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

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