A Small Girl With a Big Problem

December 5th, 2009

It’s been nearly a week since eight-year-old Saabdam Kombat came to the Baptist Medical Centre in Nalerigu. The little girl fell from a tree and broke her jaw in two places. Her chin is hanging open. The fall also knocked out so many of her teeth that Matt and a visiting surgeon were not able to stabilize her jaw by wiring her mouth shut. Simply put, the hospital here is not equipped to treat her problem.

Matt has been working with the doctors here and their contacts in the capital city, Accra, to find an oral surgeon willing to take Saabdam as a patient. They have found a surgeon at Korle Bu Teaching Hospital in Accra. Through a lot of prayer and legwork, they have also found someone willing to take the child and her father, Jafuok, to Tamale, the nearest city of any size. Someone else is willing to buy their bus tickets to Accra, and a third person has agreed to meet them at the bus station in Accra and take them to the hospital. All of this is an answer to prayer.

Several weeks ago, I wrote a post asking you to pray for a child called Saando who born with spina bifida. His parents were from a tiny, remote village, and the necessary surgery would require them to take a daunting trip to another world filled with traffic, tall buildings, and languages they’ve never heard. The parents took the child back to their village. As far as we know, he never received the surgery that would have saved his life.

Saabdam and her father come from a similar situation. Our small village of Nalerigu is probably the largest city either have ever seen. They don’t speak English or even the local language of Mampruli. They are from the Bimoba tribe and find communicating with people at the hospital difficult, though there are other Bimoba here who can translate for them. In Accra, there will be no one. Jafuok is clearly a father who loves his daughter dearly, but he is out of his depth. When he was told of the surgery his daughter would need, Jafuok responded that perhaps his relatives could sell some goats to pay for it. This surgery will cost more than many goats.

Things are falling into place to get this little girl the help she needs. With the surgery, she can be a healthy, normal girl, though perhaps one who is more leery of climbing trees. Without the surgery, she will be badly deformed at best or die from infection at worst.

Please pray that the Kombat family will arrive safely in Accra, that the surgeon will be able to successfully repair her jaw and that the infection they have been treating at the hospital here will not resurface. Pray also for Jafuok Kombat as he is trying to negotiate a truly intimidating city while worrying about his daughter’s health.

We are in the process of raising money to pay for Saabdam’s surgery and hospitalization in Accra. If you would like to donate any amount, you can do so through the Faile Foundation, an organization established to support the work of the Baptist Medical Centre in Nalerigu. They accept donations through PayPal here, or you can mail a check to
The Faile Foundation
P.O. Box 542
Cave Spring, GA 30124

As always, thank you for your prayers and support. We could not have made it through our time here without your encouragement.

Some Background

November 23rd, 2009

Matt emailed this update out last week, so I thought I’d post a slightly edited (an occasionally annotated) version here, too. Things are quite calm here now. The funeral is planned for Friday, but until then, the hospital is fully functioning again.

We went to “greet” the family of the pharmacist last Monday, almost like visitation at home. All the missionaries and volunteers rode to their house and sat down with the extended family on benches outside briefly while they informed the family inside and one of the missionaries just expressed our sorrow and our prayers for them and then we went inside to greet his sisters and two wives. (So, that might shock some people, but multiple wives are not too uncommon, even among Christians like this family, though Christians who have more than one wife are usually excluded from being deacons as the Bible mandates. If you have more than one it’s usually two, unless you’re the chief, in which case you may have to take many because of politics.)

Yes, the compound is safe, but still we take precautions. Our house is already concrete walls with two-inch sandstone pavers on the outside and burglar bars, heavy hog wire and mosquito screen on the windows. We have locked our doors at night ever since we came, not because thievery is frequent but because it’s just better for everybody. (We don’t have anything significant to steal, but if somebody did steal something from us, the police would be very hard on them. “Many a thief is saved by a locked door,” I think Jefferson said.) We also have a night watchman and watchmen at the gates of the compound. For now there are also police and military throughout the town and at the hospital.

As I am my father’s son and a Boy Scout, we packed an emergency bag in case we needed to leave suddenly. This seems very, very unlikely–even ridiculous–but hey, that’s what being prepared means. It contains a pocket knife, lighter, granola bars, water, extra clothes, and … an obscure novel by an up-and-coming Asian writer. (How can we survive without good literature, she says! I promise to pass this on to the Scoutmasters for January’s Survival Campout.) [Note from Megan: The God of Small Things is not an obscure novel.]

Things are beginning to get closer to normal, enough so that the workers met again today and have decided to resume work as normal. They will somehow attempt to keep it lighter for this and because our volume has tremendously increased. Before October, the hospital record was 9000 patients in clinic. In September they changed from the traditional three-day Monday/Wednesday/Friday clinic that they’ve had for years and years to five-day clinic every week. They were hoping it would shorten clinic days so that instead of clinic from 10 a.m. to 7 p.m., we could have clinic from 10 a.m. to 3 p.m. or 4 p.m. Instead we saw 16,000 patients in October, with days still lasting to 6pm and everyone exhausted, and now the man who juggled the pharmacy and the billing is lost, and everyone else is recovering slowly.

Rumors are many. I’ll try to synthesize what I’ve heard. The real reason this particular man was picked is hard to know, but some of the basic tribal conflict stems from the days of the slave raiders when the Mamprusi tribe were the most powerful in this region (and still are). They sent warriors to a distant village of the Kusasi to protect them, and in return that village came under the rule of a Mamprusi chief until this day.

In the early 2000s, fighting broke out in that village over the chieftaincy as the local Kusasi people didn’t want to be under Mamprusi rule any more. I have no idea what kind of implications this has when there is a stable modern democratic republic overlaying these tribal kingdoms, but the traditional governing system still has a great deal of domestic power. This fighting has continued waxing and waning but has been confined to that disputed village.

Our town is the seat of the paramount chief of the Mamprusi meaning he’s not just chief of this town but king over all the other Mamprusi chiefs who are over individual villages.

Our pharmacist was by birth a Kusasi though raised here practically as a Mamprusi, with no connection to the disputed village, but for some time had received anonymous threats and accusing murmurs through the grapevine that he was aiding the Kusasi by bring munitions up from Accra. As pharmacist, he frequently went there to buy hospital medications. He had a wife and kids all in school in Accra and had run for the national legislature. All of these things gave him pretty good reason to be there, so most people (him especially) thought these accusations were ridiculous, like late-night-radio conspiracy theories. This seems to be the pretext to last tThursday’s tragedy, and in many ways looks like somebody is trying accumulate rationale and support to get rid of someone they hate.

They have arrested a couple of accomplices, though it’s not entirely clear they’ve arrested the one directly responsible or if the agitators are all locally based or if they are being emboldened by others from the disputed village. Several more people were arrested or taken for questioning. But there has been no more violence.

It seems that the older and wiser of the Mamprusi have revealed the tragic irony that the grandfather of the man who they believe committed the murder was a Kusasi, so while he thought he was a Mamprusi, he was really a Kusasi, and now he is probably repulsive to all and hero to none. His house has since been burned down.

Some others in the hospital have left town either because of their ancestry or because a few have received threats, too. So the police and military backup remain on alert, and workers who want are ferried to and from work with a soldier riding on the back of their moto, toting a rifle across his chest.

They’ve decided to restart clinic with armed protection at the gates and in the outpatient department, but we’ll be going back to the old Monday/Wednesday/Friday clinic schedule. Today’s clinic was light but by next week, I’m sure it’ll be full.

So your prayers are effective, things have improved in 24 hours that I thought would take weeks! And for that we praise God.

Please continue to pray for the hospital and the situation here.

The funeral is next Friday so pray all will be peaceful and for the family’s continued comfort and protection.


November 18th, 2009

The hospital in Nalerigu has been running on a skeleton staff and only taking emergency cases since its pharmacist was shot and killed last Thursday night on his way home from work. The hospital staff and people throughout the village have been fearful because Nalerigu has always been such a peaceful village and because there were indications of ethnic motivation behind the shooting.

I’m happy to say that, though everything has not been completely resolved, the hospital will open for clinic again tomorrow. We had thought it would be next week or later before the hospital got up and running again, so this is very encouraging news. People have not stopped getting sick because of the problems in Nalerigu, so it is important that they be able to come to the hospital for help.

Please continue to pray for the community as it is still in mourning and awaiting the funeral. Pray for peace among the peoples and healing for the community as a whole.

A Sad Day

November 13th, 2009

Last night (November 12), the hospital suffered a terrible blow when its pharmacist, a man loved and respected throughout the community, was shot and killed outside his home in Nalerigu. He died soon after arriving at the hospital. Violent crime of this sort is practically unheard of in Nalerigu, so the entire community is in shock. The hospital staff is especially distraught. Please keep the village in your prayers during this time of mourning.

Subsistence and Opportunity

November 11th, 2009

The witches’ jewelry has become so popular that they can hardly keep up with demand. Part of the problem is that the women have had to divide their time between the immediate demands of the harvest and the less-immediate but potentially more lucrative demands of jewelry making. The women can bring in a good return on their labor selling the jewelry here, but Melinda, the American jewelry designer who taught them, has offered to show their jewelry along with her own back in the States. There the necklaces, bracelets and earrings these women create can bring in a much larger profit. The problem is that Melinda needs the jewelry to show before Christmas, and the women are having trouble making enough jewelry to send her for the show.

The reason for the difficulty was evident on the day Carolyn (the Peace Corps volunteer who coordinated the jewelry-design project) and I went out to Gambaga with several of the medical volunteers who had taken the day off to help work with the women making jewelry. Getting to Gambaga without a car of your own (which none of us have here) requires walking to the other side of Nalerigu to the “station” where you can find a taxi to Gambaga. They usually fit six passengers, plus a driver and miscellaneous small children into a compact car. Once you arrive in Gambaga, you then walk through the village and a field to arrive at the office of the Outcast Women’s Home.

After making this trek, we arrived to discover that not a single woman had come to make the jewelry. They had all gone to farm. “But couldn’t five or six have stayed behind to make jewelry?” we asked. Apparently not. The minimum wage in Ghana (for people with jobs) is GH2.65, or about $1.86. I’m not sure they make that farming. A single bracelet brings in more than that, if it’s sold in Ghana. If they can make enough to send to the U.S., a bracelet could be worth a weeks’ wages.

For women who have lived hand to mouth their entire lives, their focus is on the immediate need (food) and the immediate solution (farming). And I agree that farming is important. A good crop will provide their basic dietary needs for the next year. The jewelry-making seems less important to them because the benefits are less concrete and will take longer to materialize. Jewelry can’t be shipped to America, sold, and the profits returned overnight. But a little foresight and advance planning could meet both their farming needs and their jewelry profit potential. Most of the women can go out and farm every day. But if a rotation of five women stayed behind to make jewelry each day, they could produce both plenty of food and plenty of jewelry.

We discussed these concepts with the lady who runs the home, and when Carolyn and I returned the next day, a contingent of women showed up, too, ready to make jewelry. They’ve been pretty steady workers ever since. I’m hopeful that we’ll be able to send some jewelry to Melinda soon. Then the women should really begin to see the profit from their labors.