An Interesting visit to Southern Ethiopia.

One is interested in tribal customs. Some seem excellent, some queer, but these days we are discouraged from questioning things as everybody is considered to their opinions being as legitimate as anyone else’s. Unlike these days, in my time there were very few doctors to cover the increasing population and many of the doctors tended to stay in the bigger cities with more facilities and more money! The population were mainly rural.

The mission with which I had a close association ran several nurse clinics which were very useful but obviously limited in their capabilities. One such clinic was near the Kenyan border where the tribe had a, to us, different custom. Before a young man was permitted to get married he had, as shown in the picture, to run back and forth, naked, over 20 cattle tied transversely. By their custom boys were not circumcised as babies (the Orthodox, Muslims and some other groups are circumcised near birth or as puberty approaches). As uncircumcised penises in adulthood, unless erect, are a bit dangly and lengthy, it was their custom to be circumcised around this time. The technique was to hold the foreskin slightly stretched out over a rock and cut it off with a swift sword swipe. Not every sword wielder was accurate with some disadvantageous results.

The tribal elders came to the lady nurse who was in charge of the clinic and asked if she could arrange for someone (eventually me) to train a young Ethiopian male dresser who worked with her to perform circumcisions. It was agreed that I would come down for a couple of days and perform 40 such procedures. Interestingly there was in the area an American Army squad vaccinating goats and their young doctor asked if he could join the process and be also taught. (The dresser was the more capable student!) Very little had been prepared and I guess it was my fault as I had expected an American nurse to realize what was necessary if I wasn’t to only use a sharpened sword! So the first evening was used making sheets to be sterilized, hunting up syringes and local anaesthetics, suture material and enough tools to do the job professionally. The next morning I met the line up, had them bathe themselves and set about with a couple of demonstrations, self performed on them, teaching them to use local anaesthetics, making sure how much you wanted to remove etc. I then guided the two trainees through the process. We did the forty finishing late in the afternoon. We stopped for a lunch of ‘Injerra b wot’. When the local anaesthetic wore off I bet there were some unhappy chappies but at least still with all the necessary bits there!

There is a very different side to that trip at that time which I might tell at some other time.

Dominic Cartier

What makes a majority ‘right’?

Not often but sometimes I enter into articles on Facebook. And (you may not agree with me) I am basically on the Israeli side of the Gaza-Israeli troubles. You will note that I do not say Palestinian-Israeli war because I can’t get a clear understanding as to where or what Palestine is. “The term Palestine is also used to refer to a geographical region in the West Asia, comprising of modern-day Israel, the West Bank, and Gaza” is a quote which I think is tied into the British Mandate Proclamation in July 1922. Although many attempts have been made to subdivide ‘Palestine’ into portions for the Arabs who previously lived in the area and for the Jews who also previously lived in the area none have been successful. It is common and I think undoubted knowledge that it was in a large way meant to be a home for the many displaced Jews and this became the home of many more Jews particularly after WWII. The Arabs who basically live in this area are of Egyptian origin and what is now called Israel is open to mainly religious Jews but also Arabs (mainly Muslims) and Christians from many countries. To again quote what I find on Wikipedia ‘While most Israelis are Jewish, a growing share (currently about one-in-five adults) belong to other groups. Most non-Jewish residents of Israel are ethnically Arab and identify, religiously, as Muslims, Christians or Druze.’ (8 Mar 2016). Of course Judaism stretches from atheist to ultra-orthodox Judaism and so is a racial rather than a religious title.

It is obvious, and I think an indisputable truth, that antisemitism is rife throughout the world. Many nations (including most of the variously quoted 49-57 Muslim nations) are anti Israel. Many nations which claim to be friends of Israel have large populations of Muslims and sympathizers with the Arab Gazan people. This has been obvious in the anti-Israel often called pro-Palestinian demonstrations in many countries. Our own Prime Minister in spite of being careful about what he says these days doesn’t come out clearly on the Israeli’s side and his government has financed the terrorist (thus labelled officially in Australia) Hamas controlled Arab side of the struggle.

Which leads me to my question at the beginning – ‘What makes a majority right?’ I can remember a man now dead but very wise who taught us in a lunchtime, Government approved, Christian group in our school that ‘One man and God makes up a majority – and it doesn’t need the man.’

I am not claiming that this applies to my stand for Israel but I certainly don’t accept that the majority are correct in expecting Israel to allow the terrorist Hamas/Iran group, with a entrenched policy to exterminate not Israelis alone but all Jews. One of many quotes which are easily found and checked reads ‘On August 20, 2012, in a sermon broadcast on Hamas’s Al-Aqsa TV, Hamas official Sheik Ahmad Bahr prayed, “Oh Allah, destroy the Jews and their supporters. Oh Allah, destroy the Americans and their supporters. Oh Allah, count them one by one, and kill them all, without leaving a single one.”’. In addition the founding documents of the group are clear in what they say!

I have been called many things for taking my pro Israeli stance – but the one which I hate the most is ‘you are a nazi’! And this is in spite of my saying that if I were younger and could get permission to work in a hospital through which terrorists couldn’t be involved, I would choose to be in Gaza helping to treat the suffering, which I believe is largely caused by the terrorists who want the Israelis to get a bad name!

A 5 minute experience stretched over 3 weeks!

For the sake of a brother-in-law and anyone else who doesn’t like medical pictures I promise than there are none. And neither will there be any detailed descriptions of the pathology! I have just come across a picture in association with an album of hymns to which I was listening’, and here it is.

The picture reminded me of two things. Firstly of all the anti-Trump news about his attitude to abortion. He may have been lying (an art perfected by politicians) but I heard him say (unless it was doctored by media experts) that he was against the generalization of Roe v Wade but that he felt that the people in each state should be able to vote on it. He claimed that he personally believed that there were 3 legitimate reasons for abortion – rape, incest and if the mother’s physical life was in danger. A very different view from what his opposition presents him as holding!

But what has that to do with the title of my article? Nothing! But the picture reminded me of the hundreds of cases of ruptured uteri that I have operated upon in countryside Ethiopia where in the late 1960s our small hospital was the only hospital for millions of people and we were so busy that we could not operate things like antenatal clinics – to which people wouldn’t have come because of custom, distance, lack of roads and means of travel. We served with 1-2 doctors, 5 trained nurses and a good group of Ethiopian helpers (a few of them trained elsewhere as dressers) as the only hospital area for more than a million people!

So I have seen many babies who have died before they were born. The picture above is one suggestion as to where they end up. But this is not a theological discussion.

One day, when I was the only doctor in the hospital I was faced with three ladies with ruptured uteri arriving within 5 minutes of one another. Our ‘operating suite’ had 2 operating rooms, one of them large enough to have 2 operating tables. So I had 3 tables for the 3 women. I had a nurse who was capable of watching an anaesthetic (she was v good) after I had induced the patient. We called for help from the ward and so ended up with the sickest, having been resuscitated, asleep and me operating on her. Behind a sheet for visual protection a second lady was being resuscitated as was the third lady in the smaller OR.

It was a long morning but all were eventually taken into the ward on appropriate IV, pain and antibiotic therapy. All three babies were dead (and hence the picture above). Two ladies progressed very well and were able to go home in 7-10 days. No matter what we did the third lady did not do well. She ran a high fever and using all our available antibiotics, changing to new ones as appropriate and doing an X-ray to make sure that we hadn’t accidentally left a pack or an instrument inside we eventually had to conclude that we would probably see her depart in a box.

Sadly, I believe that much of what is called ‘faith’ healing is sham. But I do believe in God and I think that He can do wonderful things. While I was operating on that same evening on which we had come to the above conclusion, the nurses and a few of the families of workers on our mission station spent the night in prayer specifically for the healing of this lady. In spite of all our failed treatment, the lady’s temperature the next day was down considerably, she felt much better and was discharged ‘well’ about 5 days later!

Dominic Cartier

Around the table!

It seems like centuries ago but I can still remember the seven of us sitting around the table and chatting, discussing, arguing – whatever took our fancy. The boys were all into soccer, I played cricket and even one year I coached the U15 soccer team when our oldest boy was in the team. My son persuaded me to do so as they didn’t have a coach. They had lost the first two matches and as he said were ‘unorganized’. Several kids didn’t like my disciplined approach and left, but we didn’t lose a match and won the grand final 8-1. One of the boys ended up in the Australian team! But I’ve become sidetracked so back to the main story. At our table we talked about many medical things which might have made some visitors squirmish. I had returned from Ethiopia because of health, and could not return at that time because of the Communist take over. However, we had lived in the hospital grounds. There was a large leprosarium so the kids grew up seeing the deformities caused by that disease. Our first son was a bad sleeper so that with my wife’s third and fourth pregnancies he would come into the theatre, if I was operating in the evening (pretty often) so that mum and number two and eventually number three child could get a decent sleep. Aged four he learnt how to squeeze the anaesthetic bag if patients were paralysed. I had to give my own anaesthetics and a worker would manage the anaesthetic when the patient was asleep. They enjoyed teaching the little white kid how to do certain tasks. The kids used to do Sunday rounds with me in the hospital after church. So they knew the sights and screams and smells of medicine!

I remember one day, when my wife was away looking after a sick parent, the kids asking me at the breakfast table what I was operating on that day. They knew the ending ‘ectomy’ but when I said an ‘oesophagectomy’ one of the younger boys asked ‘what is an oesophagus?’ It’s what joins your mouth to your stomach’, I replied. ‘So how does the food get down then?’ was the next question. ‘I pull the stomach up and sew it to the end of the throat’ I replied. It is a bit more difficult than that and takes a few hours but I didn’t go into detail. Number four’s answer has always tickled my fancy. ‘Now there is a man who can truly say “I’m full up to here!”‘ indicating his Adam’s apple area (at 5 his Adam’s apple wasn’t developed – but you know what I mean.

Dominic Cartier

Can a non-scholar be a Christian?

I was, and greatly enjoyed being, a surgeon! Shortly after obtaining my higher degree in surgery I joined a Christian Mission to go to Ethiopia as a missionary surgeon in one of their hospitals. I was expected to and very willingly underwent an assessment of my beliefs as a Christian. Obviously and logically the mission had standards and desired a certain degree of theological unity among its members. Having satisfied them that I was okay and could be accepted as a member I went to Ethiopia, where I worked up to 80 hours a week as the only surgeon covering a population of more than a million, but I also had a vital relationship with the ‘spiritual’ side of mission life. Later on after the communist takeover was overturned I was in government hospitals on their Academic staff.

In one area that I worked in the early 2000’s the population was very largely Muslim. But there was a University with a student body of about 40,000. This student body was made up from candidates accepted from all over the country. A significant percentage of these students were ‘Protestant’ Christians. The Protestant Kale Hiwot church was small in the University town but was the central organizational base for the churches which were scattered over that region of the country which made up one of 13 regions in the whole country. The church eldership was basically made up of mature Christians who had some but not a great theological nor secular education. They were great people but the younger University students were much greater in number. An average attendance at the church which the University students attended would have been nearly a thousand. That was great but the young people kept referring to and using Paul’s phrase ‘we are not under law but under grace’ (Romans 6 v 14) to underpin the thought that, as they were no longer under law, they could act as they wanted and God would turn a blind eye. This sounds, and was, wrong. The kids were basically good kids but some of their actions were not acceptable by the elders! Well the problem was magnified because the majority of the University students, whether they were Protestant or Orthodox or Islamic, in the freedom of their situation and of modern thinking seemed to live on the same basis. The student population came from all over the country and lived in University housing without parental advice or control!

There were 500 recorded terminations among students by an American subsidised clinic in the last 6 months that I was there. There were a number of other places willing to perform abortions whose activity I have not included. Drugs were a problem. I remember an instance where I had to operate late at night on a senior member of our University staff who, when drinking and ‘drugging’ with a younger member of his own unit, was severely stabbed in his abdomen which caused a critical situation. Neither of them were members of the Protestant church to which I referred earlier but both claimed to be Orthodox Christians. So the problem of lack of morals was society wide!

The morals of our Western countries aren’t any better! It is not a theological issue in most people’s eyes. There is a broad sense of personal rights to freedom and consequently a loss of moral standards.

So how does that take me back to the Pauline teaching that ‘we are not under law but under grace’? In the context of his whole book of Romans, where he writes this phrase, Paul has said in the early part that all mankind is guilty under the law as sinners alienated to God. BUT the Grace of God in Jesus and the Easter Event gives us the opportunity to be forgiven! And that in a sense is the core of the Christian message, now God has given us the opportunity to be forgiven by His Grace and not be judged by our law breaking. There is, however, more to the law than the law relating to Justice.

In the Jewish religion the law had different aspects – sacrificial, dietary, health and moral for example. When we think about it, we also think of the law in different ways. Jesus said that He had not come to destroy the law. Most certainly he didn’t come to destroy the moral law. We have a good summary of God’s moral requirements in the ten commandments! (Exodus ch 20). Christianity is not legalism in that we have to obey certain rules to earn our way in God’s acceptance, but it is certainly a call to a high understanding of what God has laid down as moral. I find that so releasing. Most see the commandments as negative and they do have a prohibitive aspect but equally they are there to be a guide and encouragement to a wonderfully rich and peaceful life.