School

One of the hardest things for Amelia to leave was her school. She loved the teachers,classes, activities and her friends as most kids do. We were so grateful for the teachers that made her love learning, something we weren't able to do when we tried homeschooling. So it was great yesterday to drop her off at Oak Harbor Christian school. The school has allowed her attend for an indefinite period of time. When I picked her up she exclaimed, "We have three recesses; I was already invited to a birthday party; we can still have a morning snack from our lunch; and the girls in my class showed me all the good places to play." Wednesday Meredith will start at a preschool and she also is so excited to make some new friends and continue "learning my letters."

The Many Faces of Goodbye

And now as our two year contract with Samaritan's Purse has come to an end in Kenya and it is time to say goodbye...

Goodbyes to the staff at the dental clinic and for Sara the maternity ward and Theatre. Friends gathered in a circle with me and one by one shared their thanks, tears, appreciation, prophesy (that God would bring us back again), and prayers of blessings for myself and my family as we go. It was moving and surprising in a reserved culture where thanks is not commonly used that an impact was made even in people when you least expected.

Goodbyes involve tears represented by chalk images drawn by Amelia. Her pictorial response of her feelings in saying goodbye to Mocha our dog the past 18 months. Mocha moved to the orthopedist house (even with many attempts to escape back to our house), Lucy the gold fish moved to a dorm at RVA, and Flower the Bunny escaped to the forest.

Goodbyes to CS Meredith's best friend. Their smiles and hugs say it all.

Goodbyes to close friends in the mission community like the Shirley's were too hard to verbalize...and just better left at "we'll see you later."

Goodbyes to "things" brought relief as couches, piano, and our car all sold within two weeks and the rest was given to those who needed...coming back with much less than we brought.

Goodbye to the beautiful sunsets of the Great Rift Valley and the moderate sunny climate in which the Meredith & Amelia wore sundresses every day.

Goodbyes to a kenyan culture that we have grown to love.

Kwaheri Kenya!

My Top 3 Cultural Blunders

The greatest mistake you can make in life is to be continually fearing you will make one.
Elbert Hubbard

My wife could verify that 1) I'm not at all afraid to make cultural blunders and 2) I am quite proficient in doing so. My top 3 cultural blunders:

3) The Interlock-I find a seat at hospital morning chapel and settle into singing the Kenyan praise song, "We will praise you in the morning, We will praise you in the noontime, we will praise in the evening, we will praise you all the time." We finish singing and the pastor requests that we hold hands with our neighbors. So I reluctantly (like every man feels) go in for the clasp handshake with the man to my right and the man to my left. I'm thinking the only decision here is: Do I go palm forward or palm backward? Oh no. It's much different here in Kenya. My neighbor goes for the interlock...every finger no less and even the thumbs. And it was a good prayer the pastor prayed, but also such a long, long prayer. I still believe it was the longest prayer I've ever head in my life.

2) The Air Shake - The first thing I tell any Western visitor is that greeting Kenyans by shaking hands is very important. A simple hello, or nod...just does not work here in Kenya. Even if you enter a room with 20 strangers...you still take the time to shake every one of their hands even the children. I'm pretty much a hand-shaking madman now. I shake when we meet, some time in the middle of the conversation, and at least once or twice as we leave just to cover all my bases. It was my second day in the dental clinic and the following lady was my patient I went in right-handed for a hearty handshake and came up empty...a complete air shake. Strange...I thought. Next to her was her mother so I tried again with a right palm coming up high with my hand near my ear and swooping down right in front of her waist. But nothing...the patient's mother didn't even raise her hand. Another air shake. Before I could manage strike 3 in hands shakes with her sister...a kind Kenyan pulled me aside to say, "Somali woman do not shake hands with men."

1) The Kiondo -I really had some heavy dental supplies that were donated that I wanted to bring up to the dental clinic. I had seen many Kenyans using a Kiondo to carry fruit and vegetable with the strap around their forehead. I was told that using the head and the muscles of the neck with the weight of the material on your back is the best way to carry a heavy load. So I loaded up my Kiondo with dental anesthetic and instruments and walked up to the hospital. Well, have you ever had a moment where everyone is looking your direction and pointing and laughing and so you turn 180 degrees to look behind to see what is so funny...and then you realize there is nothing behind you but wide open space. And then you know they are laughing at you and you have to turn back around and acknowledge their laughter. So thanks...only later did I find out that men do not carry anything in Kenya (even their child)...and especially not a Kiondo strapped around their head.

Does anyone have a cross-cultural blunder they would like to share?

Everything that has breath...

The donations of stuffed animals from the VBS kids at WPC in Akron were so plenty that the Meredith & Amelia enjoyed a second round of giving a little bit of cheer to the kids in the pediatric ward at Kijabe Hospital.










This sign was a reminder that all life comes from God and no matter how small are valuable in His eyes.

Pedodontics

Maybe some of you can sympathize with this 4-year-old girl...seeing the dentist can be terrifying.


My favorite pediatric dental patients are the ones that the anesthetist can put softly to sleep. We (the patient and I) seem to get along better this way.


My inclination has been that dental cases are the ones that anesthetists like to avoid. We need access in the mouth to restore and extract teeth and the anesthetist needs access to the larynx to secure the airway. I'm constantly redirecting their tube away from the teeth and the anesthetists are following behind resecuring the tube with more tape. Here, reintubating the patient after too many adjustments and failure to retain a tight seal. We should push for more nasal intubation.


Our hope in pediatric dental cases is to never need to take the child back to the OR for dental care again because of cost and general anesthetic risk. We are aggressive and treat with extractions, SSC's, and preventative restorations. Our hope is that if the uncooperative child needs care again, it won't be until they are 7 or 8 years of age and able to behave in the clinic.

CATS

Cats
by Amelia

I love cats.They are nice and soft.I want a cat.
Ben has a cat.Cats chase mice.Cats eat mice.
Ben's cat is named Theo.Cats are afraid of
dogs.There are lots of different kinds of
cats.They can be big or little.We will not
get a cat I think.Cats can wear clothes if
you want them to.Cats have eyes ears a
mouth and a nose.Cats can clime tall
trees.Cats play with yarn and a pretend
mouse toy.A cat will sleep in your bed.
Cats are warm when they are by you.
Cats have sharp nails.They can have a
shot and same medicine.If you have a
mouse in your house call a cat. They live different in places.
A cat will start as
a kitten then will grow up to a cat.
What kind of cat would you get?Cats are my favorite animal.
Some people are allergic to cats.THE END

Piano Performance

We have finally been diligent in practicing the piano. Amelia's hard work shows as she has completed the primer level and now can read the grand staff and play parts with both hands. This past weekend she performed in the RVA piano recital. I was proud of her. Last minute we added Meredith into the piece by having her jingle the bells. Without prompting or explanation Meredith bowed with us at the end-- it was too cute.

Hearing

The short version is that I am free to leave the country, but that another date was set in January to continue discussing the case. We waited 3 hours before the hearing and then everyone was asked to leave except myself, the patient and her lawyer. The board asked a lot of questions of me and eventually I just started to cry as I honestly said I did what I thought was best for her and life-saving. At that point we took a break and Malin was allowed to sit in with me.

In time, perhaps I will be able to write more about this, about how it feels to be persecuted or falsely accused and to try to prove the motives of my heart. So, thank you to all who wrote, prayed, talked, and/or listened to me. I truthfully told my side of this story and in the end-- before God-- all is right and I will be alright.

Amelia's Africa Memory Quilt

To help Amelia celebrate and remember her time in Kenya she designed a quilt with animals. Together we pieced the colors and fabrics she chose. Next she drew the animals and we appliqued them onto the quilt. And then our friend, Deanna (pictured), long-arm quilted it. It truly is a masterpiece and was so fun to create with her. If you're ever at our house you'll have to come to Amelia's room and see it hung!

Skipping Cultures

O God of all creation,

Bless this our land and nation.

Justice be our shield and defender,

May we dwell in unity,

Peace and liberty.

Plenty be found within our borders.

Yesterday, Amelia sang to me the first stanza to Kenya's national anthem. I guess it shouldn't be surprising as she sings the anthem weekly at school during flag raising.
Ee Mungu nguvu yetu

Ilete baraka kwetu

Haki iwe ngao na mlinzi

Natukae na udugu

Amani na uhuru

Raha tupate na ustawi.

But then Amelia really surprised me my singing the first stanza of Kenya's National Anthem in Swahili (with just a little assistance from Nancy our househelper). So after Amelia finished I clapped and said, "So Amelia, what about the Star Spangled Banner?" She looked at me blankly...."you know..Oh say can you seeeeee, by the....." Still a blank stare from Amelia.

"Dad..I don't know what song you are singing."

I guess Amelia has in a way skipped cultures from USA to Kenya and will then be skipping back again in the near future to the USA. I wonder if they still sing the Star Spangled Banner back in US schools today? If so it will be new to Amelia.

Iowa compared to Kenya

The ADA (American Dental Association) is kind enough to give me a free membership as a missionary/volunteer international dentist. With that membership I appreciate that JADA sends to me in Kenya their monthly journal.

Above are research pictures depicting children in Iowa "suffering" from moderate to mild Fluorosis of the teeth maybe caused by excess fluoride found in infant formula.

In comparison a typical patient of mine in Kijabe, Kenya suffering from severe Fluorosis surely caused by excessive fluoride in the well water due to the enriched soil of the great Rift Valley.

The Long Walk

The walking journey from our duplex on lower station below Kijabe Hospital to Amelia's school at upper station has many detours on the way.
7:23 AM - Off to school we go.

7:25 - Climbing Gravel Mountain.

7:28 - Past Kijabe Hospital and watching out for Matatus dropping patients.

7:31-7:34 - Stop to pick up a Weaver Bird nest that dropped from the tree above.

7:37 Tight-rope walking along side the curb.

7:39 - Stop to touch the Sap Stump.

7:41 - Up the gigantic steps of the outdoor amphitheater.

7:43- A pause to quench our thirst.

7:46 - Finally a flat part of our walk across the soccer field.

7:49 - Always time to hang from the soccer goal.

7:53 - Stop to take a swing.


7:56- Made it with 4 minutes to spare before the school bell rings.

Encouragement

Why is that the one slight criticism is far more memorable than many kind compliments?

- Coach, you didn't give my son enough playing time on the court.

- Pastor, your sermons I don't follow.

- Doctor, you didn't take time to listen to all of my health problems.

-Sales Representative, your presentation to the clients are not convincing.

-Teacher, it was not fair to assign my daughter that much homework on homecoming weekend.

-Mother, you always give her what she wants and never let me do what I want.

-Ob/Gyn, my other doctor promised to deliver me no matter if he was on call or not.

-Musician, are you really going to try to do 2 new songs, the congregation can never follow that.

-Dentist, that shot hurt more than the last dentist I saw.

-Volunteer, why would you want to decorate that way, we used green last year?

-Surgeon, are those suture marks going to show forever?

I recently talked to a friend who was embattled in a bitter professional conflict. The person screamed at my friend and said I will make it so you never work in this career again. The conflict detrimentally affected his health, his relationship with his family, and his ability to function in his career. It sucked away his spirit of volunteerism. He prayed and prayed, but there was no resolution. He nearly quit his career out of disgust, depression, and discouragement. But in the 11th hour after 6 years the conflict was resolved. My friend says it is not forgotten. It haunts him everyday. He can't even make a minor decision without reflecting back to those ugly years. I asked him if there is anything that helps him today. He said the following, "Yes. Every time I doubt my abilities I open up my bottom desk drawer. Here I keep all the pictures, all the thank-you notes, all the encouraging letters I have ever received. And I read through them one by one. Many I have memorized by now. And it takes 10's of letters to even begin to repress that one angry person I faced years ago. I would tell everyone to have a drawer set aside just for that reason."

Therefore encourage one another and build each other up, just as in fact you are doing. (1 Thess. 5:11)

Finally, brothers and sisters, rejoice! Strive for full restoration, encourage one another, be of one mind, live in peace. And the God of love and peace will be with you. (2 Cor. 13:11)

It's A Hard Life

As I walk to the hospital I see this man in a stocking hat. His name is Jeremy.

Jeremy, I see you out here each morning with a hammer and chisel. You work hard.
Yes, I am a craftsmen. I am a stone mason.

Jeremy, you are always barefoot Do you not have shoes?
No I have, you see the how the splinters spray (he drives the hammer against the chisel into the rock and chards of stone disperse) into the air. They would infest my shoes. It is better to wear nothing at all.

Do you live here in Kijabe?
No, I live in Nairobi. But I am here from Monday to Saturday. That is my temporary home (he points to a 10 x 20 shipping container in the field) for myself and the others. We work until evening.

Do you have family?
Yes. I have two children and my job as a craftsmen provides for them.

How are you paid?
It is paid by the foot. You see this one here is one foot (gesturing to the rock he just split). I am paid 15 Ksh per foot (about 20 cents). On a good day I can I do 100 foot of stone. But that is just a good day (he points to the quarry of rocks he has completed) when I am feeling strong. But you see these rocks are softer....the other rocks (pointing to a new delivery of rocks) are harder. For those maybe only 50 foot in a day.

How long have you been a stone craftsmen?
15 years. I am 37 years old. Can you help me with something?

Do you want me to hammer a stone? I am a dentist..we do use elevators, chisels, and things like that. I might be good at this. Can I give it a try? (Jeremy nodded in approval. I cradled the stone with my shoes, picked up the hammer, and place the blade of the chisel at a 45 degree angle to the rock. I pounded. Nothing happened. Adjusted the chisel and pounded again. Nothing happened...more force Jeremy said. I kept at it for about 5 minutes banging my knuckles with the hammer as frequently as the chisel. I picked up a new chisel and tried again (maybe the blade was dull?). 5 minutes later the rock looked no different. Jeremy's boss arrived so I handed the chisel and hammer back to him.)

No doctor, I could really use your help with some pain medicine. It is paining here (he points to his shoulders).
Yes, of course. I could imagine your muscles may hurt.

This is what you are building (we looked behind to the new Cure intern housing sixplex)?
Yes..to that I have added.

Jeremy, that is many bricks you have made. And you are an excellent craftsmen.

Then a new king, to whom Joseph meant nothing, came to power in Egypt. “Look,” he said to his people, “the Israelites have become far too numerous for us. Come, we must deal shrewdly with them or they will become even more numerous and, if war breaks out, will join our enemies, fight against us and leave the country.” So they put slave masters over them to oppress them with forced labor, and they built Pithom and Rameses as store cities for Pharaoh. But the more they were oppressed, the more they multiplied and spread; so the Egyptians came to dread the Israelites and worked them ruthlessly. They made their lives bitter with harsh labor in brick and mortar and with all kinds of work in the fields; in all their harsh labor the Egyptians worked them ruthlessly. (Exodus 1)

Jeremy told me he is a Christian. I imagine he can relate to the struggle of the Israelites differently than I can. With brick and mortar he is building a sitaplex (not a Pyramid). But, Jeremy works voluntarily, earns a reasonable salary, and is proud of his craftsmanship as a stone mason (as he should be). But, could you imagine hammering rocks all day long for 15 years? If this was your life would the Israelites plight look a little different? Would it just be an old story with a few good moral lessons to learn? Or might the book of Exodus really be a living document...that you would identify and claim as your own with every swing of the hammer.

Maternity Guidelines

Traditional medical textbooks do not translate effectively to patient care in a third world setting. Sara and Sharon created a guideline for maternal care appropriate for Kijabe Hospital for nurse midwifes and interns. Chapters include such topics as Post Partum Haemorrhage, Eclampsia, Breast Feeding (nurses tell patients to drink Chai to help their milk come in) Pelvic Inflammatory Disease, Twin Delivery, Ectopic Pregancy, Drugs in OB/GYN, VBAC, On Call Responsibilities, Approved Acronyms, and Shoulder Dystocia.

Velcro Teeth

Typical Jack-O-Lantern Smile seen in a Mzee patient here at Kijabe. His teeth were knocked out 5 years ago.


Hakuna Shieda (No Problem). Even 5 years later from out of his pocket came his original incisors.



The patient show me how he presses his incisors into position for eating and talking...a perfect fit. Like a Velcro tooth held in by the lips, adjacent tooth contacts, and gingival contours. So how do I answer the unimaginable ethical dilemmas of our specialty....To make or not to make a partial denture?

Hearing

I should have posted this sooner. The hearing before the Kenyan Medical Board to address the accusations made by a patient was supposed to occur Nov 2nd. However, last Friday when the medical director called to confirm, the board stated that they had decided to move the hearing until Nov 17th. It is frustrating to continue with this issue unresolved and to be delayed in testifying to the truth. So, thank you for those who prayed specifically on the 1st and 2nd and I graciously ask that you continue to intercede before God that either this would just be dropped or that all is resolved well on Nov 17th.

Prove Me Wrong

There are so many good organizations, charities, and NGO's in which to donate; but I am convinced that supporting young Christian doctors to voluntarily serve at least 2 years in a third world setting (making a fraction of what they are worth back in the West) sharing Christ's love through compassionate healing is one of the best impacts that can be made to change the world for His Kingdom dollar for dollar.

I am not good at all at asking for money...and I try not to ask very often. But medical doctors and dentists could not provide care on a daily basis at mission hospital with the Post-Residency Program if it were not for your generous financial donations. In the past it has been labors intensive to logistically give to our account with Samaritan's Purse and WMM. It required our account number, a check, a stamp, the right address, and a mail-box (one donor even got lost in the word of charities and donated to Doctor's Without Borders...a worthy cause, but not us). For many in our generation (Facebook, Amazon, I-tunes & Skype) sending a donation by check and mail is just too slow and cumbersome. For months we have asked that Samaritan's Purse consider setting up online donations to our project account. And to be honest I thought SP was trigger slow and or indifferent (not believing this would truly help).

Online giving to our project account is now available at: http://www.samaritanspurse.org/wmmgiving

With just a click at the above website and search (Friess or Cichowski) you will see a picture of our family. This will allow 100% of your tax-deductable donation to go to our project account to support things like patient surgeries, medicine, building a new dental clinic at Tenwek, transporting donated medical supplies.

I told the administrators and IT people at Samaritan's Purse that the ease of online donations would increase the frequency of those that give and expand the donating base (I hope I am right), particularly if we made the information available on our blog.

I can't preach to you without trying myself. So I gave online donating a try and in less than 3 minutes (even with Kenyan speed internet) our donation to Friess PRP account was made. It's as easy as buying a song on I-tunes.

While we have been supported generously and never lacked (thank-you), often the number of our monthly supporters can be counted on just one hand. Seeing the names of those regular monthly supporters is our biggest encouragement, but I believe there could be even more people involved. I started if off and I would like to see at least 20 donations made (the amount is of less importance) to http://www.samaritanspurse.org/wmmgiving in the next few days. Maybe it is unlikely? Prove me wrong.

click here!