A Long Day of Surgery

This little skinny guy with a large abdominal mass came to me after going to a doctor in the city who sent him for a CT scan at the French Modern Hospital. The impression was a nephroblastoma or a Wilm’s tumor. I planned to spend about three hours removing it but found instead a large, cystic mass of the liver. It was not

I planned to spend about three hours removing it but found instead a large, cystic mass of the liver. It was not resectable (able to be removed by surgery). Sad case.

The next case today was a 70-year-old man with jaundice and an ultrasound that diagnosed a biliary tract stone. I had concerns it might be something worse. We don’t have great instruments for a common duct procedure. Anyway, we found the obstruction was from pancreatic carcinoma (clinical impression).

The next case was a 57-year-old educated teacher who had classical gallbladder disease symptoms. Her ultrasound showed two stones “in the biliary system.” I found her gallbladder thickened but could not palpate stones. I removed the gallbladder and opened it, and there were, indeed, two small stones impacted in the cystic duct.

So local imaging experts got a 33:3 % score today.

Advanced malignancy is much more common than gallbladder disease here. Doing a cholecystectomy (surgical removal of the gallbladder) under Ketamine (a synthetic nonbarbiturate general anesthetic) can be a real battle with no control of the airway nor muscle relaxant.

We should have “proper general anesthesia”  here within two years as we are sending one of our English speaking nurses to Kenya for formal training. Another nurse follows him next year.

Building Project Updates

Short-term Mission House

This sterilization department is inside the residential compound. It will be converted into short-term mission housing.

The New House

Just the tile work in the kitchen and a few or small jobs and the new will ready for use! It looks black but it’s dark gray. Should be great in winter!

Security Gate

The security gate is being made for the residential section.

Steve’s House

The footings are being poured for Steve’s house.


View of the residences from the sterilization/laundry department.

It’s Not a Snake. It’s Plumbing Issues.

It’s Not a Snake

This is not a snake. It’s roots that had come to reside in our American Substandard drain pipe from our bathroom sink.

Plumbing Problem Solved

So many plumbing issues.

When our bathroom sink plugged up we hired a plumber who works with Antony to check it out. The problem was not the gooseneck joint.

Guess what was found?

The individual who was here to work on the plumbing left the pipe to drain directly into the dirt.

Neem tree roots really thought that was a great idea so they got thirsty and grew right into the pipe and finally plugged it.

While the plumber and helper were here, construction supervisor Debbie, asked them to check out the shower drain and the awful odor. It drains directly into the septic tank as does the toilet drain. Without a valve to prevent it, it is no surprise that there was the terrible smell all these years.

The problem is now solved.

Dust Storm Damage

June 27th was another very hot day, but then we had a dust storm that often moves in before a rain.

Though the dust storm was not welcome, the rain was as is cools everything down some. We did not expect hurricane force winds. Pieces of sheet metal

We did not, however, expect hurricane force winds. Pieces of sheet metal blew around dangerously.

After the rain came and went, we walked around to see if any damage had been done to the hospital. It had.

This is the roof of our new staff meeting room laying against the back of the women’s ward.

This is the roof of our new staff meeting room laying against the back of the women’s ward.

Work, Blessings, & Challenges – We’ve Got it All


Another all morning case and another giant tumor of the kidney. Probably renal cell cancer. Sadly, this one is almost certain to be malignant.

We have prolonged his life but very likely there is already metastatic spread that will take his life within one or two years or less. He will have the opportunity, fortunately, several more times here to accept or reject Jesus.

His total hospital bill will be $500. If he could even find any other surgeon in this area willing to tackle such a case, his bill would be much more. The French hospital would charge at least $6000. The latter fee is only affordable by the rich here.

He says he was shot in the face by a roadside robber in Libya. We’ll try to help him.



Debbie and friends have made great inroads into sharing the Gospel with the Muslim Arab Nomads.

With an American missionary friend who knows Arabic well, she recently shared directly with a group of Nomads, some who have undergone surgery here.

The matriarch said, “Why didn’t you share this news with us earlier!?”

Debbie would have liked to have done that but her Arabic is too primitive.

She and her Arabic speaking friend will have one more opportunity before the Nomads move their camels elsewhere for about six months. But we expect to interact with them again next dry season.


A 16-year-old girl who lived with other adolescents on the street was stabbed in the abdomen. She underwent surgery here and three days later accepted Christ! One of our Chadian female nurses led her to the Lord. PTL!


Ramadan ended the evening of June 24th. Because of Ramadan, the last two weeks have been especially slower in outpatient as well as inpatient services. 


It seems the rainy season is here. More cool days and nights, high humidity, and more insects and malaria.

And no more hot showers. Plus I have a strained knee that slows me down.

There seems to be no end to the challenges here. It’s clear we’ve still attracted the enemy’s attention. But lives and souls are being saved, so it is all worth it!!

Thanks for providing prayers and financial support for this vital ministry for the Kingdom. Both are needed more than ever!

Bert and Debbie

“So be strong and courageous! Do not be afraid and do not panic before them, for the Lord your God will go ahead of you. He will neither fail you nor abandon you.”
~ Deuteronomy 31:6