

Anyway, please continue your prayers that Zane will be better by then so we won’t need to make that decision.

While I’m writing, I’d like to thank Sandia View Academy, Fully Accredited Adventist Education, for their care package. (This is THE ‘SVA’ by the way, not to be confused with Shennendoah Valley Academy, shout-out to Paul Pelley, or Spring Valley Academy, shout-out to Harriet Snyder.) Wendi Clapp, teacher extraordinaire, coordinated the students there sending us words of encouragement. They are not the first to encourage us, nor the first to send us a care package, but receiving 26 hand-written letters is awesome. Texting is gr8, email is HYPERLINK "mailto:efficient@and.quick" efficient@and.quick, but a hand-written letter is just so personal. To show my gratitude, I want to write you back a hand-written letter. But I won’t. It’s just too hard. And the post office is like 42 kilometers away. So I’ll give you a blog shout-out. (Are the kids still giving ‘shout-outs’ these days?)

Jeremy, I totally agree with the Devil putting stumbling blocks in our way. And I agree that it’s a sign that he doesn’t like what we’re doing. Like last night, we held evangelistic meetings here. The daughter (#1) of one elder (#2), a teenager, went up and bit the wife (#3) of another elder (#4). #3 then figured she could throw down on #1 and proceeded to do so. Then another daughter (#5) of #2 joined in to defend #1 against #3. Eventually, #2 himself started beating on #3. So it’s #1, #2 and #5 beating up #3. And don’t forget that #2 is a man now beating up a woman. And these are all church members there to support the evangelistic campaign. And this was, I’m not even making this up, during an altar call for those who want to be baptized as new members. I’m not sure if we’re going for the join-our-church-or-we’ll-beat-you-into-submission tactic or the join-our-church-slash-fight-club recruitment routine. Anyway, thanks for understanding, Jeremy.

Naomi, I love getting kudos. And I give you kudos for giving kudos. Kudos rock. My friend once vomited Combos, which kind of sound like Kudos, but are intergalactic (as far as I can tell) cheese-type substance wrapped in pretzel. He blames the Combos, but really, I think he barfed from a lack of Kudos. And seasickness. And don’t worry, I won’t tell Ms Clapp that you think chemistry is blehhh. That’s just between us.

Miranda, total bummer about the fatigue. You know what I’ve found helps? Like pounding five Red Bulls right before Ms Clapp’s class. Trust me, you can’t regret this decision. If she tries to scrape you off the ceiling with a fly swatter, just tell her it was my idea. And I couldn’t agree more that God helps us, regardless of our age. Which reminds me... did you know that Danae is like totally way older than I am? True story.

Rebeca, you’re so right. Opening the Bible does help. Lyol’s got cute little Bibles in French and English that he likes to read. Awesome missionary.

Areli, send me your resume when you finish college. We need some good nurses. Nursing is an awesome career. You can go anywhere! Both of our mothers are nurses. It’s such a great chance to reach people when they’re sick and scared and hurting. I often wish I was a nurse, because they have more time to spend actually getting to know the patient. I’m jealous.

Ariana, I think you’re awesome too. I’m proud of you. I’m sure your family is too. I’d give you the same speech your grandpa would. I think he sounds like a pretty wise guy. Oh, and your aunt’s right, labor hurts. Bad. According to Danae. I wouldn’t know. Hey, you know what’s cool? We’ll get to live in a mansion in Heaven. Awesome. And I don’t think you’d make a very good doctor... your handwriting is too neat. It took me years to learn how to write sloppily enough to be a doctor.

Janelle, I have a secret for you. I once got woozy during a surgery. I actually had to leave. But now, don’t worry, I can cut people open without feeling bad. In fact, I enjoy it. It’s fun. Wait. That doesn’t sound right. You know what I mean. Right? Janelle? Hey, come back!

Amanda, With God, all things are possible indeed! That’s how we got through medical school! Sincerely, Olen.

Luis, pretty sweet that you are building bridges in physical science class. I suppose you’re right, we could say that we’re building bridges between life and death. But all the patients we see are alive. If they were dead, they wouldn’t come to the hospital. So if we’re building them a bridge to get from one state to another, that would mean that we must be building them bridges from life to death. Although palliative care is an under-appreciated field of medicine, it’s not really what we’re trying to do with most of our patients. But sweet that you speak three languages! And you’re right, the stars are awesome here! No light pollution!

Katie, thanks so much for your prayers. Keep ‘em coming! Sorry Chemistry isn’t really your thing. Do think it’s like totally blehhh too? Or was that just Naomi? Oh shoot. I wasn’t supposed to tell anybody that Naomi though Chemistry was blehhh. Pretend I never said that. Very cool that you have good, caring, understanding teachers. My Chemistry teacher was Mr White. He was awesome, except he made us memorize the first three lines of the periodic table the first day!

Samantha, we actually started playing volleyball here! We have a net and a ball and everything. I think you’d really like it. And no worries, you still have a few more months before you need to choose between being a general surgeon or a cardiothoracic surgeon. And if that doesn’t work out, I bet you could be a professional origami artist, judging by the folds on your paper.

Robert, 23rd Psalm is a classic. Love it!

Jean-Luc, total bummer about your chinese water dragon. I’m praying for all your other lizards. I hope it wasn’t some communicable disease like amphibitis or something. I wish I had been there for you, but really, I don’t think I would have been much help at his passing. I think CPR on a lizard might have just caused his eyeballs to fly right out of his head or something. We’ve got a lot of lizards around here, I suppose I should start paying attention to them in case one croaks or something. Of course, if he croaked, he’d probably be a frog, not a lizard.

Phillip, I loved your inspirational story about starting the fourth quarter of your basketball game with ‘I can do all things through Christ who strengthens me.’ Bummer that you lost the game, though. Sometimes we just don’t know why bad things happen to good people.

Olivia, no way! Clapp’s in charge of drama too? Ok, here’s my idea... let’s turn our blog into a full-length play, with like at least four or five different acts. Good idea, right? Let’s do it! We just need to convince her that it was her idea from the start. Olen (heart)

And to my friend who wrote the twelve-page dissertation but forget to leave his name, nice. Is Ms Clapp giving extra-credit by the page, or what? How did the mission trip go? Eighteen sermons? That’s awesome! That’s like more sermons than I’ve preached in my entire life! And I’m a missionary! Was it the ShareHim stuff? And I love your bus stop evangelism! I wouldn’t worry too much about electromagnetic pulses and blackouts. Here where we live, I think that must have happened about 200 years ago or so. They’re still surviving.

Dear Mr and Mrs Arkusinski. Congratulations on your marriage. We have your wedding picture up in Lyol’s room. When I did Marriage and Family, there were way more girls in the class than boys. So I had two wives. Rahel Davidson and Julie Dalson. I was definitely the envy of the class. Rahel and I got divorced, but not until we had a son, which we named, of course, Lyol. I remarried Julie. Anyway, it was all very amicable. Lyol, however, struck a remarkable resemblance to a ten-pound sack of flour.

Raiden, you want to know what Ms Clapp was like in college? One word: Emo.

JT, you’re totally right: There will always be people willing to metaphorically sacrifice themselves. But you know what’s not a sacrifice? That we have about 3,498 metaphorical mangos on our metaphorical trees. There’s no way that we can even metaphorically eat them all! So we’re trying to literally eat them all. It’s awesome!

Kristen, I like your name. I bet my sister doesn’t, though. Her name is Kristin. She spells it differently. (Or ‘the right way,’ is how she would put it.) Which reminds me, we have a literal and metaphorical ton of mangos. Incredible.

Aimee, I love your quote of Romans 15:4,5. Want a mango? I have a lot. Like, more than I can literally eat. I’ll give you one. Metaphorically. Man, these are good mangos. Did I mention that I’m actually typing with one hand while I eat mangos with the other?

Jeanette, mango.

There were also a few letters written to Lyol, so I’ll now turn the computer over to my three-year-old son to answer them...

Eliab, your dad went to Africa for a month as a pastor? So he was like a missionary for that month? That’s so cool. I guess we have missionary parents in common. But seriously, dude? You don’t like fruit? We have mangos, papayas, guavas, limes, lemons, oranges... still nothing? Seriously?

Matthew, life is going to get harder soon? Dude, you’re like such a Debbie Downer, man. I’m glad you had fun on crazy hair day of spirit week. Last time we did that, I put red paint in my hair while my mom wasn’t looking. Well, actually, I guess that wasn’t technically during spirit week. It was just a random Tuesday.

Russell, rollerblading? What’s that? I need to drive 42km before I can get to the nearest patch of concrete.

Tuesday, March 20, 2012

Zane update

Thank you for all who have written and all who are praying.

Zane is on day 3 of quinine pills. He's doing about the same as he has been doing. Playing, laughing, fussy at times. Not real sick, but not 100% either. I think his fevers are getting better. He feels less hot anyways. He's more clingy that usual and has less appetite. Sometimes I think he just doesn't like what I fix for him to eat, but I'll give him a break I guess this time. At least mango season is picking up. You can't beat blended mangos and bananas for a meal!

He fell last week and busted his lip, so he looks more sickly just because of his little busted lip that's healing.

love Danae

Sunday, March 18, 2012

#102 Sweet as Sugar

Just a quick note to offer you an opportunity. We have a lot of diabetics. Our only medications are metformin (Glucophage) and glyburide (like glipizide). When I can’t keep their blood sugar under 200 on max doses of these medications (without any renal function tests to monitor them in a place where everybody is chronically dehydrated), I put them on insulin. In a place that’s regularly over 100 degrees and where nobody has a refrigerator (or electricity) at home, you can imagine what a challenge this presents. Patients will try to find a shaded spot, dig a hole, bury a cooler with insulin and keep the soil over it wet. This is as close as they can get to keeping their insulin cold. And who knows how well things stay cold on their way here. For a while, they’ll get insulin that doesn’t seem to do anything, then on their next vial, they’ll go hypoglycemic.

We have been getting by on insulin that volunteers have brought with them. It’s usually half-used vials of expired insulin that has probably not stayed cold during the trip. Recently, however, we’ve found that we can occasionally get insulin in Moundou and N’Djamena. And it’s actually cheaper than buying insulin in America (although you can’t beat free donations!). But it’s still over $20/vial, which is outside of our patients’ budgets, in an area where 65% of the population lives on less than $1/day.

So there’s anybody with a passion for the up-and-coming disease of third-world diabetes... Here we are!!!

You will notice on our blog,, that we have a link for donations. This is through Adventist Health International’s website. We believe strongly in the mission of AHI. We feel that AHI is an organization worth supporting. By donating through AHI, you can be reassured that there is a strong measure of accountability following your donation. Just mark the donation for ‘Bere.’ And remember that your gift is 100% tax-deductible.
Olen Zain: +235 62 16 04 93
Danae Zain: +235 62 17 04 80
Olen et Danae Netteburg
Hopital Adventiste de Bere
52 Boite Postale
Kelo, Tchad
Volunteers Welcome!!!

#103 Poster child

Danae wrote this just before Zane became ill. The rest of the world stopped while Gramma and Grampa worked to get Danae and Zane home. We are the cause for this delay. So this blog is about 2 months old. Sorry.

She first came in September. She was pregnant with preterm labor. Worse still she had done the same thing 3 times before. Her babies had delivered too early and died of prematurity.

My heart went out to her. If we could just get her to 8 1/2 months, her baby should live. We treated her malaria, kept her on bedrest, and gave her prenatal vitamins. The labor went away.

She stayed in a bed on maternity. When maternity would get full, she slept outside. When there was space, she slept inside.

I would have sent her home, but she lived over 25 km’s away. That’s a long way on a wagon behind a bull. So we kept her here.

She listened day after day to me explaining not to give water to newborns. She even translated for me half of the time. Breast milk only for the first 6 months!

Time went on. She stayed for 4 months! She was finally term. Everybody knew her. She knew all of the staff. I called her my “sage femme” or midwife. She didn’t know how to deliver babies, but she had been there so long she may as well have.

She became 41 weeks. I decided to induce her. I had Adam come in to take pictures of the difficult oxytocin drip that we use here. There is no pump, so you just open the IV line little by little and count the drips to make it go in more ever so slowly each time. We even have pictures at the delivery too.

A healthy 3.4 kg baby girl. The baby screamed. She was chunky, term, and a success. Soon after I helped her breastfeed her cute baby girl. They both did a great job.

It was all in all a very happy occasion. When I discharged her a few days later I felt a sense of contentment.

She was my posterchild. I was happy. “Come back in a month,” I said.

But that was not to last. Apparently I cannot change the culture just like that. I was naive to think everybody would listen to me.

There is an Arab lady from Lai who somehow knows everybody. She has some money and their family has a vehicle, so she travels around I guess. She’s been here at the hospital this week, so Baikou asked how our posterchild was doing. Word was that the baby girl was too skinny. So Baikou sent word to have her come.

Just like that she came.

I am happy that she came, but I am so disappointed. She’s been giving her baby water since 1 week postpartum.

I am so mad.

How could she give water? After all the time she spent on our maternity ward? Baby girl posterchild is over 2 months old and only 3.6 kg. That’s basically the same weight she was born with!

Yes I am mad. I am sad. I cry. I don’t even want to see posterchild. I had given her my own prenatal vitamins! (No, I’m not pregnant.) How could she!?

This poor baby girl! She is so skinny. If she didn’t want to give her the proper nutrition, then she should give her to someone that does. Do you know how many women I see with infertility here!?

I am upset, but why should this baby girl suffer. I write for deworming meds and medicine for parasites since she’s surely got them with all the dirty water she’s been getting. I’m not paying for them either.

“Danae, please excuse me, I had a breast abscess and don’t have enough milk,” she knew my name because she stayed here so long.

I checked both breasts and both were producing milk, “There is no excuse. You have milk.”

“I have no money for the medicines.”

I write in her carnet that I will pay for the medicines, not because she is my posterchild anymore, but because it’s not fair to the baby girl.

I am done with posterchild.

I touch the baby girl. She feels hot. The lab is already closed. She probably has malaria too, so I tell her she has to stay for 3 days on pediatrics while we give IV antimalarial meds to her baby. She tells me she doesn’t have any food here.

Maybe she should drink water to fill her tummy like her baby is doing. Her baby is literally starving from drinking water.

I am so sick of this problem!!!

I am very thankful Cristin O’Grady is here doing a medical school rotation. At the same time she is doing a public health project focusing on exclusive breastfeeding and not giving water. Congratulations Cristin for matching into family medicine residency this week!

Saturday, March 17, 2012

ZANE has malaria

We always said we would give IV quinine if Zane ever got malaria at a young age. Then Adam died and things became a little more real.

We don’t want advice. We don’t want judgement for bringing our kids here. We’ve seen enough of that passed on the Appels to last all of us.

Malaria is a real disease. It’s just that half the world doesn’t care about it. Not on purpose really. Most people just don’t know that it’s one of the leading killers in the world. And people here are too impoverished to have a voice in the places where pharmaceutical companies exist. I guarantee that if something like malaria existed in first world countries, it would be eliminated by now. There would be a vaccine. There would be better medicines.

But for now we weigh the options. And we ask for your prayers to help him recover.

We are so thankful that Zane made it to 8 months of age before getting malaria. He’s almost 9 months now. A month ago he got his first tooth, “All the better to bite you with, Mommy!” With the tooth came a fever.

But then the fever persisted. We didn’t just do nothing about it. I did three home tests and two smears in the hospital that were all negative. The fevers were on and off, just like malaria. After a week, we decided to just treat him.

Instead of IV quinine like we always said we would do, we gave him artemether injections. Seven days of injections is tough for a little guy, but the side effects are less risky. We gave fansidar and malarone with it. We even added Bactrim for good measure and amoxicillin for typhoid fever, just in case. He was a walking (well, crawling) pharmacy.

He got better. Then no fever for a week, yay! He was better.

Then they started again. 102. Okay, we’ll do mefloquine. A one time pill. It’s got no reaction with primaquine, so we added that too. Five days later and he has a fever of 103.

It’s hard to be your own kid’s doctor when you helped care for your friend’s child dying of the same sickness. You just can’t be objective.

If Zane came into our ER we would have started him on IV quinine long ago. But then people here don’t have other options. There are no other medicines here. No one has malarone, mefloquine, primaquine; and artemether is way too expensive for people here (not to mention not effective).

Today there was no choice. Nothing else is working. He’s going to take the quinine pills.

Did I mention they are the world’s most bitter-tasting thing ever? Yeah, they are very, very bitter. We even used a quinine pill for one of our food challenges during the SM survivor game. Just a speck of it will make your mouth turn funny shapes for at least an hour. Or vomit.

He’s gotta take it 3 times a day for 7 days.

I crushed up 1/4 of a pill and put it with 1cc of water, slurped it up with a syringe, and stuck it down the back of his mouth.

Two doses down. 19 more doses to go!

Meanwhile Zane is playing happily and doing quite well. Just pray that he continues to do well.

You Might be in Tchad if...

Your Tylenol suppositories have melted in the heat.

You will notice on our blog,, that we have a link for donations. This is through Adventist Health International’s website. We believe strongly in the mission of AHI. We feel that AHI is an organization worth supporting. By donating through AHI, you can be reassured that there is a strong measure of accountability following your donation. Just mark the donation for ‘Bere.’ And remember that your gift is 100% tax-deductible.
Olen Zain: +235 62 16 04 93
Danae Zain: +235 62 17 04 80
Olen et Danae Netteburg
Hopital Adventiste de Bere
52 Boite Postale
Kelo, Tchad
Volunteers Welcome!!!

Picture of the Bere Hospital Women on Women's Day

#101 Plastic surgeon, ENT surgeon, ophthalmologist

Just a quick note to say that any plastic surgeon, ENT surgeon or ophthalmologist could do amazing things here if they were inclined to do a short-term mission here.

We always have patients with ophthalmological issues (cataracts, retinoblastoma, periorbital cellulitis, orbital cellulitis, conjunctivitis, foreign bodies, etc). We could put advertisements out on the radio and sent out memos to all the health districts and get patients from all over.

We could also keep a plastic surgeon or ENT surgeon busy with cleft lips and cleft palates. We did one about a week ago. We’ve had several others come in, but we turn them away because they’re just too complicated for us. This is another situation where, if we just put the word out, they’d come in droves from all over.

Just an idea. Anybody out there know an ophthalmologist or ENT?

You will notice on our blog,, that we have a link for donations. This is through Adventist Health International’s website. We believe strongly in the mission of AHI. We feel that AHI is an organization worth supporting. By donating through AHI, you can be reassured that there is a strong measure of accountability following your donation. Just mark the donation for ‘Bere.’ And remember that your gift is 100% tax-deductible.
Olen Zain: +235 62 16 04 93
Danae Zain: +235 62 17 04 80
Olen et Danae Netteburg
Hopital Adventiste de Bere
52 Boite Postale
Kelo, Tchad
Volunteers Welcome!!!

Thursday, March 15, 2012

#100 Responsible #3

Responsible 3 (Follow-up to blogs Responsible 1 and Responsible 2)

If you read our blogs you may remember a woman named Josephine. I’ve known her for over a year. All of the hospital staff knows her. She lives in Bere now. You can read her story on the previous blogs.

A year ago we were just happy to have her alive. Then finally she was strong enough to punch me in the arm. I told her she could go home whenever she could punch my arm. Now she’s quite strong! Ouch.

She developed a small little chronic wound on her abdominal incision that has been getting packed for a long time.

Also, the vaginal fistula.

She’s smelled like urine for a year now. She can’t even drink water or it will run right down her leg. She can’t be with her husband, though that might not be so bad since I’ve only seen him helping her at the hospital twice. Still, she suffers from the stench of urine.

It is time to end this.

Or is it? We’ve been quite busy in the operating room this past month. James and Franklin were here last week and had been helping us a lot in the OR. Today we have already done several surgeries. It is already 3pm. Fistula repairs take a long time. They are never easy. Excuses. Excuses. Excuses. Trust me. I could find a million excuses because these are not always easy, especially at the end of the day.

But I know her. She belongs to me now. My heart melts. She hasn’t eaten anything all day. I had promised her already we would try to stop the stench of urine today. She is excited and nervous. I am just plain tired.

So we decide to go for it. I tell my dad that he had to be the energy on this case because I was tired.

We both scrub. We just did another fistula repair last week. She was still dry. So our hopes are up.

It was a big 4cm vesico-vaginal fistula located in the anterior-posterior vagina. Part of it is scarred off to the right, way back in the corner. They like to do that to be difficult!

It sounds simple to do. Just cut some tissue off between the vagina and bladder. Sew the bladder shut. Put some layers over it. Then sew the vagina shut.

Our commentary is as follows:

Wow, this is going to be hard. Okay, we can do this. Oh that’s great, we are doing well.

One hour later:

Oh I can’t see. Olen could you come hold the light behind us, this head lamp is killing my head. I think we finally have the bladder freed up from the vaginal wall.

Two hours later:

Oh, every time I find the right place to stitch, I lose my place. If I only had a small angle needle. Oh, I’m tired. Let’s switch places.

Wow, this is hard to hold for a long time. Let’s take a little break.

Okay, now I can see again. I thought we had that corner well stitched already. Why is it still leaking? We did not come here to do this over again later! Another break. Lets think.

Three hours later:

Okay, that’s where it is leaking. Where did that hole come from? I thought we had that spot well sutured. It’s so hard to see. Maybe this would have been easier abdominally? Oh good, that is the key stitch in the corner. More stitches to put more layers over the once leaking spot.

Four hours later:

Maybe we should modify our closure? If we take this posterior vaginal tissue, it will cover it all nicely. Just rip some vaginal epithelium off so it heals well. Wonderful, that worked well. It’s not leaking. Urine is coming from the foley only! Yay! God is Good! Wow, that was a hard case!

I know most people would never want to hear their surgeons’ commentary, especially if it was a hard case.

For the first time in a year Josephine is not leaking urine out of her vagina. Please pray that her postoperative recovery will go well!

Tuesday, March 13, 2012

#99 Meet the parents

Mom and Dad, these are our friends who read our crazy blogs. Friends, this is Mom and Dad. Enough said? They’ve been here for a month already and I’m finally getting this blog finished.

Okay, okay. I’ll write more.

My Mom. Also known as Nana Bland to Zane and Lyol. Friends call her Dolores. I call her Mom.

Back in Oklahoma you would find Mom helping everyone and their dog with errands. From running church kids to school, visiting with friends and sick people, and shopping for anyone who might need something. Her hobbies include gardening, traveling, sewing, camping, and visiting her grandkids.

My Dad. Also known as Papa Bland. Friends call him Rollin or Dr. Bland. I call him Dad.

Back in Oklahoma you would find Dad working as a family medicine doctor. Of course his hobbies are haying the fields for his cows, Um, yeah....most people would call that work, but that was a hobby listing. Back to hobbies...taking pictures (understatement), birding, camping, gardening, traveling, and millions of others.

I’m the youngest of 4 children. So I guess that means I’m the spoiled one. Yeah, yeah. Spoiled enough to get her parents to move to the middle of no-where desert Tchad! Yeah, you heard me...move here. My parents have moved here!

It’s not their first time living in Africa. When they were spry chickens, they spent 3 years in Nigeria. My brother was even born there! But this was long before I came along. When I was in college I spent a year in Zambia as an SM. I was very sad to leave and a nun on the airplane consoled me, “Once you get Africa in your blood, you’ll be back.” And she was right. With me... and with my parents.

Last summer, we were talking a lot about expanding. We’d been talking about recruiting another doctor to help. Olen kept saying, would you rather have so and so....or your dad? Would you rather have him or her...or your dad?

It’s not every son-in-law that offers his wife to invite the in-laws to move to a tiny little compound with 3 houses where everybody else knows your every business. It’s definitely not every son-in-law who writes a multiple-page proposal to convince his in-laws to move in next door and become coworkers! But Olen stepped it up for better or for worse.

They are already both hard at work. Dad in the hospital, Mom watching the grandkids. She’s already canned 8 jars of green mangos too! And made 6 green mango cobblers (tastes like half peach half apple pie). Mango season is just beginning!

Now for the hard part... learning French!

Here are very short excerpts from the four-page proposal that was given to Mom and Dad from Olen to convince them to come.

Mom and Dad come to Tchad

Convince Mom and Dad to move to Tchad.

Why we want Mom and Dad to take the position:
You are the two most generous people we know, created to be missionaries. You are wonderful missionaries in Oklahoma, and we think you’d be wonderful missionaries in Tchad.
You have missionary experience.
You are family. We want our kids to grow up with their grandparents. We’re thinking of what a blessing it would be to have grandparents nearby.

Why we want Dad specifically:
He’s an extremely talented surgeon with incredible missionary medicine experience.
He could really get involved in evangelism and outreach in the church.
He’s a natural leader and will be immediately respected due to age and experience and education.

Why we want Mom specifically:
One of the world’s greatest cooks and an outgoing personality.
She could really get involved in the church school (including teaching English) and the church and church planting and the nutrition center and flying with the pilots for mobile clinics, etc.

Benefits for us:
Obvious. We have our parents next door and our children’s grandparents next door. We also have another person to share the workload with.

Benefits for Dad:
Gets to be the missionary surgeon again, as well as administrator.
No call!!! (Almost.)
No paperwork (except what you want to read later), billers, coders, lawyers, lawsuits, etc.
65 days of vacation each year for other mission trips, photography trips and visits to family.

Benefits for Mom:
Gets to watch her grandchildren grow up.
Has a husband who works less and has almost no call.
Moves from missionary in Oklahoma to missionary in Tchad, donating time and energy to the church, school, nutrition center, hospital, etc.
65 days of vacation each year for other mission trips, photography trips and visits to family.

Drawbacks for us:
We don’t get to see Mom and Dad on vacation. But we get to see them the other 10 months.

Drawbacks for Mom and Dad:
One long vacation a year instead of several shorter ones.
Loss of social network in Jay (at least, face-to-face contact).
Loss of missionary service in Jay.

Deal sweetener (and this is only if you desire):
Danae and Olen have decided that, after mission service, Mom and Dad would be welcome to live with us. We could buy a big piece of property and build a three-bedroom house for Mom and Dad.

Sunday, March 11, 2012

#98 Writings from a 3-year-old

Writings from a Three Year Old (written in February)
by Lyol Netteburg

Happy birthday to you. Happy birthday to you. Happy birthday dear Lyol. Happy birthday to you.

That’s my favorite song to sing. Well for the past 2 weeks. You see, I just had a birthday. We had a party and invited lots of people over. Mommy and Tammy made a Thomas the Train cake. Tony gave me a soccer ball. We had a contest between two teams to see who could make the best train out of construction paper and pipe cleaners. They were both so cool! I loved them both.

Singing is my favorite thing in the whole wide world to do. My actual favorite song to sing is called “Who built the ark?” But mommy and daddy are tired of that song.

Two weeks ago we went to the big city of NDJ for several days. Daddy went to meetings and me and Zane hung out with Mommy. One day we went to the big city market. I walked a LOT. Mommy got tired of walking around with us, so we hung out under an arabic lady’s umbrella. One older arabic woman must have thought I looked starving. She bought me an expensive apple and some cookies.

One day when daddy wasn’t in his meeting we went camel riding! Before we came to Tchad, mommy had promised to buy me a baby camel. She hasn’t followed through on her promise, but at least riding a camel is closer to the deal than before. I rode with daddy and Zane rode with mommy. When we were at the river our camel kneeled down in the water with us on his back. I thought it was going to roll over next! I loved the camel and pray that we get one of our own someday!

So what’s new in Bere? We have new visitors. Beatrice and Norberto are visiting. They pretty much came for my birthday and then decided to stay 3 more weeks. Cristin is new too. She brought mommy lots of presents from people back home.

Friday, March 9, 2012

#97 Liberation

Sewing, sewing, sewing. That’s what my mom has been doing to help me get ready for Woman’s Day today.

There’s not much in Bere market to buy, but I wanted to have all of our women look alike for the big parade. I found some black and hot pink fabric. It’s pretty cheap quality, but it would have to work.

I was thinking that I would make something, but hadn’t decided what other than a banner.

I talked to the women of the church and they REALLY wanted T-shirts. When you have matching T-shirts, then you are in unity. However, you can’t just buy T-shirts in Bere.

Then I remembered that I had a bunch of printed T-shirts given to us that we brought on our container. I was saving them for our blood drive, but no one has wanted to organize the blood drive. As I started looking through them again I found plain black T-shirts. There were over 20!

We decided to make head wraps too. So mom has been busy overcasting the edges so the cheap fabric won’t fray. She also sewed all the letters on the banner!

Today we were READY! All dressed alike and in unity!

The day of liberation for the women of Tchad. Madame Augustine made a fun little song with a catchy tune that everyone sang together.

Our song translated into English:

“It is the National Holiday, March 8 is the day of liberation for the women of Tchad.”

“We work to prove to men that we are not slaves.”

“This holiday was organized by our friend the President Idris Deby.”

“Men, do not beat women because we are also like you.”

It’s sad that even on this day of liberation for women, I find myself wishing they had a better life. It’s great that they can actually have a day for them to say that they are liberated. But they are far from being liberated. It’s a common thing to beat your wife here. Even in the church. I know that happens back in the states, but at least people know it’s not okay there. Not that that makes it better.

Next year I’m gonna prepare some sort of a speech. I’m gonna really get myself in trouble!