Ghana Update

I know that my first email was heart wrenching and sad. I wrote it trying to mirror life, death, and the medical care available in third world countries in general and Ghana inparticular. And remember, this is an oasis of health care in a very underserved area of the world. Working here would drive one crazy if one did not focus on successes rather than what could have been done in the States.

Just a quick update on the medical problems that we see here. I have seen two cases of tetanus. Unfortunately, both died. However, it gives impetus to the need for immunization even at home. It is easy to become complacent about getting our "shots." Even adults need the tetanus immunization.

We have now had three cases of bowel perforation from typhoid. I had never even heard of such a complication from typhoid. All three underwent surgery and survived. If BMC were not here, all three would have died from peritonitis.

Two more teenagers had retroperitoneal abscesses. Again, both did well and would have died otherwise.

Right now, a four year old boy is in surgery for a ruptured spleen. Of course it was diagnosed at laparotomy (no CT available).

We have had five or six cases of meningococcal meningitis. All but one survived.

Dr. Faile repairs about eight to ten hernias a week. Yesterday, we had one that was incarcerated and strangulated--a certain death sentence without surgery.

Currently, there is a Dutch urologist here. He has done many surgeries. His main goal here is to repair vesico-vaginal fistulas (bladder leaking into the vagina). He has done several this week already. He has made the lives of these women so much better. If BMC were not here, they would continue to be shunned.

Everyday, children are admitted with malaria, anemia, and dehydration. Almost everyday, one dies. However, many more survive because they received IV or oral fluids, antimalarial drugs, and supportive treatment.

There has been a c-section almost every day since I have been here. They are mostly for prolonged labor at home. There is no such thing as fetal distress since fetal monitors are not widely used. To my knowledge, all have survived except ones including a set of triplets and a set of twins.

Many more people receive treatment giving comfort and relief for less severe problems in the clinics. Much suffering has been relieved here.

I hope that the above sheds some light on the successes of BMC. No, everything cannot be done here. In fact, a lot of things cannot be done. X-rays are of poor quality. Certainly, there is no CT scanner or MRI. Sonogram is pretty good done by the three MD's who work here permanently. Lab consists of hematocrit, malaria test, urinalysis, and stool test. Blood is transfused directly from donor to patient after undergoing HIV and hepatitis screening. Surgical capabilities are limited to a general surgeon. There are no codes, ICU's, specialty hospitals, etc.

There are many things that you can pray for.

Praise God for the physicians and their families, the pharmacist, the Ghanaian employees of the hospital (nurses, translators, lab techs, pharmacy personnel, clinic personnel, maintenance people, custodians, guards, drivers, and many more).

Thank him for the many volunteers who come here each year. Ask him to send experienced volunteers in many areas of medicine. Ask for wisdom and clinical discernment as everyone here cares for patients with minimal information.

Thank God for those who had the foresight to found this facility. Ask God to send physicians and a surgeon in particular to staff BMC on a permanent basis. Pray for the patients here that they will hear the Word and answer the call of the Holy Spirit. Thank Him for all who have received salvation!

I will be leaving in sixty hours. Ask God that I have a safe trip home and a joyful renewal with my family. I thank each of you for your prayers while I have been away.

Jim Howard

Valentine's Day

Valentine's Day is a secondary celebration at our house. It's Keegan's birthday and that takes precedence over St. Valentine in my opinion. This year was no different and we invited family over to join in the celebration. As usual, Keegan has to be different :-) and doesn't want birthday cake but pies. This year Bethany surprised him and made him his two favorite pies from scratch, chocolate and creamy lemon meringue.


Ummm, they were delicious! Naturally the birthday boy gets to pick the meal, and we grilled out thick juicy pork chops with black beans, steamed sweet and white potatoes, and fruit salads on the side. After sating our appetites we circled the TV and watched Christian comedians, laughing until the tears flowed. It was a fun evening with family, one of our favorite times. In two weeks we will celebrate Erin's birthday and we get to do it all over again, except of course, she gets to choose everything.

Please Pray

The following is a recent letter from my brother in law, a doctor, who is serving a month in Ghana, Africa helping out in a local hospital there. Please pray for him and for those who serve there.

Family and Friends,

It is much harder being here emotionally than I had imagined, even with my years of medical experience and trips to Ghana.This hospital is the "tertiary" care center for all of northern Ghana. Things work here. Medications are available here. Surgery is available here. Doctors are available here. The people and the equipment work. Yet, there are many things that we do not have. We do not have an ICU, ventilators or even oxygen. We do not have IVs at a constant rate--only slow, moderate or good rate. We do not have chemistry panels or even potassium levels for patients in ketoacidosis. There is no CT and only minimal xray. There are no code blues or even emergencies. This is the burn center, pediatric hospital, obstetric hospital, trauma hospital, cancer hospital, and any other kind of fancy whatever you can think of. There are three very dedicated men who are the physicians supported by equally dedicated wives. Two have children growing up here. Please, pray for all of these wonderful Christian men, women, and children as they dedicate their lives to His service. To date, we have had three pediatric deaths and at least that many adult deaths. They die from cancer and meningitis, liver disease and unknown causes since diagnostic capabilities are so limited. This kids have died from malnutrition, severe burns, and malaria anemia. The last one died as she was brought into my office today. I had written the admission orders and was preparing for transfusion (direct from family since there is no blood bank). She was bradycardic when I listened to here and her tiny heart stopped as I was doing the paperwork. I have a child in diabetic ketoacidosis right now. I cannot have a constant IV rate, an insulin drip, or even regular blood sugar levels or potassium levels. There is only one bottle of regular insulin available for entire complex. I tell you all of this, not to depress you, but to make you aware of life here.BUT, if this hospital were not here, many more would die. There have been two children with perforated bowel from typhoid and one with an intra-abdominal abscess who certainly would have died if they had not had surgery. I focus on what we CAN do, not on what we cannot do. We have had at least a dozen snake bites who have received antivenin. I doubt if they would have died but they would have suffered loss of function of their hand or foot. Baptist Medical Center is a true oasis in the desert of need. Pray for the future of BMC as it prepares to undergo transition over the coming years. Pray that a surgeon will be raised up to replace George Faile. May God bless each of you this night and always.

Jim Howard

Long Overdue and Late

Wow, has it really been nearly two months since I posted last? There is nothing to say except I let the time slip away each day without sitting down to write. Let me give the briefest summary. Holly, Greg and family came for Christmas and we had a wonderful family time. The children are all growing up so fast; in fact, we celebrated Connor's 5th birthday while they were here. Bryce and Erin gave us a special gift on Christmas day-- announcing they would be having a little Williamson in August. After Christmas, I began working full time in my new job at Accolade Home Health. I love it and I am so glad I made the change! Then the upper respiratory illness knocked me down for nearly two weeks before passing on to Bethany. At least it wasn't the ugly flu that is so prevalent here right now. Keegan finally got his official letter of completion for his doctorate in late January--Hooray, hooray! How's that for brief?! Let me show you a few pictures, and then I hope to be back at this regularly.Christmas Morning

Everyone had to get some outside in the warmer weather, even Alyssa loved it.

The "Twinks" were too busy playing and, yes, eating the dirt to pose for a picture. In fact, they were very, very busy the entire time they were here. They love to double team anyone willing to take them on! I don't know how Holly keeps up with them on a daily basis.


If anyone is interested in Fritz, he has made a full recovery and is absolutely beautiful. He is as goofy as they come and thinks he's a lap dog, but he made his greatest inroad into the family with how he let the Twinks love on him in their usual rough and tough fashion.

Natchitoches

This last weekend we went to Bossier City, LA to spend time with Bethany's husband Phillip and his parents. Bryce, Erin and her brother joined us on Saturday and we all went down to Natchitoches for the Christmas Light Festival and fireworks display. This is our second time to do this and we hope to make it a tradition. Natchitoches is the little town on the Cane River in which the movie Steel Magnolias was filmed.

What a delightful time we had with friends and family! This little town has the most incredible fireworks display and delicious hot meat pies to enjoy while watching the show. Live jazz Christmas music played from the bandstand and people strolled Main St. and shopped in the festive shops.

Phillip and Bethany

Tony and Pat Scott, Phillip's parents are wonderful hosts and we count it a blessing to not only be in-laws but friends.

Bryce and Erin wrapped up against the cold night air.

Phillip, Stewart (Phillip's long time friend and college roommate), Bryce, Bethany, Erin, and Daniel (Erin's brother).
Next week Holly, Greg and the gang will be here to celebrate Christmas with us. We are all so excited that we can be together one more year. Look for more pictures soon.

Catching Up

Yes, it's been a while. November was one big rush! I was out of town 4 out of 5 weekends and started a new job. Let me see if I can catch you up to date briefly.
I had hoped to give to really send more pictures from the Smokies, but we didn't have Internet service. The trip was wonderful and such a blessing for us all. Keegan's dad was able to take 3 hikes with us, even one four mile hike! Unbelievable when you realize he's 91 and had a stroke two weeks before the trip!


In mid November I went to a Women of Faith Conference in Oklahoma City with friends and had a wonderful time on a sisterhood weekend. The trip and the conference were a gift to me, and it was such a wonderful thing to receive. It's been a long time since I had a weekend slumber party, and this one was in a wonderful hotel and was centered on Christ!
We had a wonderful, but quiet Thanksgiving with Keegan's sister Pat and her family. All of our children were out and about with other family. Holly and Greg did come to town and we got to see them the night before we left for the field conference in Mexico. We can't wait to see them in December for Christmas!
Keegan and I flew to Mexico the day after Thanksgiving for the missionary conference held in Fortin de las Flores. It was a wonderful time of fellowship with old friends and new ones. The worship was strong and the teaching great. I have to say the food was also a highlight and I didn't miss a meal! Keegan and I sure drug our feet getting back on that plane to come home, but we knew God is still asking us to remain here in Dallas. What a blessing that we were able to go and we are thankful for all the wonderful folks serving God in Mexico.

I am also starting a new job this month. I was 3 years at the last one, but now God has given me a new opportunity. Once again I must be childlike and learn everything new again. Sometimes I grow weary of starting over, but I also find myself eager to learn new things that will broaden my abilities. When I was young and just beginning my nursing career, I had it all planned out to specialize in one area, but I forgot to check with God on His plan for my career. He has led my career on a journey so broad and so full of learning new roles and jobs that my little puny plans could never have included. I have had to stretch and grow and become more flexible than I ever thought possible. Each time I have begun a new change in field with fear and trepidation, and each time I have left incredibly enriched and deeper in understanding. I loved what I was doing at my last job and I know it has helped prepare me for this new one. I am so glad God's plan took precedence over my own.
This grew longer than I thought, but I wanted to catch you up. Hopefully I will be more consistent in writing here again. Thank you all for your prayers and for just keeping up with us.

Not in Texas

Keegan and I used our airmile awards and flew to Knoxville today. We will be meeting Keegan's dad, his sister Candy, and her husband Bill to spend the week in the Smoky Mountains at their time share condominium outside of Gatlinburg. What a miracle that Everett (Keegan's dad) is still able to make this trip that was planned since last spring! Remember he had a stroke only 2 weeks ago and because he has had such a miraculous recovery the doctors said he could still make this trip. There is still one more miracle to occur in his life, and many are your praying for it for him. We are all praying this will be a week of opportunities to talk to him about eternity. Please keep him in your prayers.
In December 36 years ago, Keegan and I came to Gatlinburg to celebrate our honeymoon, and we still love each other and Gatlinburg! Today we drove straight to the Park and hiked to Grotto Falls. Here's what we saw. Enjoy, especially if you live in Texas and don't get to see such sights as these.

Oops, I guess you can see the above sight in Texas:-)

Now this is what I am talking about!

Look for more pictures to come as we continue to check out the fall color here. We're a little late for the peak season, but it's still good to someone who has spent a lot of years in either West Texas and in Mexico City.

Soul Care

Recently Keegan wrote his doctoral dissertation on soul care. Sounds simple, doesn't it? I learned so much reading his paper and now I am going back to read some of the books that he read in preparation for writing his paper. Soul care seems to be counter cultural to the US lifestyle because you have to actually stop, look, listen (sounds like crossing the street, doesn't it?) to God. Since most of us here in this country drive rapidly every where and rarely walk to our destinations (and live our lives in like speed), we seldom walk across streets and may have forgotten those three basic rules. It's true in our spiritual lives as well. Let me share some thought provoking quotes about soul care:

The meaning of earthly existence is not, as we have grown used to thinking, in prosperity, but in the development of the soul. Aleksandr Solzhenitsyn

...the great malady of this time in Western history is the "loss of soul." Without soul, we base our lives on doing, getting, achieving, and performing. When soul is neglected, it doesn't just go away; it appears symptomatically in obsessions, addictions, violence and loss of meaning. Thomas Moore

Forfeiting the soul looks from the inside like lingering emptiness, purposelessness, and futility. Looking at these prospects, we need to ask, "What am I losing by all of the gaining I am doing?" Soul care integrates all of a person, beginning with the inner being. Only God can peer into a soul to see perfectly what we cannot see. He says, " I the Lord search the heart and examine the mind" (Jer. 17:10a). Deep inside are desires, passions, longings, regrets, motives, and intuitions about God, family, work and other dimensions of life. All is revealed to him. Stephen W. Smith

Keegan would love to take his doctoral work and put feet to the work. He developed a conference on soul care as part of the paper and that is his passion. I pray God will provide the opportunity for him. All of us could benefit by learning more of soul care.

Breathing Grace

I saw this prayer today in a blog written by Peacemakers. The author is TaraBarthel. I thought it was a great way to start my day and I wanted to share it with you:

"Peacemakers are people who breathe grace," Ken reminds us. The peace of God transcends all understanding and it fills their hearts like fountains bubbling over with mercy, kindness, genuine care, and abiding love. They are so filled with God's grace that they splash it onto everyone around them. They could no more stop breathing grace than a person could stop breathing air-because grace is the air that they breathe. Their prayers sound something like this:
• Breathing grace in: The one true holy God sent his Son to die for me? I am saved from hell, from my sin; justified before this holy God; forgiven and adopted? What wondrous love is this! Thank you, God. Thank you for forgiving me all my sins and making the way for me to be at peace with you. I worship You!
• Breathing grace out: And now, dear Lord, as I head into my day-let the truth of the gospel of Jesus Christ be the heartbeat of my life. Please, God, let every word I say, every action I take, the attitude of my heart, my desires and inclinations-let my life be used by You, for Your glory and the furtherance of Your Kingdom. Please help me to treat others not as they deserve-but as You treat me. May I be your image-bearer, your representative, your ambassador. Thank You, Lord.

Blessings

Yes, I know it's been quite a while since I last updated. There are no real excuses that would cover such a lengthy absence, and I won't bore you with any attempts. Even today I must be brief, but I want to share how good God has been lately.

Keegan did so well on his defense of his doctoral thesis, and I am so proud of him. He worked so hard on those 258 pages! Now we have to make all the formatting and content corrections and get the final copy returned by the 17th of November. That happening as it should, Keegan would officially graduate in December but wouldn't walk in a ceremony until June in Boston. Now Keegan is waiting on the Lord to show him just how He wants Keegan to use what's been given to him. We have many ideas and dreams, but we want only His dreams and ideas for us.

Bethany and Phillip sold their home here in Dallas in 10 days in September! To help them save money for this next year of internships and moving to three places, they are living with us. God gave us this big house to use and we are thrilled that we have the room and the physical set up to make it a good situation having them with us. Phillip continues to excel in school and loves practicing what he learns on us.

Erin got a new job at a large church in the area and loves it like no other! It employs all her talents and gifts and is teaching her so much. She works with a wonderful group of people who are strong Christians. Bryce also was blessed that he was not included in the large group of layoffs there at Time Warner this last month. He continues to do well in his manager's job there and is set to get some extra training this early spring that will enhance his abilities.

Holly and Greg continue to chase the 4 active little ones. Kylee and Ashlynn are now walking and there's no stopping them! Even Connor and Alyssa can't seem to keep up with them. Alyssa got her first stitches last month when she took a face dive off her chest of drawers, but the wound has healed well. Holly and Greg have been working on remodeling their kitchen to make more eating room and the end is in sight. If you want to keep up with this bunch (or any of our kids) check out their personal blogs. You'll find them listed here on this site. Just click on them and it will take you right there.

I am waiting on the Lord for some new direction. It looks like He is giving me some, but I don't want to be premature sharing those yet. Watch the next posting for updates.

God HAS BEEN good to us in this last month, but then that's not new. He's always good to us. May you find the blessings in your life today and rejoice in Him who bestows them.