November Newsletter
Topic: Mission
The November newsletter is now available on the website.

October Newsletters
Topic: Mission
Both October newsletters are now available on the website.

Joel's August 2004 Medical Blog
Topic: Mission
It is amazing what one can see in just several days of ENT clinic in Jos, Nigeria. I have had a family practice resident from the Jos federal medical school (Jos University Teaching Hospital) doing an ENT rotation with me for the past two weeks, and we have both been learning a lot.

A young boy came to the clinic last week having aspirated a straight needle. The Chest x-ray revealed the pin in the right lung's lower lobe. (How do you like our xray "view box?")





With our only functional ventilating pediatric bronchoscope it was not possible to even visualize the pin, much less remove it. The only other option is to subject this boy to a very big open chest operation in a city without even one ventilator in an ICU. So I am following him for now - with more modern bronchoscopic equipment I might try to remove it again.

A beautiful two and a half year old girl returned to the clinic for followup regarding her profound hearing loss. She lost her hearing one year ago after being very sick with a high fever. Six months previously she was not able to cooperate enough to wear a hearing aid. But, praise God, now she was both cooperative and able to wear a hearing aid. Pray that she will now be able to hear enough to function in the hearing world.

A man came in with a large left neck mass, and a previous biopsy done months ago that was read as adenocarcinoma. The search for a primary (original site of the cancer) has not been revealing. I recommended he go to Ibadan (a 10-12 hour drive away) where they have CT imaging capabilities, as well as the ability to treat cancers with chemotherapy and radiation therapy (our only option in Jos is surgery). Additionally, there are pathologists at Ibadan who might be able to find that he actually has something other than adenocarcinoma. But he says he has no money to go anywhere else. He accepts God's will and begs us to do whatever we can.

A baby came to the clinic with an encephalocele (brain tissue that is herniating through a defect in the skull of the forehead) in need of repair. There are no neurosurgeons or plastic surgeons here in Jos. So the missionary general surgeon and I are trying to figure out the best plan of action for this child.

A sixty year old man came to the clinic with a history of a lifelong swelling of the left cheek that had become larger and more tender in the previous week. The man actually had a rare congenital abnormality called a First Branchial Cleft Cyst that had become infected. Once the infection is cleared up with medicines, then I will remove the cyst with surgery.

A man drove over 16 hours to come to see the ENT doctor regarding his advanced maxillary tumor. Remember, we have no CT or MRI imaging capabilities here in Jos. Is his tumor resectable? What kind of tumor is it? The only place in town to send pathologic specimens for examination is the local federal medical school called JUTH (Jos University Teaching Hospital). In a normal situation it takes at least 3 to 4 weeks for the pathology results to be returned after surgery (it usually takes only 2-3 days to get results in the US). But we are in no ordinary situation currently. JUTH has been on strike for the last two weeks. That means there is no where in Jos to take surgical specimens for pathology. I took a small biopsy of his tumor and sent the patient to Zaria, six hours away, in hopes that the university there was not also on strike and could give us a pathologic diagnosis before considering further treatment options.

The strike at JUTH has affected many other patients as well. A sick child came to our hospital last week and was admitted to the pediatric service with a possible lymphoma. I took the child to the OR to biopsy the lymph nodes in the neck. But again, there is no where to send the specimen in Jos for pathologic evaluation because of the strike. We asked the family to try to take it to the Kano University Teaching Hospital for evaluation. It is difficult to watch a child grow closer to death each day while you await a pathology report that may never come.

A man who was a victim of the Muslim Christian crisis several hours drive to the south of Jos in May 2004 was brought to our hospital last week from another hospital. His throat had been cut and he had been left to die. Some good Samaritan had rescued him and taken him to the bush hospital where he was nursed back to life. But he was not able to talk and was only able to breath through a very small hole in his neck that remained from his wound.

I took him to the operating room this week and gave him a larger hole in the lower neck to breathe through called a tracheostomy. I also explored his larynx (voice box) which was the area of his injury, and reconstructed it and closed the laryngocutaneous fistula (the small hole he had previously been breathing through). Pray that the Lord would restore his voice and his normal breathing passage. Pray also that the Lord would heal him emotionally and spiritually. He doesn't know if any of his family is still alive.

A man came to the clinic with an old poorly healed jaw fracture. I was able to use a set of donated specialized mandible fracture instruments and plates that I had just brought back from the States with me in order to properly treat his injury.

And there are many other patients who come to the ENT clinic at Evangel hospital with conditions that range from nasal allergies to laryngeal tumors, from chronically draining ear infections to nasal polyps, from hearing loss to hoarseness.... Please pray that the Lord would continue to use us to extend the healing ministry of Jesus Christ here in northern Nigeria.

Recent Outreach
Topic: Mission
Posted on behalf of Cindy:

I (Cindy) have been on several different and very exciting medical outreaches in the two months.

One was to a small Muslim village in neighboring Bauchi State. I traveled with a team from our local Church in Jos. It was exciting to be part of this team that included doctors, nurses, agricultural specialists, pastors, a music group and a Gospel team (all Nigerians except me.)

The goal of our local Church is to see God plant a Church in this village. We used medicine and agricultural advice as a way to build bridges for the Gospel. The village does not have electricity or a clean water supply. None of the children I saw had any immunizations. Many of the children had signs of malnutrition.

We began our outreach by visiting all the local chiefs in the villages around the area. They were open to our visit and one chief of a neighboring larger village gave use permission to hold a medical clinic in his village as well. While we were greeting him, he requested that the Baturi (white doctor) see him and his wife for medical concerns. I was called from outside his palace (where I was waiting with the other women on the team.) As I crossed the threshold into the compound, I heard gun shots. Of course I did the logical thing and ducked. I was greeted with roars of laughter from the chief and the others inside. It seems that it is a local custom to fire your gun when an honored guest arrives. I recovered and treated the chief and his wife without any further blunders!

We slept under the stars (I actually brought a small tent) and began our work in the morning. We held a medical clinic and I made some house calls. We returned to the neighboring village where the chief had given us permission to hold a medical clinic. We were greeted by the young men of the village who told us we were not welcomed in their village. In fact, they said if we got out of our vans they would beat us. If you read the Nigerian news you know these are not idle threats. The chief had gone out for the day and was not there to sort out the trouble. We decided we would not stay where there might be trouble. We headed back to the village where we were staying and continued our work there. I had the privilege of sharing the Gospel with several of the women I saw in the clinic and several prayed to receive Christ.

We held a meeting each night which included an agricultural talk and a gospel message. On Sunday morning we held a worship service. Several from the village joined us. After the service we laid the cornerstone for a small Church building. It will be the first in this village. We pray God will establish His Church in this village.

Village Health Care
Topic: Mission
Posted on behalf of Cindy:

In the last two weeks I (Cindy) have made 2 trips out to a small village in neighboring Bauchi State. The village of Dass is 3+ hours away and is home to a small ECWA (Evangelical Church of West Africa) health clinic. The clinic is staffed by a community health worker with some simple medications. We were asked to travel to Dass to see some more difficult cases and to encourage the church and clinic staff.

Our first trip was two weeks ago. Both Joel and I went along with an eye nurse, the supervisor of community health for Bauchi state and 3 very eager college students from the states here on a short term trip. We saw more than 60 patients, but we also left at least that many unseen. It is imperative for safety reasons not to be on the road at night so we had to leave in time to return before dark. Although we were frustrated by some disorganization, and serious lapses in crowd control, it was a good day. Joel and I got a chance to work together which was great. And we really got a chance to practice our Hausa as most patients spoke no English and we didn't have a translator (only occasional other patients waiting their turn who helped us) We saw many who had serious problems that could not be addressed in this simple clinic. We had a chance to stop and pray with patients and that was the highlight! I also enjoyed listening (through the curtain that divided our work station) to Joel dealing with lots of general medicine problems that he hasn't faced since medical school days. I was very proud of him (he should have been a family doctor!)




We had several patients come because the word had gotten out that Joel is an Ear specialist. One patient stands out in my memory. She was a beautiful little girl of around five from a Muslim family. She came because she had lost her hearing several years earlier. Joel examined her and counseled the father. She is a candidate for a solar powered hearing aid and she will travel with her father to Jos to have a formal hearing test in the sound proof booth in the eye and ear clinic at Evangel Hospital. Pray that she will be helped by the hearing aid and also pray that the door will be open to share the hope we have in Christ with her and her family.

We returned to Dass one week after our first trip to see the patients we had not been able to see on our first trip. This time Joel was not able to join us, but one of the Nigerian family practice residents training at Evangel came along, as well as 5 eager American college students. This time the clinic staff was ready for us. The line was orderly and I had a dedicated translator for the day. We saw 130 patients which mostly reflects the help of the Nigerian resident as his knowledge of Hausa and tropical diseases far exceeded mine. I still had time to pray with many of my patients. Many women came complaining of barrenness which in this culture is devastating and often leads to the husband taking another wife. There was little medical help to be offered in this simple setting, but God is the Author of all healing and we prayed for His solution to this painful problem. I also saw a woman, the mother of 5 children who was complaining of insomnia. As I questioned her more closely she revealed that her husband had recently deserted the family and converted to Islam. She was left alone to support her family and the stress was taking its toll. Please pray that her husband would return to the Truth and to his family, pray for my patient's comfort in this very difficult circumstance.

The last patient of the day on our second trip was the Chief of Dass. He was an old man (82 years) but very strong. He is a Muslim and has much power in the area. He came because he was having difficulty with his hearing. I examined him, and referred him to see Joel at his clinic in Jos. He is a good candidate for a hearing aid and we pray that his visit to Jos will begin a relationship that brings fruit for the Gospel.

Thanks to all of you that prayed for these medical outreaches. It is only by the power of prayer that we are able to minister here! We appreciate you all.

Giving Thanks
Topic: Mission
Posted on behalf of Joel:

Cindy and I volunteered to work as medical doctors in a Christian Crusade that was held here in Jos during the first week of December. Believe it or not, a church from Houston, TX came out here to run a crusade in the Jos city soccer/"football" stadium for the entire week. The pastor of the church was originally from Jos, Nigeria, and is also a medical doctor. So they held free medical clinics by day, and evangelistic crusade services by night in the stadium. Considering the complexity of running such a medical clinic/crusade here in Nigeria, it was amazingly well organized, and we were blessed by our opportunity to be of service as part of the crusade. The crusade not only saw patients for free, but also bought and brought many drugs and had a "pharmacy" of free medicines for us to give to patients. They also paid the bill for many patients to receive elective surgery during the week of the crusade, or during the next week during their follow-up.

I thought I would have to try and function as a general practitioner, but there was plenty of ENT related needs for me to address without needing to branch out into Ob/Gyn or Medicine. Sadly, we saw many patients who could not hear for one reason or another, and referred them to our new Eye and Ear clinic at Evangel Missionary hospital to have their hearing tested formally. Some may be able to benefit from surgery when a functional ear operative microscope arrives, Lord willing, in January or February by container. Others may benefit from hearing aids. We are so thankful to those of you who have contributed financially towards the purchase and shipping of much needed medical equipment, and also to those of you who have contributed to cover the cost of the solar powered hearing aids ($100 per aid is a bargain!).

The amount of suffering that is part of the Nigerian peoples' lives is overwhelming and is something that I am not used to. and is something that I do not ever want to become "used to." Every time I saw a mother, and asked her how many kids she had, there was always a pause. Did the doctor want to know how many kids are still alive, or the total number of kids that there had ever been? I can't remember seeing a mother with more than one child who hadn't lost at least one other child. I was able to remove a plastic bead out of one 19 year old girl's ear canal that had been there for over 10 years! When I gave her the bead to go and show her parents, she started to cry and told us that both her parents had died, and she was the one responsible for her younger siblings. So we prayed with her and for her.

In many of the Nigerian church services they thank the Lord in their prayers for counting them among the living. Just yesterday one of two vans returning from an outreach in Bauchi state (that is where Cindy went on an outreach 3 weeks ago) was in a terrible accident. More than ten people were thrown from the van, and two people are still in critical condition. Pastor Joel is the Nigerian Christian outreach leader who is still unconscious and desperately needs prayer. Please pray for Lord to preserve the life of His servant pastor Joel. The van rolled three times, and it is a miracle that many did not die at the scene of the accident. The reality of death and suffering is so great here; and yet the Lord is still in control. And what is our response: to become more acutely aware of the blessing of being counted among the living this very day, and to give thanks to the Lord.

Prayer Partner Letter
Topic: Mission
Date: Thursday, November 27, 2003 4:03 AM
Dear Prayer Partners,

The work of missions is prayer and you all have been working hard this week! I returned last night from the medical outreach I was helping with. I was exhausted but thrilled to have been part of what God is doing. I will give you all some of the highlights, but encourage all of you to come join us here and experience an outreach for yourselves!

We left early Monday morning to travel to our first village, called Miya. The team consisted of myself, the director of community health for Bauchi State, an eye nurse, a Family Medicine resident, and a medical student from Australia and his wife. When we arrived at the clinic in Miya, we went first to the chief's palace. He had given us his permission and blessing to hold our clinic and we needed to properly greet him. He is a Muslim and a very old man. We greeted him and the local pastor shared with the chief and all the people gather a short devotional and prayed in the name of Jesus. The chief asked if we would see him and his family at the palace. We agreed and while they were setting up a place for us to work we found out the chief has nine wives! We saw the chief and his key men and all of his wives. Then we saw the chief's oldest brother and his 4 wives. We had to excuse ourselves at that point as a huge crowd had gathered at the clinic and we needed to get there and get started. Thankfully we weren't asked to see all the chief's children as he has 57!

The clinic was very successful. We saw many patients, both Christians and Muslims. We administered health care and prayed for many patients. That night we held a meeting at the local Church and showed a Christian evangelistic film in Hausa. There were hundreds of people there and after the movie, the pastor shared a message and gave an invitation. One man came forward and prayed to receive Christ. We pray that seeds were planted with many others.

On Tuesday we saw more patients in Miya and then packed up to head to our next clinic. As we drove, we blew out a tire and God protected us as the driver was able to safely bring us to a stop. We had no spare, but thankfully we were able to hire a vehicle to get us to Bauchi and the ECWA office. We picked up a different van and we were off to Gar for our next clinic. We arrived in Gar after dark and were thankful to God for protecting us along the way.

On Wednesday, we began our day by going to the chief's palace in Gar. The chief had traveled to Bauchi to celebrate Sellah, the end of the Muslim Ramadan, but we greeted his two senior men. They thanked the church officials that had come with us and asked that we do more for the health of the local people. We went to the clinic and again saw many patients. After lunch I traveled back to Jos to relieve Joel of the solo responsibility for the kids. The team held an evangelistic meeting in Gar last night and will finish up the clinic today and then travel to Ningi for the last clinic on Friday. Pray for God's continued protection for the team. Pray that many more will respond to the Gospel as their physical needs are met in the name of Jesus!

Thanks for being apart of the community health team in Nigeria. Without your prayers we would not be able to bring the Gospel in word and in deed to the people in need!

In Him,

Cindy

The Fulani Family
Topic: Mission
Posted on behalf of Cindy:

Joel asked me to write the story that goes with the most recent pictures he sent so here goes.

Many of you read in our recent news letter about my trip out to a Fulani camp to do immunizations and to see some patients. It was there that I met Jao. Jao is the 20 month old son of Fulani Christian converts from Niger. His parents have come to this Fulani camp to be discipled and to learn Hausa so they can study the Bible. Their desire is to return to their Muslim families in Niger and share the joy of the Gospel.

Ten days before I met Jao, he had visited a local medical clinic with a high fever. He was given an injection of some medication and from the time of the injection he was unable to walk. When I saw him he had severe pain in his hip near where he had received the shot and was unable to walk or even stand. He cried out in pain if I touch his hip or his leg or tried to move it. There was very little I could do for him in the Fulani camp as the only medicine I had to offer was Tylenol. I told the pastor in charge to try to get him to Evangel hospital (where we are working) in Jos if there was no improvement.

Five days later, Jao and his family arrived at Evangel. He had not improved and was still unable to walk. The doctor who saw him in the clinic when he arrived thought he may even have polio. He was admitted to the hospital for treatment and tests. The family has no resourses, so Joel and I said we would pay for what ever was necessary. Jao received treatment for malaria and an Xray showed his hip was not infected as we had feared. We continued to pray for his improvement and tests were sent to the government hospital for polio. Jao slowly improved. He was discharged home this week able to not only walk, but run! The diagnosis is still unknown and the polio tests will not return for two more weeks. As I told the father, we don't know what he had, but we know who healed him! We praise God for his recovery.

Please pray he would regain all of his strength. As for the hospital bill.. Jao stayed six days, had several tests and received medication for several diagnoses. In the US six days in the hospital can cost thousands of dollars or more. Jao's stay with us at Evangel cost roughly $26. Now I will say that that is a huge amount for many here, but we were glad to be able to help. If any of you are looking for affordable health care come and visit us. I think even including the airfare our care is a real bargain!

A family affair
Topic: Mission
Posted on behalf of Cindy:

We are here as a family because we feel God has called us all here. In many ways the children are missionaries as much as we are. There is a 13 year old boy in the hospital now undergoing a series of painful operations for a terrible scar that keeps his chin pinned to his chest. He is an orphan with no real family to visit him and bring him food. I told the kids his story after we met him at the hospital. Allison decided to donate one of her books to him and Austin wanted to give him something to eat. We went and bought him a bunch of bananas and visited with him. All three of the children talked with him and we had a nice visit. We plan to go back and see him during his stay. For school this week Austin is memorizing the verses in Matthew where it talks of letting your light shine among men so that men may see your good deeds and praise the Father in heaven. May He be praised!

Surgeries This Week
Topic: Mission
Posted on behalf of the Anthis family:

Thanks to all who have been praying for Joel's surgeries this week. Two smaller cases on kids went well earlier this week. The one man from Niger with the huge maxillary/palatal tumor did not show up for his surgery on Weds, so time will tell if he returns or not. The young 25 yr old girl named Pasima from Niger did come for her surgery today. In summation, medically speaking, it was a difficult day. The tumor had eroded the majority of her anterior neck skin, but did not reveal itself to be unresectable until much later in the case. There is no such thing as a CT scan or MRI here to give advance warnings and guidance. The power went off during the surgery, as did the cautery machine and suction intermittently. This is all part of the reality of missionary medicine in most of the world, but knowing that doesn't make the transition any easier. We as physicians in America are accustomed to delivering the results that our patients expect - as I am used to and as it should be. So it was certainly discouraging to tell this young girl's mother that although we were able to remove a large part of the tumor, we had not cured her daughter, and there was no surgical cure available for her here in Nigeria. The patient and her mother both speak Hausa predominately, the language we will be studying starting next week. But for now it is frustrating trying to discuss complicated surgical details, and to try to discuss spiritual issues through a translator. Please continue to pray for Pasima's physical and spiritual condition.