Friday, September 28, 2012

Floods and friends

Wendy and Danae look over the
flooded fields at the Bere sign.
Zane enjoys his private rice paddy pool

Lyol enjoys Brichelle, his neighbor and babysitter

Tuesday, September 18, 2012

Rain and help

In case it’s not a hot topic on the nightly news where you live, filling your airwaves and enthralling listeners curious about this corner of the world, I thought I’d tell you...

We are at war here, complete with airplanes and bombs!

Well, one airplane, a single-engine four-passenger Cessna. And the bombs are not actually weapons, although some of them are heavy. But we do have our very own refugees, trudging barefoot and everything! Just like National Geographic pictures. Like Darfur, but without the violent government issues.

The rains, unaware that this should be the end of rainy season, are continuing here. The waters recede, then advance again, swallowing up entire villages and leaving roads completely underwater. Currents, slow but distinct, run vaguely from south to north, although the river, normally 30 yards across, is now closer to 30 miles across, flowing from rice paddy to rice paddy, from hut to hut, simply blowing across the entire plain with nothing to stop it.

Villages from all around the district have been displaced to Bere, most of them living on the floors of the local schools, often more people than there is floor space. Remember, a school here does not have running water. So toileting/drinking water are a real danger.

But there are other villages who can’t or won’t come to Bere. They try to make a place above the water to sleep and cook and they stubbornly eke out an existence for a month or two. Sanitation is even a bigger problem in those places, where the well is under water, as is the toilet. Whatever you’ve put into that toilet during the last year is now free to float up through the hole and drift over to your open and underwater drinking well. The risk for water-borne illness is no longer a risk. It’s an inescapable certainty.

To us, it’s a little inconceivable that people would stay in their homes. Their homes are mudbrick, built without cement and with a thatch roof. Their homes are prone to collapsing every year anyway. Besides, they could probably carry all their earthly belongings on their heads. I don’t understand why they stay in their village, except that they feel forced to.

So how do we help the flooded folks? We don’t have boats. Our cars can’t go there. Our motos can’t go there. It’s too far to walk with supplies.

Then Gary and Wendy Roberts had an idea. How about bombing the families from the air? Not real bombs. The villagers aren’t THAT desperate yet! But wrapped up packages of food and supplies.

Wendy and Gary gathered supplies of millet, rice, peanuts and other food items to put in one watertight bundle. They got together another bundle of bleach, to treat water, and charcoal and lighters, to cook their food with.

We tried convincing Gary and Wendy to put little notes inside the bundles, saying, ‘From your friends at the Seventh-day Adventist church.’ But then we wondered, ‘What happens if the package dropped from the plane crashes through their roof. Or bonks a kid on the head. Or lands on a spoon which has a pebble balancing on the handle, causing the pebble to soar into the air, striking a passing butterfly, causing the butterfly to get disoriented and vomit, at which the vomit strikes the family’s favorite goat in the eye, causing the goat such severe pain that he goes delirious and runs headlong into a tree, falling unconscious into the swirling floodwaters and drowning.’ You gotta consider all possibilities.

After a lot of reflection, we decided that we didn’t want to be ‘That church of goat-killers,’ so we opted out on the idea of notes in the bundles, choosing the more Chicken-Soup-for-the-Soul-worthy random acts of kindness approach. Anonymous is hip. Plus, everybody here knows that the only plane around belongs to the Adventists. And when you’re only 30 feet off the ground, people can just read ‘Aviation Medicale Adventiste’ on the side of the plane.

Now for loading the airplane...

Zane assisted Gary to take the passenger’s door off and remove all the seats save the pilot’s. Lyol assisted Cherise with carrying the bundles of goods to the airplane. They loaded up and strapped everything down, including Wendy, so she wouldn’t fall out the open door.

Gary and Wendy flew over many flooded villages. They had 30 drops of 2 bundles each. Wendy’s target was somewhere close to the hut, most likely a water landing.

People fell into one of two categories. The first and more plentiful group, the half-full sort of Tchadian villagers, would run out into the water and pull the bundles triumphantly out of the water. It had all the makings of "The Gods Must be Crazy 3." They would then re-evaluate the last dance they had done and forever cement it into their local culture as the Dance of the Rains of the Metal Bird. And that day would forever be known in their village as the Day the Sky Poured Watertight Care Packages. I think that’s how you’d translate it. Well, except for the villages with satellite dishes. They just called it Friday.

The second category of Tchadian villagers were of the more timid, fearful and half-empty sort. They would go into MacGyver-like slow motion when they saw the plane dropping packages, running away and leaping headlong behind bushes at the exact split second the package touched down. Unlike the A-Team, however, the packages weren’t accompanied by awesome exploding special effects. Just a little bit embarrassed, they would hesitanty go poke the package with sticks until they felt confident enough to pick it up, open it and look inside.

All in all, a pretty awesome ministry opportunity for Gary and Wendy down there at the airport. Just so long as you’re not making butterflies vomit on anybody’s favorite goat.

Olen and Lyol, Gary/Wendy/Cherise check on the flooding
Today it is not raining.
A village in need of help received a "drop"  Their mud huts dissolve during the rain.
It is blurry as Wendy had to lean out of the plane to take this picture.
Gary, Lyol and Olen remove the plane door to prepare for the "drops."
They pack the plane

Lyol helps pack the plane

Almost full, except for the "drop lady"
Wendy is seat belted but without a seat.
She is the "dropper" for the flooded villagers.

Monday, September 17, 2012


We have some very exciting news that we’ve been doing our best to keep under wraps. But I think it’s now time to make it public.

When we arrived December 12, 2010, we recognized certain things. We recognized that James Appel had taken the Bere Health Center, a run-down chicken coop, and turned it into Bere Adventist Hospital, a fully functional 24/7 hospital well-respected for surgical expertise and caring staff.

And we recognized that there was still room for improvement. The operating room left much to be desired and was just one room. The maternity ward was no place to have a baby. And there was no private ward, causing much of our clientele to refuse hospitalization in our dilapidated wards and decide to go elsewhere for their care. There was a huge lack in nursing education evident in our staff. There was a huge lack of surgical training for Tchadian doctors expected to be do-it-all doctors in remote areas. We recognized a lack of space for family to sleep with their sick patients, a lack of places to cook, a lack of places for nurses to treat their patients, an inefficient system of payment/pharmacy/lab, a lack of shelter from the elements of Tchadian sun and rain, a lack of places for volunteers to live, a lack of dental facilities, administrative space, space to educate, space for public health/HIV/TB issues and many other needs.

So we started to attack the needs piecemeal. We found funding for a new private ward and for a new operating room (in fact, a complex with two operating rooms), thanks to A Better World-Canada and the Springfield First Adventist church. Construction here is very expensive. Cement costs more than it does in the States. And everything is done with mud brick, which is not insulating, nor strong, nor particularly cheap. There were many construction challenges, not least of which was that Jamie is my only man who knows what he’s doing, and he’s just one man, unable to run multiple complicated construction projects at once.

And then we got a visit. The people that have made One-Day Churches, One-Day Schools and One-Day Houses happened to stop by and they saw the immense need at our hospital, a need that is repeated often throughout the third-world at myriad Adventist hospitals. And they developed the dream of One-Day Hospitals. Bere would gladly be the guinea pig. And so the last several months has been a whirlwind of designing and redesigning buildings, something I have never done before and am completely untrained to do. However, with help from the people at One-Day and with help from Jamie, we have very exciting plans to report.

The One-Day Structures are better quality structures than anything that we can get locally. And since it’s all sponsored (actually, we’re all stepping out in faith, as it hasn’t really been paid for yet), it’s not costing the hospital anything. We will have metal-framed, metal-roofed, metal-siding structures, with insulation in the walls and in the ceiling, with vented ceilings/roofs, with indestructible windows, with roof overhang to provide shade on the walls, etc. And we have experts coming to erect them through Maranatha.

So far, we have planned an operating room complex, two private wards, a delivery suite, a maternity ward, a lab/pharmacy/cashier complex, a ton of new housing for ex-patriot volunteer staff like student missionaries and others, a dental clinic, a public health clinic to service things like midwifery training and HIV and many other things, open-air buildings, etc.

We are hopeful that funding will be found for buildings for a nursing school and for a surgical residency training program. This is such an incredible opportunity that we want to take every advantage we can.

There are so many exciting aspects to this project, that I’m bound to forget some. The One-Day folks have found ways to use their framing materials to construct sturdy hospital beds on wheels. These will be a huge advantage over our current beds. They are also constructing sinks and counters from stainless steel. They have found ideal mosquito screening, netting, fans, etc etc etc. Also, they have found materials for curtain rods between beds. I’ve seen these curtain rods and they will be the best in the world, I can guarantee. They’re just awesome. And we’re getting new systems for our electricity here. And we haven’t given up hope that things like refrigerators, etc will find their way into the hands of the folks at the One-Day operations.

The One-Day is just the outside frame, so we will still have a lot of costs to finish the insides of the buildings, interior walls, hospital equipment, plumbing, electricity, etc, but now we’re able to stretch those donations that were made for the operating room and private wards and those monies will be able to go so much farther now! Those monies will be used to finish several buildings, whereas before it would have been enough for just one. These projects have been a couple years in the making, but now we’re getting it done right, with the best materials at the most efficient cost. We really are so blessed.

Anyway, we just wanted to express our excitement and share our blessing with you. Already, most of the buildings have had their foundations prepared. We’ve even started pouring cement! With this collaboration and everybody working so hard to make this a reality and find every way possible to bless the people here with the best possible materials... we will be turning our 40-year plan into a one-year plan!!! It’s just news that’s too exciting to keep to ourselves any longer.

olen and danae

Olen phone: +235 62 16 04 93
Danae phone: +235 62 17 04 80

Olen et Danae Netteburg
Hopital Adventiste de Bere
52 Boite Postale
Kelo, Tchad

Volunteers Welcome!!!


Like I’ve said before, I’m not that good with names.  However, It’s the tough cases, the ones that die or the ones that come close to dying, that you remember better than the others.  And thus, you learn the individual’s name.

Merci first came to me in full blown labor.  She was well over 50 kg (over 110 pounds) at that point.  A typical story.  She had labored a long time at home.  Her baby was dead already.  Thankfully she was fully dilated.  

I brought her to the operating room for a forceps extraction of the baby.  I put in a foley catheter to empty her bladder and then applied the forcep blades on the head of her already dead baby.  Carlie, a nurse who has now been here several months, was new to africa at the time, but was helping us that particular evening.  I remember feeling bad for Carlie because it was a particular horrid delivery to get the fetus delivered.  Finally, however, I was able to deliver the baby.  

After her delivery, I attempted to move the foley a little, but it was not placed properly.  The balloon had been blown up in her urethra (causing her urethra to be dilated).  So after finding the right path of the urethra, I planned to leave the foley in for a week.  

Merci recovered after all of this.  We took her foley out, and she urinated normally.  Just to be sure her urethra was functioning normally, I instructed for her to come back in a week.  

She did not come back, however.  She lives about 30 km’s away, and road conditions were not optimal.

She went to a health center to look at her stitches I had put in.  She also had started to leak urine.  They weren’t familiar with different types of urinary leakage.  She was having trouble urinating because of her dilated urethra, so her bladder became full, and then would leak from time to time because of the fullness.  This is called overflow incontinence.  Since she was complaining of leaking urine, they referred her to the fistula hospital a long, long ways away.  She of course did not go.  

She stayed at home with her husband.  I’m not sure how it all started, but what eventually occurred was nothing short of neglect!  Maybe the urinary leakage caused the husband to think she was now worthless.  Maybe it would have happened anyways.    Maybe he is like other men who think because her baby died with the delivery, she is not a good woman.  Maybe her husband is just a selfish pig.  

Men always eat first here.  It’s polite.  It’s the culture.  Women and children eat last.  The children, who should get the best nutrition as they have the least defense, always get what’s leftover.  Always the non-nutritious rice, never the sauce that might have a little nutrition in it.  

But a urine smelling, dead-baby mama?  What does she deserve?  From the way the story panned out, he obviously thought she deserved nothing.  

After a while she just lay in her cold, dark hut....starving.  He refused to give her anything.  She may have felt a little sick and not wanted to eat at first, and this continued with him not feeding her.  Maybe she was depressed from losing her full term baby.  That would be normal.  But to leave her in a cold, dark hut with nothing to eat? Excuse me, but that is neglect! 

Almost 2 months later, her mother took her in.  She stayed with her mother for a week and then they came back to us.  

Merci!  She wasn’t even recognizable anymore.  She was only 33 kg (73 pounds)!  She had lost so much weight!  She was a starving skeleton.  I was sooooooo angry at them for letting her get like this.  She didn’t even speak a common language, so we had to get another patient to translate the whole story.  There’s nothing much to say, except it was neglect.  You get tired of getting angry over and over again here.  But this just makes you furious!  

Even more than the anger, were the thoughts like....”Was this my fault?”  “If I would have put in the foley correctly, maybe she wouldn’t have had overflow incontinence, and maybe her husband would have continued to love her without her smelling like urine.”  In reality, I know it was not my fault, but when I take on a do surgery or help with a delivery, they then become mine.  If they don’t recover, then it is my fault.  I want to help be in control of their recovery.  And now I want to beat her husband’s face in the dirt. 

How do we fight the war against hate?  The war against inequality?  It is so great here.  We cannot fight it with anger.  Not with violence.  We are all children of God.  Why can’t the men see here that women are also daughters of God?  Jesus loved each person equally.  He didn’t treat men better than women.  He healed women and men.  Why is there such a stark contrast with how women and men are treated here?  Even within the church?  Last year Tchad was ranked as the worst country in the WORLD for women to live.  It didn’t get that rank just by talking.  Women are treated BADLY here.  It’s okay to beat a woman long as there is no blood.  It’s okay to withhold food from your wife or wives here.  Hey, the husband is the one that earned the money.  His wife is his possession, he can do with her as he pleases.  As a woman here, you cannot tell your husband (and probably any man) no if he wants to have sex.  Everything is permissible.  And, men usually have 2 or 4 wives here, so he can have sex every single night of the week or twice a night.  Everything is about pleasing the man here.  Never about pleasing a woman.  

So, to all of you who think that women’s rights are awful in the states...Please reconsider, and also be happy for what you have.  I have heard that women’s equality is big time talk for the upcoming elections.  I am still thankful to be an American citizen and have rights.  If I had to personally deal with these dumb laws and rules here, I’m certain I would be killed already... or I would be the president.  

Merci came back to us in her emaciated state.  She could not walk.  She could not eat.  She could barely speak.  She had awful diarrhea, and she was lying in it.  I thought for sure she was going to die within a few days.  She looked like a corpse that breathed and had a heartbeat.  

But she lived.  God showed us another miracle here.  We treated her for everything we could think of.  I left her foley in for a long time.  

Julie, our nutritionist from the states, immensely helped to save her life in those first few days.  She started out with a milk/sugar/oil mixture and gave it to her every 2 hours.  If we could only trust our nurses in the night to give it, Julie could have stayed at home and gotten some sleep.  But we don’t trust our nurses in the night, and thus, Julie came in several nights in a row to give Merci the much needed nutrient rich, yet gentle mixture every 2 hours.  

After several nights of this, we felt it was wiser to transfer Merci to Wendy’s Mother and Child Nutrition Place (still un-named).  Olen and I loaded Merci, her mother, and her first child, into the 4Runner and headed down to Bendele.  She still was unable to walk, and had to be propped up in the backseat by her mother.  The road was filled with huge craters of mud puddles.  Merci got a little car sick and vomited in the car.  It landed mostly in her lap.  Okay, maybe a little on Olen’s back.  But that was nothing compared to the diarrhea. 

Wendy's girls at Bendele nursed her back to heath, slowly by slowly.  Bronwyn, Athens, Carlie, and Wendy.  Day and night.  At one point she got an NG tube because she couldn’t eat or keep the food down.  Then they figured out that Merci liked bananas.  When she was strong enough to eat bananas, they would bribe her to eat the other nutritious mixtures by giving her bananas.  

She had to be hospitalized one more time with IV quinine for malaria.  Afterwards, we transferred her back to Wendy’s.  Slowly by slowly she started walking.  

Danae, Merci and Bronwyn
Finally, we took out her foley and she could urinate normally again.  

Last week she was discharged home.  Well, not home, home.  Not home to her husband.  Home to her mother’s home.  At least that is what they say.  She was over 40 kg (88 pounds).  There’s only so much you can do here.  You do what you can, and you ask your friends to pray.  

Please pray for Merci.  She’s been through so much and I pray that God will continue to make her stronger.  Pray that she comes back for follow up also.  

PS.  I am not a man-hater.  I love my husband, and I am so very greatful that he views me as an equal child of God.  I just loathe social injustice, to men, women, and children.  

Sunday, September 16, 2012

To the tune of Three Blind Mice:

Two sick men.  Two sick men.  
Dad and Olen.  Dad and Olen.
My dad was in agony writhing away.  While Olen passed out on the couch for 2 days.  Hydrocodone and Quinine IV were the drugs for these Two Sick Men.  Two Sick Men.  

Two sick men.  Two sick men.
See how they lay.  See how they lay.  
My dad was in a fetal position.  In between pretending to be-ee okay.  Olen lay back with his mouth dropped wide open, an arm propped up attached to a drip.  Oh, Two sick men.  Two sick men.  

Two sick men.  Two sick men.  
What do they say?  What do they say?
My dad doesn’t have many words, but does say that “this really hurts.”  Olen tries to speak english to the french speaking visitors.  He’s not quite right.  In the head.  Two sick men.  Two sick men.  

Olen’s getting better.  Olen’s getting better.  
My dad’s still in pain.  My dad’s still in pain.  
It’s been 3 days of treatment and Olen’s finally off of IV and onto oral quinine.  My dad is off to better doctors, CT scans, and perhaps lithotripsy.  

Oh, for two well men.  Two well men.  

Follow up:  
I wrote this blog over a month ago while Olen and my Dad were both sick.  Thankfully they both have fully recovered.  Olen, to stay here with me.  And my Dad to go back to the states.  His kidney stone passed sometime in between France and Oklahoma.  My parents have been back in the states a month now.  My mom’s brother has throat cancer and it was very helpful for my mom to be in the states with him for the transition to hospice care this past week.  Mom and Dad are coming back to Bere next week.  Please pray for my mom’s brother, Ron, with his diagnosis of terminal throat cancer.  

Danae, the well doctor :-)