Bert and Debbie Oubre

Debbie and I celebrated our 31st wedding anniversary on December 6th.

What adventures we have enjoyed (and survived) together!

Following the Lord just is not dull or boring!

Blessings,
Bert

Dependent on the Government

It’s not good being dependent on the government to supply our needs in regard to medicine and supplies. They’re too expensive and often in short supply — or no supply. But we’re required by the government to try to buy all our meds and supplies from the central government pharmacy. I was told that the government has not paid its bills for five years — so suppliers are pulling out. It does not even have Tylenol (paracetamol) now.

So I contacted an acquaintance, a Chadian doctor in charge of a Protestant hospital located several hours from here (Koyom Hospital).

He and I plan to meet soon to discuss some mutual effort to buy such items elsewhere together. 

And Then I Had A Tap At The Door

A couple of white guys greeted me at my door. A French doctor and his son.

This doctor worked at another hospital in Chad that has an MRI, CT scan, big lab, etc. But this hospital didn’t survive the economic crisis and will close next month.

The doctor has decided to stay in Chad and open his own clinic. He wants to provide excellent care and plans to have all his own diagnostic machine and the best equipment.

He told me he had heard about G2 and was curious to know why we had such a good reputation.

He said, “You’re out here at the end of the world! I’m surprised that anyone would come here!”

He has a relationship with a Swiss humanitarian organization and just brought 30 hospital beds into Chad.

He’s able to bring in two forty-foot containers each year with meds and medical supplies.

God is good!

Blessings,
Bert

PRAISE

• Our reputation in this area is now excellent. We have the finest team from multiple countries that has ever been here.
• We are gradually raising standards of care and improving infrastructure.
• God provided what we needed to meet payroll during this financial crisis in Chad.
• The new power system, though not perfect, is much better.
• We will soon start using Steve’s House as the doctor on-call room. We will have a formal dedication to the Lord.
• The new house with two bedrooms will be ready for the Jan. 13, 2018 Coalition Summit. Another dedication service.
• Now we expect 13 missions to be involved in that meeting. To me, this is very exciting!
• Both BMS and SIM have solid new candidates who can come as early as Feb 2018. A doctor, who likes to train young inexperienced doctors, and a nurse. The doctor could be here possibly for two years and the nurse for three months.
• The Lord led us to a Christian Nigerian anesthetist, fully trained, who we worked with when we served in Nigeria. He is available and should be able to train three other nurses here. Two already serve in anesthesia here.
  
• The new Physical Therapy department is growing quickly with Elise Grange (SIM) in the lead. Her colleague Clément was a big help and will continue his assistance from France. Elise will train a PT tech before she leaves. This missionary community really appreciates this new service. I don’t think Elise will stay away from G2 very long. I hope not!
• Dr. Marilyn (BMS) is a breath of fresh air. She plans to go into an anesthesia residency when she leaves here mid-January. She has a good knowledge base, is a hard worker, is bold and courageous, and is a joy to serve with. We would love for her to stay longer. 
• Dr. James brings so much to the table that I can’t mention it all. He is the epitome of bold and courageous. He’s a very hard worker with a wealth of experience. He’s generous in helping us obtain medical supplies. He’s especially skilled in orthopedics and OB-GYN and sonography. He loves to teach and will supervise the fellows and residents from Ventura County Family Practice Training Program who will start their rotation here in February.
• Amanda (AIM) is from Canada and loves teaching English at the Noor a la Noor School. She is making a profound difference already. With the help of two young lady missionaries (one from Germany and the other from Switzerland) serving with Pioneers and Frontiers, they are training the teachers how to teach the Bible. Amanda fits right into our on-campus family. All these sharp young professionals love the Lord.
• PT Clément from France served us and our patients well and left us with a generous gift of parallel bars for our physical therapy patients.
• Two Ethiopian families (AIM) are just getting settled in G2. Their full-time job is evangelism through friendships. When their Arabic language skills allow, they will be incorporated into the health team here to help give them credibility. 
• We’re grateful for the rest of our fabulous team, too:
  -Joan Mckenzie (AIM)
  -Claire Bedford (BMS)
  -Kalbassou

PRAYER REQUESTS

There is much to improve.

• We need more funds for medicine and medical equipment and to continue meeting payroll.
• We need XRay service again.
• The sonogram machine evidently came without an essential part.
• We cannot ship the inhalation anesthesia machine until we get the document of exoneration signed by the ministry of health. This has hit significant roadblocks.
• We do not yet have a teacher-type anesthetist.

I do believe all these obstacles will be removed in time.

Blessings,
Bert

Elise Grange — A Real “Pro”

Elise will be with us three more months as our Physical Therapist.

She is a real “pro” and already very much appreciated by missionaries,
hospital staff and patients.

She will help train someone to take her place. We would much prefer for her to stay longer.

We don’t really have a building for physical therapy but Elise and her colleague Clément Rimaud used our conference room made of containers because of its size (16×40 ft).

Physical Therapists can hardly do their work without parallel bars to help patients start walking again. Clément and his family decided to buy parallel bars as a gift to G2. Join us in praying for them and thanking God for them.

Blessings,
Bert

C-Section — STAT!

Recently, I had a pretty full operating schedule but before I could start my first case, I was informed that a young lady with her first pregnancy was making no progress in labor and the baby was in distress.

I hurried to maternity and confirmed that she needed a STAT C-Section.

Then I was informed that the family was against her undergoing a C-section!  She had left another hospital earlier that day when a C-section was proposed. 

I informed the family that the patient would likely lose the baby and perhaps her life unless we did a C-section. Having been through this before, I knew that the delay could lead to disastrous results as the baby was already in trouble.

I felt overwhelmed to be able to reason with these folks. The poor young patient seemed to have no vote in this decision and the husband was not present.

I Stopped and Prayed Aloud

I just stopped and prayed aloud, asking Jesus to take charge of the situation and save the mother and baby.

As I was walking away from the maternity building, I saw a young man walking toward the building. I greeted him, and he understood French. I asked if he was the young patient’s husband, and he said he was.

I quickly explained why she needed a C-section and asked him to sign the operative consent.

He agreed!

At surgery we found the umbilical cord wrapped three times around the baby’s neck.

Debbie resuscitated the baby and both the mom and baby are now doing well. 

Praise God!
Bert

Chad In Economic Crisis

The mood in Chad is not good as fewer and fewer patients can afford medical/surgery care because of the very real economic crisis.

Many of our patients are military and they have been receiving only a fraction of their normal salaries.

We are finally feeling the financial pinch strongly at the hospital here, but we do not feel that we can withhold care of emergency cases-especially for infants and children.

God Met Payroll

We expected to announce to our hospital employees that we would be unable for the first time ever to meet payroll.

As explained to you previously, this is because of the major economic crisis here caused by the low oil prices and other management issues of the government. Many patients just simply do not have money.

Our leadership team met and we saw that our hospital earnings would have to be record setting for the next three days in order to avoid announcing to our employees that we would have to delay paying them. Then we turned it all over to the Lord and went to work.

We had several emergencies and Dr. James’s skills in orthopedics came into play. We still have only one OR until we move into our new surgical center, hopefully, in February. I had several cases, as did James, so we ended up not getting all the cases done and had to overflow to the next day.

Being able to run two operating rooms at the same time will help improve timely patient care and will help the hospital’s bottom line.

Anyway, we earned enough to meet payroll and did not have to make the dreaded announcement. PTL!

James has been a real blessing. We were just about out of suture but he brought enough free suture to last a couple of months. He also brought needed surgical instruments.

We will move ahead with the affiliation with the Family Practice program in Ventura, CA. It is considered one of the best training programs in the USA.
They will send fellows who have completed their residency as well as last year residents. There will be at least one fellow or resident here year around. James will supervise this program.

Please Pray with Us

Please join us in prayer for the people of Chad as well as for this ministry to unreached people groups. 

Is this economic picture going to change? Only God knows, but the reason we are here is to tell people who come here, no matter who they are, the truth about Jesus and how they can find eternal life.

Also to relieve suffering and to cure patients when we are able to do so in His name.

We cannot allow ourselves to deteriorate into becoming stressed-out servants consumed by financial worries. Then burn-out comes.

Pray for God to provide.

Blessings,
Bert

From Jean Wilund, the Oubre’s blogger: Thanks for your prayers for the Oubre’s and the hospital. I hope you’ll consider donating to G2 as an early Christmas gift.

We’ve faced many tough medical cases since we’ve been at G2. Some are tough because of medical complications. Others, because of the non-medical circumstances surrounding the case. Still others because of both.

Here are five tough cases we faced recently. Not each of these cases was technically difficult, but each had surrounding circumstances that created significant complications.

(Warning — If you get queasy, the photos below may be disturbing to view.)

1. Six-Week Old Baby with Pyloric Stenosis

Pyloric stenosis is an uncommon condition in infants that blocks food from entering the small intestine. (Mayoclinic.org)

This baby went home two days post op. Pray for total healing.

2. Twenty-month-old child with Imperforate Anus 

Imperforate anus means there is no opening at the end of the digestive tract where the anus normally is. This condition can take several forms. (SeattleChildrens.org)

The patient had a colostomy at birth (one of those nasty loop colostomies). The patient went home four days post op.

3. Ten-Day-Old Baby B.B. with Gastroschisis

Gastroschisis is a birth defect of the abdominal (belly) wall. The baby’s intestines are found outside of the baby’s body, exiting through a hole beside the belly button. (cdc.gov)

When this baby, B.B., was born, her parents took her to another hospital. The parents say they put a compress on the intestines and told the parents to bring the baby back in two months!

After spending most of their money at the other hospital (for worse than nothing) the parents could only pay 15 % of their surgery bill.

B.B. was ten days old when we received her. Her intestines outside the abdomen were dry and all stuck together.

I’ve never dealt with this type of case this old. Previous cases I’ve managed were one to two days old, not ten days old.

She was really dehydrated but seemed to be getting better after IV fluids.

Usually, this suspended sack technique works as the intestines gradually,  over a week or so, enter the peritoneal cavity by gravity.

Then the defect in the abdominal wall is closed surgically. This sack is a ziplock bag.

Sadly, we were unable to save B.B. She died November 18th. Please pray for B.B.’s parents.

4. Five-year-old boy with a partial amputation of his thumb.

I took this five-year-old boy with part of his thumb amputated into the operating room.

The father was out of town, so the mother and the boy’s uncle signed the consent for surgery. But they could only pay 25% of the bill ($20). Of course, we immediately operated on the boy, anyway.

When the father got to the hospital he was very angry with his wife for allowing us to fix his son’s thumb.

He insisted on having a refund of the $20 and threatened our administrator, who ended up returning the money and letting the boy leave the hospital.

I am praying the people of Chad will begin to associate fairness, kindness, patience, compassion, and competence with disciples of Jesus. 

5. Emergency C-Section

Recently, I had a pretty full operating schedule but before I could start my first case, I was informed that a young lady with her first pregnancy was making no progress in labor and the baby was in distress.

I hurried to maternity and confirmed that she needed a STAT C-Section.

Then I was informed the family was against her undergoing a C-section! She had left another hospital earlier that day when a C-section was proposed.

I informed the family that the patient would likely lose the baby and perhaps her life unless we did a C-section. The poor young patient seemed to have no vote in this decision and the husband was not present.

Having been through this before, I knew that the delay could lead to disastrous results as the baby was already in trouble.

Feeling overwhelmed to be able to reason with these Muslim folks, I just stopped and prayed aloud asking Jesus to take charge of the situation and save the mother and baby.

As I was walking away from the maternity building, I saw a young man walking toward the building. I greeted him, and he understood French. I asked if he was the young patient’s husband and he said he was.

I quickly explained why she needed a C-section and asked him to sign the operative consent. He agreed!

At surgery we found the umbilical cord wrapped three times around the baby’s neck.

Debbie resuscitated the baby and both the mom and baby are now doing well. Amen!

Please pray for all these patients and/or their families!
Blessings,
Bert

We’re really blessed that Elise Grange, an experienced French physical therapist, has been sent to serve with us for four months by our partner mission, SIM France/Belgium.

Elise is already making a real difference. Debbie and I have been her patients as well as have been other missionaries and nationals.

Clément Rimaud, a colleague from France, but not associated with a mission, has been visiting friends in Ethiopia. He decided to drop by for a visit as well. He, too, is already making a positive impact.

Today in the operating room there were people from Chad, the UK, Sweden, France, and the USA!

PRAISE

We praise the Lord that we have some short-termers from France and the UK here now. A  General Practitioner, a Pharmacist, and two Physical Therapists for 2-4 months.

Our main reason for being here is to reach unreached people groups for Christ. But another reason for being here is to minister to our brothers and sisters in Christ who are also on the front line.

We’ve been able to patch up some of them and their children so they could return quickly to their ministries. We’ve also treated some of the national colleagues who serve the Lord with them.

The missionaries know when they send patients here there is a Christian witness.

Debbie, despite wearing several caps, is holding up well. This is a praise item.

PRAYER REQUESTS

BERT’S KNEE:

My knee, in a word, is bad. It’s not much better now than before surgery. The long hours of standing in the OR here are taking its toll. I will almost certainly need a total knee when we return to the US next year.

In the meantime, your prayers that the Lord will intervene and help me make it another 6.5 months are appreciated. Hey, or for total healing! We’ve been back a month already so time marches on.

It is obvious that I must pull out of some of this work, but there is no replacement in surgery yet.

ADDITIONAL SURGEON:

CEF and our partner missions, Baptist Mission Society UK, SIM France/Belgium, and Lutheran Brethren US, have been unable to recruit another surgeon yet.

The greatest need in this area of Chad is surgery. There are other hospitals that can handle many of the nonsurgical problems, but here we do a broad variety of surgical procedures.

For example, in the last few of days, I operated on a six-week-old baby with pyloric stenosis and one with an imperforate anus. Both usually are lethal conditions if no surgeon is available.

We had a young man yesterday with a head injury, fractured hip, and intra-abdominal injuries from a motorcycle accident.

We usually do a couple of prostate operations and thyroidectomies and mastectomies each week as well as many hernias, hysterectomies,  C-sections, etc.

We will soon open our new surgical center that will have four Operating Rooms. We have only one OR now, and it gets stressful when we’re in the middle of a case and have an emergency such as a stat C-section.

PARTNER MISSIONS:

To run a hospital like this one without everyone getting burned out requires more depth in staff. Thus the reason to seek more partners.

All of our current partner missions have other projects in Chad in addition to this hospital.

The other missions that plan to meet with us at our Summit on January 13, 2018, also have other ministries in Chad.

It is to all missionaries’ personal advantage to have at least one dependable mission hospital in the area.

Thanks for your prayers!

Bert & Debbie

Welcome Claire Bedford, long-term missionary pharmacist (on the left) and just-arrived, short-term missionary, Dr. Marilyn, from the UK (on the right.)

Dr. Marilyn will be here for over two months. She has partial training in anesthesia and will help us improve that department as well as rotate through other departments.

We are also eagerly awaiting the arrival of Elise and Clement from SIM France. They are physical therapists.

We are loving the advantages of mission partnerships!