There is Hope

There is a phrase used here amongst the missionaries-"WAWA" which stands for "West Africa Wins Again." You use it at times when someone gets malaria, the rolling power outage happens when you were supposed to speak at church, when your desert recipe doesn't turn out just right because you couldn't get all the ingredients that you needed. You get the point.
Well, this is not one of those cases. One of the men who was suffering from necrotizing fasciitis mentioned in a previous blog is pictured above. In the picture he is getting a skin graft. Thanks to bed rest, antibiotics, removing dying tissue, the dedication of good doctors and nurses, West Africa does not win. Hope wins. Opportunity wins. The chance to say "I do this because Jesus loves you" wins again. The earth is not some cold dead place, Nalerigu is not some cold dead place. It is a place brimming with life from the only source that is truly life. Get you some of that necrotizing fasciitis.

This is What it is All About

Something happened today that totally illuminated what doctoring in a community means. Real ministry is very far from the in and out ambush trips that are more about adventure and exposure than dedicated serving. They are not inherently wrong, but boy are they missing out.
Today I had a first, and I hope to have many more of these. We went on a hike today up in the hills surrounding and overlooking Nalerigu soaking in all we could and finding some time to rest. On our way back we walked through the town and were speaking the little Mampruli that we can and waving at everyone yelling out "Saming-doa" (white man).
As we were walking through the market we saw a familiar face. It was a little boy Ibrahim Abubakari who had surgery last week. It was SUCH a joy to see someone you know, someone you had seen sad and hurting, someone who was now smiling. That is what it is all about. You don't do medicine, you don't do ministry, you don't do life from far away. The Christian life is about serving the people you see on the street. It is about loving them with a love that is not capable of being wrought on your own. Man what if every time we went out we saw someone that we had actively loved. What if simply going to the market (mall) was a joyful experience because in each familiar face there was an image of Jesus, of hope, of redemption? What if we were actively involved in the struggle to love people properly to such an extent that there were specific names and faces that we were striving for? What if you saw that person and it all felt worth it?
Doctors get a special experience of this because we get an unique view into each patient's life, (I mean seriously, who else tells you to get naked and you actually listen. Case in point.) but all of us have the opportunity. Ministry is not something people with degrees do, it is a lifestyle. It is how you breathe, it is what we do because Jesus Christ taught us to do.

Poverty is Embarrassing

Bono was right when he said this past year "poverty is embarrassing." Poverty is a spotlight that shines a light on every corner of our hearts. You want to feel the weight of The Fall? Look into this child's eyes. Spend one morning on the wards and the drastic nature of the expulsion from the Garden will have a whole new stinging sensation. In America, I rarely feel that life is really all that bad. The immense exile that has been placed on the human race very well hidden in my daily life. I have to almost convince myself that this is not the way life was meant to be. Sin has this light feeling in the States. Here in the clinic the suffering of every human heart is displayed in the open.
For some reason God is uniquely concerned about the poor. Over and over again in the Old Testament he rebukes Israel for oppressing the poor and needy, for trampling them underfoot. God even says that the ultimate reason that Sodom was destroyed was for their neglect and injustice towards the poor. This prideful attitude led to their debauchery which we so often hear about, but Ezekiel lets us know that there is something deeper going on here.
In all that I have been exposed to over the last few years, all the sermons, all the books I have not had a very good answer for why God is so focused on the poor. Why are righteousness and justice for the poor so unrelentingly linked in the whole unity of the Bible?
Why does God focus so much on the poor? Because there we see our need for him more clearly. Today I saw a man with a parotid tumor that had distorted his face far beyond comfortable viewing. There you see the weight of the Fall. There you see our race's own propensity to rob God of his glory and take for ourselves what is not rightly ours. When you see the sick and oppressed completely incapable of saving themselves you see much more clearly your status before God apart from Christ. Jesus said "blessed are the poor in spirit" but we are so middle class in spirit, blind to our total depravity thinking that there is something good in us that actually did deserve redeeming. God never says become poor and then you will be more righteous, that would not be true. God says if you are poor, trust in me. If you are not, you will show your righteousness by your love. Jesus promised that the poor would always be with us. He is not about ending poverty necessarily. God knows we need the poor. He is not unjust in sustaining the poor because He knows this is life is but a vapor and the treasures that lay in store for those who love him are far beyond any of the fleeting pleasures of this time. Do I really know that? God knows we need the poor to show us more of Himself, more of ourselves, more of where we have been, more of where we are going. One the day when every tear is washed away and this too shall be made right.

Happiest Future Amputee I Have Ever Seen

So this guy came in today, smiling and happy, but with a bit of a limp. When he unwrapped his foot the aroma wafting out of the necrotic tissue filled the room with that oh so pleasant yet unforgettable smell. He said that it has been infected for THREE YEARS NOW. Three years and he has done nothing about it. I will checking up on this guy the next few days, but his leg seems pretty well involved with infection. It didn't hurt him very much, which when you are that inflamed is not a good thing.

This Little Piggy Went to Where!?

So there is this strange thing that occurs in tropical environments where people walk around barefooted all the time. It is called Ainhum and no one really knows what causes it. It is defined as a mysterious constricture at the base of usually the 5th toe. Basically your pinky toe is just about ready to fall off. Stinks huh?

Who knew Job was a social activist?

I cannot believe that in the past year, in all the sermons that I have listened to and all the books or articles that I have read about social justice, serving the poor, being authentic, no one ever pointed at the clearest and best passage regarding serving the poor in the whole Bible. Because of my time here in Ghana, I have been doing a survey in the Bible to look at every time the Word says "poor." We so easily get caught up in the idea that Jesus was either a poor marginalized hippie or a staunch right wing preacher that thrust what we think the "correct" Christian life should be into these two opposing camps which are impossible for any of us to actually live out i.e. Perfectly Just Sacrifice or Perfect Self-Righteousness.
The story of Job has always bothered me. Yeah it is a great theological and literary work about the Sovereignty of God, but in the end he gets rich again. I was so troubled because the moral of the story always seemed to be "Just stick it out during the suffering and God will bless you in the end, don't you worry." That was until I came across this passage the other night.
In the passage below Job is justifying himself before his friends and God Himself. He is describing why he was so respected in his community, why men looked up to him, why people loved him, why he knew that he was above the reproach of his adversaries and he says:

11When the ear heard, it called me blessed,
and when the eye saw, it approved,
12because I delivered the poor who cried for help,
and the fatherless who had none to help him.
13The blessing of him who was about to perish came upon me,
and I caused the widow's heart to sing for joy.
14I put on righteousness, and it clothed me;
my justice was like a robe and a turban.
15I was eyes to the blind
and feet to the lame.
16I was a father to the needy,
and I searched out the cause of him whom I did not know.
17I broke the fangs of the unrighteous
and made him drop his prey from his teeth.

Job heard the cry of the oppressed, he did not turn a deaf ear. I was shocked when Job said that he searched out the cause of him whom he did not know. It is so hard to defend the causes that are right in front of your face. What does it mean to clothe yourself in righteousness, to wear justice like a robe? It is to seek out the causes of the oppressed, to deliver the poor, to love the fatherless, care for the helpless.
Only this man, when he lost absolutely everything, could fall down and worship God. Only this man could stand up to his wife when she tempted him with a Prosperity Gospel. Only this man could truly be above reproach when his friends accused him of unrighteousness. No wonder Satan wanted to test Job. Job was breaking his fangs and snatching prey from his teeth. No wonder God had so much faith in Job. He knew him, he knew his heart. He gave him the grace to be merciful. Praise God that he restored Job's finances, so that Job could continue to liberate that which Satan had wrongfully taken hold of. Thank God for this passage, thank God for Job.

Does something seem a little out of place here?

Africa is so strange. As the world becomes smaller thanks to technology the opportunity to access the world becomes a lot easier. I guess that development is a good thing, but I definitely question most of it. Thanks to good ol' capitalism and consumerism we can now export all our crap all over the world and make people think they need it. Things have changed drastically here the last 5 or so years with the implementation of electricity, cell phones, satellites, DVD's, stereos, motorcycles, you name it. Rather than Africans just finding new better ways to grow crops, build houses, or just get by they find new things to spend their limited resources on. I guess that it does help the economy because now someone can sell the stuff, and someone can work as a mechanic for all the motos, but seriously a satellite? Does he mail his monthly bill in by check or does he just send a few chickens down the road? I hope these kids are eating.

This Ought to be Interesting

So the other day this young girl came in and she was just obviously uncomfortable. She felt horrible and just seemed to be feeling awful. Dr. Faile felt her stomach and asked her to lay on the table. He turned to me and said, "This ought to be interesting." I felt her stomach and thought "Oh no, is that her spleen that large" thinking some kind of splenatomegaly, then I felt all the bumps and thought, "Oh no, this girl has cancer and this is a huge tumor in her abdomen." Luckily it was not nearly that serious. What this girl had was a serious case of constipation. She had eaten a TON of these seeds that are pictured above and here colon was so packed and backed up that you could feel them in her abdomen with very little effort. Imagine that. Dr. Faile got as many out by hand (Yum...) as he could, but the girl should be okay after a few enemas and some super poopin'. Just another day in the clinic.

A Day in the Life

Just in case you guys were wondering this is how things kinda work over here in Ghana:
There are two doctors here and a few native medical assistants (comparable to PA's). Rounds start at 7:30 AM with around 80-100 people to be seen. That usually goes until about 9 AM and you see a ton of kids with malaria, several snake bites a day, lots of babies being born, malnourished children, people recovering from surgery, and several exotic diseases (Guilliane-Barre, typhoid perpherations, etc.) By that time there is a crowd of people in the waiting area being triaged and what not. One doctor here saw 97 patients Monday and 69 Wednesday, the other doctor doesn't keep count because it is just too ridiculous. For those of you who don't know for a doctor to see 30 patients a day is pretty good in the States. After that is all over, there are procedures to do. For instance Wednesday after seeing patients, Dr. Faile had a C-Section, Keyloid fibroma removal, Lipoma removal, granuloma evaluation, and a laprotomy, that was 8 PM. I went home and Dr. Faile came back and did another laprotomy and some other procedure I didn't write down. He had a C-section this morning on Thursday at 7 AM before rounds. Tuesdays and Thursdays are procedure days, so today was a Bilateral Tubal Ligation, 6 hernia repairs, and handling whatever critical cases came in needing to be admitted, plus rounds.
12-14 hour days, call every other night, limited resources, less glory--all for the sake of the poor, all to the glory of God.

There Are Some Things You Can't Take Pictures Of...

Have you ever seen a man who had been tortured? Back in October a man came here to the BMC after suffering from a stroke. He was diagnosed and sent home because there is not a whole that they could do for him here. He returned a few days ago with horrible infections all over his legs and scrotum, a very scared, damaged look in his eyes, and necrotizing fasciitis (flesh eating disease caused by infection with a few different bacteria). Over the last few months the man had been treated by a local "healer" trying to restore function to his wasting limbs as a result of the stroke. The "treatment" for paralysis is lots of small cuts and boiling water. There is a sick system of darkness and tradition that binds some of the villagers here to seek traditional medicine that I have yet to hear anything good about. The debridement for this man's infection (cleaning out the dead tissue) was one of the most difficult things I have been through in my brief yet decently exposed medical career. I held his legs as he writhed in pain, groaning in a way that is felt more than it is heard. The pain and injustice of the world was glaring me in the face and it was not pretty. We went back later to visit him and other patients in similar situations, just to hold their hands, say the few words that I know in Mampruli, and fan flies away. This man had a tear come down his face as we spoke with him. I don't know if it was because of the pain or if he was just satisfied to be treated like a human being.
I can not help but think that the groanings of this man was what Paul had in mind when he wrote that "all creation groans awaiting the day of redemption." Does our sin break the heart of God the way that mine was broken? Are our attempts at righteousness as absurd and frustrating to God as this local healer's methods? The suffering here is a living metaphor for the revolting nature of my own sin.
Is it possible that beneath our facade of what we think is skin there is actually death and decay? Are there things that we can hide from the world but really they are dying underneath? The call to discipleship is a call to come and die, to admit the death that is occuring and ask God to clean out the dying tissue and replace it with life. In our suffering and pain God is holding our legs and breaking His heart, I can see how those coincide more clearly now. Today as I pondered the audacity of our American book titles I felt very strongly the question, "You want your best life now?-Then come and die." That is the answer Jesus gives. It is not a call to destitution and poverty, we miss the point and somehow neuter the Gospel when we make it simply about money. The call to discipleship is a call to follow Christ, to ask the serious questions- What oppression am I apart of, Do I love enough, Do I hear the cry of those in pain? The call to Christ is not a call to Africa, it is a call to transformation of mind and regenerated sense of purpose. I hate that I had to see this man suffer in order for me to see that in a new light.

Story of Redemption

The 50 year history of the Baptist Medical Center here in Nalerigu is an incredible example of how God can use mission and medicine in particular to actually change a city. While sin is still abundant here, there is hope in the darkness. The BMC is a bright spot in a difficult world here in West Africa. 50 years ago, right around the time that Ghana was becoming independent God called Dr. Faile senior to Ghana from Nigeria. Back then Nalerigu was an vastly underserved area and deeply in need of medical services and the Gospel. In this traditional Muslim area, the IMB planted a hospital that would grow to become superior to government programs and serve people from incredible distances.
When Dr. Faile started the hospital 50 years ago Nalerigu was a remote village of 3,000 people. The clinic was three-quarters of a mile outside of anything resembling town, and there were essentially no Christians. Now there are 15,000 people in Nalerigu and the BMC is an integral part of life here. There are 10 churches now in town, each filling up about the largest structure you can make out here. The 10 churches have an impressive sense of unity and seem to be doing well. Because of the missionary efforts in Nalerigu the Christians do not face as much persecution here as in other villages in this region simply because of the strength in numbers.
Dr. Faile Jr. and numerous doctors throughout the years have served here and still are. Dr. Faile and Dr. Hewitt work incredible loads seeing hundreds of patients a day, doing surgeries, taking call EVERY night. There is no glamour, there is little adventure, but there is an image of Christ and it is worth it in the end. These men here make scripture come alive. When Jesus consoles his disciples telling them that anyone who has given up home and family to follow him will be richly blessed, he had these men in mind.
God is in the business of bringing glimpses of redemption on Earth now. Here the Baptists have joined him in that. It is incredible to see, and great to be a part of.

In Ghana

I suppose the first post should be the mandatory-"I am here and OK" I have now been in Ghana a week and half and realizing that sending out emails is just way too time consuming.
As for some of the facts: I am working at the Baptist Medical Centre, an IMB hospital that is very impressive in it's level of comprehensive care on an African scale yet at the same time unbelievable by American standards. The town is incredible, the people live in mud houses, but have cell phones. Much more to follow, but here goes the first post!

The picture above is Nalerigu taken from a hill above the city. If you look closely you can see the tin roofs and cell tower-incredible