The lady with a back injury and fevers that we were working up for malaria actually has HIV, for which she will now get treatment. I don't know the prevalence of this in surgical patients, but likely to be high. The medical ward is about 80% HIV positive. One interesting trait of the medical people I have met here is their relative lack of concern for all the things I got worried about when planning this trip. Malaria, schistosomiasis, leishmaniasis, filariasis, dengue fever, sleeping sickness, HIV, TB, meningitis, yellow fever, etc, etc are supposed to be endemic here, which could certainly make anyone from the US hesitant to come and certainly a little anxious. 

But these people exude a spirit of trust and confidence in God's provision which makes those fears evaporate. They are not foolish and do take appropriate precautions, as they are medical professionals who may treat these diseases here and witness their manifestations. Three of them that I know of have had malaria despite taking the prescribed prophylaxis in the past, so they have more intimate first hand experience also. Many of them have decided to live in places like this despite these risks. But they share the common trait of a living faith that manifests itself in their willingness and enthusiasm to come to areas of the world where no one else wants to go, treat people that no one wants to touch, and maintain a peace of mind and spirit derived from a true knowledge of the goodness of Christ. They are the hands of God.

Went to church at Mbingo Baptist Church today. Great message, focusing on the promise for suffering and not luxury in the Christian life here on earth, with the reward of an eternity with our Lord that will wipe away the pain we now experience. He really came down hard on the false teaching of prosperity gospel, noting that the poor people suffering in our hospital were not there because of their sin or lack of faith, but because we live in a fallen world. It reminded me a lot of the sermons our pastor in Birmingham often preaches, except that this service was a little longer - 3 1/2 hours! 

Rounded on our patients and did my best to get them the treatment they need. It's been hard to figure things out here on multiple levels: language barriers (they speak French, Pidgin, English, and tribal languages), medical terminology barriers (the same meds have different names, different meds are used, and the ones I use are not available), and constantly trying to determine what level of intervention we are capable of providing without offending anyone's sensitivities. 

It's hard. Went to the theater (OR) to try to find the implants I will need for the cases scheduled for tomorrow - I think we'll be OK. More stuff I've not done before without a lot more technology - God's in charge.

Bob