Volume 17, Number 1 Sunday, January 26, 2014
The SteffeScope
Dear Friends and Family:
I hope you are enjoying this new year and that God is more real and precious than ever before. It seems odd not to be in Africa at this time of the year. I have been getting a bit of a rest (another odd thing I am not used to but I must admit I enjoy the novelty) and spending a lot of time doing the boring but necessary. It has been more than a month since we last communicated, so I will catch you up a bit. We enjoyed our time over the holidays with my mother and Micky’s family in Lapeer but did not particularly enjoy the bitter cold and nasty weather. When we left, we drove all the way to West Virginia before we found an adequately plowed road – we made a game of counting those cars who had left the road. We saw 48! The Executive Council of PAACS (Pan-African Academy of Christian Surgeons) had a retreat at the Christian Medical and Dental Association (CMDA) headquarters in Bristol, TN on January 3 and 4. The issue is not just the search for my replacement as Executive Director but perhaps more importantly, how do we expand the infrastructure to support the expanded vision of PAACS. They also agreed that I will continue in a new position called the Chief Medical Officer. In that role, I will be the face of PAACS in Africa, working hand in hand with the Academic Dean to strengthen the programs and to support the faculty. It was productive as such meetings go and the next step is to seek the approval to go ahead from the whole Commission. Based on that new vision, I have been working with my administrative assistant to restructure and reposition things within the organization. One of my dreams for years has been to centralize and organize our 60,000 files (80 gigabytes). After considering our own server as an option, we felt the best choice was to use the Dropbox Business which can be accessed easily and automatically updated on our computers. We have spent hours each day just renaming and reorganizing files and folders – and have barely scratched the surface. But it will be good when done and we are finding gaps in our records. We are also developing some new tracking databases. We have also worked on restructuring the roles within the organization in preparation for hiring a mid- level administrator in addition to the new ED and possibly moving the organization to Bristol TN after the ED is hired. I am also exploring a commercial examination software and database in hopes that we can utilize it for storing and organizing our question database and for writing quizzes and exams easily. We are also trying to develop a new program to encourage medical students and residents who are interested in PAACS. I have also midwifed (at a distance) the birth of two new programs – one in Egypt and one in Tanzania. That went well and we now have four new bouncing boys in the PAACS family. Eleven new residents in all have joined the program. I am very encouraged that our giving to PAACS is on budget and thrilled with a gift of $100,000 this last week! God is good. Micky and Sean have started home-schooling this month and that is going well. They are exploring the available resources on the web and have found some superb lectures on various topics there, so they are supplementing the desk work with those. Sean, now almost 5’6”, has outgrown his small school desk and is excited about getting a new adult-sized desk delivered this week. The one advantage of home schooling is that they can travel – so they are suffering in Orlando for a week with Micky’s folks. When not working on the PAACS projects, I am working on my project for the discipleship class that I am taking as my last undergraduate course. I am about 75% done. We may use the lessons I am preparing as part of the spiritual curriculum for the PAACS residents. That curriculum project is under the supervision of Rev. Stan Key. Stan Key is a wonderful preacher man (ex-missionary to France) who doesn’t take himself too seriously. He is a great friend and functions wonderfully as the Spiritual Dean of PAACS. In the medical arena, he admits to being over his head, but he still manages to hold his own in that testosterone-filled forum. He recently found himself in the middle of an e-mail debate about something and this was his reply:
Gentlepersons, I have to confess how much I actually ENJOY reading your email correspondence (banter,
Listening to the Heartbeat of our Ministry Volume 17, Number 1 Sunday, January 26, 2014
dialogue, debate, humor, and ___'s obvious arrogance and pride). It is no secret that my ability to actually UNDERSTAND what you are saying registers somewhere between a "moron" and an "imbecile" on the IQ scale of intelligence. As a preacher boy, stepping into this rarefied air of medical jargon and academic debate feels a bit like being asked to play football with Peyton Manning. Sometimes I guess I just need to manifest some ontological realism into your verbal obfuscations so that the eschatological purposes of the beatific vision will transcend the pedantic banalities caused by inbred harmatological decadence in yet unmortified sarx in those contaminated by hubris and pneumatological vacuity so that any hope of discursive rationality will not be made tohu and bohu. Can I get a witness? Stan
Other than his embarrassing error which should read “tohu wa bohu” (the phrase in Genesis 1:2 translated “without form and void” which of course was obvious to the most casual observer), and the fact that I smarted a bit at the jibes at our overweening hubris (and did he really say we were vacuous?), I felt moved to give him the desired witness – and chuckled all evening. Let no one complain about my vocabulary! We are still in the process of interviewing new students for next year’s class at the Physician Assistant program and I spent one day last week and one this coming week doing that. I also spent one day at the local hospital teaching Advanced Cardiac Life Support (ACLS) – that is necessary to keep my credentials so I can teach at the upcoming CMDA Continuing Medical and Dental Education Conference for the missionaries. I have also had a series of appointments with doctors this month. I like to say that I am in pretty good shape for the shape I am in, but the truth is that I am struggling with one particular health issue and would appreciate your prayers. We also had our annual meeting of our support group (combined with the officers’ meeting for S3 Ministries). We reviewed the last year’s ministry report, went over the finances and talked about plans for the future. It was a great encouragement – and some really good pound cake! This group of friends holds us accountable and they are real Christian brothers and sisters. We truly appreciate them. We are getting down to a few hundred of our books of each type and we were thinking that we probably won’t reprint any more – but then this week, World Medical Mission wanted to order 500 – 1000 copies. They have a special edition (which makes our ministry no money – just the good feeling of having helped them) but it was an encouragement to hear they are still giving it to each physician that goes out under their aegis to do short-term missions. Micky has spent time getting all the end of the year tax records out to donors to S3 and getting funds sent from PAACS to the various programs. I sure don’t know what I would do without her – her work for PAACS and CMDE has been invaluable and time-consuming for her. February will be much the same sort of schedule (with ten days of holiday in Florida – intermixed with some meetings and one lecture at the University of Florida). We leave for Tanzania and Egypt on March 9. We covet your prayers for that trip - for both safety and effectiveness.
Praise and Prayer:
1. Continue to pray for PAACS, especially for the new programs, the new residents and the new faculty. Pray for the faculty who are under stress and suffering from burn-out. 2. Pray for Bruce so he can focus on getting everything done both in school and for PAACS. 3. Pray for God’s guidance for the future involvement in ministry and for the search for my replacement. 4. Pray for Micky and Sean as they home school.
Yours – and His – for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 2 Wednesday, March 5, 2014
The SteffeScope
Dear Friends and Family:
We are packing to leave Sunday for Tanzania and for Egypt. We are visiting the two new programs there which opened in January and are praying for God’s hand to be upon us and upon those programs. We will spend one week in Tanzania at the Arusha Lutheran Medical Center and then travel to Menouf, Egypt to visit the Harpur Memorial Hospital. We return to the US on the 25th.
I have finally finished my undergraduate requirement and turned in my 66 page paper (a project on discipleship that will be included in the next edition of the PAACS spiritual curriculum). My Masters of Arts degree in Biblical Ministries and my undergraduate degree will be granted in May from BBC. I was fascinated to see Baptist Bible College ranked as one of the 15 best Bible schools in this article: http://www.thebestschools.org/blog/2013/01/14/15-best-colleges-studying-bible/. Obviously, they must have been ranked on the quality of their graduates (or perhaps the humility of the graduates).
Like many fresh college graduates, I am without a job. For a series of reasons, I felt led to inform the Methodist University PA program here in Fayetteville that I will not renew my contract for this coming fall. To be without an income after August is a little scary but I will dedicate my full efforts to PAACS and already have a full slate of ideas and projects that will take my time and energy. Because of the slated growth in the number of residents, the need to take the administration side of things to the appropriate professional level and because we need to develop the development/fund-raising part of things to cover all of that, we are looking at a dramatic and somewhat scary increase in our PAACS budget. If the PAACS Commission does not decide to help support us with a modest salary, it will be incumbent upon us to raise some independent funding. That is God’s issue – and we just strive to remain faithful. I think my efforts in my waning years of productive life will be to help establish a truly superb organizational structure and team. Please pray for all of us in this effort.
We returned last weekend from a needed vacation in Florida. The weather was not optimal but way better than NC and points further north. Sean continued his home school and we did some tourist-y things as well. It was good to see some old friends. We had dinner with Bruce and Karlene Johnson and Dean and Jill Johnson while in Lakeland. Also, we enjoyed a spring training ball game between the Detroit Tigers and the Atlanta Braves and dinner with another old boyhood friend, Tom Hegarty, and his son, Drew. I also had breakfast with Paul Puleo, the founder of Construction for World Evangelism (http://www.cwe-missions.org/). Bruce and Karlene Johnson, and to a lesser extent, his brother Dean, are actively involved with CWE. We also visited a young Air Force surgeon in Tampa that I first met in Togo as a medical student. I hope he will someday serve with PAACS.
At the end of the week, I spent the day at the Woodward Society symposium at the University of Florida in Gainesville. I spoke on the challenges of surgical education in the developing world (obviously showcasing PAACS) and it was a great day. It was good to see three residents that I worked with and even a few faculty members that were still alive and kicking.
The last day in Florida, we spent at Penney Farms between Gainesville and Jacksonville. We came to visit Bill and Joan Mial and to finally meet Paul and Mary Lierman. They are involved with us in the Hospital Radio project. While we were there, we were thrilled to hear that the Gabonese government had finally granted a frequency to the project at Bongolo Hospital in Gabon (not the one we had hoped for but you can’t have everything). We also got a letter from the administrator of the Compassion Evangelical Hospital in Guinea where our first fully functioning project is ongoing. He writes in French but translated, it reads, “It is always a great pleasure to be able to communicate with you concerning the Radio project. This tool gives us great help in doing evangelism throughout the hospital. The speakers have been installed in all the strategic places in the hospital where the bed-ridden and the ambulatory patients can listen. We run programs every day from 9:30 AM to 4:30 PM. The patients listen attentively to the transmissions and sometimes they ask questions to our volunteer pastor as he moves around, praying for the sick. Recently, we have noticed many conversions and many of the sick will come back after they have gone home and see our pastor with questions and requesting prayer. We are convinced that the Radio is one of the tools that are transforming the lives of the sick in these days. Let us
Listening to the Heartbeat of our Ministry Volume 17, Number 2 Wednesday, March 5, 2014 continue in prayer in order that many people will be touched by Christ through powerful and precious medium.” We are excited by this good news and pray that we can expand the number of hospitals affected by Hospital Radio (http://www.s3ministries.com/hospitalradio/)
Rob Robertson, Bruce & Fred Ryckman – U of F Tom Hegarty, boyhood friend, and Bruce
Micky & Sean at the Tiger game, Lakeland Sean at touch tank Florida Aquarium, Tampa
Sean’s “selfie” from the cockpit on his first helicopter ride Michelle & Joey at the Oscars (no award this year!)
Please pray for us during this trip and during this time of transition in our lives.
Thrilled to be in His service,
Bruce for Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 3 Sunday, March 16, 2014
The SteffeScope
Dear Friends and Family:
Greetings from Tanzania! But it isn’t for long, since we leave this afternoon for Egypt.
We left Fayetteville mid-day Sunday and arrived in Kilimanjaro, Tanzania Monday evening. We broke our usual rule of not traveling at night in Africa and took a cab 45 minutes into Arusha. We were greeted by our host, Dr. Wendy Willmore and were eager to get some sleep!
We are here in Tanzania to visit a new PAACS program. Arusha PAACS is largely based at Arusha Lutheran Medical Center (ALMC). This is a relatively new hospital, opened December 2008 under the authority of the Evangelical Lutheran Church of Tanzania. It was built to serve as a referral hospital for the North Central Diocese to bring competent and compassionate medical care and the gospel of Jesus Christ to the burgeoning city of Arusha and its surrounding countryside. With its older sister hospital, Selian Lutheran Hospital (SLH) which was the first mission hospital in this area, they are an important part of the medical care in the city.
The first day, we dragged our jet-lagged minds and bodies to a small national park nearby. Much smaller and more intimate than it’s more famous sister-sites, Arusha National Park is spread out upon the back of Mt. Meru, the second largest volcanic peak in the country. Kilimanjaro is the more famous but even Mt. Meru has some snow on its flanks. We had a pleasant time and were near the end of the day when we had two flat tires within two minutes (four holes in one and two in the other!) We had only one spare tire and limped down the horrible road to a point where a passing safari van loaned us a spare to get into town. That experience proved to be like the advice to eat one dead frog each morning – anything that came after that was pretty good by comparison!
This week has been busy with meetings and tours. Bruce was last here in 2011 and it was good to see old friends again. We toured the two hospitals and also a brand-new nursing school that the hospital had started. We also went to the Plaster House – a pediatric rehabilitative surgery unit that opened about a year ago. Bruce met with Dr. Mark Jacobson, veteran missionary and hospital administrator, while Micky met with the Chief Financial Officer. Bruce met with the residents alone, with the program directors and attended the Residency Review Committee meeting. He participated in the daily teaching conferences and gave two lectures to the residents on the topic of wound healing. On Wednesday afternoon, they finished up a three day COSECSA- required surgical skills course where all the surgical faculty were first trained as trainers and then the interns, medical officers, registrars and residents were trained. I was very pleasantly to find that I knew two of the four surgeons from the UK and we renewed our friendship and enjoyed the participation in the course.
Listening to the Heartbeat of our Ministry Volume 17, Number 3 Sunday, March 16, 2014
Arusha is the home of the College of Surgery of East, Central and Southern Africa. Frank Madinda and Wendy Willmore, both co-Program Directors, arranged for a meeting with the administrative team of COSECSA. They are an amazing small organization like PAACS and right now there is only the CEO and a part-time administrator. Bruce had met Francis Kaikumba, the new CEO, in Zimbabwe and had promised to stop in and take him to lunch. Micky has been communicating with Judith Andrews, the administrative assistant, and they wanted to meet. We had a wonderful meeting with Francis (who is a fellow believer, originally from Sierra Leone but who had grown up in the UK). Arusha is the home of COSECSA but ironically Tanzania has not recognized COSECSA. The two residents at ALMC are the first two officially registered COSECSA residents in Tanzania, so all eyes are on this new program. We are excited about the possibility of working closely with COSECSA here in Tanzania. Bruce has been very impressed with how well the program is beginning and how much unanimity there is here. There are issues and problems to be solved as is expected, but it is a very promising start.
Above: L to R – Dr. Lema, Bruce, Dr. Limbe Right: L to R – Francis Kaikumba (CEO COSECSA), Frank Madinda, Bruce, Micky, Wendy Willmore, Judith Andrew (Admin. Asst, COSECSA)
. Our hosts in Arusha have been very hospitable and we have enjoyed two wonderful dinners with the PAACS faculty. We enjoyed the community church service this morning and after lunch, will go to the airport at Kilimanjaro. We are catching a flight to Cairo via Addis Ababa, Ethiopia and will arrive early in the morning. Tomorrow, we will drive to Menouf to visit the new program at Harpur Memorial. We will return to the US on the 25th.
Praises and Prayers: 1. Please pray for these two residents and this fledgling program. May they bring honor to Christ while they are under the close scrutiny of COSECSA. 2. Please pray for traveling safety to, in and from Egypt.
Yours, for the people of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 4 Tuesday, March 25, 2014
The SteffeScope
Dear Friends and Family:
We have landed in the US from our trip to Egypt and Tanzania. We thank you for prayers for safety and effectiveness.
The purpose for visiting Egypt was to visit the new program at Harpur Memorial Hospital in Menouf, Egypt. This hospital is 102 years old, founded by the Irish missionary doctor Frank Harpur who came to Egypt in 1889. It is in a relatively rural, impoverished area in the Delta, 40 miles from Cairo proper (see map). Urban sprawl and over 200 speed bumps make the trip take 2 hours by car.
Dave Thompson, founder of the Pan-African Academy of Christian Surgeons and career missionary in Gabon, and Sherif Hanna, an Egyptian-Canadian liver surgeon from the U. of Toronto, have moved to this hospital to begin training. They have two new trainees who are qualified Egyptian surgeons but who wish more hands-on monitoring. They will train 3 or four years depending on their progress.
This was our first trip to this program. We were encouraged to see how much enthusiasm there is for the PAACS training, both among the administration and the physicians on staff. The hospital will essentially be rebuilt over the next decade but some great strides have already been made to make the present areas usable. They are also building housing for the career and short-term surgeons as well as a new PAACS office complex with a conference room. A 40’ sea-going container from Samaritan’s Purse went a long way to make that happen. The bishop of the Egyptian Anglican church, Rev. Dr. Mouneer Hanna Anis, is actually a gastroenterologist and was the head of this hospital for over two decades, so there is support from the very top. We had the pleasure of meeting him and dining at his home.
For one of the very few times over the years, we spent a few days sight-seeing. It was at the end of our trip. One of Bruce’s majors in college was ancient history, so he was in hog-heaven and Sean loved it. We have posted some pictures on Bruce’s Facebook page. In this country of almost 90 million, 13 million are directly affected by the tourism industry, so the lack of tourists is hitting them hard. We were often begged to tell Americans to come. We never felt unsafe except one time when the police shot a thief (who had fired his handgun first) in the street very near our apartment. The worst part was wondering what was going on since we did not understand the shouted Arabic
Next week, Bruce goes to a medical meeting (SAGES) in Salt Lake City where he will give a short presentation on tropical medicine for surgery on Friday. The rest of the time will be preparing for the upcoming semi-annual meeting for PAACS which will be held in Chicago April 10 and 11. PAACS is facing some major decisions and needs to essentially double its budget in the next three or four years to position it for the future and to meet the training needs of our present residencies. Please pray for wisdom and the ability to make the hard decisions, but most of all pray for God’s clear hand in whatever is done and decided.
Our next big trip is to the Christian Medical & Dental Associations Continuing Medical Education Conference to be held in Greece at the end of April. We are excited about this meeting which will have attendees from S. America, Central America, Africa and Asia – perhaps for the first time ever. Please pray – we are stymied in getting visas approved for all our African attendees.
Listening to the Heartbeat of our Ministry Volume 17, Number 4 Tuesday, March 25, 2014
Holding the pesky thing down Flirting
A romantic site
Bruce assisting with vascular surgery
Mary Lou and Sherif Hanna; Bishop Mouneer; Bruce, Micky & Sean Shady Fayik, Sherif Hanna, Dave Thompson, Bruce, Nayer Naiem
Praises and Prayers: 1. Please pray as Bruce prepares for the upcoming PAACS meeting April 10 and 11. Pray for God’s leading during this meeting. 2. Praise God for traveling safety. 3. Pray for the visa issue for our African attendees at the CMDA-CMDE Conference in Greece!
Yours, for the people of Africa, Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 5 Saturday, April 12, 2014
The SteffeScope
Dear Friends and Family:
I have just arrived home from the PAACS Commission meeting in Chicago, Illinois. God knew I needed some extra coddling on the way home – I was very glad for the unexpected upgrade to First Class section on the homeward journey. As you recognize, I have been working as an unpaid volunteer within PAACS with one part- time administrative assistant since 2006 and as things were growing, we have run faster and faster. Some things were not getting done in the manner that I would wish and the attached sketch was representative of where we were – the wheel may have been turning but the hamster was dead (or very nearly so!) At this meeting, I was very grateful that the Commission decided to do two things to help the organization and to help us: they are going to institute an immediate search for a new executive director and a new developmental officer (fund-raiser) and they have agreed to begin paying me a modest salary in September – to replace the income we lost when I resigned from the teaching position. I will stay integrally involved but in a new position – Chief Medical Officer which allows me to concentrate on the residents, the programs and the academic component. Once those two new people are in place, they will hire some more administrative help and a part-time book-keeper. The latter position will give Micky back some of her life – she is spending 20 – 30 hours a week keeping the books for PAACS and serving as my assistant in matters financial. She has been an amazing blessing to me and to PAACS.
The PAACS Commission showed deliberate consideration and great faith as they approved the new administration and development initiatives that were advanced. Even without those initiatives, the increasing number of residents and inflation was projected to double our budget in the next five years. With the new administrative structure it would have gone to 250% and therefore the development component was critical, even though it increases the budget further. Such a step of faith was (as steps of faith most often are) rather daunting, but we believe it is what God would have the organization do. He has demonstrated His faithfulness step by step.
If you know of anyone who would make a good Executive Director or know an experienced fund-raiser, let me know. The best candidates are always the ones that others have already employed – we will recruit them away if we can and if God puts this ministry in their hearts. Also, if you would like to give to PAACS to underwrite our personal ministry with them, please send a check to CMDA-PAACS, PO Box 9906, Fayetteville, NC 28311- 9906 and indicate on the check its purpose. We will continue to support our ministry and travel with our S3 Ministries as well.
Also, while in Chicago, I had the chance to speak to a team of surgeons and administrators led by Bob Cropsey and a new missionary surgeon, Tom Kendall, who were from Association of Baptists for World Evangelism (ABWE) who are still hoping to put a PAACS program in Togo. The financial considerations may delay it a few years, but I continue to pray that it will someday happen.
Last week, I attended the SAGES (Society of American Gastrointestinal Endoscopic Surgeons) in Salt Lake City. I gave a presentation on tropical medicine and infectious disease for surgeons as part of a full afternoon’s post-graduate course on humanitarian surgery. It went well and I was amazed how often the other
Listening to the Heartbeat of our Ministry Volume 17, Number 5 Saturday, April 12, 2014 speakers referenced the good work that PAACS was doing. While I was there, I got an unexpected e-mail from a surgeon who was a minimally-invasive surgery fellow at Duke when I taught part-time at the VAH there. He is now a very well-respected surgeon with a named chair at a University in the Midwest and influential in SAGES, the American College of Surgeons and in his profession. He wrote, “I hate that I just now saw that you were here at SAGES this year. Hope all is going well with you. You had a big impact on my career and I have not forgotten you. Really wish we had gotten a chance to catch up.” That unexpected note was a great encouragement to me. How gracious of him to write it. In fact, we actually did get a chance to speak and I hope to visit him in June at his university.
On the home front, we once again celebrated our wedding anniversary by being apart. It was our 16th anniversary. It seems like just yesterday – but if that were true, then I have to wonder where our tall young boy came from. He turns 13 in May and continues to be our joy. He is scheduled to take the set of TerraNova examinations in his school this coming week and we would appreciate your prayers for him. He does not test well and has a bit of test anxiety. He and Micky are working hard at home schooling and I would like his scores to reflect his efforts and his real knowledge. He went back on Friday to spend the day with his old class so he could get the “hellos” and excitement behind him in order that he could concentrate on his exams this week. He will take them four days this week.
We are excited that my mother, Ardith, is coming for a visit from the 15th – 21st of this month. She will then complete the circuit by visiting my sister, Sally, in Wake Forest and then Cindy in Tennessee. We praise God that her blood condition is remaining quiescent and that she is enjoying pretty good health after a rough winter in Michigan.
We leave April 26 for the CMDA-CMDE (Christian Medical and Dental Associations’ Continuing Medical and Dental Education) conference to be held in Greece. This is the first time that we are holding this conference for the African and Middle Eastern missionaries off of the continent of Africa and it is exciting that we are having a record attendance including medical missionaries from Asia and S. America. It will effectively be the first trans- world medical mission conference. Rev. George Murray will be the spiritual life speaker and we have a robust CME conference set up. I have given someone else the opportunity to be the worship coordinator, and I must confess, I will miss that honor. I am involved in giving one lecture and being involved with both the PALS (Pediatric Advanced Life Support) and ACLS (Adult Cardiac Life Support) courses. There will be some PAACS- related CME and business there as well. After the conference, we are taking a several day bus tour “In the Footsteps of the Apostles” with a Christian tour group. We are excited about seeing how the New Testament will come alive.
Some of our PAACS residents had their visa applications for visas to Greece denied despite lots of letters, documentations and even political pressure. They are deeply disappointed and those of us who are in CMDE are also deeply disappointed. Some deliberations are continuing. Please pray!
For those of you interested in missionary medicine, the latest edition of “The Handbook of Medicine in Developing Countries” is soon coming out. You can find it in the bookstore at www.cmda.org. This is the handiest such volume that I know of. I was actually in the process of writing the same sort of book when the first edition came out and I have been involved in the surgery section of the three subsequent editions. It is approximately $30 – but I wouldn’t dream of doing clinical medicine without it. It makes a great gift for someone going on a medical missions trip – from “black bag” evangelism to the hospital.
Errata: I was jet-lagged last time. Egypt has 90 million, not 30 million.
Praises and Prayers: 1. Thank you for your prayer coverage of the PAACS meeting. Now the real work begins. Pray for God’s direct leading and His blessing. Pray that God will lay it on the hearts of those who can give to give.
Listening to the Heartbeat of our Ministry Volume 17, Number 5 Saturday, April 12, 2014
2. Praise God for traveling safety. 3. Please continue to pray for the visa issue for our African attendees at the CMDA-CMDE Conference in Greece 4. Pray for Sean during his week of testing. 5. Pray for the PAACS search committee so that God would lead them to the right people.
Yours, for the people of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 6 Monday, April 21, 2014
The SteffeScope
Dear Friends and Family:
Watching a child choke to death is horrible!
When I entered practice in 1982, the first and only thing I asked the hospital to buy for me was a set of pediatric bronchoscopes and esophagoscopes with telescopes and foreign body forceps. While still a trainee, I had watched an experienced surgeon lose a child on the table when a cashew in his airway flipped sideway and blocked the air exchange – we could never get it out in time. I never wanted to experience that again. In 1999, there was a spate of foreign bodies in the airways of children at Tenwek hospital. You helped me raise the money to buy a discounted set of equipment (over $12,000 at the time) – and to this day, lives are regularly saved in that part of Kenya because of your gift. I need your generosity once again.
At Soddo Christian Hospital in southwest Ethiopia, they have had almost two dozen such events in the past two years. One week, a Chinese toy part caused seven aspirations and at least one child died. This week, Paul Gray wrote, “It's not the best photo, but this is Habtamu and his mother. He will probably go home tomorrow. After being dependent on a face mask for oxygen, he looks great. I pulled a big corn kernel out of a two-year-old two days ago. He aspirated it two months ago. He was treated with antibiotics alone for a week at the government hospital in town and then discharged home; despite their knowledge of our ability to remove foreign bodies. It was terrifying, as usual, due to the pneumonia and hypoxemia [low oxygen during and after the procedure]. But by God's grace, it went well.”
Aiah Lebbie, a citizen of Sierra Leone, was trained in both general and pediatric surgery through PAACS. He has now returned to his home country as one of only a handful of surgeons and the only pediatric surgeon. He was the recent recipient of a full set of abdominal instruments that were donated by some of you. They were delivered to him in Makeni, Sierra Leone, in late March via a visiting surgeon. Many of the instruments are delicate enough to work well with children. Dr. Lebbie writes, “Thank you, Dr Bruce, for the surprise package of instruments. This is very helpful for our work here. My sincere thanks to all those who contributed toward this venture.”
Dr Lebbie with the donated instruments. The front of the Holy Spirit Hospital
These are high-quality German stainless steel instruments good for a lifetime if properly handled. I am taking my last set to Greece to give to one of our graduates there. I can get the whole set at a discount through a friend for
Listening to the Heartbeat of our Ministry Volume 17, Number 6 Monday, April 21, 2014 approximately $2,000. They are etched with “PAACS” to remind these surgeons of those who are praying for them. Would you be interested in helping to purchase the next set? Please send a check to S3 Ministries, PO Box 300, Linden, NC or if you wish to use a credit card, you can give through PayPal at www.s3ministries.com.
I unexpectedly received this compliment from a Dr. Stanton Davis, an orthopedic surgeon in Alabama, who I have never met. He had ordered five copies of “Your Mission, Get Ready, Get Set, GO!” through Amazon.com. He wrote, “I hope this message gets to you. Thank you for taking the time to write this book. My first copy was sent to me by Samaritan's Purse before a trip to Moldova. I encouraged members of my team to read it and I've purchased these to give colleagues that will be leaving for short term missions. Your insights were Spirit breathed and met a great need. I shared your insights in some of our evening reflections. I'm so grateful. I would enjoy buying you a coffee if ever our paths cross.” That book is still offered at a discounted price through Amazon.com. Consider buying one as help and encouragement for those going on any type of short- term mission trip. The more popular “Medical Missions: Get Ready, Get Set, GO!” is still available as well.
It was a blessing to have my mother visit with us for week. She is doing much better and regaining strength. She enjoyed the time with Ryan, Bethany and Sean. We also enjoyed sharing Easter dinner with my sister and her family. Mom is spending time there for a while and then will visit my other sister in Tennessee for a while. Bethany, Mom and Sean are in the picture.
Sean’s testing went okay this week and now we await the results. He enjoyed being with his friends again for the week, even if the exam sometimes stretched him.
I have been putting in a lot of time with PAACS, accomplishing with Terry McLamb all the work the recent meeting generated and continuing to work putting the thousands of questions into the exam software. I am exciting about the new commitment to expand PAACS but it will stretch my faith as well as my week until we get the new leaders hired.
We leave for Greece April 26 to participate in the CMDA-CMDE conference. This is the first time for the African and Middle East contingency that entire missionary families have been able to come (we have done that in Thailand for over a decade). We will have missionaries there from Africa, Asia and S. America – the first trans- global conference of its type. We are expected record attendance. That it is in the part of the world where the Gospel first spread is fitting and a wonderful blessing for those who can take some side-trips to enjoy the history of the area. Please pray that God will prepare the hearts of all who attend – both to serve and to learn. Pray for traveling safety, for all the continuing medical education and for the spiritual life speaker. Pray that the missionaries will be rejuvenated and restored.
Praises and Prayers: 1. Praise God that most of our residents got visas to Greece – and please pray for those who did not. 2. Pray for the PAACS search committee so that God would lead them to the right people. 3. Pray for the CMDA-CMDE meeting and the associated travel of all the attendees. 4. Pray that the company will heavily discount the equipment we need and that God will provide the money for its purchase.
Yours, for the people of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 7 Friday, April 25, 2014
The SteffeScope
Dear Friends and Family: As part of a rather unusual Easter cantata last Sunday at our church, Steve Scheibner told his story. You probably do not recognize the name, but his story revived some old memories for me and the questions he asked resonated with me. In September, 2011, Scheibner was a Navy reservist, a church planter and an active pilot of Boeing 757s and 767s. He has worked as a pilot for American Airlines since 1991 and had 8 years prior to that in active duty in the Navy flying P3s. His story of 9/11 experience and how it affected him is told in the riveting video entitled “In My Seat”. https://www.youtube.com/watch?v=cLj4akmncsA (produced by his son). On September 10, 2001, he signed up to fly the ill-fated Flight 11 out of Boston to Los Angeles. He never did. Instead, he was bumped by a First Officer with more seniority - Tom McGuinness. We all know the story of that morning, but Scheibner added something I didn’t know. The pilot and First Officer McGuinness were stabbed and thrown into the first-class section before the plane flew into the building – but Tom McGuinness knew Christ as his Savior and had a vibrant testimony. He graduated to the paradise that escaped his murderers. Scheibner states he is often asked two questions since 9/11. Does he still like to fly? Yes. For what reason did God spare his life? He had no real answer then and he still doesn’t. He just realizes that he is living on borrowed time – and that his life’s main goal is to someday hear “Well done, thou good and faithful servant.” I understood from where he was coming. It has been a dozen years. Six months after 9/11, on Sunday, March 17, 2002, I was supposed to be preaching the morning sermon in the International Protestant Church in Islamabad, Pakistan. Things were tense in Islamabad after 9/11 and American (and many other) diplomats had just recently returned to live in Pakistan. I had been working with Samaritan’s Purse in Afghanistan near Mazar-i-Sharif and had been asked by a local pastor and his son to preach at the International Church upon my return. For some reasons that I never fully understood but to which I acquiesced, my Pakistani pastor friends changed their mind upon my return to Islamabad and instead they asked me to preach in two slum churches that Sunday. I had enjoyed the experience preaching in the slum churches a few weeks earlier and I was fine with the change. I looked forward to it. It was a bright sunny morning. After a heart-warming worship service with fellow Pakistani believers in a packed house church, we went to run some errands at the United Nations building before going to the next slum. While there, my companion, Pastor Ishaq, received a call on his cell phone. His face grew ashen and he began running for the car. The International Church had been bombed. His family had been in attendance. That day was a blur. Stories conflicted as rumors flew. There had been minimal security at the church that morning and the two terrorists had no trouble slipping in during the song service. Exactly how many assailants there actually were (two or more?), how many Russian hand grenades were tossed and whether one wore a suicide vest are all things that are still unclear – but five died that morning. One body was unidentifiable after being torn asunder by an explosion (he was presumed to be one of the assassins) and many others were injured by flying shrapnel. The preacher was badly injured. My notes at the time identified him as “Dr. Christie” but the internet reports of the time do not identify who was preaching. In the list of the injured, there was a Dr. Christe Muneer, a Pakistani, who was treated at one of the hospitals. It may well have been him. Two “Christopher”s, one of whom was Christopher Ali from Illinois, were listed but what I can read, he clearly was not the speaker. I was told at the time that the speaker sustained a severe compound fracture of his leg and that his brachial plexus near the shoulder was damaged, which would leave him with a permanent dysfunction of his arm. I was deeply shaken when I realized that I easily could have been the one torn by the blast – and that metal a few inches in the wrong direction would have ended my life. Why him and why not me? I have never heard what happened to him thereafter but I have prayed for him often. Thankfully, Pastor Ishaq’s family had only minor injuries. That day, I went to the largest hospital with Pastor Ishaq and talked and prayed with many of the injured. I saw the shrouded dead on gurneys in a side hall. I didn’t have a Pakistani license to practice medicine which frustrated me. I couldn’t help medically. Even at this remote time, I do not know the final outcome of that day. I recently read internet reports that stated the escaped perpetrator was killed and four conspirators were captured in July of that year. Two years later, the master-mind was captured and punished. They belonged to a group called Lashkar-e-Jhangvi and they claimed the attack was in retaliation for the US attack on Afghanistan.
Listening to the Heartbeat of our Ministry Volume 17, Number 7 Friday, April 25, 2014
Both then and now, I was and am forced to face the same question that Steve Scheibner still can’t answer well either. For what reason would God spare our lives? We have both come to the same incomplete answer – that we must live out our lives in the most God-honoring way we can do it because Someone actually did die on the cross for us. I am living on borrowed time. I cannot be a someday Christian, but must live each day for Him. How will God judge my efforts? It is interesting how God has changed my life in the past 20 years. I have now practiced missionary medicine longer than I practiced US medicine. My priorities are no longer the same as they once were. At the recent SAGES (Society of American Gastrointestinal Endoscopic Surgeons) meeting, I saw the OR equipment shown in the picture on the right. Now look at my drawing on the left from twenty years ago. The similarities in design are not accidental. I have somewhere in my files a letter from back then from someone in the company stating that they were using our ideas. At one point, that would have upset me terribly, especially if I had gone ahead with my plans to build such operating rooms by buying the German company with whom I had worked. Now, I only regret that they still haven’t implemented all of our ideas.
1994 2014 My chief goal now is to someday hear my Lord say, “Well done, thou good and faithful servant.” It would appear that my remaining years of service will remain with PAACS and that if any human legacy is to be left, it will have to be the dozens of African physicians who have been trained and discipled. We are not promised tomorrow and we are inherently flawed and inadequate. We are not guaranteed the next day, the next hour or the next minute. Why has He given us all borrowed time? To tell our story of how the Son of God loved us enough to die on the cross for us. That must be a burning compulsion in our lives. And when, not if, we fail? He knew that we were flawed when He was laid on the cross – and He died for us anyway! What mercy and grace!
We leave for Greece April 26 to participate in the CMDA-CMDE conference. This is the first time for the African and Middle East contingency that entire missionary families have been able to come (we have offered that in Thailand for over a decade). We will have missionaries there from Africa, Asia and S. America – the first trans- world conference of its type. We expect record attendance. That it is in the part of the world where the Gospel first spread is fitting and a wonderful blessing for those who can take some side-trips to enjoy the history of the area. Please pray that God will prepare the hearts of all who attend – both to serve and to learn. Pray for traveling safety, for all the continuing medical education and for the spiritual life speaker. Pray that the missionaries will be rejuvenated and restored. Please pray for the CMDA-CMDE meeting and the associated travel of all the attendees. Yours, living on borrowed time,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 7 Friday, April 25, 2014
P.S. The news of the three murdered American physicians at the Kabul CURE hospital is headline news. They still haven’t released the names of the father-son duo at the time I write this. It makes this newsletter even more relevant, perhaps. Whether we live or die, it must be for Christ. Pray for the families and co-workers – and pray for safety for all the missionaries in this world.
Listening to the Heartbeat of our Ministry Volume 17, Number 8 Friday, May 2, 2014
The SteffeScope
Dear Friends and Family: The highlight of each year for us is the CMDA-CMDE (Christian Medical & Dental Associations Commission for Continuing Medical & Dental Education) Conference for the medical missionaries. This year, it is in Greece at a beautiful resort who gave us an amazingly low price (sometimes you have to suffer for the Lord!) This is the first time for the African and Middle East contingency that entire missionary families have been able to come (we have offered that in Thailand for over a decade). It is also the first time that we have had attendees from virtually every continent except Antarctica.
Here are the statistics for this year’s (the 34th) record attendance: 715 attendees from 75 countries – Africa, Europe, Asia, S. and N. America. 572 are missionaries and their families. 115 of those are faculty (paying for their own involvement) giving 176 lectures and 57 multi-hour breakout sessions including ACLS, PALS, ALSO, HBB, NRP, splinting and casting courses, ultrasonography courses and a modified ATLS. They also provide spiritual and mental counseling to those who request it. 131 children – 99 from Africa (this is the first time there has been a program for them) – and 38 bonded and experienced childcare workers who raised their own money to serve for the two weeks. Each year in this newsletter, I mention how wonderful the worship is and how impactful the Spiritual Life speaker is. It is true again this year – what an amazing spiritual lift! Dr. George Murray from Columbia International University in S. Carolina is the speaker this year (and next year in Thailand as well). Each year, we also have a Stewart Lecture to honor one of the missionary greats. This year, the honoree was Roland Stephens, an 84 year old general surgeon who spent his 50 year career in medical missions. He is a University of Michigan graduate and first went to Rhodesia (now Zimbabwe) in 1962 to the Karanda Mission Hospital. I had the opportunity to visit that hospital a few years ago. He was there until the civil war forced them out in 1978. For the next seventeen years, he worked in southwestern Michigan and went back each year to Zambia and Kenya to serve. He returned full-time in 1995 and worked actively until he retired at the age of 82 in 2012. His son, Dan, is a general surgeon and continues to serve in Zimbabwe since his arrival in 1991. What an inspiration this kind of Christian servant is! It is also a great time for the PAACS team to get together. We have ten PAACS trainees here (three were not able to get visas), two graduates, twelve faculty members and 9 Commission and Advisory Council members attending. The PAACS residents each gave a paper Thursday in a juried competition and the second phase of that competition will be next Wednesday afternoon. We had a group meeting and took a group photo as well. I have had a series of meetings with the faculty at various PAACS programs and also met with some representatives of hospitals that want to have a PAACS program. I also met with Carl Haisch to work on the upcoming PAACS exam. I had the pleasure of presenting what God is doing through PAACS to all the attendees as well on Wednesday evening.
Listening to the Heartbeat of our Ministry Volume 17, Number 8 Friday, May 2, 2014
Since Wednesday, Micky has been spending 12 hours a day receiving payments from all the attendees. Her work has been invaluable to the Commission. Sean has been very active with the children’s program each day but because we are so busy, Joanna Thelander from Gabon has signed him into childcare and picked him up each day. He now refers to the Thelanders as his “other family”. They are playing hard each day and enjoying the (cold) pool. I noticed Sean limping the other day and asked about it. He replied in all seriousness that he had a “chicken leg or whatever you call it.” Guess that makes as much sense as the term “charley horse”! Stay tuned for the report on the rest of the conference and some special experiences that we had – we will send it when return to the US on the 14th. Two weeks ago, we told you of the donation of surgical instruments through our charitable foundation (S3 Ministries). We had a change of plans; we have made arrangements to mail our last set to Martin Situma in Uganda. Please see below the pictures of Dr. Situma and the rather coarse and aged instruments that were opened for him to do a delicate operation on a newborn. When we responded in the affirmative to the request for instruments, it was reported that one older surgeon shed tears of happiness and Dr. Situma praised God openly. It will be shipped when we return to the US. On EBay, I was able to find some special Dingman retractors for them at a much reduced price so they can do cleft lip repairs. They were $250 for the two sets of them. The instruments are high-quality German stainless steel instruments good for a lifetime if properly handled. I can get the whole set at a discount through a friend for approximately $2,000. I have bought two more sets on faith. They are etched with “PAACS” to remind these surgeons of those who are praying for them. Would you be interested in helping to pay for them? Also, I still need to raise $17,000 for the foreign-body instruments for Soddo. Please send a check to S3 Ministries, PO Box 300, Linden, NC or if you wish to use a credit card, you can give through PayPal at www.s3ministries.com.
Listening to the Heartbeat of our Ministry Volume 17, Number 8 Friday, May 2, 2014
Praise and Prayers: Please pray for the CMDA-CMDE meeting as it closes on Thursday afternoon. Pray for safe travel of all the attendees. Pray for them as they continue to be refreshed and then return to their places of hard service.
Yours, living on borrowed time,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 9 Wednesday, May 14, 2014
The SteffeScope
Dear Friends and Family: It is good to be back in our own beds after being stranded in Philadelphia for 24 hours. The second week of the CMDA-CMDE Conference was every bit as good as the first and the PAACS residents’ juried competition was a highlight. The first week, all of them presented their work and five were selected for the final competition on Wednesday. Three were ultimately given prizes. Micky did a yeoman’s job for CMDE while there. At the Thailand conference, we pay a group to do many of the administrative and financial aspects of the conference. That has not been available for Africa. This year, Micky did the whole thing on QuickBooks and was able to use a credit card reader from CMDA at the same time (the first time they have used one like that over the internet). Working from 7:30 AM each weekday morning until late in the evening, she took care of several hundred accounts, giving refunds if necessary and collecting the money – while at the same time creating detailed and accurate accounting reports. We have not had it so good for that conference before. I was very proud of her and those who helped her. Carol Bos helped her collect the money. Collin Sanford had done a yeoman’s job in organizing it all. Micky did it as a volunteer, but the Commission was kind enough to pay for her room and board and will reimburse her for the ticket. That obviously helped us. Being in Greece, we were pleased to be able to take advantage of the Biblical history that was all around. The first Saturday, we visited three Greek islands along with 120 other conference attendees. They were beautiful, but not as exciting to us as the tours to sites of great Biblical significance. On Sunday, three busses of attendees went to visit the site of old Corinth. One guidebook I glanced at just brushed it off, but looking at the city through the eyes of a Christian Greek was another thing entirely. Seeing it through the filter of the Bible made it – and the Bible – come alive. There are only three Evangelical tour guides in Greece – and we would have the privilege having two of them over our time there. Corinth – so much here reminded me of the issues mentioned in the books to the Corinthians. It was a wealthy and immoral city (hence many of the issues that Paul wrote about). We saw examples of the famous Corinthian pottery (treasures in earthen vessels referenced in 2 Cor 4:7), saw the bema seat where Paul was arraigned before Proconsul Gallio (Acts 18:12), read the inscription mentioning Erastus (a wealthy town official who followed Paul – Acts 19:22, Rom 16:23 and 2 Tim 4:20), looked across the Corinthian gulf toward Mt. Parnassus and the Oracle of Delphi (the Pythian Apollo temple was there and we read of Paul’s mention of the fortune-telling girl in Philippi who had the spirit of Pythios – Acts 16:16), and found out that the wreath of the Isthmian games was made from celery – the “corruptible wreath” of which Paul writes (1 Cor 9:25). We also saw the site of an abattoir/butchery that was only 30 meters from the altar of the temple of Apollo – and that meat sold to idols was sold on discount (1 Cor 8:13). On our five-day bus trip at the end of the conference (we were accompanied by many missionaries including the Thelanders from Gabon), we visited the port city of Neapolis (later named Christopolis and now Kavala) – the port has not changed location in all these years. It was here that Paul first brought the Gospel to Europe. We traveled to nearby Philippi. We saw the little river where Lydia, the first Gentile convert, was baptized a few miles away from where we were. There were so few Jews that they could not have a synagogue – but the faithful gathered by the “Living Water” to pray that day that Paul met them. We went to the ruins of upper and lower Philippi. It was here that Paul cast the Pythian Spirit out and was dragged by the slave’s owners to the agora for restitution (Acts 16). We were in the corner of the agora where the “strategos” met (the generals – v. 20) and stood before the bema seat where Paul was whipped (v.23). It is unknown where the Philippians jailed him and the earthquake opened the doors. The guide brought out that the fear that the Roman-appointed generals had (after whipping a Roman citizen) may well have protected the first fledgling church during the times of persecution. We followed Paul to Thessaloniki – and saw the agora where we knew Paul was again beaten (Acts 17:1-10). We saw the bema seat there as well. We visited the Jewish Quarter of Berea (although nothing is left that dates back to Paul – Acts 17:10-13). The last day was spent in Athens. I confess that the Acropolis was smaller than I expected and the Parthenon bigger. They are doing some remarkable restoration and the pieces are all keyed by computer and someday is may regain something like its original glory. We were actually more interested in two rocky places that have lost
Listening to the Heartbeat of our Ministry Volume 17, Number 9 Wednesday, May 14, 2014 all their structure – the first place where the Athenian citizens were called to meet for legislative and political reasons (the ekklesia – the called out ones) and the Aeropagus (Mars Hill). Mars Hill has lost all of its structures – torn apart over the ages for the building materials. It has lost the built up retention walls, stadium/Supreme court structure that was there and temple of the Furies, so that only the bedrock remains. But a carved stairway dating back to 400 BC is still there. We climbed it as Paul did. He went up those steps to the Aeropagus and gave his famous speech to the Greek Philosophers about the unknown God (Acts 17:22 and following). Speakers of the time were only given six minutes, timed by a water-clock, to give their reasoned argument – their “logos” (John 1:1). I had the honor of reading the passage from Acts and the guide asked Sean to time the speech. I must confess that in what was likely to be my only oration on this famous ground, I did put a bit of the orator into my voice (but not as much as my thespian tendencies cried out for). One minute, forty-three seconds by Sean’s timing – and according to Scripture that was enough for two people who were named to come to Christ. He argued no more with the philosophers but went to Corinth from Athens, arriving in time for the upcoming Isthmian games (a great place for a tentmaker who would be able to sell all he made to the crowds coming for the athletic/spiritual competition). We walked a few steps on the Athenian Way, the paved road which led from the agora (public square) to Mars Hill (Aeropagus) and to the Acropolis. Paul walked these very stones. Between those events above, we visited some famous churches and historical areas on the tour. We visited Aigai where the tombs of Phillip II (father of Alexander the Great) were recently discovered. We also visited the Meteora where once 21 monasteries graced the top of these freakish stones. Now only 5 remain, most destroyed by the Ottomans in the 1700s. Most still do not allow tourists, although pilgrims may be welcome if they will participate in the daily life of the monks. Hermitages were visible in the tops of some the caves around the area – it is believed that there remain hermits yet. Until 1920s, rope ladders and rope heists were the only access to these enclaves. Through our guide, I gained an appreciation for the theology which underlies Greek Orthodox iconography, even if I don’t agree with their reasons for this style of decoration. One afternoon, C.T, our guide, gave a very emotional testimony. This man had planned to be an Orthodox priest but fell in with the “heretics” after the death of a family member gave him great existential angst. At his conversion, his father threatened to kill him and yet, several years later, when his father lost his mind from what sounded like a stroke, he came back at the challenge of his grandfather to prove his “heretic” Christianity – for several years, he took care of his demented father day and night. When his father mistakenly ingested a petroleum distillate before he could be stopped, he developed severe aspiration pneumonia and nearly died. God gave C.T’s father sudden lucidity after years of dementia – and he damned his son for his faith yet again. C.T. did not waver and his father did not die – instead, he was subject to a series of hospital roommates all of whom were true believers from the small remnant scattered throughout the country. His father accepted Christ finally (they are the only ones in their immediate family who have), kept his lucidity and is now in his 80s. God is faithful but we must be faithful. Now that we are home, we have a lot of loose ends to tie up from the conference, get the S3 Ministries tax reports in, get the PAACS exams formatted and edited and send out over 4,000 fund-raising letters for PAACS. We must also get ready for our trip to Gabon in July and get Sean back into the daily grind of studying (he had some great field trips!) Praise and Prayers: Please pray that God will provide the money for the surgical instruments and scopes that we would like to contribute Praise God for traveling safety and the privilege to have the journey of Paul come alive for us. Pray for the few and faithful Greek evangelicals. Pray for us as we strive to get all the PAACS and CMDE Commission work done.
Yours, striving for the incorruptible crowns,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 10 Saturday, May 31, 2014
The SteffeScope
Dear Friends and Family: Greetings from Michigan! We have come to visit our parents in Lapeer, Michigan and all of us have been helping with the “to do” lists that each set of parents have. It has been a beautiful early summer in Michigan – and a dramatic contrast to the snow and cold we find when we visit in December each year. We haven’t really been resting much. Since my father passed on to glory, my mother had a lot of home repairs that needed to be done and we have accomplished most of them including the painting of a wall in the garage (see picture). She is doing pretty well although for the first time, her blood count fell low enough (with concomitant fatigue and vague chest pain) to justify a transfusion. That happened yesterday. With her bone marrow dysplasia, this is a rather expected turn of events. We are take some time off and enjoying visits with our sisters and their families. Since we returned from Greece, I have put in long tedious hours accomplishing the administrative needs of PAACS – signing 4000+ fund- raising letters; writing, formatting and distributing the junior and senior PAACS annual in-service exams; conference calls, budgeting for next year; and general putting out of fires. Micky and I have spent several hours trying to finish up the reporting and finances from the Greek conference; it is not yet finished. I have also been budgeting for the next conference which will be held in Thailand. I taught for two days in another Advanced Trauma Life Support course in Greenville, SC. Sean turned 13 on May 23. He had a great time as we spread his celebration over several days and two cities. The picture is of Sean and his Grandfather Turner. Although I have been threatening to take Mark Twain’s advice about putting him in a barrel, we have not yet done so and do not feel forced to do so, at least not yet. He is a great kid. He is trying to finish up his school year although the travel has interfered with any sort of consistent effort the past few weeks. He has finally lost all of his deciduous teeth and a visit to the orthodontist has confirmed the need for braces. He will have them put on when we return from Gabon. That – and an unexpected need to replace a heat pump/AC unit at home – has put a crimp in our personal finances. Yesterday, I drove to Kalamazoo to meet with Ed Bos of Worldwide Laboratory Improvement and to work on the PAACS software module. While we were there, Ed introduced me to a friend who is interested in developing some prototypes of ergonomic hand and laparoscopic instruments. It is something I began working on over 20 years ago but never pursued. If anything comes of it, I will turn the patent and profits over to PAACS. We will stay here until Wednesday and then drive to Wilmore, Kentucky, to visit our friends, Rev. Stan and Katy Key. Stan is the Spiritual Dean for PAACS. The next day, we will drive on to Nashville to visit my sister Cindy and her husband Bob at their home near Nashville before driving home this weekend. Next week, Sean will attend church camp and I will be attending the International College of Surgery conference in Memphis, Tennessee later in the week. The next week, I will go to the CMDA-CMDE Commission meeting in Chicago. S3 Ministries has seen some results from its projects. The Compassion Evangelical Hospital in Guinea is one of the three hospitals that we have supported by helping with the Hospital Radio project. This is an exciting project
Listening to the Heartbeat of our Ministry Volume 17, Number 10 Saturday, May 31, 2014 for us despite the slow acceptance of the concept. Pastor Oumar Traoré wrote this paragraph as part of a much longer report of his ministry at the Compassion Evangelical Hospital in Guinea, “We visited 62 people in all, new patients. There were 3 people who accepted Jesus Christ, and M.C. and A.B. who were injured in accidents, but they received physical and spiritual healing. Then T.Y. through preaching and the (hospital) radio, accepted the Lord.” Dr. Steve Merry, who we first met in our service in Togo at the Baptist hospital there more than a decade ago and who is now at Mayo Clinic and one of the movers and shakers of the CEH project, wrote in his letter, “An exciting first in this report is Oumar's note that one of the new believers specifically witnessed that he came to faith through hearing the Gospel presentation on CEH's Hospital Radio, the Christian programming which plays throughout the clinic and hospital wards all day now in Fulani, Maninka, and French thanks to the creative generosity of S3 Ministries. We've been aware through other patients’ comments of the way that Hospital Radio programming is speaking to their physical, emotional, and spiritual needs and softening hearts for the presentation of the Gospel; so this is not really a surprise but a great affirmation of S3's vision. Thank you Bruce, Micky, and Sean Steffes!” We are getting similar reports from Bongolo Hospital in Gabon since they recently started their broadcasting. We look forward to seeing it in action when we go there in July. Your gifts to help support Hospital Radio can make a real difference. Read more about it at http://www.s3ministries.com/hospitalradio/. We have also received shipment of the two trays of surgical instruments. We appreciate those who are contributing to their purchase. One tray has been paid for and we hope that the second one soon will be. We have also made arrangements for the purchase of the special pediatric scopes for the airway and esophagus for donation to Soddo Christian Hospital in Ethiopia. We were surprised how fast the importation permit was obtained and thrilled that they will be imported custom-free. We are transferring the $13,500 to the company’s bank and hope the equipment will be shipped soon. Since this is very delicate equipment, we will ask them to store it until the new missionary surgeon arrives in January. We have dipped deeply into the reserves to pay for this equipment and any help would be appreciated. Praise and Prayers: Please pray that God will provide the money for the surgical instruments and scopes. Praise for traveling safety over the next month. Please pray that Sean will have a wonderful week at camp. Pray that we can amiably and fairly resolve the billing issues with the hotel in Greece. Pray for us as we strive to get all the PAACS and CMDE Commission work done. Pray for the residents who will be taking the exams next weekend. Pray that the PAACS search committee can identify the right people for the job. Praise God that we got the visas to permit us to visit Gabon! Pray for the Paul Grays who are returning to the US permanently after six years of service in Ethiopia. Pray for the next six months at the hospital when there will be no permanent missionaries to support the training program there.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 11 Wednesday, June 25, 2014
The SteffeScope
Dear Friends and Family: Micky, Sean and I are leaving early tomorrow morning for a month in Gabon. We have included a map since nobody seems to know where Gabon is. The country is perhaps best known for being the site of the Albert Schweitzer Hospital in Lambarene. We will fly over it in our small missionary plane from the capital city of Libreville as we go even further into the Equatorial rain forest. Bongolo Hospital was founded by Christian & Missionary Alliance missionaries and despite its small size and remote location, was the site of the first PAACS (Pan-African Academy of Christian Surgeons) program under Dave Thompson. We will attend the graduation of two new surgeons and work there with Keir Thelander teaching the other residents. This is the first visit for Micky and Sean, but they already are friends with the Thelander family and are looking forward to it. We will tell you more about the Hospital and the work there next week. We will also give you an update on the Hospital Radio project that is installed and functioning there. Since our last note to you which was written from Michigan, we headed home to NC via a circuitous route. We visited with Stan and Katy Key in Wilmore, Kentucky where Stan is the new president of the Francis Asbury Society. Stan is also the Spiritual Dean of PAACS. Katy’s father, Dr. Dennis Kinlaw, is elderly but with a mind like a steel trap. He has been very influential in evangelical Christianity over his lifetime as the head of Asbury College and Seminary and I really enjoyed the time talking with him. We had a wonderful dinner in Shakertown with the Keys. On the way to my sister’s and brother-in-law’s home just south of Nashville, we took a short detour and enjoyed an underground tour of part of the massive Mammoth Cave national park. The next day, with my sister and her husband, we toured the replica of the Parthenon in Nashville and Sean was able to envision what the real one would have looked like. We toured the Carnton Plantation where part of the Battle of Franklin raged. Since getting home, we have been busy with both PAACS and the CMDE (Continuing Medical and Dental Education) Commission. For PAACS, we finished up the mailing of the fund-raising campaign; spent hours getting the annual exam constructed, graded and analyzed; uploaded exam questions to the database; wrote the newsletter and supported the search committee in their search for a new Executive Director. Our fiscal year ends June 30 and my administrator, Terry McLamb, is working to finish the required reports. Dr. Dave Stevens, CEO of CMDA and host of the audio magazine Christian Doctor’s Digest interviewed me on June 19 to give the listeners an update on PAACS. It will be 6 – 8 months before it is published. In addition, I have been traveling in the US. June 12-15, I attended the annual meeting of the International College of Surgery – US section in Memphis, TN, met some new friends, got some CME credit and was inducted formerly as a Fellow. June 20-21, I flew to Chicago for the annual meeting for the CMDE Commission. Since Micky is now officially their bookkeeper (with a small stipend and everything!) and I am in the financial officer, we spent many long hours consolidating the financial information from the recent conference in Greece, creating year-to-date reports and creating a budget for the next meeting in Thailand. We thank God (and you for your prayers) that we were able to resolve the billing issues fairly. I am also the quasi- webmaster for them and posted the documents from everyone to
Listening to the Heartbeat of our Ministry Volume 17, Number 11 Wednesday, June 25, 2014 the password-protected pages. I also got back yesterday from a long two-day car trip to Morgantown, W.Va. (8 hours each way) where I spoke to the Tropical Medicine course on Monday afternoon and saw my friend, Dr. Greg Juckett and his wife. Concerned about the effects of home schooling and traveling without the benefit of contact with other children his age, we try to normalize Sean’s life a bit. He spent a wonderful five days at a youth camp with other kids from our church, spent three-plus days with his aunt Sally in Wake Forest (the town north of Raleigh, not the university) enjoying the pool there (in the 98o heat) and we had a wonderful day on Shearon-Harris lake with George Massengill catching a cooler full of crappie and perch. The bald eagle we spotted was frosting on the cake. In between those things, he has essentially finished his home schooling for this year and will resume as a pupil at the local Christian Northwood Temple Academy in early August. In our packed bags is one of the two sets of surgical instruments that were purchased with donations from some of you. It will make a tremendous difference in some young surgeon’s future place of employment. The pediatric bronchoscope and esophagoscope equipment has also arrived Ethiopia. That project came to $13,500 (a great bargain compared to retail) and we are praying that God will replace those funds. I know that it will certainly save some young child from choking to death! My cousin sent me four boxes of used surgical instruments that were donated from a surgeon friend of theirs. In the past, I have restored surgical instruments and once we get back from Gabon, I will set up the surgical instrument repair lab in our garage. It will cost about $2,000 to buy all the stuff needed, but it is worth the investment. One weekend in Togo several years ago, I refurbished, sharpened and polished over $40,000 worth of instruments. If you know of anyone who wants to donate used or new surgical instruments, please give them my e- mail ([email protected]). If they pay for the shipping here, I will worry about getting them refurbished and shipped out to someone who really needs it. If God is asking you to help our ministry, please send your check made out to “S3 Ministries” to PO Box 300, Linden, NC 28356. If you want it to go for any special project, please write that on a separate piece of paper and we will be sure to honor your request.
Praise and Prayers: Please pray that God will provide the money for the scopes and that donors will help to rebuild our reserves in S3 Ministries. Pray that we will go through customs in Libreville without a hitch with the sutures, operating room gowns and instruments. Pray that the PAACS search committee can identify the right people for the job. Please pray for the PAACS programs and in particular, the one in Ethiopia and the new one in Malawi. The former one is struggling with manpower issues and unrealistic demands from the government. The one in Malawi is just getting started. Pray as I plan a trip to Ethiopia (and either Kenya or Malawi) in August.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 12 Friday, July 4, 2014
The SteffeScope
Dear Friends and Family: As I write this early in the morning before the rest are up, I hear wailing coming from the direction of the hospital. Typical of African grieving, it is a sound that quickly reminds me of the challenges of practicing medicine in the developing world. Even at this mission hospital, one of the best in the country available to the average Gabonese person, resources are very limited, care is relatively expensive for the very poor, trained nurses are scarce and people routinely die of things that would not kill back in the US. It is a constant reminder that we are here to bring both physical and spiritual healing, for it is only the latter than brings comfort in the face of ever- present death. We arrived at Bongolo Hospital in the southern rain forests of Gabon last Saturday, after a long but safe trip. We left the hotel at 4:15 AM to catch our plane to Dulles, then caught the Ethiopian Airlines plane to Addis and onward to Libreville Gabon, arriving about 26 hours after we first stepped on the plane in Raleigh. Our duffel bag with the important instruments, sutures and gowns was nearly destroyed but nothing had fallen out and we breezed through customs without a hitch. The missionary pilot, Rob Peterson, was in immigration to meet us, but we arrived too late for the missionary plane to safely fly on to Lebamba. Instead, we stayed overnight at the Christian & Missionary Alliance guesthouse in Libreville before flying in the six-seater Cessna to Bongolo the following morning. Sean enjoyed his opportunity to be copilot. This is the “dry season” (despite last night’s rain) and so there is a dense cloud cover but with reasonably cool weather (80s). Nowhere near as hot and humid as in other times that I have been here.
We have made the transition with as little jet-lag as we have ever had. Praise God for that – I hate that feeling the first week. The PAACS program director here is Keir Thelander and his wife Joanna, son Luke and daughter Sarah, are known to my family from times both at Brackenhurst and recently in Greece. They are on vacation from school. Sean has enjoyed playing with the Thelander children but has not enjoyed being bitten by dozens of small black flies (similar to no see-ums) that cause red flat circles that begin to itch later on. You never see them (hence the nickname) and their bite is painless. Fortunately, they probably don’t spread much human disease (filarial maybe). Paul Davis and his wife Maladee are here to provide maintenance support and play a critical role in keeping this place afloat. Interestingly, Paul’s parents attend the church near our hometown of Lapeer where my folks used to attend and his father had given Sean a beautiful wooden train when Sean was a small child. It was a pleasure to finally meet them. Sean and Luke have followed Paul around and were rewarded with a ride on the backhoe and some other interesting experiences, including watching the butchering of goats for the Sunday celebration dinner. Micky has plunged into mission station life and has gone shopping for food at the local village, addressed the residents’ wives at their weekly get-together (which she thoroughly enjoyed in her role as “Mama PAACS”) and helped Joanna Thelander with the creation of decorations for the graduation ceremony Sunday. She has also been working on the year-end bookkeeping for both the PAACS and the CMDA-CMDE Commissions.
Listening to the Heartbeat of our Ministry Volume 17, Number 12 Friday, July 4, 2014
People have been gracious about helping us feel welcome. We had a meal with the Thelanders twice and also dinner with Carolyn Thorson (the senior missionary remaining and an instructor at the nursing school), with the Davises and with the O’Connors. Both Zachary and Jennifer O’Connor are general surgeons who are finishing their two year Post-Residency commitment with World Medical Missions (Samaritan’s Purse). They have decided to become career surgeons here (praise God!) and head back a week from today to spend three months raising funds before returning. They have a little child Caleb and so neither of them works full-time as they juggle clinical and child-raising responsibilities. I have used this week to ease back into clinical medicine while keeping up with my PAACS duties. In one sense, it is like getting back on a bike, but general surgery in the North American sense with which I am most comfortable is relatively uncommon; instead, orthopedics, gynecology and other types of sub-specialty cases predominate. Those areas are not strong points for me but I have been able to concentrate on the more mundane this week and let the three missionary surgeons handle those types of cases. I am on call for the next week and am sure I will run into things with which I am not particularly facile. I was surprised when the chief resident seemed to know exactly what I was going to do on some pediatric hernia cases – and then he told me that one of the previous residents (Dr. Dembele) whom I had worked with on the Mercy Ship had showed him the same techniques. That is of course exactly what this training program was about and though a small thing, it gave me great pleasure. This afternoon, we celebrated Independence Day. Since it was not a holiday here, the morning started out at the hospital as every other morning does – rounds, meetings and surgery. In concession to the needed planning and work for the graduation ceremony (but not the American holiday), the clinic was kept at a minimum. A few cases were scheduled and I staffed the OR with the residents while the other surgeons did other things. Mid-afternoon, the American celebration began. We have 23 Americans on campus right now (including us and another couple here from Ohio to do electrical work). It was a wonderful picnic meal and the red, white and blue was abundantly evident. It is interesting how much one’s patriotism increases when you are out of the country. One of the hard things for any missionary is when one’s loved ones are having problems and you are separated by the ocean and half a continent. One often feels helpless even if one’s faith is firmly in the Lord. It was true for us as well. My mother had gone back into atrial flutter and some degree of heart failure. She was hospitalized, put on anticoagulants to prevent clot formation (and subsequent stroke) and on Thursday, finally underwent a successful ablation of the area causing the abnormally fast rhythm. She had a similar procedure done during the open heart surgery and had done well until a day or two before we left. We are led to understand that one lead of her pacemaker used for back-up is problematic and she is staying in the hospital until Tuesday to have it replaced or repaired. Dicey internet delayed the exchange of news. I am very grateful that my sisters were able to be with her in my absence. I am grateful that she responded to the intervention. Praise and Prayers: Pray for my continued adjustment back to clinical medicine in Africa and for my relationships to the residents and faculty to be effective. Praise God that we went through customs in Libreville without a hitch with the sutures, operating room gowns and instruments. Please pray for the inspection by the College of East, Central and Southern Africa early next week of the Malamulo program in Malawi. Some issues have arisen that might be problematic and we trust God for the outcome. Pray that God will bring together the final details for my trip in August to Malawi, Kenya and Ethiopia. Praise God for the successful intervention and please pray for my mother’s continued recovery. Pray that the PAACS search committee can identify the right people for the job.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 13 Saturday, July 12, 2014
The SteffeScope
Dear Friends and Family: We tell Sean that it is school work before play. So we shall give you a lesson about Gabon before telling you of the great things that are happening: Gabon is half the size of France and 1/35 the size of the US. It has a population of approximately 1.5 million and therefore a pretty low density of people. Sixty percent are Christian (Catholic making the highest percentage) – the rest are Muslim and animists. It is true here as well as elsewhere that some Christians are Christian on Sunday and animists when the rubber hits the road. Low population density, abundant petroleum, and foreign private investment have helped make Gabon one of the most prosperous countries in Sub-Saharan Africa, with the highest HDI (Human Development index) and the third highest GDP per capita in the region (after Equatorial Guinea and Botswana). One third of the GDP is due to the oil – and therefore it is subject to the vagaries of the price of oil. It is third in Africa in per person revenue – at over $4k per year. However, like many other places, it doesn’t trickle down very well. The richest 20% of the population receive over 90% of the income while about a third of the Gabonese population lives in abject poverty. We are working in one of those areas. Last Sunday was a very eventful day. Early in the morning, Cynthia Niyukuri required a C-section to deliver her twins. It was the Niyukuri’s first wedding anniversary (July 6 is also the Thelanders’ anniversary) and this was a wonderful present. The twins were 1975 grams (a little over four pounds each). Little Tracy is doing very well. Little Mercy was born with a large encephalocele (the skull and brain is malformed with a cyst the size of her skull protruding from the back of the skull). These children, if they live, are severely developmentally delayed. Please pray for Alliance and Cynthia as they face the joy of a beautiful little girl and the tragedy inherent in their other little girl. Their attitude has been extraordinary and they are a living lesson of God’s grace in life’s disappointments. Bruce was on call and made rounds with the resident early in the morning so everyone could get ready for the big shindig. Two of the Bongolo residents would participate in the graduation ceremony. The wives (both faculty and resident) and some friends had spent much of Saturday decorating the church auditorium and the reception hall. One of the wives had made a beautiful huge cake decorated with the PAACS emblem and the names of the graduates. That morning, Keir Thelander gave the sermon in French (translated into Njebi). In front, there were several reserved seats and special chairs for the various dignitaries and the residents. After the sermon, we slipped out while the congregation continued to sing. They were led by a superb praise and worship team. We slipped into our academic gowns and then lined up at the back of the church. To the strains of “Pomp and Circumstance”, we marched through the palm frond arch and down to the front. After the residents and graduates were seated, we took our place on stage. Many local officials and dignitaries were there, both secular and members of the Gabon Christian & Missionary Alliance. After all the greetings, I was asked to give a short history of PAACS (the PowerPoint for which I had translated into French) and give a short challenge on servant-leadership to the graduates. Deborah Walker, a pediatrician who had grown up here, translated it into French. The statistics about the lack of surgery in sub-Saharan Africa got their attention and later I was asked for them by both the regional Director for Health and a journalist. We had another hour or more of brief words from various important people and then we presented the certificates of training for the past year to all and eventually the diplomas to the two finalists. Simplice Tchoba is the first Gabonese to graduate from this program and a big deal was appropriately made of that. He is normally pretty somber, but that afternoon, his grin split his face from ear to ear. Both Jacques Ebhele and Simplice Tchoba gave a nice address thanking everyone.
Listening to the Heartbeat of our Ministry Volume 17, Number 13 Saturday, July 12, 2014
Jacques said in his speech, “I would like to thank in a special way our God who made possible our training in record time - that is to say, 5 years. If I speak of “record time”, this is because in my country, the Democratic Republic of Congo, this training could take me around 10 years to complete and most often it is attached to many difficulties. We were the beneficiary of a good time-limited training - well structured, with a clear curriculum. We now feel free to say that an institution like PAACS (Pan-African academy of Christian Surgeons) is also an answer and a solution of the difficulties faced by young doctors looking for specialization. It is a blessing for us, a blessing for young African doctors in terms of quality of training, and a real salvation for the local population in terms of quality of service. It is an institution that allows African doctors to be trained in 5 years according to international standards and most importantly, provided training in Christian environment… PAACS is unique because we become a specialist in general surgery, able to heal the body but also able to win souls for Christ. That is our specialty. It is therefore no exaggeration to say that PAACS has allowed the emergence of a new generation of Christian surgeons in Africa.”
The graduate ceremony took several hours and was complete with the obligatory reception line, photos and then lots of excellent African food prepared by the wives of the residents themselves. I felt a great sense of pride in what God has accomplished through PAACS in the lives of these men and women – and felt honored to work with the missionary surgeons who actually make it happen. I pray that they will continue to have an impact on their peoples for health and for God.
Jen and Zachary O’Connor, both surgeons, went back to the US for a few month furlough. They will be coming back as career missionaries and have become a vital part of the teaching faculty here at Bongolo. With their absence, I have stepped into being a full partner in carrying the load. Bongolo is very short on what I would consider traditional general surgery cases and so Keir has still had to handle the lion’s share of orthopedic and urology cases. I have been of little help in those. We have had one or two operative orthopedic cases each day. I have tried to take up any other slack. I have been on call each night for the past week and have been the hernia and pus doctor. It has been a great deal of fun teaching the residents; I have given two lectures on hernias and also gave the Bible study on Luke 15 on Thursday. Micky has enjoyed being with the PAACS wives each Wednesday afternoon. They are a close-knit group, perhaps more so than elsewhere that we have been. They have really become family to Cynthia and Alliance in their time of need.
Praise and Prayers: My mother finally returned home. Her ablation procedure to stop her fast heart rate has worked and they have fixed her pacemaker. However, early this morning, she had to return to the hospital with visual loss (possibly a mini-stroke) which cleared spontaneously. She is undergoing evaluation. Please pray. Praise God that the inspection by the College of East, Central and Southern Africa of the Malamulo program in Malawi went very well and we expect full accreditation. Pray that the PAACS search committee can identify the right people for the job. Pray for God’s mercy upon young Mercy and for the Spirit’s reality for the Niyukuris and all who love them.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 14 Saturday, July 19, 2014
The SteffeScope
Dear Friends and Family: Each year about this time, I have put together a Fall Prayer Guide for PAACS. I have spent almost every spare minute this past week in trying to get it together. It is tedious at times and getting people to respond in a timely fashion can be frustrating, but the Lord has given me tremendous joy when I see what He has done and the fantastic group of people that He has brought together in PAACS. I am blessed to work with them. Between the surgery and long computer sessions, we were invited to dinner with four sets of residents, the Davises and the Petersons. Each was a great pleasure and the stories were fascinating. One of the residents graduating in December told how he had heard of PAACs. This was in 2007 when PAACS was not well known and still small. He was in a surgery residency in Bunia, DRC, when his father-in-law, a pastor, was taking classes in counseling at Wheaton. The pastor was telling a friend of the need to find good surgical training for his son-in-law and this friend somehow mentioned it to his barber in Wheaton who informed him of PAACS in Africa. He knew because his brother in California had something to do with PAACS. In a bold step of faith, Jacques promptly quit his training program, moved to Kampala for months of English lessons and then applied to PAACS. The rest is history. He hopes to go back to that far northeastern region of the DRC when he is finished. There are also some interesting family ties. Niva Nzanzu is the daughter of Dr Kakalo, one of the early Bongolo trainees and her sister, Carine, is the wife of Malikidogo at Mbingo. They are all of DRC but Kakalo was working in Kenya for a long time. Anatole, her husband (a 4th year resident her) met her for the first time in Nairobi when he skipped the weekend activities at our Brackenhurst basic science conference and went to visit the family along with Ben Malikidogo who had married Niva’s sister, Carine. Along the same line, Dr Iasy, the wife of Fabruce, is the daughter of a Malagasy surgeon that Harold Adolph was training in Galmi Hospital at the time that PAACS was just getting going in the mid-90s. Seems that one must buy a program – as the baseball stadium hawkers, say, you can’t tell the players without a program. God is in the healing business. A case this week confirmed that. We had a young child with a spinal lesion and the pediatrician, Deborah Walker, was concerned about Pott’s disease of the high thoracic spine. She asked us to see the child to see if surgery might help. The child had a paralysis of all the muscles but weirdly had preservation of all the sensation below that level. It was hard to figure out where the lesion might be. After careful consideration of the child and the x-rays, we declined to operate. She put him on steroids, hoping it would help. That was late last week. Monday on rounds, the child was up and walking. The gait was not entirely normal but he was dramatically better. Praise God. He takes care of fools and little children – and did so here in both categories! Yesterday, we had mock oral exams for the residents. Keir and I gave them. It was painful for them – and us – but I think they learned a great deal. These are done to prepare them for the COSECSA exams in December. A new visiting vascular surgeon arrived today with his wife (an OR nurse) and their children. His name is Tom Strawn and he is approximately my age. They will be a great help to Keir after I leave in 10 days. I am taking call this next week. Another internist, Ken Wicker arrived earlier this week with his son to spend a month. Surrounded by jungle, there is always the concern for snakes. The week before we came, the Thelanders cut down all the bushes around their home after finding (and killing) a six-foot tree cobra and a green mamba in their yard plus another unidentified one. We haven’t seen any – and we are okay with that! The big rat we hear above our ceiling is concern enough. I found an old surgical instrument honing kit that I was not familiar with. After watching a scratchy VHS video, I figured out how to use it and spent some time sharpening instruments in the OR and showing Keir and the
Listening to the Heartbeat of our Ministry Volume 17, Number 14 Saturday, July 19, 2014 residents how to use it. A nice little kit. I was offered another set of instruments (by e-mail) this week and hope to set up a more robust instrument lab in my workshop again this fall. We spent this morning trying to restructure and refurbish instrument trays. Micky is staying busy doing some chores and also working on the book-keeping for PAACs and the CMDA-CMDE conference. Sean is playing hard with the Thelander children and they recently got a chance to ride in the fire engine that was purchased for the hospital on EBay for only $3,000 – complete with hoses, etc. I have planned my next trip. After being home for 12 days, I will leave the US August 12 to go to Malawi, Kenya and Ethiopia. I will the new program Malamulo SDA near Blantyre on August 13-17. I will fly that afternoon of the 17 to Nairobi and then visit Tenwek Hospital August 18-21. On the 21st, I will drive to Kijabe hospital and be there from August 21-24. The morning of August 25, I will fly to Addis and then drive down to Soddo Hospital, being there from 25-27. On the 27th, I will drive back and fly with Jon Pollock to the Surgical Society Meeting of Ethiopia to be held in Bahir Dar August 27-29. We will then fly back and I will visit Myungsung Christian Medical Center from August 29 until I fly out late on the 1st of September. I will be at Tenwek and Kijabe at the same time as a team from IMCK (Institut Médical Chrétien du Kasai, translated Christian Medical Institute of the Kasai; www.imck.org), a Presbyterian Mission Hospital not too far from Kinshasa. They are exploring the idea of starting a PAACS program. Given the budgetary restraints, PAACS will not add any new programs for at least three years but that actually puts the timing about right since it will take some time to get the surgeons and improve the hospital. Part of my job is to just keep plowing new ground to see what and where God will allow a program to sprout. My mother, Ardith, has not had any more blind episodes and the work-up was negative (they did not due the echocardiogram of the heart that I would have preferred). She continues on anti-platelet therapy and looks forward to getting her sling off (from the repair of her pacemaker) in a few days. Thanks for your prayers for her. I would now ask you to pray about something else. Jeri Lynn Steffes, my ex-wife, has been diagnosed by CT scan with a mass in her pancreas. Obviously, there is great concern about whether this is malignant. She saw a surgeon this week and will get a second opinion Monday at Duke. Pray for her as well as for our three children. Bethany, with her anxiety issues, needs your prayers in a focused way. Jeri loves the Lord but this is a scary time for everyone. Praise and Prayers: Praise: My mother’s recovery and the successful emergency surgery on Paul Davis’ mother Thursday. Praise: The COSECSA inspection team has recommended Malamulo Program for full accreditation. Praise: In appreciation of his surgeon’s skills and his surgeon’s heart for PAACS, a patient gave a PAACS commissioner a check for $250k. It is the largest single financial gift given to PAACs in its history. Praise God for this answer to prayer – and for the fact that this surgeon lives out his Christianity in the hospital and clinic. Pray for Jeri and my children.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 15 Friday, July 25, 2014
The SteffeScope
Dear Friends and Family: Our last full week at Gabon has come to an end and we remain constantly involved in something. We have been invited to dinner several times this week and helped host another dinner. Last Saturday, Joanna and Keir Thelander helped us order some food from two different African restaurants and the four of us hosted the dinner at the Thelander home. All the residents and their spouses came (sans children) and it was a night out for everyone marked by too much food and lots of laughter. We enjoy seeing the women blossom in such a setting and those of us at the men’s table looked askance at the women’s table more than once as laughter and loud chatter rang out. It was a great time of fun and fellowship. Micky and Joanna had given some baking lessons earlier in the day and their strawberry crumble masterpiece was served as dessert. Marco Faniriko, the second year resident, told a wonderful story that night about an event in Madagascar. A friend had little money but was very hungry. He ordered a plate of rice but sat close to the food to enjoy the smell. He was apparently obvious or even obnoxious about it – so much so that the owner tried to charge him for the food he smelled. There was an argument and a passing policeman was called in. He listened to the story from both sides and then asked the diner for a coin. He dropped it so that the sound rang out clearly. He then told the owner that the sound of the money paid for the smell of the food! Wonderfully Solomonic! Sunday, we were invited to an African’s home for supper. Christine is a missionary-trained accountant at the hospital and has been here a long time. She served a nice spread – boiled taro, pounded taro, pounded gourd seed, fermented manioc, green beans and antelope, chicken in palm oil sauce, mixed vegetable salad, French bread, rice and boiled manioc leaves. It was tasty, but the fermented manioc tuber was my least favorite – like fermented rubber in smell and consistency (Christine doesn’t like it either but wanted us to try it). They soak it in the river for a week and then boil it. Monday, we went out to a local restaurant with the Thelanders as the guest of the hospital administrator, Serge Batouboko. The menu that evening was wild boar; porcupine, manioc leaves with dried fish, fresh fish, salad (cold vegetables with a sauce) and once again, fermented manioc. The fresh fish was nice (although we declined to eat the heads as our African friends did) and I can do without porcupine again – rather a strong gamy taste. Tuesday we ate at the home of the Samaritan’s Purse Post-Residency family practitioner, Elizabeth “Izzi” Elliott, and were pleased to get back to food we recognized and enjoyed. We enjoyed getting to know her. Wednesday, we had dinner at the home of our most recent graduate, Simplice Tchoba, who is officially done as a resident in a week. He is the first Gabonese graduate. With another surgeon here (Dr. Tom Strawn from Phoenix), I could turn my attention to some other things. As at many mission hospitals, organization of available resources is lacking. We spent most of Saturday and Monday sorting instruments and standardizing trays. We came up with a big bag of instruments that were low-quality but functional – and Keir will share them with local health centers. Monday, I spent almost all day sharpening all manner of instruments – scissors, curettes, osteotomes, rongeurs, chisels and the like. Now they have to be careful not to hurt themselves! We created some new trays including one larger abdominal tray that consisted entirely of the instruments that our Sunday School class had purchased for missionary use. It is a beautiful tray. With some extra time away from the OR, I was able to spend a bit more time working on PAACS administrative issues. A lot of time went into cajoling and harassing the members of the PAACS family to meet the deadline for the new 2014 Fall Prayer Guide. It will be very nice and several pages larger, due to our growth. I must get it done so I can send it in when I get home on the 30th (a 20% off sale stops the 31st). The painfully slow Internet has been a handicap – haven’t had this bad a connection since our first days in Togo. I also have met with Keir and worked with him on a new Memorandum of Understanding with the hospitals. The PAACS Commission has decided to cap the support of the hospitals and help them become a bit more self-sufficient in training. This will provide some money for us to train others at hospitals which have not yet benefited from a PAACS program. Talking money, especially in these sorts of limited-resource settings, is always a delicate thing. Sean has been working with Luke Thelander and Ben Strawn in the mornings, organizing a storage room. He has really enjoyed being here. Micky has been working solidly on the end of the year accounting for PAACS and CMDA-CMDE – when she is not doing something with the missionary ladies, cooking, cleaning and other such appreciated activities.
Listening to the Heartbeat of our Ministry Volume 17, Number 15 Friday, July 25, 2014
Bruce repairing and Keir Thelander receiving instruments The Hospital Radio Equipment (antenna on the roof)
Micky proctoring the baking class The PAACS spouses – finally quiet enough for a picture! Praise and Prayers: Praise: Jeri Steffes was evaluated at Duke by a previous colleague of mine and received the good news that the mass in her pancreas is probably benign and that she can probably have her surgery done laparoscopically. She has some further testing to do, but is scheduled for surgery August 6. Please keep her in your prayers. Pray for all the residents of PAACS who are taking the remediation exam this weekend. I will be invigilating the exam here at Bongolo.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 16 Thursday, July 31, 2014
The SteffeScope
Dear Friends and Family: We are home in the US, tired but with memories of a wonderful experience in Gabon. Last Friday, between cases, I continued the work with the surgical instruments by standardizing the nine hernia trays and due my help and that of Lisa Strawn, Keir now has a better grasp on the contents of all the trays and all the instruments he has in reserve – and the instruments are sharp! It is one of those needed things that just keep getting pushed off when you are by yourself. He is relieved to check that job off. He and I also worked for a few hours to update the Memorandum of Understanding in follow-up of an earlier meeting with the hospital administrator. We now have to get it translated into French and it will be signed. It will be the first MOU under which PAACS will limit its support of the trainees and the hospital will take half of the budget (eased in over five years). I really appreciate Pastor Serge Botouboko here at Bongolo – he is a “big picture” man and strongly supports PAACS even when the new shoes pinch a bit. I will next work on new proposed budgets for Tenwek Hospital and Mbingo Hospital. It was good to get over the first major hurdle. It was good to be at Bongolo and hear the “Hospital Radio” playing through overhead speakers. They also have specially tuned radios for some patients. The missionary who has been spearheading it (Carolyn Thorson) is going home soon and Micky and I are praying that someone will catch the vision and made this program vibrant and an effective tool for evangelism. We received some communication from Steve Kelley, the surgeon in Bangladesh whom we have visited in the past. He has found another young Bengali Christian man who wants to be a surgeon (few and far between in that Moslem country) and has three other general surgeons who will be joining Steve in the next year as long-term missionaries. Two of the three are career missionaries and the other a post-residency two-year surgeon from World Medical Mission. Praise God for all of that good news. I sure hope Steve can finally get some rest – he has been carrying a huge load for a long time and I have nothing but the greatest respect for him. And we are thrilled that he can again train someone! I spent much of last Saturday proctoring the PAACS remediation exam here at Bongolo. Two were required to take it (one passed and one didn’t) and four took it for practice. It was a great chance to catch up on a lot of computer work for PAACS. Over the next few days, the results from other centers came in and the analyses were then sent out, along with a study guide for each resident. That evening, we had Dr. Ken Wicker, his son Nathan and recent Cedarville graduate nurse Abby Toburen for a simple dinner and then joined the entire station for a bonfire at the Thelanders. The bonfire was replete with s’mores which made a wonderful dessert. The next night (Sunday), we were thrilled to join a steak grill hosted by the Thelanders and the Davises. They brought out some hard-to-get and long-hoarded filet mignon – and it was wonderful! The Davises are leaving for a 3 month furlough just two days after we leave. A couple, Jeff and Cheryl Bradbury, arrived this week to keep this place going in the Davises’ absence. The doctors may do some things special at mission hospitals – but the places usually grind to a halt without a proper maintenance guy! Go out and send a check to such a person right now – they usually need more support than they have because they are not as “sexy” in terms of missions. On the last evening, we joined the Thelanders for some pizza and then all the residents came with their spouses to say good-bye. It was a great evening.
Listening to the Heartbeat of our Ministry Volume 17, Number 16 Thursday, July 31, 2014
I spent a lot of time getting the 2014 Fall Prayer Guide ready to send – and of course dealing with those who inevitably wait till past the deadline to send in their pictures and information. I tried to send the final 31 megabyte file from Bongolo but the Internet was too slow – I had to wait until I landed at Washington-Dulles to finally get it out (where it literally uploaded in less than 10 seconds after I spent hours in Bongolo). If you would like a printed copy of the Prayer Guide (available after September 1), please let us know at [email protected]. If you are the inpatient sort and open Christmas presents on Christmas Eve, please download an electronic copy now. Go to http://paacs.net/wp-content/uploads/2012/09/PAACS-Prayer-guide-2014.pdf. It is about 4 MB, so please be patient. As always, it was a long trip home, made much longer by five separate attacks of renal colic. I started passing a stone on Saturday night and it made that next several days rather miserable. Still haven’t passed it and I am scheduled for an intravenous pyelogram on Monday. Hope it passes before then. Addis Ababa airport was again very busy and unpleasant experience but we made it smoothly and without any time to spare. The flight westward from Addis Ababa to Washington requires a refueling stop in Rome to have enough fuel to fight the headwinds. It certainly makes it longer. It is good to get home and we are struggling with jet-lag, a stack of mail, a notice from the IRS and the usual. Deep in the stack of mail, I found something good. Finally, I got my undergraduate degree (B.S. - Highest honors - major "accelerated degree completion - whatever that is) and my Master's (M.A. - Summa cum laude - Biblical Ministries). Hope I can finally get a real job! The time home is busy and short. I am only home for 12 days before I leave again for Malawi, Kenya and Ethiopia. Doctor’s appointments, dental appointments and meetings are on the docket. Sean gets his new braces next week and then starts school again the day before I leave. My ex-wife, Jeri, is undergoing a laparoscopic (hopefully) resection of her gallbladder and a pancreatic mass (benign, hopefully) but it could be a complete resection of the tail of the pancreas and the spleen. That will be on the 6th. Please for her, my children and for the surgical team. The search committee for the PAACS Executive Director is meeting in Atlanta to interview candidates. That will be August 23. Please pray for them. In the meantime, I am jumping through the hoops to terminate my employment at Methodist University, making sure my health insurance makes the transition and getting signed up over the next few days with my new employer – the Christian Medical & Dental Associations. I will be working a .8 FTE so that I can continue participating in some of our other ministries. Praise and Prayers: Praise for the traveling safety. Please pray for the passage of the stone. Please pray for Jeri’s surgery and for her and our children, no matter what turns up. Pray for Sean as he prepares to get braces and also to return to school. Praise God for the completion of the 2014 Prayer Guide and pray that it will be used to great effect in the hands of His saints. Pray that the Hospital Radio project will take it off, that a new champion will be found and that people will come to Christ through it.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 17 Sunday, August 10, 2014
The SteffeScope
Dear Friends and Family: The time at home has been a short time but with a lot accomplished. Traveling alone this time, I will leave very early on Tuesday August 12 and will arrive in Blantyre, Malawi and continuing on to Malamulo SDA Hospital where I will see the few program there. It opened on August 1 and this is my first official visit. Ed Bos from Worldwide Lab Improvements in Kalamazoo will be arriving within an hour of me and will be there to install the PAACS software and the new hardware. My bags are packed to overflowing with books and other materials for them. One of the residents is getting married today in Malawi so I won’t get to meet him – although I must wonder about the priorities of someone who would rather get married than meet me! On August 17, I will travel back to Blantyre and fly to Nairobi via Addis Ababa getting in in the wee hours of August 18. After a few hours of sleep, I will travel with a team from the ICMK (Institut Médical Chrétien du Kasai or, in English, the Christian Medical institute of Kasai, www.imck.org) in Kananga, DRC to Tenwek. They are interested in a PAACS program in the future (once our budget is stabilized again in three years or so). I will be there at Tenwek Hospital until Thursday, August 21 when I travel back to Kijabe. At Kijabe, I will talk with folks in the general surgery program, the pediatric general surgery program and see our friends from Uganda, John and Rebecca Fulks, who are now dorm parents at Rift Valley Academy. I return to Nairobi on Sunday August 24 and fly out early the next morning to Addis Ababa, Ethiopia. I will be driven down to Soddo Hospital for a 48 hour visit. On the 27th, I will be driven back to Addis and then fly with Jon Pollock and Bill Wood to Bahir Dar, Ethiopia, to spend two days at the Surgical Society of Ethiopia. On Saturday and Monday, we will talk with the folks at Myungsung and then I fly back out in the evening to the US, arriving in NC in mid-afternoon. I am home for 24 hours and then drive to Charlotte to participate in a CMDA Medical Missions Summit Meeting for the rest of the week. I have also met this past week with the new person at Campbell University School of Medicine who is charged with rejuvenation of the medical missions advisory council. His name is Oscar Aylor and he has been an administrator at the Hôpital Lumière in Haiti and worked for several years with Mission to the World (a Presbyterian Mission agency). I gave him a set of our books for use with the first class of students that will participate in this special program. I have also been working on getting my surgical instrument lab set up in the garage. I have ordered almost everything I need but am still looking for a source of the diamond grinding wheel I need. I was very pleased to have someone contact PAACS with an offer to contribute some used instruments. If you know of anyone who has surgical instruments to offer, please contact me at [email protected]. I can give a tax-deductible receipt for the gift. I will refurbish them and then distribute them to PAACS graduates in Africa. Sean returns to school tomorrow, August 11. He is eager to get back but was taken aback a bit when they had their introductory meeting on Friday. He is used to being one of the tallest, if not the tallest, in his class. Four of his friends hit their growth spurt this summer and now they tower over him. He is not pleased to be called “shorty”. If he follows my pattern, he has another year or more before his growth spurt will start in earnest. He is also a bit
Listening to the Heartbeat of our Ministry Volume 17, Number 17 Sunday, August 10, 2014 self-conscious about his new braces – and a bit sore in the mouth. Please keep him in your prayers as he starts this new 8th grade. We were very pleased to receive the 2014-2015 PAACS Fall Prayer Guide this week. We will send them out to donors this week but if you would like a printed copy, please contact Micky at [email protected]. Digital copies (4 Mb) can be downloaded by clicking here. I personally proofed that thing six times, and had two other people check it as well – and it was frustrating to find two errors the first time I saw the printed copy. Sigh. However, it was a real blessing to have visual proof how PAACS has grown and God has blessed. I have updated a table that shows that growth. The year 2005 was the year before I took over as CEO. I do not take credit for that growth – only rejoice that I have been able to see it and participate. I pray that God will bless PAACS in a similar way during the next 8 years of growth.
2005 2014 Number of PAACS training sites 2 11 Sites wanting to join 2 3 Number of programs 2 12 Number of PAACS residents 9 65 (as of January 2015) Number of PAACS graduates 3 43 (as of January 2015) Number of approved faculty 2 53 (as of January 2015) Number of Commission members 12 18 (+ admin) Budget $37 K (given) $1.33 M
The last episode of renal colic was on the plane from Washington to Raleigh last week. I am so glad that it has stopped and thank you for your prayers. I do not miss it! However, I replaced it with a very bothersome muscular spasm in my back and it makes sitting and moving very uncomfortable. Please pray that it will go away and I can get through this long trip. Thank you for your prayers for Jeri Steffes. She underwent a laparoscopic resection of the body and tail of her pancreas and a cholecystectomy on Wednesday at Duke University. It was performed by a colleague I knew well during my times at the Duke VAH and it went well. The pathology is not yet back but it would appear to be a low- grade malignancy called a neuroendocrine tumor. The prognosis for this is much better than for the usual pancreatic cancer. The surgeon estimated an 80% five-year survival but that all may change with the final pathology report. Please continue to keep her in your prayers, praying for a cure for her and for her rapid recovery. Praise and Prayers: Praise for the traveling safety for me and protection for Sean and Micky while we are apart. Pray that I will be open, receptive and wise in all my interactions and meetings for PAACS. Please pray for the back spasm to go away. Please pray for Jeri’s cure and recovery. Pray for Jeri and my three older children as they process this. Pray for Sean as he returns to school.
Yours, for the peoples of Africa,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 18 Sunday, August 17, 2014
The SteffeScope
Dear Friends and Family: Greetings from Malawi! Having arrived on Wednesday, I am flying tomorrow to Kenya via Addis Ababa and will not arrive until the wee hours of Monday morning.. The trip here was unremarkable – just too long. Since I had to leave Tuesday at 6:00 AM from RDU, Micky and Sean drove me to a motel near the airport Monday night and the next morning, I caught the 4:30 shuttle to the airport. The layover in Addis was not a long time, but I made it comfortably and arrived a little ahead of time in Blantyre. We were met by health officials who asked each passenger whether they had traveled in West Africa in the previous three weeks and they glanced at the yellow fever certification. A visa was a mere formality and I was pleased that all my bags had arrived. The missionary surgeon, Ryan Hayton, was a little late, but that wasn’t a problem since I knew that Ed Bos, the founder and president of Worldwide Lab Improvement was coming in an hour later than I was. Ed was coming to install the PAACS module at the hospital and would eventually convince them to sign up for the entire software package for use in the rest of the hospital. Ryan and I had a chance to talk before Ed came out the swinging doors pushing a large pile of boxes and trunks on a luggage trolley. He had no trouble getting the computer equipment through customs once he mentioned the hospital. It was good to see him again. The conversation carried on as we drove about 90 minutes out to Malamulo SDA Hospital near Makwasa, Malawi. The last portion of the drive is through the tea country and it was beautiful scenery. Ryan and Sharlene (his lovely Australian-born wife) and their three active boys, aged 2, 4 and 6, greeted us with a nice meal and a lively evening until we crashed, desperate for a night’s sleep in a horizontal position. Ed was able to go ahead with his plans to work with the IT person to install the server and computers, but the plans of Ryan and I went awry. During the first conference of the morning, word was received that the Malawi Medical Council was making a long- anticipated but totally surprise visit to the hospital – and they were there! Fortunately, Jamie Crounse (another native-born Michigander, Medical Director for the hospital and family practitioner) and Ryan were able to dust off their month-old presentation prepared for the COSECSA visit. After the presentation and a time of questions, the team split into three teams and each were led on a tour of the hospital, concentrating on a different part. Two of the inspectors were surgeons (who had been on the team for two days) and this was the first such inspection tour the team has ever done apparently. At 1:00 PM, they had a working lunch to consolidate their report and then they held a debriefing session with the Malamulo team. Some of their questions and recommendations left the team here shaking their heads in wonder, but most of them were reasonable suggestions and if followed, would improve the hospital considerably. It was rather ironic at times to hear suggestions that the team here knew were not being met at any hospital in the country. The hospital team expects to hear the final report from them sometime next week. With the exception of one resident who was on his honeymoon (strike one – lack of commitment and proper respect! ), I was able to have some one on one time with every member of the administration and the surgical team over the next two days. I answered questions, reviewed expectations, made sure they had access to all the forms and knew how to fill them out, were signed up for the Covenant Eyes internet accountability software and so on. I also delivered five textbooks, two Bibles, four white-coats, the new PAACS Prayer Guides and some things Ryan had ordered from the US. It was a pleasant time and if it were not for the effects of jet-lag, it would have been wonderful. I am very encouraged about the potential of this rural hospital as a training site for
Listening to the Heartbeat of our Ministry Volume 17, Number 18 Sunday, August 17, 2014
PAACS. We have two superb and committed surgeons to train and the administrative team seems unwavering in their commitment to train residents here. In fact, they want to train family practice people as well and I have talked at length with them, giving them my ideas on how the overall structure should look. Seventh Day Adventists celebrate Saturday as their Sabbath. Ed Bos, Arega Fekadu (a 2012 PAACS graduate from Tenwek and now a faculty member here) and I were the guests of the hospital CEO, Jason Blanchard) for the Friday day meal and then we had a large group potluck for both lunch and supper on Saturday. We attended the early morning English- speaking service at the local church. We had some good conversations in the afternoon and the evening was a get-together of games and laughter. Today, I will leave mid-day for the airport and fly to Nairobi via Addis Ababa. After a too-short night at the Methodist Guesthouse, I will drive with a team from the IMCK hospital in DRC to Tenwek Hospital. Thursday, I will go to Kijabe Hospital. By report, Sean has truly enjoyed his first week of school. I hope that his enthusiasm continues.
Praise and Prayers: Pray for the approval of Malamulo from both the Malawi Medical Council and COSECSA. Praise for the traveling safety for me and protection for Sean and Micky while we are apart. Pray that I will be open, receptive and wise in all my interactions and meetings for PAACS at Tenwek and Kijabe. Please pray for the back spasm to go away – it is slightly better but still annoying. Praise that Jeri Steffes has returned home from Duke Medical Center and that the surgery went as well as could be expected. Please pray for her cure.
Yours, for the peoples of Africa,
Bruce for Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 19 Saturday, August 24, 2014
The SteffeScope
Dear Friends and Family: It has been a good week in Kenya! Before I left Malamulo Sunday morning, I inspected the new duplex for the resident housing. One side will be in open in a week or two; the other may take a bit longer. We also looked at the plot of land where they plan to build at least three more duplexes. The building of housing is one of the larger demands on a hospital’s financial input into the training programs. Ed Bos continued training staff on the new computer system Dr. Hayton drove me into town about noon and I caught the plane at Blantyre, flying to Addis Ababa and then back to Nairobi. We didn’t arrive until 2:20 AM Monday morning and there I faced a chaotic situation as they tried to force people through a makeshift screening process for Ebola. One had to fill out a full page of information and answer questions about any symptoms before they took a forehead temperature scan. It wasn’t well laid out and there was a lot of jockeying for position and trying to find a place to write on. Not sure I was convinced of its effectiveness but it is a sign of everyone’s nervousness about this horrific disease. Not getting to the hotel and in bed until 3:30, I was very pleased to be awakened at 6:30 by a noise at my window – there was a monkey climbing on it! The noise from outside and the other guests made it difficult to return to sleep, so I got up and went to eat. However, there was a whole convention of pastors at the same hotel and the breakfast bar looked like it had been ravaged. I picked up two new traveling companions that morning. The Good Shepherd’s Hospital near Kananga, DRC is interested in beginning a PAACS program. Dr. John Fletcher and Mr. Jack Muthui had come to look at Tenwek and Kijabe after our plans to have them visit Bongolo while we were there in July fell through. John, a MK, has been at the hospital for the majority of the time since 1990 and is now the sole expatriate. While it once had a fair number of specialties represented by expatriate missionaries, the civil unrest in 1991 caused a mass exodus and only a couple returned. Only John stayed. Jack is a Kenyan with a background of hospital administration, once running the CURE hospital at Kijabe and now working as the African regional representative of the Medical Benevolence Foundation, a Presbyterian aid agency. I rode with them across the Rift Valley and we had a good conversation, the first of many over the next here days, about PAACS and what it took to start a program. Tenwek Hospital in rural Bomet is bursting at the seams! It certainly looks different than it did when we first visited in 1998. Construction is going on everywhere and even individual houses are adding extra guest quarters. They are building a major project for more resident housing and the new dental and eye hospital (paid for by an America School and Hospitals Abroad, i.e. USAID) grant, is rapidly taking form. Carol Spears, the acting Program Director, had a fully-packed schedule arranged for me. The very first meeting was the study of the spiritual curriculum. They are doing an inductive study of the book of John and it was a real blessing to see these 14 residents and faculty studying together. That evening, she had arranged a social evening. There was a good meal and the entire evening was one of laughter and bonhomie. I enjoyed meeting the residents and faculty I hadn’t met before and a good time was had by all. I participated in rounds, morbidity and mortality conferences and mock oral examinations but spent most of the time in one on one interviews with the
Listening to the Heartbeat of our Ministry Volume 17, Number 19 Saturday, August 24, 2014 faculty and residents. With the latter group, I got caught up on their lives and plans. Like all of our residents in each program, they are an outstanding group of young Christians. I challenged them to consider placement in mission hospitals and PAACS programs when they were finished and then also challenged them to speak about Christ with at least one patient each day. It was a blessed time but with 14 residents and the entire faculty, it was spread over three days. Carol Spears and I also talked to the CEO, Mr. Geofrey Langat, about the PAACS Commission mandated cap on the contributions we can make. That was a bit uncomfortable but a critical step for sustainability of both PAACS and the program in Kenya. Thursday morning, I was driven back across the Rift Valley to Kijabe Hospital to Kijabe Hospital. I spent the first afternoon in clinic. The interns are on strike (the medical payment system in Kenya has recently been severely disrupted) and I wished I had a Kenyan license to help them out. I did what I could with the junior residents. That evening, I had a wonderful time with old friends that I hadn’t seen since we left Uganda in 2006. John and Rebecca Folks are still involved in the Global Theological Seminary in Jinja but have come to be dorm-teachers and chaplain at the Rift Valley Academy. Having such godly dorm-parents and teachers is a relief to missionaries everywhere who must send their kids to boarding schools. John told me that ¼ of the RVA graduates return to the mission field and he is excited to increase that percentage and better prepare them. Friday was a day of meetings capped off by a PAACS supper at the home of Rich and Stacy Davis. The most encouraging thing about the day was the meeting with the senior management team. Housing has always been a problem and the support of the management variable – after that meeting, I felt much more confident of some progress and we will pray that they will grant us two apartments a year from here on out. The dinner at the Davis was a wonderful time with all the residents’ families there. Certainly a fertile bunch! Saturday was a bit more relaxing with a few meetings and then a wonderful night at the home of Erik Hansen, the pediatric surgeon. Tomorrow, I meet with Dr. Jon Fielder of the African Health Missions Foundation, one of PAACS’ larger supporters, at Brackenhurst and then we will drive into Nairobi. I leave in the middle of the night to catch a very early plane Monday morning to Addis Ababa and will drive to Soddo Christian Hospital from there. Praise and Prayers: Praise for the traveling safety for me as I go to Ethiopia tomorrow and for protection for Sean and Micky while we are apart. Pray that I will be open, receptive and wise in all my interactions and meetings for PAACS in Ethiopia. Please continue to pray for the back spasm to go away – it is slowly improving. Praise that Jeri Steffes’ pathology was favorable and they feel the risk of recurrence in only 10%. Still pray for a complete cure.
Yours, for the peoples of Africa,
Bruce for Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 20 Tuesday, September 2, 2014
The SteffeScope
Dear Friends and Family: I am finally home after a long trip from Addis Ababa. It was a good week in Ethiopia but it is very good to be home with Micky and Sean. After leaving my guesthouse in Nairobi at 2:30 AM, I arrived early Monday morning at Addis airport and I then shared the six hour drive down to Soddo with a missionary family who were returning from the States with their three children, including a new-born child. They were jet-lagged and we were all glad to set foot on the grounds of Soddo Christian Hospital. I haven’t been here for almost two years and I was amazed at the growth of the campus. The PAACS housing has been finished, the hospital has expanded (including some outpatient space, a CT scanner, new conference/library, a new gazebo and a new generator building. There were new houses and one two-story duplex going up. The landscaping has been markedly improved and many of the areas around the houses resemble an English garden. In the past, I have come during the dry part of the year and this time, everything was green and lush. My timing for this visit was not good. The only expatriate surgeon at Soddo was Bob Greene, an orthopedic surgeon, who is here for a limited time and the PAACS graduate, Tewodros, who had only been back on campus for ten days when I visited. Even half of the PAACS residents had left to attend the COSECSA (College of Surgery of East, Central and Southern Africa) tropical medicine course. Since the loss of Paul Gray earlier this year, we have not had a dedicated general surgeon at this hospital and the education of our residents has suffered greatly. I met with almost all the missionaries who were present(many are gone at present) and with the administrator in an attempt to figure out what needs to be done to make our training here more effective and to figure out how to retain the general surgeons who may come. We have lost three surgeons since we began the program and recruitment is not easy. Studies have shown that one of the main reasons given for leaving the mission field is conflict with other missionaries and that is certainly true here, too. Please pray for God’s leading on all of this and for His unity at the hospital. After only 48 hours, I was back on the van heading back to the capital city. We perfectly timed our arrival at the domestic airport; as we drove in, my traveling companions were walking up. Jon Pollock, Tim Love (a senior resident at Emory who hopes to come to Ethiopia as a missionary) and Bill Wood (PAACS Academic Dean) traveled with me to the resort city of Bahir Dar. It is located on Lake Tana, the start of the Blue Nile. This planned city is about an hour’s flight north and west of Addis Ababa. When in Uganda, we lived on the start of the White Nile in Jinja but I never dreamed I would visit both headwaters of the Nile. The Surgical Society of Ethiopia was the occasion for the trip to Bahir Dar. In a country of almost 90 million people, there are only 300 surgeons in government service (the number in private practice seems unknown). This was also the occasion for a regional meeting of the COSECSA Council so it was good to see some friends from that august body. The first question I asked of my COSECSA friends was about news on the decision on the Malamulo accreditation visit. I was informed that they had granted full five-year accreditation (both MCS and FCS) for Malamulo. I could hardly wait to e-mail that great news back to those in Malawi. What a blessing! Over the two days of the conference, we did a lot of networking. Five of the PAACS Ethiopia residents were there and two were there from Kenya (one from Tenwek and one from Kijabe). Dr. Wood and I met one morning with the CEO of the COSECSA and talked about various ways we could collaborate. I renewed acquaintance with a Christian brother from Zambia, Dr. James Munthuli, who I had met at the CMDA meeting there. He is a protégé of Dr. Jim Jewell. I also received some information that I needed regarding the basic science and surgical skills courses. Six papers were presented (one as a poster) by surgeons from PAACS–Ethiopia. The residents did a good job. Jon Pollock gave a report on his preliminary work on determining the impact of PAACS surgeons and that would win the nod as the “Best Paper”. It came with a $500 prize that Jon plans to plow back into the program.
Listening to the Heartbeat of our Ministry Volume 17, Number 20 Tuesday, September 2, 2014
Travel around town was in three-wheeled Indian taxis that are commonly called “Bajajs” (after the brand name). They dart hither and yon and narrowly miss upsetting each other. It was a good reminder that trauma is becoming a leading cause of death in Africa. However, it was too far to walk and the $1 price for two people was a bargain.
PAACS-Ethiopia near the Blue Nile in Bahir Dar. PAACS team at MCM in Addis Ababa. Back in Addis, we had a discussion amongst ourselves about how things were going at the Myungsung Christian Medical Center. This hospital is the only one where PAACS is truly a minor part of the overall picture and it is hard to influence decisions along the direction we would prefer. There are some rotations that are of great value to our residents but it is likely that general surgery will play less of a role here if certain things come to pass over the next few months. I am definitely praying for God’s guidance of and His hand on PAACS-Ethiopia. We met with the hospital administration but not sure we accomplished a great deal. My friends at Tenwek were kind enough to share their cold virus with me before I left there and this weekend has been rather miserable. I finally got a chest x-ray (negative) and began antibiotics, but it was sleeping around the clock that seemed to make the most difference. Under normal circumstances, it is bad enough to get on the plane coughing but with the Ebola fear, I sure didn’t want to be seen as a risk to everyone’s life nor spend weeks in isolation. I knew the symptoms were different but I am not sure they would. . The next few months will be spent working on PAACS “stuff” – lots of projects to finish up and advance. If a new Executive Director is selected, that will affect what I do. I will have one conference in early October, the Louisville Conference the second weekend of November, and our PAACS meeting in Chicago the third weekend of November. If flights are still open in Africa, I will be going to the COSECSA examinations in Dar es Salaam, Tanzania, the first week of December. Praise and Prayers: Praise for the traveling safety in the past week and please pray for safety as I leave tomorrow for a conference at Charlotte. Praise God that the back spasm is almost completely gone. Pray for wisdom as we continue to address the issues of PAACS-Ethiopia. Yours, for the peoples of Africa,
Bruce, back with Micky and Sean
Dr. Bill Wood and Dr. Pollock in Bajaj
Listening to the Heartbeat of our Ministry Volume 17, Number 21 Sunday, September 28, 2014
The SteffeScope
Dear Friends and Family: It has been good to be home and have something resembling a normal life for the month of September. Fall is my favorite time of year and I love the crispness in the air. Earlier this month, I was home from Africa for only 18 hours when I drove the 3 hours to SIM (Serving in Missions) headquarters in Charlotte for a two day Medical Missions Summit. It was attended by 88 people from 57 agencies which are integrally involved in medical missions. It was sponsored by Christian Medical & Dental Associations and MedSend. The conference focused on the results of a survey of MedSend participants and discussion was designed to attempt to achieve a consensus on the factors that will improve preparation of medical missionaries and diminish attrition rates. It was a great time of networking and hopefully some changes will happen. The jetlag was not bad returning home this time but a respiratory virus that I picked up in Kenya lasted the entire month. I am only now almost fully recovered from it. I was kind enough to share it with Micky while Sean caught a different virus at school and was kind enough to share that with us, too. Micky and I have spent this entire month trying to catch up on paperwork and tasks for both the Pan- African Academy of Christian Surgeons (PAACS) and the Continuing Medical and Dental Education Commission. This is my first month as an employee with the Christian Medical and Dental Associations and I spent more time in the PAACS office than I have been before. Writing questions for exams has taken up a good part of the time lately – I can write four to six high-quality questions an hour from the review text but it is amazingly difficult at times and at other times, it is mind-numbing. I hope to write nearly a thousand questions and help construct at least three 200 question exams in the next three months. Our fall fund-raising appeal, updating the web site, critical phone calls and a thousand other details took up the rest of the time. My daughter, Michelle, and her husband, Joey, visited for ten days. They were taking some vacation time to spend on North Carolina’s barrier islands. We had hoped to spend some time with them on the beach, but Sean’s school limited our available time and then life happened so it didn’t happen. It was good to see them. We are still trying to teach Joey how to be a North Carolinian so we took him for eartern North Carolina barbeque at a local hole in the wall – aptly named Bruce and Mickey’s. Unfortunately, it is not ours. Sean has settled back into school. He is in 8th grade and is doing very well with his grades. He remains a source of great pride and joy to us. We also celebrated the birthdays of Ryan and Bethany, my children, this month. I was browsing the internet and was shocked to see my name and picture in a book that I was unaware of. The book is entitled “Stitches in Time: Two Centuries of Surgery in Papua New Guinea” written by a PNG surgeon by the name of David Watters, whom I have never met. He had a nice section on the fantastic work done by Dr. Jim Radcliffe (one of my heroes) and in the book, there is a picture of Jim and I working together. I have no idea how he got the picture (to the left), but I am honored to be linked in even a minor way with Jim. In my spare time, I was finally able to get my surgical instrument repair lab up and functioning. I have wanted to do this for a long time. I can basically clean and sharpen everything. The only exceptions are serrated blades and carbide inserts. I have
Listening to the Heartbeat of our Ministry Volume 17, Number 21 Sunday, September 28, 2014 three variable-speed grinders with various wheels (including a fine-grade diamond grinding wheel and several varieties of deburring and polishing wheels), a glass-bead abrasive blasting cabinet, belt and disc sanders and various types of hand-tools. It is possible in a few hours to bring several hundred dollars’ worth of badly needed equipment back to a “like new” condition. I have received donations of used instruments from two different physicians and another box is presently on the way. And to top it all off, Micky’s kitchen knives are good enough to do surgery with! If you have access to high-quality used surgical instruments and would like to donate them for use overseas, please contact me (before you send them).
For years, my parents have come from Michigan to our home in North Carolina the second week of October so that both Micky and I could attend the Prescription for Renewal conference at The Cove in Asheville, NC. We have really appreciated their kindness in doing so and Sean loved having them here. Mom was able to continue the tradition last year and it was a precious time for both Sean and her. Sadly, medical issues will prevent it from happening this year, so Micky will stay with Sean and I will attend the conference October 10-12. It is a vital time of networking with the short-term faculty members that come from World Medical Mission and who are so critical to the success of PAACS. I received an e-mail recently that Kent Brantly, the physician who survived Ebola, will be speaking. He was with us in Greece this spring before he got sick. When I was in Charlotte for the conference, I saw Nancy Writebol (the other Emory patient who recovered) and found out that an old acquaintance, Dr. Tom Cairns, had survived Ebola in 1973 – three years before the epidemic was named after the Ebola River in that part of the DRC. I certainly know Dr. Rick Sacra well from my times in Liberia – I was thrilled to see that he was cured and left the Nebraska hospital earlier this week. We have four PAACS graduates in that area of West Africa. One, Jerry Brown, is running the second isolation unit at ELWA in Monrovia, Liberia. The others are in Sierra Leone (two) and one in Guinea-Conakry. Please pray for their protection and for the control of this horrible epidemic. I will stay an additional day in the Asheville area after the PFR conference to meet with a team from ABWE (Association of Baptist for World Evangelism). After years of deliberation, they have finally decided to begin a PAACS program in Togo. It will take two to three years of preparation and this is a meeting to get things off on the right foot. Praise and Prayers: Please pray for my mother’s health. I am having conversations with the person likely to replace me. Please pray for wisdom and the ability to make the transition well. Pray for wisdom as we continue to address the issues of PAACS in several locations.
Resting in His arms,
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 22 Friday, October 31, 2014
The SteffeScope
Dear Friends and Family: We have finally been given permission to announce something we first learned in early August – we are going to be grandparents for the first time! Michelle, Bruce’s daughter, and her husband, Joey Aucoin, are expecting a boy the end of March. Michelle announced it to me with a very unique gift and later sent the announcement. The weekend after my birthday (my 39th if I calculate properly), I spent the weekend at the Prescription for Renewal Conference at The Cove in Asheville, NC. For the first time in a long time, Micky was not able to attend because of Sean’s schooling, but it was still a good three days. I did a lot of networking for PAACS, renewed old acquaintances and enjoyed hearing Rev. Ervin Lutzer of Moody Church expound upon the Bible. Dr. Kent Brantly was also there and it was very interesting to hear the inside story of his hair- raising experience with Ebola. Immediately after PFR was over, I went to Northpoint Baptist Church in Weaverville and was able to address the congregation for a few minutes during the Sunday morning service. They are the second of the two churches that faithfully support us and our old friend, Rev. Johnny Byrd, is the pastor there. I enjoyed the day and evening with the Byrd family and with the church members. The next morning, the church hosted a small meeting of ABWE missionaries (Bob Cropsey, Tom Kendall, Michael Gayle and Tim Dykema) who met there with me to discuss the development of a PAACS program in Togo. It will take 3 years or so to get it ready to open, but it was a blessed time of fellowship and the Spirit was present and active, I believe. Yesterday, I spent much of the day with the woman who is proposed as the new Executive Director of PAACS. I then spoke in the evening at the White Coat Ceremony of Methodist University for the class of 215. They seemed very pleased to have me involved and already the legend of the Steffes years has begun – you can see the phrase “the last hard class” on the shirt that they had made. The handwritten notes of thank-you were very meaningful to me. They actually seemed to have a glimmer understand why I pushed them so hard. This has been one of the most beautiful Octobers in November that I remember. Classic beautiful fall weather. What a blessing! Because I am no longer teaching or practicing medicine, it is the first fall I have truly enjoyed in a very long time. This past month, I have spent time getting ready for a busy November. We are attending the Global Health Missions Conference in Louisville again, leaving Wednesday, November 5 and returning late on the 8th. Micky is going with me this time because her parents will come to watch Sean (one of Sean’s highlights for the year!). I am also traveling to NYC and Connecticut to participate and learn from MedSend fund-raising events November 17 – 19. We also have the PAACS annual business meeting in
Listening to the Heartbeat of our Ministry Volume 17, Number 22 Friday, October 31, 2014
Chicago on November 21 and 22. My mother is visiting from November 11 – 29 and will spend time with us and my sister’s family in Wake Forest. I fly to Tanzania for 8 days, leaving on Thanksgiving, so we will have an earlier Thanksgiving celebration with my mother and my sister’s family. Sean has enjoyed school this fall and relishes his new-found notoriety as one of the smarter kids in the class. He recently had an assignment to stay away from technology (“anything with a cord”) for three days – and found it much harder than he expected. Micky has played travel agent this month for the PAACS residents who are getting tickets for their exams in Tanzania in early December and for the Basic Science conference in Nairobi in late January. The Ebola crisis adds some uncertainly to everything. She remains busy in her volunteer role of book-keeper for both PAACS and CMDA-CMDE. I also played travel agent for my family and myself – the trip to Tanzania to participate in the COSECSA (College of Surgery of East, Central and Southern Africa) oral exam, the Basic Science conference in Nairobi in January and the CMDA-CMDE conference again in Thailand in late February. I am also tacking on a quick one week trip to visit the Christian Memorial Hospital and Steve Kelley in Malumghat Bangladesh after that Thailand conference. Micky and Sen will head home directly from Thailand. Part of the preparation for travel this month included the application for a new passport for Sean. This will be his 4th passport – by age 13. The rest of the month has been a little more prosaic. I spent over 110 hours writing 565 exam questions for our PAACS annual exam and have a few hundred left to go. I also have begun working on the new 300 MCQ basic science entrance exam for PAACS. The latter is on anatomy, physiology and pathology so I will be able to recycle many of the questions I have already from my courses at Methodist University. I also taught Advanced Trauma Life Support this month at Eastern Carolina University and so Carl Haisch, a transplant surgeon at ECU and good friend who is the chairman of the PAACS academic committee, and I were able to allocate the job of question-writing from the new textbook of surgery and to settle the new blueprint for the 2015 PAACS annual exam. That took several hours to accomplish and it is good to have that task done – now to await the submission of the 1600+ questions. We have over 50 surgeons who are writing questions in their various areas of expertise (or who are kind enough to slog through chapters that are NOT their areas of main interest). If any of you are interested, I have posted the Christian Doctors’ Digest interview of me by Dave Stevens. It is an update on PAACS. It is available on the Resource page of the PAACS website (http://paacs.net/involved/paacs-resources/). You might enjoy listening if you have an extra 23 minutes. Christian Doctors’ Digest is a monthly audio magazine produced by the Christian Medical and Dental Associations.
Praise and Prayers: Please pray for some health issues. Pray for the continued transition at the PAACS. Pray for us as we both continue to serve hard in both PAACS and CMDA-CMDE.
Yours and His, for the peoples of Africa.
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 23 Sunday, November 23, 2014
The SteffeScope
Dear Friends and Family: The month of November has been very eventful so far and the month is far from over. November 5th, Micky, Terry McLamb (the PAACS administrator) and I drove the ten hours to Louisville Kentucky to participate in yet another wonderful Global Missions Health Conference held at the Southeastern Christian Church. It was the biggest conference yet with over 2800 people attending – all with a focus on medical missions. I spoke once, participated in one panel and spent most of the time talking to interested people. On Friday evening, we held a supper-hour get-together and three program directors (Joe Starke – Galmi; Russ White – Tenwek and Dave Thompson – Egypt) shared their hearts with the 100 attendees. On Saturday, the last plenary session also featured Dave Thompson as the speaker. The Ebola epidemic was on everyone’s lips at the conference. I talked to Rick Sacra (from Liberia) and saw Kent Brantly several times across the room. Debbie Eisenhut, a general surgeon from ELWA in Liberia, talked with Kent Brantly about their shared experience with Kent’s illness and she also presented a breakout session that I attended. It is such an ongoing tragedy. That tragedy struck even closer to home when I got an unexpected e-mail on the morning of November 11 – one of our own PAACS family had the disease. Martin Salia, a trainee at PAACS-Banso in northwestern Cameroon from 2004-2008, has been back in his native Sierra Leone since 2010. I think that most of you are aware of his transfer to Nebraska and his subsequent death on the 18th. He was much more critically ill than the others who came back and how much of that was due to lack of appropriate and timely treatment and how much is just individual variance in a disease which does, after all, kill the majority of its victims is unknown to me. How tragic it was on both a personal and national level – he was only one of a handful of surgeons taking care of his countrymen. I was not really prepared for the calls from Associated Press, Washington Post, Wall Street Journal, CNN, BBC and the local press and TV stations. However, I soon got into the swing of it and tried to give a uniform message. Despite their superficial search for a sound bite, I tried my best to emphasize two things – first, the kind of hero that he was for going back into that situation when he didn’t have to and secondly, the fact that there was a much greater tragedy that was getting no press. Not sure I was particularly successful even though I suggested that they do a feature on the greater calamity. I wrote on Facebook on the PAACS page, “Martin Salia's death is a tragedy in the face of the greater tragedy of Ebola. But it serves to point out the even greater tragedy - that nearly one billion people in Africa do not have basic medical care or surgery and that the people of the developed nations are not helping the developing nations to have what many would consider a basic right - freedom from pain, fear and death through good medical care. There is no simple answer. It is a long-term commitment to train and help every level, increasing competency while not creating dependency. PAACS is trying to do just that - on a painfully small budget in painfully underdeveloped hospitals with painfully few people. But it works. Martin Salia is just one of dozens of men and women just like him that are PAACS surgeons. And while we grieve, we hold up our head and praise God for those surgeons.” If you would like to help the Salias with their unexpected bills, you can donated to a special fund that the United Methodist Church has established: https://gp-reg.brtapp.com/drsalia
Listening to the Heartbeat of our Ministry Volume 17, Number 23 Sunday, November 23, 2014
On November 21 and 22, the PAACS semi-annual meeting was held at a motel near O’Hare airport in Chicago. I am not yet permitted to announce the replacement for me but I was glad it was unanimous. I only pray that we have chosen wisely. As of January 2, 2015, I will step down as Executive Director and assume the newly created position of Chief Medical Officer. Preliminary plans are that the new ED will concentrate primarily on the US side of things and I on the African side of things. I was deeply touched when my 9 years of volunteer service in the role of leadership was recognized by the PAACS Commission on Friday night. I received a handsome logo-bearing plaque which read, “Presented to Dr. Bruce Steffes in appreciation of your faithful service and dedication of the Pan-African Academy of Christian Surgeons (Executive Director 2006-2014)” and received a standing ovation. They also have arranged for a get- away weekend in the NC mountains sometime in the future for Micky, Sean and me. And yes, I was very emotional about it. I am very thankful that God has given me great peace about the change despite the uncertainties and I look forward to working with an expanded team to finally accomplish some things that have been on the back burner for a long time. I am also glad that I can continue to work closely with the missionaries and trainees which is where the hearts and passion for Micky and me have long been centered. I will still need your prayers because although I have peace, it will still not be easy to give up the reins and have the patience to assist in new ways of doing things and in training my replacements in both roles. Pray for both them and me. I did write a multipage document that summarized what I have done the last 9 years. I fully recognize that they were not my doings but the results of the wonderful team of dedicated people with whom I have had the honor to work. Rejoice with me about what the Lord has done! 2005 Nov. 2014 Number of PAACS training sites 2 11 Sites wanting to join 2 3 Number of PAACS residents 9 64 (as of January) Number of PAACS graduates 3 43 (as of January) Number of approved faculty 2 54 (as of November) Number of Commission members 12 19 Advisory Council No Yes (17 members) Task Forces 0 6 Short-term volunteer faculty 8 171 (2013-2014) Budget $37 K (given) $1.33 M
We look forward to our early family Thanksgiving today and ask for prayer as I fly to Tanzania on Thanksgiving Day. I will be participating in administration of the COSECSA oral exams in Dar es Salaam. We hope that you have a blessed holiday with your family and that your hearts are truly thankful for all God has blessed you with. We are deeply thankful for each of you and for your support of our ministry through the years. May God richly bless you. Yours and His – thankfully!
Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry Volume 17, Number 24 Wednesday, December 10, 2014
The SteffeScope
Dear Friends and Family: I hope you had a blessed Thanksgiving and wish you a very Merry Christmas. We had a blessed family reunion with 12 around the table the Sunday before. The picture to the left is my mother, Ardith, with her grand- children who attended.
PAACS’ new Executive Director: My replacement as Executive Director has been formally announced. Ms. Susan Koshy was born in India and moved to the Midwest as a young child. She has over 20 years of experience in the non-profit sector working with physicians and surgeons. She directed and managed two national specialty orthopaedic associations, the Ruth Jackson Orthopaedic Society and the J. Robert Gladden Orthopaedic Society, helping re-organize and strengthen these societies. She also developed the state organizational and legislative programs for the American Academy of Orthopaedic Surgeons and the American Academy of Dermatology. Susan has a law degree from the University of Iowa and a Masters in Public Health with an emphasis in health policy and management from the University of Illinois at Chicago. She is currently going through the Kellogg Executive Scholars program for non-profit management at Northwestern University. She will begin service January 2. Please keep her in your prayers. I know better than most how much she will need them I have served as a volunteer in the role of Executive Director for 9 years since 2006 and served on the Commission prior to that since November, 2003. During those 9 years at the helm of PAACS, there has been significant growth: the number of training sites has gone from 2 to 11, the number of trainees from 9 to 64, the number of graduates from 3 to 43, the number of approved faculty members from 2 to 54 and the number of short-term faculty from 8 to 171. The budget went from $37k to $1.33M (for the 2014-2015 year). After yielding the role of Executive Director to Koshy, I will become the Chief Medical Officer of PAACS and put my emphasis on the academic and programmatic side of PAACS.
Trip to Tanzania: I left on Thanksgiving Day to attend the 15th COSECSA-ASEA Annual General Meeting and Scientific Conference. It was also the 6th COSECSA graduation ceremony. A record number of trainees sat the exams. Sunday was a very long day of examiner education, then Monday even longer as we examined the 77 junior residents. Tuesday was the examination day for the senior residents. They were fewer in number and we were done much sooner. The heat and humidity was miserable – fans were in short supply and the few times we had air-conditioning, it couldn’t keep up. Monday evening, twenty-seven faculty members and trainees came together to celebrate PAACS and to celebrate with those who passed. A few did not pass and that always puts a damper on things. Our overall pass rate was 62% (8/13) compared to 67% overall passage rate. The next morning, 5/7 residents passed (71%) and both attending surgeons passed (100% with a total of 77.8% overall for PAACS). The overall passage rate was Bruce & Francis Kaikumba, CEO COSECSA also 14/18 (77.8%). Of special Interest: Daniel Gidabo from Soddo
Listening to the Heartbeat of our Ministry Volume 17, Number 24 Wednesday, December 10, 2014 was the first FCS General Surgery recipient in Ethiopia. We had already graduated the first pediatric surgical FCS in Ethiopia. Looking on the bright site, I shall brag a bit on others. For the past three years, PAACS has won 3 of the 4 prizes for which its residents were allowed to compete. It certain helped bring our spirits up. There were rumored suggestions that we might allow others to win – I choose to ignore them and wish success to next year’s candidates. The conference was a good time of networking and God allowed me to accomplish a great deal. It was fun to see the residents and program directors as well as long-standing friends of the PAACS and me. However, I certainly was glad to get home late Friday night as well. I will be even happier when the jet-lag goes away!
Monday, December 8, I got back on the plane and flew to Washington DC to participate in the memorial for Martin Salia, our PAACS graduate who recently died of Ebola. It was held at the Georgetown University and I gave a short eulogy. It was good to give our condolences directly to Mrs. Salia and the boys. I flew back the same day.
Today (Wednesday), I was again in the airport and flew to Michigan to visit with my mother for a week and will once again visit Worldwide Lab Improvements in Kalamazoo on Friday. I have lots of computer work to keep me busy while there – and I am sure that Mom has a list of honey-do things.
End of the year appeal: Long-term readers of this letter know that we don’t do much (or even “enough”) in terms of aggressive fund-raising. We are deeply appreciative of the two churches and two dozen individuals who regularly give to our ministry. Our funds are at a very low level. We have used your gifts wisely. As you know, we have set up the instrument repair lab to fix old instruments and in addition, this year we purchased several trays of new instruments at $2400 each. This is a great blessing for those who receive them. We have also purchased two rigid sigmoidoscopies and they have been distributed to hospitals who did not have any. We continue to support medical missionaries and their special projects as we can. Just this weekend, we have now received a new request for support of a new Hospital Radio project at the Hospital Loma de Luz in Balfate Colón, Honduras (www.crstone.org). They want a PA system for the hospital and are looking at the idea of a true hospital radio for the surround areas. We do not have the funds to meet their requests. Would you please consider giving what you can as a year-end gift after you have given to your own church? Please send a check made out to S3Ministries, PO Box 300, Linden, NC 28356.
Prayers and Praise: Praise for the safe trip to Africa and the two trips within the US Prayers for Ms. Koshy and the new administrative team she will put together. Please pray that I will find a role within this team in which I can be effective and joyous. Praise God for Micky’s father good experience with hip replacement. Pray for his continued recovery. Pray for Sean and Micky as we finish up this school semester and prepare for next year’s home schooling. Pray for sufficient giving to S3 Ministries so we can do as God has led us. Bruce, Micky and Sean
Listening to the Heartbeat of our Ministry