Going for Ride with Friends

Going for Ride with Friends

Sunday, September 26, 2010

Further Images Illustrating Rebecca's Post

Pictures in Relation to Rebecca's Post

Rebecca mentions many different things in her blog that I'll try to illustrate. Of course since I'm illustrating, I have artistic license. Here they are. If you have questions, e-mail us. This blog isn't quite as nice for photos as the previous homepage, but they kicked us off. I'll need to do a couple of blogs to get the photos on.

Saturday, September 25, 2010

Weekly Life for Ritchey's in Mbingo

Greetings from beautiful Cameroon! There is so much that goes through my mind to share, but I think I’ll give you a description of our weekly routine as it exists now.

Daily, Dasen goes into rounds with residents and surgery around 6:45 AM. I wake up slowly as he goes and then ,if all goes well, I sit out on the patio for some great bonding time with God in His Word with prayer and journaling, while viewing the beautiful terrain and eating some granola with yogurt (those are my ideal mornings and my favorite part of being here.) The kids wake around 7 to 7:30 and play, eat, and get dressed with my interaction until we start home school around 9 AM. We have a cook who makes our lunch, Janet, and a Cameroonian man, Ben, who washes our laundry by hand. Both come around 8:30 AM, so that time gets a little hectic with greetings, instructions, etc. (Janet brings her 3 mo old baby girl, Shammah, who we all hold and love on throughout the day. Her 3 other young children also come later in the day around noon or 1pm. Ben just had his 3rd child born last week and we visited their family in the health center in the neighboring town to greet and hold the baby when she was just 5 hours old.) We do home school from 9 to noon, then take a break for lunch and play. Then we re-start at 1 pm until about 2:30 or 3 pm. Home school in general is going very well, although we all have our moments. I love having a room just for home school!

Dasen usually works through lunch and comes home around 5 or so- very unpredictable. A day or 2 a week he might stop in for a quick visit between cases, and do some work with emails or help Elle with reading, which she is loving. We also have many unpredictable visitors coming in and out. Last Tuesday I had 18 visitors in 1 day, which is a bit more than usual, but never-the-less we find many missionaries who come to the hospital stop by to share a meal and say hello. We’ve gotten to know quite a few missionaries through the home school conference, and by word of mouth. We also have had local missionaries here in Mbingo to our house on a weekly basis. There are a lot of short-termers coming through, and several other couples who live here. Most weeks we’ve hosted a party on a weekend night of 10 to 16 people or so. Last week we had a Wii tournament then a prayer time. Play and Pray , or Prayer and Pizza, or Prayer and Potato Soup have been our themes. We have found one of our “secret missions” here to be offering hospitality and striving to create unity and joy among those here working.

So day by day in the afternoons and evenings we have scheduled happenings:

Mondays- 3:30 I have a prayer/discipleship group with the wives of the residents here at the house.

Tuesdays- 3:30 The girls play the violin in the children’s ward at the hospital, while my mom greets the kids, and then we close in group prayer time with the children and their families. 6 or 6:30 PM Dasen hosts the residents here for a discipleship/Bible Study time.

Wednesdays- 4pm The local kids from very close-by come to play for a couple hours. These are kids whose parents were very ill at the hospital then were given housing on the hospital grounds b/c one or both of their parents had leprosy and couldn’t provide for their families. The kids have very little materially and love to come here to play with soccer balls, basketballs, scooters, and a trampoline.

Thursdays- 1 pm I go to the surgery clinic to see patients while Dasen does lectures and gives tests to the residents. The surgery patients for the clinic don’t get scheduled so there are always people waiting to be seen. This past week I also observed Dasen doing a c-section, and we then try each week, when done with work, to go to the local “canteen” and share a pop for a little “date.”

Friday- Our one day without any plans! This week when Dasen came home we played American football in the yard with all the girls. It was surprising how much they wanted to tackle each other, but Dasen limited it to “2 Hand Touch.” We had a lot of laughs, and Elle kept running around the house with the beagle, Archer, on a leash.

Saturday- Every other weekend Dasen works both Sat and Sunday. Saturday is local market day so the girls and I often walk to the market and visit the Bardins- a wonderfully kind American missionary couple newly arrived here. Debbie Bardin offers us sweet drinks and a place to rest as it’s a mile walk to the market, then some more walking and a mile back. Today Dasen was home and I went hiking with another missionary couple, Sarah and Christof, and another short-termer, all from Switzerland. We hiked from 10:30 AM until 4:30 PM rather continuously, probably more than 12 miles or so. I felt like “This is the life for me!” I loved it- seeing waterfalls rage, balancing over stick bridges, being submerged in tropical greens, crawling over rocks and under low branches, dodging undodgable mud puddles, seeing horses run across mountainous fields, climbing over multiple fences, and observing remote African homes and fields.

Sunday- We go to the local church which is vibrant and full. It goes from about 9 to 11:30 AM and has some great singing. They love to repeat the same verses over and over much to Dasen’s chagrine, but they have great variety of rhythms for clapping. The sermons are “meaty” and meaningful. Then Sundays are family days where we try to relax some and play outside together, usually soccer or maybe now football. Then it’s usually Sunday nights in which we host parties.

All in all we are finding a rhythm to this life and are quite thankful. There are many stressors both physically and spiritually, none of which I have mentioned here. But all in all, there is clear reason to point to God and say “Thank You! For being so good and leading us here and working through us to do Your will. We are so glad to be used by You.” And we want to say “Thank You!” to our friends and supporters who are praying us through all this. God is moving in response to your prayers. Please keep it up if you are praying for us.



Sunday, September 5, 2010

More Home school group pictures

Pictures from the Home school two weeks

I realize that these pictures are late, but I tried before to get them on the blog and failed. I hope that you can enjoy this mix of the two weeks' activities.

I have been remiss in not letting you get to view some surgical pathology. I realize that the joy of surgery is the pictures (isn't it?). In a counter-clockwise progression starting from the top left, (1) when you have a huge neurofibroma that is coming of the lower part of your face it is good to have a good surgical head and neck surgeon and blood back-up to remove the mass. The poor boy walked around with a scarf to cover up his lower face as the mass took his lower jaw/lip/face and extended it to the lower chest. (2) Central lines can be used as drainage tubes into the pericardium to diagnose the effusion. The poor boy also has a septic left hip that needs surgery but couldn't breathe well due to the effusion. He has TB. (3) My first Hirschprungs case didn't go as I had exactly hoped. I did a variation on a Duhamel [sic] procedure. The boy had a stoma diversion and is 7 years old. His distal segment was still really dilated, and I couldn't really see the differentiation into the aganglionic segment. The picture does show anatomy well, though. (dilated sigmoid, ureter, bladder reflection, etc) (4) "Big uterus" is becoming my most common diagnosis. Kocher clamps in many sizes and levels of clamp ability, poor lighting, and sometimes doing them with just an inexperienced scrub to assist have all been interesting challenges. (5) Recurrent chest wall neurofibroma that is infected will be a new challenge. The XRay doesn't show any bony involvement so how will I resect this thing and cover the defect in the 11 year old girl? Anyway, don't look if you don't want to see pictures, but do pray that God will continue to give wisdom as many different challenges come along that are new to me. Even if they aren't new, I need lots of God's grace to proceed. dasen

Poor Copper

Today is Sunday, I am waiting to go to back to the hospital to assist in surgery exploratory laparotomy. I just wanted to share our sad news related to a traffic accident. You will note a happy little girl in one picture with a little beetle named Copper. This bug was given to her by a missionary friend in Bamenda. Miriam and Elle have enjoyed taking care of it and taking it out for walks. I took the picture after church around 1pm. Around 2pm, I heard heartfelt wailing coming from our bedroom. An inconsolable Elle explained the sad story to me. Betwixt bouts of crying, she explained that the bug was taking a ride in the back of the semi-truck (nt picture with poor dead black bug on ground), and she used a spoon to help get the bug out of the trailer when "its head fell off." That was a literal quote. Rebecca asked me to do the comforting as she was having a hard time not laughing. If that is our only traffic accident here, we will be blessed. Rebecca wants to have funeral later when the rain stops. dasen

Wednesday, September 1, 2010

Greetings from the "theatre" where I am using the computer today. Today, I get the computer because the family, except Sarah, is in Bamenda visiting and shopping. Please pray for Sarah as she has had some ongoing GI distress that is manageable but distressing. In the OR, we have now switched from Urology to ENT with Dr Wayne Koch arriving. He has come with his wife for two weeks as another Cameroonian doctor, Dr Acha, has arrived back from ENT residency in Kenya. Another ENT surgeon will come in two weeks as they hope to help Dr Acha establish himself well. They have already seen some "African" pathology which will be operated on in the coming weeks. (side note-Dr Koch was the president of the head and neck society in USA last year. along with the crew from MD Anderson, I chuckle at the "big boys and girls" that I get to learn from here in the corner of Cameroon.)

The girls are doing well as homeschool has begun full-time. I've asked Rebecca to help in the surgical clinic on Thursdays as the residents are to be spending time in lecture and what not on that day. She does well and has enjoyed this. The only problem is the "fire-hose" style of outpatient and surgical pathology. "Fire-hose" relates to the poorly manipulated schedule as people just keep showing up every day except Sunday. Therefore, one can't carve out much flexibility as the patients are scheduled in time-slots or specific days. They just keep coming and coming. So it's nice to have Rebecca to help the flow so the residents don't have to come back after lectures and see all the backed up patients.

We are now running on a skeleton crew of residents, but the positive point is that I like small groups. The negative point is that means I have to work harder as do the residents. Work hasn't killed too many people. I read a chapter in Dr Hale's book "On Being a Missionary" last night that I enjoyed. It was titled, "Nepal 1: Visitor 0." It is about the grind some call culture shock. If any of you have that book, I highly recommend it as I think his perspective is good. The concept is to bond early in the culture and don't be too critical of others (ex-pat or national). I sat and thought of the bond issue (language acquisition and national friends) and wondered how we were doing. Rebecca's weekly meeting with the residents' wives going over the book, The Power of a Praying Wife is going great with good relationships being formed. I think that I'm doing well with getting to know the residents. (I mean, I've already fired one so I must be doing great right?) The administrative thing is not necessarily my forte, but someone has to do it. I've learned that if no one does it, things just don't go so well. I appreciate what another couple here for Switzerland express. He, Christoph, hasn't had "culture shock," he is having bouts of "culture fatigue." I think we all go through this aspect, but in the USA, we'd just call it weariness. The reality is that the normal ways that we have learned to deal with that weariness and fatigue in the USA have to be changed as there isn't the same escape mechanisms in place here. In the house here, there are lots of books and videos that the Sparks have collected which is nice. There are beautiful hills to climb, also. It is just hard to go out and get pizza. I really enjoy the "fo fo and njama njama," but my family has not joined me in that enjoyment. I was the designated supplier of the food this week for the OR "party" on Monday. One person signs up each week and pays 15,000 CFU which supplies the "fo fo - cornmeal glob, njama njama-cooked greens, bitter herbs-bitter greens, and fish-dried and fried fish cut (one piece is the head and some of the body and the other piece is some body and the tail) for the OR staff. I didn't get to eat it until mid afternoon on Monday because I was trying to accomplish my first modified Duhamel procedure on a Hirshprung kid. I hope he does well. I now have a normal cautery unit to work with. I still wish I could have a Thompson retractor or Bookwalter as my pyloroplasty and vagotomy yesterday was so much harder with a little lamp and my intern cranking intermittently on the chest so as to see. We make do. We had to postpone the Heller Myotomy today because the young man had a heart rate in the 40s and anesthesia wasn't comfortable. We'll let medicine have a look, but they can't do too much anyways except an EKG. His esophagus is big and has what is called achalasia so that when he swallows the food gets caught up at the junction of the esophagus and the stomach. I'll try to send some nasty pictures along now and then for all of you who like nasty pictures of pathology. I have a good picture of pus coming from a pericardial effusion on this poor young boy. He probably has TB and so to see what the effusion was we inserted a central line catheter into the effusion blindly. I thought this was a neat way to use the central line catheters as I don't need to use my skill to place them into veins. He now has a good drain and hopefully he can breathe well enough to get his septic hip operated on now.

Anyway, I hope all of you are hanging in there, wherever you are. May God bless. dasen