Coach Tolar Takes Teens Abseiling

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

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

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

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

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

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?

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)