A Day in the Life of Me

Many of you have been wondering what everyday life is like for us here in Angola. I will take you on a photo tour.

First things first, mosquito nets are a must. 

The boys room

Our room

 

Henry also helps with the mosquito problem. We are learning to love Henry.

Babies still take first steps in Africa.

The kids are going to a school right now. I was hoping it would help them get used to things and learn the language, but it's not so great. We are seriously considering good old fashion home schooling.

I'm hungry!

24 hours a day, we have a guard who also tends to our garden, and we share the fruits of his labor. The guards also teach us the local tribal language, Umbundo.

We live near a beautiful beach that we get to enjoy on some Saturdays.

Another Saturday trip exploring sea caves and boulders

I'm washing cloth diapers every day.

I'm learning how to wear Roman, African style. I still have some learning to do.

Another local friend

Babies still have first birthday celebrations in Africa.

And they get sleepy

Visiting friends in their home

Hungry again!

Sometimes John has non-patient visitors at work

makashishi- that is it's Umbundo name, John calls it the brain fruit, despite it's looks, it actually tastes good.

Produce Department

we have another "mosquito" problem here in Angola, this one is just as dangerous as the bugs, but doesn't cause malaria.

Another pic of the motorcycles. It get's much worse, but I didn't want to go seeking them out just for a good photo.

Thanks for coming on my tour. I'm trying to put some light content on the blog, so It doesn't get so heavy that I loose some of you. Please keep coming back, and keep praying! We love and miss you all.

Not every day is a day at the beach

Fair warning, there are graphic medical pictures shown here. If you don't like gross eyeballs you should probably stop reading this.

I wanted to give the reader an acurate snapshot of a typical week in the office here in Angola. These are just a few of the difficult cases I've had to deal with here (we see 80 patients daily, and I don't have time to take pictures of all of them). I'll give a brief summary of each case.

Case #1- 35 yr old woman has had this growth for the last 2 years. It appears to be squamous cell cancer of the conjunctiva. I elected to treat this with a topical chemotherapeutic agent (5-FU). I don't easily have access to pathology here in Angola and I don't have the standard equipment to treat these with surgery. So, I elect to treat these small tumors topically. I see at least one of these every day in clinic.

Case #2- This is what happens to the eye in case #1 in 10 years if left untreated. This eye was removed entirely and sent away to the capital for examination. If I'm lucky they will send me the results of the exam.

Case #3 - Cataract, lots and lots of cataracts. This man had a trauma to the left eye. I've done almost 100 surgeries at this point, and on review of my records 90% of the surgeries have been for patients that can only see shadows because their cataract is so dense. Really crazy, because in 4 years of surgical training in the USA I did maybe 6 of this type of cataract.

Case #4 - Many people suffer from trauma here. This man had a rock fly up and hit his eye causing a cut in the cornea and the sclera (white part). His iris (brown part) was sticking out of his eye. He came to me a week after his injury. I debated on what to do for him, the eye looked pretty good but his eye pressure was very low and on inspection there was fluid still leaking from the wound. I took him to the OR today and sutured the wound closed. I may not have done this surgery except for the child I had seen the day previously with the same story, except they waited 2 weeks to come and in that time he developed a terrible infection of the eye causing him to lose his eye.

Case #5- Cornea scars. These are all too frequent here. This man had a central infection, leaving a nasty scar. It is more than 50% deep so I need some good cornea tissue to do a transplant. Cornea transplants are complicated, first I need fresh tissue which I don't have here. Next I would need a patient who good get medication reliably for 1 year. Since most of the patients we see here are well below the poverty line, the chances of them paying for medicine for 1 year is low. If they stop taking medications the transplant will likely reject, now they have a blind AND painful eye. That being said, I took a picture of this man and took his cell phone number. Maybe one of my US collegues can lend me some fresh tissue one day...

Case # 6 - orbital cellulitis in children. While I don't love the over-use of antibiotics that exists in the Pediatric medicine culture of the US, it does prevent things like this from happening.  I was wanting to admit to the hospital, start IV antibiotics..... oh wait, I'm in Africa and I am the hospital and I don't have IV antibiotics to give the child. This child did very well with oral Amoxicillin only, made a full recovery. That is the benefit of people not having good access to health care, the bacteria have not seen antibiotics.

Case #7 - Presumed retinoblastoma. A deadly tumor. Sorry to disturb you with this one, but I see a couple of these a month. With a population of 20 million people all of whom have no access to easy eye care, I have a huge referral source and people take buses with their children; faces taped or wrapped to hide the gruesome sight of their bulging eye. The white on this childs face is actually adhesive from the tape used to hide the eye.

I  have no good solution for these tumors currently. I do not have general anesthesia for a 3 year old child. I do not have chemotherapy. In fact there is little access to this in the entire country. Sadly, even with a surgery this child is likely to die soon from the metastasis. I referred them to the children's oncology unit in the capital city 8 hours away at the Government hospital.

So, while there are some tragic cases here, I'm really enjoying the practice of medicine in Angola. I'm seeing things here in less than 2 months time that US physicians may go their entire careers and not see. Plus I'm at a place that shares the Gospel message of Jesus Christ to every patient that walks through our sacred doors. I don't get to choose who I can help physically. I wish to God that I could fix everyone's problems, but I simply can't. I don't know why God allows some people to suffer, and others to live in comfort. I don't have answers to many things. But I do know that for those patients I can't help physically, there is hope in Jesus Christ. To Him be the Glory, forever, Amen.

Witness to a Tragedy

A very common situation (This is not Elizabet)

Elizabet loaded up her vegitable bowl for the day, tied her one month old baby to her back and went to the market to earn a living for the family. Elizabeth married a blind man, so her husband, her three children and her husband's blind brother all depend on her and her mother-in-law for support. After she arrived at the plaza to sell veggitables, she laid her baby next to her. While he slept, she busily tended to customers; and the next thing she knew, her baby was gone.
I heard of her story at the blind mission. (A ministry that feeds the blind, and get's together weekly to talk) Through some very good connections, we were able to have the governers wife come with us to visit the family. Her and her husband are concerned about the people of Benguela and reach out to them like this frequently.
As we arrived at their house, we were devastated to find out the conditions of the homes. No electricity, no water, no furniture (except a lawn chair). I saw a chicken in the corner, and a tire in another room. Upon further investigation, we found out that the father of the stolen baby and his brother were blinded 20 years ago, when they were 5 and 6 years old (most likly from complications of the Measles). His brother is totally depressed and refuses to eat or speak, probably because ever day he sits in a dark "home" on the dirt floor, not being able to fend for himself. (pictures of his house follow)

 The brothers

I was wrong, they actually do have electricity

Oldest daughter

The families middle daughter

I know that the world is unjust, but in the United States, we don't have to see the problems. We only get to receive the blessings of being born in a rich county. We did nothing to deserve such a wonderful life, and this family did nothing to diserve such a hard life.

 The neighborhood kids

Another neighbor

Please pray for the Governed and his wife, as they attempt to make a difference. Only the Lord can lead people of influence like they have to change these kinds of problems. Pray that they can infuence other leaders in the country as well, to see what the Lord's people can do in Angola. Pray for this family, as they mourn a terrible loss, and may the Lord give them peace and comfort like only He can do.

The Need is Great.

This past weekend, we went on a trip to Lubango, a six hour drive to the mountains (more like hill country if you live in Colorado). We met with another Ophthalmologist who wants to take John on a village trips, where they are making lists of patients waiting for surgery. At this particular meeting, we learned of two specific villages with over 180 people waiting for surgery. Steve Collins was saying that he would like to go next week, but they are out of surgical material and post-op medications. Even in his Lubango clinic, he is using out of date madeications.
Supposedly, there is a shipment that is stuck in the "system" somewhere. It was expected last month, we have run into many troubles trying to send these kinds of materials. Since ther eare no meds at John's clinic either, they are only able to do durgery on people who can go purchase their own post-op medications, which is expensive. Therefore, only those with some money and resources get surgery at the moment. This is not an option for the villagers. They must wait.
We need your prayers! Please pray that the shipment arrive soon. We need this miracle.
Many of you have also asked what you can do. If anyone out there would like to take a trip to Angola, we welcome you! It would be quite helpful for someone to bring over medications and equipment in their luggage. That's right, I'm asking you. We are currently looking for American donations, when they come together, we will need someone to bring it for us.
Other things you can do is to send your old frames. The glasses deparment of the clinic is also lacking in resources. If any of you would be interested in collecting frames at your respective church, I will find a way for them to get over here when visitors come. Let's work together, to help restore sight to the Angolan people. Please respond to this message if you are interested in helping in any of these areas. May the Lord meet these needs by using us! His body!

 Roman is standing Grandparents!

Zekie

Lubango Visit

                                                Oliver enjoying swing at our base in Benguela.

The road to Lubango.

    These trees are called Baobab, very common, so are the stick Huts you see to the right. I was amazed at the presence of people all along the road. It seemed no matter how desolate they road, if we stopped we had a crowd of folks gathered around.

 This man was blind before our simple cataract surgery restored his sight, he is pointing with joy at his family members. He has just had the patch removed from his eye the day after his surgery. His wife was praising the Lord and singing with joy.

 O Cristo Rei statue depicts Jesus spreading his hands overlooking the city of Lubango.

 This view depicts the beauty and pain of Angola. This beautiful mountain overlook was used as an execution tool during the civil war. Rival soldiers would bring prisoners to the top of the overlook and tell them to run or be shot. People say you can still see human remains at the bottom of the cliff.

Serra da Leba, Lubango. Angola

The man on the left is Dr Jose Afonso de Moraes, he has been at Boa Vista for 10 years. He will be leaving for Brazil in January, I am his replacement. The man on the right is Dr Steve Collins. He is 74 yrs old and still going strong performing cataract surgeries in the Angolan Bush. He was here during the war and has not left. He gave up his Canadien citizenship and owns a house in Lubango, he plans to remain here the rest of his life.

We made a home visit to one of the pastors of a local church in Lubango. This tight, twisting, maze-like alley led to his humble home. It was a mud, block hut with a tin roof.

Culture Shock

 Fish Market

 These fish are drying out.

 Typical Angola Dish.

 Beautiful Church that we visited

It's my birthday! Thanks for the cake Geisa!

I am enjoying life in Angola; John is happy in the OR, and I'm figuring out how to run a household "Angola style". I went shopping at the fish market for the first time this week, and I can safely say that we won't be having fish for a couple of months, until I get over that experience. But then I'll have to go back. eek!
Then, there is the other market that they call the Plaza, where you pretty much can find all necessary items new or used. This is an outdoor experience with many people running individual booths. Let me talk you through this experience:
 As I parked the car, I had to be careful not to knock over the boys waiting for business, whether it be to guard our car, wash it, sell me bags to carry my produce, or carry my bags. About four of those boys will follow me throughout my shopping experience. Then I'll pass a shoe booth, then jeans, then hair beads, then a pig sty full of squealing wiper-snappers. They don't even bother to cage the chickens, they have embraced their roll here in the food chain. Then I go through my favorite part, but sadly very small part, the hand crafted items reflecting the artists African roots. (One must always be careful not to bump into a lady carrying twice her weight in merchandise on her head, or the baby on her back.) Now we come to the grain, in huge open bins, that if you want to buy any of that they just scoop it up with their bare hands into the bag. We have all kinds of fruit and vegetables, beans, dried fish (don't ask me how to cook that), laundry soap, music, furniture, cell phones. . . as long as your willing to elbow your way through the crowd, you can find it here.
I like the plaza, but I haven't gotten up the nerve to go with the boys, and probably won't. I have much more to tell, but will save it for another day. Someone go enjoy an air-conditioned grocery store for me.