Doing something worthwhile
It is estimated that the total population of the world today exceeds 7.71 billion people, and this number is continuing to grow each day. An article by the Lancet, a leading UK medical journal, stated that around five billion people in our world do not have access to safe surgery and anaesthesia. This is not the type of inequality that features much in our daily news but it is a terrible reality that huge numbers of people are dying unnecessarily each day because of inequalities and inadequacies in medical care. Mission Hospitals throughout the world are attempting to meet some of these needs and Chitokoloki is one such relatively small hospital in the rural north west province of Zambia.
It is difficult to express on paper the excitement and joy of working in a mission hospital in rural Africa. We have had this privilege for around twenty-eight years now and each day brings new excitement and new challenges. We seldom, if ever, have a boring day and it is very infrequent that one goes to bed at night without feeling that you have done several things worthwhile during the day! I would like to share with you some stories of just a few of the hundreds of patients encountered here in the past few weeks.
Giving hope
There is a wonderful informality to work here. On my short walk to the hospital recently I was met by three young men with major psychotic illnesses. Each greeted me warmly with a handshake and we discussed their problems and whether or not they were coming for their monthly medication. A short but valuable point of contact helping reassure them that we care for them.
When I commenced the ward-round of around one hundred patients; one of the first patients I saw that morning was Sombo. She came to us, after a neck injury three months ago, completely paralysed in arms and legs. There seemed little hope. We knew that she needed skull traction but we did not think we had the necessary equipment. However, Sister Julie-Rachel searched through some boxes and amazingly came up with exactly what we needed. The small procedure was done and wonderfully over the next few days she gradually recovered movement of her limbs. She was flat in bed for over three months and this photo shows her first steps with her husband some days ago. Please continue to pray for her as she may yet have many problems. I have just heard that she has trusted the Lord after being witnessed to by one of our sisters. Despite being so incapacitated she bravely continued to breast feed her baby and his size bears testimony to the effectiveness of her efforts!
Visiting specialists
Early in September we had a visit from the plastic surgeon who flew up from Lusaka. He comes two or three times a year. Typically, he would arrive on a Thursday and see a number of patients. He operates all day Friday until about 10-00pm and then all day Saturday until a similar time, before flying out on a Sunday morning. Plastic operations are often massive procedures. Some patients have burns to around fifty percent or more of their bodies and these areas have to be skin-grafted. The surgeon can spend two or three hours releasing the contractures of a child’s hand allowing the fingers badly damaged by burns to move again. Babies with cleft lips are made beautiful again to the delight of their mothers and between us we also repaired a cleft palate on the visit, as well as many other procedures.
Orthopaedic help
Later in September the orthopaedic doctor was flown in by Flying Mission, a Christian Flight Service. Patients come from long distances from the surrounding area by cars, landcruiser ambulances and usually one or two lorries! The doctor saw 105 patients, finishing his last one at 11-30pm. It was around midnight when my wife Lorraine got back after scheduling the cases for surgery the next day. Next day the operations started at 7-30am and continued until about 11-00pm. Around twenty operations were carried out during this period and helping with the anaesthetic for almost all of them was a visiting MMN trustee Dr Ray Allen. The process was highly efficient and it is difficult to envisage a unit at home getting through so many cases in that time frame! In the middle of it all at 8.00pm we had an emergency from a nearby hospital; a young man was seriously ill with a strangulated hernia for several hours. I was able to operate on it in our second theatre without interrupting the orthopaedic cases much. Lorraine did scrub nurse for the procedure before going home to arrange the evening meal which was eaten at around midnight!
The orthopaedic doctors come six times a year. These operations are hugely life-changing for those operated on. Crooked feet and legs in children made straight, diseased bones of osteomyelitis that have been discharging pus for years cured (one little boy operated on this time was sent over by our missionary colleagues from Angola), replacement of broken hips with a prosthesis, plating of broken arm bones and so on. The picture shows Muzala the Angolan boy with Phil Kennedy the Brass Tack worker who is here working on our new conference centre. Phil had met Muzala several months ago while working in Angola.
Day to day work
These visits are specific events (usually bimonthly) but the main work of the hospital goes on twenty-four hours a day every day. During a national holiday we saw around 100 patients on the ward rounds, diagnosed one little child with a kidney tumour and carried out a gastroscopy on a young woman who could not swallow as well as carrying out an ultrasound scan on a lady in labour. I also had opportunity to share the gospel in Lunda over the hospital intercom system. There is immense variety in the work.
Recently a baby of one year old arrived by ambulance from a hospital over 100 km away. This baby had severe tummy pain and a temperature of forty. She had been sick for several days. The hospital had phoned us at midday the previous day asking us to operate. We went on standby awaiting arrival. That night Sister Julie-Rachel and were up at 3.00am dealing with a woman who had bled massively after child birth and Julie-Rachel suddenly remembers that the surgical case has not arrived so she sends a text message. There was no reply and so we think that perhaps the child has died. At lunch time the ambulance arrived. The reason for the twenty-four hour delay was that there was no fuel for the ambulance! When we operated the baby was seriously ill with abdominal infection and gangrenous perforated bowel. Interestingly, the baby was the first case with our new Glostavent anaesthetic machine which had just arrived from MMN a few days earlier and again Dr Allen helped with the anaesthetic!
It just happened also when Dr Allen was here that we received a big medical order from MMN. The picture shows him with one of the big MMN medicine boxes. We submit three orders to MMN each year and these medicines are absolutely invaluable to us and life saving for our patients. Over our twenty-eight years in Africa the supply of medicines from MMN has been the mainstay of our work and they have saved thousands of lives. It is impossible to do major surgery without adequate medicines such as high-quality antibiotics being available and thanks to MMN these are almost always available.
As I write in late October we are now past 1,400 surgical procedures for the year. In September we undetrook 143 surgical cases and it is surgery that consumes the bulk of our time with many major cases lasting three to four hours and sometimes most of the day.
Giving sight
Recently we operated on five patients with cataracts in one day while doing a number of other procedures in between. We are delighted to have our youngest son Jonathan with us for a year. He can start the case or finish it and I can scrub in between the cataracts to do the main part or give advice. One lady, while having her second eye operated on, was very thankful and Sister Julie Rachel took the opportunity to tell her that while we can help her physical sight only God can heal the blindness of heart that is caused by sin. The picture shows her now seeing clearly after she had arrived at the hospital, completely blind just a short time before
Recently we were hoping to have a quiet weekend but had to operate on a young woman with cancer and then a patient delivered her first twin safely but the second twin was breech and the heartrate began to fall drastically. It was now an emergency Caesarean Section. Lorraine had just come off the plane after attending the Sakeji School board meeting but she was immediately press-ganged again into service as surgical scrub nurse! After a hectic few highly focused minutes by the whole team the baby was delivered and we were relieved she was still alive and breathing satisfactorily. It was good to see her doing well on the ward round the following morning.
Spiritual opportunities
Each morning the gospel goes forth over the intercom and around 100 people will hear the message. Patients will often ask for tracts and bibles. There is always a good supply of tracts where we see the outpatients and at the theatre. It is usual to see patients reading the tracts as they await their turn for surgery. We try to pray with each patient immediately prior to surgery. There are gospel texts throughout the hospital. Our sisters often have informal meetings with singing in the maternity ward, the children’s ward and the woman’s ward. There is also a little hospital village where patients awaiting surgery and their relatives can stay for a time. Sometimes the assembly brethren and sisters will go there with the gospel and one sister is very faithful in going there each Monday. She told me that one lady trusted the Lord a few weeks ago.
The need for medical missionaries of all disciplines is greater today in our world than it has ever been in history. There are a multitude of reasons for this, not least the huge population increases, a high incidence of HIV infections (around 10% in the Chitokoloki area). There is a chronic shortage, often absence of doctors in many parts of rural Africa. The believers at these hospitals pray constantly for doctors and nurses. The government makes every effort to facilitate them coming and there is a whole hearted community welcome.
We have also been greatly blessed by regular overseas visits from doctors from the UK, North America, Australia and New Zealand which are a big help to us in dealing with the high-volume workload.
As I conclude this article I have to record that the little baby operated on with the intestinal problem mentioned earlier sadly died a few days later as a result of an overwhelming infection. His death was a sad testimony to the truth of the UK medical journal article that I mentioned at the beginning. Delays and inadequate services have led to a disaster for this family and the needless filling of another little grave in Africa.
I trust that these few paragraphs convey a little of the intensity and variety of medical missionary work as well as the joy (although often tempered with intense sadness) and excitement and fulfilment that it entails. I trust also that some Christian doctors or nurses reading this article might prayerfully consider coming to Africa, with their skills and the message of the gospel, to help alleviate what is the real and awful inequality of our modern world.
