Birthday, Mathare and the Sunrise...

Had the opportunity to spend a week in Nairobi with my sister Mary at Robyn Moore's house. Robyn is a PNP and oversees the medical care of around 1000 children in and around the city. We were able to accompany and help out where possible in various orphanages and had a great time. The picture above is of Mary, me and the cake Robyn made for my birthday (27 years now).

Twice now I have been humbled by this girl in pink. Her name is Esther and she lives in an orphanage in Mathare (muh-thar-ee), a Nairobi slum with a reputation for its harshness even when compared to other slums in the area. Esther's history is unclear even by those who know her best. What is known is she was neglected and abandoned by her mother. Some time later she went to live with her uncle(s) who abused her severely . She also suffers from epilepsy. As a consequence of her life so far she does not or can not talk, acts out inappropriately and generally is in a world of her own. Inaccessible. Here is an excerpt from my journal from that day...

"...was all this morning in the Mathare slum with kids who have real problems (I still eat every day, right?). Glad to be there holding the kid with the soggy pants (pictured above) in one arm. He was maybe 1 or 2 years old and starved for just some loving touch. Any loving touch. The slums are so bad to the human spirit, to the human life. Poor little Esther was still there. Oddly dressed even for a slum girl. Her stare still semi-blank and drooling on herself - she had a seizure recently and hit her head. What kinds of things has she experienced, seen, had done to her? Stories she can never tell. She (in this world) will never get to enjoy loving parents, a good steak dinner at "home", a Christmas tree with presents all neatly wrapped beneath. I can barely comprehend the difference between my world and Esther's..."

What's the point? Why blog about her instead of anything else?
Because she should motivate us. Not towards feeling bad or guilty about how good we do have it. That helps no one. Rather, she motivates towards using what we do have for the benefit of others.

We have significant material wealth. Praise God. But how are we using it to practically love others? Girls like Esther remind me of the need to make the most of every opportunity to use what we have toward loving others. The poor of the world need tangible love.

Ephesians 5v1-2 "Be imitators of god, therefore, as dearly loved children and live a life of love, just as Christ loved us..."


Beautiful sunrise on top of Mt. Motigo

Sunburn, Shamba foot and what matters and what doesn't...

One of the ladies who works around the hospital is a refugee from when a genocide was happening in Rwanda. While she was here she met another Rwandan man whom she married and they started a family. Some time ago he went back to Rwanda to look into moving their family back. He was murdered and she was left with 6 children here in Kenya. With no land of her own she rents a small farming plot (shamba) and works as house help for one of the missionary families here.

She needed a fence to keep the neighboring cows from eating her garden as it grows. A visitor bought the supplies and some of us joined up with her kids and a few other locals to put in a fence for her. The many hands made light work as we dug fence post holes, put in the posts and put up the barb wire around her whole property in just one day! The only picture I got, though, was one of my sunburn afterwards...

Working in orthopedics in the developing world can be especially rewarding. Often people have long standing pain or difficulties than can be alleviated with surgery. In ortho we get to see our results right away and, in general, the patients are otherwise healthy. Patients often feel good and really comprehend that they have been helped. We all work hard and put in significant hours living for God by serving other people in orthopedic ways. It's not unusual, though, to see and evaluate cases for which we can provide limited or no help at all.

Yesterday was clinic day and there seemed to be quite a few of the more difficult cases. At clinic we see all those whom we've treated and are returning for follow up care. We also see those who come for independent check up's as well. Here are a few which stuck with me. The first one case was of a woman who returned with her foot biopsy result which was positive for cancer. She needs an amputation to stop it from spreading. But amputations cost money and she has none. Traveling from far she had to leave her baby with her husband (who doesn't work and is a drunkard) only to find out she has cancer and can't afford the less than ideal treatment. All this and she is only 23 yrs. old! We went ahead and scheduled her anyways and told her to come back regardless of whether or not she could pay....we'll work it out we said.

Often we see problems that would have been prevented or treated far earlier in the developed west. One such case was of a young boy with scoliosis which was progressively getting worse and worse. Dresses in worn out clothes that hung off his thin frame he stood there while his dad was told of the potential for surgery. "There is a spine surgeon coming back in some time...evaluated for the possibility...can't do anything for you at this time..."

Another was of a women who has progressive problems with her pelvis. Barely able to walk she explains that she recently had a baby (yes, through that pelvis) and must also walk long distances to get water, carrying up to 20 litres at a time. She's having a lot of pain. Her pelvis isn't going to get better and her options for treatment are limited.

One of the challenges working in health care is infection. We do our best to prevent it but some patients are more challenging than others (by no fault of their own). Here is a picture of classic "shamba foot" as we like to call it in the O.R. A shamba is a small personal farm and those who don't own shoes have feet with callous and dirt permanently ingrained. Almost like a dirt tattoo on the bottom of the foot. Difficult to clean, shamba foot is an excellent vector for infection in distal leg wounds. Pictured here is a middle aged woman with a dirty open tib/fib fracture and classic shamba foot.

I hope that, after reading this blog, your impression isn't that everything is sad, hard, or heartbreaking. Some things are but there is a lot which isn't. The cases I included are just ones that have been on my mind recently. There are others which I could have written about, such as the guy who had a horrible leg fracture that walked in, healed, without a limp. The child with a painful bone infection who is now healed. Another kid who had a fractured femur which is now healed smiles and giggles when I shake his hand every day as I walk past him in his wheelchair...

The hardship and suffering observed reminds me of what matters and what doesn't. It makes me incredibly grateful for the unnecessary but nice things I have in this life. It questions my priorities and reminds me of how self-focused I can be. It makes me look forward to a day when all suffering will be gone and done away with.

Revelation 21v4 "He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away."

The challenge is to live for that day. To love God first and other people at an expense to ourselves.

Finally!

Greetings to everyone from the west rift, Kenya. Finally, I'm able to get some pictures up to show exactly what I've been writing about.

I still consider myself blessed to be where I am and am so grateful and thankful for those who make it possible for me to be here financially and for those who spend time in prayer for me. Neither is an easy thing to do.

Without further ado, here are some pictures with descriptions below them. Thanks!

The monacle man and his one (not so) good lens.

The finished product after an eye consult, new prescription, new ground lenses and a fresh pair of real Ray-Ban frames. Total cost: about 4-5 u.s.$!

Here is a close up of the wound-vac dressing. The tubing is IV tubing and the dressing cover was sterile Ioban generously donated by MedWish International. The tubing went to a glass IV jar where the suction was connected. It worked great!

My super cool sister Mary and I standing in front of a White Rhinoceros at the Mara. She is here to help teach some kids schooling and will stay until Dec. 17th. Having her here has been and is wonderful.

Isiah 40v5 "And the glory of the Lord will be revealed, and all mankind together will see it."

The whole chapter of Isiah 40 was a good read for me recently, reminding me of how great God is. Given God's greatness and my incredibly human un-greatness, that chapter really served to remind me of the significance of God's grace in my life and the astonishing fact that he continues to use me to care about other peoples well-being.

Monacle man, my sister Mary and 3rd world wound vac's...

Pictures will come when the interenet is good enough to load them.

Monacle man...

People here are used to having to make due with what they have. Monacle man was no exception and every morning during rounds he would hold up his one eyeglass lens to look through at the world around him. He didn't mind posing for a photograph, either. After seeing his picture my awesome parents decided he had to have a good pair of glasses.

2 days and one eye consult later this guy was fitted with a prescription pair of brand new ray-ban glasses for the whopping price of $3 u.s.! He loved the new frames and could see great.


3rd world wound vac's...

We've had a large number of dirty open Tib/Fib fractures (shin-bone) lately. Some of these patients have had a terrible time healing with slow or no tissue growth over the exposed bone at the fracture site. What we needed was continuous wound suction.

Using a large glass IV bottle, large tubing cut from a urinary leg bag, IV tubes, Ioban drape and some donated sterile wound sponges I was able to create a continuous wound vac set-up that actually worked great!

There were 3 patients with 4 wounds that the new wound vac set-up was used on and it really did the trick to encourage the drainage and tissue granulation that the wet-to-dry dressings just weren't accomplishing. With one wall suction available on the surgical ward we had to find 2 more suction devices. The ones we found were very old but still worked. It was great to see the little machines still working each morning.

My sister Mary is now here and will remain until December. She is going to be teaching some of the Galat kids their school studies. I'm really glad that she is here and that we'll be able to spend time hanging out. What a blessing to have family so close all the way here in Kenya!

I'm so thankful to God for the time I have here in the beautiful country and glad to be able to report on just some of the amazing things that I am privilaged to get to be a part of here at Tenwek. Thanks for your prayers and that you keep checking these updates.

More to come... -S

I've been without internet for a while but now it's back. Update coming very soon.

Thanks for checking in!

A little long but, hey, it's been a while...

What do these three pictures have in common?



A broken jaw,




...a fractured hand,




...and a dirty open tib/fib fracture.


They are all the same patient! A 90 y/o “mama” who was hit by a boda-boda (motorcycle) and eventually ended up in our care at Tenwek. She spoke a language that NOBODY understood and would consistently end up shouting and cursing everyone with a loud “OOOOOOOH-EE !!!!” Despite concerned care all around her consistent cursing of everyone across specialties earned her the affectionate name, “the oooooh-ee lady”.

Spent most of the afternoon today(Sunday) up in “theatre” after rounds with Dan working on a 4 year old child with a neck of femur fracture. In the developed world this gets taken care of right away as increased length of time after fracture increases the likelihood of a poor outcome. We received this child with the fracture already 4 days old. For a 4 year old with the rest of his life in front of him we wasted no more time. The small body in traction was at odds with the adult sized fracture table. 2 screws, a solid reduction and an hour and a half later Kipkemoi now has a chance for functioning hip in his future.

Fixing the body is good, but healing the spirit is better. For our bodies pass away but our spirits live on after. So I am excited to be part of a group of people starting a bible study on Wednesday nights for spiritually interested teenagers. This Wednesday is the first night and I have no idea what to expect. Pray that God blesses it and his spirit is at work.

Recently I have been praying about possibilities of becoming part of the work that World Gospel Mission (WGM) is starting in south Sudan. There are 2 medical centers now with only a few staff at each. Both are in need of trained nurses to come and teach, instruct and give care. WGMs goal is to form teams made up of current staff in Africa, to recruit new staff, and empower and mentor the Sudanese. The approach is community-based, participatory and wholistic. Although there is still a lot to learn here at Tenwek I am gladly looking into possibilities in Sudan as well.

Lastly, in this long, catch-up blog (thank you for reading!) I wanted to quote a worthwhile verse.

Hebrews 12v1-3 “Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us. Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross…consider him…so you will not grow weary and lose heart.”

What is the race God has marked out for you? Are you running it? Are you even on track? I have to ask myself those questions often, as it is possible to be “following God” and be completely sedentary or willfully wandering off track. Let’s remember our example, Jesus. Let’s spur one another on toward love and good deeds, even to a sacrifice of our personal comfort. It’s what only makes sense!

Thanks so much for your prayers, God knows I need them.

Until (hopefully not much) later,

Stephen

Bad at chronology...

This is supposed to be a picture of me looking sorry for not updating the blog with anything about Tenwek lately...I hadn't realized it has already been so long since the last real post.

I intend to get one up tomorrow or Sunday with more pictures, thoughts and developments of late.

Hope your weekend is a good one!

Happy Friday - Stephen