Refugee Camps

Hi everyone,

I was planning on posting about my trip to the refugee camps since Sabbath morning, but haven’t gotten the chance.  Sorry for the delay.

Before I get into that, I’ll give a quick rundown of other events. 

I got back to Moundou on Thursday.  The shipping container is now completely emptied, but some organizing still needs to be done.  I was able to do physical therapy on Thursday.  The trip worked out well that way.  Even though it was Monday-Thursday, I was able to do PT Monday morning and Thursday afternoon so I really only missed 2 days of PT.  I think I’m starting to somewhat get the hang of the PT here.  Praise God!  I know I couldn’t get the hang of anything here on my own.  He’s just carrying me through.  This week I will be able to do PT every day, Sunday through Friday, so pray for Bekki, Patricia, and I.  I will have a post about PT at the end of this week (hopefully).

We went up to Bere on Sabbath to see one of the other Adventist hospitals in Chad (We are 1 of 3).  Bere is much more rural than Moundou, but the hospital is much bigger.  They have more buildings, more staff (foreign and local), and do just about everything.  They are the only hospital in Bere.  There is a government hospital in Moundou and multiple private practices, so there’s no need for us to duplicate services that are already provided.  The drive was really nice and beautiful, about half paved and half dirt road.  We came at a great time of year, because the southern half of the country is all green.  The road was very wet.  One section is completely submerged in water for over 100 yards probably.  I was told that the road has like a 30 degree slope on the edges, so if you accidently go off the road it is easy to get in trouble quick.  We still drove through it.  I talked to God, saying “you walked on water, I know you can bring us safely to the other side,” and praise the Lord, we made it!

Now for the story of the refugee camps…

This was not something that was planned for my trip here, but God opens doors we don’t expect. 

The day after we arrived I met James and Casilda.  They both are volunteers for an aid organization for Chad.  From what I gathered, they are basically one of the many organizations sub-contracted by the UN to take care of the refugee camps.  They are very passionate about what they do, and it is a blessing to be able to see them work like they do for those less fortunate.  It’s also interesting to actually see in action all these things we just hear about in America.  Interesting in good and bad ways.  I say good, because it makes you appreciate what you have and gives you a cultural experience that most Americans never get.  I say bad, because you see all the more that could be done.  There are a lot of resources in place for the refugee camps, but unless people like James and Casilda go there to make it happen they often just stay stagnant and don’t get to the refugees.  James described it like a machine with all the parts available and even in the right place, but you have to push every part of it to make it move and do what it’s designed to do.

The opportunity was presented to me to go to the camps on Friday.  We were sitting at the Gardner’s table when James asked me.  I was a bit surprised, so I wasn’t sure what to think at first.  I said that it was up to Bekki.  I came here specifically to help her and I didn’t want to up and leave without her being ok with it.  She told me that I should go if I wanted to.  I would have preferred to ask Jolene privately what her thoughts were, but she was right there when it suddenly came up so I asked her about it too.  She also told me to go if I wanted to.  She’s such a wonderful wife.  Not only would I be gone for 4 days, but 1 of those days would be our 1 year anniversary.    We still saw each other the morning of our anniversary and exchanged gifts/cards.  James and I agreed that he would call again on Sunday to check, but that we could tentatively plan on me going.

Monday we left, about 9:00 AM Chadian time.  And by 9:00 AM Chadian time, I mean 12:30 PM.  As I said, it was a blessing in disguise because I was able to organize Bekki’s PT stuff and also do PT that morning.  I went down with James and Casilda, along with Madeline and Tourral from the local Handicap Center.  The Handicap Center is a wonderful resource for the Chadians here.  It is a Catholic organization.  It is a blessing to be able to be here and see all the skilled workers God had planted in these places of need.  Madeline is a physical therapist and Tourral is a PTA/mechanic of sorts.  He makes the tricycles (see picture below), crutches, braces, etc.

We visited 3 camps: Gonje, Dosseye, and Amboko.  There are about 44,000 refugees in all 3 camps.  Dosseye is the biggest, with about 20,000.  Most of the refugees are from the Central African Republic and came in 2003 or 2007. It really opened my eyes to what these camps are.  I guess I always thought of refugee camps as things that are set up for short emergencies and then dissolved.  There’s no sign that the refugees will leave the camps any time.  When they first arrive they are housed in these large plastic type tents.  Most of them will eventually build their own houses.  Except for the security when you enter the camps look pretty much like any other Chadian village.  Amboko was the only camp where I actually saw any UN housing.  Dosseye has a market right in the middle and people’s houses around it.

The first day we drove straight to Gonje and hit the ground running.  The second day was Dosseye, and the third day we visited Amboko.  James and Casilda did all the initial consults before the trip to determine who would be seen.  They started with children and worked up, so most of the people we saw were at least under 30.  Madeline and Tourral really did the Lion’s share of the medical work.  I feel like I wasn’t doing much of anything a lot of the time, but James and Casilda still seemed to genuinely appreciate me being there.  Madeline and Tourral are quite amazing, doing about 10 evaluations per hour.  A lot of the refugees just needed simple equipment.  They did a lot of leg length measurements for adaptive shoes and crutches.  Some of the refugees will be able to have an arm tricycle made for them.  It was determined that others needed to be seen by the camps’ physician.  1 physician for 44,000 people (but according to Dr. Gardner that’s better than the ratio for Chad as whole).  A few others were referred to somewhere else, like the Adventist Center in Moundou or government hospital.  A lot of these cases really should have been taken care of a long time ago, especially since they often developed and lived with their conditions completely in the refugee camps while under the jurisdiction of the UN.  James asked me to write a letter talking about the trip, the success, the condition of the refugees, and the need of follow-up care.  Just being foreign gives you more credentials in the camps.  James actually asked me to put my scrubs right away when we arrived at the third camp.  If there’s a white guy in scrubs people assume he’s important and things will get done quicker.

Here are a few stories from the camps.  We actually saw one woman with leprosy (no longer active), but the ends of all her fingers were gone.  Her right leg ended mid-tibia and her left leg mid-femur.  She had sores on her right leg from dragging herself along the ground.  She will have her right leg amputated mid-femur, and she will either get a new tricycle or get an old one fixed (I’m not sure).  We saw 2 children with tuberculosis that was really progressed.  Their rib cages and spines were protruding.  Unfortunately there’s not much that can be done in Chad at this point.  This is one of the particularly upsetting cases, because if they had been getting the proper check-ups it could have been treated earlier.  One child had the early signs of tuberculosis and will be going to the camp physician to begin treatment.  Praise the Lord!  There are a surprising number of refugees with severe knee flexion contractures.  They’ve been like that for years and there’s really nothing that can be done to change it now.  So, they either get around on their tricycles or crawl on their hands and knees.  This problem isn’t only in the refugee camps.  I’ve seen a couple Chadians getting around like this outside the camp, and seemed to be traveling quite a long distance like that (longer than most Americans are comfortable walking with 2 good legs).  We were shocked from one child that looked like he was maybe 3-4 years old, but was actually 7 (this was confirmed by his teeth).  Also, his name was Papa Noel J. 

I evaluated 2 children with hydrocephalus.  Finally, a diagnosis I am actually familiar with.  The first child was quite delayed.  From his mother’s report the hydrocephalus has been continuing to progress.  I wrote a quick note for their resettlement.  Resettlement is where they can get moved to another country like the US or Canada.  Each country has a yearly quota for how many refugees and immigrants they take from different countries.  A child with health problems like this that can’t be treated in Chad, are candidates to resettle so that they can get appropriate medical treatment.  Unfortunately, we found out after that they already had a resettlement case and the mother didn’t want to leave.  It’s odd for us to think of her choosing not to when it means her child will probably die.  But, I had to keep in mind that these people have already been forced out of their first home and it’s reasonable that they have a strong desire to not have anything remotely similar to that happen again.  There’s also a different mindset with death here.  It’s just such a common-place thing.  If you ask someone how many kids they have a normal response would be something like, “6 living.” 

I’m not sure what will happen to the second child with hydrocephalus.  I did the evaluation and now it is in James’ hands.  I told him that I could do resettlement paperwork if needed.  This child’s hydrocephalus is not has severe, but he has other complications too.  He was not as delayed in regards to their motor skills.  I’m not sure how he is cognitively, but he’s 2 and he can say a few words.  Also, he was cognitively aware enough to notice that we were white and to cry in response.  We went into the village area to see him and we were probably the first white people he’s ever seen.  The trouble with him was that on top of his hydrocephalus, he gets sick almost every couple of weeks, and has some type of surgery on his abdomen that hasn’t quite held.  It seems like probably an umbilical hernia.  If you’re reading this please pray for this child.

Before I close I must mention how wonderful the cultural experience was.  I actually went out at night, walked along the water, and watched the sunset.  I was able to walk right into the refugee village and their market.  I was called ‘nasara.’  It is kind of a deragoratory term, but kids tend to use it innocently and just mean ‘white person’.  I believe it means something like ‘protector’ or ‘powerful,’ and comes from European imperialism.  At night we would walk around town and eat at the street vendors.  I even watched a couple locals slingshot and kill some type of reptile from the water (looked like a really small alligator).  In the camps I actually got to play soccer with some young boys.  They were much better than me.

This trip was not expected, but it was a huge blessing.  I hope that even if just for a few refugees I was able to provide a little help.  It gave me a much more real understanding of how many people live.  More than I could even get living in the compound in Moundou for a few weeks.  Despite that, I was really happy to return to the Moundou clinic.  It feels more like a Chadian home because of the people here that I actually know and care about.

Please everyone keep the refugees in your prayers.

                                                            

                                         Boys at Dosseye playing on someone's arm tricycle

                                                Madeline and Tourral with a boy at Gonje

 

 Young boy with hydrocephalus sleeping on his mother after the evaluation

Sunset in Gore