Tuesday, February 26, 2013

We Made the News!!!

The Washington Post had this on life expectancy:
#3 Japan 83.9
#36 European union 79;8
#51 United states 78.5
#164 Russia 66.5
#221 Guinea-Bissau 49.1
#222 Chad 48.7

We're number one! We're number one! We're number one!

Although any statistics coming from Tchad are suspect at best. We've seen their sketchy addition skills in official medical reporting meetings. Also of note is that fact that most Tchadians identity cards (for the minority who have them) list their owners' birthday as January 1, typically rounded to the nearest decade. Inordinate numbers of Tchadians are born in the years 1960 and 1970; however, very few Tchadians seem to be born in boring-numbered years, such as 1963 or 1967, etc.

And of course, sometimes rounding to the nearest decade still doesn't suffice. Case in point, a lady who came in last week for sterility. She had never been pregnant. We asked her how old she was. She said she was 18. Her husband confirmed this. We asked her how many years she had been married. She proudly stated she had been married 20 years. Her husband confirmed this as well. However, glancing in her medical carnet, it was noteworthy that she actually knew her birth year. Actual age: 38.

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

Sunday, February 24, 2013

Modern Medicine

IV antihypertensives.  Medicines that you give through an intravenous catheter to lower the patient’s blood pressure.  


Well, maybe not so modern in America.  But seems to be modern to Tchad, in that we haven’t been able to get any in the past 2 years.  

It’s not like I wish that I had IV antihypertensives every day, but once in a while I find myself needing it.  And like everything else in Africa….you just learn to deal without.  

Improvising.  That’s what we do best here!  

When we were in the states for annual leave, we had some nice people mail us a package from Alaska.  In it was all sorts of medicines that had been on our wish list.  One of them was IV antihypertensives.  IV labetalol.    

Last week I had a pregnant woman referred to me for swelling in her legs.  We did an ultrasound and found out that she had twins and was approximately 7½ months along.  Swelling can mean nothing, it can mean that you’re just pregnant.  We sometimes see it with high blood pressure in pregnancy, so I decided to keep her over the weekend.  Her blood pressure had been normal.  She had a couple of elevated blood pressures over the weekend, but then was normal again.  

I determined that she was a walking time-bomb for preeclampsia.  It was just a matter of time.  

Upon deciding that the family could go home the next day if everything was normal, her blood pressures started to be more consistently elevated.  

You see, it’s not easy to just go home and come back here in Bere.  Many people live 20 or more kilometers away.  That’s just an easy commute, right?  Well, they walk, ride an ox cart, or ride a motorcycle taxi just to get here over the dusty, rugged, dirt roads.  So it’s not that easy just to go home and come back quickly if there is a problem.  

Her name is Odette and she is probably in her early 20’s (no one knows their age here).  She is a beautiful Nangere woman.  She wears simple clothes.  A plain shirt and a wrap around brightly colored african cloth as a skirt.  Her legs are quite noticeably swollen.  Odette is shy and withdrawn like most women here when you first meet her.  Her husband seems quite educated and seems to understand the need for her to stay here in the hospital.  He answers all of the questions I ask her (all of the men answer for the women here).  But still, he seems gentle and not overbearing.  This was her third pregnancy.  She had a set of twins with the first pregnancy; one died at birth.  Her second pregnancy gave her another child that is living.  This was now her third pregnancy.  And with twins again!

With the rise in blood pressures, I decided to inject her with steroids to help mature the babies’ lungs in case we needed to deliver them early.  

Sure enough a few days later, I decided to induce her labor.  Odette’s blood pressure had risen to 180/100’s.  Now I needed IV antihypertensives….and I had them!  It was so exciting for me to be able to use it!  And it worked.  Her blood pressure decreased to 150’s/90’s with the new medicines.  

We can give oral medicines, but they are more dangerous to give while a woman is in labor because they are less predictable.  If you lower the blood pressure too much, the baby (or babies in this case) doesn’t get as much oxygen and could die.  It can be dangerous for the mom also because of possible excessive blood loss during the delivery.  

Her cervix was 2½ cm dilated.  Both babies were head down.  Now for the fun part.  The not so modern part of modern medicine.  Oxytocin via a drip in which you count the drops per minute by hand.  You just try to count 5 drops per minute with a valve that is touchy.  I always start slow here and advance slowly also.  I put one hand on her pregnant belly and kept it there, so that I could count her contractions.  Slowly by slowly after a few hours, she started to get into labor. 

Her blood pressure rose again, but thankfully we had our ‘modern medicine’ of IV labetalol to use.  

Finally, the first baby delivered.  A beautiful little boy!  Screaming, healthy, big enough!  

I got called away for another emergency to do a c-section (only the second one all month actually) for a woman bleeding in which the baby was still alive.  The mother did fine, but the baby ended up dying.  

Athens delivered the second baby twin back at maternity.  A beautiful little girl!.  Screaming, healthy, big enough also!  

Odette then had a postpartum hemorrhage and ended up having a d&c and repair of a cervical laceration.  She is doing fine now though.  Of course she would hemorrhage… it was Lyol’s birthday and I had invited friends at a certain time to come!  

Both babies are about 2 kg each.  They are breast feeding well now one day out.  Odette’s blood pressure is still high, but we will now control it with oral medication.  

Oh, and…..they have decided to name their new children…..Jamie and Tammy!  (After our dearest friends here who live next to us.)  

You will notice on our blog, missionarydoctors.blogspot.com, 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.

 HYPERLINK "mailto:danae.netteburg@gmail.com" danae.netteburg@gmail.com.
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!!!

Odette and her 2 babies (Tammy and Jamie)

 Twins Tammy and Jamie dressed in donated clothes/blankets for our baby bribe program (an incentive to try to get women to deliver at the hospital)

Tuesday, February 19, 2013

Zane reports on building project #4, our helpers

My great Aunt Bekki and Uncle Scott with their friend Mike are visiting us right now!

My new friends from Switzerland came to visit for several weeks.  Beatrice, Vincent, and Genevieve.  They helped mom and dad out at the hospital.  They had great success with a 5-day stop smoking program for the community!
Every once in a while we let the Maranatha volunteers who came to build our buildings a break.  Here they are all looking at our hippos in the river. 

More hippo watching from the safety of the vehicle!
 On Sabbaths we take a break from our work and try to get out an enjoy nature.  Midnight wanted to climb the tree with us!

Thursday, February 14, 2013

Prayers needed

Please pray for us as our district medical officer has accused us of killing patients.

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!!!

Tuesday, February 12, 2013

Writings from a 4-year-old boy

That’s right. I’m 4. Lyol Hadden Netteburg turned 4 years old yesterday.

With Cherise

With "Little" brother Zane

I wake up early (but can’t tell time so sometimes it’s midnight, sometimes 3am, sometimes 6 am), read books by myself (sometimes holding them right-side-up), and wipe my own bottom after going ca-ca (then smear whatever I didn’t completely get off onto my next pair of underwear). I am a big kid!

Mommy and Daddy threw me a big party yesterday (Jan 31). I had 3 cakes! Mommy actually heard me say that cake is too sweet. (Then Daddy threatened to take away my Netteburg Card. ‘Too sweet‘ is not in the Netteburg vocabulary.) 

I really like Lightning McQueen, so mommy made a cake that looked like him! Tammy and Brichelle made me a Lion cake, and Nana made me a vegan cake. Daddy made me two big checkered racing flags, so once I get my own race car, I will be ready to go! Pedal to the metal!

I even got to open presents just like Christmas! Birthdays are fun. Everyone watches you open presents.  Most people are happy for me and love watching me open presents. Others are just haters (cough, Zane, cough). I got some arm floaties to go swimming in the river with (or around the house if it’s in fashion that season). I got a few puzzles. (Note: If puzzles bore you, mix three of them together. This increases the degree of difficulty significantly and is guaranteed to make your parents happy.) I got a new pair of flip flops from the Moulders. I was so excited that they fit me perfectly! (I get more excited and defensive about shoes than a Hilton sister.) I got several small race cars too. 

Nana and Papa finally have their shipping container and they bring over new stuff everyday, but on my birthday, they got me and Zane a new wagon! As if we don’t stand out enough already! Brichelle brought Cherise, Zane and I out for a spin, and it is a sweet ride! It’s currently in the shop getting fitted for neon lights and spinners. 

In the fields

With Brichelle

Well, just wanted to let you know how big I’m getting. And how much older and wiser I am than Zane (who is just 1 ½ years old and still a baby).

Au revoir (bye),
Love, Lyol

Wednesday, February 6, 2013

Zane reports on building project #3

Inside Mommy's new delivery suite and consultation area

Inside the future new OR building
Two private wards with roof and outside walls done!
On the left is the private ward, in the middle is the OR building, on the right is part of the new maternity ward
On the left is the new corner of the OR building, in the center are the two maternity buildings, 
on the right is the corner of the private ward

The front of Nana and Papa's new house.  The roof and walls are done, now just for the inside walls and extra stuff!

This is my sweet stroller ride in front of our new 4 bedroom hotel.  Each will have it's own shower, toilet, kitchenette, and bed.  I KNOW you want to come visit us now!!!  Look at these fancy sidewalks! 

Saturday, February 2, 2013

Zane reports on building project #2

Lyol and me surveying the site of the future private wards

I'm surveying Nana and Papa's house being started

January has flown by.  So much has happened that it seems like it’s been a whole year!  

So I hope you don’t mind if we just do a little picture diary.  You won’t believe your eyes unless we show you the pictures!  

As you can see it’s hard work directing all of the bosses, workers, volunteers, and of course my parents.  But somebody’s gotta do it.  It’s been a very, very busy month!

Building buildings is hard work, but my biggest project this year will probably be learning to go ca-ca on the toilet.  Maybe I’ll learn that too if I can pull my self away from this building project! 

Volunteers making windows

New maternity roof being started

Progress on maternity wards

The big man giving orders directly to Lyol and me.  We in turn tell Jamie who surveys all of the workers.  Lyol abnd I are pretty important.  That's our Nana by us.  I'm trying to stand up really tall so the big man knows I am big enough for this project.

Zane reports building project #1: Containers arrive!

Inspection of 2 of the 4 shipping containers that FINALLY arrived. 

Lyol and Allah inspecting the new hospital mattresses

I also have to check them out.