Paul and Becca

Nathan is now 8 months old and getting a few teeth. His teeth are very hard to get a picture of.  So here is the best I could get.  My dad isn’t around to take professional shots.  Nathan and I took a trip into one of the villages yesterday.  It was a nice walk up the mountain and the people were so hospitable.  I will post pictures of the walk into the village soon.  Becca

Warning: Fairly gross story that will mostly be interesting to people as juvenile as myself

When I was in medical school, I was fascinated by a video shown in our Parasitology course. It was shot sometime in the 1950’s and showed an operation for small bowel obstruction due to a worm parasite called Ascariasis. They cut open the bowel and it looked living spaghetti spilled out. It was awesome! I’ve been looking forward to the time I would finally see something like that myself. Since then I’ve participated in operations on two other continents plus the United States and I’ve never seen it… until now. Unfortunately, my triumph was quickly stolen.

I helped one of the residents operate on a woman with a small bowel obstruction. Once we got into the abdomen, it was evident she had an abnormal narrowing of the very last part of the small intestine just before it entered the colon. We had to remove this part, along with some bowel on either side of it, and sew the ends back together. Before sewing the ends, though, I needed to drain all of the liquid out of the largely distended small bowel so that we would be able to close the abdomen after the procedure. Placing a bowl under the cut end of the small intestine, we removed the clamp and began milking all of the stuff out. The resident was milking while I was holding the bowl in one hand and a suction tip in the other to evacuate all the liquid. Suddenly, to my utter surprise and delight, a six or seven inch worm plopped out! At last! Get my camera! Then, to my utter dismay, one end was sucked into the suction tip. It was just like watching someone slurp a long piece of spaghetti into their mouth. Before I could react, the worm spun around a few times and disappeared into the tubing, gone forever. The last kick in the pants was when, as the last bit slurped into the sucker, it flung a drop of intestinal goo onto my glasses. Oh, well… maybe next time. (I’ll include the picture when I get it.)

Paul

Nathan's response to being told this story while eating homemade carrot baby foood

I’ve added a new section to the site which includes a list of materials lacking here in Soddo that would be quite helpful. For those of you around such things, if you know of any items being discarded or available for donation, please consider us. I welcome any email contact regarding these items or other suggestions you may have. We will be returning to the US periodically and would be available for picking them up for transport. In addition, people are often visiting the hospital and they may have roomfor transport. In general, we’re not sure how feasible mailing is for getting items larger than letter size to Ethiopia. Thanks in advance and I look forward to hearing from you!

Paul

It’s rather challenging to figure out what to say in this first blog post of mine. There is so much to say! We have now been here in Soddo for about two weeks and there is much to report. First let me say that God is faithful and good. He has helped us greatly as we have adjusted to all the changes.

As a family, we are slowly making our little duplex a home. I say little, but, frankly, it’s bigger than the apartments we have previously had. We have all the necessities and are making a “wish list” for the future. Unfortunately Walmart has not yet opened its first Soddo Supercenter and Target is behind the curve as well. I am pleased to report that “authentic” Ethiopian food is actually quite similar to the Ethiopian food we have tried and loved at restaurants in Dallas and Louisville. I am also pleased to report that the movie “Super Size Me” is correct in its hypothesis that fast food is making America obese. Though I’m certainly not going hungry here (don’t worry, Mom, Nan, and all concerned mother figures), my spare tire is getting smaller! This beats the tar out of the Adkins Diet. I must confess, though, that I often long for Whopper or Chipotle’s burrito. Hmmm.

Look, Ma, no hands!

The hospital and surrounding terrain

Nathan is doing great. He is enjoying the fresh pureed carrots from our garden. They taste much better than the store bought variety we are used to from the US. Though the weather is cooler here than we anticipated, he is staying warm and growing nicely.

I am amazed continually how God has blessed me in Becca. She is a jewel. In the midst of the changes and adjustment, God is bringing us closer than ever before both to Him and each other. She is adjusting to life here wonderfully. She and one of the other missionaries here, Stephne, as well as a visiting nurse named Jesse, have visited the market several times. I’ve already consulted her dietician skills on a patient. She is involved in a women’s Bible study each Sunday. She is a huge blessing to the people here (me included).

I’ve now spent enough time in the hospital to gain some familiarity to it. There are currently four residents here (one is away on rotation in Kenya) and I am growing quite fond of them. It is a joy to build into their lives. From a surgical perspective, I find myself learning about as much as I am teaching. I am doing many procedures and taking care of many medical conditions for which I have no formal training. Thankfully, my training at Baylor has given me a strong base on which to build. Between the knowledge Baylor has given me regarding anatomy and basic surgical principles, I am figuring it out. The library here is reasonably well stocked and I have been reading a lot of urology, gynecology and obstetrics.

Solomon, one of the chief residents, and his family

Just part of our garden

For those who are interested, I’ll mention a few of the more common things we see here. There is a lot of benign prostatic hypertrophy (BPH), which is a common condition back in the US as well. Basically, as we guys grow older, our prostates tend to grow as well, blocking the flow of urine. As these men don’t have access to the medication available in the west, theirs can get really big. Due to the sheer size of the prostates we are seeing as well as a lack of familiarity with endoscopic techniques, these prostates are removed via an incision in the bladder. As I have been rooting around the supplies and equipment here, I suspect we have the necessary stuff for endoscopic surgery, but I need to look further. We see a lot of large thyroid glands, called goiters. Indeed, these are bigger than anything I’ve seen in the US. This is primarily due to a lack of iodine in their diets. They are also quite challenging to remove and their size can make them dangerous. One of the Ethiopian surgeons removed a huge goiter last week (about football size) and I’ve been challenged taking care of her post-operatively.  The hospital recently signed a contract with a non-governmental organization (charitable) to operate on about 480 women to correct a condition called uterovaginal prolapsed. Essentially, this means the muscles and ligaments that hold their pelvic organs in place have become very weak and everything is “falling out”. Their vaginas have flipped inside out with the uterus hanging between their legs, often with parts of the bladder and rectum along with it. I’ve taken the liberty of not including a picture. To fix it, we remove the uterus through an incision in the vagina and repair the supporting structures of the pelvis to keep their junk where it’s supposed to be. In addition, there are the usual Caesarian sections for obstructed deliveries of babies. The cancer we see here is typically quite advanced. We see a lot of esophageal, stomach, cervical and breast cancers. We remove it if it is safe and we have a chance of removing it all. Trauma here is of a different sort than we see in the US. No one arrives immediately after their injury, usually several days or weeks later. Those people who sustained more life threatening injuries have likely already died. The injuries we see, in contrast, are complicated by neglect and delayed presentation. It is made further challenging by the lack of a real intensive care unit to take care of the truly sick patients. I find myself spending a lot more time in prayer over my patients than ever before.

OK, I’ll end my book. There is more to share and I’ll do so later. We thank God for His mercy and grace. Please pray for our activities and life here. We want to share not only our abilities but our hope in Christ. There are certainly challenges living here, but we are doing well and enjoying it.

Paul

We had to move our blog.  But now that we have a new virtual home, hopefully we will be able to share more of our adventures and pictures with you.  This is a picture of us on my (Becca’s) 29th birthday.  It was pizza night with the missionaries and we have a wood burning pizza oven!  It was good although I haven’t figured out how to make pizza like some of our favorite Dallas places yet. 

We have been settling in well and Paul is busy at the hospital.  He is already accumulating pictures and stories.  We had one of the residents and his family over for dinner last night.  It was a lot of fun and a great experience to hear there story. 

We will keep you posted…

We have asked our friends in Dallas to post this information for you. We apologize for the lack of input on this blog since we arrived in Ethiopia, but it appears Ethiopia has blocked many blogger sites and we are unable to access the site from Soddo. We are in the process of setting up a different site and will post the new information on this site and in our next mailed newsletter as soon as we have the information. Thank you so much for your patience and looking forward to sharing our experiences! As of now, we are doing well. God has been merciful and kind to us and we are settling in.

Paul and Becca

We have made it safely to our new home! We are in Soddo, Ethiopia.
We have been settling in and Paul starts at the hospital on Monday.
Most of the things packed in our really heavy bags seems useful,
however we did not bring enough warm clothes. When we got off the
plane it was 59 degrees and it has only broken 70 one day. But trust
me we are NOT complaining after hearing Dallas was scheduled to 107 a
few days ago.

The trip went well and after arriving in Addis Ababa we spent a few
days there buying appliances and meat and cheese. We are 8 hours
ahead of central time and we are over jet lag. Nathan did great
switching his clock to African time.

We are having trouble accessing our blog and have had our good friends
Dan and Diedra post this for us. Hopefully we will figure it out and
be able to access it soon, but we do have reliable email, so feel free
to email us at paulandbecca@gmail.com

Thanks for the prayers and encouragement, they have helped a lot.
Please let us know if there are things we are missing out on in your
lives, so we can be praying for you.

love, Becca, Paul and baby Nate

I’m thankful that God has arranged a little time for reflection before we fly to Ethiopia. As Becca mentioned below, we are currently in Washington DC and will be departing for Addis Ababa tomorrow evening. We arrived at the hotel via shuttle with our quarter ton of luggage so we aren’t going anywhere except back to the airport tomorrow afternoon. Perfect!

It has been a long time of goodbye’s. God has blessed us with so many wonderful people that it takes a long time to say goodbye to only a fraction of them! Wonderful parents who raised us and taught us to be the people we are today (Mom, JD, Dad, Kim, Patty and Steve, I’m going to miss you all big-time). Amazing grandparents, aunts, uncles and cousins. Close and endearing friends (today I talked with a very dear friend, Chad, a surgeon in Dallas). They are all over the world. Due to our layover here we had the opportunity to spend an evening with one of my long-lost and much-admired uncles, Uncle Dan. He lives here in Washington and works for the U.S. Securities and Exchange Commission. He’s a brilliant lawyer, one of the smartest people I know. The congressmen may talk about their laws, but Dan is the one who writes them. I haven’t seen him in over 10 years and, thanks to this trip, we had a great dinner and I got to show off my wife and son.

It makes me think of all the places God is putting people. I recently talked with an old roommate and friend from college who is leaving for the mission field in Angola as a church leader and pastoral educator. As we talked, we realized that three of the seven of us guys who shared a suite in college will be living in Africa! In addition to the two of us, our other friend is working for the US government in Nairobi, Kenya. One of my best friends from medical school is living and working at a mission hospital in Cameroon as a family practice and obstetrics doctor. My sister-in-law and her husband, two people dear to my heart, will be leaving for the mission field around December this year to work with Wycliffe Bible translators, likely in west Asia.

For an introvert who has often struggled with people skills, God has put a lot of awesome people in my life! I realize I’m kind of rambling, but it’s late and I’ve had about seven hours of sleep in the last 72 hours. I say all that to say this: it’s people that really matter. I thank God for the people I’ve met and known. I’m going to miss all you people, but it’s for people that we’re going. I’m also excited about the new people we will meet and befriend. Looking forward to sharing them with you.

Paul

Well, we are in Washington DC and although it is not technically half way to Ethiopia, we are very thankful we have made it this far without any hassles. In fact, at 4am this morning in the Houston airport we had the nicest ticket agent. She was such a hidden blessing. We were afraid they would give us a hard time about having 7 huge bags, but she was so friendly and helpful and even let us board early with Nathan. Now we just have one more flight from DC, USA to Addis Ababa, Ethiopia. It is a direct flight with just a stop in Rome to refuel, but we won’t get off the plane.

We leave DC at 8:30 eastern time Monday and should arrive in Addis in the evening on Tuesday. Which will be around midday central time. We hope to be able to blog from Ethiopia in a few days, to let you know we made it safe and sound…