Civilization in the Wilderness

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?

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

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

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

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

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

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

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

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

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

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!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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