Volume 13, Number 1 Sunday, January 10, The SteffeScope

Transcription

1 Volume 13, Number 1 Sunday, January 10, 2010 Dear Friends and Family: The SteffeScope Sean, Micky and Bruce with our plate of culinary good luck on New Year s Day, It is traditional in the South to have certain foods on New Year s Day. The politicians in our area, including our friend Lee Warren, the Cumberland County Register of Deeds, have put on a meal on New Year s day for the last several decades. It is felt that those lucky foods will bring you money in the coming year. Collard greens (or kale or cabbage) is eaten in hopes of receiving folding green in the next year and black-eyed peas for the coins. Never mind that to us Yankees, the first dish tastes bitter and the second mostly like dirt, no matter how much fat-back you put into either one. At least they didn t try to get us to eat fried okra! Sean took only a bit, Micky ate about half her portion and only Bruce can look forward to prosperity in the New Year! Glad it is only once a year! Birth pangs with another book: When we began to consider a reprint of the Handbook for Short-Term Medical Missions (ABWE Publishing, 2002), it was obvious that the medical scared away the nonmedical folks and the short-term scared away the career missionaries. The pure size and cost scared away the rest. We decided therefore to publish it in two companion volumes. The first one, Medical Missions: Get Ready, Get Set, GO! was published in March, We have been spending much of our spare time getting the second volume ready for the editor. It will be entitled, Your Mission: Get Ready, Get Set, GO! The two books are designed to be read as stand-alone works and therefore there is some overlap in the material, but the newly updated material in this book will emphasize the tricks of planning, packing, traveling, staying healthy and cross-cultural ministry. We hope that it will be available in March this year. The table of contents looks like this: 1. What Have I Gotten Myself In For? 2. Eeny, Meeny, Mino, Mo - Picking an Organization and Planning Your Trip 3. Raising Support and Building a Support Team 4. Getting Ready to Go Travel Documents 5. Spiritual Preparation 6. Health Tips for the Traveler 7. Packing 8. Step by Step Preparing to Go 9. Traveling with Children 10. Adapting to a Different Culture Can Be Painful 11. Feeding and Watering the Family And Yourself 12. Bargaining, Buying, Bribes and Beggars 13. Other Things One Could Do. 14. Oh, for a Repeat of Pentecost! Spoken Communication When You Don t Have the Gift of Tongues 15. Sharing the Good News 16. Home, Sweet Home? 17. If Only 18. What Now? Appendices: A. Suggested bibliography B. Helpful web sites C. Sample support letter

2 Volume 13, Number 1 Sunday, January 10, 2010 D. Travel agencies experienced in mission trips E. Packing list F. Language phrases to learn before you go G. Conversion Tables - measurements H. Testimony worksheet I. Photography hints J. Traveling with your computer to the mission field. K. solutions Clarification of S 3 Ministries: We apparently confused some people in the last SteffeScope. S 3 Ministries, Inc. is the name of our new taxdeductible [501(c)(3)] organization. The three S s in S-cubed can stand for us three Steffes or for the focus of our ministry the Savior, the Sword (Bible) and the Scalpel. From this point on, please send your checks to S 3 Ministries, PO Box 300, Linden, NC or you can contribute through your credit card (or PayPal) by going to The receipts will come from S 3 Ministries, Inc. Please do not send gifts any longer to Village Baptist Church. PAACS Strategic Planning Committee: Back row (L to R) Chuck Baker, Bruce Steffes, Dave Thompson, Carl Haisch, Ervin Barham; Front row (L to R) Gene Rudd, Diane Shook, Ron Sutherland PAACS Meeting in Charlotte: On January 8 10, the ad hoc Strategic Planning Committee met in Charlotte, NC to seek God s will regarding the future direction of PAACS. The meeting was mediated by Dr. Gene Rudd, the Senior Vice-Present of the Christian Medical and Dental Association. Despite the bitter arctic weather, the meeting was warmly convivial and a great deal was accomplished (and now I have a long list of things to do!). A friend of PAACS, who wished to be anonymous, picked up the tab for accommodations at the beautiful Duke Mansion, a beautiful private home which is now an inn. On the 11 th and 12 th, I met with two prayer groups in Charlotte to acquaint them with PAACS before driving back home. Praise and Prayers: 1. Praise God that we have enough money to publish the book. Pray for us as we do the final writing and proofing. 2. Praise God for safety in travel to Philadelphia and Charlotte. 3. Please begin to pray for the continuing medical education conference in Kenya February Please pray for my cousin, Peggy, who is in the ICU on a ventilator due to aspiration pneumonia. She is very ill. 5. Please pray that God will provide a person who can serve as a Chief Operating Officer for PAACS. We need an experienced mature Christian who has executive experience in operations and who is able to work as a volunteer (expenses will be covered). 6. Pray for us as we continue to restructure PAACS. We need wisdom and God s direction. Praising the God of second chances, Bruce for Micky and Sean

3 Volume 13, Number 2 Thursday, February 4, 2010 Dear Friends and Family: The SteffeScope The Kingsmen Quartet and Calvary s Hill Quartet closing the concert. S3 Ministries (our non-profit organization) was one of two groups which benefited from a special southern gospel concert held at our church last Friday evening January 29, A good friend from our Sunday School class, Roger Wendell (far right above) sings bass in the Calvary s Hill Quartet and he invited the Kingsmen to join them for a wonderful night of singing and praise. Attendance was down because of the threatened winter storm which paralyzed the area a few hours later, but it was a warm, wonderful evening inside. It was a very special effort to help our ministry and very much appreciated. Something free! Our book designer wrote with the unwelcome news that our updated book, Your Mission: Get Ready, Get Set, GO!, was too long! Bruce spent the last week trying to decide where to cut it (much like trying to decide which arm to cut off your own baby!) and we have decided to give part of it away for free rather than to lose the opportunity to share the material. If you go to our new website, and go to the Books section, you will see where you can go to download the following materials. Please feel free to let others interested in short-term missions know about this opportunity. We hope that the book will be available in printed form in April. Chapter 6: Health Tips for the Traveler Other lists and articles: Bibliography, Helpful Web Sites, Sample Support Letter, Travel Agencies Experienced in Mission Trips, Packing list, Language Phrases to Learn Before You Go, Conversion Tables Measurements, Testimony Worksheet, Photography Hints, Traveling with Your Computer to the Mission Field, and Solutions. Bon Voyage: Bruce leaves tomorrow for Kenya. From February 8 18, he will be involved with the CMDA s Continuing Medical and Dental Education (CMDE) conference for 300 medical missionaries. He will be teaching Advanced Cardiac Life Support, Pediatric Advanced Life Support, give two lectures, attend a special symposium of surgical education, pick up 40 hours of his own continuing education credit, be in charge of the worship services, attend meetings for the CMDE and PAACS (Pan-African Academy of Christian Surgeons) commissions and give oral examinations to senior PAACS residents. Meetings start at 6:00 AM and go until 9:00 PM or later each day. On the 19 th, the PAACS administrator, Ervin Barham and three doctors (and one wife) will pick Bruce up at the Conference Centre as they begin the East African circuit of PAACS training hospitals. They will visit both Kijabe Hospital and Tenwek Hospital before flying to Ethiopia to tour the CURE hospital in Addis and the Soddo Christian Hospital in southern Ethiopia. On February 28, four will fly back to the US and the next morning, Ervin and Bruce will fly on to Libreville, Gabon where they will meet Dr. Carl Haisch, a PAACS commission member for a visit to the

4 Volume 13, Number 2 Thursday, February 4, 2010 program in Gabon and the two in Cameroon. The visit to Ngaoundéré will function as a visit to confirm compliance to the terms of probation. They will touch down back in the US on March 11. These visits have multiple purposes. It will be the first time that Ervin Barham will be visiting the programs and he will get a better understanding of the difficulties they face. It is hoped that the four doctors will grasp the vision. We are praying that at least one of them will become a career missionary surgeon beginning in 2011 and that the others will see where God would have them become involved with the training program. Bruce will be busy problem-solving and trying to encourage, talking to residents and faculty alike. Would you be willing to help? Regular readers know that we don t often solicit money but we have something that is worth the investment. Recently, a very promising resident candidate, Jacques Ebhele, from the Democratic Republic of Congo (DRC) was accepted for the PAACS program at Ngaoundéré, Cameroon. At the time he was selected for the program, he was in Uganda studying English in preparation to become a PAACS resident. He is fluent in French and several African languages, but since the PAACS curriculum is in English, he had to learn yet another language to become a resident. On faith, he was in Uganda for 9 months at his own expense during which time he was not able to work, For a series of good reasons, PAACS requires all residents to pay for their travel to the program and back home at the end of their training. While in Uganda, Dr. Ebhele did not have the money to travel to his training program in Cameroon. In addition, the DRC required all its citizens to transition to a new passport system by December 31, Dr. Ebhele and his wife had to go back to the city of Bukavo in DRC to apply for new Congolese passports. This process took more than 30 days and was very expensive. They got their passports and returned to Kampala in Uganda, thinking they could get Cameroonian visas and a flight to Yaoundé from there. However, there is no Cameroonian embassy or consulate in Uganda, and they were unable to get a visa or an airline ticket without either a work permit for Cameroon or a round trip airline ticket. So they were advised to go to Kinshasa in DRC to apply for a Cameroonian visa, which they did - at yet more expense. Once the visas were approved, they were still required to buy round trip airline tickets from Kinshasa to Yaoundé. From Yaoundé they took the train to Ngaoundéré, and arrived at their training post last Sunday, completing almost a 2 month process. The passports, visas, and the bus, air, and train tickets cost about $5000. Could you help him with this huge sum? This is almost a year s salary for him and he also needs to save to return to his country in five years (they won t honor the return ticket even though he has one!). If any of you would be willing to contribute toward his moving expenses, you may send a check made out to PAACS at the following address: PAACS, PO Box 9906, Fayetteville, NC Please clearly indicate on a separate note that the contribution is to be used for "Dr. Ebhele's moving expenses". You will receive a receipt for tax purposes. Praise and Prayers: 1. Please keep Micky and Sean in your prayers as we are apart for the next six weeks. 2. Please pray for the continuing medical education conference in Kenya February Pray for traveling safety for all attending. Pray that they will be strengthened and encouraged as they minister to each other and as Robertson McQuilkin preaches the Word. Pray for Bruce as he meets with PAACS as they attempt to solve problems and find unity of purpose and mind. 3. Please pray for all those on the PAACS vision trip. Pray that these men and women will indeed catch the vision and be open to God s call on their life. Pray for safety as they travel to and from the continent. Pray for safety as they travel by van and small plane. Pray for discernment for them so that they can see the problems and for wisdom as they seek answers. Pray for the families as they are apart. 4. Praise God that Bruce s cousin, Peggy, is slowly improving. She is still hospitalized and has a long recovery ahead of her. Praising the God who gave His Son for us, Bruce, Micky and Sean

5 Volume 13, Number 3 Thursday, February 18, 2010 Dear Friends and Family: Greetings from beautiful Kenya! The SteffeScope A picture of most of the attendees at the CMDA-CMDE Conference held at the Brackenhurst International Conference Centre in Limuru, Kenya. There were 305 attendees from 37 countries and 24 states. There were 192 doctors, 8 PAs, 21 dentists, 39 nurses, 11 other paraprofessionals among the attendees. Eighty faculty members gave of their time and money to serve the missionaries in this way. I have circled myself in case you were looking for me looking good, eh? 30 th CMDA-CMDE Convention: I flew from North Carolina on Friday morning, February 4 and had an uneventful but long trip to Nairobi. I met old friends (and a new one) in the Amsterdam airport and it was the first of a series of joyful reunions that would last over the next 10 days. It is a true honor and pleasure for me to serve at this conference. First and foremost, I have been blessed by these amazing missionaries attending the 30 th Christian Medical & Dental Association s Continuing Medical and Dental Education. I have been attending since 2003, so this is only the 7 th one I have attended (the one in 2008 was cancelled due to the risk of violence here in Kenya). That s nowhere close to some of those who attended a lot more including at least one (Marvin Jewell) who has attended all 30 of them! Of the eleven who were original founders, six were able to come to Kenya for this conference. Four of the original eleven are still active in the activities each year. During a special Founders Night Celebration, it was fascinating to hear all the challenges of that first conference held by faith in Monrovia, Liberia in I have been very busy these past two weeks. I have taught both Pediatric Advanced Life Support (PALS) and Advanced Cardiac Life Support (ACLS). I have given two lectures which were well received and attended at least 30 other lectures for my own needed CME credit. I was in charge of organizing the worship services each morning and evening including last night s heart-warming communion service. The worship leader was again Michael Thompson and I am so blessed by his lowkey but meaningful godly style of leading worship. I was blessed to again sit each morning under the ministry of Dr. Robertson McQuilkin. What was most meaning to me were the times of worship. I was awed by God s grace to me and to all of us and it was unusual to get through a service without tears in my eyes and a break in my voice. I am so glad that I serve a God of second-chances who loved me enough to rescue me. Kenya has had sufficient rain this year and the grounds of the conference center are truly breathtaking the Kenyan birdlife is abundant and stunningly beautiful and the flowering bushes all around the manicured grounds are the most spectacular specimens of their type that I have ever seen. It had been sunny shirt-sleeve weather, a pleasant change from the snow at home. I haven t had time to luxuriate in it, but at least I appreciated it as I scurried from place to place fulfilling my responsibilities. I had hours of meetings with PAACS personnel and tried mightily to recruit some of the attendees and faculty to join us, including a third year general surgery resident who is exploring the call of God on his life. We spent one full afternoon in oral certifying exams for the graduating PAACS residents (a stressful

6 Volume 13, Number 3 Thursday, February 18, 2010 new experience for them and for us) and I helped arrange the competition for the presentations for the PAACS residents (see the picture to the left of the winners and me). I attended two long Commission meetings that went late into the night and was named the Financial Officer of the Continuing Medical and Dental Education Commission. I have been the assistant FO prior to this. I was scheduled to go off the Commission after next year s meeting in Thailand because my term of service was up and although this new position means added work, it is worth it for the privilege of staying on the Commission and serving a group of people I consider my heroes. I had a lot of informal meetings as we networked to solve and share problems. I met in counseling sessions with a few who requested it. I showed some brand new movies to folks on the weekend. I led a hymn-sing and worship time last Sunday evening. I even dedicated a few hours of computer time yesterday to the effort of reproducing 300 flash-drives containing all the lecture materials. Those flash-drives were given to the attendees as they departed today. I was usually out of my room by 6:00 AM and rarely back in it by 9:30k PM and I had the worst jet-lag I have ever had. I was totally frazzled. May God bless the maker of Ambien! I must confess that I am relieved that my duties are over as of today, despite my joy at being here. Another set of duties will begin tomorrow as we begin the PAACS vision trip of East Africa. Let it snow, let it snow, let it snow! Although Sean has seen snow before and gone sledding, he has never seen good packing snow and certainly not in his own North Carolina back yard. Building a snowman was a new experience and his mother and he had the best snowball fight he could imagine. He loved it! Praise and Prayers: 1. Please keep Micky and Sean in your prayers as we are apart for the next four weeks. 2. Please pray for traveling safety for all those missionaries who are going home refreshed and rejuvenated from this conference. Pray for those returning to trouble those in Cote d Ivoire in particular. Pray for Kenya which is bracing itself for more violence. Pray for those in Togo facing the risks of an upcoming election. 3. Praise God for the wonderful conference and for the answered prayer that we saw during this conference. Praise God that things went well for PAACS that was a real concern for me. 4. Please pray for all those who arrive tonight in Nairobi to go on the PAACS vision trip. Ervin Barham, the PAACS Administrator; Dr. Jon Pollock, a chief surgical resident at Emory University, Dr. Bill Wiggs, an ENT surgeon from our home church and Dr. and Mrs. Keith (Susan) Forwith, an ENT surgeon on faculty of the U. of Louisville will be traveling with me to Kijabe Hospital, Tenwek Hospital in Kenya and Soddo in Ethiopia. Pray that these folks will indeed catch the vision and be open to God s call on their life. Pray for safety as we travel by van and small plane. Pray that they will seek God s face during this trip. Pray for their families as they are apart. Yours and His, for the peoples of Africa Bruce for Micky and Sean

7 Volume 13, Number 4 Saturday, February 27, 2010 The SteffeScope Dear Friends and Family: Greetings from Ethiopia! The East African Vision Trip is almost over. On February 17, Ervin Barham (the PAACS Administrator), Dr. Bill Wiggs (ENT surgeon from Fayetteville, NC), Dr. Jonathan Pollock (a general surgery chief resident from Emory University in Atlanta who plans to be a missionary surgeon with PAACS beginning in 2011) and Dr. Keith Forwith (ENT surgeon from Louisville, KY) along with his wife, Sue, left the US. On the morning of February 19, they picked me up at the Brackenhurst International Conference Centre and we were off to see what God would show us. This was the first trip to Africa for all of my travel companions with the exception of Bill who had been to Northern Uganda with a mission team from our church. Our first major stop was Kijabe Hospital where PAACS has two programs one in general surgery and one in pediatric surgery. We met our two newest additions to the PAACS program Dr. Dan Ochieng and Dr. Catherine Mong ong u. My colleagues were dismayed at the limited resources and were startled to hear that the two Kenyan hospitals they would see were the best resourced of any mission hospital that we work in. For some of the group, the idea of missionaries raising their own funds was a new one. For others, it seemed clear that if people back home only knew the true need, they would open their purses and hearts (from their lips to the ears of God!) For some, the tragedy of those that couldn t be helped was heart-breaking. They were impressed by the missionary surgeons and by the quality and intellect of the residents we were training. There is a new ENT career missionary coming to Kijabe, Dr. Tom Boeve, and he was here as well as a regular short-termer, Dr. Tom Nagy. The two visiting ENT surgeons came away from their meeting inspired with the vision for the ENT task force for PAACS. While at Kijabe, we also visited the Rift Valley Academy, the largest missionary school in Africa. They were impressed with the facility but as all including missionaries do, struggled with the idea of boarding school and long separations for members of missionary families. The cornerstone for this school was laid in 1909 by Teddy Roosevelt on one of his hunting trips to Africa (see left). On mid-day Saturday, we bid adieu to the wonderful folks at Kijabe and spent the rest of the weekend at Lake Nakuru National Park. Daily deluges, unusual at this time of year in Kenya, made the slickest mud imaginable and we got stuck two times. One time was within sight of our evening s lodge but visiting hyenas and other wild animals between our van and the lodge made walking seem somewhat unadvisable. We were mired axle-deep but finally someone came along who had a web towing strap and pulled us out. We managed to get stuck on a lonely road the next morning but got out but not without throwing Jon Pollock off the back of the van. He may have cracked a rib in the roll and was very sore, but fortunately nothing more serious happened. Our five game drives were successes and hugely enjoyable nonetheless and the stop at the curio shop on the way out of the park seriously endangered our airline weight limits. We drove the highlands around Kericho on the way to Tenwek. The tea fields stretched mile after mile and was a beautiful site. We arrived in time for a late lunch. Our tour of the hospital in the rain was interrupted when it was discovered that Dr. Tim Fader, a new missionary surgeon at Tenwek, was doing an ENT case with which he was not as familiar as he would like. The scene was reminiscent of the old Southern tale of Brer Rabbit getting thrown into the briar patch. They dove in and weren t seen but in glimpses from that point on. Knowing these two experts were coming, Tenwek had arranged for an entire

8 Volume 13, Number 4 Saturday, February 27, 2010 day of ENT patients in the surgery clinic and several emergent or severe ENT cases showed up in Casualty (British/Kenyan for the emergency room). Those two were as happy as hogs in slops the entire time they were at Tenwek and got a true glimpse of the need for ENT training for our PAACS general surgery faculty and residents. Dr. Pollock had plenty to do as well and had a good time in the OR. The breadth of the work and knowledge required by a general surgeon in mission hospitals was staggering to them. We participated in rounds (and the sight of surgical residents starting rounds with prayer was unforgettable), teaching conferences, clinics and other aspects of routine life. We had a pleasant dinner at the home of Russ and Beth White on Tuesday and on Wednesday, most of us participated in a Bible study for the interns and residents which I was asked to lead because of Russ fatigue. On the first night, I unexpectedly also helped teach an ACLS course. Ron and Colleen Johannsen had come here directly from Brackenhurst and Colleen is one of the instructors of the ACLS course I participate in each year with the CMDA-CMDE conference. She was providing certification for about a dozen people here at Tenwek. Ervin and I had a series of meetings to solve some issues and help train the administrative secretary. Sue discovered the understaffed and overcrowded nursery and spend many hours feeding the orphaned babies. She also wandered around the hospital and had her eyes opened to the reality of medicine per se and the realities of practicing it in the developing world setting. A lunch meeting with the PAACS residents was also engraved on their memories we have some outstanding young men and women who wish to serve the Lord and their peoples through their surgical training. The stay was all too short and we went back across the Rift Valley on Thursday morning. We stopped at the Giraffe Center in the Nairobi suburb of Karen, had an outstanding meal at the Carnivore Restaurant (featuring game meats of all types) and then got to the airport only to find our flight was cancelled. We were put up at a hotel and got up at a ridiculously early hour to go back to the airport. That flight was delayed in departure and we were glad to finally get to Addis Ababa the next morning. It was a long drive to Soddo (over four hours), punctuated by a vegetarian Ethiopian meal that was very inexpensive and very good. We didn t arrive until 5:30 PM, only to find that the compound had no water. The four men stayed at a nearby hotel (nowhere as nice as the one the night before!) and enjoyed cold showers if one was man enough. On Saturday, I helped Paul Gray with a carotid body tumor resection. These are rare tumors, more common at high altitude. We were very dismayed to have her procedure complicated by a stroke and we are praying that she will recover fully. The rest of the day was more upbeat with an excellent Bible study with the missionaries and residents, a couple of wonderful shared meals and a time of discussion with the residents. Ervin was able to get the administrative issues settled as well. After dark, the water finally came back on, too late to do laundry and too dirty to do much with it but at least we could wash up so we were a bit less fragrant. Tomorrow, we are having a worship service, lunch and then the long drive back to Addis. The Forwiths, Bill Wiggs and Jonathan Pollock are flying back on Ethiopian Air to Washington Dulles, via Rome if the snowstorm back in the US permits it. Please pray for them. Despite the stresses and difficulties at Soddo Christian Hospital, Jonathan Pollock feels more strongly than ever that he is called to serve at Soddo beginning in the summer of Praise God. Praise and Prayers: 1. Please keep Micky and Sean in your prayers as we are apart for the next 12 days. 2. Please pray for traveling safety for those returning to the US and for Dr. Carl Haisch flying to join us in Gabon. Pray that all that they have seen and experienced will change their lives. 3. Please pray that this woman at Soddo will recover fully from her stroke and for Dr. Gray and myself we are feeling pretty low about this complication! 4. Please pray for traveling safety as Ervin Barham and I continue on to Gabon, pick up Dr. Haisch and visit the three hospitals in Gabon and Cameroon. We will be flying in small planes and need your prayers for safety. 5. Please pray for these amazing missionaries. They are overworked, overstressed and underresourced. It is hard, tiring and often discouraging. Keep them uplifted before the throne. 6. Please pray for Dr. Russ White as he flies to the US for a medical check-up. I am not at liberty to tell you more but he is very concerned. Please pray for healing and peace. Yours and His, for the peoples of Africa Bruce for Micky and Sean

9 Volume 13, Number 5 Sunday, March 7, 2010 Dear Friends and Family: The SteffeScope Greetings from Cameroon. We are about to leave our next-to-last stop tomorrow morning. I am getting eager to get home to Micky and Sean. Last weekend, while we were in Ethiopia, Dr. Carl Haisch flew from the US and landed in Libreville one week ago on Sunday evening. That was the same evening that the other four from the East African vision trip boarded the plane to head back to the US. The next morning, Ervin Barham (the PAACS administrator) and I had a four-hour flight from Addis Ababa, Ethiopia to Libreville, Gabon. After going through formalities to enter Gabon, we met Carl as well as Dr. Bob and Elaine Greene (orthopedic surgeons who are here to work with PAACS at Bongolo Hospital and with whom we have worked on the Mercy Ship). We flew in a six-passenger Cessna on a relatively new missionary airplane service (Air Calvary) from Libreville to Bongolo. On the trip south, we flew over the famed Albert Schweitzer hospital in Lambarene and headed further into the jungle. Our two hour flight over dense impenetrable rain forest was a bit pricey but far superior to a bone-jarring 10 hour van ride and worth every penny! Above left Bongolo Hospital from the Air Calvary Plane. Above right The Bongolo PAACS team including family and children Right Ervin and Bruce in front of the SIL Cessna at the Yaoundé hanger. We spent a wonderful three days and night at the Christian and Missionary Alliance Bongolo hospital. Dr. Dave Thompson, the founder of PAACS is home on furlough, but Dr. Keir Thelander and his family made us very comfortable. We were involved in the OR, had lots of conversations and enjoyed our time with the residents. The last evening there featured a wonderful potluck of African foods with all the residents and their families attending (excepting one family which is in S. Africa on rotation and one resident who is on rotation in Cameroon).

10 Volume 13, Number 5 Sunday, March 7, 2010 Early the next morning, we flew out again on Air Calvary from the dirt strip and met the SIL plane in Libreville. We went through the exit formalities, paid the fees ($330 for the Cameroon-based SIL plane to land in Libreville!) and then flew another 2.5 hours to the Yaoundé Nsimalen International Airport. A sudden thunderstorm delayed us there before we flew a short hop across town to where the SIL hanger was located at the military airstrip. We all had a serious case of TB Tired Butts! We got to our guesthouse in time to enjoy another African specialty no power. Our hopes for good Internet connections were gone. We had a light supper by lantern-light and turned in early. The next morning was another 2.5 flight on the same Cessna 206 from Yaoundé to the northern town of Ngaoundéré where the Lutheran Protestant Hospital is located. This is the hospital which was placed on probation last summer and I was dreading what I might find. I was very pleasant surprised and pleased to see that they had taken our conditions and suggestions very seriously and that great strides forward were being made. They still have a long way to go to get to the level of quality that we need to have, but they are clearly striving to improve, having taken some very important steps which flew in the face of local culture to get it done and they are pleased with the results. This afternoon (Sunday), we had a wonderful Bible study with the residents, their families and the Browns before watching a movie for some shared relaxation. Jim Brown is a year younger than I am but is putting in full days with calls every night and up operating every other night. We desperately need someone to come along side him as permanent (career) faculty. Tomorrow is our last of the four flights in small planes. They are an expensive mode of travel but critical in undeveloped areas where it takes 10 hours or more to travel what can be traveled in 2 hours by air. Most of these planes cost about $400 an hour to run and require great skill to keep them air-worthy. Pray for and thank God for all the dedicated missionary pilots/mechanics who provide this vital service to others, often acting as air ambulances as well as air-taxis. The Ngaoundéré Protestant Hospital PAACS team: Front Anthony and Joy Nesoah, Yali bin Ramazani (Bongolo resident on rotation), Dinah and Jacques Ebhele Back Jim and Carolyn Brown Praise and Prayers: 1. Praise God for traveling safety thus far. Please pray for continued travel 2. Please pray for the family of the woman we operated upon in Ethiopia. She was improving when she suddenly passed away. She did personally know our Lord as her Savior but her family is grieving. 3. Please pray for the ability to focus for these remaining days. Good to be in Africa! Bruce for Micky and Sean

11 Volume 13, Number 6 Saturday, March 13, 2010 Dear Friends and Family: The SteffeScope Jet-lagged again (so much so that I just accidentally deleted the completed newsletter and had to rewrite the entire thing) but being at home makes it much more tolerable. I returned Thursday night along with Dr. Carl Haisch who had accompanied Ervin Barham and me on the PAACS West African vision trip. I have been living out of a suitcase since I left on February 5 and it is good to be home in the bosom of my family. And sleep in my own bed. And have fast Internet connection. To pick up the travelogue where we left off: Monday morning, we had an exit interview with the administration of the Ngaoundéré Protestant Hospital in northern Cameroon. When I was last there in the summer of 2009, I had to play the role of bad cop but it was much more enjoyable to be the good cop this time. Although most visitors from North America would still be shocked by the level of provision of care, they have made some great strides forward since PAACS placed them on probation last summer and some of those steps took great personal courage and conviction to go against culture, church and tradition. I was really impressed. They have a long ways to go and were discouraged when they received news during our visit that the construction of their hoped-for 112 inpatient bed facility had been called off due to unexpected increase in the expected cost. One of the major reasons beside inflation was an unexpected governmental development tax equal to a full 20% of the cost of the project. How short-sighted some governments can be! No one else is doing anything to help. Another inspection team from PAACS will return to Ngaoundéré in July and a new set of goals and levels will be set at that time. Our last missionary airplane flight was in a 1963 Helo-Courier. We flew slightly over 2 hours to the southwest with my by-now old friend Rob Peterson at the controls. The Harmattan, dust from the Sahara carried by the prevailing winds, cut visibility and left a fine coat of dust on everything. The airstrip at Mbingo Baptist Hospital in the northwest region of Cameroon is one designed to give the first-time visitor palpitations. Located at the end of a box-canyon, the strip just looks like an oddly shaped somewhat rectangular cow-pasture. Landing at the bottom of the strip (assuming the cows are not on it), you run uphill and over a hump. Appearances and apprehensions aside, Rob made a picture-perfect landing. Getting out of the plane, you are best advised to avoid stepping in the cow-patties (it really is a cow-pasture at times after all!) We stayed in the beautiful home of Steve and Suzanne Sparks. Their home is on a peninsula with a beautiful 360 o panoramic view. Since we were at the end of dry season, the paired waterfalls were not flowing. A series of mountain ridges were vague phantoms in the distance seen through the sand and mist. It was cool and would rain every afternoon the weather was a welcome change to the heat of the past week. This may be the most beautiful combination of scenery and weather of all the PAACS sites Mbingo was founded as a leprosarium in 1952 but in the past 20 years, it has transformed into a vibrant and rapidly growing general mission hospital. It is run by the Cameroon Baptist Convention. PAACS has 8 residents there and a new internal medicine program has opened with four residents. They have plans for new buildings everywhere and hope to have 480 beds at the end of their present expansion project. Three residents are graduating this summer after their four-year training program. One Cameroonian graduate will be going in July to work at Banso Baptist Hospital (20 minutes by airplane, 40 miles as the crow flies and 4 6 hours by road) to fulfill his PAACS obligation. Another Burundi resident soon to graduate has not yet decided whether to join his fellow graduate at Banso or use his French speaking abilities working with Dr. Jim Brown at Ngaoundéré before he ultimately returns to Burundi. The third graduate is from Sierra Leone and he will train with the pediatric surgery program in Kijabe Hospital for three years before going back to Sierra Leone to join the University there. PAACS primarily trains missionary surgeons but when we have someone who can have a major impact as a Christian within their nation s secular training program, we consider that a very happy result. One of my reasons for coming to Mbingo was to discuss the options with the last two surgeons and to see how we could facilitate things for them. These men will make a difference no matter where they go. I had the pleasure of renewing my acquaintance with a general surgeon from Idaho, Dr. Steve Schmid. He had only been there at Mbingo Baptist Hospital for five days but was finding out the reality of the saying that general surgery in Africa includes the skin and its contents. After four solid days of operating on urology, gynecology, orthopedic and other things not generally considered in the realm of general surgery in the US, he was finally going to get to operate on a colon case. Odds are, that wasn t straight forward either. I surely appreciate all the work Steve and the other 100 short-term faculty do each year for PAACS, the residents, the mission hospitals and for the Lord.

12 Volume 13, Number 6 Saturday, March 13, 2010 Above left: Dr. Steve Sparks, Bruce and Dr. Carl Haisch tour the Mbingo Baptist Hospital near Bamenda, Cameroon. Sparks is a vascular surgeon who is the program director at Mbingo. Haisch is on the PAACS Commission and is a transplant surgeon at East Carolina University in Greeneville, NC. Each finished apartment costs about $25,000. Above: Construction continues on the PAACS quadriplex. The finished building to the left in the picture is also PAACS building and is slated for conversion of the top floor from one to two apartments. Left: Dr. Lebbie, senior PAACS resident due to graduate in June, tolerates my help in the placement of a ventriculoperitoneal shunt on a four-year-old boy with hydrocephalus (water on the brain). Wednesday afternoon, we took a six hour drive to Douala (no air-conditioning!), had a pleasant alfresco meal at a Mediterranean restaurant and then waited for three hours at the airport for our Air France plane. It was so good to have air-conditioning in the lounge and we could finally quit sweating. We endured a seven hour flight to Paris (where we bid Ervin Barham good-bye he was meeting his wife for a romantic weekend in Paris), a four-hour wait in the DeGaulle airport, a ten-hour flight back to the US (five movies while crammed in the middle seat), a two hour wait in Atlanta and finally a 90 minute flight home followed by a 90 minute drive after that. I ignored the huge pile of unanswered mail on the counter and the long list of unanswered . My bags made it and only one souvenir didn t make it a beaded calabash had been broken by the rough handling of the suitcase. You will be relieved to know though that the huge African cockroach that had hitched a ride inside it without my knowledge was well and unhurt, waving his antenna at me amongst the fragments of the gourd. I promptly carried him outside and dispatched him. The guilt from this murder did not interfere with my appreciation of a hot shower and a good night s sleep! Praise and Prayers: 1. Praise God for safety in traveling and for care of Micky and Sean during my absence. 2. Many thoughts and half-formed concepts are whirling in my brain. Please pray for God to grant clarity and vision so that I can best lead PAACS and solve with God s help the many problems we face. 3. Please keep these outstanding men and women of the PAACS team in your prayers. They are trying to do everything with nothing. Pray for strength, for health, for wisdom and for the Lord of the Harvest to call more workers. Praising God for His many blessings, Bruce for Micky and Sean

13 Volume 13, Number 7 Saturday, March 20, 2010 Dear Friends and Family: The SteffeScope This is the first spring we have enjoyed as a family in Fayetteville in quite a long time. The camellias are blooming profusely and the daffodils are beautiful and we get to eat fresh strawberries to our heart s content. Being back together is pretty good, too! Bruce s schedule is a bit hectic over the next six weeks but he probably wouldn t know how to live otherwise. Please pray for him as he travels and speaks at many places over the next five weeks: March 25 Fly to California March Korean-American Mission Health Conference in Irvine, California. He will be attending the conference and helping to man the CMDA & PAACS booth March 28 Speak with mission committee Palm Desert Presbyterian Church and time with some friends March 29 A day with Michelle, Bruce s daughter March 30 Speak at the Student CMDA meeting at Loma Linda University March 31 Give Grand Rounds and make rounds at LLU Dept. of Surgery, followed by an appointment with Dr. Richard Hart, President of the University. April 1 Fly back to NC arriving April 2 April 8 Drive to Harrisburg, Pennsylvania April 9 Speak at chapel and meet with folks at the Association of Baptists for World Evangelism about the new PAACS program in Togo, W. Africa April 12 Visit Baptist Bible College in Clarks Summit, Pennsylvania and speak to student missionary fellowship in the evening April 13 Speak at Chapel for both the seminary and for the Bible college, meet with president, April 15 and have other meetings until about 1:00 PM; then drive back to Fayetteville Drive to Atlanta, tour the Emory U. anatomy lab on behalf of Methodist University, and have dinner with multiple surgical specialists interested in PAACS. April 16 Breakfast with missions pastors from several large churches in the Atlanta area to introduce them to PAACS; lunch with several businessmen interested in PAACS, dinner with Dr. John Galloway and the Emory surgical residents. Please pray about a potential meeting with an African NBA player who resides in Atlanta and who is interested in African healthcare April 17, 18 Medical Volunteerism Conference in Atlanta, supported by all three medical schools in Atlanta. April 23 April 27 April 28 Bruce goes on an all-day field trip with Sean s school class Pick up Dave Thompson in Greensboro and drive to Boone, NC Dave will be speaking at the morning chapel service for Samaritan s Purse and we will have meetings with folks there about PAACS. That afternoon, we will drive to Weaverville and speak at prayer meeting at North Point Baptist Church in Weaverville that evening. April 29 May 1 CMDA national meeting at Ridgecrest Conference Center near Asheville. Bruce will give a report on PAACS to the House of Representatives on the afternoon of April 29. May 1, 2 Continuing Medical and Dental Education Commission meeting until noon on Monday, then drive home on the afternoon of May 2. Information on the conferences mentioned above plus another you might be interested in knowing about: Korean-American Mission Health Conference, March 26,27 at the Bethel Korean Church, Harvard Ave., Irvine, CA Medical Volunteerism Conference (free) to be held at Emory University. This is a secular conference but will have a large component of faith-based ministries.

14 Volume 13, Number 7 Saturday, March 20, 2010 Christian Medical & Dental Associations Annual Meeting, Ridgecrest Conference Center, Ridgecrest, NC. It will be held April 29 May 1 The 2010 Exploring Medical Missions Conference will equip healthcare professionals to serve those who are most forgotten. Participants will also have opportunity to connect with service opportunities. Conference Info: Details: At the University of Missouri-Kansas City on Fri and Sat, May 21-22, Early registration discount ends March 31. All healthcare professionals and healthcare profession students are welcome. CME and CEU credit available. For more information office@inmed.us, or call Bits and Pieces: We have been busy doing the final proof-reading for the next book to be published. Your Mission: Get Ready, Get Set, GO! should be ready to send to the printer by mid-week next week and we hope to have the printed volume in our hands a month or so after that. It will be about 350 pages in length and sell for $14.95 plus S/H. It is designed as a companion volume to the one we published last year, Medical Missions: Get Ready, Get Set, GO! and we plan a special discounted price if someone purchases both. An article that Dan Poenaru and Bruce wrote a while back was finally published in an online book. The article is entitled Developing world perspective on minimally invasive surgery and training and can be found in: Park A, Klein RV, editors. Minimally invasive surgery training: theories, methods, outcomes [Internet]. Washington: Department of Health & Human Services (US), National Institutes of Health, National Library of Medicine; 2010 January. It is available from: Reading it will probably solve your insomnia. Sean had a project due for his science class. He has learned a tremendous amount about Saturn and Bruce and he had fun working on his project. Praise and Prayers: 1. Please pray for traveling safety. 2. Please pray that Bruce can cast the vision of PAACS and that God will provide both surgeons and resources to help advance the program in Africa. 3. Please pray that God will go before him as he speaks to university and college students about committing their lives to God s purposes. 4. Pray that our new book will be honoring to God and that both of them will sell well enough to at least break even. Pray that they will be used to help many serve on the mission field. 5. Pray that many of those attending the Emory Conference who do not know Christ as a personal Savior will see something in the lives of those who are there and seek God as a consequence. 6. Bruce s father had another positive cytology report. Please pray for wisdom for the doctors. If we are going to wait until every possible hindrance has been removed before we do a work for the Lord, we will never attempt to do anything. T. J. Bach Venezuela May we always reflect Christ and be always ready to serve, Bruce, Micky and Sean

15 Volume 13, Number 8 Saturday, April 3, 2010 Dear Friends and Family: The SteffeScope We wish you a very blessed Easter while we rejoice in the death and resurrection of our Lord! I have returned from a busy but enjoyable week-long trip to Southern California. I arrived in L.A. the evening of March 25 and returned to Fayetteville yesterday. On this trip, I represented PAACS at the Korean-American Mission Health Conference held in Irvine California March 26 and 27 and met with the mission committee of the Palm Desert Presbyterian Church. I spent two days with my daughter while in Irvine and while in Palm Desert, I renewed friendships with several who had gone on the original trip in 1998 that started Micky and I on this whole area of medical missions. It was a blessing to spend time with Dr. Mel and Sylvia Cheatham, Floyd and Leilani Vail and Barbara Peters as well as several on the mission committee that I had met when there five and six years earlier. I then spent 24 hours with my cousins in Escondido (using some of the time to pursue some ideas for designing and manufacturing equipment for medical works in the developing world) before traveling to Loma Linda. Bruce and Dr. Carlos Garberoglio, Chair of the Department of Surgery. Bruce and Dr. Richard Hart, President of Loma Linda University. Loma Linda University has been a valued partner of the Pan-African Academy of Christian Surgeons since 2001 but it has remained a long-distance relationship. On March 31, that changed. In my role of CEO for PAACS, I gave a Grand Rounds lecture entitled Lions and Tigers and Brain-drain Oh My! to the LLU Department of Surgery. It seemed to be well-received and the fact that a room of surgical residents stayed awake was encouraging. After rounding on the wards with the residents, I met with Dr. Carlos Garberoglio, a surgical oncologist recently appointed as the Head of the Department of Surgery to discuss the possibility of more resident and faculty involvement in PAACS. I also had a great meeting with Dr. Dick Hart, the President of Loma Linda University. Dick previously was a missionary in Africa and continues to oversee the Adventist international mission agency in addition to his present duties. A fruitful discussion between Dr. Hart and me included the plans for the next accreditation visit (in 2010 or 2011), the possible future involvement of Adventist mission hospitals in the PAACS training program, and ways to solidify the relationship. While at Loma Linda, I also addressed the student chapter of the Christian Medical and Dental Association, giving my testimony and challenging them to serve the Lord throughout their career. Over the two days in Loma Linda, I met individually with several students and residents, some of whom were very interested in pursuing a career relationship with PAACS. I had a blessed time talking and dining with Dr. Ev Bruckner, a member of the PAACS Commission.

16 Volume 13, Number 8 Saturday, April 3, 2010 The week ended with another enjoyable 24 hours with my daughter before flying the red-eye back. Now for a couple of days of hard work in following up on all the new contacts and ideas and all the honey-dos that have accumulated. I leave again on Thursday to travel to Pennsylvania and Atlanta to travel and speak several places over the following ten days. Bits and Pieces: Sean began his 10 day spring vacation on Thursday this week with the observation, Now this is the way I should live my life. We were pleased that he was one of a handful of kids in his school to receive the Eagle Spirit Award for demonstrating outstanding Christian spirit. You can now see Michelle s movie Driftwood for free. Go to It is a great short (19 minute) family film and worth downloading for future repeated viewing. One of the three planes that Bruce used on his recent trip to Africa had a scary incident. Air Calvary's Cessna 207 aircraft, based in Gabon, Africa, experienced a loss in engine power and made a forced landing in the village of Owendo, just south of the city of Libreville. No one on the ground was injured and neither were the two pilots and one passenger participating in the training flight. There was minor property damage and the aircraft also incurred structural damage. We praise God for that all were safe and I breathed a sigh of relief that it didn t happen when we were on it. Our book has finally reached the final step. Your Mission: Get Ready, Get Set, GO! will go to the printer this week and should be available in printed form in mid-may. This book is designed for all short-term and career missionaries getting ready to go to the mission field. The next SteffeScope will have the details about a pre-publication sale price. Praise and Prayers: 1. We praise God that the visit of the Ethiopian Department of Higher Education Relevance and Quality Assurance to the Soddo Christian Hospital on March 29 was a very good one and that SCH is now expecting a provisional accreditation. This was clearly a work of God. There are still several more steps of governmental approval to climb and they continue to need your prayer 2. Praise God for the traveling safety over the past two weeks. Please pray for traveling safety over the next two weeks. 3. Please pray for me during the upcoming meetings and speaking engagements in Pennsylvania and in Atlanta. I will be speaking to C.U.R.E, ABWE, Baptist Bible College and Seminary, the Medical Volunteerism Conference in Atlanta and several groups from Emory University and churches in the area. 4. Pray that many of those attending the Emory Conference who do not know Christ as a personal Savior will see something in the lives of those who are there and seek God as a consequence. 5. Please pray for my father as he undergoes yet another set of bladder biopsies April 13 to determine the proper therapy for his recurrent bladder cancer. If we could only remember that God always gloried in choosing the foolish things, the weak things, the base things and the things which are not, in order that His power might be revealed to us in our weakness and through us that the glory might be all His. Kenneth Strachan ( ), missionary to Costa Rica Glad to be a fool for Christ Bruce for Micky and Sean

17 Volume 13, Number 9 Saturday, April 10, 2010 Dear Friends and Family: The SteffeScope Some weeks, there seems to be nary a cloud in the sky. Some weeks, there are showers of blessings. Other weeks, He dumps it by the bucket. This week, it was a deluge. Monday, the mail brought $47,000 in donations for PAACS in one day (a tenth of our annual budget). The same day, I received an with word of a grant that will buy 7 new ventilators for the Soddo Hospital, a letter from a US military doctor confirming his desire to go to the mission field with PAACS, an offer for a refurbished ventilator for Gabon, an offer for some monthly support for a resident at Soddo, a note from a Norwegian surgeon inquiring about a possible career with PAACS sometime in the future, confirmation that one 2010 PAACS graduate will go to Ngaoundéré to help Jim Brown for two years before going to his home country of Burundi to finish out his time of service with PAACS and an encouraging note that suggests that the Ethiopian government may approve our program (and wants us to quadruple the output of residents!). I also signed the contract for the printing of Your Mission: Get Ready, Get Set, Go! That s not all! On Thursday of this week, I got the news that the Ethiopian governmental agency had indeed approved our program. Approval at this level is the first big hurdle. Our graduates must still be accepted by the Ministry of Health as Specialists in Surgery. We must also continue to work to meet some items they want to see in place before they grant complete accreditation. This answer to prayer still has our head spinning. We are amazed at how we went from No way to Way, Dude! Let me tell you a brief story that may explain a bit of it and sheds wonder on the way God works. First, let me explain the setting of the story: You must first understand that we have had our application in process for at least two years and I and others from PAACS have flown to Ethiopia at least twice for this purpose. We met with the heads of the government agencies during those visits. At their request, the team wrote a 130 page application and a many-page policy and procedure statement for the government, describing our ideas of what constituted adequate surgical training. Dr. Gray and Dr. Anderson in Ethiopia have made innumerable phone calls and trips to Addis in an attempt to move this stalled application. We had come to a dead end with our efforts and were just sitting, waiting on the Lord. Prayers from folks like you were flooding the throne. Back to my little story: One of our PAACS Commission members went on the recent PAACS vision trip to W. Africa and to get ready to go, he went to the travel medicine clinic at his university. He made acquaintance with the Ethiopian physician who was running the clinic. The conversation turned to PAACS and our training program in Ethiopia and this Ethiopian was very interested in what was happening. A short number of days later, I was in my friend s office and he wanted to know if I would talk to this man. To my surprise, the doctor immediately walked across campus and I was blown away by his enthusiasm. I explained the program and all I knew about the politics behind it, including the issue of our policy to train Christians exclusively. It turned out that he knew many of the key players and had grown up with them in his village. He stated he was convinced that this sort of program was exactly what Ethiopia needed to address its problem of a lack of surgeons. He promised to do what he could to help. I was skeptical. Many are those who promise to help, but few are the results thereof. (To quote a verse from the book of Hezekiah or Second Condominiums, but I forget the chapter and verse number ). It was less than two weeks later that we got the notice that the Ethiopian government officials were coming to inspect Soddo. On Monday, March 29, three came from the government agency (Higher Education Relevance and Quality Agency) and one from the Black Lion University Department of Surgery (he was also the Secretary-General of the Surgical Society of Ethiopia). They left with encouraging words. Ten days later, Dr. Paul Gray picked up the letter of accreditation. I wrote a letter of thanks to our new Ethiopian friend and while he admitted that he had talked to some folks, he demurred at taking the credit. Still, the timing was so coincidental that I suspect that it is a God-incident. Oh, a small fact I forgot to mention God used this follower of Islam to move His program forward. I am in Harrisburg, PA, today because of a meeting Thursday with Scott Harrison, the CEO of CURE, and for a speaking engagement yesterday at the Association of Baptists for World Evangelism which is headquartered near here. Dr. Harrison is an orthopedic surgeon/entrepreneur who has founded CURE ( an organization focusing on children with disabilities, and I have crossed paths with many of their people over the years. They have an excellent orthopedic training program at Kijabe Hospital and one of our PAACS graduates is training there. They have 10 hospitals in multiple countries and are now increasing their focus on the window. I recently met Dr. Harrison at the

18 Volume 13, Number 9 Saturday, April 10, 2010 Korean-American Mission Health Conference in Irvine, California and I set up this appointment subsequently. It was an enjoyable time we are the only two evangelical surgical training programs although we have dramatically different paradigms. You might find it interesting to read this 2004 article from CNNMoney: I don t know if we accomplished much, but we are better aware of each other s organization and maybe God has something for us to do together in the future. I also spoke to the staff of ABWE at the prayer chapel service yesterday morning. ABWE is the mission agency which owns the hospital in Bangladesh where PAACS has a program and they are seriously considering opening a new PAACS training program in Togo. I was glad to be able to share the vision with them and to refresh my friendship with Ron Washer, the ABWE administrator for Africa (see picture). Ron was a third generation missionary to Africa and we have met many times during our trips to Togo. Bits and Pieces: While here in Pennsylvania, I had the pleasure of finally meeting Todd Burgard, the man who has designed our three books. I enjoyed the meal together and was pleased to hear that Samaritan s Purse is re-ordering more copies of their edition of our book for distribution to their volunteer missionaries. Mindset makes all the difference in the world. I can bemoan the fact that I had to spend 30 hours this week slogging through the textbook and writing exam questions for PAACS and the Kenyan COSECSA surgical residents or I can rejoice that I had the opportunity to free up at least 30 hours for the missionary surgeons that I serve, hours they can use to save lives, spread the Gospel or enjoy their families. My mindset is my choice. I had a good 30 hours. Praise and Prayers: 1. Praise God for the traveling safety thus far on this trip and pray for continued safety as I go to northeast Pennsylvania to Atlanta to home. 2. Please pray for me as I speak to the students and faculty at the Baptist Bible College and Seminary in Clarks Summit, PA. Monday and Tuesday, I will be speaking to two chapel services, the student mission fellowship and the recipients of the Dorothy B. Steffes scholarship. The scholarship is granted to students who intend to have a career in missions. 3. Please pray for me during the upcoming meetings and speaking engagements this week in Atlanta. Starting Thursday and going through next weekend, I will be speaking at the Medical Volunteerism committee (at Emory U.), talking to mission pastors from several churches, meeting with Christian businessmen and a few other folks. 4. Pray that many of those attending the Emory Conference who do not know Christ as a personal Savior will see something in the lives of those who are there and seek God as a consequence. 5. Please pray for my father as he undergoes yet another set of bladder biopsies April 13 to determine the proper therapy for his recurrent bladder cancer. I will keep the ground that God has given me. Perhaps in His grace, God will ignite me again. But ignite me or not, I will keep the ground He has given me. John Knox Hoping to burn brighter for him, Bruce, for Micky and Sean too

19 Volume 13, Number 10 Thursday, April 15, 2010 Dear Friends: The SteffeScope Tears clouded my vision as I looked out over the full auditorium. The lump in my throat almost hurt. It seemed only yesterday when I knew that, because of the errors I had made, this opportunity would never again be possible. But He is God of second chances. Several years ago, shortly after my lowest point when I wondered what the future would hold, He gave me the promise found in Jeremiah 15:19a Therefore this is what the LORD says: If you repent, I will restore you that you may serve me; if you utter worthy, not worthless, words, you will be my spokesman. (NIV) Forty years ago I left the student body at Baptist Bible College in Clarks Summit, PA, on my way to the University of Michigan. I was certain that the world was my oyster and I had quite convinced myself that I was destined for great things of my own making. It didn t work out that way. This week, I had the honor of addressing the entire student body of the college and seminary. Due to His grace, I was there in my undeserved role as an ambassador of the Lord God Almighty, rejoicing in the reality of what God has done in my life and sharing the vision of PAACS. I rejoice that God uses broken and flawed people. Two of my favorite faculty members were still there and one of my classmates, Dr. Dennis Wilhite, is now a professor. My music professor, Dr. Don Ellsworth, is one of only two professors who gave me a B during my undergraduate career. Ironically, both Bs were in one-hour courses. When I mentioned this dubious distinction to him, he asked why he would have ever done such a thing. A little late to be asking that question, I thought! I had to admit it was because I hadn t memorized my music in time for one of the rehearsals and I probably deserved it. Of course, we never want justice, we want mercy. Dr. Ellsworth always impressed me when I was a student. I prayed that I would get his voice (a beautiful cultured bass voice) and that I might have his sense of presence. Instead, God gave me his hair. Sigh. I was able to hand out 115 copies of our 2002 Handbook for Short-Term Medical Missions to students going on short-term medical mission trips. I was amazed to discover that it is used as a textbook for one of the mission courses there. The professor got some copies for future use, as well. It was a very special two days and there were a lot of bittersweet memories. Last Friday, Laura Abbey (L) received the Dorothy B Steffes Scholarship in 2009 and 2010; Andrea Mays (R) in Both are students at Baptist Bible College and are majors in missions. Coach Jim Huckaby (R) was (and remains) a great mentor and friend. I also took a few minutes to work on a special project of a personal nature. I talked to the provost to see if there is any way I can begin a remote-learning master s degree program in Biblical ministries. I had applied over a year ago but was turned down because I don t have an undergraduate degree. This should be a lesson for all of you stay in school and don t be a drop-out! Actually, since I actually have more than 120 credit hours, he even wondered if they might be able to finally give me my undergraduate degree. I thought that ironic and wonderfully funny: I got my doctorate in 1976 and my

20 Volume 13, Number 10 Thursday, April 15, 2010 master s degree in With this reverse approach, I might get my undergraduate degree in 2010 and that would give me the chance to work on and get my G.E.D. in 2020! But then what? Kindergarten? Shopping for Jesus! What a deal this is you can shop and support S 3 Ministries all at the same time! Christian Book Distributors (Christianbook.com) is one of the best sources on the Internet for all things Christian. We love that site. You can donate to our ministry 10% of all you spend in general merchandise and 5% of all you spend on music downloads simply by making one extra click. How? Go to click on the link for Christianbook.com (on the right side) and voila! Just order as you ordinarily would and they will send us a check at the end of the month. You have made yourself happy and blessed us at the same time. Thanks! Have we got a deal for you! Before you put your credit card away, please consider this additional great deal. The new book Your Mission: Get Ready, Get Set, GO! will be available from the printer by the end of May. This 360 page book will have a retail price of $ If you order now, you will have the special pre-publication price of just $12 plus S/H. If you wish to order both books ( Medical Missions: Get Ready, Get Set, Go! and Your Mission: Get Ready, Get Set, GO! ) you will get this $27.90 value for just $22 plus S/H. Please write us or order them on We don t want you to buy a pig in a poke, so go to our website, look around and download some samples from the book. Then buy a set for your church library too just because you are wonderful person! Bits and Pieces: Today's fortune cookie: "A different world cannot be built by indifferent people." I can do the possible. God can do the impossible. I must remember the difference. Kay Walsher in One Candle to Burn Praise and Prayers: 1. Praise God for the traveling safety over the past two weeks. Please pray for traveling safety as I go to Atlanta tomorrow. 2. Please pray for me as I have several meetings in Atlanta. Tomorrow night, I will meet with several physicians and their wives who are going to Tenwek. I will also meet with attending surgeons and residents from Emory University s Department of Surgery. On Friday, I am having breakfast with several mission pastors in the area and lunch with several Christian businessman. Friday night and Saturday, I will be attending (and speaking at) the Medical Volunteerism Conference at Emory University. On Sunday, I will be speaking to a Sunday School class at Johnson Ferry Baptist Church. Please pray that God will open hearts and minds. Pray for those students and visitors who are not believers may they have an appointment with Christ this weekend. 3. Praise God that Dad s procedure went well. The results will be available in a week and decisions regarding therapy will be made then. Amongst many who sought to deter me, was one dear old Christian gentleman, whose crowning argument always was, The cannibals! You will be eaten by cannibals! At last I replied, Mr. Dickson, you are advanced in years now, and your own prospect is soon to be laid in the grave, there to be eaten by worms; I confess to you, this if I can but live and die serving and honoring the Lord Jesus, it will make no difference to me whether I am eaten by cannibals or worms. John G. Paton ( ) missionary to New Hebrides (islands in the South Pacific now known as Vanuatu). Yours, for Africa and the Kingdom, Bruce for Micky and Sean

21 Volume 13, Number 11 Friday, April 23, 2010 Dear Friends: The SteffeScope Ten meetings in ten days and 2,000 miles on the odometer. Each time, I presented PAACS to a group with different interests. Last week in The SteffeScope, I told you about my meetings with CURE, ABWE (Association of Baptist for World Evangelism is affiliated with the Bangladesh program and the potential program in Togo) and the three times I spoke to the students of the Baptist Bible College and Seminary in Clarks Summit, PA. After being home one day, I headed off to Atlanta. I presented PAACS to the Atlanta Christian Medical & Dental Association chapter, spoke to a large Sunday School class at Johnson Ferry Baptist Church in Marietta, met with mission pastors from several churches, and met with a group of Christian businessmen. I was very pleased to be introduced by Jon Pollock to the officials of the Emory University Department of Surgery. Jon is the chief resident in general surgery who traveled to The PAACS Contingency: Ken Rutledge (member of the PAACS urology task force), Jon Pollock (slated to be a career PAACS surgeon at Soddo in 2011), Harold Adolph (career missionary surgeon) and Bruce Steffes represented PAACS at the Medical Volunteerism Conference held at Emory University in Atlanta, GA, held April 16 18, Meeting with Christian businessmen in northern Atlanta area. Ken Rutledge (far right) was my host and did a fantastic job in setting up a full calendar. Presentation to the mission pastors over breakfast perhaps I put too much of a slant on the facts? On the way home, I met some of our faithful prayer warriors. Betsy Grenevitch (with her guide dog Lassen) did not let her blindness stop her from serving as a missionary in Togo in the 80s. Three of her four children were with her: Michelle, Joshua and Paul. In the small world category, the children s grandfather taught in Lapeer, Michigan while we were there.

22 Volume 13, Number 11 Friday, April 23, 2010 East Africa with me on the recent Vision trip. I was very encouraged by their enthusiastic support for Jon, though it seemed clear that they had no good understanding why any sane person would do missionary medicine. Jon will be in charge of a new Global Surgery Initiative for Emory University. He will spend next year creating it before going in 2011 to Ethiopia as a PAACS surgeon. My original reason for going to Emory this past weekend was to speak at the Medical Volunteerism Conference held in Atlanta at Emory University. Emory is a very secular university despite its long-forgotten Methodist beginnings and yet over 50% of the speakers and ministries were clearly (and sometimes very outspokenly) evangelical. I suspect that there will be complaints about our testimony and it was clear that many attendees were clearly befuddled by the Christian focus but I am thrilled that this weekend many may have heard more about Christ and the effect of faith on people s life than they may have heard in their entire life heretofore. The rest of this week was spent in preparation for the upcoming annual meetings of the Christian Medical & Dental Association, PAACS and the Continuing Medical and Dental Education. Micky has put in a lot of hours setting up a new accounting system for CMDE and helping me with the new budget. I have also spent lots of time working with Ervin, the PAACS administrator. Absolutely vital and critical work but boring to write and read about. The next thing on the schedule will be a trip to Samaritan s Purse on April 28 with Dave Thompson, then speaking at North Pointe Baptist Church of Weaverville that evening before going to the CMDA annual meeting in Ridgecrest, N. Carolina. I will be staying Sunday and Monday (May 2 and 3) to attend the annual meeting for the CMDA-CMDE meeting before coming back to Fayetteville. Bits and Pieces: Support our ministry by going to click on the link for Christianbook.com (on the right side) and shop away. Ten percent of all you spend in general merchandise and 5% of all you spend on music downloads will be donated to S 3 Ministries. Pre-order the new book Your Mission: Get Ready, Get Set, GO! at a discount by going to It will be available from the printer by the end of May. We found several errors in the printer s proof of the new book. Sigh. Worse, they were our fault. This will delay our printing schedule by a few weeks although we still hope to hit our May target. Praise and Prayers: 1. Please pray that the approaching annual meetings for CMDA, PAACs and CMDA-CMDE will be productive and honoring to Christ. 2. Praise God - I did meet a surgical intern at Emory, Dr. Love, who is interested in PAACS as a career! Please pray for him as he prepares the next five years. Pray for Jon Pollock as he prepares to go to Ethiopia next year. 3. Praise God for Wayne Shepherd s wonderful professional help this week in producing a narrated PowerPoint video. He donated his voice talent, the one with which he has praised God his entire career. Please pray that this piece will better introduce PAACS to many new audiences. He made a post to his Facebook page that I hope will get us some radio interviews from all over the continent. 4. Thank God for the safety in traveling. Please pray that all that we have shared will take root and grow. Thanking God for your partnership, Bruce for Micky and Sean P.S. If any of you live near Chicago, I would like you to invite you to the free Friends of PAACS Dinner to be held Saturday evening, May 15 at 6:30 PM. It will be held at the Pine Grove Restaurant at 6580 Mannheim Rd, Rosemont, IL. This will be our first spring dinner, so please come to encourage us and receive a blessing. Please contact Ervin Barham at ervin.barham@paacs.net to reserve a spot for you and any friends (including pastors or physicians) who might like to hear more about PAACS.

23 Volume 13, Number 12 Tuesday, May 4, 2010 Dear Friends: The SteffeScope Home for three whole days! Then I am off again. Last Tuesday, I picked up Dave Thompson at the Greensboro airport (blurry-eyed and minus luggage from a red-eye flight from California) and drove on to Boone, NC, to meet with World Medical Missions (Samaritan s Purse) Tuesday and Thursday. We met with their short-term missionary sending team Tuesday afternoon. We enjoyed a good time and additionally we were encouraged to request funds for some of the construction programs associated with PAACS activities. We shall certainly do so! That evening, we had a wonderfully relaxed dinner with Franklin Graham, Dick and Harriett Furman and Ed and Becky Williams at a modest local barbecue restaurant no business allowed, just a lot of good food and conversation. On Wednesday morning, Dave spoke to the morning chapel service at Samaritan s Purse to over 450 employees. Afterwards, we met with the administration of the Post-residency program. This is a program which supports missionary physicians for two years after their residency with the intent of promoting their long-term missionary service. We accomplished a lot and we are excited about our plans for future collaboration. After lunch, we drove to Weaverville, NC to the home of our dear friends Rev. Johnny and Jennifer Byrd. Part of the way, we enjoyed the meandering Blue Ridge Parkway. The spring is much delayed at that altitude but the scenery was awe inspiring. Dave and I spoke that night at the North Point Baptist Church for their prayer meeting and enjoyed the time with friends (and a reunion with Dave s luggage). Late Thursday morning, we drove to the Ridgecrest Conference Center, just north of Asheville. That afternoon, I presented the annual report about PAACs to the House of Representatives of the Christian Medical & Dental Associations and then entered a three-day whirlwind of meetings, networking and some phenomenal speakers. Os Guinness, John Patrick, Dave Stevens and Dave Thompson were the plenary speakers and it was a wonderful time. I had literally dozens of meetings with various people to promote PAACS and God opened some new doors. For those of you in the Southern Baptist Convention, I had the pleasure of finally meeting Rebekah Naylor. Dr. Naylor was a medical missionary to India for most of her adult life and came home when the International Mission Board diminished the emphasis on medical missions. She has opened up an opportunity for PAACS to take advantage of a wonderful internet-based curriculum in basic general surgery and we are working on those details now. We had a PAACS booth there and Ervin Barham, the PAACS administrator, and his wife Tabitha manned the booth during the conference. Sunday, the CMDA conference came to a close with a worship service and the CMDA-CMDE (Continuing Medical and Dental Education) annual meeting continued on without dropping a beat. We met from 10:00 AM until 9:00 PM on Sunday and then met for four hours on Monday. It was fruitful but very draining. It was good to see those friends again. After a busy three days here this week in Fayetteville, I am flying Friday to Michigan to help my parents. You can tell that I REALLY love them because I am going to paint, something I hate to do. I will spend Mother s Day with them and will share PAACS at the adult Sunday School time that day. Next Tuesday, I will speak at a local CMDA meeting in Grand Rapids and then Thursday fly to Chicago for the PAACS meeting and Friend of PAACS dinner. If you are anywhere near O Hare airport, I would like you to invite you to the free Friends of PAACS Dinner to be held Saturday evening, May 15 at 6:30 PM. It will be held at the Pine Grove Restaurant at 6580 Mannheim Rd, Rosemont, IL. This will be our first spring dinner, so please come to encourage us and receive a blessing. Please contact Ervin Barham at ervin.barham@paacs.net to reserve a spot for you and any friends (including pastors or physicians) who might like to hear more about PAACS. Bits and Pieces: I have found that authors can t have too sensitive an ego. Recently, I did a little vanity surfing on Amazon.com for our Book Medical Missions: Get Ready, Get Set, Go! I was fascinated to find several book sellers selling new and used copies of it. New copies are being sold by people to whom I have never sold them wholesale (which means any copies they have are technically used) and one place is selling this is $12.95 book for as much as $60.32 plus 3.99

24 Volume 13, Number 12 Tuesday, May 4, 2010 S/H. At that price, I can give you a great bargain! How many copies do you want for, say, $49.95 each? I will even ship them to you free at that price. The used copies made me sad. I am sad because obviously the people who received them are now dead or if still alive, in severe financial straits to the point of starvation. Their tragedy is clearly self-evident why else would they have gotten rid of such a great treasure? At the conferences in Atlanta, I told about the need for 22 general surgeons to help PAACS expand. I made the comment that I didn t know 20 general surgeons on the mission field (a true statement), but this past week, I made a list of those who have said that God is calling them to the mission field for service with PAACS. There were over 20! God does indeed prepare in advance the good works for us to do (Ephesians 2:10). We also realized that PAACS has been responsible, either directly or indirectly, for the recruitment of over a dozen surgeons in the past few years. God is good all the time! One of my greatest pleasures in the past few years has been the chance to work closely with Dr. David Thompson, the missionary surgeon to Gabon and founder of PAACS. He is a fourth generation missionary and just a wonderful guy in all regards. In John 13:5 and following verses, we read of the time when the Lord took a towel and washed the feet of the disciples. Christ s humble action has come to symbolize true servant leadership. On April 29, 2009, Dave was honored at the Christian Medical & Dental Associations annual meeting for his long history of demonstrating servant-leadership. He received a wall plaque and a wooden bowel and towel. It was a complete surprise to him (deliberately kept so because they feared his humility would preclude his acceptance of the award). It was very much deserved. Praise and Prayers: 1. Please pray that the approaching annual meetings for PAACS and my meeting with surgeons in Grand Rapids 2. Thank God for the safety in traveling and please pray for ongoing safety. 3. One of PAACS strongest advocates at World Medical Mission is moving back to Texas. We are sorry to lose her in Boone, but we may be hiring her as a grant writer for PAACS something we have needed for a long time. Please pray that God will direct through all of this. 4. Tomorrow night, we are having dinner with a military surgeon who wants to serve with PAACS. Please pray for him as we give advice and as he and his wife seek to serve beginning in October, I am reading a book about cross-cultural teaching and came across this statement, We don t have to bring Jesus into the classroom. He s already there. 1 How simple and yet how profound. I don t have to work to bring Him into the clinic or the operating room He is already there. In fact, I can t keep Him out. I can only ignore Him. In doing my work well, I honor His presence. And I look pretty stupid by going about my business and not recognizing His presence, by not taking advantage of His expertise when I am faced with a problem and by not introducing Him to the others in the room. I would never be that rude to a human visitor in my room. Why do I do it to Him? As I meditated more on this truth, I also realized that there is not a problem or fear I face where He is not already fully present. And my worry about the uncertainties of the future is equally futile. As the saying goes, Fear not tomorrow; God is already there. My prayer must thus be: May I always have the sense and faith to practice Your presence today or tomorrow, in joy or sorrow, in good times and in bad. And may I quit being so foolish as to try to run from You. The farther I run, there He is. Preferring to run to Him, Bruce for Micky and Sean 1 Romanski & McCarthy, Teaching in a Distant Classroom, p. 26

25 Volume 13, Number 13 Sunday, May 16, 2010 Dear Friends: The SteffeScope The latest book arrived! The months of effort paid off when two pallets of Your Mission: Get Ready, Get Set, GO! were delivered on Friday. This book will help any new missionary, short-term or career, who needs to think through the processes of preparation, to select an organization to go with and to deal with the new culture and experiences. There is nothing quite like it on the market and certainly not in a single volume. We are now faced with moving them not just from the garage to storage but from storage to your hands. Help us move them! Buy one for your church library, buy one for anyone going on a short-term mission trip and buy one for anyone you know who is going to the mission field as a career. This book is priced at $14.95 but for a short time only, it can be purchased on the web at at the pre-publication price of $12.00 plus S/H. This offer is good only until the end of May. Medical Missions: Get Ready, Get Set, GO! is also available. You can also buy both books (a $ value) at $22 plus S/H. Trip to Michigan and Illinois: I had a great time in Lapeer visiting my folks. It was Mother s Day weekend and I enjoyed time with both my mother and my mother-in-law. I presented PAACS to the combined adult Sunday School classes at their non-denominational church and kept the most important obligation I made sure they got out on time so they could get to the restaurants ahead of the Baptists, Methodists and Presbyterians. Mostly, I relaxed for several days, read and worked on some projects for PAACS and enjoyed the pampering. I have taken some grief about the painting job for my folks. Too many seemed to enjoy the prospect of my toil. I am just thankful that Michigan weather stayed true to kind. It either rained or was far too cold to paint. I escaped this time but will just have to do it when I come back in late June. One can only hope for some cataclysmic event between now and then! Tuesday, I drove the 2¼ hours to Grand Rapids to meet with the Christian Medical and Dental Association (CMDA) meeting at Butterworth Hospital. I presented PAACS and in a separate meeting, talked with two fourth year general surgery residents and an ex-missionary surgeon about starting a future program in Rwanda. Thursday, I flew to Chicago for the first spring meeting of PAACS. It was a great time of prayer, fellowship and planning and a great deal was accomplished. The main goal was to continue the restructuring of the organization in preparation for the future. We approved a new vision statement, a new mission statement, new by-laws, and an extensive new board policy manual. We also made great progress on a. PAACS Commission attendees in Chicago a strategic plan. We met with a financial consultant from CMDA to help us with a fund-raising strategy. Saturday night, we had the first spring Friends of PAACS dinner and an intimate but warm group of 37 joined us. The restaurant was kind enough to give us a touch of Africa it was 2.5 hours from order to the serving of the last meal! Bits and Pieces: Sometimes there is just no pleasing the woman! Micky complained about seeing field mice around the house. I came up with a solution but she didn t like that either! This picture is of a common rat snake that was escaping from the crawl space under the house.

26 Volume 13, Number 13 Sunday, May 16, 2010 I saw several classmates from high school when I presented PAACS to my folks church in Lapeer last Sunday. It has been 41 years since I left Lapeer Senior High School. I knew that time is not always kind to people and I had made a secret promise to myself not to mention how much they had aged until I saw one familiar face. He looked awful! Ridden hard and put up wet! Thanks be to God before I said anything too harsh, I realized I was looking in a mirror. One woman really hadn t changed much and I would have recognized her anywhere. I said as much. She returned the same compliment. She should be ashamed to be such a liar or am I being too harsh on her? I decided that perhaps I was. Maybe she is right. Maybe I do look good! Let s make this a contest a test of my friend s veracity. One of the pictures above was taken at graduation from medical school at age 24; one a couple of years ago at age. I won t tell you which is which. The question: Have I tried to fool you by using the same picture twice or was my friend just telling the truth? (Unstated rule: No comments about hair are allowed.) Send in your entry on a 3 x 5 card (block printing) along with a bank draft for a hundred dollars or more to be eligible for the fantastic gift card worth ten dollars at a store about to undergo Chapter 11 reorganization before you can redeem it. Praise and Prayers: 1. Please pray that our new book will have a profound effect and be of a great help to those who read it. 2. Please pray for me as Carl Haisch and I get together Friday in Greenville, NC, to write the first draft of the 200 questions annual PAACS exam. 3. Pray that all the talking about PAACS that I have been done will bear fruit. 4. Please pray for a meeting scheduled with the founder of a charitable foundation that is scheduled for the morning of May 27. We have a $44,000 grant application pending. Closing thoughts: It was a cold (43 o ) blustery day and I was driving a yard tractor and roller around and around my parent s 1.5 acre lot. My icy fingers were aching and a nice shade of blue. The wind chilled me to the bone. It was boring and I didn t think I was accomplishing much toward smoothing the bumps in their lawn. It was a seemingly foolish and unnecessary thing to do. Then I realized that the reason I was doing it was because my father had asked me to do it. That realization was sufficient to change my heart and mood just pleasing him was all the reason I needed to continue. It is a good metaphor for life. There are so many things in life that I consider difficult, unpleasant or just beyond understanding but when I remember that the reason to do them is to please the Father, there is a change. Not necessarily in the discomfort, but certainly in the heart and mind. And that is enough. Trying to be obedient, one step at a time, Bruce, Micky and Sean

27 Volume 13, Number 14 Saturday, May 29, 2010 Dear Friends: The SteffeScope Annual Exams: It is that time of year again when life gets so exciting. We are preparing the annual exam for the PAACS residents. A 200 multiple-choice question exam, it is the product of a truly vast number of hours of work. Reading the reference text and writing questions per chapter takes approximately 3,000 man-hours. This question-writing is done by the already very busy Program Directors and by other volunteers. Once the questions are written and critiqued for their compliance to the desired format, Dr. Carl Haisch, chairman of the PAACS curriculum committee and Professor of Surgery at East Carolina University, literally spends days painstakingly selecting appropriate questions to fit the blueprint of the exam. I traveled to his home in Greenville, NC last Friday and we spent all day getting the majority of the exam questions selected. Our work continued into the weekend as the questions are carefully read and restructured to make sure that the English is simple and clear to trainees, ambiguity is avoided, all measurements are expressed in proper units and the formatting is easy to read at a glance. We still have about 20 questions in a few topics to select. Once the full complement of questions are selected and sifted, instructions will be written and test copies and answer keys are created. Some of the program directors then volunteer to take the exam. Their performance and critiques are taken into account to make final adjustments. That process takes a minimum of 50 hours and sometimes up to 100 hours. A second 200 question remediation exam must also be created with a similar investment in time. The taking of the four-hour exam is monitored by one of the faculty at each site and then all answers are carefully entered into a spreadsheet making sure that there are no transcription errors. That file is sent by to the US where the exams are graded and the results sent back within 24 hours. This process rapidly allows each question to be analyzed individually to determine whether it is invalid and should be excluded. The actual answer sheets are mailed back to the US and when all have arrived, they are scanned and the results statistically analyzed by PhD in education (also at ECU) who helps determine the reliability of the exam. At least 50 man-hours are expended in the grading and evaluation process as each one of the questions is carefully scrutinized. Validity and reliability are two of the major goals of any exam. Validity implies that the questions are appropriate and fairly represent the desired body of knowledge; reliability implies that the test has reproducible results which fairly discriminate between those who know the material and those who do not. The blueprint for the exam, based on the curriculum, tries to minimize sampling error and the fact that the questions are written and selected by experienced clinicians helps give confidence that the exam is valid. Reliability is a statistical tool in which reputable organizations attempt to have an index of at least.90 for high-stakes exams. The 2008 PAACS exam had a reliability index of.94 and the 2009 exam was calculated at.91. The American Board of Surgery reportedly spends almost $1,000 a question to achieve that level. The PAACS budget is considerably less! And now, the only thing that remains is the simple matter of extensive study and passing the exam. We wish the best for all of our residents. Please pray for them as they prepare and sit the exam on Saturday, July 3. It was Greek to me! Not only Greek, but it was cuneiforms of all types, hieroglyphics, Armenian, Cyrillic, runes, Arabic, North Semitic, Brahmi, Indic, Chinese, Cree, Ethiopic, Tifinagh, Bamun and dozens of other syllabaries and alphabets. I have never felt so totally like a fish out of water as I did in my recent visit to the JAARS Museum of the Alphabet (a virtual tour is available at The museum is in a modest building nestled in a bucolic setting near Waxhaw, NC (just southeast of Charlotte). On my self-guided tour, my poor aching head spun with terms such as: bilabial fricatives, coronals, dentals, glottal, epiglottal plosives, forward stops, posterior stops, phonemes, approximants, and prenasalized consonants. I have a vague understanding of only a few of those terms. A linguist I most definitely am not.

28 Volume 13, Number 14 Saturday, May 29, 2010 The outstanding exhibits gave me a renewed and profound appreciation of the phenomenal work that Wycliffe Bible Translators (and the sister organizations, JAARS and Summer Institute of Linguistics) continue to do. With 7,000 languages on the face of the earth, these organizations have worked with over 1,000 of them and there are still many new alphabets to be invented so heart languages can be written and read. Computerization has significantly eased the process as the computer is capable of looking for and analyzing patterns much faster than the human brain. If any of you are interested, the used book stores have a book about this topic and about the museum entitled The Alphabet Makers, published in Birthday Boy! Sean turned 9 this past weekend. He remains well above the 95 percentile in height (4 10½ ) and weight. With two of his neighborhood friends and his older brother Ryan, he celebrated with some rousing games of laser tag, played video games in the arcade, and had pizza and cake while they watched a special downloaded movie on Saturday. On Tuesday, he celebrated with his older sister Michelle. This coming week, he will celebrate with both sets of grandparents. He considers a multi-day celebration normal! His life is more than a bit odd in many ways. In his school class the other day, they were talking about what the students were going to do on summer vacation. One was going to the lake, one to the ocean, one going camping and so on. When it was his turn, Sean nonchalantly said he was going to California, Hawaii, Asia and Africa. The conversation ground to a halt, according to his teacher. Micky and I weren t sure where he got Asia but maybe he confused our trip next February with this summer s itinerary. Praise and Prayers: 1. Praise God for an encouraging meeting Thursday morning with Robin Hayes. He was our congressman for the NC 8 th district and has founded the Hayes Family Foundation. Our mutual friends, Ed and Becky Williams, arranged for us to meet with Congressman Hayes to discuss a grant proposal that we had submitted to the foundation. I was very encouraged with his enthusiasm for PAACS and with his Christian testimony. I praise God for Mr. Hayes willingness to think about ways to promote PAACS. 2. Praise God for an encouraging meeting Friday morning with Brian Tyndall of Global Outreach, a sending missionary agency located in Tupelo, Mississippi. Scott Reichenbach of World Medical Mission, Ervin Barham of PAACs and I met with him to discuss a possible relationship between PAACS and WMM with Global Outreach. I will also be meeting in a couple of weeks with Go Ye Fellowship in Pasadena to pursue the same goal. Please pray that we can find a partner that will serve our career medical missionaries well and which can work with the needs and demands of our respective organizations. 3. This will be the last SteffeScope for a few weeks. (No, that is not a praise item!) Sean s last day of school was yesterday and tomorrow is the first day of our first true family vacation please pray for true relaxation and for safety in traveling. We will be driving to Michigan tomorrow, flying Tuesday to southern California for 9 days of fun before going on to Hawaii for week before returning to Michigan. We will be doing all the tourist things (including straining our credit card). We will spend time with my daughter, Michelle, in California and with friends in Hawaii. When we return to Michigan to spend time with both of our folks, I will be painting my parents house and also going to West Virginia the end of the month to lecture in the tropical medicine course. We then will leave for Togo from there. We will be on the Mercy Ship for four weeks before flying back to Detroit. 4. Praise God for the blessing that all of our children are to us. 5. Please pray for my health complications of my diabetes are progressing at a faster than desirable rate.

29 Volume 13, Number 14 Saturday, May 29, 2010 The world needs Christ more than it needs skills. It will not accept Christ unless we offer it help with these other things. But if we give skill without character, we make the world only more powerful to do itself harm. Frank Laubach ( ) linguist in Asia, Africa and Latin America Training and discipling for exactly that reason, Bruce, Micky and Sean

30 Volume 13, Number 15 Friday, July 2, 2010 The SteffeScope Dear Friends: As Robbie Burns observed in his poem 1, The best laid schemes o' mice an' men/ Gang aft agley. We were supposed to be getting on the plane today to wing our way to Togo for another four weeks on the Africa Mercy. Instead, I am sitting in my old bedroom at my folks home in Michigan, still coughing up pieces of my lung (well, it seems that way!) See, I want to avoid the temptation of saying I told you so but... I told you so! I told you that God didn t mean for people to take vacations. It isn t that it wasn t fun and all. It is just that is was too much of a change of pace for this old workhorse. Micky and Sean adapted just fine, however, and I figure we will be out of debt sometime next year! So, why don t I enjoy the time off? Actually I did, but the pressure of all the things to be done was overwhelming. It doesn t help if you have a delusional sense that you are the one who should do it all. It is not easy to be responsible for the entire world! Yeah, I know save your breath to cool your soup. Still, it will be three weeks that we will never forget. If you want to see our album, you can see it on Facebook even if you are not normally on Facebook (how wise of you!). Just go to this public URL Once we returned, I fought the jet lag and spent much of the week back in Michigan trying to put together a decent set of lectures. I had agreed to do a new lecture on tropical surgery for the Tropical Medicine course in Morgantown, West Virginia. I have had plenty of time, but I really struggled to get it done. It seemed like running under water. On a new lecture, I figure on hours of preparation for every hour I talk and this one seemed to take longer than that. Fortunately, two of the four lectures I had to give were old ones and only required some freshening. When not working on the lecture, I was able to keep my promise to my parents power-washing, bleaching, scraping, painting and caulking the front of their house. Michigan weather made it difficult I had to dodge the rain storms but completed the job before my parents returned from a short trip. I became very ill with shaking chills and fevers. A dry cough began to invade my every waking hours. I deemed it just a cold and soldiered on. I seemed to be improving as the trip to Morgantown, WV, loomed ever closer. I felt I wouldn t have to cancel the lectures, but only if Micky could help me drive in both directions. I wasn t sure I felt that well that I should be in charge of a two ton machine going 70 miles an hour. She agreed to do so and since Sean got to stay with his grandparents and play at the lake with his aunt, he was perfectly happy. On the way to Morgantown from Michigan, I had the pleasure of introducing Micky to an old boyhood friend and I got to meet his family. Steve Olsen is now a Baptist pastor in Smithville, Ohio. His father was my pastor when I was little but Micky had no real recollection of them (she was only in first grade when they left). We were inseparable as small children, but I have only seen him once since he moved to Ohio as a sophomore and that over 40 years ago. I enjoyed staying at his home Monday night and getting to know (hopefully, not infect) his family. My, amazing how he has aged and I have not! Hoarse and hacking, I managed to get through both half days of lectures although I can t promise that the attendees got full value for their money. It was good to see Dr. Greg Juckett, a friend who is involved with the program and who runs the student health program for the University. He was kind enough to examine my chest and confirm that I had pneumonia in my left lung. He prescribed some expensive antibiotics and an inhaler and told me I would be unwise to go to Togo. Being stubborn (no, 1 To a Mouse

31 Volume 13, Number 15 Friday, July 2, 2010 that is an accurate choice of words but thank you for your kindness), I resisted making that final decision for 48 hours but realized he was right and cancelled our flights. So what now, now that our schemes have gang agley? Don t know. With a nod to Robbie s poem, I would just have to assume that the Lord is plowing in my life in a way I don t understand. I might find something to fill in the hours but only after I get some rest... A note from the Africa Mercy: Dr. Glenn Strauss and his wife Kim are good friends who we met through our work on the Mercy Ship. He is a superb ophthalmologist. He recently finished his time of service on the ship. This piece came from a newsletter received the first of June. It shows the pathos we so often face: One small 5 year old stood in line with the 500, waiting to get into our mobile eye clinic that was being held in a large Catholic Church. The little girl remained nameless as her mother pressed her forward with the line. She was completely blind, her little eyes scarred from disease. Our translator, a local pastor, stood calling the children to be lined up. We always see the children first and this little girl was now at the front of the line. As she stood quietly in front of the pastor and listened, she looked up toward his voice. When he stopped speaking, she said, "Are you Jesus? Can you help me?" The pastor choked as he looked into her white eyes that no longer had color to them and realized he would be the one to pray with her after they told her that there was no hope from us. With tears, he told the child that only Jesus can help...and he wasn't Jesus. We pray that that little girl's faith will bring her the healing and the hope she longs for. She was sent home (and we never learned her name.) Pray for her. Pray for our field team as they experience this daily. Pray that even though we cannot help them see physically, that they will come to see spiritually. These are the faces that haunt us, but also bring us to our knees. "For it is not of him who wills, not of him who runs, but of God, who shows mercy" Rom. 9:16 Are you Jesus? What a haunting question. Does anyone even think to ask that of me? Praise and Prayers: 1. Praise God that my folks were able to celebrate their 60 th anniversary this week. They are such a blessing to so many. 2. Praise God that my meeting in Pasadena with Go Ye Fellowship was a fruitful meeting. We discussed the possibility of GYF being a sending agency for PAACS surgeons. 3. Praise God that He prompted to me to take out trip insurance on this trip to Togo for the first time ever. We will lose very little money by cancelling. 4. Please pray for all those disappointed patients in Togo. Pray that the Ship will be able to find a substitute on short notice and that the Spirit will work through the disappointment of others. 5. Praise God that my youngest sister came through her cardiac catheterization well. She can delay her aortic valve replacement for a few months in order to complete her PhD lab work. 6. Praise God that He put Greg Juckett in my path I would probably have not gone to the doctor yet and could have gotten much worse. Sometimes I feel... that my cross is heavy beyond endurance.... My heart seems worn out and bruised beyond repair, and in my deep loneliness I often wish to be gone; but God knows best, and I want to do every ounce of work He wants me to do. C. T. Studd Resting, Bruce, Micky and Sean

32 Volume 13, Number 16 Saturday, August 7, 2010 Dear Friends: The SteffeScope Hospital Radio: Do you want to make an eternal difference for a relatively small amount of money? How would you or your church, Sunday School class or service organization like to have a major impact in evangelizing and educating patients at a mission hospital? What an opportunity to leave a legacy! For as little as $4,000, you can help a hospital install a complete hospital radio a closed circuit system which brings radio programming to those many patients and families who sit around the hospital while they wait and wait and wait. Back in 1998, on our first mission trip to Togo, it was painfully obvious that there was a lot of wasted time for the patients who might wait all day to be seen. It was clear to us that focused programming in their own language would provide not only entertainment, but might educate them in personal health and public health as well as speak to their hearts regarding the need for the Great Physician. When you are scared for yourself or your loved ones is a great time to open your heart to the questions of eternity. About a year ago, Bruce was introduced to Bill Mial via a mutual friend. Bill has worked for years with Trans World Radio, the worldwide Christian broadcasting system. In 2001, he had the same idea that we had about hospital radio but where I lacked the radio, he lacked the hospital. God has brought us together and we are excited about this possibility. The first installation will be functional late this year in Bongolo Hospital in Lebamba, Gabon. If you would like to learn more, please go to and download the proposal for the pilot program ( Radio-Proposal.pdf) to share with others. We are so excited about this that we have in faith promised to raise the money for three more hospitals. That will be about $30,000. We don t know where the money is coming from but we have made this commitment in faith, feeling strongly in our hearts that this idea of hospital radio can bring hundreds and thousands to Him at every mission hospital. Would you be willing to help us? Please contact us to learn more and to partner with us. Planning for 2011: It s that time of year again. The passport is only one year old but had to already be sent off for new visa pages (editorial comment: the new prices for passport services are highway robbery!) We are scheduling our activities for 2011 and are excited about the possibilities that God has put before us (especially Bruce he will get to do some surgery again!). We are in the process of figuring out itineraries and buying tickets (spending about $13,000 for just the international flights). Right now, our approximate schedule is: August 16 Sean starts Fourth Grade. August Global Focus Conference, North Point Baptist, Weaverville, NC August 30 Bruce begins teaching his classes at Methodist University October 3 Speaking in a postgraduate course, American College of Surgeons Annual Meeting, Washington, DC October 16, 17 - Speaker at the Korean-American Kingdom Pioneers Mission Conference, New York City November Speaker and PAACS exhibitor Global Health Missions Conference, Louisville, KY November 12, 13 Pan African Academy of Christian Surgeons annual meeting and the Friends of PAACS dinner, Louisville, KY December 1-4 COSECSA annual meeting, Kampala, Uganda January 8-13 Tenwek Hospital January Kijabe Hospital January PAACS Principles of Surgery Conference at Brackenhurst Conference Centre, Limuru, Kenya January 29 February 5 Visit Arusha Medical Centre in Tanzania (for PAACS) and possibly more time at Kijabe. February 6 10 West African College of Surgery meeting in Abidjan, Ivory Coast

33 Volume 13, Number 16 Saturday, August 7, 2010 February Continuing Medical and Dental Education Conference for missionaries to be held in Chiang Mai, Thailand Mar 4 7 Plenary speaker at the Loma Linda University Alumni Conference April 8 9 CMDA-CMDE Spring Business Meeting, Chicago April PAACS Spring Business Meeting, Chicago April 26 May 1 CMDA Annual Meeting, Mt. Herman, California May 8 August 6 Working on the Africa Mercy ship in Freetown, Sierra Leone. Three PAACS residents will be rotating on the ship with me (at least if we can work out the remaining details with Mercy Ships). Methodist University PA Program: Bruce s responsibilities at the Methodist University Physician Assistant Program are heavier than ever. Classes start on August 30. He is now lecturing 13 contact post-graduate hours a week plus working an intensive hands-on 8 hours a week in the anatomy lab. That is outside of the newly added responsibility for supervision of the general surgery curriculum, a new faculty development program which he is implementing, design and implementation of the new anatomy lab, some lectures for undergraduates well as the usual faculty committee responsibilities. The new human anatomy building is not finished because of delay in obtaining the federal funds from a grant. Both the new anatomy building and the new classroom building do not have the necessary electronics installed yet. We can use the amphitheater with portable equipment but not the anatomy lab. They have promised to have the funds by mid-october which probably means late December. In the meantime, Bruce will continue his anatomy lab in the basement of the VA Hospital where they have been for several years. Pan-African Academy of Christian Surgeons: Bruce has unexpectedly accomplished a lot with Ervin Barham, the administrator of PAACS, because of the large amount of unplanned free time caused by the cancellation of our trip to Togo. Most of what we have done is organizational and while critical, it is boring to relate and to read about. But there is something that we think you might like. The 2009 PAACS Fall Prayer Guide was such a resounding success that we have just completed the 2010 Prayer Guide and sent it to the printer. We hope to have it available by late August for distribution. There are 30 days of suggested topics of prayers for the residents, the faculty, the administration and the goals of PAACS. The pictures and brief articles give you an unparalleled opportunity to see PAACS. If you would like to be certain to get a copy, please notify us at bruce@s3ministries.com and give us the mailing address. Praise and Prayers: 1. Pray for Hospital Radio. 2. Sean started fourth grade on August 16. He is going to the same Christian school and this year it will once again be a combined school and home-schooling year. Micky will home-school the second semester. Please pray for his ability to focus and learn. 3. Bruce started August 23 in his online Master s Degree from Baptist Bible College. It will be a Master of Art degree in Biblical Ministries. It will also allow him to finally get his undergraduate degree. Please pray for the ability to focus and for the energy and drive necessary to keep all the balls in the air. Pray that his traveling and speaking schedule will not interfere with the assignment and internet schedule. 4. In mid-september, Bruce s youngest sister Sally is going to have her aortic valve replaced for aortic stenosis due to a congenital bicuspid valve. She is desperately working to finish up her research work for a Ph.D. in neuroscience and hopes that all will go well and in sufficient numbers to finish the work for her thesis. Pray for her peace of mind, for her energy and focus, and for healing. 5. Bruce is still hacking from his pneumonia cum bronchitis and his airways are still rather spastic. He spent almost four weeks in bed with this illness and he spent the next three weeks exhausted and still coughing. Please pray for a final end to this miserable disease. Trusting in Him for strength and direction, Bruce, Micky and Sean

34 Volume 13, Number 17 Friday, September 20, 2010 Dear Friends: The SteffeScope Astronomical: There are between and stars in our galaxy. That used to be thought a huge number. But it`s only a hundred billion to a trillion. It`s less than our national deficit! We used to call those kinds of numbers astronomical. Maybe now we in the US should call them economical numbers. There are also at least and galaxies in the universe. That is a total of to stars (10 sextillion to 1 septillion). By most estimates, there are more at least 100 times more stars than there are grains of sand on Earth. But God doesn t have to guess the number. Thank God that we have a God of whom it is said in Psalm 147: 4 He determines the number of the stars and calls them each by name. Thank God we have a God who is that mighty and yet still cares for us. Psalm 8:3, 4 When I consider your heavens, the work of your fingers, the moon and the stars, which you have set in place, what is man that you are mindful of him, the son of man that you care for him? Are you important to God? Yes, So much so that He gave His only Son for you and for me. A spiral galaxy similar to our own Milky Way galaxy. CMDA Summit Meeting: (L to R) Dave Stevens (CMDA CEO), Bruce Steffes (CEO-PAACS), Jim Smith (Commission Member), Bruce MacFadyen (President PAACS Commission) and George Gonzalez (President CMDA) at CMDA headquarters in Bristol, TN. On Saturday, August 14, I attended the Christian Medical & Dental Associations annual Summit Meeting. Once a year, the leaders of the major ministries (Commissions, Councils and Sections) get together to learn more about the organization and to brainstorm for new ways to work together to promote Christ in our practices. Five of the attendees were associated with PAACS in some way or another (see picture to the left) so we didn t miss the chance for a picture. What if we read what it REALLY says? Acts 1:8 But you will receive power when the Holy Spirit comes on you; and you will be my witnesses in Jerusalem, and in all Judea and Samaria, and to the ends of the earth. Acts 1:8 is a well-known verse and one used in every mission conference. We are comfortable with that verse, even if we are not always good witnesses. But how would you feel if it read, and you shall be my martyrs in Jerusalem, and in all Judea and Samaria, and to the ends of the earth. It does. In the Greek, witnesses is the from the word μάρτυς (martus), from which we derive the English word martyr. Tom Little, Karen Woo, Cheryl Beckett, Brian Carderelli, Dr. Tom Grams, Glen Lapp, and Daniela Beyer were martyrs in Afghanistan. We were shocked, but we shouldn t have been. Many national Christians in many countries are martyred each and every year for the privilege of naming Christ as their Lord and Savior. The World Christian Database has estimated that, on average, 171,000

35 Volume 13, Number 17 Friday, September 20, 2010 Christians worldwide are killed for their faith every year. That is equivalent to all the citizens of Fayetteville NC and its surroundings who disappear each year because they name the name of Christ. We of the Comfort Generation are risk-adverse. Many of our acquaintances have told us that we should stay home and work here. Here are the facts: In the unevangelized world, there are only 20,500 full-time Christian workers and 10,200 foreign missionaries. In the evangelized non-christian world, there are 1.31 million full-time Christian workers. In the Christian world, 4.19 million full-time Christian workers (95%) work within the Christian world. To put it simply, if ten men are holding the log and nine of the ten are on one end, where should I go to help them? It is obvious, but it is not risk-free. Reverend Stan Key, ex-missionary and pastor of the Loudonville Community Church near Albany, NY wrote to us on August 19. He reported, Tom Little (and Libby) have very close ties with our church. Our service was devoted to him the weekend that it happened. Many here (me too) know Tom and Libby quite well. We are in shock and grief. Today is the funeral in Kabul and Libby is there. Tom will be buried there. Our church will host the memorial service here on October 9 th. If I interpret the times right, this sort of event will be more common, not less common. Serving Christ will require a higher risk. I remember well when I narrowly missed being involved with the bombing of the International Church in Islamabad. I remember asking why me? and then why not me? We of the Comfort Generation are shocked by recent events but Christ promised such persecution. I can only pray that many will step forth for the honor of serving the Lord God even with the risk of martyrdom. This is tragic for those left behind but an absolute triumph for Tom and the others who behold their beloved Savior s face. If only we of the western church would understand this reality both the persecution and the eternal reality we would certainly do things differently. Pastor Key continued, The 21st century will likely be defined by the confrontation between the cross and the crescent and blood will flow but the blood of the martyrs is the seed of the church death is at work in us, but life is at work in you (2 Cor. Chapter 4). I told our church, If the enemy (Satan) takes out one (Tom Little) let s send TEN to replace him! People are dying and going to hell. Most have never heard of Him. Do I truly care? How much of a witness am I willing to be? Praise and Prayers: 1. Please pray for us as we are involved next weekend with the Global Missions Conference in Weaverville, NC. 2. Please pray for the Hospital Radio project. We received a totally unexpected from someone in Zimbabwe who had something similar already in place but needed help. 3. In mid-september, my youngest sister Sally is going to have her aortic valve replaced for aortic stenosis due to a congenital bicuspid valve. She is desperately working to finish up her research work for a Ph.D. in neuroscience and hopes that all will go well and in sufficient numbers to finish the work for her thesis. Pray for her peace of mind, for her energy and focus, and for healing. 4. I am still hacking from pneumonia cum bronchitis and my airways are still rather spastic. I spent almost four weeks in bed with this illness and I am still coughing and fatigued. Please pray for a final end to this miserable disease. 5. Please pray as I begun teaching the new PA students beginning August 30 Yours and His for the peoples of Africa, Bruce for Micky and Sean P.S. In the things haven t changed category, people didn t write to missionaries back then either. I yesterday received your welcome letter. It is but the second that I have received, after having written at least two hundred. Written by Robert Morrison ( ), missionary to China

36 Volume 13, Number 18 Saturday, September 25, 2010 Dear Friends: The SteffeScope Football and Christianity: We are diehard Michigan fans and are relieved that we are 3 0. It is certainly the time of year when the truth comes out. For many Christians, football is their religion and church is their hobby. Football is a great metaphor for the church and missions. Twentytwo men are exhausted and desperately in need of rest and 70,000 are watching them, desperately in need of exercise. PAACS always slows a bit in the fall, at least for me. The administrator, Ervin Barham, is still slugging away with some long-term projects. I was pleased that all of the residents passed the annual exam, either the first or the remedial exam. We look forward to the Annual Meeting in Louisville, Kentucky the second weekend of November. If any are within driving range of Louisville, please plan on coming to the free Friends of PAACS dinner held on Saturday, November 13. Please notify Ervin.Barham@paacs.net of your interest and he will make a reservation and send you particulars. We are still short of both long-term faculty and qualified physicians who wish to become residents. Half of our faculty is back in the US on furlough which really stresses those missionaries back in the hospitals in Africa. Pray for both groups. Methodist University: In the Physician Assistant program, we are now in the two new buildings but they won t be fully outfitted with all the bells and whistles for two or three months yet. Still, it is really nice to have a much nicer auditorium and the new anatomy lab will be amazing (but I don t get to use it until fall 2011). We are already selecting new students for the fall of They have been talking to me about taking over directorship of the program but we are still praying about that. It would mean a much more limited role with PAACS and overseas missions. We are reluctant to do that (see the paragraph on football) but may be an answer for my health issues. God will have to make it very clear that this new open door is from Him. Discussions are exploratory at present. Life goes on. Sean is enjoying 4 th grade if not always the teacher he has. My students at the Methodist University are enjoying the learning but not always the teacher they have and not always the process. I am enjoying the learning associated the graduate course I am taking the teacher is fine but it is the process that is kicking my behind. Still, a good experience for all. One never ceases to re-learn the rules of living from one s own children. Sean had to do a diorama on the Blackfoot Indian tribe and the directions insisted that he do it alone. He also insisted. So we helped only minimally. The day he took it in, Micky was dismayed to note that the other projects looked professional (or clearly adultdirected). We were concerned all day and prayed about his selfesteem. When he got in the car after school, Micky asked how his project had compared to the others. "Oh, Mom - it was the best one!" Self-delusion and the innocence of childhood are wonderful

37 Volume 13, Number 18 Saturday, September 25, 2010 things! We didn't bother to counsel him. He handled it just perfectly. I still need to learn to be more like him. Just do my best and let the rest go. Ever feel like you are spinning your wheels? We do. Sometimes, we wonder if what we do has any impact. A new missionary to Cameroon wrote this note to me and it warmed my heart and encouraged me to continue to do the administrative stuff when I would rather be operating: We wanted to let you know what an important part you played in our call here to Cameroon. God used you in a miraculous way. We had been praying for 5 years about where the Lord would want us to continue our missionary career. We had served in Nigeria for 11 years. We attended the INMED conference in KC where you spoke. I (Debbie) attended one of your sessions having no idea how it would impact our life. As I heard you speak about the PAACS program, I thought this is exactly what we have been looking for except my husband is an internist. When I spoke to you after the program and asked if there was anything around like the PAACS for an IM doctor you said YES, a doctor Dennis Palmer has just started a residency program for IM in Mbingo, Cameroon and I can put you in contact with him. I introduced you to my husband later and you all talked some more. Well, the rest is history and here we are! Our God is so amazing and I thank you for your part in our story, God used you in a mighty way!! May He continue to bless you in your ministry and maybe we'll see each other in Mbingo [Cameroon] one day :) In Christ's Love, Debbie and Rick Bardin October Schedule: Bruce will be attending the American College of Surgeons Annual Meeting in Washington, DC. On Saturday,October 2, he is taking a course in surgical education along with several others from PAACS. On Sunday, he is lecturing in a postgraduate course about humanitarian surgery and assisting in work stations. Monday will be meetings and attending the session where our friend, Dr. Dick Bransford, will be recognized by the ACS for his lifetime of humanitarian work. I also hope to see some other friends from around the world, and will eat dinner with Dr. Bode from Nigeria. Up at 3:30 AM to catch a shuttle to catch a plane back to Fayetteville to resume afternoon teaching, Tuesday will be a long day. I will work my homework for my graduate class into the cracks that weekend. On October 15, I fly to LaGuardia and will be the plenary speaker twice on Saturday for the first-ever Kingdom Pioneer Missions conference in Queens. It is for Korean-Americans and my two hours will be simultaneously translated into Korean. I will be back home on Sunday. Praise and Prayers: 1. Please pray for the Hospital Radio project. We received a totally unexpected from someone in Zimbabwe who had something similar already in place but needed help. 2. Praise God that my sister Sally sailed through her aortic valve replacement at Cleveland. She is now back home in New York. 3. Praise God that my cough is 99% gone and my wheezing is improving. 4. Please pray for us as we prepare for Louisville in November, Uganda in December and full schedule for We wish to do only what He wants done in and in His timing. God is good all the time and all the time, God is good Rejoicing in that goodness, Bruce for Micky and Sean

38 Volume 13, Number 19 Wednesday, October 27, 2010 Dear Friends: The SteffeScope Request Want to help us (and PAACS) out and have it not cost you a thing? But you have to act fast (by October 31)! I received an from American Airlines which read, Transfer some of your extra AAdvantage miles to a friend or family member's account so they can book a flight award sooner! On transfers made between now and October 31, 2010, they'll receive 20% of the miles transferred as bonus miles if you share 1,000-15,000 miles or they'll receive 25% of the miles transferred as bonus miles if you share 16,000-25,000 miles! As CEO of PAACS, this would be a great help in getting around in the US. If you are interested, please contact us so we can give your our details and account numbers. The website is: Disappointed Reading in a men s magazine from our Church that I like, I saw a little sidebar. It asked, What is the shortest verse in the Bible? Every kid knows it is John 11:35, so I read on, No, not John 11:35. It is the shortest verse in the English bible but the shortest verse in Greek is 1 Thessalonians 5:17. This sort of trivia fascinates me but sadly I must report that I have been lied to. It is not true at least as far I as I can find out. John 11:35 reads in Greek, ἐδάκρσζεν ὁ Ἰηζοῦς. 1 Thessalonians 5:17 reads, ἀδιαλείπηως προζεύτεζθε. Unless I can t count any more, John 11:35 is still shorter in Greek 16 letters versus 22 letters. I am devastated. Are there any other Greek scholars out there who can restore my faith in the Southern Baptists? God Uses Our Mistakes Pastor John Adam Sumani, teaching FAITH evangelism with his new Bible When PAACS residents graduate, we give them a high quality study Bible with their name imprinted on the cover. Due to a lapse in a synapse, we accidentally ordered an English Bible for a Frenchspeaking resident. I wondered what to do with it. After talking to the Bible store, I used a pin and carefully removed all the gold imprinting. The impression in the leather was still there though and so I wondered what to do with it. Our friend, Don Honeywell, took the Bible to Ghana on one of his mission trips. He gave it to Pastor John Adam Sumani, a Ghanaian that his ministry had supported through the Baptist Seminary in Tamale, Ghana. Don wrote, After spending a few minutes showing him the many features of the Study Bible, he exclaimed, Wow, wish I had this when I was in seminary. He loves it and went out the same day and bought a Bible cover for it. God can even use our errors to bless others. Updates: My lecture at the American College of Surgeons went well and it was a great time of networking with many others interested in PAACS. My two sermons at the Kingdom Pioneer Mission Conference in Queens, NY went well. I enjoyed the time with my Korean-American brothers and they treated me exceptionally well. I finished my graduate course in Bible interpretation with an A and look forward to resuming courses the end of February (being out of country with poor Internet access will make it impossible before then). Not to be outdone, Sean finished the first marking period with an A average!

39 Volume 13, Number 19 Wednesday, October 27, 2010 A lot of work is going into preparation for the annual business meeting of the PAACS Commission held in Louisville, Kentucky in conjunction with the Global Missions Health Conference, a conference jointly sponsored by the Southeastern Christian Church, Christian Medical and Dental Associations, TECH, Nurses Christian Fellowship, Christian Pharmacists Fellowship, MAP international and others. This year, the GHMC is November and one of the plenary speakers will be Carol Spears, MD, dear friend and assistant program director at Tenwek Hospital. You can register for the conference and find out more at I will be hosting a panel discussion during the 4:00 PM breakout session Thursday. This session is designed to assist medical students and residents who are interested in a career as a missionary surgeon-educator. The PAACS Business Meeting will be held from 1:00 PM Friday through Saturday PM at 5:00 PM. You, and your friends, are invited to attend the free Friends of PAACS dinner Saturday evening. It will be held in the Celebration Hall of the First Baptist Church, Main Street in Middletown, Kentucky (only a couple of miles from the conference site). Dr. Steve Sparks, Program Director at Mbingo Baptist Hospital in Cameroon, and Dr. Agneta Odera, senior surgical resident at Tenwek Hospital, will be sharing with us. Please notify Ervin Barham (ervin.barham@paacs.net) of your intent to come. I will be leaving the US November 27 for a seven day trip to Kampala, Uganda. My purpose for going is to attend the College of Surgery of East, Central and Southern Africa (COSECSA) meeting where I hope we can finally sign a Memorandum of Understanding with COSECSA while I am there. I will also be encouraging the five PAACS residents who are undergoing their oral examinations. On a personal note, I look forward to seeing our good friends from the UK, Ruth Sims and Sue Bonner. Over halfway through the semester at Methodist and the demands are slowing down. I am glad I have been working hours a week between PAACs, MUPA and my schoolwork. Praise and Prayers: 1. Bethany, my youngest daughter, is considering returning to college at Montreat College in January to finish her college degree. Given her anxiety disorder and the fact that she has been essentially housebound for several years, this is a huge step. Please pray that this will become possible for her. There are some courses that would have to be accepted by Montreat to make this work, she will have to find lodging close enough to walk, and she needs the Lord to help her with the anxiety. She is a brilliant young woman and this would be a true answer to prayer for her family who loves her immensely. I know many of you have been praying for her healing with me. 2. Praise: My father underwent re-evaluation of his bladder cancer. He tolerated the procedure well and we are awaiting the results. My mother is undergoing laparoscopic surgery November 15 and my father is having his shoulder replaced on the 18 th. Please pray for them. 3. Please pray for the PAACS Commission. We are faced with the decision of closing a program which has limped since its inception and even if closure is the right decision, it will have great impact on the missionary surgeons, the PAACS residents and the hospital. Please pray for all concerned. 4. Please pray for those we talk to at the Global Missions Health Conference this is PAACS best chance to meet residents and surgeons interested in medical missions. Jim Elliott, the martyred missionary, wrote, Missionaries are very human folks... simply a bunch of nobodies trying to exalt Somebody. Exalting Him! Bruce for Micky and Sean

40 Volume 13, Number 20 Wednesday, November 17, 2010 Dear Friends: The SteffeScope Dave Thompson, founder of PAACS, visiting Fayetteville and speaking to PA s at the Methodist University Fellowship of Christian PAs meeting. A copy of his book On Call was given to each of the 30 students that attended. The students were deeply moved by his testimony. WAYNE SHEPHERD was a boyhood friend, attending my home church in Lapeer, MI. We grew apart but I was always pleased to hear him on the radio, a well-known Christian radio personality with WMBI. Recently, Wayne interviewed me for his new internet and radio show called First Person Interview. Given the other well-known names on his show, I felt out of place, but I enjoyed the chance to talk to him. If you are interested, please go to the website and click on listen. There are two sections of the interview to hear. While you are there, listen as well to some of the other fascinating interviews and bookmark this site so you can come back often. SHOPPING TO DO? SHOP FOR JESUS! A good physician friend who I first met in Kenya in 2002 has launched a new venture called Storyteller Toys. Carrying collectibles as well as toys by Hasbro, LEGO, Disney and others, all of the 2010 Christmas toy-sale profits will be donated to PAACS. If you have toys or collectibles to buy (for yourself or others), please go to and as a friend of ours says, exercise your spiritual gift of shopping for Jesus! Storyteller studios also does video projects and he wrote that he was completing a video project for someone and going to ask them to contribute the money to PAACS. Wow! Global Missions Health Conference and PAACS Annual Meeting: A highlight of each November is the time in Louisville, KY. Sean goes with his grandparents to be spoiled in Myrtle Beach and we head to Louisville. The Commission of the Pan-African Academy of Christian Surgeons met for the Annual Fall Meeting. This was held in conjunction with the Global Mission Health Conference at the Southeastern Christian Church. Twenty-eight Commission members, Advisory Council members and invited guests met for a total of 12 hours over the two days to conduct the requisite business of the organization.

41 Volume 13, Number 20 Wednesday, November 17, 2010 Also, the Friends of PAACS dinner was held Saturday evening, November 13, at the Celebration Hall of the First Baptist Church of Middleton. It was an aptly named location as the record number of 92 attendees celebrated what God is doing through PAACS. Steve Sparks, Program Director at Mbingo Baptist Hospital in Cameroon, gave his testimony and thanked PAACS for permitting him to accomplish his dream of teaching Christian physicians in Africa. Agneta Odera, a third year surgical resident at Tenwek Hospital, also shared the impact that availability of a Christian residency had on her life. Over half of the attendees were attending a PAACS function for the first time and many students and residents attended. During the conference, PAACS had a booth in the exhibition hall and it stayed busy. Dozens of medical students, residents, and physicians and stopped by to learn more about the PAACS ministry and to renew acquaintances. During the conference, I gave a presentation to a breakout session Thursday afternoon on the steps necessary to become a missionary surgical educator. A panel of missionaries and educators with connections to PAACS also participated. I spoke with Dan Poenaru on Sustainability on Friday as well. Saturday, Carol Spears, the Assistant Program Director at Tenwek, and Agneta Odera hosted another breakout session on the development of the surgical training program at Tenwek (in which PAACS was prominently featured) and then Spears and Odera were the plenary speakers in the final session of the day. It was a superb challenge to all and PAACS was featured prominently in the presentation. Make plans to attend the second weekend in November, 2011! Planning for Year-end Giving: After you have appropriately supported your local church, please consider a year-end gift to S 3 Ministries, our tax-deductible organization that funds the mission work we do. The check can be made out to S 3 Ministries and sent to PO Box 300, Linden, NC Alternatively, you can give by credit card or PayPal on Praise and Prayers: 1. Last week, my mother fell from a small stool, broke a rib and collapsed her lung. A chest tube was necessary. She is back home but in pain. Please pray for her healing. 2. Thursday, November 18, my father will undergo replacement of his right shoulder joint. At his age, this is quite an undertaking. Please pray for his safety under anesthesia, his healing and for wisdom for his surgeons. 3. Thank you for your prayers for Bethany. She was not able to return to Montreat College but is considering returning to Western University this summer. Please pray for her that her anxiety will be controlled and that she will be able to face this challenge. 4. PAACS closed the program that had been under probation. Please pray for the missionary surgeon and the residents to whom this was a grave disappointment and pray for the hospital for which this will be a major blow. 5. Please pray for the dozens of students and residents who heard about PAACS at the Mission Conference and who are considering a career in missions. 6. Please pray for me as I get ready for my trip to Kampala, Uganda in late November. Agneta, our Kenyan resident, said somethi ng that really struck me hard. She noted, It is not so much that I should look for God s will for my life as much as it is that I change my life in conformance to God s will. Trying to conform, Bruce for Micky and Sean

42 Volume 13, Number 21 Saturday, December 4, 2010 The SteffeScope Dear Friends: Some quick advice for you don t do six day trips all the way to Africa and back unless you enjoy pain! The flight over was unremarkable and I even slept a bit on the plane. After the taxi ride into town late Sunday evening, we were told that there was no room for us in the inn. We were shuttled off to a smaller hotel a short ride away. Now I am not saying that the room was small, but I swear that I had to back out into the hall to in order to be able to turn around and the mosquitoes had to fly in formation to avoid midair collisions. Fortunately, exhaustion and Ambien worked wonders. The following morning, I met our missionary friend John Fulks for breakfast. His son, Jacob, joined us. He was home with his older brother on semester break from the Rift Valley Academy. We had breakfast at the first hotel (still no room for me) and enjoyed the reunion. He is a Buckeye fan but I can overlook it if God can. He is doing a phenomenal job as the president of the Global Theological Seminary in Jinja. Dr. Veronica Moss, Dr. Elizabeth and Ruth Sims stand in This child was a new admission with severe kwashiorkor one end of the newly refurbished acute care wing of the (protein malnutrition). Note the rash on the face from nutrition center of excellence. nutritional deficiencies. He was eagerly drinking this nutritious formula. Old Friends: The reason we were here in 2005 and part of 2006 was the Hope Children s Hospital project. Ruth Sims from the UK became our dear friend and we still miss her. Still active at an age when most have long since retired, she is now working for the government s Ministry of Health setting up a malnutrition unit as part of the Mulago Hospital. It was a steep, warm walk up the hill to her facility and after asking around, I finally found her. It was a pleasant reunion and I was pleased to see Dr. Veronica Moss as well. The two of them were instrumental in the creation of the Mildmay HIV hospice in London and later in Uganda. The children s malnutrition unit was brightly painted with a menagerie of animals cavorting on the walls. Ruth gave an encouraging report of their success in saving the starving children. Still, watching a six month old who weighed less than 10 pounds lie listlessly, too weak to eat, was not an enjoyable experience. The ward was overflowing with young children just like that. How very sad. COSECSA Meeting: I had come to Kampala, Uganda to attend the 11 th annual College of Surgeons of East, Central and Southern Africa (COSECSA) meeting. My highest priority was the final negotiation and signing of a Memorandum of Understanding between COSECSA and PAACS. I have been working on this for three years. We had several false starts this week but we finally got the MOU in a final form. I signed my part and was flabbergasted (gobsmacked as my British friends would say) when they told me wanted to wait until April to sign so they weren t rushed into it. Sigh. Still, we are closer than ever. We also had an unexpected meeting with friends from the Western African College of Surgeons (WACS) who were officially visiting the same conference. They assured me that the PAACS application process was not dead within WACS despite the previous communications. They were impressed that we were almost accepted by COSECSA. One of them in particular has become a dear friend to me and is a fine surgeon and brother in Christ. I must upgrade the application from last year and send it to him with a

43 Volume 13, Number 21 Saturday, December 4, 2010 description of the terms of the COSECSA MOU. This was all an encouragement to me after the disappointment of not completely accomplishing the other MOU. I must remember that this is God s project and must be in His timing. PAACS Residents: I was in the Department of Surgery at Mulago Hospital Monday afternoon as they graded the results of the oral exams being taken by the surgical residents. The results were listed anonymously and my heart sunk when I saw that two of the fourteen candidates for the lower level (Membership) exam had failed. This was the one that the PAACS residents were sitting. Oh, ye of little faith! All five PAACStrained candidates passed and they were one happy bunch. One resident who took the test has been hospitalized repetitively for a difficult pregnancy. She had come directly to Uganda from the hospital. In celebration, we went out to dinner at my favorite Chinese restaurant in Kampala. Little Bruce: When we first worked in 1999 at Good Shepherd s Fold, an orphanage, in Jinja, we met the new administrator, Abel Muhanguzi. He has remained a dear friend since then. He is a gentle man of God. My last evening in Kampala, we were able to celebrate dinner together with most of his family and Bruce Muhanguzi, my namesake, celebrated his 8 th birthday. The two of us are in the picture to the left. The Flight Home: The severe snowstorm that overtook Northern Europe interfered with my trip home. We left over three hours late from Entebbe (5:00 AM in the morning!) and it would have made me miss my connection. Knowing that, I had already rearranged my schedule to leave four hours later than my new estimated arrival. However, my second flight to the US was delayed over 3 hours as well and I missed my flight connection Friday night and had to overnight in Atlanta. I finally arrived home late this morning. My sitter is sore! It is good to be home. Praise and Prayers: 1. Praise God that my mother s broken rib is healing and my father has come through his shoulder joint replacement without difficulty. My father will have a long rehabilitation period ahead. 2. Praise God for the traveling safety. 3. Praise God that we have almost signed the Memorandum of Understanding with COSECSA. Pray that it will be accomplished in April. 4. Praise God that we have friends within WACS who are carrying the torch forward for PAACS. This is God s project and He is the only one who will accomplish this. 5. Please pray for the resident who failed his exam. He is very discouraged and we need wisdom in how to help him fix this situation. 6. I am entering the last week of lecture and the final exam weeks. Please pray for wisdom and strength for me. Closing Thoughts: Ruth Stull, missionary to Peru, once wrote, If my life is broken when given to Jesus, it is because pieces will feed a multitude, while a loaf will satisfy only a little lad. I don t like to be broken and inadequate but this strikes a chord. If God must break me further to use me, may His will be done. Willing to be used, Bruce for Micky and Sean