MABINTY

The RAC Mobile Clinic Team, Sanko, Paul, Kadiatu, Mr. Abu, and Shawn Hannah, KCMA PA Student

The Restore a Child Mobile Clinic team heads out from the Adventists Health System-Sierra Leone, Waterloo Hospital each Tuesday and Wednesday, taking medicines to children in villages with no access to health care. The following story is told in the words of James Abu, our beloved CHO (Community Health Officer) and head of our mobile clinic program.

Mr. James B. Abu, CHO, Director of the Mobile Clinic Program.

This child, Mabinty Kanu, age 3, was seen during one of our mobile clinic sessions in a village called Masentigie. According to the mother, the child had been having a fever on and off for one week, which became continuous over the last two days before we were there. In addition, she was coughing and vomiting after every meal. Her abdomen was distended and she was obviously seriously anemic. She was so helpless that she could not stand without support.

Mabinty Kanu, sitting on her mother’s lap with an IV hanging from a Mango Tree.

I asked the mother, “Why have you kept this child at home until now?”

The mother’s reply was, “I had no money to take her to the hospital. To get even what we eat is a problem. I have been giving her some native treatment, but it does not help.”

I asked about the father and she told me he ahs separated from her and does not even visit to know how Mabinty is doing.

Mabinty was quickly examined by another PA student from Kettering, Olivia Kwiatkowski, and given emergency treatment with IV fluids and antibiotics. A motorbike was hired and she was transported to the Adventist Health System—Waterloo Hospital, where Mabinty was admitted and laboratory investigation confirmed the severe malaria and anemia. Treatment that had begun in the field was continued and she was transfused with whole blood.

Mabinty on the road to recovery, sitting up on her hospital bed.

By God’s grace she responded well to treatment and 2 days later she was discharged to home with oral medication. The mother was so happy and was crying as they left, saying, “Thank you for saving my child’s life. I pray that God will continue to bless you.”

Ready to go home!! Praise God!!

We shall be making a follow-up visit on her after one week to see how she is doing. But she would not be alive today with the Restore a Child Mobile Clinic Program.

James B. Abu, Community Health Officer
Restore a Child Mobile Clinic Supervisor

Truly this child would not be alive today if it were not for the mobile clinic program. And the mobile clinic program only functions because of donations given through Restore a Child and our other faithful supporters. Thank you and God bless each of you.

For more frequent, up to the minute short updates, please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

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AN ANGEL IN FATIGUES

“Fire, Fire!!!!”

The cry went up from the back of the bus, somewhere near the border of Burkina Faso and Mali. It was about 1:30 am when some cables overheated and caught fire in the back of the passenger bus carrying a precious cargo, a part of our AHS family.

The Danquah family, Elizabeth, Rebecca, Samuel, with Nana and Samuella.

Elizabeth Danquah, my very special surgical assistant, her cousin Rebecca and the two Danquah children, Nana, 6, and Samuella, 3, were on that bus, sitting toward the front. They were traveling back from visiting their families in Ghana for the first time in years. So it was the first time the family had met Nana and Samuella.
When the cry of fire went out the children were asleep, the adults mostly asleep. As the bus pulled over to the side of the road people began running forward toward the door, pushing and shoving to be the first out. No one knew when the bus might explode, or become a fireball. In the melee that ensued, little Samuella was trapped, crushed by this river of panic stricken adults.

Somehow, by the grace of God, Elizabeth and Rebecca were able to rescue Samuella and get her and Nana to safety.
In many ways though, it was out of the frying pan into the fire. All the passengers were now stranded in the bush, in the middle of nowhere, with a broken down bus that is on fire and going nowhere. Soon a policeman showed up and warned them that it was not safe in that place. There were robbers around who would take great delight in relieving the passengers of whatever they might have of value. So he stayed with the group, although I doubt he would have been much protection had they come under attack by a band of thieves.

Nana trying to sleep on the ground in the bush.

The angels of God surrounded this stranded group of travelers that first night as they huddled together. Morning brought light (safety) and transport to the next city in Mali. And so the little family boarded another transport to continue their journey home, a journey that normally took 5 days, but already was now a day delayed.
Later that evening, again in a remote area of Mali the driver of the bus realized he had no brakes. He was able to get the bus slowed and stopped on the side of the road, but another night was spent in the bush with little to no protection from robbers, save the presence of God’s angels.

The next day Elizabeth, Rebecca and the children were able to get transport to the nearest city in the country of Guinea. Now only one border was left to cross, between Guinea and Sierra Leone, but it would be a very long day to get to Waterloo. Not to mention all the time that would be spent at the border crossing as each passenger had their documents checked and verified. Then there would be several immigration checkpoints before and after the border.

By this time Samuella was obviously ill. She was complaining of abdominal pain, she was throwing up, unable to keep even liquids down.

Here at AHS the entire hospital was praying. Our worldwide prayer team was praying. Mr. Samuel Danquah, Elizabeth’s husband and the children’s father, and our Director of Spiritual Ministries, had received a brief message about the fire and that Samuella had been caught in the made scramble to exit the bus. But then for 48 hours, nothing. No word from the family. In this case no news is not good news. No news can mean they were attacked by robbers, maybe they had been kidnapped, maybe Samuella was badly injured. Too many unknowns. But through it all his faith did not waiver, he had left them in God’s care and that was that.

In Guinea, Elizabeth knew they were in trouble. Her husband had sent enough money for the trip, but not for extras, like two nights in the bush, a bus fire and bus breakdown. They were down to about 700,000 leones, ($100). Something was seriously wrong with Samuella, she was getting more lethargic, and listless. Still vomiting, and still complaining that her tummy hurt. Although they were getting closer to home, it was still a long way off, with a lot of delays likely to slow things down, and Samuella needed to be seen at the hospital sooner rather than later.

As the family walked toward the bus station hoping to find an express bus to take them to Waterloo a man in military fatigues approached them. He had noticed that Samuella did not look good and he offered to help. Would they like him to drive them in his vehicle to their destination? They had never seen this man before. And they are two young women with two little children. Not a good combination. He wanted 1,500,000 leones ($200). They only had 700,000. Elizabeth was able to get her husband on the phone and negotiate with this army man down to the 700,000 le.

And so began the final leg of this incredible journey. At the first checkpoint he flipped on his siren and lights and the guards saw the military label on the vehicle and waved them though. At the border between Guinea and Sierra Leone he did the same thing and the guards just waved them through. It was the same at each checkpoint. No stopping, no document checks, no questions. They were able to drive straight through to Waterloo in record time.

Samuella in the hospital, on the road to recovery

When they arrived later that same afternoon, Samuella was nearly unconscious. She was severely dehydrated, suffering from malaria, typhoid and anemia, an often lethal combination. Our nurses are experts at getting IV’s in little dehydrated children, and this was no exception. She was started on IV hydration, Ceftriaxone and Quinine. When I went to see her, she barely acknowledged my presence.

Samuella and Nana are two of the cutest kids you would ever hope to meet. And they faithfully greet Dr. Scott and Mommy Scott in the mornings and afternoons as we walk by their house. It was hard to look at this beautiful little child of God, knowing that the odds were not good. I comforted myself that at least her lungs were still clear.

I went home that night not knowing what would happen, it literally could go either way. I stopped by her room the next morning before worship and was relieved to be greeted by a cry from a cranky little girl. She was better!!! She was going to be alright. That morning in worship there were plenty of praises for God’s grace and healing power.

The military man in fatigues? He took off right after dropping the family off at the hospital. Was he their guardian angel masquerading as a man? Perhaps. Was he just a mere mortal military man with a compassionate heart that was tuned into the Spirit of God? Perhaps. Does it matter? Not really. To us at AHS he will always be our angel in fatigues.

Elizabeth with a now recovered Samuella.

For more frequent, up to the minute short updates please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

A CULTURAL AWAKENING

One day last month I realized I was homesick. Now I have been in West Africa for four years, you would think I would be over homesickness by now. But nonetheless I realized I really missed America. What made it even more bizarre is why. I missed Christmas. I missed the lights, the store displays, the music, the movies, the programs, the concerts and even the parties. This is the original Grinch talking here, just ask Bekki. It bugged her to no end as I would bah-humbug my way through the holidays, until the last week when suddenly I went all in.

Julian putting our up our 32 year old Christmas tree.

But Christmas, even though it is a national holiday, does not exist here, not really. I did see some lights on a partly constructed building coming back from the airport the week before Christmas, but that is it. We have done our best to overcome this deficit, we had the volunteers up and had a Christmas tree decorating party, I have tried to play Christmas music when I could get the electronics to work, we hung the stockings with care, even on the elephant’s trunk. But, alas, it is just not the same when you are all alone in your festive spirit.

Even the Elephant head has it’s own stocking.

The gang at the Christmas Tree Party, Bekki, Ian and Heather, Julian, Eric, JP, and Dr. Donn Gaede.

The Adventists here don’t do Christmas, I was told. The other Christians do, just not the Adventists. The Muslims are obviously not really into it either. But for us Adventists it means no Christmas carols at church, minimal if any decorations, and certainly no mention of it. (On the Sabbath before Christmas I did preach on the Magi, however.) It all added up to a homesick missionary longing for Bing Crosby and Danny Kaye, dreaming of a White Christmas.

Finding myself in a bit of a snit, I decided to find out why Adventists don’t celebrate Christmas. The answer was not what I expected. It is simply that we don’t know that Jesus was born on December 25 so why should we celebrate Christmas? I also heard that Christmas is too materialistic and commercialized as the other reason. But the main one is that Jesus was almost certainly not born on December 25.

As I pondered this I became more and more annoyed. First, I don’t like the logic. I will grant you Jesus was almost certainly not born on December 25, truth is we don’t know when. So, the logic here is, if we don’t know the date, let’s throw the whole thing out and ignore it. My logic says that since we don’t know the date, pick one, and December 25 happens to be very convenient because literally the whole world is celebrating and talking about the birth of our Savior. So what if you don’t like the commercialism, then don’t do the gift exchange thing, but what an evangelism opportunity. Everyone is at least thinking a little about Jesus, between eggnog and wrapping presents, so capitalize on it. Don’t just ignore it. Everyone already thinks we are practically Jews because we go to church on Saturday, this is not helping convince them we are Christians too.

That was my logic and my rather convincing argument, or so I thought. I tried it out on a few of my Sierra Leonean SDA friends. I didn’t get very far. They thought my logic was senseless. I thought their logic was senseless. We are still friends because we could agree to disagree.

To my credit, even though I was annoyed, I dropped it. When in Sierra Leone do as the Sierra Leoneans do, the Adventists at least, that’s my motto.

Two nights ago I was leaving the hospital to head home and a short, well dressed older man stopped me asking for Dr. Koroma. I told him Dr. Koroma was on leave until February, could I help him? We were in the back so he asked about the lab/pharmacy building. I explained what it was and then pointed out the chapel currently under construction, surreptitiously patting myself on the back as I am rather proud of our construction projects.

“The chapel is just for Seventh-day Adventists?” he asked.

“No, it is for all faiths, even Muslims”, was my reply.

He then proceeded to quote scripture to me, “Remember the seventh-day Sabbath of the Lord your God.” I was pretty impressed. This man was obviously well educated, or at least well read. I didn’t recognize him, so I asked if he was Christian. No, he is Muslim he told my quite proudly.

It was at this point that he dropped the bombshell.

“Why do Christians celebrate Christmas when they know that is not Jesus birthday?” he asked. Going on he pointed out that at least Muslims know Mohamed’s birthday.

I was ready, had my argument all primed and loaded.

“Well, since we don’t know the exact day He was born on, what difference does it make then which day we choose to celebrate His birth? The alternative is not celebrating His birth at all?”

Had him. There is just no beating that kind of logic.

Unless you are West African.

“If you don’t know the day, you should not celebrate any day.”

We spent the next five minutes going back and forth, basically repeating our arguments, but getting nowhere. He had me, I had him, but we were playing in two different worlds.

But, I had an ace in the hole, if you don’t mind my mixed metaphors.

“Seventh-day Adventists don’t celebrate Christmas,” I told him triumphantly.

“What? That’s not true.”

I looked over at Pa Cole who was sitting there quietly, probably loving every bit of this interchange.

“Tell him”, I said.

“It’s true, we don’t celebrate Christmas for that very reason.” Pa Cole backed me up.

The man’s entire demeanor changed. These were Christians he could understand, Christians he could relate to. None of this crazy American idea of just pulling any date out of thin air to celebrate the birth of your sect’s prophet.

And the crazy American understood. It’s their culture, it’s their logic, and it gives us one more part of the bridge between Christianity and Islam.

I am still homesick for Christmas, and the first Christmas I am back home I am going to go nuts, we are going to drive around and look at the lights, we are going to watch Christmas movies, go to hear the Messiah, go to school programs, attend every Christmas party we get invited to. I told Bekki I am getting a 25 foot tree.

But now I see that for this culture where the logic is different (not wrong, just different) and there is such a strong Muslim influence, the Adventists here have a valid point.

For more frequent, up to the minute short updates, please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

A RAY OF LIGHT

For four years now I have been living in the stronghold of the devil. For those of you living in Christian countries it is almost impossible to describe. Everything up is down, inside is outside, evil rules. The locals tell us the country is 65% Muslim, 35% Christian. However, when the chips are down and things are not going well, all but the most devoted Christians and Muslims abandon their faith and their God. They return to their native roots, consulting the witch doctors and performing the traditional rituals.

It is election season here in Salone. No less than weekly we are told stories of the horrors that accompany this every 5 year event. The ten year old neighbor of one of our nurses did not come home from school one csday. Three days later his dismembered body appeared on the doorstep of his home. He was almost certainly murdered in a Satanic ritual carried out by a sorcerer at the behest of some politician (or political party). I was told about eight men murdered and cannibalized in another ritual killing, presumably for the same goal, to be elected. No one is safe here, everyone is afraid. Orphanages keep their kids from school because orphans are a prime target. After all who cares about finding out why an orphan went missing.

However, this country is not Godless, people true to Him exist, shining out like that ray of sunshine coming through a break in the clouds on a rainy day, or for the millennials like the bright beam of the LED on their phone lighting their path on a dark night. One such ray of light is Albert Cole Jr., the son of our most faithful security guard.

Albert Jr. is all of 17 or 18 years old. The sweetest young man you will ever meet. Always with a smile on his face, always singing one of the hymns out of the SDA hymnal. In fact we could give him almost any number in the hymnal and he could sing that song without looking it up. I can reliably do that with two hymns, #1 “Praise to the Lord”, and #530 “When Peace Like a River”. Albert could do that with probably 75% of the hymns.

I remember one of our hikes up Mount Erin with the youth of the church, Albert was with us. He was always the odd one, you know the type, sweet, the adults love him, but the other kids, well he never quite fit in. So, on this hike he brought his drum and was beating on it as we hiked up the very steep hill (Tillamook friends, think King Mountain), he was leading us in singing “I’m pressing on the upward way, new heights I’m gaining every day; Still praying as I onward bound, “Lord, plant my feet on higher ground.” It was Albert who suggested we pray together as we stood at the top and looked out over the plain below us.

We first met Albert because of one of his many little side business, quite the little entrepreneur, that young man. He sharpened our knives for us. Then he has become well known to our volunteers, and to us because of his role as a retail seller of African clothes. He has sold me most of my African shirts. Every time we get new volunteers, I set up an appointment with Albert to come to our house in the evening and sells shirts and dresses. Good stuff for a reasonable price, no haggling. But what with living in one of the five poorest countries in the world you would think Albert would save his money for himself, or at least spend it on a new smart phone or fancy shoes. Not Albert. He used his money to buy things for his AHS church. He called Mr. Danquah, our district evangelist last night, all excited. He had made the last payment on some musical instruments for the youth. They are coming tomorrow.

Albert likes to come to the house in the evening to visit, often just to say “hi”, or show us his grades. He will come into the house and Bekki gives him a glass of water and cookies if she has them. It is funny to watch him try American food, it is clear by his facial expression that he is really not sure about it, but he is always gracious. He stays for a bit and then heads on his way, just leaving his ray of light wherever he goes, shining through the darkness that is this world.

That beautiful ray of light given to us by God went out sometime early this morning. His family found him face down. He had a seizure disorder and all we can figure is that he had a major seizure and maybe he choked on his tongue, maybe he vomited and aspirated, maybe he fell and hit his head. We will never know. All we know is he was here, and now he is not, and his bright beam will be sorely missed.

The question always comes up, “Why, God, why?” Why young, dear, sweet Albert whose true religion puts the rest of us to shame, who never hurt anyone or anything, why has God let his light go out and the evil or sorcery continues. Everyone around the world wrestles with that question, everyone reading this blog has wrestled with that question. Its just that during my time in West Africa I have had to face that question on a far more regular basis than I ever did before. The only answer I can come up with is, there is no answer. Sometimes it is clear why, but most of the time it is not evident why this happened. And as unsatisfying as that is, it is reality. God never promised us answers on this earth, He only promised to be there with us through the valleys and on the mountains, and that someday all would be made plain, but until then He just asks us to trust Him.

Albert Cole, Jr. on one of our hikes up Mount Erin, this time without his drum. Unfortunately, the drive with my other pictures of Albert on it was stolen from our house last month.

They say a butterfly flapping its wings in the Amazon basin can cause a hurricane in the Atlantic. If that is true then the brightness of Albert’s ray of light should have equally far reaching consequences. Albert’s light is out, his seat on the aisle right front row will be empty, the world will be a noticeably darker place. But that just means the rest of us need to let the light of Jesus shine through us, wherever we are, to make up for it.
When Albert wakes up from his post-ictal sleep, he will have no more seizures, he will have a collection of musical instruments waiting for him that will exceed his wildest imaginations, and he will sing with the angels, and we will join him- “when we all get to heaven, what a day of rejoicing that will be. When we all see Jesus, we’ll sing and shout the victory.” Amen.

For more frequent, up to the minute short updates please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

Stress in Sierra Leone

“Hmm, I wonder why Bekki took the screen off the window”, I mused to myself.

It was Monday afternoon and I had come home a bit early. I was in our bedroom putting my clothes away in the closet when I noticed the mosquito screen on our window propped up in the corner. I thought it was strange but figured Bekki had come up to the house earlier and was doing some sort of project. Nothing else seemed amiss.
However, a quick look around and I realized a laptop was missing, then I noticed the hard drive was missing. My nightstand drawers were open, my money belt was on the bed, open, with my passport and credit cards strewn across the bed, and all the money gone. Finally, after nearly 4 years in Africa, we had been robbed. I guess that makes us official now. It took me a while to figure out how they got in as nothing was open. They had pulled out an iron bar in the window and squeezed through an incredibly small space.

They got maybe $150 and the lap top I was going to donate to the hospital anyway and the hard drive with our entertainment on it, but not much else. Nothing we can’t live without anyway. So we count that as a victory. Oh yeah, that morning I had left $540 of donor money on the bed, but came home at noon to put it away, so they didn’t get that money. They came over the back wall sometime in the afternoon. Quick in and out job.

But it still was unnerving. That night we slept (and still do) with a baseball bat at the edge of the bed. I figure I will whack them while they try to wriggle through the tiny gap in the iron bars. We hired a day guard, so the house is never left alone, and now we lock all the door in the house. So, if they break into one room they are going to have a heck of a time getting anywhere else. Even the bathrooms are locked. We kind of hope they break through a bathroom window, only to find themselves locked in a tiny room with just soap to steal.

That started a week that was supposed to be better than the week before which had been majorly eventful and stressful.

The capstone days were Thursday and Friday. As you know we (AHS) have the biggest, baddest autoclave in all of Sierra Leone. But it was not hooked up and there was no way I was going to tackle that job. So with the help of AHI and our grant from Winifred Stevens Foundation (WSF), we brought Rick King out here to hook up the beast and teach us how to use it. He had Wednesday, Thursday, and half of Friday to accomplish these tasks. My African colleagues are often quick to tell me, in an effort to calm me down, “Dr. Scott, this is Africa, relax, it will be OK.” That is all fine and good when there is no deadline, or plane to catch.

At the same time we had an anesthesia team from Western Carolina University, which was a huge blessing because on Tuesday I had to fire our anesthetist, and so had no other anesthesia but Professor Shawn Collins and student Joe Popa.

Back to the autoclave and Rick. We really tried to have everything ready, but literally spent 2 1/4 days of the 2 ½ allotted days waiting for our maintenance guys to get all the piping we needed and fix the mistakes they made on the electrical. Even then it was jerry rigged, or is it jury rigged, I don’t know, and fuses were constantly blowing. Even the autoclave itself was spewing steam from places Rick had never seen, and the fuse in the boiler was bad.

Then too, the hospital had not had water for 2 weeks because the main water line was broken again. Seems that plastic water lines that are buried less than an inch under a dirt road don’t stand up well to cars and three ton trucks driving over them. Even though the break is not on our property, the local government types said we had to pay to fix it if we wanted water, which would also then give them water, but they did not have the money, but we are rich, so AHS can fix it, for the third time this year.

Steam autoclaves need water, and need a consistent source, so we rigged up a 55 gallon barrel in the sterilizer room and hooked that up, and fixed the water line, this time with metal fittings and concrete over it. But the main pipe is still plastic and is still under less than an inch of dirt and still being driven over. Wonder how long that will last?

However, by the end of the day on Thursday the autoclave was hooked up and ready to go. Friday we would run it through a cycle and teach the staff. But Friday was also the anesthesia team’s last day and a lady came in with a nasty breast cancer, but still operable. I really wanted to do the surgery with good anesthesia, oh how I wanted to do it without having to fight off the patient during the case, or telling the anesthetist every move to make. So, I scheduled it for Friday morning.

Friday dawns bright and clear with the promise of a great day. We went in early to get the boiler on the autoclave started. Lights came on and we anxiously watched the temperature and pressure gauges, not move. Finally, a blown fuse (Rick had never seen this before) on the boiler unit was found. We actually had something to replace it with, Praise God. Now the temperature started to rise, the pressure went up. I was in my office and wandered back to see how it was going. I can assure you it is a steam autoclave, our sterilizer room was now a sauna, the glass water level tube was cracked and steam was coming out like a nineteenth century locomotive. (We now refer to it as “Puff the Magic Dragon”.) Rick had never seen that happen either (in 17 years of doing this). He bypassed that so the steam would go to it’s intended destination, and we were in business. Then it stopped, ”Oh, you wanted a 60 amp switch for the autoclave, I got a 20 amp switch.” Yea that is what I wrote down when I told the maintenance crew what to get, 60 amp 380 V 3 phase. 20 amps just doesn’t do it.

Rick has the patience of a saint. I, on the other hand, was assiduously avoiding the area because I had by this time flipped most of my internal breakers.

All the troubles were solved, they bypassed the fuses on the switch (really safe) and we were off and autoclaving. About this time, I was called into the OR to start the mastectomy.

I was happily prepping the patient when the power went off. Word quickly came to us that the generator was on fire. This was worthy of investigation. So, I scrubbed out and dashed up to the generator room. No flames, because JP knew how to use a fire extinguisher. Turns out that the radiator got blocked and so the engine overheated and caught the roof of the generator shed on fire. This is a Perkins (top British brand) 125 KW diesel generator, it is supposed to have safety shut offs for overheating, low oil etc. That is when I was shown the wire bypass someone had done to bypass those safety mechanisms. Wonder who thought that was a good idea?.

Fortunately, about that time state power came on, so back to the OR, and back to restarting the autoclave. Sadly, state power is weak, so the air conditioning did not work and it was like operating at Bere Hospital. (Those guys are really tough.) During the most critical part of the operation the power went off again and I was so grateful to have my surgical headlight, axillary dissections are really difficult to do by braille.

I think maybe that is why on Monday I really wasn’t that upset about the break in. Just didn’t seem that bad. It is all relative.

Good news is the lady with the mastectomy is doing great, the autoclave now has 60 amp switches, and works, we actually sterilized some packs, we have had water all week, and the generator is back in service. God is good.

For more frequent, up to the minute, short updates, please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

INTRODUCING JONATHAN PORTNEY

Dear Readers, I am sharing a blog post written by our newest long term volunteer, Jonathan Portney. “JP” comes to us from Loma Linda University, having just graduated with his Public Health degree, with an emphasis in international public health. He, like all our long term volunteers, has taken on his responsibilities with gusto and enthusiasm, or as they would say here, lustfully. I appreciate his post as it shares his thoughts, feelings and reactions to life here in a poor hospital in Sierra Leone. If you want to see his other posts, check out jpinternationaltraveler.wordpress.com. Or you can see his posts on our Waterloo Adventist Hospital facebook page.

JP leading out in stretches at morning worship

It’s 8:00 AM on a Monday morning. Sounds of praise radiate from the chapel located near the front of the hospital where the staff of the Waterloo Hospital gathers every morning to partake in worship. Inside this common area is a nursing station and at any given time a patient can be ushered through the staff worship to the nursing station to receive patient care. This particular morning was emotional for me because a few nights before a child aged 2 years came into the hospital with what was perceived as an untreated case of Malaria. The child was gasping for air, you could hear the fluid gurgling in his lungs. Beneath him, on the bed, there was a pool of blood that he had peed — the child was unconscious. As orders are being shouted by the nurses around me, I do what I can to help “Give me the oxygen mask” one nurse shouts looking at me. I held my headlamp over the child so the nurses could see what they were doing, I had to do this because there was no electricity, this is a common problem at our hospital because the electrical power is hit or miss and we can only run our generators at certain times due to hospital finances. The light I had focused on the patient was shaking, and I began to feel nauseous, I could feel myself becoming very hot, and had to continuously tell myself to breathe so that I would not pass out. For some, experiencing death is a common occurrence. For me, this was my first time seeing anyone on the brink of death, laying right in front of me, and I wish I could say it would be the last. The nurses did everything they could, but it was to no avail, the child aged 2 years died. It was quiet in the room once the child was pronounced dead, some staff cried, and other staff members walked away to be alone because I’m sure we all felt that this should not happen to a child this young. However, here at Waterloo Hospital this is a reality and does happen on a regular basis. We are here trying to do everything we can with the limited education and supplies that we have. Could WE do more? Yes, should WE do more? Absolutely. Unfortunately, we have limited equipment and funds to reach this goal, and this is just a reality.

On Monday morning I decided to take a shortcut to the chapel room which passes by the connecting nursing station. Songs of praise are heard radiating from the building. I peer in the nursing station window and see a child around the same age, if not younger, peering out the window with Dr. Scott, our physician, leaning over the child checking her pulse. The child had a little pink beanie on its head with matching footies and blanket. The child was so young that it still had that baby smell which we all love. The child had her eyes open wide, and her mouth opened as if she were yawning. For a brief second, I smiled because the child almost looked scared, often children this age are afraid of Opotu people “white people” because the encounter is probably their first introduction to someone with white skin. As I entered the chapel, I decide to see the baby because it was so cute. I walk in the nursing station, the child has the same facial expression that I noticed before with eyes big and mouth open. The mother is standing at the door of the nursing station holding back tears, saying a soft prayer, the dad is standing at the nursing station bed next to Dr. Scott with a hopeless almost blank stare expressed across his face. I look at the child and notice she is not blinking. I think to myself, this surely isn’t going to be a repeat of the night before. After this thought passed, Dr. Scott pulls his stethoscope away from the child and looks at the father and says gently “I’m sorry, she is gone.” I crumbled emotionally along with the parents as they wrapped the baby in the blanket and carried her off.

Us missionaries often sit around the dinner table on Sabbath evenings envisioning what it would be like if we had more funding and resources. In Gods power, we hope they will come eventually, and we have faith that He is molding the hospital just as He sees fit. We have fully come to accept that we are powerless over our current situation. Every morning without fail we wake up with a smile on our face to greet the day, staff, and patients. If we come off as defeated, then the whole morale of the hospital would change. While I have a smile on my face, inside, I am pained. While praying, I question if it would be foolish of me to ask God for just one week where a patient doesn’t die from preventable causes. I continue to pray for this, but my prayers are a little different now. I’m asking for strength, not only for myself, but for the other missionaries, the patients who have lost loved ones, and of course my family. I feel like if I pray for no one to die, I’m trying to play God and I know that is not my role. My role is to let God use my hands, body, and mind, stay out of His way and put a smile on my face to make the lives of those around me better. For me, this prayer is manageable and keeps me waking up to greet the day with a positive attitude despite waking up almost every morning to screams from the courtyard from family members who have lost yet another loved one.

Jonathan C. Portney, MPH — Mobile Clinic Director

Autoclave

Life lesson 452: When one is in Pittsburgh, PA, make the two hour drive to Erie, PA to actually look at the autoclave before you buy it.

I had no idea the autoclave, was soooo big. It did not look that big in the picture. It is so big we can just autoclave the patient and the instruments together, eliminating the need for prepping. We are pretty sure we now have the biggest, baddest autoclave in all of Sierra Leone, and probably in West Africa. My staff is thrilled, I am, well, frankly embarrassed.

Bekki showing just how big this sucker is.

OK, to back up a bit. Part of the grant from the Winifred Stevens Foundation for the OR upgrade was to be used to purchase a new autoclave. When I came they were trying to sterilize the instrument packs in an ancient dental desktop autoclave that barely worked. As in you have to manually turn it on and off to keep the temperature in the right range. Remy Hirschy got one of our other non-functioning autoclaves to work, but it drips hot water all over the floor when we use it, and it too is a desktop model, so it is fine for a small clinic, but not a real OR, like ours!

Luke Hingson at Brothers Brother in Pittsburgh, PA got us in touch with Rick King who runs Chosen International, a company that refurbishes autoclaves, puts on a new boiler and then renders them “West Africa proof”, with the proper current and plugs etc. They come in several sizes, but the two full size ones were the same price, so go for the big one, right?

Healey Foundation, a Catholic NGO out of New Jersey, who has helped us ship things over here agreed to give us some space on their next container, so it made the move from Pennsylvania to New Jersey, then on the boat to Sierra Leone. We got the call Wednesday morning that they were offloading the container and wanted to know what we wanted done with our crates. Fobbie went to the wharf to check it out.

He called me, “Dr. Scott, the crates are big, we need a crane to unload them.”

I was pretty cool with that, I had been warned the crate was large. Notice I said crate. I was a bit surprised Fobbie said crates, but I just figured it was the oxygen concentrators Loma Linda had sent, and only one crate needed a crane.

Fobbie arranged for a truck with a crane to transport the crates to the hospital. They arrived just as we were starting prayer meeting at 4:30 pm. Two HUGE crates sat on the back of the flat bed truck. Not large, massive. 4000 pounds between them. The oxygen concentrators were with Fobbie in the back of the Xterra. We had no idea what was in the second crate. Turns out the police wanted to know as well.

The truck with the MASSIVE crates on the back. The chairs unfortunately were not for us.

In the the next 24 hours we experienced an absolutely awesome, incredible set of miracles.

Miracle 1: They got both containers off the truck and on the ground without dumping them. They had only one strap around the containers, which was fine for one direction, but containers are 3 dimensional objects hovering in space, even if you have side-to-side covered, they can still fall end-to-end, or vice-versa. And when they tried to lift the big one, the wood bottom of the crate started breaking up. It was clear these guys were pros, but also clear that they were making this up as they went. Bekki and I? Silently praying. We have seen too many unloading disasters in West Africa to not be aware of the risks.

Unloading the big crate, notice the bottom starting to separate.

Unloading the small crate, yea, one direction is supported, but it can still fall to the side.

Miracle 2: Getting them unpacked and moved into the hospital, without damage. I wish you could see the video. I will put it on the blog site next time we are in the US. It was the ultimate tug of war as about 15 guys fought against 2500 pounds of autoclave and gravity as they pushed and pulled this thing up our amusement park ride steep ramp into the hospital. It cleared the first two doors with an inch or two to spare. We only had to take out one door and wall to get it into it’s new home.

Ultimate tug-of-war with Joseph as the anchor.

We had our usual prayer of dedication and blessing Thursday morning before we unpacked the crates and moved them inside. Part of that prayer was that God would send His angels to protect the contents from harm as we moved them inside. God answered that prayer. There is no doubt in my mind that angels excelling in strength surrounded our autoclave as it was heave-hoed up the ramp.

Miracle 3: No rain. We are in the teeth of rainy season, it is raining more often than not, especially at night. And this is not a little sprinkle, man, it pours, it gusts, it storms. Tuesday night, Wednesday morning and early afternoon it rained, beaucoup. Mid afternoon, the clouds parted and the sun came out. As they unloaded the truck it was clear, but it was too late in the day to do anything more. So we put tarps over the wooden crates and prayed.

All night I listened for the rain, it is easy to hear it on the tin roof. No rain. The morning dawned bright and clear. After worship, we gathered outside for the blessing and pictures. No rain. For 2 hours every able bodied man pried apart plywood and 2X4s under blue skies. No rain. The ramp was dry as they heaved it up into the hospital.

Not 5 minutes after getting the last of the autoclave pieces under cover it began to rain. Two hours later we had as big a storm as we have had this year. The water was overflowing the drainage ditches. The autoclave? Warm and dry. The ramp? Now a slip and slide.

Jesus calmed the storm on Lake Galilee. He held off the storm over Waterloo Hospital just as long as we needed.

The second crate? We were happy to be able to tell the police it was just more parts of the autoclave, the boiler and a rack to put the instrument packs on.

Next time, I will take the time and go look at the merchandise, but thank God that He doesn’t hold our stupid human mistakes against us.

For more frequent, up to the minute short updates please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner