Last Post

Today after lunch we will be making our way back home.  The last couple of days have been busy, many people have come with conditions we unfortunately cant help with.  We have seen terrible keloid scars that would come back often worse when removed. A 38 year old pregnant woman came in with a large tumor growing in her left cheek, probably from the salivary duct and had broken through to the inside of her mouth. Another lady arrived with fractures of the arm and thigh, we don't have fracture sets to fix them. A man came with extreme weight loss, he couldn't eat because food would get stuck, we used the scope and found esophageal cancer, he and his family are deciding on a feeding tube, the cancer cant be removed.  Along with those frustrations and other heartbreaks, we have had successes.  We have removed several large thyroids. a very difficult gall bladder, large renal cyst. We were able to repair an incarcerated lumbar hernia (hernia thru the back) and use mesh sent by Samaritans Purse. We did a hysterectomy, removing a uterus as large as a full term pregnancy.  Most of these surgeries would not happen for these people without short term volunteers coming to places like Adi.  The Congo has a reputation as you all know and the people freely acknowledge.  The reputation of uncertainty, insecurity and risk.  Our trip here has shown none of these.  

Adi is a small community of about 2000 within a larger population of 10000 or so more.  The hospital has developed a very good reputation and is considered a referral center and patients come from neighboring Uganda and Sudan as well as Congo. Pastor Yoma Balonge Charles gave me a brief history of Adi passed on by his Grandfather Yonad Akudi.  The Good News was brought to Adi by way of Aba where AIM (African Inland Missions) developed a base.  A missionary named Richardson from England then went to Kulunga then to Adi in 1924. He brought 3 things to Adi, The Good News (The Bible and its teaching), Education, and Health Care.  Originally the people were treated on the missionary's veranda and later a clinic was built and run by Richardson's assistant Daniel Yeka, who he trained. This left Richardson free to preach and teach. The clinic moved multiple times until its present location in the 1950's.  

The Church was the nucleus of support for the development of Adi.  The church supported financially and with labour the building and operation of the clinics and also developed a successful bible school. This school began in Aba and eventually moved to Adi in 1948.  It was originally a 2 year school which expanded to 4 years when it started in Adi.  They have graduated more than 500 pastors which have spread the Word throughout the region of central africa.

During the civil war of the late 90's, Adi was occupied, and unfortunately pillaged. The books were burned, the church and school ransacked and much distroyed, the Wiltons (AIM missionaries) home was occupied and looted and the hospital closed and pillaged.  The school and hospital basically started from nothing and rebuilt. The spirit of the people overcame and there has been stability in this area since 1998.  

There are frustrations.  The pastor says they need materials to combat the growing pressures of Islam in the region.  The young people have increasing diversions and they would like to develop more youth programming. They need French and Lingala Bibles and materials.  Like much of Africa, this country is rich in natural resources but only a few profit, virtually none reach the people.

The accomplishments and opportunities we have experienced could not have happened without the support of World Medical Missions, Samaritan's Purse and Dr. Warren Cooper.  Warren called several weeks ago and asked us to comed with him to Adi, a place he has been several times.  It has been a true blessing.  Warren is a general surgeon in the truest form.  He is the youngest son of a missionary couple who grew up in places like Vietnam and the Ivory Coast.  He did his medical training in Chicago and immediately began work overseas.  He has truly worked worldwide, from South America, Asia, and Africa.  He married a year ago. His wife Lindsey is completing her fellowship in pediatric intensive care and they plan to continue with medical mission work.

Samaritan's Purse is most commonly thought of as the Christmas Shoe Box organization, but its principle work is relief work in disaster and war torn areas.  An arm of Samaritan's Purse is World Medical Mission which places Christian doctors for short terms with hospitals worldwide.  This helps relieve severe shortages of physicians in many needy places.  All specialties are needed.

We will be leaving Adi today after lunch.  The trip back will include 3 hours of dirt road, a border crossing, an overnight in Arua, Uganda. Tomorrow we will fly back to Entebbe, wait about 11 hours then fly back to knoxville via Amsterdam and Detroit.

We have had a great team, Mary has been scrubbing and first assisting the difficult cases and made difficult cases possible, Greg of course has done outstanding anesthesia and has done great work with training the local anesthetist who has just completed training and is very "green".  Gina has been more than a blessing with her compassion and touch to the patients and families.  She would spend hours with the family when their loved on was in surgery, she would show love to them despite the language difficulty.  She taught the children and encouraged the employees of the hospital in ways that none of the "clincal" team could.

Thanks for following the blog.  I hope to have photos posted when I get home.

In Christ,  Mark, Mary, Greg and Gina

Monday evening

Sorry about lack of posts but our connections have been down. Saturday night we had a difficult case. The principle surgical tech, who actually does much of the surgery, brought his mother to the hospital. She was vomiting blood and her blood pressure was very low. They drew some blood to get her blood type ( B+ ) . Warren was the only one on our team with that type and he immediately donated. They do not have a blood bank, so if we do a case that might require a transfusion then there must be donors at the hospital. Anyway, we brought the ultrasound machine to her bed and checked her liver, it appeared cirrhotic and was likely causing the bleeding, but we needed to verify. Adi does not have a gastroscope for looking into the stomach, but there was an old sigmoidoscope. Warren rigged a light source from another old piece of equipment and we were set. We used a bulb aspirator to blow air through the scope and passed it into her esophagus. There I unfortunately found many esophageal varices. there was nothing more to do but line up more donors and pray with the family. unfortunately she passed away during the night. Hepatitis B is a very common cause of liver cirrhosis in Africa, we see it commonly.

On a happier note, I delivered my first breach baby,(feet first). I was getting ready to do a c-section when the mother had other ideas and began delivering, so there we were, no choice but get him out. Nice healthy boy. The mother walked out of the operating room.

Sunday was a good day. Greg and Gina had a full day of sharing with the youth. Gina and Mary went to the youth sunday school classes and Gina spoke through a translator, Mr. Onzi Langa the english teacher at the school. She spoke to 4 classes, the last had 140 youth. She probably taught between 300 and 400. When Greg, Warren and I caught up after church service, Gina was praying with several to receive Christ! The afternoon was full of youth activities and Greg gave a message to about 150. After the service, several young men came to them to pray about concerns and 4 young men came to the Lord.

Today we revised a colostomy, did a thyroidectomy and a few smaller cases. We changed the dressing on the burn patient that we skin grafted and it looks good so far.

See you guys soon,

Mark, Mary, Greg, and Gina

We had a great visit with Pastor Yoma Balorge Charles on Sun night. He gave us the history of Adi mission, I will share this next time.

Today we had a slow start but by the end of the day we had done a good days work. I lost count of the dozens of patients that Warren saw in clinic. One of the local Docs does clinic with him. Warren has to speak French to the Doc who translates to Lingala, which is the general trade language.Most also speak a tribal language. Some speak english but they are generally from Uganda or Sudan. Adi is only about 12 miles from those borders. In surgery today I did a colostomy revision, we changed the bandage on the burn patient, did a thyroidectomy and irrigated an infected lacrimal (tear)duct on a 3 year old.

We didn't have water last night or this morning and do now, so its off to the showers.

See you guys soon

Mark, Mary, Greg and Gina

Half way

It is Sat. evening and it has been a very quiet day. The morning was beautiful and after our run we made rounds on all our patients. Everyone is doing well although Kokole, the 15 yo with the abdominal abcess was draining more pus than we liked. Greg sedated him and I opened his wound and cleaned out a good bit more pus and placed an irrigation catheter to help keep it washed out. He actually speaks english and has been quite a brave young man. He asked Mary to adopt him and bring him home. Mary said his mother and father would miss him, but he assured her they want him to go to America. I think she would bring him if she could.

Late in the morning we walked about 3 km to a small town where they have a market. Didn't find anything but it was a nice walk, but you have to be careful of the motorbikes. They ship them from China(surprised?) and cost about 500 US. They fly around and cause considerable trauma with common accidents. We had lunch and a little nap before going back for rounds in the "ICU" which is the recovery room and post op care ward. In a couple of days they go to the general ward, usually staying at the hospital for a week and sometimes significantly longer. The wards are broken up into pods of about 3beds by concrete half walls and there are mens, womens, and maternity.

This afternoon we walked up to the church where the youth were having choir practice. They were very good. The choir director spoke to us afterward asking for prayer for his choir and increased participation, especially from the teenage boys. He said there a lot of conflicting beliefs that they have to deal with.

Tomorrow church is at 8:30. There is a French service followed by a service in Lingala. Gina and Mary will be with the youth and Greg was asked to speak a short message and he graciously agreed. I have to say that I'm glad it was him. The youth have more activities in the afternoon.

Let you know more tomorrow, thank you for your prayers and encouragement.

In Christ,

Mark, Mary, Greg and Gina

Fri evening

Another day and more challenges! The last two days have been great. We are being well cared for here in the Congo. The area where we are staying is rural, a farming community where the hospital is the biggest employer. The hospital supplies the guest house and we have a gentleman who cooks and takes care of laundry. He is a great cook and right now I am resting off beef tips and rice, greens, tomatoes and mango for dessert.

Yesterday we drained a pelvic abcess from a young boy, removed a prostate, did a c section and then a sub total thyroidectomy. Today we operated on a two year old girl with terrible burn contractures which pulled her head to the right into her shoulder and her arm toward her face. This required removing most of the scar tissue and extensive skin grafting. We also had to do a colostomy on a 2 month old girl with a birth defect. This afternoon we placed an external fixator on a 5 yo girls femur. She had been shot by the LRA or group of bandits. They were harassing her family and her father was shot and killed defending them, she was then shot in the leg, shattering the middle portion. Evidently she had issues with infection after her first operation and when we saw her she was in a huge cast and had a nonunion (no healing) of the fracture.

Tomorrow we should have a lighter day unless more emergencies come in. We will do a little exploring.

Keep praying, In Christ's love,

Mark and Mary

Wednesday may 18th

Good day with more challenges.

The days begin here at a little after 5 when the rooster that lives behind our bedroom window starts his morning crow. This is no subtle rooster. So, might as well get up. This morning Warren and I when on a 5 mile run, the weather and views were great . We ran along a dirt road going out of town (all the roads are dirt) past fields with cattle and goats and even some tobacco fields. They grow tobacco in small fields then dry it in square brick silo like buildings. It looks like they build fire in ovens underneath or base of them. The weather is in the 70s and 80s and so far hasn't rained even though it's rainy season.

The people are very gracious and quick to welcome us. They joke that they don't get many visitors to "the Congo". The devotions include a lot of old hymns but they are in the local language Lingala. They have hymnals we can follow in easily, though like at home, I think they would just as soon me stay quiet.

Today, Warren and I removed the huge tumor on the 2 year old. Greg and the young local anesthetist gave great sleepy medicine as usual. This was important as we had to do a fore quarter amputation of his left arm and shoulder. The next case was significantly harder, working in an abdomen that had been visited several times and had things draining into things it shouldn't.

All for today, love you all

Mark and Mary

First clinical day

This was quite a day. Quick rundown due to lack of time.

At 7:30 we went for devotions with many of the hospital staff. We loved it even if we didn't understand anything. The music was great, with traditional drums and a bass drum made from a 55 gallon drum with a skin stretched over the end.

Clinic started about 8:15 and lasted all day, we did cases through the day as well. The pathology we saw was unbelievable for the first day. So far we have seen typical hernias and thyroid disease, but also two large rectal cancers with significant complicating pelvic problems, a stenosis of a colostomy placed due to imperforate anus, a large no very large tumor involving the shoulder of a two year old, and a huge cystic hygroma on a two month old.

Today I performed a c section, bilateral hernia repair, chest tube for fluid, revision of colostomy, and assisted Warren Cooper with the removal of the cystic hygroma. That was a very urgent case because of a severely compromised airway. I am afraid this child may not make it, the mass was very large and we couldn't remove it all.

Gregg's wife Gina is the star as she spent the day with patients and their families encouraging them and praying with them. She is the one who made the greatest impact and was a blessing to all.

Keep us in prayer as this is the most challenged I have been on our trips.

Mark and Mary

Day 1 in the Congo

Our first day,or part day at least, is ending. When we arrived at Adi, the hospital employees met us lining both sides of the street. They were dressed in white and were singing. They presented us all with flowers and welcomed us very warmly. It was very moving to say the least. They showed us to the guest house and introduced themselves but their names will have to wait until later when I can write them down.

The guest house is very nice. It is three bedroom, one bath. There is a caretaker named Soloman who prepared use a great lunch of chicken, rice, and slaw,

The hospital is similar to others we have visited. It is fairly small but takes care of some huge problems. We will begin surgery and examen patients tomorrow.

Devotions at the hospital at 7:30. Keep us in prayer.

Time difference is 6 hours ahead here.

Mark and Mary