The Latest from Bob the Builder

The Warehouse
While we were in the States, Craig Hanscome did a great job of keeping the warehouse project moving. Between running out of cement and figuring what to do with the rain water until the systems to handle it are in place, he was able to oversee the finishing of the walls inside and out. Plus much more.
Ever since our arrival we have been working on the steel trusses for the roof and how we will get them up. You can see in the photo that we have been able to get the first 2 up. The biggest job is always establishing the technique. Once that is established my very capable crew here takes off and does the same thing over and over again. Yes, I have to keep track of the quality but they do a great job of that also.
We have 3 teams coming to help with installing the 300—6 meter sheets of roofing and the 6,000 bolts to hold it all on. Please Pray for their safe travel and their safety in working with sharp steel during a rather warm time of the year. The teams that are coming in the next 2 months and their dates are as follows:
Christ Community Church, Omaha Nebraska October 6-17
Shawnee Alliance, Lima Ohio. October 20-31
First Alliance Church, New Castle Pennsylvania November 4-14

The Morgue
I arrived to work in the usual way this day. On my little Yamaha scooter like I do most every day. And on most days many of our workers are already getting things ready for the days projects. They may be watering new bricks or cement that was just poured the day before. There are always many tools and supplies to prepare for the day’s projects.

Here in Mali it is good to get going a little early to get a jump on the heat. There are 4 seasons in Mali, they consist of warm and dry, really hot & dry, hot & wet then there is really hot & dry. I know I said that before but it is sooo hot during that season that is worth repeating!! But today was different and I wasn’t exactly sure why. Everyone was just standing around my shop and not really appearing to be doing anything. This was puzzling but with a scan of the area it was evident that we had visitors this morning and it didn’t take long to figure out why.

There was a Muslim van backed up to the warehouse project which, at this time, had some walls up on one end. They were using the privacy of the space between the rear wall of the property and the warehouse wall as an area to wash and prepare a woman’s body for burial. It was what you would expect around a construction sight, scaffolding, bricks, steel, etc, and none of it in an orderly manner. It was a mess! But there they were! Carefully preparing the body of their loved one who would most likely be buried the next day or even the same day.

As soon as the realization of the situation sank in I did the only thing I could. Expressed sympathy to the family and then cried. I seem to do that a lot here. Tears come easier all the time for some reason. And so does the phase “But for the grace of God, there go I”. While traveling down the road I see village after village and wonder, “Do they know?” ‘Who will tell them?”. Who will tell them that Christ came and died for us and rose from the dead to pay the price for me, you and them. Not only that life eternal is ours and theirs but life in abundance here on earth also simply through faith in Jesus Christ our Lord and Savior. The peace that surpasses all understanding!! We don’t have to kill anyone or sacrifice anything on an alter to obtain a place in heaven. It is already there, in a better state that we can imagine.

So we are building a morgue!! The phrase I have heard time and time again is “They don’t care about what you know until they know that you care”. So we are trying to help bring some dignity into an already difficult situation. All of these side projects cost money and detract from the main building projects but they are needed none the less. Please pray for the finishing of this building and also the funds to help pay for it. Pray also that those who pass will ask questions as to why and that we would again have an opportunity to share Christ’s Love.
Please pray also for the evangelization of Mali.

HELP!!
I need older style waterbed thermostats to build baby warmers for premature babies. If you have one stored some where, please contact me. bbraafhart@gmail..com

Neonatal Care in Mali from Dr. Brett

In Mali, where 1 out of every 4 kids dies before age 5, the first month of life is definitely the most critical time. A quarter of all the kids who die in the first 5 years die in the first month of life. Neonatal infections, respiratory problems, and prematurity are the main culprits. Babies get infected more often here because the pregnant women are not followed as closely as in the states. Often women come to our hospital after having been in labor with their water broken for 3 days leading to neonatal infections. Also, as in the states, but much more often here, the babies are frequently under extreme stress in the womb which leads to the passing and aspiration of their own stool (meconium) leading to extreme breathing problems. And, of course, just like all over the world, prematurity is a big problem. In WestAfrica 15.4% of babies are <2500g>

Thankfully, the cost isn't much for the families since most of our main equipment is donated. We just have to charge enough to cover our staff's salary, electricity and medicines. So we charge $2 a day for the first 2 weeks and then $1 for each day thereafter. At first I insisted on using the US NICU rate of $10,000 per day, but we eventually worked down to this price. :)

Caring for these neonates has been really enjoyable, but it can be pretty difficult as I face challenges here that I never did in the US. Besides adjusting to the obvious differences in technology and staff knowledge level, I have faced challenges such as having to swat flies from inside preemies' incubators, learning how to explain to illiterate moms how to give medicines at home (19% of Malians are literate, but those are mainly men), as well as asking myself…When a newborn has a temperature of 102 but the room is 110 is that a good thing or a bad thing? Does that mean he is doing a pretty good job keeping his body cool, or that he might die soon from a serious bacterial infection and needs emergent antibiotics? Some days our post-partum room feels like a car turned off in the summer with the windows rolled up. I tried using this analogy with our staff but since none of them have cars, they didn't really get it. :)

Latest from Jessica Shaeffer

Dear Friends,

Whenever I am in town, whether buying fruits and vegetables, looking for fabric for a new dress, or making photocopies, I hear the same thing. "You work at the Hospital for Women and Children, right? You really do a good job there. We want you to treat men too, the whole family!" J One person emphasized how our hospital takes patients seriously and cares about them. In other clinics or hospitals, he explained, patients aren't "taken into account", and doctors and nurses often take some of the patients' medicines for themselves. The honesty and kindness shown at our hospital are making a difference, and we have seen patients come from countless cities and villages (including the capital city 5 hours away) for medical help.

Although I hear regular positive feedback, there is some opposition in town too. A few weeks ago, in a mosque near the hospital, the imam (Muslim teacher) spoke before the Friday prayers telling the people to stop taking their women to our hospital because we would force them to become Christians. Those present openly disagreed with the imam, telling him that they have found that we give good and loving care at the hospital. After expressing their disagreement, they left. Many seeds are being planted through our ministry at the hospital. Pray that these seeds will grow and bear fruit.

Today I went to visit Adam, the young woman who was so ill with typhoid and perforated bowel in January and February. She had 3 surgeries during her hospital stay, but has been home for nearly 2 months now. She told me to thank everyone who prayed for her during her illness. She said that she and her husband are seriously considering following the "Jesus way".

In February I completed my last language test, and hope to finish my final language requirements in the next few months. I come home from my 10-12 hour shifts at the hospital pretty exhausted after speaking 2 foreign languages all day, especially with current daily temperatures of 100-110 degrees. In the next few months I will be taking on the role of supervisor of hospitalized nursing care. This will include training and teaching new nurses and nurses aids, writing protocols to improve organization and consistency of nursing care, problem solving, etc!

We've had some difficult cases this past month, and it has been discouraging to lose 3 women. One pregnant woman was brought in from the village because she was in a coma. We treated her for 10 days, but she showed little improvement. Early last week it became clear that she had only hours left, and the baby was in distress. The family agreed for us to do a c-section, which Dr. Dan did at the bedside. The baby was 8 weeks premature, but is growing and doing well. Another young woman, age 18, came in a week after delivering a stillborn from a village 65 kilometers away. She looked like she was still pregnant as her abdomen was ballooned up. She was quickly taken to the OR, where 1 to 2 liters of pus was removed from her abdomen, and a hysterectomy was done. She had retained placenta that had eaten through her uterus, the upper half of which was dead. I spent the following 8 hours at her bedside until she died that evening. We did everything possible we could for her medically that day, and several staff members and our chaplain spent many hours praying at her bedside. The response of the family was very typical. They received the news with stone faces saying "It was Allah's will". I know many of you also read about this young woman in Dr. Dan Nesselroade's last update…if you haven't and you want to hear more, I can forward it to you. The third woman came in with eclampsia, having seizures and blood pressure through the roof (200/120). She died on the operating table, and a few days later her premature baby also died.

Fatigue and discouragement have almost overtaken me a few times this month, but I have been frequently reminded of God's faithfulness: He never fails. He is with me. He is at work here. As I mentioned earlier, people here tell me that the name of the hospital is spreading around Mali. May Jesus' name also be spread throughout Mali. Thank you for the ways you partner with the ministry here through your prayers, your gifts, and your encouragement.

Living the Call Together,
Jessica