A Call to Compassion

I complained I had no shoes, until I met a man who had no feet.

Last Friday was a really bad day. After a month of slow collections, Friday was full of problems: workers' comp issues, professional relationship squabbles and noncompliant, complaining patients. Then I went home to take care of an 84-year-old Alzheimer's mother that night. Could my day go much worse? Somehow, I managed to muddle through it.

Sunday came, and it was announced that one of our church members, Karen Asher, DO, and her husband, Tom Asher, DO, were home from setting up shop in a remote bush hospital in war-torn Sierra Leone, West Africa. They would be speaking at 6 p.m. that night. Well, the Pistons were playing the 76ers at 7 p.m., and did I really want to sit through another church service? Trying to be a good example for my kids (and knowing I would still be able to get home for the second half of the game), we went to church.

It started out typical enough - stories about missed planes, companions lost, yadda, yadda, yadda. Nothing a traveler through Chicago or Atlanta hasn't experienced. When the story got to the customs experience, it began to change. Every bag going through customs was being systematically torn apart and gone through. Karen reported their bags were packed tighter than a Chinese puzzle box and she didn't know how they would get them back together. However, news of their arrival had preceded them. When the customs agent saw them, he asked if they were the doctors coming to work in the bush hospital. When he heard the answer, he said, "Doctors, whatever you're bringing with you is fine with us," and waved them through.

When they arrived at the hospital, culture shock, death and disease greeted them. A baby died of malaria that night, the first baby they had lost under their care in 20 years. The hospital operates, for the most part, without electricity, because there are only funds to run the generator four hours a day, and it costs $100 in fuel for those four hours. Welcome to Africa.

The stories continued: a child whose face and foot were torn up by a monkey; a man with tetanus carried for eight to 10 hours in terrible pain and spasms. He got a shot of valium to relieve some of his pain and died peacefully, while his weeping widow thanked the Ashers for easing his pain during his last hours (not threatening to sue, as would be the case here in the U.S.).

In our country, there is a 7.5 maternal mortality rate per 100,000 births. In Sierra Leone, it's 270 per 100,000. Prenatal care is nonexistent for the most part. The women of that region are short and have small pelvic openings, but have large babies. This leads to many problem deliveries. In the bush, when a pregnant woman in labor is finally determined to be in trouble, she is carried 12 hours to the nearest hospital. Naturally, many women die.

People then wonder if the hospital is killing babies and mothers deliberately, generating a grave distrust. To overcome this, the doctors devised a simple chart of height and belly circumference given to the local "midwife" (this is a generous title, since it's usually local women who have no training). Using the chart, along with a bag of rice as payment, the midwife measures the women and sends in those who are either too small or too big. Those outside the normal range are at high risk. For example, those who are too small might have a small baby and those too big might be carrying twins.

The second night, a pregnant woman was sent in after an aid station measured her as too small and could not detect a fetal heartbeat. Also hearing no heartbeat, Karen opted to do an ultrasound with a new battery-operated unit and detected a faint but diminishing heat rate. An emergency C-section brought forth a limp baby, not breathing, whom they finally saved. The mother named him Lazarus, since he had come back from the dead. The next lady tested had twins that were facing each other, with one breech and its chin hooked under the other baby's chin. Apparently, the ultrasound is a very useful device; Karen later said that with it, she saw her first worms in the liver.

Sierra Leone recently was torn apart by civil war. A rebel army ravaged the area, with many child soldiers as young as 11 or 12 brutally hacking people to death with machetes and raping, shooting and pillaging. Entire villages were wiped out. Through this horror, the hospital stayed open, treating all who came in, including the rebels. The scars remain.

The country is desperately poor. Famine is a real prospect. The people work all day just to buy enough rice for that day. Watching Karen break down and cry while viewing a picture of three small boys cleaning up her plate of leftovers she was too hot to eat brought tears to my eyes at the suffering of these little ones. Yet, somehow, there is true magic there. She said if you close your eyes and count to 10 while holding up a soccer ball, 50 children will appear from nowhere and begin playing.

You may ask, what has this got to do with me? What has this got to do with chiropractic? At the beginning of this article, I quoted a saying my Depression-era, WWII-generation father used to tell me when I would bemoan the severity of my sheltered, teenage life. It's fine for us here, in our abundance, to contemplate whether to join a PPO or an HMO, the amount of Medicare reimbursement we are going to get and even the types of shoes we are going to wear, but Karen's patients (some literally) have no feet to stand on. Sierra Leone is desperately in need of doctors of all types. Tropical diseases we have studied but have never seen are a daily fact of life there. Malaria, sleeping sickness, dengue fever, tetanus, malnutrition, parasites and any other disease you can think of, thrives there. AIDS is decimating the entire region.

They have a medical college to train the native people. They will start with a class of 80 but only graduate seven to 10. Why so low? Not for lack of will or intelligence, but lack of supplies. They might have one anatomy text for 40 students. If you have texts that have been unopened for years, these books literally can save lives. If you have an extra Gray's Anatomy, orthopedic texts, optometry books - all of them will help immensely. I plan on going through my old texts and donating them. As Dr. Asher told me, "Anatomy does not change." For the cost of book-rate postage, your old text can make a world of difference half a world away. If you get them to me, the mission will get them to Africa. Before you send them, please e-mail me with the titles and I will let you know which ones would help the most and will give you further instructions. Wouldn't it be nice if they had an entire reference library and textbooks supplied by their chiropractic colleagues?

Also, for those of you who would like to make a difference, I am sure Karen and Tom Asher could put you to work for a short-term mission. Can chiropractic make a difference in Africa? Of course! I am sure much suffering could be alleviated by our care. Your life will never be the same. Karen and Tom are finding out what it means to be a doctor. They are family-practice physicians who are now in the role of surgeon, OBGYN, orthopedist, internist and even dentist. They are good, sincere doctors who have left everything, giving up a comfortable life and practice, leaving family, friends and their own culture, trying desperately to make a difference. Can we as a profession help out another colleague?

Knowledge is power; ignorance is death, disease, famine and suffering. So much we take for granted is unknown to these people. What could be done teaching simple hygiene? How many of us came from farming and construction backgrounds? The knowledge you have that might seem useless to you now can save lives elsewhere. Seeing the genuine smiles of a people so poor and destitute, grateful for even a gentle touch, makes one realize we really have nothing in comparison to complain about.

Any help would be greatly appreciated and will literally save lives. Bandages and supplies are always in short supply. My old microscope will be traveling to Africa in the next few months. If you want to give your kids something to do for someone else, take your old bed sheets, cut them in 4-inch strips and roll them tightly for bandages. They have no throw-away gauze bandages there. Cloth here is much superior, since their cloth has too much lint. Bandages with Smurfs, Mickey Mouse, Superman or other cartoon characters are prized greatly by little ones and bring smiles to tiny faces.

Already today, I have fought with workers' comp, collections are still low and I've had to deal with an unhappy patient. You know, for some reason though, today just seems to be going better than Friday.