The hospital in Bardai is impressive, well equipped and bizarrely, for a hospital in Africa, empty. Inside the spacious walled compound the cream and green-trimmed buildings are well laid out but there are no inpatients on most days. If you searched all the buildings, you’d find only a few hospital staff with little to do. After years of neglect, with equipment gathering dust, this shell of a hospital had few vital signs until recently - when two experienced British doctors arrived, ready to roll up their sleeves and bring it to life.
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Mark Ortman and his wife Sheryl have lived and worked in Chad for 25 years, based mostly in Bardai, a village near the Libyan border in the heart of the Sahara. This region is known as Tibesti and the Teda, a proud, free-thinking non-Arab Muslim people group, live in an area that includes southern Libya, northwestern Chad, and northeastern Niger. The Ortmans are well known here for their linguistic work putting the Teda language into writing and supporting the community in many other ways.
'Back in 2013,' Mark tells, 'the governor of the Tibesti and a friend of mine asked if I could find any missionary doctors to man the Bardai Hospital.' It was an unusual request, but missionaries to this region, have proven to be people who bring good to the community…and they stay.
The hospital was built in 2011 as part of a development effort by the president of Chad. 'It was probably the best equipped government hospital in Chad, but there were basically no staff to run it,' Mark explains. Government doctors assigned here found reasons either not to come or not to stay. 'Missionary doctors were known to be interested in the welfare of the people they were treating and to be in it for the long-term.'
Three years later, British doctors with BMS World Mission, Andrea Hotchkins, an Obstetrician and Gynaecologist, and her husband Mark, a surgeon, found themselves looking for a new assignment after six years managing the private and highly respected hospital of Guinebor 2 on the outskirts of Chad’s capital, N’Djamena.
The Hotchkin’s began by looking at Goz Beïda hospital which served refugees on the eastern border. Mark Ortman told the Hotchkins about Bardai Hospital, and MAF pilot Phil Henderson, who knew first-hand the needs in the far northwest, quickly and enthusiastically organised a flight. In April of 2016, they made a visit to each hospital. Helen, a Swiss midwife and colleague joined them for the tour of the facility in Bardai.
'The hospital in Goz Beïda is very, very busy,' Andrea observed. 'This one in Bardai is very, very quiet. We could see a lot of potential.'
The Hotchkins went home to the UK unsure what to do. While visiting supporting churches, they decided to present both options, asking for prayer about the decision. 'We thought we were presenting them completely equally and fairly, but everybody, everybody said we should go to Bardai,' Andrea says. In February 2017 they moved to the Sahara.
Starting from Near-Zero
For the first five months, the doctors began with an important, non-medical task: learning the Teda language, a daunting endeavor but one that will pay off in building relationships both on the job and among the community. During this time they set aside one day a week to work at the hospital.
There is so much equipment, but nobody really knows how to use it. There were two operating blocks but no one had ever operated.
The doctors were basically starting from zero despite the buildings and fancy equipment available. The job required building an empty space into one that was functional and serving patients. Much of the equipment still sat in its original packaging. One completely full room could only be entered as pieces of equipment were removed.
'It’s just amazing,' Dr. Andrea describes. 'There is so much equipment, but nobody really knows how to use it. There were two operating blocks but no one had ever operated. It was just a complete mess, so we made at least one of them functional. There are things missing. For instance, there are a number of oxygen concentrators but no tubes or things that connect it to the patient. There’s a lot like that – missing equipment to go with the equipment. You can’t always get those things in Chad so people have given us donations and we brought quite a lot of that back with us.'
In July, just before they left on a four-month trip to the UK, surgeon Mark received a patient who had been shot in the chest. 'We had to improvise the chest drain using bits of plastic tubing and a urinary drainage bag. The patient survived, thankfully, but the ideal is to have a proper drain. Now I’ve brought up two chest drain bottles.'
Following their return to Bardai in mid November 2017 in just a month and a half the doctors saw a great increase in patients: 35 inpatients, 22 surgeries, and, a recently acquired skill, 27 dental patients.
Making a Difference
When the Hotchkins first moved to Bardai in February 2017, they were excited to drive, despite some trepidation, to see what an overland trip through the Sahara would be like. It took three days at 14 hours per day, squeezed into a tight space with little legroom. At times through the mountains they could walk faster than the car could move. It was an adventure.
'Having MAF around just makes a huge difference,' Dr. Andrea explains, 'because obviously you can come up in one day. Otherwise you’ve got to travel three days minimum across the desert. It’s fun but not easy and it is dangerous. Living in quite an isolated place like this, it’s nice to know that you can have a break every five or six months but that would be more difficult if it was a land trip every time. So that’s one huge way MAF helps.'
MAF has also flown supplies for the hospital, including small equipment such as missing tubes, a steam autoclave and medicines, and will continue to help as needed.
'I believe why the Lord gave us the Hotchkins is that only people with great humility on the one hand, and on the other hand confidence in their skills and trust in the Lord's timing, could survive here,' Mark Ortman says. 'It may take three years before they are completely accepted and the Bardai Hospital is humming. But when it is, it will be drawing in people from 600-800 km to the north and as far away as Faya to the south and from all parts of the Tibesti, even those a full day's drive away. We have no doubt this will happen.'
Above all else, the Hotchkins know they are in the right place. 'We feel very strongly that God wants us to stay here,' Andrea reflects. 'Many things have happened that help us feel reassured that this is where God wants us to be. We’re quite excited.'