Lessons from Tchad

The following is a transcript of the sermon I gave in Clarkston, Washington on Sabbath morning, September 13.

It was just two years ago that Bekki and I received our official call from the General Conference to serve as medical missionaries to Koza, Cameroon in West Africa. Much has happened in the last two years, in fact I would venture to say the last two years have been the most eventful, the most challenging, the most difficult and the most rewarding of my life, of our lives.

This morning I would like to share with you some of the lessons I have either learned or relearned in these last two years.

God does not need the able, He needs the willing.

You are looking at a miracle, go ahead, stare look me over. I am standing before you as a miracle as surely as blind Bartemaus, or Lazarus, or any other miracle you know about. Let me explain.

For a year and a half Bekki and I worked toward, planned toward and focused on moving to Koza. We even named our blog gardners2koza. Just a word of advice don’t put a place name in your blog address, it is a sure guarantee that things are going to change. We visited Koza, we got to know the people there, we fell in love with it.

Our world was turned upside down on November 21, 2013 when we were called into the Principals office at language school in Collonges, France. He was the one to inform us that the terrorist group Boko Harem had just kidnapped a Catholic priest just 5 miles from our hospital in Koza. Within 10 days our assignment had been changed to Moundou in Tchad. We were moving to a city, to a small surgical center, to work with people we didn’t know, and had never met.

The only bright side to the change was that due to visa issues we had to come back to the US for Christmas break. So we had two more weeks to spend with Jon and Lindsay before heading East, way East.

I will never forget the flight into N’djamena. It was the fourth time we had flown into that airport on the same Air France flight from Paris, but this time it was oh so different. Do you remember the old Flintstones cartoon? Fred and Barney would be in Fred’s car, and to make it go they would run their feet on the ground in a forward motion. And to slow down or stop they would run their feet backwards. Well that is how I felt that night, in my imagination I was pedaling backwards as hard as I could. I was not ready for this, I was scared spitless. At the same time there was the feeling of a condemned man on his way to his execution with a sense of resignation, nothing can stop it now, this is it.

We arrived in Tchad New Years Eve, and made our way to Bere the next day. We spent the next few days getting reoriented, recovering from jet lag, and finally early Sunday morning we headed down to Moundou. The feeling of resignation and wishing I was in Fred Flintstones car never left.

The next 7 weeks were ones I never want to live through again, but they were also probably the most important seven weeks of my life, and certainly the most intensive 7 weeks of education I have ever experienced, far more than anything I ever experienced in Medical School or residency.

Everyone was so excited to have this surgeon with 23 years of experience going to the mission field. And I had been telling anyone who would listen, which was about no one, what that really meant. It really meant that I had spent the last 23 years preparing to NOT BE a missionary. And now it hit me smack in the face that I had been right all along. Nothing I had done, well OK almost nothing I had done for the last 23 years was applicable here. Not even the way I repaired hernias. I hadn’t done hernia surgery this way for 20 years. I certainly had not done orthopedics, urology, gynecology, Head and neck surgery. I also was not a tropical disease specialist. If I had no hands I could count on my fingers the number of malaria and typhoid cases I had treated in my life.

During our time in France I worked really hard to learn all the French I could, and I kept fussing that three months was not enough, I was not ready. Again, I was right, they talked so fast. They used such big words. My administrator had a lisp, my head nurse is deaf and so speaks really weird. And Olen (my nephew in Bere) was wrong, they did use the subjunctive, all the time. I learned to smile and nod and act like I understood and walk away without a clue, hoping it wasn’t anything too important.

One day one of the nurses complimented me on an Arab outfit I had worn, she then went on and talked a blue streak about something. I had not a clue, but I nodded my head and smiled like a good missionary. A week later she showed up at my door with an ugly scratchy hot long sleeve shirt that I had apparently bought from her for $32. I learned my lesson about agreeing to anything, especially with Larpeur.
I arrived at the peak of busy season. We worked constantly, and I saw no relief. I knew there were administrative issues that would need to be addressed, but I had no idea how or when I was going to address them.

One night I turned to Bekki and said, “If me and the hospital are still here in six months it will be a miracle. I can’t do this, there is no way, this is so far over my head I can’t even see the surface.”

I have been at Moundou now for 8 months, the hospital is still there, I have a ticket to return. I left not because I was fired or quit, but because it was time for vacation.

I do surgeries I never thought I would be able to do, I don’t quake in my sandals anymore when I see people coming in with bones sticking out, or with limbs bending in ways that they shouldn’t. I still don’t like gynecology, but I can do it without panicking. I treat malaria and typhoid and other tropical diseases. I have dealt with administrative problems out the wazoo. I preside over our hospital administrative committee in French. I practice medicine in French. I have been asked to be an elder in the local church, I am able to participate in the Sabbath School discussion in French. The Sabbath before we left I was asked to be on the platform in church, and read the Bible verse and gave the Pastoral Prayer in French, with no preparation. We have a lot of plans for making the hospital better, our work there is just beginning. We have successfully recruited our own crop of volunteers.

I don’t tell you this to say look at me at what I have done. I tell you this to say look at what God has done. God has taken an older, balding, average at best surgeon, with no language skills, the least qualified person for the job, and He has worked a miracle. God does not need the able, He needs the willing.

My daily need of utter dependence on God

My nephew, Olen Netteburg, who is the medical director at our sister Hospital in Bere described a typical day like this: 7 am to 7:30 – Morning Worship; 7:30 – 8 organize the day and schedule with the the physicians and hospital leadership; 8:00 Rollin begins operating, Danae begins rounds on OB, Olen begins rounds on Pediatrics; 8:01 the day unravels and all your plans are gone. Truly each day is like that proverbial box of chocolates—you never know what you will get. You never know what will walk, crawl or be carried into the hospital. All you know is that it will be challenging, difficult, and confusing. Pray without ceasing has taken on a whole new meaning. You cannot get through a day without God.

Worship is primarily culturally driven

This is a tough one and may get me into trouble, but I have come to believe this very deeply. And this is not to say that there are not Biblical principals with respect to worship. There are and they are to be followed wherever in the world you are worshipping our Creator and our God. But how those principals are applied is very very cultural.

I attend a relatively large city church for Tchad in it’s second largest city. It is very well organized, in fact much like churches were organized here with committees, a church board, officers etc.

We study the same Sabbath School lesson, and have very similar discussions. During the church service the elders come in as we sing a reverent song, Silence, and they kneel as the service begins, we have special music, the offering call, the Pastor preaches a sermon, we have communion and after church a potluck. Pretty much like home. The catch is always the music.

Music is a huge part of African worship, just like here, but there is a big difference. They dance. Worship would not be worship in their minds if they didn’t dance while they sing. Mostly it is just moving their feet in rhythm, sometimes with hand motions as well. And it is accompanied by drums, always. Now they have a homemade drum set, complete with drum sticks, I really mean drum sticks, as in sticks that are used to beat the drum. And the drum covering is stretched plastic shopping bags. But it works.

I consider myself fairly culturally sensitive, I don’t let someone else’s culture bother me, and I try not sit in judgment. People usually have a fairly good reason for cultural tendencies if you are willing to look for it. However, there was one time where even my cultural sensitivities were stretched.

I was at campmeeting in Doba. The four churches in the district get together one long weekend a year, from Thursday evening to Sunday. It is a lot like campmeeting here, they have it in the hottest month of the year. Sabbath is of course a high day. There is the childrens Sabbath school, the adults study the lesson outside under a mango tree, the pathfinders there guarding the door. The church is packed with the overflow crowd just outside looking in. After a rousing sermon from the pastor there is a baptism at the river. After a nourishing meal of Boule and goat sauce everyone rests and visits during the afternoon. Just like in the US.

As expected music is a huge part of the Sabbath Service, with a number of special musics. During church I somehow ended up on the very front, and the combined four choirs was really going at singing at full volume, feet and arms moving in rhythm, when suddenly one girl came out of the choir with her chest out front and backside sticking out the other way, as she danced her way to the front. I kept expecting a deacon to escort her out, but no one did, then another girl starting doing it, and a grandmother from the congregation came up front dancing the same way. Next thing I knew one of the young men was dancing chest to chest with one of the girls. I quickly tried to get my eyes back into my head before anyone noticed as I realized that not only was no one going to stop this, this was normal, this was expected, this was OK.

On the way home that night I asked one of my Tchadian nurses if this was a traditional dance or a traditional Christian dance. He laughed and told me that it was a traditional Christian dance. As I reflected on it I realized that in Africa, breasts are utilitarian organs and totally asexual. As evidenced by the fact that women breast feed in church with no attempt to cover up or hide anything. Showing your knees, or having your head uncovered, now that is something else.

But the point is that what is surprising and maybe even a bit offensive to me, is normal life in Africa. And what may be hard for this white American boy to understand and appreciate, is how my African brothers and sisters express their joy in being children of God.

How we worship God is very culturally driven.

People are the same wherever you go in this world

Shortly after I got to Moundou and started seeing patients in consultation, I realized I had seen most of these people before. The names were different, the skin color and hair was different, but the personalities were the same. They came with much of the same baggage and problems that many of my patients here had. Some were very demanding, never happy, no matter what. Some wanted fixes for things that had no fixes, many were grateful for what I could do.

My nurses and the church members are the same way. All the characters and personalities of any hospital I have worked in or church I have attended are there. Culture and language may make how things are expressed a bit different, but underneath we are the same.

The majority of people just want to live their lives in peace and harmony with the rest of the world. They have the same emotions we do, the same thoughts, the same desires. We are truly a human family.

Which leads me into the next lesson…

I am fortunate to have been born in the US.

When I look at my African friends and co-workers, and the patients we serve, I realize that it was just luck of the draw that I was born when and into the family I was given. I did nothing to deserve it. But with this tremendous blessing I was given a tremendous responsibility. That is to share what God has graciously given me with my fellow human beings in any way that I possibly can.

It is a great privilege for Bekki and I to work in Africa. It is a great privilege for all of us to give to others what God has given to us.

Friends and family are indispensible for survival

During those dark days of January and February, many of you sent words of encouragement to us via our blog. I have always been one who doesn’t accept help willingly, I don’t need it or want it. Well, I certainly have learned what it is like to need, to crave the love and support of friends and family. You have no idea of how those words of encouragement carried us through. Sitting on our bed, under the mosquito net in the little 10X10 room, we would read your messages with tears in eyes as we realized how much we were loved and cared for.

I am still not very good at accepting help, but I am getting better. And I certainly am now very aware of the importance and necessity of love from friends and family.

The evil of death and suffering

As a physician I have seen my share of death and suffering through the years. Bekki and I went through the three months of hell that characterized the last three months of Midge’s life. I pronounced the death of all four of our parents. But I have never come face to face with death and suffering like I have in the last 8 months.

At least twice a week we have a baby or young child come in, gasping for breath, limp, dehydrated, with a hemoglobin of 3. We start IV’s, oxygen, and quinine and antibiotics. They all die. Some in a few hours, some in a day or two, but they all die. We have children and adults come in that look like the pictures the Allies took of the Jews at Aushwitz, they all die. We have people, children and adults come in with bones sticking out of their leg. They have been like that for weeks.

We do major orthopedic operations with incisions covering most of the thigh, screws, rods and plates in the bone, and they get to have Tylenol and motrin for the pain.

I didn’t think I would see much cancer, I figured they would die before they got old enough to get cancer. Wrong again. They just get these horrible cancers at a much younger age. And they don’t know how or where to get help, so it just grows until there is nothing that can be done. It is too big to remove surgically and we have no chemotherapy or radiation.

I can’t count the number of times I have had to say, “Je suis desolé, mais il n’y a rien ce que je puex faire.” “I am sorry, but there is nothing I can do.”

I have been with our college age volunteers as they saw, for the first time in their lives, someone die. As they watched a child takes it’s last breath. Death and suffering are constant. You can’t dwell on it a lot or else you will go crazy, you just have to move on. But there are times where it more personal than others.

The nurse came to my door about midnight. Once I go to bed, I don’t like having to get up, not really a good characteristic for a doctor, but I obviously didn’t think this through years ago. Anyway, she told me they had a little baby that was really sick and they couldn’t get an IV in her. Would I come put in a central line?

The request didn’t help my mood any, putting a line in a dehydrated infant is miserable and very difficult, and the kits we have for it stink. But off I went. I found her in the minor surgery room, a perfect beautiful baby girl, 3 months old. She was surrounded by nurses and nursing students with signs of IV attempts all over her. She was on oxygen, I looked at the oxygen saturation monitor, 90%, 85%, 80%, dropping before my eyes. My nurses were desperate to get an IV in this baby to get her on treatment. It was obvious she had only a short time to live. I was torn between helping my nurses and letting this little one spend her last few minutes in peace. In the end I made a few vain futile attempts to put in a central line, but I finally could not take it any longer and told the nurses to “Hallas”, “Stop”. I told the grandmother she was going to die soon and tried to get her to hold the baby. She was too upset. When I left the room the baby was alone. I got halfway home and thought, “I am not going to let this baby die alone.’’ So I went back and found the staff and the grandmother around the baby. We put our hands on her, and stroked her skin as her breathing slowed and finally stopped.

She was just another of a countless number of endless African babies who have died, who won’t grow up, but who won’t be hungry all the time either, and she won’t suffer like so many people suffer where I now live. I don’t know for sure what eternal plans God has for these little babies that die, but I hope I will be able to watch her grow up in heaven.

This afternoon, I am going to read what Lindsay wrote for the Sabbath School presentation she did last week in Tennessee. But in it she describes Tchad as the closest thing to hell she has ever experienced. She could not have stated it better. I thought in all my little mission trips to Africa and India and South America that I had seen and understood suffering. But no, I didn’t really get it.

What I learned is this, I will never get it. I will never understand the suffering that happens, not just in Tchad, but everywhere. It is evil, cruel, random, cold and heartless, there is no sense to it, it is the work of not just a devil, but the devil. The only remotely good thing about it is that it makes me grateful for and long for…

“For the trumpet will sound, the dead will be raised imperishable, and we will be changed.

…”Death has been swallowed up in victory.”

“Where, O death, is your victory?”

“Where, O death, is your sting?”

Therefore, my dear brothers and sisters, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you know that your labor in the Lord is not in vain.”

-I Corinthians 15:52, 54, 55, 58

For those of you 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. 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. You will also find links to other missionary blogs such as Olen and Danae Netteburg, Jaime and Tammy Parker and others. 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. For our Francophone friends there is a French translation of our blog that you can find at http://gardnersenafrique.wordpress.com.

We welcome volunteers.

-Scott Gardner