A Night on Call!

I had just fallen asleep, when I awoke to the ringing of the phone with a maternity nurse on the other end. She just called to inform me that a patient arrived who had delivered at home, and continued to have significant bleeding. I was tired as it had been a long weekend on call, and I was hoping for a good night of rest before the start of the week. Half asleep I reached for my scrubs and bag of random medical supplies and stumbled to the door to assess the situation. As I walked to the front gates of the hospital I noticed an anxious man standing next to a small cart with two large oxen attached to the front. This was an ox cart which was a common mode of transportation for many of the Shona people. I could only assume this was the husband of the lady I was about examine.

I proceeded to the maternity ward where I saw an elderly lady holding a small newborn right outside the delivery room. She was friendly, but nervous, and I also assumed she was the mother of the women I came to see. I arrived at the bedside to find and HIV positive mother who was completely pale, and barely responsive. I came to find out that she delivered at home which was 20km away. Evidently only a part of the placenta was delivered, and she had spent the next several hours with significant bleeding. They all loaded in the ox cart and initially drove 5km to a local clinic only to find no one available, and then turned and drove another 25 km to our hospital. All the while our young mother continued to bleed. As I examined her I knew  she needed several (3-4) units of blood. Unfortunately we had no blood in the hospital to give her. I asked one of our midwives how much she was still bleeding, and her response was "She has stopped...I do not think she has any blood left to bleed". Sadly, this was not much of an overstatement. The only option was to perform a D&C to remove the rest of the placenta and hope she would stop the bleeding, and we could keep her alive through the night.

We took her back to the theatre (operating room), and gave her some sedation. With some difficulty I was able to manually remove most of the placenta. Her placenta was firmly affixed to the uterus (placenta accreta). This made it quite difficult to remove. After removing most of it, I then used a curettage to remove the rest. Her bleeding slowly stopped, but the battle for her life will continue on through the night.

For now the night appears to be over. The rest of the hospital is quiet, and I'll try to get some sleep. This may be difficult, because I don't know if she will make it through the night. I know the best medicine I can give her at this point is prayer. I know our prayers have the power to move mountains (Mark 11:23-24). I'm also thankful Christ has removed the fear of death, and with him safe place to seek shelter (Prov. 18:10).

Happy Birthday Sekuru!

Happy 81st Birthday Dr.Roland Stephens! Or as he is affectionately known "Sekuru", which means grandfather in Shona. We just celebrated Sekuru's 81st birthday on January 24th. Roland Stephens is still working hard here at Karanda, and shows no signs of slowing up! He operates 8-10 hours a day, takes call with frequent C-sections in the middle of the night, and still runs 3 miles three times a week.

I guess 81 candles was just too much!

Sekuru has been the stabilizing force at Karanda for the last 40-50 years. After finishing his surgery residency in the early 60s he and his wife Kathy, and there 4 boys came to a very small bush hospital in eastern Rhodesia called Karanda. They both felt called from the Lord to spend there career serving others on the mission field. Its was at Karanda where Sekuru operated quite faithfully for many years. In the late 1970s as the civil war erupted in Rhodesia, violence threatened Karanda Hospital. In those days they would frequently hear mortar rounds right outside the gates. Sekuru had no intention of leaving, and he continued to operate through the violence for many months. He felt that was where God wanted him, and that God would continue to protect him. As the war escalated, and violence near Karanda continued to worsen the "powers that be" finally were able to persuade Roland Stephens and his family to leave. In 1979 Roland Stephens and his family were flown out of the war zone, and shortly thereafter Karanda hospital closed.

A rare smile by Sekuru Stephens

In the years that followed Dr Stephens and his family continued to follow the Lords calling on his life, and spent most of the next several years working in other bush hospitals all over africa. His heart however, was always at Karanda. Karanda had since reopened in the country that was now called Zimbabwe.  In the early 1990's Roland Stephens returned to Karanda to work with his son, Dan, who followed in his fathers footsteps as a missionary surgeon. Here at Karanda, Roland continues to work quite tirelessly at one of the busiest hospitals in the country. He still performs 5-15 surgical cases a day, rounds on multiple wards, and has been on call as the only physician for several months straight over the last year.

Beau, Gracie and the Reimer kids patiently waiting for some cake!

Dr Stephens doesn't do all of this for accolades, notoriety, or fame. In fact, if he knew I was writing about him he would probably just crack a small smile, shake his head, grunt, and walk the other direction. Sekuru Stephens does this because he loves the Lord. He felt a calling on himself at an early age, and has never looked backed. At an age when most 81 year old surgeons would be counting there retirement saving, playing 4-7 rounds of golf a week, or worse yet, sitting in a nursing home with a diaper and some milk, Sekuru Stephens keeps working..day after day...after day. He has no plans to slow down either. As long as God gives him the strength to get out of bed, a brain that works, and the ability to pick up a scalpel, you can be sure Sekuru will keep going. He is a tremendous example to me, and should be to all of us. The most important thing to realize though, is he doesn't do it for himself nor for you or I. He does it to bring Glory to our Lord!

Physical Therapy in Zimbabwe

    Beau and I walked down to the rehab room, Beau was very excited that we could bring some braces for other children that needed them too!  He ran into the room and handed one to Ms. Oshe, she is the rehabilitation therapist here a Karanda Hospital.  We refer many things to her from post operative rehab to congenital problems.  She does geriatrics, orthopedics, and pediatrics. We had the opportunity to bring new supplies to Ms. Oshe. The supplies were donated by Team Rehab's physical therapist Lisa Krieg. 

     Now how we came to now 'Miss Lisa', as Beau refers to her is an interesting story.  Of course, our insurance company has it's "in network" physical therapists. I heard about Team Rehab when we moved to New Hampton from one of the local physical therapy aides .  I called our insurance company to see if they were in our "network" and I was told that they were.  That same day, Lisa had an opening due to a cancellation, so I drove Beau to Decorah.  Beau immediately bonded with her and after some conversation, we found out that Lisa had grown up in Nigeria, as a missionary child.  We had a lot of good conversations about serving in Africa.  Lisa even tried to arrange her and her husband to come on this trip with us to Karanda, but do to the many details that needed to be worked out in order for them to leave their business, they were not able to accompany us this time.  Lisa did send us with many orthotics and two pair of pediatric crutches.

As it turns out, Team Rehab, is not in our network. If it wasn't for that first lady who told me that it was, I wouldn't have had the opportunity to meet Lisa or have their supplies donated here at Karanda.  It is  awesome to look back over the past 2 years and see how God used Beau's stroke to work for the good.  I am sure God will continue to use Beau to help us grow, learn, and even reach more people for Christ. 

The Epperlys 

No Power, No Water, No Problem!!

A little bedtime reading!

We just finished a 5 day stretch without power. It is something we became quite accustomed to last year. This year we were hoping for a little more power consistency. Unfortunately, the only thing that has been consistent is the lack of power. Water has also been a bit of a problem. The water pumps have been dry by 11 am since we've been here. It really hasn't been that difficult though. We've learned to take showers early and save the water for dishes later in the day. (We haven't had to use cloth diapers yet either...that's been awesome). We have a generator on the compound that comes on several hours a day to help with some daily tasks, and gives us a chance to check emails. We also have a gas stove for which we do most of our cooking, and plenty of good flash lights. (We've even had to pull out the headlights again for Csections) I find it interesting how quickly our perspective can change, and how quickly things that seem necessary, just become luxury.
I was just reading in Psalms 63: 1-8 the other day. As always, I was struck by David's reliance on the Lord. He says: " My soul thirsts for you, my body longs for you in a dry and weary land where there is no water" The Lord was his ultimate source of power, strength and protection. Being here really puts that passage into perspective. To often while living in comfort and luxury in the US my eyes are taken off the Lord. I instead  turn toward my own strength, and ability to provide for myself and family. Thankfully, being here has really reset my mind and heart to a complete and utter dependence on our Lord. I hope this way of thinking can persist and I continue to say as David says: "My soul clings to you; your right hand upholds me".

Back in Zimbabwe

We made it! Our trip to Zimbabwe took about 3 days. We had a few unexpected delays, and challenges but overall went as smooth as we could have asked for. Its good to be back in Zimbabwe! Its been really nice coming back to a familiar place.

The kids have both adjusted to jet lag quite well. Gracie was sick for the first week of our trip, but is now back to normal and full of smiles again! Oh yeah, and back to annoying her brother again! She also found Beau and Abbie's old chairs from last year and realized that she is now big enough to use them. Also, dad thought it would be a good idea to give her a little play-do while I was cleaning up. I had no idea she would put it in her hair, nose, ears, and of course belly button.

Beau is doing well too! He's back to chasing bugs and lizards and anything that moves. He's also enjoying playing soccer with some of the other local kids in the area. Oh yeah and he still loves climbing on the jungle gym out back!

My favorite quote of Beau's so far happened on the night we spent in Ethiopia. After trying for about an hour to get him to sleep. He said: "Dad, why is the sun broken?" I said: "What do you mean? He replied: "Well I don't think its night night time right now, but its still dark?"



Looks like Beau has a cold!



Shea and I have jumped back into work at the hospital. As always its quite busy. Between the wards, operating room, delivery room,  and outpatient clinic.....there is always something going on. We've both enjoyed being able to get right back into the swing without the steep learning curve as last year. We've already seen a lot interesting pathology, strange diseases, and several tragic stories...including snake bites, a crocodile attack, and a surprise twin c-section. The medicine is always a lot of fun, but its really just a tool to allow us into the lives of these wonderful people. I think the best part for both of us is getting to rekindle many of the relationships of the last year.  

We have already seen God work tremendously in allowing us to get our visas.  When we arrived in the country, we had a temporary work visa that was valid through Jan 27th, 2011.  We tried to get a 30 day visitor visa when we arrived at the airport, but they wouldn't allow it. They told us to go to immigration.  At immigration, they started a "file" on it, and told us to return in a few days.  Our hospital is located 3 hrs from immigration, so another missionary that lives in Harare went to follow up on it for us.  He just emailed us and notified us that they extended our visa for 60 more days, for free.  Awesome!  This was more than we expected, as we were planning on have to take a couple thousand dollar trip out of the country to be allowed to get a second 30 day visa.  Praise God!  It has all been taken care of and we do not have to pay another dollar.

Many of you have contacted us by email and have told us that you are praying for us.  Thank you so much.  Our health has been great and as long as the Internet allows we will continue to keep you updated on the things God is doing here.

The Epperlys