The Road to Gimbie Letters

05/11/01

Dear Family and Friends,

I haven't written in a few weeks. We are doing fine, but I have had a number of things going on that have kept me from writing sooner.

Dr. Rose has now left for vacation, so I have been medical director, and hospital administrator. I am not bragging, though. I would be glad to give this responsibility to anyone who wants to do it. Our business manager has been reassigned to another post and we were not able to get another one before Dr. Rose left, so I am wearing that cap too. We do have a surgeon that is covering for Dr. Rose while he is away, so that helps a lot. This has kept me a bit more busy than usual since I still have my other responsibilities. I am learning to appreciate what Dr. Rose does and find myself having no envy toward him. It really is a blessing to walk in the shoes of another.

Now for some hospital stuff. I got called to the labor and delivery ward. This ward always seems to provide me with reasons to pray. When I got there, I saw a very pale woman who had been sent by the government clinic. They said that she had delivered there a half hour before and the baby was fine and when they checked on her, she didn't stop bleeding. When they examined her, they said they found a mass in her vagina. I thought, that is weird. Well, she had bled a lot and so we got an IV started and brought her blood pressure up and I checked a vaginal exam on her. I found lots and lots of clots there and then I felt the "mass." Actually, I was feeling for the cervix to see if it was still open, but there was no cervix. We had a case similar to this a few month ago. I realized that the uterus had been pulled inside out. Someone had pulled too hard on the umbilical cord and placenta. This caused the uterus to turn wrong-side out. This is a very bad thing since it just exposes the part of the uterus that bleeds, and, wow, did it bleed.

I remembered the last case that we had a few months ago. In that woman, her uterus had been inside out for a couple of days and she was severely anemic. We couldn't find a blood type to match her so we sent her to a government hospital about 3 hours' drive away (the nearest hospital to us). I found out that she expired there since they could not get anyone to donate blood for her. That flashed through my mind when I saw this woman. In the previous woman, we had been unable to turn the uterus right-side out since the cervix had closed like a tourniquet, so we needed to do surgery, but we couldn't since she was so anemic.

Anyway, this case in front of me had only been 30 minutes. I tried to remember the picture in the book that I had seen about how to turn a uterus right-side out. I began to try it. I had never done this before. As I was trying, this woman was just pouring out blood. I was praying first quietly. Then as I had more and more trouble, I began to pray out loud. I finally began to feel the uterus turning back right-side out and then, suddenly, it slipped into the correct place, right-side out. The bleeding didn't stop, though, and I began doing some very painful but necessary things to slow the bleeding and it finally stopped. It took about 45 minutes to an hour to do it. I was so happy when it stopped bleeding. I was also covered with about half a liter of sweat. My prayers had been answered and I was happy I could tell the patient that the problem had been solved by prayer.

I have mentioned before that certain medical problems seem to come in groups. This past week it was auto accidents. There were three of them. With the first accident, there was one fatality, the pastor of a local Protestant church, and three others injured, not seriously. The next accident had 5 injuries. One had a scalp laceration, the pastor of the church that we attend. Another had a rib fracture. Another had a lower leg (tib/fib) fracture. Another had a pelvis fracture. The rest just had bumps and bruises. The final accident had only one person injured and not too seriously. I am glad to report that other than the fatality, all the rest have done well and have gone home now. Another answer to prayer.

This leads me to mass casualties. Our little hospital is not set up for handling too many patients at one time, so when we do get that many at a time, we just pray and hurry. The most tragic of all mass casualties that I have ever worked on in my life happened this week here in Gimbie. A man went crazy with an axe. He went from house to house attacking people at home with the axe. He only hit people in the head. All told, there were six victims. Five of the victims were between the ages of 1 and 2 years. The only adult was a grandmother of one of the children. Four of the children and the adult were brought to our hospital. The fifth child was brought to the government clinic. The child who was brought to the government clinic was dead on arrival. One of the children brought to our hospital was dead on arrival. One more of the children died soon after arrival. The other three victims were divided among the three of us doctors. The adult was taken to the OR and surgery was done by the relief surgeon. He removed bits of skull that had been pushed into her brain. She died after a few days. The child that Dr. Fetene was working on got taken to the OR by the surgeon and he also removed bits of skull that were pushed into the brain. She is still alive and was able to sit up today. The last child I took care of. She also had a skull fracture, but a person screamed at the time the man was swinging the axe and instead of hitting the child directly and pushing bone into her brain, he hit the head at an angle and this fractured the skull as a flap lifting outward rather than pushing inward. The surgeon peeked in while I was checking her and told me we should just remove that bit of skull. He helped me with that and then went to do the surgeries I described above, leaving me to repair things. The skull bit, about 2 cm in size, was removed. This showed that although the skull was injured, the membrane around the brain had not been cut (the dura), so I sewed things up as best I could. This is the second time that I have done some sewing around the brain, and I can tell you that I was praying this time too.

Well, I came by on rounds the next morning to see her and she stood up and smiled at me. I was so happy to see her smiling. She did well, and went home from the hospital today.

The man is from another tribe than this area and says that he was sent here to do this. He also said there are others who have been sent. We heard about several students in another area a ways from here that had also been killed in the last few days. We need your prayers that this will calm down and not lead to more tribal conflict.

For those of you who have written about the riots you heard about in Addis Ababa in the past few weeks, please know we are fine. The riots were at the university in Addis. There was student unrest and the police responded vigorously. 30 were killed and over 200 injured. The university, the only university in Ethiopia, was closed for a few days and things have calmed down there and we are praying that things stay that way. These events are so far away from us, so we are really unaffected by them, but please pray that peace will reign. Africa is such a volatile place, but we have been very blessed to be in a region with very little violence. Please keep us in your prayers that things will stay that way.

There is more that I could write about, but I need to close for now. I will write again when I can get a bit of a break in the schedule.

Sincerely in Christ,

Nick, Phosfe, Christopher and Ian Walters