Missionary Doctor – Day One in Review

They wasted no time in getting me involved in work at the hospital. I was on-call yesterday, my first day here. Initially, I wondered if that might mean “you’re on your own,” but thankfully it did not. I worked with a doctor who will soon finish his two-year commitment in Togo, just as I will start mine a little more than a year from now (after language school in France).

For the most part, nothing has come as a surprise. I have had some limited exposure to medical missions and have otherwise thought quite a lot about it over the past ten years. Resources are limited and out of date, the diseases are unfamiliar, and the organization skills of local medical staff are…different. All expected. I was also mentally prepared to see suffering and death out of proportion to what I see in practice back home. And yet, nothing can make it real as much as the experience itself. To some extent, I have already developed some ability to leave the emotion of each encounter when it’s time to move on to the next patient or to go home and be with family, and I have very often prayed over patients while I’m listening to the heart or working on the spine or when they are in surgery. I prayed a lot yesterday.

Being on call here is similar to what call is like at home. The on-call physician is responsible for a certain population of people who may need medical attention, he is called when needed, and makes rounds on his patients. There are no pagers here. If the doctor is not in the hospital, he needs to be available in one of a couple places where there is a phone. But then, why wouldn’t the doctor be in the hospital? Here rounds start early just as in most places, but we were covering the “intensive care unit” as well as men’s ward and women’s ward. The pediatrician is home for a few months, so we covered the pediatric ward as well. On top of that, the doctor I was working with is one of only a few who takes care of maternity/obstetrics, so of course we covered that too. Thank God, there is a short term family doctor who is helping with maternity and a surgeon who helped with C-sections. People come to this hospital from all over the country and from surrounding countries. This hospital has become the place to go if other western clinics and witch doctors have failed. This tends to mean that many of the patients are very sick.

We started with the patients in the intensive care unit. One with HIV and other related diseases, one with sickle cell crisis, another in heart failure, and the last with significant back pain. We work on each patient as a team which lends itself to excellent education for me as well as to a very lengthy process in general. The lady with back pain had fallen six months prior and was having difficulty with bowel movements since. I was able to spend some time practicing osteopathic medicine on her (for the medical people, aimed at lumbosacral and SI joint). She was in significant pain with the gentlest touch. Nothing I tried was able to get her muscles to relax. I started praying for her aloud despite her inability to understand me. That’s when her muscles began to relax. She no longer jumped in pain when I touched her back. Praise God! Hopefully her bowel function will improve. We went to the men’s ward and women’s ward and treated people with malaria, typhoid fever, and hepatitis C. We were not able to finish in the pediatric ward before being called to check on a woman trying to deliver a second twin. It was evident that the baby was not getting good oxygen, so the mother was taken to surgery for C-section. It took quite a while for the family doctor and surgeon to get the baby out as the baby was not in a good position (transverse). Three of us: the doctor I was working with, a short-term missionary physician assistant, and I received the baby after delivery. She was not breathing and her heart was only barely beating. Understand that this is not a typical part of my work at home in America. I was fervently praying for the life of this child as we tried to resuscitate her. Praise God! She began breathing on her own after 3-4 minutes (this is an eternity). A second C-section after lunch went much more smoothly. Praise God for that too!

The pediatric ward is seven beds in one small room with only two monitors for tracking vitals. It seems that these beds are always full of children, usually babies up through 2-3 years old. Most of them are being treated for anemia and malaria. Many have parasites or other infections on top of that. One little boy came in with a type of cancer called lymphoblastic lymphoma. He did not respond to treatment given in the past and is considered palliative/comfort care. He had a bloody nose and his right eye was swollen and protruding from his face. I am unsure if there is a tumor or bleeding.  Towards evening, two very small children came who both seemed to be having seizures and were neither of them breathing very well. Please keep breathing. My prayer for these beautiful children was the same I pray over my own children. That they would be healed. That they would be safe. That God would use them mightily in His kingdom. The little boy was doing much better this morning. The little girl is with Jesus now. I praise God for that too.

The hospital lives up to my expectations. The compound is very nice and the medical facility, although thoroughly substandard, is actually much better off than many other places in this part of the world. The doctors here truly do good work with what resources they have. However, medicine is not the reason we are here. It was never the reason for coming. It’s not why I even went through medical school. Christ is the reason we are here. His love is so great and big that we cannot keep it to ourselves. Medicine is only one of many ways to share his love and open avenues for sharing the gospel. This hospital is run as a ministry. We pray as a group over every patient in the hospital. The ministers work with patients just as the doctors do. I am excited to learn the language and be able to pray with these people in French and to build relationships with patients and the workers here. I can’t wait to share Christ with people. Many of the patients and their family members pray with us when we pray for them. There are Muslims and many of animistic religion. There are many who mix religions and still worship ancestors and fear magic. We know Christ is greater and that His perfect love casts out all fear.

I am optimistic about our trip here as well as for our two years here later on. I foresee a lot of work, fatigue, difficulty, and frustration, but that sounds like life anyway. Christ has called us here for this time. Pray that we would continue to have the hearts of true servants to the missionaries and people here. Pray for health and strength for us. Pray that we would be overcome by the love of Jesus and that our words and deeds would reflect his perfect love.  He is the one who changes hearts and minds beyond our understanding. May He be glorified.

“Love suffers long and is kind; love does not envy; love does not parade itself, is not puffed up; does not behave rudely, does not seek its own, is not provoked, thinks no evil; does not rejoice in iniquity, but rejoices in truth; bears all things, believes all things, hopes all things, endures all things. Love never fails.” (1 Corinthians 13:4-8)

Tomorrow I may get to work in the clinic after hospital rounds. Clinic is closed on Wednesdays and today (Thursday) was a national holiday in Togo. So far the greatest danger I have faced is falling mangos. Becca has been busy meeting other missionaries and helping them in their various ministries. I’m sure she will have an update. I do hope to get out and take some pictures soon. I’m unsure if I will be able to upload them, as the internet here is intermittent and cannot handle too much data. When you think to pray for us, pray for the other doctors and missionaries here as well. The lifestyle is interesting and exotic in many ways, but there are numerous challenges as with any ministry or mission.

Blessings to you all.

In Christ,

Dr. Seth