Psalm 62 v1 For God alone my soul waits in silence.

In practice what does this mean? A lot of disturbed nights and weekends  which have left both us and the nurses tired and ready for a rest. The walk up the hill at 3am is not quite as appealing as the photo. A few of the staff us included have had a nasty viral infection too. The situation hasn’t been helped by the anaesthetist leaving abruptly in late January so one of us to do the anaesthetic while the other operates. It is challenging seeing the suffering caused by the violence around us, with people away from family and friends and so often struggling to get the general nursing care they need, much of which is provided by the family in Chadian hospitals. We were particularly marked by an incident involving a landmine where four young men needed leg amputations, three of which were bilateral. They had driven over an anti-tank mine in the quest for gold. Another one died before surgery and there were 9 more minor injuries. We operated all night and the laboratory managed to find blood from volunteers to help save the patients. It was a remarkable incident following on from a similar tragedy in November, and so the following day they were thankfully evacuated by military aeroplane to Ndjamena to be with their families; but what tragedy for them. What will the rest of their lives look like?

It has however meant that Dr AbdelKerim has been able to do a lot of practical surgery. He has been present at all the operations we have done and has done a lot of the major surgery under instruction, its great to see the progress he is making. We also look after complicated cases together and have been trying to keep stock levels up in the pharmacy, as when faced with such an influx, stocks diminish quickly. Fortunately we have enough Leischmaniasis drugs now, as cases have also undergone a surge, we think due to the prolonged rains last year meaning more sand flies were around. As if there wasn’t enough to do Dr Abdelkerim and the hospital nurses also had to organise a measles and yellow fever vaccination campaign for our half of the Tibesti. It took place over a week in mid February; the Area health director and Regional health director were unable to find the time to come up from the capital. It’s a good job Dr Abdelkerim has a calm disposition.

Through all this this we can see the fact that the hospital is so busy as a sign of increasing acceptance of the work that is being done. We have had a number of difficult cases where people have not wanted to take our advice despite it being clear what was needed. Amongst others, often people with fractures not wanting a plaster and crutches  preferring to sit in bed with traditional rough wooden splints. There were two cases of men who needed chest drains to drain the air and blood from around their lungs refusing to have them, and a lady flatly refusing a transfusion despite a dangerously low blood count. Most frustratingly both the Caesareans that we have done took hours and hours to accept that they needed surgery. In one case this led to the unnecessary death of the baby shortly after delivery. It is difficult to see people and their families risking their health in this way despite good explanations and encouragement to go ahead with the treatment. 

We have found some relaxation time early morning for reflection in poems and pictures during Lent and by watching films and reading and more recently celebrating the birth of our hospital caretakers baby (a new Dr AbdelKerim), with a delicious meal . But The long hours have meant little time for language study and visiting neighbours. We hope that the month of Ramadan might be a little calmer and we may find more time for this. We keep in touch with Ruth and Rebecca and both are well and continuing their work in the Refugee centre and as a doctor respectively.

We give thanks

 that we have both our National ID cards and the Leischmaniasis drugs - requests we made before.

 for the many patients treated and the hard working staff, especially Dr Abdelkerim.

We pray

For a deeper acceptance of advice given.

For less violence in the region.

For calm in the leadup to elections on the 6^th of May,  suddenly  announced not long after the referendum.

For success when the X-ray technician arrives in early April to carry out suggested repairs.

For new nurses to replace those who plan to leave soon or that some may stay to keep minimal staff levels and that some doctors may arrive soon before we take a break in Ndjamena in early April.

We pray that you too in this season of Lent may find time for reflection in whatever way is best for you in the business of your lives. May you also know ‘ the peace of God that surpasses all understanding’  Philippians 4 v7.  Thankyou as always for your support.

Andrea and Mark

We will be returning to the UK at the end of August and will be available for Church visits between the 23/09/2024 and 20/10/2024.

Please contact BMS if you would like us to visit.