Fall Update II

We are actually doing this post in the living room of this cabin. We are currently on our first full weekend off since starting residency in July. We took the opportunity to come to the Smokey Mountains and rent a cabin. It is amazing and the views are outstanding! On top of that, it is restful, something that we truly appreciate.




Just a view from the inside of the cabin. Angela's parents are actually building a mountain house...we hope it has some windows like these!

This is at the large city park just beside our townhouse in Nashville. We took some bread to feed the ducks and the birds and as you can see, they were hungry. We have been blessed to have most of our days off together so we can enjoy activities like this. There is also a full-scale replica of the Parthenon in this park. We will post a picture of it soon.

Merry Christmas! Chuck's family took this picture at the ICE exhibit at Opryland hotel in Nashville over Thanksgiving. We hope you and your families are enjoying the holidays.

Fall Update I

Happy Thanksgiving! Our families came to visit for thanksgiving...everyone, even Bella, Jennifer and Seth's dog. We ate a lot of turkey, pies, and stuffing...played games...and saw the christmas lights at Opryland Hotel. We also bought a tree and decorated it. Thanks to our families for visiting!

Jr and Lindsay lived with us for a month during October and November while they did a pediatrics rotation at Vanderbilt. It was a lot of fun to have them here and we were recruiting hard for them to come back to stay next year for residency! This is us in front of our carved pumpkins. Chuck's is a skeleton face, Angela's is a spider, Jr's is a tree, and Linday's says "Boo". We had some help from other friends of ours carving the rest of them.

This a picture we took while hiking at Radnor Lake in Nashville. Although we have been busy at work, we have had time to get out and enjoy Nashville and some beautiful scenery. Jr and Lindsay were with us on this hike and it was surprising how far we felt from the city while still being so close. We were lucky to catch the lake on a clear day with the changing of the leaves.

This is a tribute to Zeke Barrier. Zeke died about 2 weeks ago. Many of you had met Zeke and knew how big a part of our family he was. This is the last picture that Chuck took with Zeke. He will be missed dearly.

Galapagos I

We had a great time in the Galapagos! It was great to adventure out, relax, enjoy the company of friends, and get really close to some amazing wildlife. In this top photo, we are overlooking one of the most spectacular landscapes in the Galapagos. We are at the top of an active volcano with a view of some amazing beaches and mountains.

This is us with JR and Lindsay Young. They are some of our best friends and have been in South America working in medical clinics and learning Spanish. They planned the trip to the Galapagos and it was great to be able spend some time with them. Oh yeah, there is a 100 year old giant tortoise behind us (only found in the Galapagos).

Sea Turtle. We took this picture with our underwater camera...and yes, we really were this close. We swam with sea turtles, sea lions, penguins, tropical fish, sting rays, and sharks (not carnivorous).

Shark vs. Fish. Actually they are just passing by and have very little interest in each other since they both mostly eat plant life...but it made for a cool picture.

Galapagos II

Penguin. We were snorkeling just a few feet from these guys. Then they jumped in with us. They are only about 1.5 feet high and are able to live at the equator because of the cold water currents from the south.

Blue-Footed Booby. These birds descend 20 feet down into the water to catch fish in a display that we referred to as "dive-bombing". It is by eating a certain fish that their feet become this bright blue color.

Frigate Bird. Very high flying bird that is known to steal other bird's food. In this photo, the male has inflated his neck sack to attract the female frigates...works every time!

Marine Iguana. This reptile gets its food by diving to the ocean floor and eating algae off of rocks. It then drinks salt water and expels the salt by way of unique desalination glands in its nose. In this photo, the iguana is catching some afternoon rays.

Chuck and Sea Lion. This young sea lion has the daily job of eating, sleeping, and playing. We had the opportunity to swim with the sea lions after Chuck finished his conversation with this one.

Med School Graduation

We graduated from UNC med school on May 13th! The weekend was a lot of fun with our families in town and many activities planned by the med school. We had awards, dinners, galas, and picnics before the actual ceremony. We left for the Galapagos Islands a few days after graduation. Plenty of pictures from our vacation are coming soon.

Africa 8

We have finished up our time at the Baptist Medical Centre in Nalerigu. It was a wonderful month, full of great memories, and tons of learning. God really blessed both of us during our time there. Then we had a few days to go to Mole, which is the Ghanaian game park. It is located in the northwest region of Ghana and is 4,000 square kilometers of protected area. It is not like going to a safari or anything, but it is beautiful and they have elephants....as you can see. On our way to Mole, we decided to rent a car and driver. As the park is very remote and the public buses are a little sketchy. We got a "deal" on a car that had no air conditioning, but was a 4 wheel drive, and looked ok on the outside. We had just gotten to probably the most remote spot on our drive, many miles in either direction from a village, and probably 30 miles from a town of any significance....when the car breaks down because the battery died. Of course being the pesimists that we are...we were already planning what we were going to do when it became dark. However, about 10 minutes after we broke down, God provided a bus that pulled over. The driver had a battery we could use, but did not know what to do with it. Then God provided a 2nd car with a mechanic inside. The first picture was taken with all the men outside working on the car. The "mechanic" then somehow jumped our car from the other car's battery....without any jumper cables! He then bolted some things down, poured water and rubbed vaseline over other things, and then hopped back in his car. So our car made it to Mole....of course on the return trip the hood came loose, the bumper fell off, and the transmission blew out....beware of "deals" in Ghana. God truly was looking out for us on this trip.

So once we did arrive to Mole, we found there was no running water and they are on a 12 hour scheduled blackout every other day (this is throughout the country due to low water supply for their hydroelectric power, so we were a little used to this). So no fans much less AC in 95+ degree weather. That being said....we went on 2 walking safari's. We saw various types of antelope, crocs, warthogs, monkeys, baboons, and elephants. In the 2nd photo, the elephants had come down to the watering hole for their daily baths. It was kind of scary/cool how close the guides let you get to the animals. The funniest part of the park is that the animals have no fences....NO FENCES! This means that you walk out to the restaurant to find monkeys have stolen the ketchup and there was an elephant going through the trash of the village while school children played nearby.

In the third picture you can see a few of the baboons that were wandering around in the forest and in the village. There are 600 elephants in the park and many more monkeys and baboons. Apparently there are also some lions and hyenas...but usually only tracks or carcasses are left as evidence of their presence.

The last photo was just last night at sunset. In the bottom of the picture you can see the watering hole and the rest of the park is in the distance. This morning we left Mole early to head to the airport in Tamale. Our in-country flight was an experience...a tiny non-pressurized plane that was fishtailing and bouncing in the air. We were very thankful to land safely. We are now in the capital city of Accra and will fly out tomorrow and get home sometime Sunday afternoon. Hopefully we will see some of you at church on Sunday night. Please pray for safe travel.

Africa 7

Yesterday we took a trip to Bolgatanga. It is a town about 2 hours away that has some souvenir shopping and they are famous for their handmade baskets. Charlie decided that he wanted a straw hat and went to pick one out. This picture was taken after he had already decided to buy the hat on his head. The other sellers were not quick to give up though as they continued for a few minutes to show him all the other hats that he should buy!

The next picture is one of our favorites. This is a picture of a young Ghanaian boy standing in front of the Nutrition Center (locally called Kokodu). The boy is at the Nutrition Center to help his mother take care of his younger sibling. This building is just beside the hospital and it is where malnourished children are brought so they can be properly fed and the mothers can be taught now to make more nutritious food. Koko is a popular porridge-like food that is often eaten by the young children. You can see some bowls filled with the "hospital koko" just to the side of the boy in the picture. This service provided by the hospital is amazingly effective in improving the health of the local children who have become extremely malnourished.

We had to toss in a graphic picture, but we thought you all could handle this one. Chuck just got finished removing this massive lipoma from the patient's leg. Krisy Burri helped as some of the other volunteers looked on. Lipomas are just fatty growths that are not harmful, but can become quite large. The local people seem to be very bothered by their appearance (especially when they are this large) and we are more than happy to remove them!

The last picture was taken today at church. It was our last Sunday, so we decided to go back to 2nd Baptist Church because that is where Chuck went most of the time last year. While the choir sings, some of the women often go to the front and dance along with the music. Angela and Zsila (one of the new volunteers) went to the front to dance with them. Angela is holding hands with Peace, the daughter of Judith, one of the hospital translators. Chuck also had the opportunity to pray for the offering during the service. It was a great time of worship and we are definitely going to miss the churches here in Nalerigu. Please pray for these churches and the pastors as they lead their congregations and at the same time share with people both at the hospital and in the village about Jesus Christ.

Africa 6

Another update from Nalerigu. This first picture is a photo of us and our father's in the front of the hospital. We just wanted you all to get a look at what the building is like. It was built in the 1950's and has had a few additions since then, but this front part has been there since the beginning. Just behind us is where the clinic patients gather and morning devotions take place. There is also a 30 minute gospel presentation that occurs each clinic day for the patients here.

As we mentioned in a previous post, we had the chance to go out with a missionary, Tommy Harrison, to one of his village Sunday services. This is a photo of him preaching his Sunday sermon to the village people of Duuni. Over the past 10 years, he has learned enough Manpruli (the local language) to not only communicate but also to be able to share the gospel. Many village churches have been started because of his efforts in going to unreached areas of northern Ghana. He goes out 4 days a week to villages up to 2 hours away.

The next picture is a wonderful story that we just had to share. The little girl in the picture (smiling for a photo is not exactly understood in Ghana...so she is showing us her teeth instead) was a patient at the hospital. Our first week here, her family brought her in to see Mike Kimbrell at clinic. She had fallen out of a mango tree and had a closed head injury. She was comatose, her pupils were minimally reactive, and she barely responded to pain. We admitted her, and gave her as much treatment as possible. Unfortunately that is not very much as we have no way to do brain scans....much less attempt any sort of surgical intervention. We prayed with the family, and sent the little girl home several days later. When she left, she had shown little improvement. We tried to prepare the family for what life with a severely impaired child would be, and planned for her to follow-up in clinic 2 weeks later. On clinic Wednesday, in walks this child to clinic. Until we looked at her record, we did not even recognize her. She has been walking, talks (although her speech is still slow), and is doing remarkably well. It was just such an open reminder that God heals. We did nothing for this child, and God in His infinite wisdom saw fit to heal her. What a beautiful example of his love, and a humbling example of our limits. We just wanted to share.

This is how we look at xrays here....luckily there is plenty of sunlight. This was a little baby with pneumonia. It has been great having our dads here to teach us some of the finer points of medicine (like reading xrays) even if we don't always have the usual American technology. We have both learned how to use physical exam and clinical judgment to make decisions and to become less reliant on tests and studies. Not to say that we don't plan to use and appreciate them when we are back home!

Only 4 more days here in Nalerigu and then we will be going to Mole (the Ghanaian game park) on our way home. We are tired, but also starting to become a little nostalgic about our time here. It has been an amazing experience. We are going to try to make the most out of our last few days here. Please pray for safety as Mike Kimbrell starts the trek home tomorrow and we follow him next weekend.

Africa 5

It is hard to believe that we have already been here almost 3 weeks. We have had a great time so far and have enjoyed working in the hospital, both from a medical side and a ministry side. The first photo is one that we took while walking through the village this past week. These mud huts are the typical house for the people of Nalerigu. Each compound has a few mud huts opening into an inner courtyard. Your entire family including parents, brothers, sisters, and grandparents all live in the compound with you. During this hot time of year, the people sleep out in the courtyard, but other times of the year, the men sleep in some of the huts and the women in the others.

Ghana as a country recognizes Good Friday and the Monday after Easter as national holidays. That means no clinic for the hospital, but still plenty of sick patients coming in. Just in the past two days we have seen a few cases of typhoid fever (one needing surgery for a bowel perforation), an incarcerated hernia, a couple cases of seizures, meningitis, plenty of malaria, and some c-sections. But since there is no clinic, we had time to go to the Good Friday church service at one of the Baptist churches in town. When we arrived, they were having a baptism service just outside the church building. The 2nd photo was taken at that service. Most of the congregation was in a circle and they were singing praise songs during the baptisms. It was really a neat experience and there were about 20 people who were baptised. The Good Friday service was a lot of fun as well as it had even more of a celebratory feel than the normal services. It is truly encouraging to worship with the Christians of Nalerigu. Though they are considered poor by just about anyone's standards, they are rich in the Spirit of God.

The third picture was taken as Angela was helping Dr. Faile with an ex-lap (abdominal surgery). A lady had come in looking just like she had a typhoid bowel perforation, but when they opened her belly, they only found the evidence of a perforation, but no source. They finished the surgery and closed her and she got better with antibiotics and recently went home. At the beginning of each surgery case, everyone is quiet and Dr. Faile leads the team in a prayer for the patient. It is only through God's care that so many of the people here get better when we have relatively little to work with compared to other hospitals around the world.

The last picture was taken just today as Charlie and Chuck did an EGD on a patient who had been vomiting blood. We found the source and now he is being treated for his ulcers. Just before Charlie arrived, the last endoscope broke and since that time we have been using a colonoscope. Yes, that is right, the same scope that is normally used for colonoscopies. It is a little longer and a little wider, but the patients have been tolerating it well. And we don't use it for colonoscopies anymore! Thanks for following along with us. Happy Easter!

Africa 4

Life in the hospital...This is a picture of us seeing patients in the men's ward of the hospital. This is a pretty typical set up for a ward. There are usually about 10-12 beds in a ward, and as you can see they are pretty close together. Usually a family member or friend is sleeping on the floor beside the patient's bed, if not under the patient's bed. There is no cafeteria and limited nursing staff, so the family takes care of bathing and feeding the patients. There are usually only 2-3 nurses for 25 beds so they are busy just getting out the meds and collecting labs and vitals.

The next photo is a clinic day...this is only part of the waiting room, with an average crowd. Several hundred people are seen each clinic day, which is Monday, Wednesday, and Friday. We never know how many people we will need to see, as they do not end clinic until every person has been seen. We have been seeing patients together. We average about 25 per clinic day, but the full-time doctors here can see over 75 at times.

The next photo was taken when we went with Tommy Harrison, a missionary pastor / hospital maintenance man / farmer, out to a Sunday service in a local village. The service started with about 45 minutes of singing, clapping, and dancing. The praise songs were in the local language, so we only took part in the clapping and dancing. Tommy gave us a chance at the beginning of the service to share why we had come to Ghana and their village. Then Tommy gave a message on the death of Jesus on the cross (Easter is coming up!). After the service, there was a lady with a new baby that she wanted "named". They looked to us and we chose Ester. They wanted a Biblical name that was not too hard to pronounce. The photo is of Angela and Ester.

The last photo was taken at Nakpanduri, a village about 30 minutes away. We had stopped for a drink on our way back from the escarpment (see the last post) and when we went to the small store, a lady recognized Chuck. He had treated her child last year in the peds ward. She was very excited to show him how well her child was now. So, they all took a picture together. She is a beautiful healthy girl.

Charlie Barrier arrives in Nalerigu tomorrow, so please pray for a safe flight from Accra to Tamale and safety on the road the rest of the way. We are excited to have him come and we already have an EGD lined up for him tomorrow! He is bringing supplies for the hospital like sutures and bandages and supplies for us like gatorade and granola bars. Thanks again for your prayers...they are needed and appreciated.

Africa 3

We have had a great week here in Nalerigu. Angela is pretty much running the peds ward now. She sees everything from extreme malnutrition and sepsis to meningitis and malaria. She is also going to be the most accomplished lumbar puncturist in her intern class! Mike Kimbrell and Chuck have been busy with the adults and lately we have been running a snakebite clinic (about 4 each day). We are also seeing all the "normal" things like typhoid, malaria, TB, and even a few buruli ulcers in the past week (caused by mycobacterium ulcerans for those interested). Although we were on call for 4 of the past 7 days we have had time for some fun outside the hospital. The first picture is from the Dumba Festival. We have asked around and nobody seems to know what we are celebrating, but everyone in the town comes to the Chief's house. There is drumming and dancing and as you can see in the picture, some firing of rifles. The first few shots almost scared us to death! The Vice President of Ghana came up to Nalerigu from the south. It was a big deal around here to have him come...roughly equivalent to Dick Cheney coming to Chapel Hill. The next picture is from our trip to the escarpment in Nakpanduri today. Dr. Hewitt took us and his kids to the top and we were able to look down and see for miles and miles. We had to climb up about 30 feet of rocks to get to that overlook...it was worth it. The other couple in the picture with us and Angela's dad are Chris and Krisy Burri. They are the new volunteers that just arrived a few days ago. The last picture was taken in our room today. The heat has become stifling in the past week. It was about 110 in the shade and over 120 in the sun today! Even the Ghanaians admit that it is hot! Thanks for following along with us and please continue to keep the hospital in your prayers. Please also pray specifically for Dr. Faile and Dr. Hewitt, the full-time local physicians that work here and have dedicated their lives to serving the Mamprusi people.

Africa 2

Week 2 in Nalerigu, Ghana is drawing to a close. One group of volunteers left early this week, and a new couple just arrived. So we have had several days of call in a row. We are a little tired, but enjoying things here. A few stories...in the top photo, we went to the local market which is held every 3 days. They sell everything that the people here could want, from produce, to shoes and cloth, even a dried monkey head (I kid you not!). In the 2nd picture, we had brought some crayons and coloring books to Africa. The kids in the hospital have little to nothing to do all day, but sit there. So we thought we would try and entertain them a little....here is a sample of their artwork. We are planning to sell a few of them on Ebay this week...ha ha. On a medical note, there was a sad delivery today. One of the nurses went into labor and had to have a c-section for breach. Unfortunately the baby had an upper airway obstruction and was never able to breath. In the US they probably would have had emergency surgery, but unfortunately that is not an option here. Death is just an accepted way of life. Parents often do not name their children for several weeks, because of the high infant mortality. On a happy note, there have been several kids with meningitis that we effectively tapped, treated, and sent home. The surgeon here saved a child with a small bowel obstruction today, and several people with perforated bowels due to typhoid. So there is a lot of happiness here as well. In spite of the tough conditions here, the people are joyful and happy and have a wonderful sense of community and family. We think some US communities could learn a lot from them about how to support and serve one another. Please continue to keep us and the hospital in your prayers.

Africa 1

We have arrived in Africa. We spent most of the first 2 days traveling (4 hrs to Minnesota, 8 hrs to Amsterdam, 8 hrs to Accra, spent the night in Accra and then 1 1/2 hour plane ride to Tamale, and then a 3 hour car ride to Nalerigu.) We immediately started working at the hospital, rounding on the 80 or so inpatients. We participate in outpatient clinic 3 days a week. On other days, we have gone out with the public health team to give immunizations in nearby villages. While there, we often see some of the sicker children in the village (like in this picture.) It is not uncommon to see a one year old child who has gained no weight since 6 months of age. The hospital is filled with people suffering from meningitis, malaria, and typhoid. Usually 1-2 people die a day. People also have more common things like reflux, hypertension, and arthritis. There is extreme poverty, with the villages usually having no running water or electricity. All of that being said, the people of Ghana are wonderful. They are warm, welcoming, and very appreciative. They love their children and their families and want the best for them. I believe that it is the people here who have motivated people like the Failes (one of the full-time docs and his wife) to serve here for 18 years in what is most definitely the African bush. It has been a busy week, and since several of the volunteers are leaving, next week promises to be even busier.

MATCH DAY

We matched at Vanderbilt! We will be moving to Nashville so all of you that have been wanting to visit the Music City have a place to stay now. It was an exciting day. They call each name one at a time and you go and get your envelope at the front. I held mine until Angela got her envelope and we opened them at the same time. We are looking forward to starting residency, but right now we are excited about going to Africa. We are leaving for Ghana today and will be gone for 5 weeks. We will be working at the same mission hospital that I worked at last year. Angela's dad is going with us and my dad is joining us in a couple weeks. We all would appreciate your prayers for our travel and our time there. We will be leaving updates on the blog so follow along!