It was a Friday night & Emmanuel arrived in uncertain circumstances—he had been in a bad car crash, and came to us confused with blood pouring out of his mouth.  He had a badly broken jaw with the bones exposed inside of his mouth.  To stop the bleeding, I was able to line the bones up & place wires around a couple teeth on either side of the fracture.  I wasn’t really sure what my next move was as he also had a fracture of the top part of his mouth called the maxilla—normally, you can wire the jaw shut, but not if the top is broken, too.

Emmanuel patient Egbe

Knowing we were heading into somewhat unchartered waters here in Egbe, Nigeria, I spent part of my weekend looking through the OR for equipment…what I found is probably not too common a thing in a small bush hospital—I found a maxillofacial trauma plating system!  This is basically a really expensive set of tiny plates, screws, screwdrivers, and drill bits that the ENT surgeons use in the West to fix the problems that Emmanuel was having.  That following Monday I was able to plate his maxilla (the bone holding his upper teeth) and put some external pins and bars around the outside of his jaw to keep it together (external fixator).  I put in a tracheostomy so he wouldn’t run into any breathing problems during or after surgery & a feeding tube into his stomach so we could start getting him nourished (we needed to avoid food in his mouth until his wounds from the fractures in his mouth healed).  I wasn’t sure if any of this would work—so many things can go wrong even with simple things, and this was not so simple…

I have been busy organizing the OR and helping to build the capacity here at Egbe as they haven’t had a surgeon here consistently for some time.  Soon after arriving, it became apparent that the one nurse anesthetist whom we have here was not going to be enough.  After much thought and prayer, my wife Dr. Ashley Reimer decided that she would be willing to step-in and take control of the anesthesia department.  It has been a fun and exciting experience watching Ashley use her medical and organizing talents as she adapts to and learns the role of the anesthetist, and figures out how to make the whole department run better and more efficiently.  At the beginning of November, she began to train 2 experienced nurses the basics of anesthesia so that we can grow the abilities of our small hospital in this very poor region of Nigeria.  It’s a lot of work, but Ashley has and is doing a tremendous job.

We’ve certainly had our ups-and-downs since we have arrived.  I think a great deal of the challenge comes from the unknowns—they frighten us.  When we feel like we are losing control, we do what humans do—we react, get angry, bitter, or try to usurp control by any means necessary.  Yet, if we can get past those responses, crawling inch-by-inch, then maybe we can arrive at that place where we most desperately need to be which is on our knees at the feet of our Savior.

Our hands don’t need to work & our minds don’t need to scheme…they just need to rest knowing that He is God.  He knows where we are and why & He desires that we should know HIM.  He is the One who is the origin of Truth, the One who is the beginning & the end, the One whose sacrifice gives us the freedom to call on HIS name with our iniquities washed by HIS blood.  Our world needs the Truth, & with His help we will share the Good News that gives us hope, which is Christ crucified so our sins are paid for & forgiven AND that Jesus Christ rose from the grave, defeated death, & sits in power at the right hand of the Father.  He is alive & most assuredly walking with us.

Emmanuel patient Egbe 2

Emmanuel came back to see me a few days ago.  He carried a large smile & a warm greeting.  His mouth was all healed up; his trach is long gone; and his feeding tube was removed.  Seeing his smiling and slightly imperfect face was a special thing.  We have no idea what is ahead of us or what we might be asked to do, but we take such comfort knowing God knows & He is walking with us. 

Egbe Hospital Doctors

Here is a current picture of our medical team at Egbe (only missing one of our junior residents, Dr. Walter). In middle are the consultants, starting at the left, Dr. Jen, Dr. Joseph our medical director, Dr. Dana, Dr. Sean, Dr. Ashley, and our Family Medicine residents–Dr. Osuji, Dr. Jimoh, Dr. Babatunde, Dr. Ojuh, & Dr. Stephen.

Adapted from Reimer’s Update