Mitchell Mission to Jos, Nigeria

Mission Accomplished

2009-06-01T21:55:00.000-07:00

What an exciting and eventful year this has been. We thank you all for your support. We are so grateful for all of your moral, spiritual, and financial support. Our experience has certainly impacted Nigerians and our family in a very positive and meaningful way. God has answered prayer and we believe we have truly accomplished the goals and missions that we set out to do initially. Lives have been saved, others, including our own, have been transformed.

Not only have lives been saved, but many more patients have a significantly better quality of life because of Michael’s intervention. Giant tumors have been removed, hearing restored, and severe traumatic wounds have been repaired. What excites Michael the most, however, is that much of the knowledge and skills that he has brought to Nigeria will stay in Nigeria. In one week, the lives of three small children were saved by Dr. Aboiyar, who used very specialized equipment and skills to remove foreign bodies from their airways. There are very few places in Nigeria where the parents could have taken these children. Certainly, the quality of care that they received from Dr. Aboiyar is as good as it gets in Nigeria (and America for that matter.)

Lisa has accomplished her mission of teaching English in an academic setting. She went far beyond meeting the requirements of completing her master’s degree. Not only did she improve her students’ English language skills, but she mentored interactive teaching methods out of love and compassion for her students. Such methods are rare in this culture. Outside of teaching, the challenges of managing a large home in a developing country were brilliantly overcome by Lisa. She was very much in her element.

Emily, too, achieved her goals. She not only learned something of medicine and surgery in a mission hospital, but has been a great help as well. She was instrumental in setting up and organizing the ENT clinic. Her help was most appreciated by Michael as she assisted him in surgeries. She went on to help with patient care on the surgery service, where she has become quite proficient at wound care, especially burns. Additionally, children at a local orphanage, the neighborhood children, and grade school children at Hillcrest where she has substituted have all benefitted from her loving tutelage.

Hannah, Sterling, and Camille have matured as well. They are now keenly aware of how two thirds of the world’s population live, in contrast to the luxury that we have in America. They have all come to appreciate the lively, cosmopolitan, and yet devout community of missionary families that we are a part of. They have all expressed interest in service-oriented careers, and they are all interested in coming back overseas in some way.

Our mission in Nigeria has ended for now. We will consider if, how, and when we will return to Nigeria in the future. On May 31st we departed Nigeria from the Abuja airport. We are taking advantage of our route through Europe and vacationing in England. On the way home we have to stop in Charlotte, NC for a debriefing with SIM, our mission organization. We will arrive back in Vancouver, Washington in mid June. The remainder of June will be spent taking care of over ten months of business and visiting friends and family. Michael will join ENT Clinic of the Northwest (formerly Vancouver ENT) on July 1st. This is a new and exciting practice opportunity for him.

Thanks again for all your support. We know we have many friends and family in the US as well as in Nigeria who have been following this blog. Blessings to you all. We may add a few reflection entries to the blog in the next couple of weeks.

Michael Mitchell, MD

Last Surgery

2009-05-29T22:12:00.001-07:00

I had hoped to spend more time with administrative duties in my last couple of weeks, but there were a number of surgeries that needed to be done and only I could do. So needless to say, it has been busy for us up to the end.
On Wednesday, the 27th May, I operated on a nice elderly woman who desperately wanted to have her large tumor removed. We have been trying to get her medically ready for surgery, since she says she is 90 years old.
The surgery went well and she did very well after the surgery. We were all pleased. It was another major event as we finish up in Nigeria. I thank God that everything went so well.

Another closure event was a “Sendforth” dinner last night for the missionary doctors that was attended by all the doctors of Evangel Hospital. It was a very nice time. I received a couple of nice gifts and had the opportunity to thank the medical staff for being such great students.

Michael Mitchell, MD

Graduation Day

2009-05-28T14:46:00.000-07:00

We have been quite busy as we prepare for departing Nigeria as well as all the end of school year activities. The most significant of these activities was Hannah participating in the Hillcrest School Class of 2009 Graduation tonight. There has been much preparation and celebration. Over the past weekend, we had a SIM Senior Tea where families and friends of the eight graduating SIM seniors gathered and we showed pictures of the seniors as they were growing up and then talked a little about them. Later Sunday we had a Baccalaureate service. We enjoyed wonderful music and a fantastic sermon by Dr. Bill Ardill, our general surgeon whose oldest daughter just graduated.
Today was a small and personal graduation. Twenty-three students graduated. All are going to universities around the world – Australia, New Zealand, United States, and Lebanon. A few were going to big name schools like University of Southern California and George Washington University. We have been told that this year’s senior class has been an exceptional group of kids. During the ceremony, each graduate was addressed individually with funny anecdotes and words of encouragement. We feel privileged that Hannah could be involved with such great group of people. We certainly have enjoyed being a part of this school community, which is diverse, highly educated, selfless, and very family oriented. Graduation was a wonderful event that helps bring closure to our mission in Nigeria.

Michael Mitchell, MD

Final Exam and Saying Goodbye

2009-05-15T23:29:00.000-07:00

Final exams in Nigeria are very different from final exams in America, especially when you are saying goodbye to 71 students who have become quite dear to you. This past Friday, I gave my final exam to my students. It was quite the event, and I am very happy that my husband was there to be a part of it. (I had asked him to come and help me proctor the exam.)

The first order of business was announcements. By popular request, I finally gave out my email address. I am hoping to stay in contact with my students. Gifts were presented by me and by the students. The students had taken a collection and were quite thoughtful and generous in showing their appreciation to me. I got flowers and a beautiful wood carving of Africa that I am going to proudly display in a prominent place in my home in America. I also got a unique Nigerian gift: phone credit! (You buy little cards from street vendors worth a certain amount of credit and load it onto your phone - - no monthly bills.) Even more precious to me though were the words of gratitude and affection and prayers said on my behalf. They told me that I had been like a mommy to them . . .I have felt that way about them as well! That makes for an awfully empty nest as we part ways!

The second order of business was a final class picture. This time, I am surrounded by all 71 students (both classes). This picture will also be very proudly displayed in my home!

At last, we got down to the business of taking the final. Exams are very tense events in British system schools. And it is no wonder since they count as 70% of the final semester grade! I am very uncomfortable having so much weight resting on one test, so I gave a very predictable test with directions that are familiar to the students (they have seen them before on our regular quizzes throughout the semester.) Though the examination process is brutal, the grading scale makes up for it: you can have a final average of 40 and still pass the course with a D in the British system unlike our American system schools that allow for a final average of 60. Reconciling these two vastly different educational systems has been a challenge for me while teaching in Nigeria.

One of the most encouraging things to me personally has been the students who have communicated to me what an impact my teaching style has made on them. Some of the students will in turn go on to teach themselves or are already teaching. The classes my students are used to are very teacher-centred: the teacher lectures and the students take notes quietly. There is very little interaction. There is also very little assessment to determine the students’ level of knowledge going into the lecture and very little assessment to check for comprehension during and after the lecture. The idea of meeting the students where they are at, engaging in group activities, and involving the students, in general, is a new thing here. I am excited to think that I might be passing this on to my students.

Lisa

A Tense Ending to a Sweet Year

2009-05-07T13:09:00.000-07:00

No, not tense in the way you think . . .today was my last regular class day at JETS, and we finished out the year discussing grammar tenses. It was a fun class where the students shared some of their habits and regular activities (you use simple present tense to talk about those things as well as to express general statements or truths.) I learned all sorts of new things about my students as they shared using the present tense: many love to read, many of them pray regularly (which isn’t too surprising since they are seminary students), one thinks about a certain girl named Nancy all the time, and my student who cannot hear even told us that he eats gwata everyday! (Gwata is a vegetable soup thickened with grits.) I also learned a Nigerian proverb as one student shared a truth that uses present tense: When lizards lie prostrate on the ground, how do you know which ones’ belly is aching? (Hmmm . . .I think something got lost in translation on that one.) It was a great last day of class!

We ended our class time together with a photo session. Included you will see pictures of both my first hour class and my second hour class. Also included is a picture of Nehemiah and Kingsley, two students who kept me on my toes with LOTS of questions!

Even if I should come back and teach in Nigeria 40 more years, these students will always have a very special place in my heart. I am going to miss their warmth, their sincerity, their friendliness, and their ability to enjoy each moment to the fullest. My students have treated me with such respect and gratitude for every little thing I do. Though the living conditions here are hard by American standards, the joy that comes from teaching and interacting with my students far outweighs having no water, inconsistent electricity, and no air conditioning.

Lisa

Dinner with the Ibrahims

2009-05-06T11:52:00.000-07:00

Just a little bit ago we had dinner over at the Ibrahim’s (a Nigerian family on our compound) house. After sitting and talking to Gwakmon and Victor for about 15 minutes we finally got to the meal. We had pounded yam, a vegetable soup, and a traditional Turok (the name of the tribe that Gwakmon is from) dish. The dish looked like a brown soup with carrots and peas mixed in at first glance. Once Gwakmon took a ladle full out of the pot I realized that it was no normal soup. It was made with tapioca flour so it had a sticky texture. Also we ate two chickens named Princess and Precious that were given to Emily as gifts when she visited Gwakmon’s village for a wedding. All of the food besides the pineapple we had for dessert and the pounded yam were quite spicy. Throughout the meal Lilian, the mother of Victor and aunt of Gwakmon kept speaking in Hausa to me and Camille to try to teach us the language. We could barely understand even what kind of questions she was asking. Unfortunately due to schoolwork I had to leave a little early. Still, it was a fun Nigerian culture experience.

Sterling (16)

Final Friday Night Potulck

2009-05-05T12:05:00.000-07:00

Last Friday night we had our final SIM potluck at the Fretheim’s house. The whole experience was quite special because it was the last potluck that we Mitchells and the Taits would be attending. After eating the delicious food that was provided by the different families around Jos we had a short worship time. Being the only drummer around I played bongo for the worship songs while the Sampsons sang and played guitar and keyboard. Then came the farewell testimonies and skits for the Taits. We have not known them for long but we have known them long enough to know that the amazing things people were saying about them were all true. Next came the prayer, we split off into groups of 2-3 to pray for the Taits, us, and other people that needed praying for. After a few minutes of small group prayer we all came together and prayed as a whole. Hearing the things prayed about for us was encouraging and touching. It is extremely encouraging to know that even though we have only been a part of the Jos mission community for a year we have people thinking about us and praying for us. The Friday night potlucks are just one of the things that we will miss most about Nigeria.

Sterling (16)

Final Honor's Recital

2009-05-01T03:08:00.000-07:00

Last night was the final honor’s recital at Hillcrest: an evening featuring the jazz music of George Gershwin and others. The event was just as elegant and classy as the first one last semester. Heidi Tolar, the Hillcrest teacher and wife of Coach Jay Tolar, did an outstanding job organizing and decorating for the event. She was also a participant herself, playing several piano pieces very well.

I haven’t said much about my other teaching position. I teach brass players at Hillcrest School on Thursdays. I have prepared and performed pieces a couple of times now with highschoolers, Heather Ardill on trumpet and Jessica Strydhorst on trombone. Once a week, I also teach the middle school trumpet players, and we are working on an ensemble piece for seven players right now. I can hardly wait to perform a Renaissance piece by Gabrielli at the final concert next month!

Never did I think when I was practicing and competing on trumpet in high school that I would be teaching young trumpet players one day in Africa!

Final Trip to Yankari

2009-04-29T13:14:00.001-07:00

This previous weekend I took a trip to Yankari with my friend Ryan Devoe and his family. With this trip I have now been to Yankari three times. The drive there was a long drive because we stopped several times for petrol, food, and to get our room at a hotel in a nearby town. Once we were finally there we went straight to the warm springs. After five hours in the car we were ready for some swimming. We swam there from about one in the afternoon to 4:30 when we had to leave due to rain. On the way back to the hotel we stopped to get real Nigerian “suya.” The kind that is sold at Hillcrest is Americanized and doesn’t have the true flavor of suya. This suya that we ate was much spicier and tasted better than the kind at Hillcrest. After roadside dinner we drove to the hotel at which we were staying for the night. While walking in we saw what we thought to be a pool. It had a diving board, it had ladders on its sides, and a nice sitting area nearby. Once we got to go check it out we found out that it was so poorly maintained that it had become more of a pond with its own ecosystem. The water was so green that you couldn’t see the bottom even in the shallowest part of the pool and there were frogs and who knows what else swimming around in it. By American standards the hotel was mediocre but by Jos missionary standards the place was a palace. The rooms each had two double beds, a small tv, and best of all an air conditioner and all of this was for a third of the price of the rooms at Yankari. The next morning after having slept in a nice air conditioned room we took off for the wildlife reserve again. Once there we went on our safari which in the end turned out to be a great experience. For the first hour or so we saw nothing but a few water bucks and different kinds of birds but finally we came to a swampy area where we found the elephants. There were about one hundred elephants that crossed the road fifty feet ahead of our car. The most exciting thing was the big male elephant which was about one and a half times as big as the safari truck we were riding in. Once we were back to the main area of the resort we ate and headed down to the warm springs for the last time. Along the way home we stopped quite a few times also. One of those times we were fortunate to have spotted a Nigerian version of beef jerky. Ryan and his family had eaten it before but I didn’t even know that it existed. It didn’t taste much like meat, all I know is that was spiced with pepper and was quite hot. Overall the trip was bunches of fun. I had to admit that I was sad to be leaving such a beautiful place behind.

Sterling (16)

Better Than an Apple

2009-04-28T06:28:00.000-07:00

It's getting closer to the end of the semester at JETS; I have only 3 more classes to go. There is so much more I want to cover with my students, and there is so little time. I am going to miss them very much! My prayers are already going out on their behalf for next year; I am confident that the Lord will provide for their needs.

In all the years I taught secondary math, I never received the thank yous that these students have lavished upon me regularly and as of late. In the U.S., I would get a few Hallmark cards hurriedly signed with a name only, plates of cookies here and there, and even an apple a few times (which, once upon a time, was the gift that you brought teachers.) I have recently discovered a teacher gift unique to the Nigerian culture (I suppose it could be unique elsewhere, but I haven't been there to know.)

I was actually quite puzzled why students suddenly began to insist that they have their picture taken with me. Actually, there were so many pictures taken a couple of class days in a row that I was late to my appointment afterwards!

Then a few days later, the puzzle was answered . . .pictures started pouring in back to me. White envelope after white envelope with pictures inside of them, each hand delivered by the person pictured with me. Each picture presented with a smile and a thank you. Some pictures even had handwritten notes on the back. I know these pictures took money and forethought to present. What a lovely custom! Nigerians know how to express their appreciation and take the time to do it. I will treasure these pictures always! More than that, I will treasure the memories that I have made with these students.

I believe these men and women are the future of Nigeria. They struggle for an education and better ways that we take so for granted in America. I feel privileged to be used by God to help them in their struggle.

Lisa

Junior Senior Banquet

2009-04-26T07:12:00.000-07:00

So this weekend was the junior senior banquet at Hillcrest. The banquet is sort of a prom equivalent, but banquet is a lot classier than the prom I went to. Every year the 11^th grade students put it together as sort of a farewell gesture to the graduating class. They get one of the nicer restaurants in town to cater it and have some of the underclassmen serve everyone. Everyone dresses up really nice and spends quite a bit of time getting ready for it.

Now that you have the background, I can tell you my person experience with the banquet. Gabe, my boyfriend, asked me with a song a few weeks ago; so we went as a couple. Mr. Cunningham, one of the teachers at Hillcrest, is a chaperone for the event and asked Emily to go with him. Sterling was recruited as a server. The three eldest of the Mitchell kids ended up being at the event.

I actually spent two nights away from home because the banquet is on a Friday. I spent Thursday night at the house of Penelope Tait, one of my friends from school. We did as much towards getting ready as we could. That included nails and straightening Penny’s hair. She has really curly hair so it was quite an ordeal, but it turned out really nice. The next day we only had a half day at school to give everyone time to get ready. After school I went with a group of girls to go out to eat for lunch and then we got ready together.

The banquet itself was really cool. The junior class had made it a Hollywood theme and had gone to great lengths to make everything perfect. They even had a red carpet and a Hollywood sign, and that was just the outside. The inside looked like the Oscars. I couldn’t believe that I was still in Nigeria. Each person had a seat reserved for them. At the end of the night there was even an awards ceremony at which every senior got a little golden person for either they’re participation in the senior play or their participation in sports. After the actual banquet was over all the juniors and seniors went to the Niger Creek hostel for the after party that lasted all night. It was a really cool experience.

Keloids and Peanuts Keeping the Doctor Busy

2009-04-22T14:23:00.000-07:00

Time flies when you are having fun and also when you are busy. I must say that my days are not always fun, but often busy. Dr. Aboiyar, the family medicine physician who is now a diplomate in otolaryngology, has been taking some well earned vacation time. Therefore, my days have been a little fuller than usual. In addition, we have two family medicine residents rotating on the service. While they try to help when they can, it does take time to teach. I do, however, find the teaching part of my job very rewarding. I feel that I can make a more lasting impact as well as making a difference for a larger number of people by equipping young Nigerian doctors with more knowledge and skills to better treat patients.

This week is barely half over and I have found that we have done quite a bit clinically. On Monday, we were in the operating room all day for our regularly scheduled operating day. Dr. Aboiyar came off of vacation for a few hours and repaired an eardrum beautifully and with very little help from me. I then went on to remove a tumor off of a vocal cord and then removed a thyroid gland. We got a late start, so the day went a little long.

Tuesday was normal clinic day. I coached the residents through seeing and treating our patients. Along the way we had a two year old boy come into clinic with a peanut in his airway. Peanuts are a mainstay in the Nigerian diet and there is little education at this point about safe foods for young children. Consequently, peanut aspiration is a common problem. This young boy had aspirated his peanut five days prior. He lives near the capital city of Abuja, a three hour drive from Jos. Medical care is so expensive there, that his parents brought him to Jos University Teaching Hospital (JUTH). The ENT surgeons at JUTH don’t have their equipment up and running yet, so they sent the patient on to Evangel Hospital, where the boy arrived five days after aspirating the peanut. He was obviously having some difficulty breathing, so we rushed through our patients in the clinic and got to the operating room in the afternoon. In the operating room, I found half of a peanut firmly lodged in his windpipe (trachea) just below the voice box (larynx). I suspect that he would have developed infection, a blocked airway, and eventually died had he not been treated. He was doing very well and went home today with very happy parents.

Today, we went to the operating room with an extra, overbooked case. This young man has many tumors called keloids that have been growing over the past 10 years. A keloid is scar tissue that has gone wild and continues to grow. Clearly, this is the worst case I have ever seen, much less operated on. Dr. Aboiyar and I spent several hours excising the keloids and then remodeling the skin on his neck. There are other large but significantly smaller lesions on the other side of his neck. I was very pleased with the initial outcome.

I still need to find time this week to take care of a couple of patients in the hospital with broken jaws. I think my remaining time in Nigeria will go very quickly, just because it is so busy. I look forward to the weekends for a little more fun, which will also make the remaining days go by even quicker.

Michael Mitchell, MD

A Trip to the Library

2009-04-16T13:56:00.000-07:00

Lisa the Librarian! That’s my most recent hat to wear. Recently, I discovered that my students, who are freshman in a university, don’t know how to use a library. We in America are very fortunate to have great public libraries and school libraries with regular classes to help us become familiar with how to use it. In the past week, I have met with my students twice outside of our usual class time to teach them some library skills. It was a voluntary class, so I was quite pleased at the turnout!

It was amazing to me to see an actual card catalogue again (ever tried to use a computer catalogue with no regular electricity?) It was even more amazing to me that grown-ups had no idea of how to use a card catalogue. The students listened quite attentively as I first told them how to find their title or author in the files and how a library filing system works. I felt like a mother duck as my students followed me around to different parts of the library and we found some of the books we had looked up together. Then it was their turn to go solo; it brought me great pleasure to see the looks on their faces when they found their very first book all by themselves! Many came up to me proudly waving the book in my face!

Next week, I am going to assign a project where they have to select a book from a recommended reading list that I compiled for them from the card catalogue. My hopes in doing this is that, well after I am gone, my students will continue their education and improvement in English through reading. The books I selected are very practical books on marriage, finances, and living out your everyday life in faith. I tried to get books at a lower reading level since many of them struggle to get through their textbook readings.

To “help” my students explore this goldmine of information sooner rather than later, I am going to borrow an idea from my grandpa. I’ll never forget one of my favorite Christmas presents: a toilet roll with dollars stuffed in it. I have never unrolled a roll of toilet paper so fast! I am going to have a treasure hunt, so to speak, in the library. I figure a little bit of pocket change stuck in the pages of random books from the list will be a good motivation for my students to explore the books I have recommended. I’ll keep you posted . . .

Lisa

Easter Day

2009-04-13T06:13:00.000-07:00

To our friends and family back home, Happy Easter! We are a little bit ahead of you so we are able to give a full report of our activities for the day.

We went as a family minus Sterling to our Nigerian church, ECWA Seminary Church. It was a more lively service than usual with lots of familiar music. Afterwards, we went to the home of Rick and Brenda Naatz, who are another missionary family on the Evangel compound. Rick heads up the medical lab at Evangel, and Brenda works in the SIM travel office. Jacob is their son and Sterling’s close friend. Also invited was a short term nurse that we have gotten to know named Simone, who is from Switzerland. You would have never known we were in Nigeria; the menu was ham, roast chicken, mashed potatoes with gravy, rolls, salad with raspberry vinaigrette, green beans, sweet corn, and 3 kinds of homemade pies (French silk, mango, and lemon meringue.) It was a feast. No short cuts here . . .homemade piecrusts, handsqueezed lemons, home frozen corn, etc. I don’t think Brenda had to slaughter the animals, thankfully!

After our great meal, we headed next door for the annual Easter egg hunt with all the missionary families on the compound. A good time was had by all.

Later that evening, we were the guests of our Nigerian pastor, Barje Maigadi and his family: wife Amina, sons Sulmane and Surane, and daughters Kauna and Kiota. (I hope the spelling is correct!) It was a real treat to be invited into their home and see how a Nigerian family of 6 lives. We had an American friendly meal, but the best part of all was the time spent sitting around chatting and getting to know one another. The Maigadis lived in America for several years when their children were at a very impressionable age. Our families, especially the kids, seem to hit it off. We laughed quite a bit as we realized that despite our different cultures, we had some striking similarities: mothers who can’t seem to finish sentences, fathers who like their remote controls and who don’t listen, and teenagers who like music and can talk silly (at least by adult standards.)

The longer we stay in Nigeria, the more people we meet and become attached to. The Maigadi family is yet another family that will be difficult to say goodbye to in just 7 short weeks.

Lisa

Coach Tolar Takes Teens Abseiling

2009-04-12T08:31:00.000-07:00

We have been privileged to enjoy a lot of adventures. Yesterday offered yet another one. Coach Tolar offered to take some of the teens abseiling. In the US we often call it repelling. I came along as driver, chaperone, helper, and participant. Hannah, Sterling, and Camille were some of the teenage participants.

The drive to the 150 foot high rock face was not long. It is near Miango, where we have often gone in the past. Double click on the image to enlarge. You will see the people at the bottom.

At the base Coach Jay Tolar briefed us on technique and safety.

As an aside, we cannot praise Coach Tolar enough. The kids all love him. He is a huge asset to the school. He directs all of the athletic programs, teaches physical education, and coaches the men’s teams for soccer, basketball, track and field, and volleyball. For physical education, he not only involves the kids in the basic sports, but for the seniors he includes archery, shooting, and abseiling. Not only is he a great teacher, but he is a great role model. He is man of deep faith and he emphasizes good character and integrity in all activities. Because he has both challenged and entertained our children, their experience here in Nigeria has not only been enriching, it has been fun as well. He has consequently been very instrumental in making this year a success for our entire family. We are very grateful for his outstanding leadership. In my book, he is the coach of coaches

The usual way down the mountain is back first. Camille had her first trip down in the usual fashion.

Hannah was the most experienced abseiler amongst us, since she had been up on the rock with the senior PE class. She was fearless. She preferred coming down the mountain “Aussie” style, i.e. face first.

By the end of the day, the Mitchell family was able to come down together Aussie style.

Michael Mitchell, MD

Motorcycle Mayhem Continues

2009-04-08T12:50:00.000-07:00

Today I once again spent a Wednesday afternoon trying to piece together the face and jaw bones of a motorcycle victim. Today’s patient is a 60 year old gentleman who was hit by a passing motorcycle. He had multiple fractures of his facial bones as well as two jaw fractures. In addition he had brain fluid leaking out of his ear for the first few days after the injury. Fortunately the leak stopped on its own, as it usually does. In the operating room, I managed to piece his upper jaw together, wire his upper and lower jaws closed, and put a titanium plate over the fracture line in his lower jaw. I used the manual hand crank drill that we dusted off and tried for the first time. Overall, it was a long afternoon as we sweated away in the muggy operating room.

The man in the photo is a 48 year old man who was riding his own motorcycle and had an accident. He fractured his left ankle in addition to also having brain fluid leaking out of his right ear. Again, his leak stopped spontaneously. He was in our clinic this morning for a follow up visit. He initially hobbled in with the help of his family members. I asked him, “Where are your crutches?” He had purposely left them in the car, for some undisclosed reason. A family member brought them so he could leave my office on his own accord. The crutches were brand new; he just got them from the carpenter yesterday. You may notice that they are wooden and not exactly the same size. He paid 1,400 Naira for them, which is almost $10 at the current exchange rate. The aluminum crutches are much more expensive to purchase.

Michael Mitchell, MD

Epidemic of Deafness

2009-04-07T13:31:00.000-07:00

One of my great concerns are the number of deaf patients I encounter every week. Today was an exceptionally bad day. Of the 28 patients I saw today, five wanted something done for their deafness. They were as follows:

1. A 45 year old man was also treated for a febrile illness and came up completely deaf.
2. An 18 year old well dressed young man was treated for a febrile illness with antimalarial drugs. After taking the drugs for five days he could no longer hear.
3. A six year old boy had meningitis in early March. After he had recovered from his meningitis, he was deaf.
4. A two year old boy has never been able to speak or hear according to his mom. Though she admits that he did have a severe illness when he was one year old.
5. A four year old boy was treated for severe infection with unknown drugs in an outlying hospital two months ago. He has not been able to hear since then.

Most of the patients I see have preventable causes of deafness. In the developed world, we have vaccines to prevent meningitis and measles, but most Nigerian children do not get all the vaccines that are available in the developed world. In the West, we rarely use a toxic but effective antibiotic called gentamycin, but here it is used very commonly and blood levels are not monitored as we would do in the West. In America, the Food and Drug Administration and our legal system keep our drugs safe and pure, but in Nigeria NAFDAC (the FDA equivalent) is not able to keep the drugs safe.

The impure drugs are most concerning to me. Many patients have told me that they took an antibiotic like chloramphenicol or an antimalarial like fansidar and have subsequently lost their hearing. These drugs should not cause hearing loss. I strongly suspect, though I have yet to be able to prove it, that the drugs have been laced or even replaced with an antimalaria drug called quinine which is toxic to the ear. Unfortunately, it is hard to prove without the actual drug in hand that caused the hearing loss. I have only had one patient who stopped taking the drug immediately and brought the unused drug back to me. We have sent the drug for testing.

I estimate that I have seen at least one hundred patients with preventable deafness. I know I am only seeing the tip of the iceberg. There must be tens of thousands, if not hundreds of thousands of deaf patients in this country of 140 million. The options for the hearing impaired are limited. If a patient has enough hearing left so that a hearing aid could help, there are few places to get aids (our hospital being one of them). In America, a cochlear implant is an option, but this costs $40,000 to $50,000, which is almost a lifetime of earnings for most Nigerians. To make it even less accessible, the surgery is not done in Nigeria, but only in developed countries. Consequently, all I have to offer patients is that they try to find some of the few resources for deaf patients and learn sign language. I find this most unsatisfactory, and I wish I could offer them more.

For now, I do my best to try to educate the doctors that come through my department and let them know that there is an epidemic out there. Most Nigerian doctors seem unaware of the problem, since the deaf patients don’t return to the doctor who prescribed the medicine that made them deaf.

Michael Mitchell, MD

Bargaining 101

2009-04-07T12:27:00.000-07:00

I don’t know if my mom has talked about shopping with Alphonsus, our driver, in past blogs, but after having had the joy of shopping with him this afternoon, I feel the urge to document it. He’s a funny guy. Getting to the point, this afternoon Alphonsus and I went shopping for soccer cleats and goalie gloves. First of all, Alphonsus is a funny character. He definitely has spunk. Even though my mom is his employer, he doesn’t hesitate to voice his opinion and is also very stubborn. These traits come out particularly in his car-washing habits and in shopping.

Anyways, we went out shopping at Terminus, the downtown market. Now I know absolutely nothing about soccer gear because I’ve never bought it before. Being in Nigeria didn’t really help with knowing what to expect either. So needless to say, I got as much info as I could from fellow students and asked Alphonsus as many questions as possible before we got to the store. But as soon as we arrived, I was immediately unsure of what to ask for. I had been quietly hoping that Alphonsus, being a soccer coach in his free time, would know what to ask for and what price to pay for it. At first he did what I was hoping he would do. He showed me the two types of “boots” that I could buy; my choices were “hard boots” which were cleats with hard plastic or metal spikes or “soft boots” which were cleats with spikes made of the same rubber that bottom of the shoes were made of. Now hard boots are higher quality and thus more expensive, but because of the poor quality of the alternative, I thought that they would be best. Oh, and just as a side note, Alphonsis is very stingy. But getting back to my story, as the guy selling the shoes and gloves named his price, Alphonsus got very quiet. I did my best and managed to barter the sales guy down 2,500 naira from his original price. When I asked Alphonsus if that was a good price he responded with a grunt that I assumed at the time meant yes. So I bought the shoes and gloves.

Then we got into the car. : )

As soon as the door of the car shut, Alphonsus proceeded to tell me how I had been ripped off and how I was “too quick to take the price”. Now before I got in the car I was feeling pretty good for bartering the guy down that much, but by 30 seconds after getting into the car, that happy feeling had diminished to a shame for how much I paid (which I had thought was fine but I guess not). Thinking back though, I was a bit frustrated that he didn’t say anything in the shop. But I guess that’s not in the culture. Sterling told me a similar story of when he bought a jersey at the market and received a similar response from Alphonsus and Shadrack, one of the neighborhood boys. I guess it’s just one of the life lessons that I’m learning for shopping in Nigeria. Never settle, barter your heart out, the price can always be lower.

Hannah (18)

An Answer to Prayer

2009-04-05T08:44:00.000-07:00

As the time gets closer for us to leave Nigeria, I get both excited and sad all at the same time. With the hot, humid weather before the rains begin, home sounds especially good: green grass, beautiful flowers, cool weather, and easy living with lots of consistent electricity and clean water. But I also feel torn because of the loved ones we have made here. One of those loved ones is our housekeeper Asabe.

Asabe is a lovely Christian lady. If ever there could be a Nigerian equivalent of Gunda Mitchell, it would be Asabe. She is always dressed immaculately even though she is doing dirty work, is graceful and charming, is deeply devoted to her heavenly Father, and even has a laugh a little like Mom’s. But most of all, she cleans German style! If you have ever been to Nigeria or Germany, you would know how unlikely that combination is! Asabe is a pleasure to work with. Ever since my first cook left, I have gotten to know Asabe better (in spite of her moderate English skills!)

Asabe has survived two husbands and has 6 children, 3 of which are at home and rely on her paycheck. She has modeled many things to me: sacrificial giving during the crisis when she opened up her home and shared what little she had to people left homeless by the rioting, and a cheerful spirit despite some of the difficult life experiences she has undergone. I have been very concerned for Asabe as the time has gotten closer to our leaving. Jobs are hard to find here. I have been praying that God would provide a new employer for her so that there would be no gaps in her income like there was before she came to us.

My househelp and I were all rejoicing this week when God answered this prayer! A new family has come to Jos that I met at our orientation in Charlotte, NC this past May. Asabe has already started working for them one day a week and will begin working full-time as soon as we leave. The new family was willing to wait for her because she is such an excellent employee. What an answer to prayer!

Lisa

Fishing and Hippo Watching in the Heat

2009-04-04T14:01:00.000-07:00

Sterling and I just got back from a short fishing trip that was short on fish, but tall on tales. We headed south off the 4,000 foot plateau that we live on. It was quite the adventure. No one knew of any rod and reel fishing on this lake in recent times, but apparently there had been some kind of fishing tournament on the lake that was last held 13 years ago. We set out on a three hour drive hoping to catch Nile perch, which can weigh up to several hundred pounds.
Things were not as we had hoped. There was no easy access to the lake with bank fishing as we had hoped. Last night was spent in tents with an outside temperature over 90 degrees farenheit, no wind, and much humidity. Today warmed up quickly to over 100 degrees. We fished some this morning, but without a bite.
On the good side, I got my first ride in a dugout canoe. We had great company. We did see hippopotami in the water and monkeys in the trees. We successfully warned some of our guys to get out of the way of some of the hippos on the move. Hippos are very aggressive and more people die in Africa from hippo attacks than from any other animal. We had more uniquely African experiences.
We were quite happy to drive back this afternoon and leave the 100 degree temperature. We came back onto the plateau to the first rain of the season. It has been over four months since any rain has fallen. It was 65 degrees while raining. Ahhh! We like the cool and the rain.
Michael J. Mitchell, MD

Hannah the Hillcrest goalie?

2009-04-04T08:43:00.000-07:00

I don’t know if it has been mentioned in the past but for the first half of our time in Nigeria, Emily and I played soccer with the neighborhood kids on the field in front of our house. Emily played a lot more than I did, but whenever I did play I really enjoyed the game. Recently it has become so busy that it’s hard to find the time to get out and play with the boys but I still enjoy the game. Anyways, jumping back to the present, soccer tryouts were this week. I can’t really call them tryouts because the team has a no cut policy, but needless to say I made the team. I actually first kind of got the idea when Coach Tolar approached me at school and asked me if I would be willing to be goalie for the girls team. Michelle Palmer, the girl who usually is goalie for the Hillcrest girl’s team, has an injured knee this year and consequently did not come out for the season. So after Coach planted the little seed in my head I got to thinking about trying out and decided why not? There’s a first time for everything right?

So, Wednesday was the first day of practice and it was pretty fun. The field players did their own drills while I did goalie drills. I got out of a bunch of running. Being a goalie is pretty tough on your body though. Just so I could be up to par, I did a couple pre season practices with the goalie from the boy’s varsity team. After one afternoon I was pretty cut up from the ground we practiced diving on. But I guess it’s just part of the job.

But what’s even more crazy is that it looking like (this is based entirely on my own observations, so I can’t say it with 100% certainty) I could be starting goalie for the Hillcrest girl’s team. Our first game is in about 2 weeks, which gives me that long to get good at being goalie. I just hope I can live up to being a starter. So far I have shown my newness to the sport very well. So, we’ll see.

Hannah (18)

Women's Sport? I Think Not...

2009-04-02T10:40:00.000-07:00

Yesterday, Hannah and Dad convinced me to participate in this season’s sport, volleyball. Yesterday was also the first practice of the season. About eighteen boys showed up for tryouts although the tryouts may not even be tryouts after all. At this point we are not sure if we are going to have two teams or not. Coach wants to split up into two teams but at this point we do not have a coach for the second team. The season will be very short and due to various school activities we will be limited to only twelve practices the whole season. We have about the same number of matches to make up for it though.
Sterling (16)

Back to School

2009-03-30T22:33:00.001-07:00

Today is the first day back to school after an uneventful but nice spring break. For most of spring break none of my friends were in town so I spent a little time reading The Shack but most of my time was spent bonding with my Xbox. Wednesday through Friday we spent out at Miango along with my friend Jacob whom we brought with us. During the time we were there we played tennis, talked, ate, and slept so overall it was an enjoyable time. The last exciting thing that happened over break was me having Jacob and my Lebanese friend Jad over for the night. At some point during the conversation Jacob and I realized that these hangouts of ours are very numbered. We only have eight weeks left in the country. We are excited to come back home!

Sterling (16)

I before E except after C . . .

2009-03-30T08:23:00.000-07:00

Remember that old elementary school chant? After continuing to see misspelled words like “receive” and “relieve”, I decided to teach this old rhyme to my students. I was afraid it would be a bit too juvenile. In class, I had them say it in unison over and over again. The students, who are in their 20s and up, were amazed that there was one simple spelling rule that solved this common spelling problem!

I was quite shocked though when one of my students immediately started ranting a little to the class and me in response; he is normally a quiet, respectful guy. With restrained anger, he expressed his feelings of frustration at the Nigerian school system. What I had just taught him was so helpful, so simple. He repeated what I had just told him, that every American child knows this rule by heart. Yet not one person in the classroom had heard this rule before!

These young men are working so hard to improve their English; it is the key to better jobs and the key to further education. Few materials are written in their native languages, and trained teachers who are native speakers are a rarity (I am the first Western teacher most of them have ever had.) I tried to encourage this student, reminding him that we Americans have had hundreds of years to observe the patterns of our language and pass them onto others. His country just needs more time! His country could also use a few more teachers from the West who would be willing to share their expertise.

The very next day, I was unexpectedly encouraged by a different student to continue doing my job. I passed George in the library and complimented him on the great job he had done in church last Sunday. He had sung an original song he had written in English. The student just smiled at me and said,” See Ma, what you give to us will come back to you!” I was quite pleased to think about what he was saying to me: by helping my students improve their English, I get to enjoy, along with the Nigerians, original worship music written by a local. Pretty cool thought!

Lisa

Senior Trip in Ghana

2009-03-29T06:00:00.000-07:00

So this past week I got back from my senior trip. Senior trip is a trip that the senior class takes together every year over spring break. In years past, the class would just go somewhere in Nigeria, but for the past ten years or so the classes have vacationed in places outside of the country. This year the class went to Ghana. Originally we were realistically looking to go somewhere like Gambia or Dubai (I don’t know if I spelled that right and I’m too tired to look it up, haha) but because of some bad decisions on the school’s part and the economy crash, we only made it as far as Ghana.

However, as disappointing as it was that we had to go to Ghana like all the classes before us, we still had a lot of fun on the trip. Most of the time was spent getting to where we wanted to go but it was fun. All the bus trips definitely gave the class time to bond with each other. We spend a night in Abuja so that we could catch our early flight in the morning. Then we spent a night in Accra, Ghana after coming in on an early afternoon flight. In Accra we got lots of time to shop and enjoy the slightly more developed society of Ghana. From what I saw, Ghana is still West Africa, but with a few more western influences. Anyways, from Accra we went on to some random little vacation spot called Big Milly’s. That was nice for the girls, but all the guys got crammed into one room so they didn’t enjoy it much. But since I only had 4 roommates, I liked it. Plus, the beach was amazing. I swam pretty much the whole two days that we were there. Then we went on to another fancier resort called Coconut Grove. On the way we went on a tree walk thing and saw an old slave castle called Elmina, both of which were pretty cool. But Coconut Grove itself was really nice. There was a nice pool and I got to eat Calamari for the first time in however many months. It was sweet. Then coming home we stayed in Accra and Abuja again.

But overall, the trip was definitely worth it. It was some free time to just cut loose and enjoy everyone in the class.

Hannah

One hundredth ENT Surgical Patient

2009-03-23T14:26:00.000-07:00

I have been keeping a log of the patients that ENT (Ear, Nose, Throat) department has been taking to the operating room. On Friday, we had our 100th patient since I have been here. I have been involved in most of the ENT surgeries, though not all.
John is a seven month old boy who was strapped to his mothers back while riding a motorcycle taxi. The motorcycle took a tumble and so did mom and baby. There is a very nasty wound under the bandage with exposed bone and tissue loss (much of the eyelid gone). I was able to do some plastic reconstruction to close the wound and graft the eyelid. We pray that it will heal well.
Michael Mitchell, MD

Missing Charlie Brown

2009-03-22T11:54:00.000-07:00

My friend Jacob and his family are spending the weekend in Abuja. As a favor we (primarily me) are taking care of their dog named Rocky. Owning a dog is not such a walk in the park as in America. Along with Rocky the Naatz’s left us his “toys,” which are a plastic bottle and a toy fire truck. Rocky is a lot like Charlie besides the fact that he is a Rottweiler. He is smart and playful but not quite as trained as Charlie. Having him around has reminded us of our dog waiting for us at home. We are looking forward to getting back and seeing our missing family member.
Sterling (16)

Spring Break Begins

2009-03-21T09:42:00.000-07:00

It’s March 21st and everyone is on spring break now - -Hillcrest and JETS, so the kids and I are all home. I for one am glad for the break; I always enjoy my students, but I am glad to have a reprieve from the grading!

I have felt especially tired and needy of rest lately. I was pondering why I felt so tired. After thinking about the week that is now behind me, I realized why I am feeling so tired. I thought I would share some of the things that have happened this week with you, just so you can know a little more about our daily lives and the stresses we are facing regularly. Michael has his own equally long list!

In the past week, I have:
-spent at least 20 hours grading and lesson planning.
-spent 6 hours in the classroom.
-taught trumpet lessons for a short time at Hillcrest.
-managed 4 household helpers and fed them lunch daily + our two Nigerian boys (for most of these, it will be the biggest and most nutritional meal they will eat all day.)
-managed a household of 6 and made sure they were fed daily.
-hosted a dinner for our Nigerian pastor and his family of 6.
-hosted a dinner for some new missionaries, a family of 5.
-gathered food for a widow I know who is a supporting 4 children at home and who had little to no food in her home.
-helped set up a consult for physical therapy for a student who was left crippled from a medical injection; this same student desperately needs a new pair of crutches and cannot afford them, so I am pursuing that as well.
-met with another missionary who is also teaching English; we talked about materials and lesson ideas.
-went with my workers to investigate a noise just on the other side of our compound wall. Asibe, my cleaner who has had 6 children of her own, heard the sound of a newborn baby crying all morning. Emily heard the baby the night before. We drove around to the girls’ hostel behind us and met with the principal to search the grounds for an abandoned baby. To my great relief, we found no baby and no signs of foul play in the field behind us.
-dealt with numerous requests from students. Many of them are quite upset that I will not be returning to JETS in the fall and different ones stay behind class daily pleading with me to see if they can change my mind! Others are begging me for help so that they can continue improving their English after I’m gone and are asking me to direct them to materials.
-got signed up for summer classes for my masters at Concordia University.
-got Camille’s paperwork for the International Baccalaureate (IB) program at Columbia River High School sent in. Actually, I accidently missed the deadline by 2 months, and she is now on a waiting list. That is a prayer concern!

I feel very pulled in many different directions and the stress is definitely taking its toll. The needs are almost overwhelming at times. Please continue to pray for us over the next couple of months as we begin to prepare for our return home. We have one foot on each continent now. Emotionally, it is quite difficult. We will be leaving loved ones behind, especially our workers who may or may not be able to find work after we leave.

Lisa

Northwesterners and Their Frappucinos in . . .Africa?

2009-03-20T14:19:00.000-07:00

This evening we had the pleasure of hosting a new family to the area: Gary and Kimberley and their 3 young daughters. They are also from Washington, from the Seattle area. Gary has just come to Hillcrest International School as the librarian. I personally am excited about having a real librarian in town! They are a lovely family, and I look forward to getting to know them better in the months we have remaining here in Jos.

We had a lovely time talking about many things, including unique things to Washington and the Northwest that we are both familiar with. It was kind of strange to be sitting at a table in Jos, Nigeria discussing things like Clark College, Burgerville, and Starbucks and to have someone know exactly what we were talking about!

When planning the menu, I knew just what dessert to have for these guests . . .Frappucinos! And as evidenced by the pictures, I was absolutely right. Jordan, Cypress, and Isabel could hardly wait for their decaf drinks. Oh yeah, it’s obvious they are from the Northwest all right! They start young, and they gotta have that coffee!

One of the first things I did after coming to Jos was to improvise a frappucino recipe with the ingredients on hand; it was just too hot to have midday regular coffee. It all started with my pet peeve about wasting things. Michael continued to make too much coffee in the mornings. I have always fussed about this in the past. But now, we were hand carrying coffee beans from the U.S. and were continuing to pour coffee down the drain in the morning. What do you do with too much coffee in Africa when every drop counts??? Isn’t the logical conclusion to pour it into ice trays to be used later? (Okay, my family didn’t think so either! I was teased quite a bit.) But now, they enjoy those frappucinos. Actually, our neighbors enjoy the frappucinos. As word got around that the Mitchells have daily frappucinos, the whole mission community enjoyed them at the senior class Valentine’s Day fundraiser thanks to Hannah. Now the gospel of Starbuck’s Frappucinos is even spreading to Nigerians: my cook, housecleaner, and driver like them. (Actually, my driver’s comment in Hausa after he eagerly slurped down his glass was something to the effect of “the bature are killing me with all their good things!” Even Victor, our 10 yr. old “adopted” son, shows up daily in hopes!

Now all we need is an enterprising young Nigerian to come in and take advantage of this market that’s been created!

Lisa

Field Trip to Zaria and Kaduna

2009-03-15T10:52:00.001-07:00

Zaria and Kaduna are a couple of the larger cities in north central Nigeria. They are in Kaduna state. Over the past several months I have been sending some of my cancer patients to Zaria for radiation therapy. Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria is a large academic center with radiation and also a large maxillofacial surgery department. Those are both services that are not here in Jos. Since, there are no yellow pages in Nigeria, and it is difficult to make phone contact, we chose to make an onsite visit. We also wanted to see the National Ear Care Centre in Kaduna, one of the more advanced centers in Nigeria.

Jay Maxfield , a short term missionary dentist, came along to see the maxillofacial unit. Ben Babson our audiologist (far left) and Audu, our ENT nurse (far right) came along as well. On Thursday, March 12th, we left for Zaria, a three hour drive away at the end of a very bumpy highway. Nigerians call potholes “gallops”. We did a lot of galloping to Zaria. We were able to have brief conversations with the heads of the two departments we were interested in. On the way out of town, we drove around the nearby Ahmadu Bello University campus, where there were quite a few HIV awareness billboards. We then drove an hour south to Kaduna, where we spent the night.

At the National Ear Care Centre, I had the privilege of giving the grand rounds lecture in the morning. As evidenced by the photo, the chairman, Professor Ahmed, found the talk more interesting than one of the other consultants. We were then given a tour of the facilities. The campus is basically a hospital dedicated to ear, nose, and throat care. They have two new operating rooms and a six bed ward where patients stay after their surgery. They are not yet comfortable with the concept of same day surgery, since many patients come from far distances. There is some very nice state of the art equipment there. They are still working to renovate some buildings and get some essential services going. One such service is audiology, (hearing tests).

At the Ear Care Centre, Dr. Kodiya was our primary host. I got him to show off some of his advanced equipment. At the end, we had a stimulating conversation. His frustrations are not unique. In Nigeria, there are definitely challenges to providing care to poor patients in a government funded system. Often there are gaps in essential personnel and equipment, making it difficult to provide much quality care to those who need it.

Michael Mitchell, MD

Flesh Eating Bacteria: ENT Tropical Version

2009-03-11T12:47:00.000-07:00

Since early February, I have been busy with a patient who has an unusual type of infection. The inside of his nose and left sinus is being eaten away slowly. He first showed up last month after he had such a bad nose bleed that he required transfusion of 15 units of blood. By the time I evaluated him, I could see the normal structures inside the left nose were gone. Over the course of the next couple of days, it was apparent he had some kind of infection slowly eating away from the inside out. It has taken some time to get a firm diagnosis, partially because of our limited lab support and partially because of my inexperience with a rare tropical disease. I am now fairly confident that he has a condition called rhinoscleroma which is caused by an unusual bacteria. For an American ear, nose, throat surgeon it is an obscure disease that is mentioned in one paragraph in our American ENT (Ear, Nose, Throat) textbooks. Something we were tested on, just to make sure we read the book. It is very rarely seen in the US, and then only in patients who have come from third world tropical climates. It can be treated with some common antibiotics and surgery, but not before significant damage has been done. He will need to be on antibiotics for six months, and even then the infection can recur. Today he went back for another surgery to remove dead bone and tissue from his nose and sinus. He now has a hole in the roof of his mouth. I am optimistic that we can control his disease now. If left untreated, it could eat away his cheek and nose and spread to other more vital structures in the head or airway.
This has been quite a trial for the patient who lives a three hour drive from here. He was going to be discharged at one point when he was looking better, but then by a miscommunication he did not take antibiotics for seven days. This is not uncommon when working with patients who do not speak English and who are unfamiliar with western medicine. He got much worse. He initially did not want to be admitted and treated again since he was already having a tough time paying his $500 dollar bill for 25 days in the hospital and three surgeries. We agreed to help him with our ENT Poor fund and he agreed to stay and undergo more surgery.
It is interesting that the Evangel Hospital ENT department is not new to the family of this patient. In 2005, his then two year old nephew’s life was saved by Dr. Joel Anthis, when Dr. Anthis removed a nail from the esophagus that had been present for many months. Many of our friends in the states have seen the chest x-ray image of the boy when we showed the Anthis video. Our ENT department is certainly well known to one family in Nigeria.

Michael Mitchell, MD

Marketing 101 – A Business Venture

2009-03-09T07:44:00.000-07:00

You have heard us talk about Victor and Gwokman a lot. They are two young boys on the compound, ages 10 and 15 respectively. As the time gets closer for us to leave, I have been concerned for these two who have become a part of our family. I had the idea of trying to help them start their own business so that they can generate a little income and help their single mom who is raising 6 children, 2 of whom are her niece and nephew.

The boys are already selling eggs from their chickens. We are trying to expand this business. In addition, we are adding selling whole wheat flour since most of the missionaries make their own bread. There is only one store in town that sells whole wheat flour already ground.

Our first trial was a success! My driver bought 10 mudus of wheat kernels, and then my housekeeper showed the boys how to wash it and separate the stones out of it. (It was very cute to see the boys washing and drying the wheat.) After several days of first gathering, washing, drying, and having the wheat ground, the big day finally came: bagging the wheat and going door to door selling it.

First, with a pen and paper, I gave the boys a little business lesson. We tallied up our expenses and figured out how much we would have to sell each bag for to make a profit. Once the price was set, we then moved onto a short lesson in marketing strategies. I coached them on what to say, and why they needed to say it. (In this culture especially, they had to emphasize that Mrs. Mitchell had helped them, that the wheat had been washed 3 times with clean water, and that the wheat had been packed in clean bags from America.) I coached them on how to increase their pool of customers and how to give good customer service. Before I turned them loose on the community, we rehearsed several transactions with them knocking at the door and going through their speech. Victor, who is a born talker and quite charming, is a natural salesman. They laughed out loud as I pretended like I was an old lady and hassled them when they didn’t give enough information about their product.

I was very happy when the boys came back a short time later with all of the bags of wheat sold. And they were ecstatic: 350 naira of profit ($2)! It’s been two days since then, so I asked them today if they had spent their money already. Yes, was the reply. But it was not your typical frivolous expenditure, by any means. They spent all the money on tomatoes to put in their soup . . . After telling me this, Victor quickly asked me when we could go and buy more wheat so they could do it again. What a different response from what I would have expected from my teenage American son. What a joy these boys have been in our lives!

May God bless their business!

Lisa

Hillcrest School Carnival

2009-03-07T10:23:00.000-08:00

Today was the one of the long awaited Hillcrest Carnival day. The school has an annual carnival complete with cotton candy, ball tosses, forty foot high zip line, and many other activities. It is anticipated every year by the Hillcrest School community. The carnival is put on every year by the Sophomore Class (and their parents) as a fund raiser.

A few days ago I was volunteered by Sterling to cook hot dogs for the event. Sterling worked the basketball shooting game. Hannah helped with the zip line. Lisa helped with bussing tables. I grilled 400 hot dogs over four hours.

It is a fun event for all. It provides a meeting point for the community as well as entertainment for the kids, since options for family entertainment are rather limited here. It is also fun to see all the different nationalities and cultures come together.

Much Thanks to Dr. Doug Myers

2009-02-28T12:56:00.000-08:00

Dr. Doug Myers left today. He is a practicing ear, nose, throat, surgeon in our hometown of Vancouver. He was here for almost the entire month of February. He was a great help and had some great outcomes with his ear surgery. He operated on one woman with severe hearing loss in both ears. She could only hear people if they would shout. The morning after the surgery she could hear whispers. Another gentleman jubilantly proclaimed that he could now get rid of his hearing aid. His assistance and advice were most appreciated.

Doug assisting me on a "jaw wiring"

I also enjoyed getting to know Doug better. It has also been fun to relate some of the rewards and challenges of our service here. In other words, it is nice to be able to talk “shop” with someone who can appreciate what I am saying. We have a growing number of family and friends who can totally relate to the transition from Vancouver to Nigeria.

Doug and I on a hike near Miango.

Michael Mitchell, MD

Medical Outreach to Kamrum

2009-02-27T13:49:00.000-08:00

Kamrum Outreach Team

Emily and I celebrated her 20th birthday on Thursday, February 19th in a very special way: by going on a medical outreach to Kamrum with our neighbor Dr. Don Sampson. (Michael and the other kids stayed at home.) Emily and I were prepared to tent camp at our destination along with our other 20+ team members. We were actually spared of that though. In fact, we shared a bedroom and had a bed and a toilet down the hall. (Mind you though, there was no running water in the whole house!) A well-off retired man in town graciously opened up his home and hosted us.

It was a big deal that foreigners were coming to the village (people from another place), much less that some of the foreigners were white! The whole village turned out the first night; the women and children danced for us to the drums. The children were especially ecstatic when Emily and I got up and allowed them to coach us on how to dance their way. One boy was so excited about how I danced that he told me I couldn’t leave the village; I belonged with them!

Dancing welcome was warming up

The next morning and again on Saturday, Emily and I participated in the outreach by filling prescriptions. Medical care is the honey that draws the villagers from all around. They come to see the doctor and get medicine. Before they can get their prescription filled, however, they must meet with a counselor. The pastors that came along were very friendly and talked and prayed with each individual about their spiritual health as well as their physical.

The "pharmacy"

In addition to the medical care that was offered, another team came and provided a live worship band, outdoor movie, and guest speaker. The soccer field was packed with people dancing and singing and laughing. We learned later that the village does not usually turnout like that for locally sponsored events.

Emily and I both had special friends that we made on the trip; mine was a young Fulani woman. I looked up the first day from the pills I was counting to find two young mothers with their babies strapped on their backs gazing at me intently and openly gawking at me. I looked up and smiled and they giggled to each other and continued to look at me in wonder. (Many Nigerians we encountered on the trip had not seen a white person before.) One of the ladies was bold enough to come up to me and signal for medicine for her head that was hurting. (Later she started walking down the road with a 30+ pound sack of grain on her head and a baby strapped on her back so fast that I couldn’t catch up to her - - no wonder she had a headache!) We weren’t taking anymore patients that day (we’d already seen over 200), so we told her to come back the next day. We actually ended up seeing more than 500 patients over the course of the two days we were there. Patients waiting at 8:30 am

I woke up and prayed in the night specifically for this one girl. She touched me for some reason. Fulani keep to themselves and are very resistant to hearing the Gospel. I was very excited when she came back alone the next day to me specifically. We had stopped seeing patients already again, but I was able to get one of the doctors to see her. My friend agreed to be counseled and hear about Jesus. She promptly came back to me and just pulled up a chair and sat next to me for a long time just watching me. It was precious. Only the Lord knows what seeds were planted that day; I would love to find out one day!

Our trip concluded with a visit to the village chiefs and important men. The village musicians, this time horn players, turned out to send us off. Especially touching were the village women that gathered around our vehicles and began singing and wouldn’t stop until we finally drove away. Nigerians really know how to make you feel welcome and very special!

Lisa

Chiefs and our gracious host

Farewell send-off by the musicians

The women singing for our farewell

Best Teacher Gift Ever!

2009-02-26T10:40:00.000-08:00

Just last week, a student came up to me and asked if I would like a local bred chicken. I was amused by the fact that in America, students show their appreciation with apples; in Africa, they show their appreciation with chickens. My mouth just watered at the thought of receiving a nice plump, hormone-free frozen hen ready to cook. I told the student they could just bring the chicken and put it on the concrete floor because I would take it home right after my last class. I don’t think the student got that part . . .

I was quite surprised at the end of my last class to turn around and see a student holding a living chicken, upside-down by its feet in my doorway! The chicken calmly sat on the floor of my Toyota Sienna van for the ride home while I pondered what to do with this fine gift. . .

My driver knew just what to do with it! He got his pick of the chicken pieces, and the rest of us, workers and all, enjoyed some tasty fried chicken. Alphonsus got a good laugh first though when Hannah suggested that we make a pet out of the chicken and name it Sally.

I am jealous of all the cool, dramatic before and after pictures my husband has from the O.R. I decided to take my own before and after pictures . . .

Lisa

Sally - Before

Sally - After

Another Life Saved

2009-02-22T12:40:00.000-08:00

At 9 pm last night Dr. Aboiyar called and said there was an 18 month old boy who had probably aspirated a bean and was in respiratory distress. He needed to go to the operating room as soon as possible. I happened to be coming home from picking up Emily and I was driving by the pediatric ward just as I was talking to him. I stopped the car and sent Emily home with the car.
The boy was in the intensive care unit and struggling to breathe. His chest collapsed with every effort to inhale. He was clearly getting tired. Two days prior to this, he was at his grandmothers’ home in Lantana, a four hour drive away. He coughed and had difficulty that night, but they waited to take the boy to Jos on the next day. He was initially admitted and observed in another hospital here in town. He was not improving, so they recommended that he be evaluated at Evangel Hospital, recognizing that we had the necessary equipment to manage airway problems. Thus he arrived 48 hours after choking on what was presumed to be a bean.
Dr. Aboiyar and I quickly set up the operating room and broke out the very specialized scopes, which were supplied by Dr. Joel Anthis when he was here 2003-2006. With careful coaching of our anesthetist, we were able to get the child asleep and get a good look. Something like a fishbone was lodged between the vocal cords. The vocal cords were now red and swollen. The voice box was starting to get infected by the foreign body that was lodged there. The airway was truly in jeopardy.
Dr. Aboiyar was able to deftly remove the barbed fish spine and then visualize the windpipe and make sure there was no other fishbones lodged deeper in the airway. After removing the fishbone, the child was breathing slightly better, though he still had to struggle with a swollen airway. In the US, we would have left a breathing tube in place overnight, but our pediatric intensive care unit at Evangel cannot take care of intubated patients. We simply gave him oxygen, antibiotics, and medication to relieve the swelling.
By this morning our patient, whose name is “Godswill”, was breathing comfortably. It was clear that it was God’s will that the parents have a young boy. It was also apparent that it was God’s will that Godswill survived this life-threatening event. We pray that Godswill will live up to his name and go on to do great things for God.
It has been a good day. We don’t often get to see such dramatic events in our specialty. It is a special bonus when I can see such immediate results. It is especially pleasing to me to know that we have equipped a Nigerian doctor to make a such a great difference in this community.

Godswill is bathed by his grandmother in front of his bed in the pediatric intensive care unit.

Left to right: Dr. Aboiyar, father, Godswill, mother, grandmother, me
Michael Mitchell, MD

Evangel Hospital is 50

2009-02-15T12:41:00.000-08:00

Evangel Hospital is 50 years old now.

We have been celebrating Nigerian style. There have been three days of festivities. The music has been remarkable. The speeches have been long. The memories have been wonderful and encouraging. We have had many guests from the past. Dr. Glenn Verbrugge, who was a surgeon here from 1974 – 1984 has come for the festivities. Dr. Phil Andrew of Australia was here from 1979 to 1994. He is a family practitioner who started the training program in 1989. It has been encouraging to see how far the hospital has come over the years, knowing that it will continue to progress with time and the dedication of so many people. Back when it started, Evangel had two doctors from the United States and for many years it remained a two doctor hospital. It took off in 1989 when the residency program started.

Now there are only five American doctors and nine Nigerian consultants who are graduates of the training program at this hospital. We have 18 resident doctors in training. Over 100 doctors have been trained at Evangel. Evangel is soon to be a teaching hospital for 23 medical students as well. We have many other nursing students and pharmacy students passing through. Though it is a humble hospital by western standards, this a greatly respected hospital in the region and people travel hours to receive care here that they know will be better than they can get anywhere else.

Adventures in the Classroom, Part II: Fun with Vocabulary

2009-02-14T19:53:00.000-08:00

Every week on Tuesdays, I assign my students 10 vocabulary words. These words are from a well-known list in the ESL (English as a Second Language) world. We go over pronunciation of the words and then the students are responsible for defining the word, writing the part of speech, listing other forms of the word, etc. in hopes that they will truly retain the word. Their vocabulary is an area that needs great improvement, particularly learning academic words that they will encounter throughout the remainder of their time in seminary. The only part of the exercise that I grade for errors is the 10 original sentences they must write using the assigned words. Grading 720 sentences a week is no small task!

The students eagerly flip through their notebooks as soon as they get them back. Using actual sentences from their notebooks, I target and address areas that I see need some work. It might be usage of the actual vocabulary words, commonly misspelled words, or writing tips in general. An area that I am especially targeting this semester is using the correct form of the word. (“He emphasized the importance of industry”, not “He emphasized the important of industry.”)

As you can imagine, I get some pretty interesting sentences and some lively discussions in class about them. My favorite story of the week involves the word “magnetic.” Many of the students used this word incorrectly in their exercise. At the board I had to tell them that “magnetic” does indeed involve two objects that are attracted to one another. However, care must be taken when the two objects are humans! Somehow

“A husband should be magnetized to his wife.”

just doesn’t quite work!

It amused me that though many students wrote this very sentence, the class as a whole instantly burst into laughter when I brought the matter up! They realized how funny it sounded out loud, but didn’t seem to think it was so funny on paper.

We have a lot of fun! It’s a joy to help the students in their struggle to understand the English language better.

Lisa

Tres Amigos (the three friends)

2009-02-13T22:10:00.000-08:00

Here are two of Camille's closest friends in Nigeria. Hopefully, I can get Camille to add to the blog and tell you about them . . .

A New Semester Begins at JETS

2009-02-13T22:04:00.000-08:00

We are now three weeks into the new semester (and the final one for me.) This time around, I am teaching two sections of first year English for the Bachelor students; in fact, I AM the freshman English department at JETS (Jos/ECWA Theological Seminary). Kind of a scary thought, actually! I’m sad to report that my colleague, Abi Hunt, has moved on. She and her husband are moving up to the Kano area in northern Nigeria where the needs are even greater, spiritually and academically. I am very thankful for the semester Abi helped me. I am feeling much more comfortable now dealing with cultural issues and am more familiar with the academic needs of the students. I could not have been an effective teacher without Abi’s help initially and am grateful to God for granting her assistance for at least one semester!

I currently have a total of 72 students. I teach on Tuesdays and Thursdays from 8 am until 10:45 am. Marking papers so far has been a real challenge. The students need as much individual attention as possible, but there are only so many hours in a day! I definitely need prayers as far as strategies to maximize their learning with the least investment of energy on my part. There is such a range in their abilities and age. Individualizing is another concern. I have to constantly be mindful of my student Nkwe who is completely deaf.

I spent the first semester laying a foundation with the students. This semester we are continuing to work on vocabulary building, the way English words are put together, and the way English sentences are put together. Now we are working our way up to the different types of sentences and writing paragraphs. I am beginning to see some improvement in their understanding and skill in using the English language. It just thrills me to see their progress!

Lisa

End of First Semester and Student Feedback

2009-02-13T06:51:00.001-08:00

I am just about to turn in grades for the first semester. A new semester has begun. . .

In an effort to improve upon my teaching methods, I offered my students an opportunity for extra credit by turning in a student evaluation form. All but one student took me up on my offer. Since our family and friends have made it possible for me to be at JETS (Jos/ECWA Theological Seminary) as a teacher, I thought I would share some of the results with you. (Jeanie suggested that I do this while she was here.)

I purposely did not edit the students’ writing errors; it will give you a little feel for their needs (and what I am working with.) By the way, only the cream of the crop make their way into JETS; these students are being groomed for key positions within the Nigerian church.

What did you like most about this class?

I like the method of Mrs. Mitchell teaching. She treated in an easy understanding. I am happy because I am one of her student. I like this class because all the student are faithfull to their studies.

I like all the activities and also the puntuality of the teacher. The teacher is so patient in answering questions and also been friendly thats good ma!
(Those of you who know me and my tendency to run late might get a good laugh out of that comment!)

The notes provided to us is just wonderful, and the way we students flow with the teacher is excellent. I also love the vocabulary, and the way you make pronounciation is really improving mine own pronouncement. I again love the practicals we do in the class because my personal problem with english grammar is my foundation.

What did you like least about this class?

nothing.

I like least about this class because of the improvement I had I don’t think I can forgate the class In fact almost I like every thing in this class it helped me much

Nothing bad about the class I love everything about her class from her to how she teaches is lovely she does it the Native English speakers style.

What do you think the teacher can do to make this class better?

She can carry on. And God bless her

I want our teacher to continue with her teaching method, and this will help me, my friends even at home to learn and have the experience in English language. This will give the pattern to have a practical English languages.

I want the teacher to apply here at JETS so that she could a perminent lecturer have.

Other comments? (Use other side of paper if needed.)

I personally want to appreciate God for having you as my English lecturer because your present has improved my English, and it also made an impact to my learning. Actual my words cannot appreciate you proper, but I know that God will reward you with his abundance blessings.

I thank God for helping the teacher to teach me well. I am glad that I belong to a class where the source of English Language originates.

I whan to tall you that, the impack which you have make in my life will NIVER BE IN VAIN

Please don’t stop helping us

Thanks again for partnering with me in teaching these students in the name of Christ! I am really excited at the progress I am seeing them make.

Lisa

Conclusion of Jeanie's Visit

2009-02-13T03:26:00.000-08:00

The most recent blog entries have been done exclusively by Michael. Though it’s been exactly two weeks since Jeanie left to go back to the U.S., I’m just now feeling caught up from the things I left undone while she was here. It was worth it though! What a special blessing to have her here with us. She has gotten a little bird’s eye view into our time here: a time that we will be talking about for years to come.

Jeanie had written a blog entry just as she left, and though I’m a little delayed in posting it, I thought you might enjoy reading a little of it:

It’s been very interesting and enlightening as to what my sister and her family do while living here in Jos, Nigeria. I feel like I know how to pray for them, the people they work with and minister to in a more effective and specific way. It’s amazing all that they do here. It’s nonstop activity from BEFORE sunrise to AFTER sunset.

I’ve enjoyed meeting many of the missionaries here and their kids..... So many people from different backgrounds working towards the same goal, sharing the love of Christ. So many different ways of accomplishing it too.

. . . What I’ve been so impressed with is how much more connected people are here. Our usual greeting to one another in the States is “How are YOU doing?” Here, they want to genuinely know how you, your family and work are doing. The people here are so warm and receptive.

It was a little tearful saying goodbye at the airport, but I trust that in just four short months, we will be greeting one another at another airport, this time in very far away Vancouver. Before that time, there is much work to do right here in Jos, Nigeria!

Lisa

Birthday – Lecture – Nigerian Thank you meal

2009-02-09T12:50:00.000-08:00

The past 24 hours has been pleasantly full. Yesterday we had a nice Sunday dinner prepared by Lisa, and to top it off we had homemade pumpkin pie. The pumpkin was local Nigerian, though they don’t look like our orange pumpkins. Since Hannah’s birthday is coming up on Wednesday, February 11th, we put candles in the pie and sang to Hannah. The kids are trying to make their voice quiver like Uncle Larry’s voice when he sings “Happy Birthday”.

I operated on an unusual facial tumor today and Dr. Doug Myer did his first surgery. He tested the operating room with a tympanoplasty (ear drum repair). I then gave a lecture this afternoon to the family practice residents. I have been getting a lot more exposure to the residents. I have two family practice residents rotating with me now and I had one last month as well. It has been a pleasure teaching them.

This evening’s dinner was provided by Mrs. Lilian Ibrahim, Victor’s mother and Gwakmon’s aunt. These are two boys here on the compound who have captured our hearts. Mrs. Ibrahim has done an amazing job at raising some lovely children. Over the past 10 years, she, as a single mom, has raised her three daughters, one son, one nephew, and one niece (six total) in a very modest two room apartment here on the compound. We have been trying to help the family in various ways. Mrs. Ibrahim has been very appreciative and treated us to a meal in her home this evening. We had pounded yam with peanut vegetable stew. You eat this with your hands, as Sterling is demonstrating. We also had moimoi, which is husked bean mush made into balls and then dipped in a red tomato sauce. It was a lovely evening with a remarkable woman who is living out her faith.
Michael Mitchell, MD

Fire Truck Water Delivery

2009-02-06T12:47:00.000-08:00

Our water problem is not resolved yet. Several months ago, our well was contaminated by the septic tank that was too close. Until a couple of weeks ago, we were getting water from our neighbors via water hose from their outside faucet to our ground water storage tank. The water was good, but the neighbors’ well cannot indefinitely support two families of six during the dry season. We supplemented by having our driver make one or two trips daily to another compound with a high yield well. He would fill up five 25 liter Gerry cans. He would then pour them into our ground storage tanks.
We at one point thought we were going to fix the problem by running a new pipe to a nearby hospital water storage tank on the compound. The construction was halted by politics. Some people were upset that we were getting access to water that they did not have access to. Our new tentative solution has been to get another large ground storage tank and fill all our storage tanks with a water tanker truck. We send our driver to make sure that a truck is filled with treated water from the “Water Board”, since there are stories of truck drivers filling their tankers with river water and then selling it as treated water. Our first delivery was two weeks ago.
The water lasted 12 days and by Wednesday we had gotten very low on water. We sent our driver again to hire a tanker. Apparently they are now in high demand and he had trouble finding one that was available. He somehow negotiated with a Water Board official, who arranged a delivery by a fire truck. Don’t worry, the driver assured me that they were leaving some water in the fire truck in case they were called to a fire.
Michael Mitchell, MD

ENT Help Has Arrived

2009-02-05T03:10:00.000-08:00

Dr. Doug Myers from my hometown of Vancouver, Washington has come to help me. He has been in practice in Vancouver for many years and has a wealth of experience. He is slowing his Vancouver practice and now looking for opportunities to serve. He arrived in Nigeria on February 2nd and will stay until February 28th. He is still getting over the jet lag and getting oriented to Nigeria as well as the hospital. He saw his first patient (pictured above) today and he will operate on him on Monday.
It has been great to have someone from home and I look forward to his help.
Michael Mitchell, MD

Busy in the hospital again

2009-02-04T20:38:00.000-08:00

Business in the hospital for the Ear, Nose, Throat department has definitely picked up again.

Monday, Jan 26

Excised this woman’s tumor. She never smiled for me before the surgery.

Nine days later she is not looking too bad. She was much happier and laughed with us when we joked around. Pictured with her is the baby that she was pregnant with in the first picture. We had to wait a few months until after she had the baby before we could do the surgery.

Tuesday, Jan 27

We had a busy clinic and then went to the operating room. An 8 year old girl aspirated a metal spring, which Dr. Aboiyar removed.

Friday, Jan 29

I repaired a broken cheek bone. We had some technical issues with our surgical drill, so we used the standby Black and Decker drill. Dan Reimer, a visiting American medical student, helped me with this case. Dr. Aboiyar was tied up with some administrative business.

Saturday, Jan 31, We drained a neck abscess in the operating room. (No pics.)

Monday, Feb 2 We had a full day in the operating room biopsying tumors and performing an extensive sinus surgery. (No pics.)

Tues, Feb 3, was an especially long day. We had quite a few patients to be seen in our clinic and we then had booked a surgery in the afternoon. Dr. Aboiyar was capably fixing a broken jaw in the operating room (using surgical techniques that he has learned over the past few months), I was still trying to see the last few patients in the clinic. At the end of the day, one man walked into clinic with a bandage taped between his eyes and blood stains all over his clothes. He had been hunting that morning in the bush. His homemade gun had misfired and the bolt flew back into his face. The bolt fell to the ground as did the patient, though he never lost consciousness. He was driven into town by his father. They first went to the outpatient clinic where they sat for some time in the waiting area to be seen. After he was finally seen, he was sent immediately to the ENT clinic. When I returned from my late and brief lunch break, he was waiting. I called for him right away and he staggered to the exam chair, where I removed his bandage. He had a large hole between his eyes -- large enough to put a thumb in. He had no vision in the right eye. I took pictures, but they are too graphic for this forum. We took him to the operating room immediately after finishing with the boy with the jaw fracture. I debrided and closed the wound and finally got home for a late dinner with our new guest and my help, Dr. Doug Myers.

Michael Mitchell, MD

A Birthday Gift from God

2009-01-28T12:39:00.000-08:00

Today has been a memorable birthday for me. Our schedule and Jeanie’s schedule worked out best to go to the Yankari Game Reserve today, which happened to be my birthday. The beginning of the week had been pretty busy, so it was a nice day off. What a great day it has been! We left early this morning to make the 2 ½ hour drive to the main gate with another 30 minute drive in the park to the main facilities and swimming area. We first took a 2 hour safari drive through the park. Within 15 minutes of driving, we came upon a herd of elephants. The safari group that had gone just before us had not seen any elephants, and indeed some of our missionary friends have yet to see elephants at Yankari, even after many trips. We were right in the midst of them and only 20 to 30 feet away at times. It was fantastic! The safari was a great success. We encountered : a snake, elephants, water buck, bush buck, dik dik, crocodiles, baboons, wart hogs, guinea fowl, water buffalo, many birds, and tse tse flies. Seeing both water buffalo and elephants on the same trip is unusual. Hannah noted, “Dad, God gave you a birthday present today.” And indeed it was a much appreciated gift.

After the safari we had lunch with the wart hogs, which are very docile and have no problem begging for food.

We then went to the Wikki Warm Water Spring just down the hill, where we had a delightful time swimming.

We had heard stories of mischievious baboons stealing clothes, but we were lucky, we did not have any problems with the baboons, though we did get quite close to them just as we were about to load up to leave the park. Camille unknowingly rang the dinner bell so to speak when she rattled the plastic container containing peanuts. We had ten baboons scurrying to the back of the van. We shooed them away and were able to leave without incident.

We made it home before dark and most importantly before 7 pm curfew.

Michael Mitchell, MD

P.S. Interesting clinical pictures coming soon. I had quite a case this past Monday.

Medicine in the Seminary

2009-01-27T12:54:00.000-08:00

Today I was invited to share ear, nose, throat medical advice to the seminary students. Every day the Jos ECWA Theological Seminary (JETS) has a chapel service and guest speakers are often invited. Today I was the featured guest speaker. I spoke on basic ear care, avoiding colds, and taking care of the voice. The voice topic was especially interesting to the students, since most of the students will be ministers of some kind. The talk was well received.

Michael Mitchell, MD

Day 3 of Jeanie's Visit

2009-01-23T12:07:00.000-08:00

Today was an exceptionally busy day. We began the day going over to a ministry in town: Mashiah Foundation. (You can see their website at www.mashiahfoundation.org). This ministry was started several years ago by a woman who wanted to help women who are affected by AIDS earn money to care for themselves. Their gift shop features the quilting and sewing work of over 100 women. Jeanie and I helped support many women today!

We continued on to the open market where we bought matching pieces of fabric. It’s a Nigerian thing to get matching outfits made out of the same fabric. After returning home for lunch, we made good on our promise to take Victor out for a birthday shopping trip. It was a first for me as well: going to Katako Market where most Nigerians go for their clothing and other second hand wares. Jeanie and I also both had our first taxi ride (see picture.) Fortunately, no chickens or goats went along for the ride and there were only 6 people crammed into the dilapidated Toyota Corolla. Victor is one happy boy now!

We had another game at Hillcrest and then came home for dinner where Jeanie had a very authentic Nigerian meal: moi-moi with red sauce (a ball of ground black-eyed peas and sliced boiled egg.) It’s one of Emily’s and my favorites!

Lisa

Welcome Lunch at Hillcrest/Immunization Clinic at Gyero

2009-01-22T07:50:00.000-08:00

Jeanie made it! She's here and hit the ground running. After overnighting in Abuja, we arrived back home for a brief time to greet Emily and Michael and meet our household helpers. Then we were off for lunch at Hillcrest School to greet Hannah, Sterling, and Camille. The kids ran up and literally swept Auntie Jeanie off her feet. We sat down for our usual Wednesday picnic on the school grounds with our bonus visitor. Jeanie had her first Nigerian food: suya (barbecued beef), puff-puffs (not sweet doughnut balls), masa (prepared rice flour), and potatoes (fried potatoes.) So far, she likes Nigerian food . . .

Before dinner, we attended Hannah and Sterling's basketball games where Jeanie met a significant portion of the mission community. Then came Christmas as we sat around the box Jeanie and Larry graciously packed up for us. We all took turns squealing with delight as we were handed the items we had requested. There were even some surprises from school friends who had thoughtfully prepared and delivered items to Aunt Jeanie just for the trip.

Today, we went with our neighbors Don and Kim and another friend named Kelly to Gyero. At this orphanage, we gave over 150 injections to children vaccinating them against measles, polio, hepatitis B, and tetanus. Jeanie helped give shots as well as draw up shots. We got a tour of the orphanage as well. Many of these children were on the streets before coming to Gyero and have no living parents. Others might have one living parent who cannot adequately take care of them. I had a lot of fun letting the girls select a bracelet off my arm (as a prize for being brave) and putting it directly on their own arm. Most of the girls looked at me with wide eyes and gave a little curtsy in thanks. The boys just got a piece of candy, "sweets", and were happy to get that as well. We really enjoyed getting to know the two Nigerian nurses Vicky and Salome who worked alongside us as well.

Lisa

She's coming . . .He's coming . . .

2009-01-18T06:53:00.001-08:00

For those of you who think Africa is just too far away, you are about to be proven wrong! We are gearing up for not one, but TWO visitors from Vancouver, WA! Very soon, you will see pictures abounding on our blogspot of someone from a faraway place just like you pictured in the various settings that Nigeria has to offer . . .the crowded marketplace, a distant waterhole with elephants nearby, a high school basketball game with a mob of international parents cheering on, etc.

Who are these wild and crazy adventurers?

The first one is my spunky, daring sister from Vancouver who is about to bravely get on a flight solo to Nigeria. She is coming for 10 days. So far the plans are to blitz the trade shops for souvenirs, navigate our way through the side streets of the marketplace, spend a day at a nearby game reserve and natural spring, immunize orphans at a makeshift clinic, be a guest lecturer to eager Nigerian seminary students, drive out in the country to a nearby orphanage as guests for tea, and many more. After this whirlwind trip is over, I am expecting to need a vacation!

Crazy adventurer #2 is a colleague of Michael’s: Dr. Doug Meyers. He is also coming solo to work and experience all that Nigeria has to offer.

Anyone else want to come?

Conference

2009-01-15T21:26:00.000-08:00

SIM Conference was definitely a highlight of the year, maybe even up there with South Africa. Every morning us teens would wake up at about 8:00 in the morning to eat a breakfast consisting of cereal, breakfast meats, and usually pancakes (which is quite a treat if you have lived here awhile). My friend Jordan and I would then take off to the chapel to go rehearse worship songs for the morning worship service. At the service we would play the songs and then all of the high school and middle school kids would leave to go have our own youth group. We would start off with a short game to have some fun and then we would watch a Rob Bell video. After the video finished we broke up into groups to discuss what was in the video. By the time we were done it was time for lunch so we would all head over and eat in our own area away from the adults. There were no plans for us after lunch so we could do whatever we wanted. Usually there was a hiking group going somewhere, people wanting to play ultimate frisbee, or airsoft wars to be had. On the last evening we had a Talent Show. Most of the acts were skits and there were some musical ones including me, Jordan, Ryan, and Caroline throwing a band together and playing Forgiven by Relient K. Our act would have pretty good had the mixing been better. Caroline was on guitar and it didn’t turn on until halfway through the song giving us a little bit of a shock. Overall Conference was really great, I was sad that it was over so soon.

Sterling (16)

Round the Cape and Return Home

2009-01-05T21:36:00.000-08:00

We have safely arrived back in Jos all refreshed and ready to work again.

Cape Town, South Africa will go down in the Mitchell History as one of the best vacations ever! Why you ask?

-beautiful beaches

-German chocolate

-real movie theaters and malls

-real grocery stores with overwhelming selection (I actually got teary-eyed)

-picturesque mountains

-great hiking

-all the cheese, milk, and ethnic food you want

-fantastic dining at budget prices

-nice cool climate

-wonderful family time

-sleep that isn't interrupted by guards tromping around outside your window, occasional gunshots, and Muslim prayer calls and Christian church services over loudspeakers throughout the night

We are now getting ready for the annual SIM missionary conference. It will be a time of great encouragement, teaching, and fellowship with the other missionaries in Jos. Upon its completion we will begin our last semester in Nigeria.

One of the last things we did in Cape Town was to go to Cape of Good Hope. It was amazing to stand on the point where ships have struggled to round on this major trading route. Hope you enjoy the pictures.

Lisa

A Trip to Egbe

2009-01-01T23:22:00.000-08:00

Last month I took a surprise trip to Egbe with Phil Tait, the SIM director of Nigeria, and Tobias, one of the Swiss medical students studying at Evangel. Phil sent out an email saying that he was traveling to Egbe for the Centenary Celebration of 100 years of the gospel in Egbe and invited anyone who wanted to come along. Tobias and I decided to go because we were interested in seeing the mission hospital at Egbe. We did not know much about the celebration, but Phil explained that it was a celebration of the hundredth anniversary of the missionary Tommie Titcombe bringing the gospel to Egbe. Tommie Titcombe was a small man, barely 5’2” and 100 pounds, who applied to SIM back in the days when Africa was still considered to be the “white man’s grave” and SIM (still Sudan Interior Mission) was only accepting the hardiest individuals. SIM turned him down repeatedly, but he applied so many times over the course of several years that they finally gave up and accepted him. Tommie Titcombe started the first church in Egbe and his wife started a maternity care clinic. Beginning with the Titcombes’ effort in Egbe, the gospel spread to all of Nigeria. Eventually the churches founded by SIM became the Evangelical Churches of West Africa (ECWA), which is the dominant denomination in Nigeria today. The Centenary Celebration was a week long event celebrating the anniversary of Titcombe’s arrival in Egbe. It included dramatic reenactments, sporting events, speeches, traditional dances, and every night a worship service. Each night thousands of people attended the service, all seated on lawn chairs arranged in a semicircle around a central grandstand.

In addition to Phil Tait, Tobias, and me, there were two other groups from outside of Nigeria. One group was led by Don Campion, the son of the doctor who founded Egbe Hospital. The other group was accompanying Dr. Kantayya, who was the medical director of Egbe Hospital a few years ago. Dr. Kantayya, Don Campion, and Phil Tait were highly honored guests at the ceremony because they represented the missionaries who had over the years brought Christianity to Egbe. Even though Tobias and I had only come to visit the hospital, people saw our white skin and assumed that we were related to one of the famous missionaries being celebrated. I was asked if I was Phil Tait’s daughter, Dr. Campions niece, and even if I was a granddaughter of Tommie Titcombe himself. Tobias and I became guests of honor in a ceremony we knew nothing about. We were given seats in the grandstand, served meals catered by a company in Lagos that specialized in American food, and hailed like heroes as we walked down the streets.

The whole week was full of long ceremonies and important people dressed in fine robes. But the grand finale was the final closing ceremony. Whenever there is a wedding or an important ceremony, there will be an official cloth for the event. Everyone who is attending the ceremony buys the official cloth and has it made into their particular style. The official fabric for this event was blue with a big portrait of Tommie Titcombe on it. When we came to the ceremony there were thousands of people wearing this fabric. Tobias borrowed an extra shirt from Phil and I got an extra outfit from the Kantayyas.

At the evening worship services the pastor who spoke got so excited and was shouting in Yoruba so fast that the translator had to yell over him to keep up. At the beginning of his sermons he would start calmly, but by the time he reached the end of his sermon he was screaming in Yoruba, the translator was screaming in English, and the whole thing was completely unintelligible. The services each evening always started at least an hour late and went well into the night. On the last day, the final ceremony lasted 5 hours. During that time I managed to read the entire biography of Tommie Titcombe, a book I got from Phil the day before. The copy I read had a funny story associated with it.

Especially for the occasion SIM reprinted 1,000 copies of the biography of Tommie Titcombe written by Sophie de la Haye, “Tread Upon the Lion.” When the artists showed Phil Tait the cover art they had designed. They gave him two options for the cover that were exactly the same, except that inside the “O” of the word “LION” one had a picture of a lion and the other had a picture of a tiger. Phil selected the one with the lion, but instead the company proceeded to print 1,000 copies of the biography with a tiger on the cover. My family has jokingly been calling the book “Tread Upon the Tiger.”

- Emily

Civilization in the Wilderness

2008-12-29T11:30:00.000-08:00

Greetings from Wilderness, South Africa!

Michael and I have found our new favorite holiday destination - -South Africa. We absolutely love it here! Cape Town is a lovely Western city on a picturesque coast with mountains around . . .kind of like a mini-San Francisco with the Sierra Nevadas and ocean all together. I personally fell in love with the countryside as we left the coast and headed toward the Garden Route. It reminds me of Texas and the Sierra Nevedas all rolled into one - - vast, open land with rolling grass and mountains in the background. There are lots of cattle and sheep because the soil is poor. I couldn't help but think of my dad and how he would have loved this area as we drove through.

We saw one thing you wouldn't normally see though: herds of ostriches (or is it broods?) They are raised for their meat, which by the way isn't too bad. Even Emily sampled three types of game at a local restaurant just so she could say she had eaten them: kudu, springbok, and ostrich. The kudu steak was my personal favorite of the three though I couldn't help but order the lamb.

After heading east from Cape Town and passing through the ranch lands, we arrived in Wilderness, South Africa. We got to swim in a different ocean this time, the Indian Ocean. It is much warmer than the Atlantic Ocean that Cape Town had to offer. The beaches are beautiful with fine white sand. We were truly blessed to stay in a home that we got last minute which was the nicest one we have ever stayed in our lives. Our hosts were Christians who even offered us a cut rate. The homes are a curious mix of African and Dutch architecture since the Dutch originally settled this area.

We are truly enjoying our holiday!

Lisa

P.S. The van in front of our home with the thatched roof has come to earn the name of "The Beast." We are all in agreement that we will not ever rent a mini-bus again especially when Dad is learning to drive left-handed stickshift on the wrong side of the rode! He has done a good job of getting us around. (But do keep praying for a little extra dose of traveling mercies . . .)

Christmas and Penguins?

2008-12-25T04:31:00.000-08:00

Merry Christmas from the Mitchells!

This was a most unusual Christmas for us: it's not everyday you go to a beach and enjoy the penguins! Especially penguins that bray like a donkey (hence their former name - Jackass Penguins.)

We woke up Christmas morning enjoying breakfast in our B & B and then headed for the beach. We just got back from a wonderful buffet at a nearby hotel.

These are all pictures taken near Cape of Good Hope. We didn't quite make it to Cape Point. That will have to be another day.

Lisa

South Africa: On Holiday

2008-12-23T12:44:00.001-08:00

We are taking a break from the third world. Earlier in the fall we asked our missionary friends what they did during the long Christmas break, when the kids are out of school for four weeks. Most try to get away from Jos, since the kids get bored. The closest retreat is Miango and many families go there for Christmas. While Miango has comforts that are not available in Jos, it still has its draw backs. Our last extended family vacation was in August 2007, so we justified spending some savings for a REAL vacation and a chance to enjoy the privileges and luxuries of the developed world. We chose South Africa.
The airport outside of Jos was about as nice as any facility in the city, but as demonstrated by the sign, it was not first world. We flew to Lagos where we had a 7 hour layover that was extended to 9 hours due to a delay. We finally got on the plane after midnight and landed in Johannesburg at 7:30 am. We then had to go through immigrations and customs and buy tickets to Cape Town. We finally arrived in Cape Town at 2 pm, 22 hours after taking off from Jos.
Our stay so far has been pleasant. The only excitement has been my driving. We have rented (“hired”) a huge full size van to accommodate all six of us with our luggage. It has standard transmission and the driver’s seat is on the right, since one drives on the left side of the road. The controls are opposite American cars as well, so I am still turning on the windshield wipers every time I turn. We had a laugh last night after I frightened one poor teenage boy trying to cross the road. I made a sudden left turn into the appropriate lane and came to a sudden stop lest I run him over. His eyes were huge!
We have thoroughly enjoyed the conveniences of western civilization. We had a lovely seafood meal overlooking the Atlantic Ocean yesterday evening followed by a nice one mile stroll along the sea wall. We went to a grocery store in the evening. We were all frenzied with all the choices that we have not seen in 5 months. It is going to be a nice vacation.
Michael Mitchell, MD

The Widow's Mite

2008-12-19T13:49:00.000-08:00

I haven’t talked much about my housecleaner Asibe. She is such a gift to us! She brings order and sparkle in a place that is very challenging to do so. Africa is not very conducive to cleanliness and order. Asibe has a gentle spirit and loves the Lord intently. She is very active in the widow’s group in her church and has even gone on outreaches and seen many people come to know the Lord. She never complains and does her work heartily.

The recent riots impacted Asibe’s life tremendously. She lives in one of the areas that saw some of the most intense fighting. Three times her house was set on fire. Three times she and her four children put the fire out. All of her neighbors’ homes were burned down around her. She herself was injured and had to go to the hospital: she had scrambled up a pole to keep from being run over and was rammed and was sent flying.

She actually reported to work several days after her injuries though it was still unsure if the fighting was completely settled down. I thanked her for her dedication and immediately sent her back to her children!

Recently I found out that in addition to caring for her four children on her $72 a month salary, she had been providing a safe haven for four Muslims after the crisis for an extended time. Today, out of the funds our donors have made possible, I was able to help replenish her food stocks. Not expecting this, Asibe was tearful and overwhelmed and gave thanks to God.

I can’t tell you how awkward and humbling it was for me to be thanked when the $45 dollars I gave her seemed as nothing compared to what she had so sacrificially given. Without complaint and no thought for herself, she gave out of her limited resources to help protect neighbors putting herself,her children, and her home at risk. She did this at a time when she herself was suffering physically. What an amazing example of faith and love and sacrifice!

I consider it a privilege to work alongside Asibe and am thankful for your help as donors to support her as a widow and a local missionary to her own people.

Lisa

As he looked up, Jesus saw the rich putting their gifts into the temple treasury. He also saw a poor widow put in two very small copper coins. “I tell you the truth,” he said, “this poor widow has put in more than all the others. All these people gave their gifts out of their wealth, but she out of her poverty put in all she had to live on.” Luke 21:1-4

The JUTH Connection

2008-12-19T12:52:00.000-08:00

In addition to working with our own Evangel hospital, I have the privilege of working with staff from Jos University Teaching Hospital (JUTH). It is the center for academic medicine here in the Plateau State. It is a tertiary referral center where most medical and surgical specialties are represented. When I remove a tumor from a patient, we give the specimen to the family and ask them to take it to the pathology department at JUTH.
The Ear, Nose, Throat (ENT) department is relatively new and growing at JUTH. It is headed up by an energetic and bright surgeon, Dr. Samuel Adoga. He just returned from a 40 day course in India to learn some advanced ear procedures. He spent his own money for the trip. I am encouraged by his drive and perseverance as he hones his own skills as well as advances his department. He has three residents training under him and his two associates.
A future JUTH ENT consultant is Dr. Adekwu, who will finish his training and exam in April and join the department. We have come to know Dr. Adekwu first through his daughter. Our youngest daughter Camille is a close friend of his oldest daughter, Emiene (“Emmy”). They are in class together at Hillcrest School. In addition, we just travelled across the country with Dr. Adekwu when we went to the national ENT meeting.
Dr. Adekwu is an inspiration to me. Despite his hardships, he maintains a positive outlook and is a loving father to his three children. He grew up in a small village, but managed to come to Jos to attend medical school. He was in practice for a while and then went back to train as an ENT surgeon. He has a great interest in hearing preservation and testing. His family has suffered many tragedies. In 2001, there was a much larger crisis in Jos. He was sheltering Muslims in his medical office and consequently his facilities were burned down. Two years ago, he lost his wife to severe burns she suffered as she was saving their youngest child in a house fire. This past September, he and his children were held at gun point during an armed robbery in their home here in Jos. Any one of these events would be an unusual life event for an American physician, but Dr. Adekwu just moves on.
My Nigerian friends inspire me. They have a sincere faith in God and truly want to make a difference in their families and their communities.
Michael Mitchell, MD

First Tooth, First Step, First Hair Plaiting

2008-12-17T23:44:00.000-08:00

This is one first as a mother that I never even imagined! I thought you’d enjoy seeing a picture of Emily gone Nigerian. My baby’s first hair plaiting! This process is not for the faint of heart: a trip to the market to buy hair extensions, and about 5 hours of sitting still while the extensions are put in. No washing your hair until you take them out. I give Emily about one week before she can’t stand it anymore. Also pictured is Emily’s friend Nanfe who earned a little pocket money in the process.

Nigerians take great personal pride and care in their appearance. Extra money is spent for nice clothing and nice looking hair. Nigerians always look neat and clean and have a personal cell phone no matter how basic their other living conditions. Americans could learn a few lessons from Nigerians in this regard! Only your finest clothes for church and no shorts except for actual sports activities.

I thought you would also enjoy seeing Michael, Emily, and me in our Nigerian clothing. We went to our first Christmas party for staff at Evangel Hospital on Wednesday , December 17th. I'm afraid with balmy air and mosquitoes buzzing around that it doesn't feel much like Christmas. For our potluck we had such delicacies as vegetable soup (Southern greens), egusi soup with fish (greens with ground-up melon seeds), groundnut stew (greens with ground-up peanuts), draw soup (greens with ground-up okra) . . .get the idea that greens are a staple here? . . fried chicken, watermelon, pineapple, a few American desserts compliments of some of the missionaries. Oh yeah, and for filler, a ball of starch . . .your choice of a ball of wheat mush (semo-vita), a ball of rice mush (tuwon shinkafa) or a ball of yam mush (pounded yam.)

Are you hungry now?

Merry Christmas!
Lisa

Our Morning at a Refugee Camp

2008-12-13T07:56:00.000-08:00

This past Friday, Emily and I had the opportunity to go with our neighbor Dr. Don Sampson, an American pediatrician, a Nigerian doctor, and five other people on an outreach here in Jos. Our patients were displaced residents of Jos who are in a refugee camp about 20 minutes from our house. We passed a burned out mosque and another intact mosque with armored cars and soldiers actively guarding it on our way to the camp. For three hours that morning the patients streamed in, the first ones being very tired-looking soldiers with their automatic rifles still slung over their shoulder inside the clinic. Their complaints were insomnia, chest pain, malaria . . .no wonder after what they have gone through the last couple of weeks. The patients that followed were a mixture of men and women, Christian and Muslim all living together in the same camp. In all, we saw almost 60 patients: everything from hypertension to malaria, dizziness and a possible broken hand on a toddler. Emily and I are now quite proficient at filling prescriptions in a very makeshift set up. Dr. Sampson and Dr. Dennis were able to keep us busy with a steady stream of patients needing medicines. As a side note, Emily escaped yet another marriage proposal . . .and the clinic escaped yet another escalation of violence as one young man grew very frustrated with the other man’s interest towards Emily. Mama had to step in on all accounts and squelch advances as well as rising tempers. All in a day’s work in Jos, Nigeria . . .

Lisa

Greetings Mr. Obama

2008-12-09T08:03:00.001-08:00

Let me pass on a greeting to our President-elect in an open letter.

Behind the Miango Rest Home in open country with occasional little farm plots located along the valleys and creek beds we took a two-hour hike on Saturday, December 6, 2008. We went over Nigerian hill and dale in remote central Nigeria, here on the Jos Plateau. The landscape is beautiful with large weather-worn granite rock formations dotting the undulating landscape and golden chest-high grasses waving gently in the breeze. The gold was interrupted by the green valleys of creek beds where dry-season gardens are maintained. We walked through small garden patches of corn, milo, tomatoes, and peppers. The closest dirt road was over a mile away. No rumble or roar of a combustion engine was anywhere within earshot. Water is hand-carried to little hand-tilled plots. The harvest is then carried out on the head of the women, who walk one to two miles to the road. They may take their goods to the local Miango market, or some may stuff themselves and their produce in taxis and make the drive to a larger market.

We walked by some men working their plots. The first two were simply amused that I would want to take their picture. However, the young, lone, bare-chested Nigerian farmer was more eager to pose. After I showed him the digital image of himself on the camera, he looked at me and said in his thick African accent, “Please greet Obama when you return.” And so I have…sort of.

Michael Mitchell, MD

Back from Miango to a quiet Jos

2008-12-09T07:54:00.000-08:00

Jos has been very quiet over the past week. We consider it answered prayer. Despite the many rumors and arrests, no major incidents have occurred. The Muslim holiday, Sallah, passed without a hitch. We returned from Miango today, driving through many military road blocks. Everyone at the hospital seems happy and relaxed as well. The city-wide curfew has been eased, now 7 pm to 6 am.
We made the best of our time away. We went on three different hikes. Kids watched movies, played ultimate Frisbee, basketball, and volleyball. Emily is now adept at the game Settlers of Catan, the local favorite board game. Lisa played trumpet. Most relaxing to Lisa is that she did not have to plan or prepare meals at all.
We would have much rather been busy with our normal activities, and waited for our planned vacation that is coming up. Unfortunately we did not have a choice. I think we are all in better spirits though and we appreciate our relatively nice home in Jos even more.
For one week, very little has gone on in the ENT department. However, today, I returned to a busy clinic and three patients needing surgery in the next 24 hours. Others were scheduled for surgery next month.
School starts up again tomorrow. The kids will mostly be reviewing for the semester final exams next week. School is then out for four weeks.

Refugees in Miango Rest Home dining hall

Michael Mitchell, MD

Refugees waiting for the storm clouds to subside

2008-12-06T10:12:00.000-08:00

The storm clouds are churning in Jos. We hope it is only a threat. Currently there is a curfew from 6:00 pm until 8:00 am. That has slowed things down at the hospital. There were no new admissions to report on Thursday morning and only one on Friday. No trauma. Still the rumors have been churning and there has been concern for renewed violence in the streets. The injured in our hospital wards have all been Nigerian young males. We have heard no reports of attacks on white people nor have they been a target to date.

As a precaution, we, as well as many other families, have left Jos and are currently staying at the Miango Rest Home, a Christian retreat center 50 kilometers outside of Jos. On Thursday morning we retreated to this peaceful place. The kids are having a great time hanging out with friends.

Today, Lisa and I led a pack of 25 teens and young adults on a 2.5 hour hike. We trekked through little subsistence farms, unaccessable by vehicle, where strong young men were tilling the soil by hand. Small crops of cabbage, pepper, and tomatoes were growing. The snake of pale skinned explorers wound its way through rock and field to a jutting boulder formation overlooking the valley. Young raggedly clad children were waving at us from a distance. Some in our group were shouting in Hausa the long greetings customary for Nigerians, "How was your night? How is your tiredness? How is work? How is your family? How is your home?" The Nigerian children were excited to see the gathering of so many white people in the fields where they work. We are told that they find it somewhat comical, since the idea of hiking for fun is so foreign to them. Earlier in the week, we took a Nigerian surgeon with us on top of the volcano (see pictures from Oct blog). The 45 year old surgeon said he had never been on a hike nor had he ever bothered to climb a hill just for the view. He was exhilerated and vowed to come back with his children.

Our stay here has been peaceful and we are feeling rested, as much as we would rather be home and back working as was our intent in coming to Africa. Clearly, we are not in control.

The rumors continue. Still it is not safe to return. Sallah is the Muslim holiday to be celebrated tomorrow and Monday. The celebration involves large prayer meetings. We hope that temperence will be observed by both Muslim and Christian extremists. Once, the holiday is over, we suspect we will be able to return home. Meanwhile we continue to pray and play while the storm clouds threaten destruction 50 kilometers away.

Michael Mitchell, MD

Quiet Monday in Jos

2008-12-01T12:21:00.000-08:00

Jos is returning somewhat to normal. We heard the beep beep of motorcycle taxis this afternoon. Our driver went off the compound and was able to get fuel. The market has some items, but prices are doubled on many items. There were not many trauma admissions to the hospital today. My day was slow, since I do mostly head and neck surgery. Most of the injuries have been orthopedic with gunshots to the extremities. I presume that victims with shots to the head and body have not survived long enough to get to the hospital.

We are still on a high level of alert and prepared to evacuate if things flare up again. There is currently a curfew from 6:00 pm to 8:00 am (sunsets at 6:30 and rises at 6:30). We here occasional shots fired in the distance. It sounds like the sporadic fireworks that go off the week before 4th of July, but there are no fireworks here. We are told that most of the shots are simply warning shots from the patrolling military units.

An emergency relief coaltion of multiple organizations has reported that up to 30,000 people have been displaced in Jos and are in need of food and water. Apparently relief efforts are being coordinated.

Our kids are tentatively scheduled to return to school Wednesday at 8:30 am. Evening events have been moved up or cancelled due to the curfew.

Continue to pray for peace between our Muslim and Christian neighbors. There is concern for more violence during upcoming Muslim holidays next week followed by Christmas two weeks later.

Michael Mitchell, MD

What a week!

2008-11-30T13:30:00.000-08:00

We are back safe and sound as many of you have heard. I thought I would fill in some of the details of our week for you:

On Wednesday, Michael, Emily and I left with our driver and 2 other Nigerian doctors for an ENT conference about 9 hours away. The bad news is that it turned out to be really 12-13 hours away. Ever traveled cross country on a two lane highway with huge potholes, no roadmap, and few road signs? We had some good laughs because we had to stop and ask for directions so many times. By the way, there were no roadmaps because there are none to buy!

The conference was worthwhile for Michael to attend. Several Nigerian residents are now eager to come observe him for a month or so to further their training. Michael is excited about training more doctors to do surgeries that he alone is doing in Nigeria right now.

While in Ife, we got the message that rioting had broken out and that Sterling, along with all the other missionaries, was being evacuated from our compound. There was really not anything we could do so far away, except pray. And that was the very thing to do! That is when we first made our family and friends aware of what was going on. We thank you for your prayers and ask for your continued prayers as things are still not back to normal here in Jos.

We finished out the conference and then Saturday morning headed for home. I am amazed at how the Lord provided in advance for us personally: our Nigerian travel mates went through the 2001 Jos crisis and were a wealth of knowledge and advice to get us home safely reunited with our children. They also had families they had left behind in Jos during the conference and understood our eagerness to be with our family. They very wisely suggested, however, that we delay our return and overnight in Miango (see previous blog for Miango Rest Home.) They even suggested routes that they felt were safer. The Lord knew our need and made provision for it even before the fighting ever broke out. And we just thought we were giving friends a ride!

We are all in our house now. The kids and Michael are even unwinding in front of a movie.

I would have to say the highs of this week so far for me would be: in Ife, seeing unusual lizards and a massive bat population flying around, having a bonding experience with our Nigerian acquaintances who are now friends . . .witnessing our driver Alphonsus eat his first American hamburger at Miango and spending a significant amount of time with him (as he is a newer Christian) . . .seeing God’s faithfulness firsthand in our time of need amidst the rioting . . .reuniting with our kids and having a special time of prayer and worship with all of the other displaced missionaries before heading back home.

One low: realizing that our hotel in Ife that had inconsistent water and electricity was the best hotel in town and the one that all the other conference attendees were trying to switch to! Oh well, we will get a real vacation one day!

LIsa

Jos is calm for now

2008-11-29T10:52:00.000-08:00

Lisa, Emily, and I just made the 12 hour trip back from the other side of Nigeria but we were advised to not come into the city just yet. There was shooting this morning, but since then things have been quiet.

The newspaper reports at least 50 people including 2 high ranking generals were killed in Jos yesterday. No white people were reported injured. Sterling had a scare when a crowd of people gathered around the van he was evacuated in and started pounding on the windows. They just sped on. Since then, the kids have been having an extended party with a bunch of other teenagers at a hostel for the boarding students.

We are currently staying at the Miango rest home (see entry in October). It is very peaceful here. We plan on joining the kids and going home tomorrow if all remains calm.

Michael Mitchell, MD

Worried about the birthday boy

2008-11-28T04:07:00.000-08:00

We have been in the city of Ile-ife, Oceanic State, Nigeria, 500 kilometers and a 10-12 hour drive away from home in Jos. Lisa, Emily, and I have been attending the annual meeting for all Nigerian ENT surgeons. We just found out about the riots in Jos this morning. Sterling has been evacuated from the hospital compound where we live to a safer compound where Hannah and Camille have already been staying. We hear that one pastor in Jos has been killed and his church burned. The emergency room at Evangel is receiving many injured patients. The missionaries are prepared to evacuate to an outlying city if necessary.

We are choosing to stay here for now, since we would not arrive home until after dark. We will be heading home to join the rest of our family tomorrow.

We pray that peace will prevail and that the violence will subside quickly.

Michael Mitchell, MD

Riots In Jos

2008-11-28T00:26:00.000-08:00

Today is my sixteenth birthday and unfortunately we have school off for the day. Election Day was yesterday and the results came out the opposite of what the Muslims wanted. Consequently there is rioting everywhere in the city. My parents and Emily are off at a medical meeting near Lagos so I am staying on the same compound that I usually do but with my friend Jacob Naatz. We went out into the football field in front of our house and we could see large pillars of smoke coming up from fires in various places of the city and all the while gunshots were going off from all around. The fires and gunshots all seem to be a mile or so away but the danger is still there. As my friend Jacob says “Since we don’t have ‘snow days’ here we have to make up for it with ‘riot days’.”

Sterling (16 as of today!!!!)

Final Day of Class

2008-11-25T13:08:00.000-08:00

Today I taught my last class for the semester. My students will prepare for their finals next week. I will resume Jan 19th with not one class, but two. I look forward to getting to know a second group of students!

I thought you would enjoy seeing a picture of my students and the classroom. If you click on the picture, it will blow up bigger so you can see more detail.

The student I had asked for prayer concerning, Tikikus, so far has survived the car wreck. Unfortunately, there were some issues going on before the crash that were aggravated. He left the hospital, though not fully recovered. He is missing and his parents are very worried. You can continue to pray for him and his family.

Lisa

A Peaceful Retreat

2008-11-25T11:37:00.000-08:00

We had a nice relaxing hike this past Saturday. Our friends, the Taits from New Zealand, took us on an afternoon stroll through the hills and rock formations west of town. It was quite fun and relaxing. We have had quite the week with the senior play, water shortage, Lisa preparing for finals, and Michael preparing for his presentation. It was nice getting out in nature. The wilderness here is a lot like the foothills of the Sierra Nevada of California, though there no wild monkeys in California . It was a needed little break.

We are back to the mayhem. Tomorrow Lisa, Emily, and I leave for the city of Ife, a seven hour drive away. I will be attending a national meeting for Ear, Nose, Throat doctors. It will be quite interesting.
There was no active blasting that day at the gravel quarry, so we were OK.

Michael Mitchell, MD

Hannah Goes to Broadway

2008-11-22T11:34:00.000-08:00

Well , … not really. But she has a part in the annual Senior Play at Hillcrest School. What great fun! The entire senior class of 22 students was involved in some way with the production of Neil Simon’s “Fools”. Hannah plays the part of Yenchna the Vendor. The setting is a late 19th century Ukranian village whose citizens have been cursed with stupidity and no love. A fresh young school teacher comes to the village to try and educate the population and break the curse. He subsequently falls in love with the doctor’s daughter. There are many animated characters with a lot of comedy. Hannah’s Yenchna passes off flowers as fish and umbrellas. The part of playing a ditzy lady comes quite naturally to Hannah. She is fabulous. In fact, all of the kids do a great job of acting and delivering the punch lines. It has been a source of entertainment for the entire ex-patriot community here in Jos – even for those who have no children. Last night the house was packed.
I like what Gareth Mort, the director, writes in the printed program, “And the question that may jump out at you from amid the mayhem of this crazy play is: Would I be willing to go to an out-of-the-way village and try to make a difference?”
Michael Mitchell, MD

Hannah, in pink, with her friend Caroline (Mishkin the Mailwoman)

More Water Woes

2008-11-19T13:41:00.000-08:00

Clean, running water is a blessing. Today we are without that blessing. The foul odor of a stagnant puddle came trickling out of the shower this morning. I hoped it would clear, like the muddy, rusty water often does after I first turn on the shower, but that was not the case today
The culprit is a hand-dug well that is too close to the hand-dug septic tank- a mere 20 feet separates the two. We rely mostly on the well for water. I spotted the problem when we first moved in, but until now, the water has only looked dirty. It had never smelled bad.
We have gotten water from the hospital three times. The hospital has a “bore hole” --the term for a deep machin -drilled well. The water itself is cleaner than our well water, even before today’s event. It is delivered to the two ground tanks pictured next to the tower very infrequently. We suspect it comes only when everyone else along the 1 inch pipe line has finished getting all they need. We have not yet found an inexpensive way to get a more reliable supply of the hospital water.
This is only for running water to wash and flush with. We have to filter the water for drinking and cooking. We use a double filter system (pictured). The first sediment filter pictured here had been in place for four weeks. The red African earth tinges many things, especially water filters. A second filter gets out all the small particles and microbes. When it works, it works well. It worked better when we filtered rainwater runoff from our roof. Now that we are using well water, it seems to be clogging up faster. More woes.
We are showering next door, and also gathering water in buckets to wash dishes. We will fill our ground tanks with the neighbor’s water tomorrow and then look for a more permanent solution… new well, new septic tank, or re-plumb hospital water. Stay tuned.
This is only stressful for us, the pampered Americans. We don’t have to look far to appreciate what we have. None of the physician residents on the compound have running water in their homes. They gather water in buckets from rainwater runoff during rainy season or from outdoor spigots when they are running. Occasionally they have to retrieve water from hand-dug wells with a rope and bucket. My residency was difficult, but at least I had running water in my home. We will get over this momentary inconvenience and count our blessings.
Michael Mitchell, MD

Please pray for Tikikus

2008-11-18T12:54:00.001-08:00

Dear Family and Friends,

I am asking you to pray for one of my students. I just found out today that Tikikus is unconscious in a hospital in another part of Nigeria. I was told that he has a head injury which occurred as he was traveling by car back to his village for the weekend. He was just in class this past Thursday.

Pray for the care he would receive in the hospital. Healthcare here is a far cry from what we have available in the States. I believe this young man will only be back in my class one day by the grace of God.

Thank you,
Lisa

Meet the Sampsons

2008-11-16T20:53:00.000-08:00

Recently, we had a fun evening out with our next door neighbors, Don and Kim Sampson. It was a first: a dinner out with another couple just for fun! We had a delightful evening chatting and laughing which was very much needed. We can count on one hand the number of times we have eaten out since we arrived. American prices in a 3rd world setting on a missionaries’ budget . . .not a good combination! Plus there are only 3 restaurants in town known to be safe to eat at. The choice of cuisine is Lebanese, Lebanese, or Lebanese. I take that back; one of the restaurants offers Lebanese and Chinese. We sampled the Chinese portion initially. As one of the other missionaries put it, "the longer you are here, the better the Chinese tastes!" Let's just say we need to be here a bit longer!

Don and Kim were the first family that we met. We are indebted to Kim because she helped prepare the house for our arrival. She was determined to make our homecoming more welcoming than their own. She told me stories of searching with a flashlight through 40+ boxes for bedsheets. They had no electricity, no running water, no beds made up, and all after 48 hours of travelling. We had fresh bedsheets, food, and even a decorative centerpiece of candles and a fresh rose in a vase to greet us. What a blessing!

Don is the pediatrician at the hospital. Kim is a nurse by trade, but currently she is an organizer extradonaire. She is a key person for many different groups. Accomplishing anything here takes great effort, patience, and organization. Don and Kim are both active in music ministry and do combination medical/worship outreaches within the local community and out in the bush. They and their 3 children who are very similar in age to ours are longterm missionaries. They arrived here just one year ahead of us.

This next week, they will go on an outreach to the bush. Emily is hoping to go with them. I am, too, but I don't think I will manage it due to finals approaching. Stay tuned for an update from Emily . . . .

In the Classroom: Adventures in Teaching Prepositions

2008-11-15T02:14:00.000-08:00

This week in my class at JETS, I have been teaching prepositions to my students. For those of you who don’t know, this area is one of the most persistent sources of errors for English speakers of other languages. We have had some interesting discussions in the process of trying to explain the meaning of such words as at, on, and in.

I have discovered that there are many challenges in coming up with examples when teaching English outside of America. For example, the classic illustration for helping students to identify a preposition is to tell them that anything a squirrel can do to a tree is a preposition. I quickly realized one thing though . . .no squirrels in Nigeria. Hmmm . . .okay, anything a monkey can do to a tree! Later in the discussion, a student asked me the difference between at, on, and in. He had no idea how to tell the difference. I told him to think of a car . . .at the car, in a car, and on a car all have very different meanings. (The students all laughed at the thought of this student being on top of a car.) The light bulbs started coming on so I quickly tried to think of another example to drive the meanings home. I told him to think of an elevator . . .,but I had to abruptly stop. The blank stares of 39 students were looking back at me. I thought to ask a key question . . .”How many of you have ridden in an elevator?” Not one person raised their hand . . . Okay, bad example!!! (Though one of my students was very quick to enthusiastically inform me that he thought there was one in the big city 3 hours away!) (By the way, Jos is a city of 600,000+ and not a small city.)

My favorite question of the day though was from one of my strongest students. Some prepositions must be deleted where we would normally use one. Ever wondered why you say, I’m going to the store, I’m going to the mall, but say I’m going downtown or I’m going home(no preposition)? After finishing up this short discussion, a young man raised his hand. “Mam, there is a club in Jos named Downtown. If I am going there, what would I say?” Managing not to laugh out loud, I told him that it was okay to say,” I’m going to Downtown” in that case.

Teaching these students is a lot of fun!

Despite the fun (there’s a prepositional phrase for you), the goals of my students are very serious. They are studying to be future pastors, small Bible college teachers, and missionaries in the African bush. Some of them are active in ministry already. They need/will need English to communicate effectively in their work. I consider it an honor to work with these students, and I pray for them regularly as they are the future spiritual leaders of Africa.

Lisa

Hillcrest Service Day

2008-11-13T11:37:00.000-08:00

Today the whole of Hillcrest High School had a half day and spent the second half of the day splitting up and going to 4 different child care ministries. I personally went to the one which is made up of kids ages ranging from 12 to 18 called Transition House. All of the boys have been rescued from the streets, fed, educated, and had the gospel shared and made a part of their every day life. The boys are not taken off the streets and put directly into Transition House though, it is called Transition House because they are preparing them to go off and live life away from a ministry. First we all got a tour of the boys’ compound. We were led into tiny bedrooms packed with bunk beds. The next stop was the “kitchen” which was a covered area outside with two fires going and two massive pots on top of the fires with food inside. We were then led across the compound to the “library” which was the size of a small bedroom with hardly any books on the shelves. The last stop before we really got to business was seeing their computer lab. The lab was not much bigger than the library but had about 10-11 new looking computers in it. Out of the 15-20 boys going to serve at Transition House were 3 groups. One group helped some of the boys repaint many areas of the small concrete buildings. Another made bracelets and other little crafts like that with the boys. My group was to play sports with the boys. (Lots of the Nigerian boys were sneaking off from their other activities to come join us.) At first we played soccer, we split into 3 teams of 3 and took turns playing. The games were quite short as to make it so that everyone could play more, we only played until a team scored just 1 goal or until 3 minutes had pasted. To give us American boys a break we played basketball briefly. We used the same system for games except that we played to 6. Not many of the Nigerians are skilled at basketball so the games were short lived. We made multiple attempts at playing basketball but we could never get past 2 or 3 games before kids started hauling the 3x4 soccer goals onto the court along with soccer balls to play soccer again. After we were done with sports we went down to a newly built covered area next to the court and sang praise songs led by probably the oldest of the boys named Timothy. We sang “How Great Is Our God” and “His Love Endures Forever.” Following the music Mr. Abaya came up and gave a small talk on sexual purity. No girls were allowed to come to Transition House because the guys are older there and they want to help them out with their purity as much as they can.

Sterling (15)

To Market, To Market

2008-11-13T11:01:00.000-08:00

My driver! Because he is from the old school in Nigeria, he has many notions that, no matter how hard we try, we cannot convince him to abandon. One of those notions is that the oga (boss), especially if they are bature oga, are not allowed to carry packages! It doesn’t matter how laden down he is and how empty my hands are, he refuses to let me carry anything. (Okay, he doesn’t fight me too much on not carrying my purse.) Today, as we left the crowded street and ducked into a dark passageway to another part of the market, I decided it was a Kodak moment. . .Alphonsus’ hands full with the market in the background.

I go shopping only once a week or so. I like to see what new produce might be available and buy the import items that my driver would die of a heart attack from when paying the final bill. Alphonsus does all my shopping, and he shops almost every day. This weekend we are hosting two large dinners, one for our new friends the Chamis (featured in an earlier blog) and the other for our monthly compound missionary dinner and fellowship. Because shopping takes so long and because availability isn’t always consistent, you have to start shopping several days in advance.

Nigerians don’t always like to have their picture taken. However, because I had just bought a pile of beef from the butcher, I thought he would accommodate me. He looked a little confused when this bature lady asked if I could “snap” him. His confusion turned to elation when I told him that I wanted to send his picture to America! Despite all the shouts from the women on either side of him who were afraid of what might happen to him when his likeness was trapped inside my camera, he agreed. I thought you might enjoy seeing the butcher I go to weekly (the fly-infested meat that I buy,too) and seeing the market in the background.

Lisa

Off to Church We Go

2008-11-03T20:32:00.000-08:00

Our family attends two separate churches each Sunday. Emily and Hannah walk across the street to Bishara #2, the first church we visited here in Jos. The wooden pews are jam-packed (there is no such thing as personal space); the service is lively and there is a lot of singing. But everyone’s favourite part is the Women’s Fellowship Choir. These ladies go back and forth singing sometimes in English and sometimes in Hausa. (Although because of their thick accents, you can’t always tell which of the two languages they are singing in!) You can always know they are about to start singing because you hear one lone voice start up. Then the hand drums join in. The ladies are experts at building the excitement of the song: the choir comes in, then adds harmony, and finally at the most exciting part of the song, the choreographed movements begin. Michael and I get teary-eyed everytime . . .there is no doubt we are in Africa at that moment. Their music is beautiful and touches you deep down inside your soul! When I hear the ladies singing acapella as the drums begin, I can picture these women in small villages. I think this is the way music has been sung for hundreds of years, well before any bature showed up!

The rest of the family has settled on JETS Seminary Church. This is the church that is associated with the seminary I teach in; many of my students also attend there. Though the music is not quite as unique to Africa as Bishara #2, the teaching is excellent. We really appreciate the pastor’s sound theology and his expository style of teaching. I was particularly struck by a comment Pastor Maigadi said this past weekend. He talked about what a difference Christ has made in the lives of African Christians since the gospel came to the continent 150 years ago. He talked about how they as individuals have been delivered from the darkness and have left their former ways behind. He drove this point home with a rhetorical question:” Do you go to witch doctors anymore?” Initially, I smiled; you would never hear a comment like that from a pulpit in America! Jesus Christ has made a huge difference in the lives of the people of Africa. He has delivered His loved ones from horrible practices and ways and filled their hearts with joy so that now they sing a new song unto Him, drums and all!

By the way, witchcraft and animism are alive and well in Africa. Michael recently took care of a lawyer from Jos who had been driving in northern Nigeria on a business trip. The Christian population and influence is almost non-existent there. This man was involved in a car wreck. When he awoke in the hospital, he discovered that both of his ears had been cut off as he lay unconscious at the scene of the accident. Such animist rituals are common where Christian influence is so scarce. He is lucky compared to another man he heard of who awoke from his injuries to find that both of his eyes had been gouged out.

Lisa

A Sad Day

2008-11-01T10:26:00.000-07:00

I took Daniel (see October 29 blog) back to the operating room yesterday and again this morning to clean out the abscess in his brain again. He has been very sick and delusional in the intensive care unit. The procedure seemed like it went well, though there was still some bleeding that I had to pack off. He was never stable in the ICU after the procedure today and died 3 hours later. I am deeply saddened at losing such a young patient (21) who obviously came from a concerned family. In addition this complication was preventable, had he been able to have the necessary surgery three years ago. His father and often his mother and sisters have been at the hospital daily over the past 3 week. In general, the family is responsible for providing food and other necessities for patients during their stay. I was really hoping that Daniel would get better, despite the odds.

To add insult to injury, I have had a stomach bug today. I first started getting nauseated this morning while I was operating on Daniel. By midday I had vomited. I have been in bed all day. It is now 6:30 pm and I am feeling better, though not well enough to go to Hannah’s basketball season premier tonight. She was supposed to play yesterday, but she was just getting over the same bug I have. No one else in our house is getting sick so far, but sickness is going around many of the families associated with the school. Since it is so widespread and short-lived, I suspect that it is a virus. In isolated cases we often suspect food contamination. Lisa and I had diarrhea last month when our cook failed to properly bleach the cucumbers in our salad.

Michael Mitchell, MD

Malaria and Basketball

2008-10-31T22:55:00.000-07:00

In the states, the topic of malaria prevention doesn’t come up in conversation too often during a high school basketball game. Last night at the basketball game Lisa was chasing down Sterling with insect repellent shouting, “I am not going to have anyone in my family die of malaria!” Malaria is alive and well here in Nigeria, especially in the city of Jos where there is standing water everywhere (though we have started dry season and it will get better.) Every day we admit patients to the hospital with suspected malaria. The strain of malaria here is resistant to the basic malaria medications, so we are careful. Lisa dutifully puts out the mefloquine pills every Sunday for Emily, Camille, and me. She has a daily pill dispenser to make sure that she, Sterling, and Hannah are taking their daily doxycycline. Mefloquine often has side effects and was affecting their sleep. We all sleep under mosquito nets as well. All of these precautions are not full proof. Many of our friends have still gotten malaria despite taking precautions and taking prophylactic medications. We are thankful that none of us has gotten malaria so far.

Last night was the season opener for the Hillcrest High School varsity boys and girls basketball teams. You will notice that the court is outside. Hillcrest has one of the best courts in town. There is no indoor wooden court in Jos, a city of 600,000. High school basketball is a favorite source of entertainment for the ex-patriot community and quite the social event. Any game after 6:00 pm is a night game, since the sun always sets around 6:00 pm and rises around 6:00 am, because we are near the equator. Many people without children on the team come to watch the game. Pictured with us are our Lebonese friends, Muhammed and Zaina. Sterling and Hannah are in school with their boys and they recently had us over to their beautiful home where we had the best meal we have had so far in Nigeria—it was a feast.

The game was fun—we won 28-8. Since there are not many courts in town and since soccer is king in Nigeria, the ball-shooting skill of Nigerians is not that great. Nine of our points came from 3- pointers from the other American boy on the team. Sterling was in for almost half the game, which is an honor for a sophomore. He played great defense. He admits he was pretty nervous, so he did not score any shots. I am sure he will be more comfortable tonight when he plays again. Hannah will be playing her game tonight as well.

Michael Mitchell, MD

Patient Profiles: Mr. A and now Daniel

2008-10-29T13:44:00.000-07:00

I am sorry to say that Mr. A (featured on Oct. 2 blog) passed away a couple of weeks ago. Fortunately he was at home in his village when he started bleeding heavily, lost consciousness, and then died. I was very sad to hear this as we had spent so much time with him. He was a very determined and strong man, whom I had grown fond of. Despite his determination, he could not overcome his condition.
My current challenging patient is Daniel, a 21 year old. Daniel had an ear condition called cholesteatoma for several years. My predecessor, Dr. Anthis, had even seen him and offered surgery. Unfortunately, Daniel could not come up with the $300 for the surgery and hospital stay. He returned to our clinic two weeks ago with a very severe infection of his ear on the inside as well as an abscess forming behind his ear. He was very sick and would have died without intervention. We tried managing with strong intravenous antibiotics and draining the abscess behind the ear. Unfortunately his infection was too deep and required more extensive surgery. I returned home from our Miango getaway on Friday and had to operate on Saturday. I found bone that had been eaten away and the infection had spread to his brain. He had a large brain abscess. I drained the abscess and hoped the antibiotics would do the rest and that I would have a good report by this time. Though he has been better, he has still been very ill and I have taken him back to the operating room two times, including today, to drain pus that had reaccumulated in his brain.

Daniel has benefited from generous donors who gave to the ENT Poor Fund at Evangel Hospital. His family would never be able to pay the large bill (it may be as much as $600) from this admission. We pray that Daniel will get better soon.

Michael Mitchell, MD

Residency Inspection

2008-10-24T13:03:00.000-07:00

We have had some excitement with our resident training program over the past 6 weeks. Evangel Hospital has a Family Practice Residency. Residency is the practical training that doctors receive after medical school. In the U.S. a family practice residency lasts three years. American family practice residents are trained in managing most medical problems. They have training in obstetrics and gynecology as well. They have a small amount of training in surgery, enough that they can often do some very minor procedures like removing lumps, bumps, skin lesions, etc. The training program here at Evangel Hospital lasts 4-6 years, depending on when the trainees can pass their board exams. They have much training in general surgery, orthopedic surgery, gynecology, and urology. Fifty years ago and in some rural areas of the U.S., you may have had your GP (general practice) doctor remove an appendix or perform a tonsillectomy—a rare occurrence now. That and much more is common place at this hospital. Dr. Aboiyar is the fellow that I am currently training. It is clear that he is very skilled in surgery, along with his skills in general medicine, pediatrics, and obstetrics. Last week when I was gone, he took care of a couple of Ear, Nose, Throat emergencies using skills he had just learned from me in the past couple of months. What is amazing is that earlier in the day, he had done two prostatectomies. Ask your family practice doctor when was the last time he did a prostatectomy!

Dr. Aboiyar with his first tonsillectomy patient. A 3 yo with Down's syndrome.

The excitement at Evangel started last month when we were suddenly informed that our residency program was no longer accredited by the West African College of Physicians. This was quite a blow, since a couple of residents were just about to sit for board exams, and were not allowed to take the exams. Our program is well known and well thought of, but there seems to have been some politics going on. After some petitioning and scrambling, the college agreed to inspect our program and consider recertifying our program. The inspection team was at the hospital today. Though a visit of my clinic had not been scheduled, they did manage to pop in on me while I was seeing patients. As an entourage of six people barged into the exam room I explained to my patient, “Excuse me, I need to show the inspectors around. I will be back shortly.” Fortunately, my patient was a physician on staff who understood the situation.

The postop recovery area. No nurses, no monitors.

This afternoon the “consultants” (board certified staff physicians) met with the inspection team. The team seemed to be fairly impressed with our program. There were some criticisms of the hospital facilities though. I was happy to hear that somebody besides me thought that soap and running water would be nice to have in the wards. We hope that the decision to re-instate our program will be swift. We now have four residents who would like to sit for board exams at the next opportunity in April, including my fellow, Dr. Aboiyar.

Hot and cold water in the male ward.

Michael Mitchell, MD

Jobs Around the Hospital

2008-10-23T05:34:00.000-07:00

My resume is expanding every day. In the ENT clinic I have worked my way up the ladder from janitor to scrub tech. I started out mostly as an observer, watching my dad and Dr. Aboiyar see patients and occasionally getting to look in a patient’s ear. After a couple of weeks I started organizing the stockroom, which turned into a much longer project than I was expecting. The building in which the ENT clinic is currently located was not actually built until after Dr. Anthis left, so all of the ENT supplies were moved over later. Junk and medical supplies were haphazardly jumbled together on the shelves and allowed to accumulate three years of harmatan dust. After one month of dusting, sorting, organizing, and labeling, the stockroom finally started to look orderly. Much remains to be sorted, but the organization is at a stopping point until the ENT clinic gets some shelving for the office and theatre.

Shortly after I finished organizing the stockroom, a visiting dentist named Dr. Maxwell asked for my help in the dental clinic. I observed more than helped, but I learned how to read X-rays and got to take out a tooth that Dr. Maxwell had already worked loose. I observed tooth fillings, root canals, and complicated wisdom tooth extractions. I learned how to make mouth molds, how to do an effective nerve block to numb one side of the mouth, and how to extract difficult molar
After a week in the dental clinic I returned to the ENT department. ENT runs four days a week: Monday is theatre day, Tuesdays and Fridays are clinic days, and Wednesday is set aside for audiograms. During my first couple of months in the clinic I was organizing on clinic days and just observing on theatre and audiogram days. Not so anymore! Wednesdays are becoming my busiest days of the week ever since I have been trained to do audiograms. I now do most of the audiograms at Evangel Hospital, freeing the other ENT employees to get other things done around the clinic.

Mondays have also been getting busier since ENT was given two operating rooms instead of one. I am present for most ENT surgery days because I am the department’s only circulating nurse. Every Monday I walk through the waiting room to the changing room passing rows of mothers holding newborn babies bundled up heavily with knitted hats and sweaters despite the heat; in addition to being ENT theatre day, Monday is circumcision day. Circumcisions were done in the second operating room (we would hear babies screaming all day long from next door), but since the ENT operating schedule is getting more and more packed, ENT took over the additional room. Now Dad and Dr. Aboiyar jump back and forth between the two rooms, with anesthesia getting the next patient ready so that they can begin immediately when one case is closed. Sometimes they even split up, with one operating in the first room and the other operating in the second. In order to enable this arrangement I am being trained as a scrub nurse. So far I have assisted on some minor procedures and a couple of tympanoplasties. On the most recent tympanoplasty I even got to suture the skin when the case was over.

I am getting a lot of medical experience here that I would not have had the opportunity to get in America until much later in my training. Every month that I am here the list of jobs on my resume gets longer: stockroom organizer, dental assistant, audiologist, circulating nurse, and scrub tech. I have passed through a lot of job titles, but I like the one that our driver Alphonsus gave me the best. He just calls me “Small Doctor.”

Emily Mitchell, 19

From One Extreme to the Other

2008-10-19T15:21:00.000-07:00

Michael wrote you about our time at Miango Rest Home. I second everything he said . . .the beauty and peacefulness of the surroundings, wonderful friends to fellowship and recreate with, and best of all food, gloriously easy food! Food that I didn’t have to:
· make a list out for
· send Alphonsus to shop for
· explain to Alphonsus what the word on the list meant
· count out money for
· make sure Alphonsus was able to get
· count money back in for
· make sure Zainab bleached properly so we don’t get sick
· reshuffle our tiny frig around to fit in
· tell Zainab to cook
· make sure Zainab cooked at the time I said
· make sure it didn’t get burned in the oven
If I ever complain about grocery shopping in the US again upon my return, you have my permission to “abuse me” (as Nigerian kids say frequently.)

On the road to Miango, we saw another memorable achaba with passenger and cargo. See the picture. This was a highway we were driving on!

At Miango, we had a great hike on top of a volcano that blew a long time ago. There are actually two dormant volcanoes side by side. You can see one of them in the picture. Right now, the countryside is lovely and green. In just another month or two, that will change as the dry season gets well under way.

Upon our return from Miango, our peace and solitude was quickly shattered by a huge Muslim revival and trade fair just outside of our gates (see the picture.) We were trapped on our compound for a couple of days. Ever try to go to sleep with 3 huge PA systems blaring motivational speakers and prayer calls until 2 am?

Ahh, the extremes of Nigeria . . .

Lisa

Miango Break

2008-10-17T06:19:00.000-07:00

We just returned from a three-night holiday at the Miango Rest Home. It is a retreat center that was established in the 1940’s as a place for SIM (our organization) missionaries to vacation and get out of the heat that oppresses the rest of Nigeria. Miango and Jos are on a 4,000 ft plateau so the temperatures are much milder. Most of the year temperatures are 70-80 degrees Fahrenheit, though it is fairly humid most of the time. It is very pleasant if you are sitting in the shade with a nice breeze. Miango is in a lovely location, about 50 kilometers outside of Jos, where we live. It is next to a small village in a rural location surrounded by weather worn granite formations and farmland. We found it a nice change from the city living. The constant beep-beep of motorcycle taxis was noticeably absent.

The retreat functions more as a group retreat center now and not as many missionaries come for rest only. Two missionary groups were having regional conferences while we were there. We were one of three families there for rest and relaxation only. Activities included, tennis, hiking, volleyball, games, movie-watching, shopping, car driving lessons, teenage hanging out and goofing off, reading, and much visiting. All meals were provided, so Lisa had a nice vacation.

Highlights of the trip for me included a hike to the top of a nearby small dormant volcano with a panoramic view of the plateau. We packed 16 adults, teens, and kids into the van and drove a couple of miles down the road for that little outing. Another highlight was the tour of the Miango Rest Home and Kent Academy , which is the boarding school that was established in 1945 and part of the campus. The guide was Dr. Bill Ardill, who was born in Jos and went to school at Kent Academy. He is now the general surgeon here at Evangel Hospital, where I am working. His knowledge of the area and history of the mission is vast.

The most poignant part of the tour was the small cemetery behind the chapel. SIM missionaries who died in Nigeria are buried there. There are many stories of children and adults who lost their lives. There is a pilot who died on a test flight. Also buried is a four year old boy who drowned in a small pit that had been dug by the gardener without the knowledge of the parents. An elderly woman missionary who died in her sleep is there; she was known for always walking the long road between Miango and Jos. Two of the first known cases of Lassa fever are buried here; one was the missionary patient, the other was the physician who cut herself during the autopsy and contracted the disease. Several infants were buried there, including the Ardill’s own baby who died at birth. Many of the names on the tombstones were familiar to us as we have learned the names of the SIM community. It is clear, that there has been sacrifice among the families that have served in Nigeria.

Greater love has no one than this, than to lay down one’s life for his friends. John 15:13

Michael Mitchell, MD

Varsity Basketball

2008-10-13T11:55:00.000-07:00

This past week Hillcrest had tryouts for the basketball team. We had about 35 or 36 players tryout so Coach split us up into three teams, Varsity, JV 1, and JV 2. I was the only sophomore that made varsity. I have found that sports is the best past time for me here. If I am not playing basketball on our compound or at Hillcrest I am playing soccer with Gwakman, Victor, and the other Nigerian boys in the neighborhood.

Sterling, 15

Solar Powered Hearing Aids

2008-10-12T13:55:00.000-07:00

We encounter many patients with hearing loss. Many have loss due to infections and large holes in their ear drums or missing bones. Some of these patients can be helped with surgery. Many have nerve damage that cannot be helped with surgery. Often the nerve damage (sensorineural hearing loss) is the result of a strong antibiotic that is used to fight life-threatening infections. We use the same antibiotic in the United States but we are able to better control the blood levels of the medicine. I have seen many deaf and partially deaf patients here in Nigeria. Many can be helped with hearing aids. We are fortunate enough to have a fairly good audiometry booth that is sound proof and reasonably well equipped. It is certainly the best facility in our region. Audu and Ben, assistants in the ENT clinic, fit many patients every week with hearing aids. Because most hearing aids require batteries that don’t last long, we have solar powered hearing aids for the poorer patients. These were developed by a non-profit ministry called ComCare, Inc. They sell the aids to ministries for the cost of their supplies. These aids work very well for our patients who cannot afford to replace batteries on a regular basis. The aids are also rugged and can last a few years. Our Hausa language teacher is still wearing his solar powered hearing aid that he was given 5 years ago.
I have included a couple of photos of patients. One young woman has been blind since she was a baby. She is continuing to lose her hearing. We have been able to help her with an aid. Another woman had a life threatening infection after an abortion. She was treated with the antibiotic that poisoned her inner ear. She is orphaned and has no family to help her with the cost of medical care, much less a hearing aid, a common situation in our region of Nigeria where there is no medical insurance. Patients pay cash for all medical care. They often go to family to help pool the finances to pay for medical care. Thanks to generous donors, we were able to provide both young women with solar powered hearing aids. One will now have better opportunity of communicating in her dark world. The other will hopefully be able to find work since she can better communicate.Michael Mitchell, MD

Victor

2008-10-11T09:07:00.000-07:00

I thought I would take the time to introduce you to Victor. Our family is quickly becoming attached to this 9 year old boy and his 14 year old cousin, Gwakman. Victor reminds me of a young male, Nigerian version of Camille: very charming, very bright, talkative, and precocious. He wanders over to our house daily to visit us as well as enjoy some of the things that you see pictured on the table, very luxurious things at that: clean, tasty water; high quality English books, and best of all plentiful food! In addition to these items, he is always hopeful of getting a chance at playing electronics which he has to work for in the form of reading English for 20 minutes (by Emily’s orders!)

This Saturday morning, Victor was at our door with his bright smile at 7am. Good thing we are always up around 5am! He came to retrieve a forgotten item from the movie night before. There is always a little hopeful look in his eyes . . . I can’t blame him since he usually only gets one meal a day. I promptly told him to go around to the back patio which is just outside my kitchen door. While I got busy in the kitchen with breakfast dishes, Victor enjoyed his peanut butter sandwich and water, happily chattering my ear off.

Today’s topic was school. Victor really likes school except for when the teachers beat him with a bamboo cane! Not just him, but all the students! This is an accepted form of discipline in Nigeria. Forgot your homework? Made a failing grade? Disrespectful behaviour? There is one solution for all. (No wonder my students at the seminary treat me with such respect!) Victor would like to be either a doctor or an agricultural scientist so he can feed lots of people. He makes very good marks in school and also speaks three languages: Tarok, Hausa, and English. We have great hopes for this little boy who has captured our hearts.

Patient Profile: Mr. A’s Laryngectomy

2008-10-02T04:12:00.000-07:00

Left to right: One of Mr. A’s 50 children, Mr. A, Dr. Mitchell, Dr. Aboiyar (ENT apprentice)

Mr. A is a 65 (best guess since birth dates are often not recorded) year old male from the Tiv tribe. He was evaluated by a local ENT surgeon and found to have cancer of the larynx. The surgeon recommended laryngectomy, which is the surgery that removes the voice box and leaves a hole in the neck to breathe through. Another option is radiation therapy which is the usual initial therapy in the states, and has very good results. Radiation is not as controlled or as effective in Nigeria. Mr. A decided to have radiation in March 2008. It did not work and his cancer returned and was blocking his airway by July 2008. He was to have surgery at the University Hospital, but there were logistical problems and the surgery was going to be postponed until September or even November. The ENT surgeon asked if we could do the surgery here at Evangel Hospital. I agreed and I assisted him in the laryngectomy in late August.
Unfortunately things have not gone well and the patient has had multiple complications. His wound completely broke down and opened up. His feeding passage (pharynx) opened up as well. Much of this was a result of the radiation which causes poor healing in the tissues that have received radiation. Mr. A has gone back to the “main theatre” (operating room) four times to try and close the wound. We have taken tissue from his chest and put it up into his neck to try and cover the wound. He has remained in the hospital for 5 weeks. I have been seeing him daily. The University ENT surgeon has left the care to me. He did not foresee the long hospital stay, and the ENT surgeon has actually gone to India for a six week training course. Fortunately one of Mr. A’s sons has been staying with him for the entire time and doing excellent nursing care. The son has been doing the tube feeding, dressing changes, tracheotomy tube cleaning, and even monitoring his oxygen saturation with a pulse oximeter.
We are discharging Mr. A to his home, though he is not healed. He lives in a village about a 6 hour drive from here. He was supposed to go home yesterday, but his hospital bill is 200,000 Naira ($1,800), and he did not have the money on him. A patient or family member must pay in cash in full before the patient is allowed to leave the hospital. If the patient dies, the hospital will hold the body until the bill is paid by the family. Fortunately Mr. A is a relatively wealthy farmer. He has made a lot of money from his crops over the years. He has had seven wives, four are now living. He has 50 children that his accompanying son is aware of. One of his sons is coming later today to pay the bill. Mr. A will return to our clinic in 2 weeks. We pray that some healing will have taken place.

Michael Mitchell, MD

Happy Nigerian Independence Day

2008-10-01T09:45:00.000-07:00

Today, Wednesday, October 1st, is a national holiday in Nigeria. We congratulate Nigeria on 48 years of independence. The Federal Republic of Nigeria is a federal constitutional republic comprising thirty six states and one federal capital with a population of about 140 million. Nigeria gained its independence on the 1st October, 1960 and became a republic on October 1st, 1963. Nigeria re-achieved democracy in 1999 ending almost thirty three-years of military rule between from 1966 until 1999. The last major uprising here in Jos was in 2001 when there was sectarian violence between Muslims and Christians. Other than the rebel group in the far south, Nigeria is politically calm for now.
The celebration in Jos is subdued, compared to American Fourth of July festivities. Most workers have several days in a row off. Elective and routine care at Evangel hospital is shut down and there is no school today. As a matter of fact, school has been out for 3 days. Monday and Tuesday were last minute holidays in observance of Sallah, the end of Ramadan. Muslims have had their own celebration as they are completing a 4 week period of fasting. During the day, roughly 6:30 am to 6:30 pm, they did not eat or drink. Roughly half of Jos is Muslim. Many of our patients at Evangel Hospital are Muslim, despite our strong Christian emphasis.

Please join us as we pray for the country of Nigerian: for strong leadership and for strong leaders full of integrity who will work hard to make a better life for all Nigerians.

President Umaru Yar'Adua

Michael Mitchell, MD

Our “Adopted” Family Member

2008-09-29T13:31:00.000-07:00

Tonight we spent the last evening with our beloved house guest, Shannon Castle, MD. She has been with us for over three weeks and the time has flown. Shannon is a 28 year old general surgery resident from San Diego. She came to do a four week rotation at Evangel Hospital. Her original living arrangements were a little cramped with two other medical students in a one bedroom apartment, so we invited her into our large home. She has been rooming with Camille. Shannon has become an honorary Mitchell. We have enjoyed her company and she has been a great role model for the kids. Dr. Bill Ardill, the general surgeon, has benefitted from her hard work and expertise in the hospital as well. We will all miss her.

Michael Mitchell, MD

A familiar sight on the streets of Jos

2008-09-28T14:23:00.000-07:00

I spend a lot of time in the car with Alphonsus every day. We see some pretty unusual sights as we are driving around. Attached is one of my favorites that I see quite regularly. I still can't figure out how they get the bulls into the back end of a pickup truck. This is a familiar sight since the road to the school also happens to be the road to the butchers!

Nigerians are pretty fussy about having their picture taken. You must ask if you can "snap" them. They may or may not let you. I took the liberty of taking this picture since the guy's back was turned. The bull had too many other things on his mind.

You can also see large mattresses balancing on the heads of the driver and passenger of the achabas (motorcycle taxis), goats (dead or alive), families of four, and even a large office desk. Our furniture that we ordered was delivered this way!

Car rides offer some daily entertainment. They also offer some time for serious conversations. My driver asked me just this week out of the blue how you could know for sure if you are a Christian. It was a great privilege to talk with him and remind him of the great gift of salvation we are given in Christ and God's forgiveness even when we are disobedient. Alphonsus is really growing in his faith and his understanding of the Lord. What a joy to have these moments!

Lisa

Wee Sachets of Porridge

2008-09-24T06:32:00.001-07:00

Since we’ve been here we’ve enjoyed spending time with the medical students who are working at Evangel. We have particularly had fun with the Irish medical students, Gemma and Gary. They are pretty funny, especially Gary. I had always thought that the weird sayings you hear people say when they imitate Irish people were just stereotypes, but they’re TRUE. Gemma and Gary would both use the word “wee” all the time. Our favorite was when Gary talks about his “wee sachets of porridge” which are really just instant Quaker Oat packages. At our going away dinner for Gemma, Gary got it in his mind for me to teach him how to solve a Rubik’s cube. So I sat there for about an hour just attempting to teach him how to solve this cube. Well… maybe not for the whole hour. I spent a lot of time making fun of him. I thought guys had better spatial skills than girls but I guess Gary is an exception. As far as Gemma, she is really cool. One time when she and the other med students came over, we got to talking about Ireland and stuff. I actually found out a lot. I’m in the process of convincing my parents to let us go there for our family vacation on the way back from Nigeria. That would be exciting. Plus, the accent is so cute.
Hannah (17)

JETS

2008-09-23T09:14:00.001-07:00

As I ponder how to answer the latest question, forty faces look back at me expectantly in silence. I begin writing in response and behind me instantly I hear the scritch scratch of pens as my students diligently copy down every word and mark I write. This is typical of every class that I have taught so far at JETS (Jos Evangelical Theological Seminary.) These first year pastoral students are very eager to fill the gaps missing in their English which may be their second, third, or even fourth language. English is the official language of Nigeria. It unites the several hundred different dialects spoken across the country and provides a language for government, business, and even the Church.

Many of my 37 male students and 3 female students are from the bush. They have come to one of the most prestigious seminaries in Nigeria and will study for 2-3 years before returning to their homes to be pastors and leaders in their communities. Initially, their greater understanding of the English language and its structure is preparing them for learning Greek in their second year of seminary. Their knowing English also enables them to communicate with church members and potential converts from outside their tribe. It also enables them to communicate with other missionaries as well as be able to read textbooks and articles published to further their theological education.

There are two things I love about my new job: my wonderful students who are exuberant about their faith and so appreciative of the time I spend with them, and my delightful colleague, Abigail Hunt. Abi was singlehandedly teaching a class of 80 students before I was recruited to split the class with her. We now each have our own class of 40. I really appreciate the time she is spending with me helping me to know what to teach and looking over my shoulder a bit to make sure things are going well. I couldn’t have asked for more . . .a lovely Nigerian sister in Christ to fellowship with and exchange teaching ideas and tips with. Abi is also enjoying looking at the materials I brought from the US; quality, current materials are in short supply here. I do not even have a class set of books to refer to. One whiteboard is all I have, so much of the class time is spent calling out or writing (and erasing) the board. I have had several students approach me and ask about my nice grammar workbook that I refer to often in the classroom. Unfortunately, it costs more than half a month’s wages for them. An impossible sum for most of them and certainly for the school to provide!

I look forward to each Tuesday and Thursday morning that I get to spend with these future leaders of Nigeria!

Purity Retreat for Boys

2008-09-21T13:34:00.000-07:00

Last weekend was tons of fun. I went to the Hillcrest Purity Retreat for the whole weekend. All of us figured out very quickly that there was a trampoline on the compound and that was where we spent pretty much all of our free time. Because no one has trampolines here I was the only one that could do any sort of flips. All of the Nigerians were going wild because of the fact that I could do a back flip on a trampoline. Besides the fun, the sessions were quite helpful. Coach Tolar was my small group leader and he had many great points on the matters we were discussing throughout the weekend.

Sterling (15)

Football

2008-09-20T08:57:00.000-07:00

In Nigeria, everything revolves around football. Real football, not the American game that you don’t actually play with your feet. During the Olympics, while my dad and I were sitting in the clinic, we could hear the whole hospital around us roar whenever Nigeria scored a goal. People would crowd around TV’s in the general ward to watch the games or watch on cell phones that picked up analog directly. Everyone watched the games, and bringing up the final where Argentina beat Nigeria for the gold medal was a touchy subject for a couple of weeks. But not only does everyone watch football; they all play since they are knee high. Even the toddlers will run after the ball and kick at it. Football is the neighborhood social event. Any footballs in the neighborhood are used so much that they quickly break or go missing. Currently our family has the only intact football in the neighborhood, so we always have kids knocking on our door asking to borrow it. The other day one of the boys who lives down the street knocked on our door while I was baking muffins, asking if I could come out and bring the football with me. I told him I would finish the muffins and then bring out the ball. When I came out about half an hour later, I was surprised to find that he had rounded up what appeared to be the entire Evangel compound for a game. Not only all of the elementary school aged boys, but also high schoolers, residents, and doctors were out to play. The teams were already divided, the order decided, and the only thing missing for the game was the ball. One of the older players called for me to toss him the ball, pointed to which team I would play for, and the game started immediately.
Since that game I have been playing with the same group of high school students every day. Playing football has been a great way to get to know people in the neighborhood other than the ones under the age of twelve, who just roam loose in packs. People here are often named after people in the Bible or days of the week, so of the five or six guys that I play with, two are named Joshua and two are named Monday (Sterling’s football coach’s full name is Sunday Monday). Playing football has also turned out to be the perfect solution to my problem of figuring out how to exercise every day in a safe and culturally acceptable way. Jogging outside the compound is not particularly safe, especially for white women alone. It is possible to jog around the compound, but it is a fairly small loop and stays muddy most of the time. Football is a fun way to keep fit and has been a good way to connect with all of our neighbors at the same time.

Morning Report

2008-09-16T13:26:00.000-07:00

Every week day morning at 7:30 we have morning report. There are a team of doctors who are take in admissions and do the initial evaluation and treatment. They work hard and often have sleepless nights. The complexity of the admissions varies greatly. There has been an increase in the number of trauma patients. This has been attributed to an increase in the “achabas”, which are the motorcycle taxis used by many for transportations. There are rarely helmets worn.
Patients with malaria, typhoid fever, and retroviral disease (local name for HIV) are commonly admitted as well. The house staff take care of obstetric and pediatric emergencies.

The picture shows the three house officers who had been on call the weekend before. They are sitting under their respective lists of admissions –and one mortality. They are a hard working bunch, who are eager to learn. Every morning they discuss their management of the patients and we will often use the opportunity to discuss the appropriate diagnosis and management of a patient.
Michael Mitchell, MD

A New Routine in Nigeria

2008-09-12T12:47:00.000-07:00

I don’t know which wakes me up first each morning: the sound of our two ferocious Dachshund guard dogs barking at the neighbors as they rouse, the distant high-pitched beeps of the achabas (motorcycle taxis), or the Nigerian radio music that is floating over the fields in through our open windows. Before sunrise I roll out of bed, remembering to turn on the hot water heater so I can have warm water for showering, before I head off to the kitchen. I immediately start a load of laundry in the washer since it will take a couple of hours to finish. Maybe today I can squeeze three loads of laundry out of my machine that holds about a third of my machine at home. I turn on the water pump to fill up the outside tank so we will have adequate water flowing into the house. The tricky thing is to remember to turn it off. Then finally I fill the indoor water filtering system so we will have plenty of drinking water for breakfast.

One of the wonderful advantages of having to cook each meal every day is that two or three times a day our family is gathered around the table. After a nice breakfast courtesy of our morning cook Emily, everyone races off their separate ways. I am left to rinse the dishes and begin filling out marching orders. I consult with Zaineb to plan out a menu since she is my expert on local ingredients and their availability and correct price. Alphonsus is sent off to the market with a list and a close estimate of the cost involved. What I do in about 45 minutes in America will take him literally hours with every item bartered for. Because everything is on a cash basis here, I must carefully count out the money and send him on his way. Then Zaineb and Asibe (our latest helper who is a widow supporting four children at home), get their instructions. Finally, I can start my day.

On Tuesdays and Thursdays starting next week from 9:30am-10:45am, I will begin teaching an English class at the Jos Evangelical Theological Seminary (JETS.) Abigail Hunt, a Nigerian teacher with many years of experience, was singlehandedly teaching a class of 75+ first year students. We are going to split the class and work together to get the job done. I will very much appreciate her experience and guidance, her knowledge of the customs and the seminary, and her very sweet personality. I am nervous and excited all at the same time as I take on my first official English class with two thirds of my masters completed. I’m sure I will have many stories in the future to update you with! The picture included was my first day on the JETS campus. I will be wearing Nigerian clothes regularly. I look forward to helping these future pastors and Bible teachers improve their English speaking, reading, and writing as well as fellowshipping with these dear brothers and sisters in Christ.

Fridays are my day at Hillcrest School. I am the local trumpet/brass expert and am teaching music three periods over the course of the day. The high schoolers, middle schoolers , and the sixth graders are a lot of fun to work with and really appreciate the extra attention they are getting. On November 7th, there is going to be an Honors recital. I am helping several of the kids get ready for this recital. I will be thrilled if by the end of the year we are making some beautiful music together!

My schedule is picking up, and I am really enjoying being out and about and interacting with the Nigerian people and the missionary kids. Oops! Time to turn the outside water pump off!

Lisa