December 2022 Nattier News

To all of our family and friends who love and encourage us so well, we hope this update finds you well.   We are very thankful for all of you around the world who support us in so many different ways and allow us to continue being part of the ministry here in Togo. We want to wish you a Merry Christmas and happy new year!  We aren't sending Christmas cards this year, but we did have a chance to update our family picture this past summer during our time in the US.  

Our time stateside was a great encouragement, seeing many of you and our family.  The three months passed extremely quickly.  One highlight was catching up with some of our supporting churches, and in particular our sending church UBC in Beavercreek, Ohio.  We were able to work with them on planning a team who will be coming here in January 2023!  We hope this will be the first of many, and that some of our other supporting churches might also come and be a part of the ministry here in the future.  

In addition to the team coming in January we have many things happening here in the next few months.  In just a few days, we will be welcoming Bryce's sister Aimee and her family and are greatly look forward to celebrating Christmas and New Years with them here in Togo.  Another great excitement and long awaited answer to pray is that our PAACS program (5 years of surgical training and discipleship) will officially begin on January 1st.  Our first two surgical residents will arrive in Togo a few days after Christmas.  We are waiting with great anticipation for this opportunity to invest in the lives of these young men and women.  This year we selected two residents.  One of our residents Yannick did his medical school in Congo.  He is recently married.  His wife is completing her medical school education in the Congo and then plans to him here in Togo.  

Our second resident for 2023 is Sweni.  He is coming from Cameroon where he did all of his medical training in English.  Since Cameroon is a bilingual country he also speaks French. 

 

We would really appreciate your continued prayers for this program.  It has great potential, but it is also a large undertaking.  We pray that God blesses and uses this program to accomplish great things for His glory.   

We would like to highlight a special opportunity for giving for those looking to make an end of year gift.  We are starting a surgical benevolence fund for cases that could be helped by a surgery that we cannot perform here in Togo.  My first year in Togo, I (Bryce) met a young women that had a very advanced mass extending from her mandible.  It was very difficult telling her there was nothing we could do.  At the time, I believed this was likely a malignant tumor of the bone.  Over time, I've learned that some of these masses are a benign tumor, called Ameloblastoma, that is very destructive. These occur in the US as well, but are normally caught early, and can be resected completely prior to invading the mandible (jaw bone).  Here in Togo with limited dental care, these masses are often not caught until they have invaded the mandible and are quite large.  Here are example pictures of two of our patients below.  

The first picture, was a young female (Nafi..). We were able to help her this past year by resecting the mass because it hadn't yet crossed over the midline. The second picture shows one of our patients who we were not able to resect, because it had clearly crossed over to the other side.  If we do a resection without reconstructing with bone from either the ribs or often the fibula, these patients would have a loss of the facial contour and difficulty eating, swallowing, and talking for life.  It's referred to as a "Gump" deformity, and it can be pretty severe.  I originally learned about the treatment of these tumors in 2018 from a surgeon named Dr. Peterson. He is an ENT that has worked at multiple missions hospitals.  He has since gone back and done training, so that he can do free flap reconstruction with Fibula from the leg.  It requires doing a microvascular anastomoses (connection) of a vessel from the leg to a vessel in the neck.  He is currently working at a missions hospital in Kenya called Kijabe hospital.  

Nafi recently came back to see me again in clinic, and we realized the tumor had come back.  Unfortunately, it was more advanced than we realized initially, and has returned now crossing the midline.  We reached out to Dr. Petterson and he has agreed to care for her there in Kijabe.  However, there are many logistics to be worked out, like getting her a passport, plane ticket to Kenya and then transport to the missions station.  She also doesn't speak English or even a lot of French, which will make things a bit challenging.  Our family was already scheduled to attend a conference for the PAACS residents in February of this year,  and the conference center is less than an hour from the missions hospital. We are hoping to take Nafi with us when we go. 

Nafi is 24 years old and has a young child who is 2.  When I told her we couldn't resect the recurrence here at our hospital, as you can probably imagine, she was heartbroken. However, she was overjoyed when we told her of this opportunity in Kenya.  If you would be interested in giving to help with the expenses it will take for Nafi to get to Kenya and back, as well as some of her surgical expenses, Click the blue giving link here if you would like to give and help make this possible.  We are excited to see what God is going to do through all of this.  We are also hopeful that this might be an opportunity for others, like the second young man pictured above, to receive the same needed surgery that is not available anywhere in this area.

Prayer Requests

Our Family: Please pray for our families physical health as we have been battling multiple illnesses these past few months, maybe like some of you stateside.  Also pray for stamina for us, as these next few months will bring a multitude of challenges and changes.

Our Team: Please pray also for our team, which has also experience many changes like a new team leader.  Pray also for us to grow in unity with the addition of several new teammates.  Within our surgical team we have some African surgeons trained by PAACS at other sites who are considering joining us in the work here.  Please pray for them as they are processing where God would have them serve.  

Surgery: Please pray for our PAACS surgery program that starts in a few weeks.  There is still a lot of prep and details to be worked out.  We pray that God would be at work and glorified in this training program.  Please also pray with us for Nafi, that her surgery would be possible and successful.  Also pray for her to to see and understand the love of Christ.

  

  

April Nattier News

It's hard to believe we are already in April.  2022 has been our busiest year of work and ministry since we arrived here in Mango.  We are grateful though to be part of what God continues to do here in northern Togo. 

We wanted to share with you an answered prayer since our last newsletter.  We were praying for a nanny to watch Josiah and Mélyna, so that Natasha could continue working in women's health.  As we were praying,  the Lord brought to mind a woman we met when she brought her son into the hospital for a severe medical problem.  We saw the way she cared for her own son who is now doing very well after a couple of surgeries.  Before we left for furlough, she asked us if we knew of any work for her. At the time, we did not, but little did we know that God was already at work orchestrating an answer to both of our prayers.  Upon our return, we reconnected with her and offered her the job. She accepted with joy and gratefulness.  She moved from the city to our north and has been caring for Josiah and Mélyna since November.  The kids love her dearly, and she loves our children as if they were her own.  Her son has become one of Melyna's best friends.  We helped him enroll in the christian school that was started here in Mango last year.  He is thriving in school and was the top in his class this past quarter.  

Natasha has been staying busy as we've had several visiting ob/gyn surgeons since the start of the year.  One of her patients that she has been caring for since she started doing women's health is a friend of ours. She and her husband got married around the time the hospital opened.  They had been trying to conceive but had been unsuccessful.  After several years of infertility consultations and various treatments, heartache and yet hope that our God indeed had a plan far bigger than what we could comprehend, it is in many ways a miracle that she has been able to become pregnant.  She is due in September, and we are praising the Lord for His answered prayers and this miracle child! 

Bryce was chosen to be the medical director for this year.  In addition to the surgery work, he has been working to improve and update the systems that are in place in the hospital ministry.  After 7 years, the hospital has changed and grown with new staff and more patients.  We really have a great team to serve alongside, and God is at work in our midst.  We have had many colleagues leave permanently and temporarily the past 6 months.  Others are scheduled for furloughs this coming summer.  One of the biggest challenges most missions hospitals face is how to maintain adequate staffing, especially of medical providers (doctors, PAs, NPs).  This year we hired the first Togolese doctor at our hospital, a new graduate from medical school.   It's challenging to find people who are willing to leave the capital, the big city with access to most things, and come to the far north to work here.  He was an answer to prayer, but it has also helped us to realize the need to consider staffing now and for the future.    

We have been praying for several years about training medical doctors at our hospital to become surgeons.  There is a program that was started in Africa to train surgeons for Africa.  It's called the Pan African Academy of Christian Surgeons.  There are currently surgery training programs in 9 countries.  Only a few of these are French speaking programs.  The program involves 5 years of training and discipleship of christian doctors to become surgeons.  In February our team voted to pursue a partnership with PAACS.  PAACS accepted our application, reviewed our site, and we are awaiting final approval at their upcoming board meeting.  Please pray for wisdom for all parties involved as we seek to move forward with this new avenue of ministry and training.  

We also wanted to let you know we will be returning stateside for a brief 3 month break in July.  As we've reflected on life and ministry, we are hoping to try and take breaks in this way approximately once a year.  We hope to see many of you, but it will be a little more challenging as 3 months will pass quickly.  Please let us know if you would like to connect while we are stateside, as we are still planning our time.  

Prayer requests:

Our family: Prayers for wisdom as we plan our 3 months stateside (July, August, September). Also, we will be in need of a vehicle large enough for our family of 8. Please pray with us as we seek out a solution to this need. Vehicles, especially large ones, seem to be extra expensive and in short supply these days.  

Our Team: URGENT NEED: We have a thriving MK school here, but we have an urgent need for a teacher this upcoming year. One of our two wonderfully gifted teachers will be permanently returning stateside to take a different ministry position. While we are happy for her to fill this new role, we are fervently praying for the provision of a new teacher to help educate and pour into the lives of our precious children. If you are interested or know of someone who might be a great fit for this role, please let us know or contact Amanda on the photo below.  Additionally, please continue to pray for wisdom for staffing and our potential partnership with the PAACS.

Ministry: Please continue to pray with us for a couple of surrounding villages where the ground has been hard and there are still no church or Bible studies.  Also pray with us for our Muslims friends who are currently in Ramadan.  This is a time during which they are seeking God, and we pray for increased sensitivity to the hope found in the Good News.