A 73 year-old man comes with sorethroat, difficulty swallowing, fever and dehydration. WBC 21K. Neck tender to palpation but oropharynx only slightly erythematous.

Left peritonsillar abscess!!

Most peritonsillar abscesses occur in the age group 20-40 years BUT DON'T BE FOOLED. MOST THINGS CAN HAPPEN IN ANY AGE GROUP!



If you have surgical supplies or contacts with supplies, let me know. We have the manpower, but always need supplies-suture, laps, staplers etc. Opened or expired are alright, as we can reprocess them. Non-disposable supplies are needed as well, such as electrocautery units, suction units, etc.



The Nigerian Christian Hospital (NCH) was founded in 1964 by Dr. Henry Farrar. For decades it has delivered great health care to Nigerians in Southern Nigeria, near Aba. Financially, the hospital largely survived on locally generated revenue from patient care, as well as supplements from the mother institution in the USA-the International Healthcare Foundation..  Revenues were assisted greatly by missionary teams, mostly surgical, that came about three times per year and performed many surgeries. In 1998, I became one of these "regular" teams, coming 21 times since.  From sometime around 2000, I noticed that the attitudes of employees deteriorated and the hospital entered the doldroms. Mismanagement, corruption, nepotism, indifference and greed lead to a unhealthy financial situation which continued up until 2008,  at which time the Perfect Storm hit. 

In 2008, the roads leading to the hospital were in the worst repair ever, preventing patients from coming to the hospital. In March, the resident physician missionary, who was in residence for over 2 decades,  was kidnapped and shot. He survived but left the hospital. A series of kidnappings overwhelmed the area in the following months. These kidnappings had significant repercussions, the most notable being that all expatriate missionary teams except my own, stopped coming to NCH. My own teams consisted of Nigerian physicians and, we not only continued,  but increased our presence. In 2009 we made two trips, in 2010 we made 4 trips and in 2011 we made 3 trips. I don't believe that we were unusualy brave-we just loved what we were doing. Even as the kidnappings continued, more problems were coming. In January, 2009, Dr. Farrar died-a terrible blow for the hospital and everyone who knew him. 

The financial situation continued to worsened, and interest waned in the USA. Many felt that the hospital could not continue. I was not one of them. I pushed for drastic action. Finally, the International Healthcare Foundation decided to move.  Through a  brilliant decision or divine intervention, Dr. Kelechi Eguzo, a young NCH physician, was appointed the new administrator. Kelechi has a business and medical backround and, through sheer energy, revived the hospital. CPR included a housecleaning of the deadweight, including most of the management, as well as a many workers.

It is now about one year since Kelechi has taken charge and the hospital is on the road to recovery.



The trip is over-for now. We did 160 surgeries in 20 days. We are exhausted. It is time to return to our families.



Thursday the big rush began. First a woman arrived with a terrible breast cancer. Amazingly, she did not have enlarged axillary lymph nodes. We started her on chemotherapy.

Next we saw a very strange problem. An adult patient came with ambiguous genitalia. She was in fact a woman! She has a small vagina (about 1 cm diameter) and menstruates but has a large penile looking clitoris. Genetically she is female. We don't know the etiology of the ambiguity. 

The next patient also had a genital problem. This patient underwent female circumcision (? mutilation) and developed a postoperative clitoral cyst. We excised this without difficulty.
Starting at 8AM, we began a marathon of surgery for 16 hours including, 2 parotidectomies, 1 parotidectomy with radical neck dissection,  1 c-section/hysterectomy, 2 goiters, 1 incarcerated hernia, 1 facial neurofibromotosis, 1 lipoma, excision of anal warts, 1 maxillectomy and 2 neck biopsies. 
Maxillary tumor


Parotid tumor requiring radical neck dissection

Facial Neurofibroma

Finally, children arrived from Susann Holmes Orphanage to present me with gifts! They brought eggs, pineapples and a homemade placard. I was very touched



We are making progress. As of the close of business 1/31/12, we have done 138 surgeries. Another 150 million surgeries and we are done. In the last 2 days we have done 3 hernias, 2 goiters, a giant intramuscular lipoma of the arm, a TAHBSO, an strangulated hernia with dead bowel, a cholecystectomy for carcinoma, a resection of ovarian tumors in a young girl, 2 biopsies, a giant ganglion of the wrist and more. The trip is coming to an end soon and patients are getting nervous they won't get their surgery.


Don is here. He is a USAF jet engine mechanic. a pilot, licensed electrician, certified heat and air technician and many more things. And, of course, he is a missionary. He has been at NCH 12 times. He repairs anything that is broken and loves to scrub on surgeries. We are glad for how assistance.