Monday, March 11, 2013

Be Mine

Is there anything romantic to do in the midst of all of this chaos?  What do we do for romance?  What do missionary couples do to keep those sparks flying?  
Meeting Gary and Wendy in Lai (half-way to Club Med
Schedule dates is a good answer. 

But go where?  

That’s the problem.  There is NOWHERE to go!  If you have ever been here, you would understand.  If you haven’t, you probably will never understand (sorry).  

Sometimes you just want to get away.  Go to a nice restaurant.  Go for a walk in the park, etc, etc.  

For Valentine’s the lady folk decided to surprise the men folk with an outing.  A date really, but for the whole day.  Make a picnic, go out in the blazing hot sun…..but get away….anywhere!  

Beach Resort for free...just come to Tchad!

This turned out more difficult than we had expected. 

Left to right:  Olen and Danae, Rollin and Dolores, Jamie and Tammy, Wendy and Gary,
Jonathan and Melody

The biggest problem was that we were having issues with our MCD (see previous blogs).  Olen was stuck with meetings scheduled the very morning we were to depart.  Tammy was preparing for a trip.  Gary doesn’t like secrets or surprises.  Jonathan and Melody were planning on being gone.  Nothing seemed to be going well to get this date underway.  It was going to be us and my parents going to the local river.  

Scott and Becky were here, but Scott (a US extremely qualified surgeon) had been banned from the hospital by our MCD.  He also had malaria and was sick.  Samedi was going to cover for any emergency surgeries.

I wanted to go to Club Med Lai, a 2 hour drive away.  

The morning of Valentine’s Day, we had decided not to operate until further notice because of issues with MCD telling people we were killing patients in the operating room.  Olen had meetings the whole morning.  Church people had come to “help” from NDJ.

The lovely ladies:  Wendy Dolores, Tammy, Danae, Melody
I didn’t think we were actually going to be able to leave.  I finished rounding though, and quickly packed stuff for a picnic of hot dogs and watermelon.

Somehow, everyone decided to come!  The wives had to be sneaky, but mostly we had to just tell the men what the stinkin’ plan was.  Olen was home by 11:30 am and said, “let’s go.”

So at that, we left.  We left our troubles for a brief few moments that search of romance on Cupid’s lovely day.   

Gary had to fly the plane to Lai, so we met him on the way.  

2 hours later...Club Med Lai!  

The men: Rollin, Gary, Jamie, Olen, Jonathan

Oh, how blissful.  Just like the Virgin Islands (plus a little cow poop).  So secluded.  Well, at least we didn’t know any of the kids peeping through the bushes.  You can never really get away here without someone watching you.  It’s true.  We live in a fishbowl.  But today it was a romantic fishbowl.  

We ate.  We swam and relaxed in the cool water with the temperatures soaring to 105 degrees out of the water.  We had a good time!  

It was an important bonding time for us all.  For couples.  For friends.  

It’s hard to get away here.  But the times you do are forever cherished.  
Enjoying the cool water at Club Med Lai

(And we also discovered the reason it’s called ‘Club Med’.  You need to see the doctor after swimming in that water!)

Saturday, March 9, 2013

5-year-old baby by C-section

This one we’re going to entitle, “How to deliver a 5 year old baby by c-section.”

She came in one afternoon for an ultrasound referred by the nurses.  At first notice, you would think she was pregnant.  You would even think she was pregnant with a 5 year old by the way her belly protruded forward.  She looked so uncomfortable.  

She’s in her mid 40’s and has 4 living children.  But this ginormous creature or thing had been growing for at least 5 years in her abdomen.  When asked later why she waited so long to come see us, the family said they had been saving up their money for a surgery. 

On examination her belly was taut with a huge solid, irregular mass.  You couldn’t see much on ultrasound.  It was hard to distinguish what was what.  It was clear there was no 5 year old baby though.  On vaginal examination, her cervix felt normal, so it gave me some hope that we could get this mass out and that it might not be cancer.  

Our working diagnosis was a really big ovary that had taken over her entire abdomen.  

We told her that we would try to take it out.  But if it was advanced cancer, we would have to open and close only.  The family agreed.  It was either that or nothing.  

The week of valentine’s day our MCD was spreading rumors that we were killing people in the operating room (which is not true).  We were trying to decide to take a break or not.  We took one afternoon off from work.  The nurses were threatening to go on strike for us.  We were unsure what to do.  

The following week the operation requests come in by the hoards.  We spent the entire week with a list of 20 surgeries paid for and awaiting then turn.  It seemed that every time we finished one operation, two more came in.  This lady was one of them.  She had been suffering so long (like so many people here) that we could not just leave her until after the problems with MCD resolved (which may be forever).  

My dad and I made a small-ish incision below her umbilicus just to peek.  Then we made it a little bigger.  

Attached are a few bloody pictures (sorry).  Please beware of the blood and guts and don’t scroll down if you don’t want to see.  

“Wow! Those look like huge snakes!”  We were actually looking at huge dilated veins of the omentum that were 2-3 cm dilated in diameter.  The omentum was attached to this big mass.  If you put your hand in past the veins, you would accidentally break one open and she would bleed like stink (bleed like stink=actually a medical term).  So we had to carefully clamp and tie off each one.  

After clamping off several huge omental veins to free up the mass some, I finally was able to get my hand into her abdomen.  It was definitely ovary, and it didn’t seem like cancer (ie, wasn’t adhered to everything).  

It was still difficult though because of all of the vessels that had been growing and thriving like leaches for years and years.  

Once we freed the huge ovarian tumor from the omentum, it still had some vessels to the sidewall and posterior abdomen.  It was EVERYWHERE, but was able to be dissected (unlike difficult advanced ovarian cancer).  

Finally we detached the HUGE ovary from everything except the uterus (which it seemed to be adhered to).  I had Ross scrub in just to help us hold the thing up so I could see beneath it.  

Did I mention that it was BIG?

It was so difficult to hold up, that I cut the largest portion free from it’s base that was stuck to the uterus before finishing up with a hysterectomy (a much simpler surgery at that point).

We put everything into a large basin.  How much did it weigh?  16 kg without the weight of the basin!  That’s a little more than 35 pounds!  

How would you like to lose 35 pounds in 1 day?  

We finished up by irrigating and tying off a few more additional bleeders coming from her omentum, upper abdomen, and sidewall.  

She received several transfusions during the surgery, but she was fine.  

Usually if something interesting happens in the OR, everyone hears about it outside.  People were coming and gawking from everywhere, with their eyes popping out as they looked at the specimen.  

I heard that the sous-prefet (a local authority) came to see, as well as other important people.  Someone even called the radio, who came to interview her, and then broadcasted her story on the radio.  

Please continue to pray for the surgeries that are ever on-going here!  We never cease to get bored!

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Wednesday, March 6, 2013

James Bond

So what do you do on your typical Saturday night?  

What did you want to do tonight, Brain?

Maybe watch a James Bond movie?  

The same thing we do every night, Pinky.  Try to take over the world!!!

How often do you get to BE James Bond?  

Alright, Brain. But where will we find fourteen rubber chickens and a hose that long at this time of year?  

We had just gotten back from watching the hippos at the river.  It was a nice relaxing day and we were just winding down.  

She was down at the river wrestling hippos.  They seemed to be part of an international hippo-smuggling ring.  She played it cool.  They never would have known she was actually sent to guess their weights for an upcoming raid.  

Knock on the door.  It wasn’t your typical knock on the door like from the nurses at the hospital.  It was a half-hearted knock, like a “do I really want to be here?” knock.

Out of nowhere came a rap on the door.  Instinctively, she knew this wouldn’t be a typical visitor.  She reached for her water gun.  

I answer the door without a flashlight.  The person didn’t have a flashlight, so I ask who it was because I couldn’t see.  

She peered into the blackness, cursing herself for not remembering her night-vision goggles.  

“C’est Moundeng et Appolinaire,” came the soft reply from the teenager.  

They spoke an indeterminable language.  French?  Klingon?  Whatever those freaky arrow-shooting elves speak in Lord of the Rings?  She didn’t have time to get out her decoder.

I go back inside to grab a flashlight so I could see and talk with them outside on the bench.  It was a very, very dark night and you couldn’t see anything without a flashlight.  

She suddenly remembered that Q had implanted night-vision in her corneas.  She tapped the special button hidden behind her left ear to activate it.  

Moundeng brought Appolinaire with him because he was afraid to talk to me by himself.   He’s not just any kid.  He’s a kid with history.  Not to get into all of the details, but last year we banned him from the compound for beating up two of Brichelle’s friends.  He’s been forgiven by the families on the compound MULTIPLE times for various things, including lying, stealing and repetitive drunkenness.  

She stooped to fraternize with known felons, but pretended not to know their pasts.  Sometimes, you have to do dirty things to stop the bad guys.  She did all she could to not punch him in the nose or kick him in the knee.

I like the kid, I just don’t really trust him.  

She had a gut feeling that not all was well in Beretown.  That, or it might have just been a little gas.  She had eaten haystacks at lunch.  

So he comes to me with an interesting story.  He tells me that he overheard that someone found a computer in the dirt.  Supposedly this computer is now in a guy’s hut.  

It was a nice story, but just that… a story.  Fiction if ever she had heard it.  

Now I must explain why this is interesting to you.  You wouldn’t find it weird if your neighbor had a new computer, would you?  Well, maybe you would if NONE of your neighbors had electricity!  

Something didn’t add up.  The lights weren’t coming on.  Probably a dead battery.  Hadn’t had a charger for eight months.  

The even more interesting part is that one of our SM’s had their computer stolen last year, 8 months ago, and it was never found.  

Now the pieces were all coming together.  But there was still a piece of this puzzle missing…  

There was a reward out.  A big reward.  Nothing.  No computer turned up.  

Money also changed things.  She wouldn’t be the first ‘double-o’ to turn double agent just for money.  

One SM had to go home for the year with only half of her pictures, letters, and whatever else private she had stored on her computer.  

Would life ever be the same again?  Not likely.  

We had written it off to careless mistakes and then soon after hired a night guard that we split between the families.  

The night guard, of course, was just a diversion to distract the attention away from our hero, while she set up observations around the town over the proceeding eight months.  

Moundeng was one of the prime suspects for stealing the computer all along.  But we could never prove anything.  He was frequently in the SM hut spending time with the SMs, so he would have known what was in there and how to work the unique windows to get in quietly.  He also SHOULD have known to steal the charge cord too, but he didn’t.  

Intense interrogation couldn’t drag the truth out of this hardened criminal.  Interrogation tactics were employed at the time.  Very similar to water-boarding torture, our hero took drastic measures, such as asking, ‘Hey, do you know what happened to Mayline’s computer?’  Even this couldn’t break him.  Sometimes, criminals are able to convince themselves they’re innocent.

Moundeng suggested that we go to the hut and see if the guy was there.  He said it was “tout pret ici.”  (very close).

Of course!  Her sixth sense had told her all along that danger was just around the corner.  

Wanting to catch the guy in mid-action, I quickly grabbed a flashlight and told Olen where I was going.  I was kind of an idiot and didn’t even put on shoes or grab my phone.  Moundeng had said it was just outside of our gate. 

Completely abandoning personal safety in order to restore honor to the crown, she sprang into action.  It was a risky move, letting her instincts take over.  But it had always worked out for her in the past.  She was still alive, wasn’t she?  

I kept the flashlight off, so that the locals wouldn’t notice that a nasara (white person) was out at night and send tribal drums to warn the thief who had the computer.  I couldn’t see however, so had to rely on Moundeng’s ability to guide us through the moonless night.  I told our night guard where we were going (even though I didn’t exactly know) and headed out onto the dusty footpath.  

Having no time to apply camo-paint to her face, she went with the next best option… dark ops.  But she was up against the latest drum-beating technology.  Could her old-school training and weaponry possibly compete with digital super-sonic percussion?  Not to mention that her opponent was extremely well-funded.  She entrusted her whereabouts to the only person who she knew to have her back.  No, not her husband, stupid.  The random night guard.  

“I thought you said it was very close Moundeng,” I said as we continued on, me barefoot.  

She was started to doubt the veracity of the felon, strangely.  

“It is, it’s just here.”  We continued walking quickly, ducking under a few mango branches along the way.  I could tell that we were going in the direction of the market.  Then we turned a different direction.  Now I couldn’t tell exactly where we were.  

She had once spent 37 hours blindfolded in the trunk of a hurtling Camry, then found her way home… still without removing the blindfold.  This would be child’s play.  

After traveling on and wishing that I would have put on my shoes, we finally approached a mud brick enclosed compound.  It was very dark, so I finally switched on my light.  

After doing some spiffy super-spy dive rolls from one shadow to the next, she flipped on her flood light, temporarily blinding the evil-doers.  

There were a few women who came out to greet us.  “Lapia.” “Lapia.”  
After several greeting exchanges, they asked us what we wanted.  One teenage kid came out and pretended that he couldn’t understand my french, even though I know he could.  He was starting out with an attitude.  

Of course they would send out the women to try to catch us off guard.  They were used to dealing with male spies.  They had another thing coming.  

Then an older man came out carrying a big sack of charcoal, like he was preparing to leave.  

They threatened our hero with starting a fire.  Danger.  

I explained that I heard their family had found a computer and that I was looking for one.  

She sat down at the casino craps table and started up a casual conversation.

“Oh,” he said in french, “Did you drop one?”  

She had been through interrogation training and had even been an instructor at one point.  But nothing could have prepared her for anything this intense.  

“Well, yes, we must have dropped ours in the dirt,” I said.  

Spies learn to lie.  She had passed her last 49 lie detector tests.  And hadn’t even told the truth.  

They seemed a bit nervous that we would think that they stole our computer, so I reassured them that I wasn’t looking for trouble with them.  I only wanted our computer back.  In fact, I would offer a small reward if it was in fact our computer.  

She tried good-cop, bad-cop, but had nobody to complement her.  So she just went with good-cop.  

After a little more discussion on us not looking to get them in trouble, he finally seemed to believe me.  So he said that we would go to another house and look to see if it was there.  

Every sinew of her being told her it was a trap, but she was in too far now.  

On into the night, barefoot (stupid, stupid Danae!) on dusty roads where cows, goats, and people pee and poop we went.  I didn’t turn on the flashlight, just followed Moundeng and the old man.  

She was led down a pitch-black sewage tunnel.  If this were their secret lair, she decided she would let them live in peace.  Nothing could be worth taking this hepatitis risk again.  Except maybe an orange soda.  Man, that sounds good right now.  

We came to another house where 2 ladies seemed to know me.  The old man slipped into one of the mud brick houses to hopefully retrieve the lost goods.  While waiting, one of the ladies spoke in Nangere.  Moundeng translated that her baby had breastfed exclusively through our program for 6 months.  I had even taken and given her a picture of her and her fat baby.  I turned on the light and she looked familiar.  Yay, we’re off to a good start, I thought.  We chatted a little about their family and finally the old man, whose name is Moise I learned, reappeared with a shiny, silver, new-looking Macintosh computer with no power cord, although somebody had tried to pry off the back in order to replace the battery, most likely.  

You have GOT to be kidding me?  She’s come this far just to have her cover blown?!??!  If they wanted to gain the element of surprise, they got it when the first lady dropped her top.  Danae had to quickly dispose of her so as to not distract attention.  With a hefty degree of quick-thinking, Danae told the old man that the other women had gone ‘to bleed the lizard’ when he came back.

I didn’t remember exactly what Mayline’s computer looked like, but I knew this one definitely belonged to ONE of the nasaras.  

She knew a MacBook when she saw one.  And she saw one.  The one the guy was holding.  In his hand.  It was a MacBook.  And she knew a MacBook when she saw one.  Just like that one.  That one right there.  Are you blind, it’s the one right there?!?!  There’s only one computer even in this scene, of course that’s the one I’m talking about! Come on, people.  Get with the program.  I will pull this story over right now.  I will turn this story around and take it home.  Don’t make me.  I’ll do it.  Try me.  Try me.  I dare you.  Yeah, that’s what I thought.  Now sit down and listen to the story.  Punk.

“Merci!, Merci! Merci,” I repeated to Moise.  

She thought she saw Marci off in the distance, but it was actually somebody else.  Ironically, her name was also Marci, so it caused a little confusion.  After much apology and laughter, they got it all sorted out.  

The family still seemed a little bit nervous about me thinking that they stole something.  “Do you want us to get the little girl who found the computer in the dirt?” they asked in french.  

She knew from experience, that it was often more important to accomplish the mission that to put the bad guys away.  She had gotten into major fights before with her bureau chief over this exact same issue, and knew that it was no longer her battle to fight.  

“No, no…..I’m not looking to give blame. I’m just thankful to have my friend’s computer back,” I reply back in french.  

She could not get a confession from them onto her cleavage tape recorder.  They were tough nuts to crack.  She always got her man, just not always on the same day.  

The old man still seemed nervous so brought a small scrap of one of his kid’s old school papers for me to print my name on.  As if it’s hard to find one of 10 white people who live in Bere.  I smile and politely write Dr. Danae, L’Hopital Adventiste de Bere down on his paper.  I tell him that he can find me at the hospital every single day.

She remembered hearing about POWs in ‘Nam signing statements they were told were something else, then learning later they were statements of confession to horrible crimes they had never committed.  Just to be sure, she signed this one in disappearing ink.  Jokes on them.  

For the small present, I reminded them that I would come back another day.

Yeah, right.  They always fall for that one.  

I told them that if they ever found anything else that clearly belonged to a nasara “laying in the dirt” to please just bring it to our house next time.  The older son said the same thing to me.  If I ever found anything of theirs, please bring it to them.  As if it would be that easy to know whose it was.

We had an understanding.  They didn’t want trouble.  I can’t say I blame them.  I mean, have you seen this girl’s biceps?  Dang!

“Pas de problem (no problem)”, I say.

Little did she know this actually meant, ‘A chicken lives in your shoe,’ in Nanjere.  

At this Moundeng and I left.  A young lady came trailing after us seeming to be upset with Moundeng for something.  I don’t think he translated exactly what she said, but I was just happy to be leaving with the long, lost computer of our former SM in hand.  I couldn’t believe it.  It was too good to be true!  

Classic car-chase escape scene.  Gotta love it.  Totally reminds me of Lethal Weapon I, II, and IV.  But not III.  III was so lame.  

As I walked barefoot on the dirt path back home with Moundeng, I realized that he was probably in on this also.  He or someone else likely stole it from the SM hut last year.  Then eventually decided it needed to get given back because they couldn’t use it with no power cord and no electricity.  The culprit either set up that family to find it or convinced them to take it and not tell me that someone had given it to them.  

Sometimes spies do ethically and morally sketchy things to achieve the greater good.  Who are we to judge her actions?  

Whatever the real truth was….I was just happy pretending to be James Bond, Indiana Jones, or some other hero finding the lost treasure.  Pretending not to be set up.  Pretending not to be lied to.  Pretending to not be tired with corruption.  And actually feeling happy and good about it in the end.  

A whip!  She knew she was missing something!  She needed a whip.  That would have made the story sooo much cooler.  Can we do it again?  My personal favorite was Temple of Doom.  Let’s do that one.  

The next day someone suggested that we get the police involved, have Moundeng questioned, have the family questioned.  

By that time, Moo Dung would be long gone, she knew.  He was no amateur.  The poor local authorities really had no idea who they were dealing with.  

None of this would change anything.  In my opinion the police are not helpful.  They just want our money when we break rules like walking by a one-person flag lowering that you can’t even see is happening or carrying too many people on your moto or top of car (even though every other Chadian does this).  Moundeng is not going to change, and it wouldn’t matter if we found out anything else differently about the family of Moise.  

Moo Dung and Charlton Heston are those guys who would never change.  Unless money brought them to the good side.  

So….I declined further investigation.  We’ll just keep our eyes open wide.  And ask for prayers from our friends to keep us safe.

Even super heroes need vacations.  Danae can be found manizing (the opposite of womanizing???) her husband on a deserted beach somewhere.

Congratulations Mayline!  You can finally have your pictures back now!   It actually works with a power cord!

After weeks of collaboration between the CIA, MI-7, the FBI, the NSA, the DEA, the ATF and the ASPCA, we have been able to restore Mayline’s computer.

(As a footnote: It turns out that the night before Moundeng came to us with information about the computer, he was informed by the Parkers that he had run out of second chances and was no longer welcome in their house.  So this could have been motivated by a desire to get in good with the nasaras again.  The day after we got the computer back, Moundeng told Augustin that we had promised him 100,000 CFA to recover the computer and sent Augustin to collect.  We never said any such thing.  So perhaps it was money-motivated.  Either way, Moundeng remains the most likely suspect.  But we got the computer.  James Bond always completes his mission!!!)

I’m sure this isn’t the last we see of Moo Dung.