Goodbyes

Amelia's farewell party began with hotdogs and ended with pancakes; it was a sleepover. Only she decided it was still best to sleep at home! Even Meredith enjoyed playing with these girls and celebrating their friendship. She also ate 2 hotdogs. The following day was my theater (operating room) goodbye: cake, tea and mini-speeches from some staff. Muruka, the Kenyan OB resident, who I've spent a lot of time working with and teaching concluded his speech by saying, "I like that she is young." I added, "Yes, even younger than you." Sunday we will say,"Goodbye" in church and then with a soup/bread get together with the other long-term missionaries. 

I guess what I'm trying to say in all these "goodbyes" is that we've been really blessed by the community here. We've received encouragement from more experienced missionaries, we've shared challenges with the 2 other families that came the same week we did in November and been able to support one another, we've enjoyed the help from nurses, dental assistants, midwives, theater staff,  and we've both taught and learned from our colleagues. It's not easy to be leaving.

Thankfully we are only 3 hours away (2 hours once the road is fixed!) and many families here have older children at RVA (the school at Kijabe). Amelia will be able to start school immediately since it's year round. We did learn though that not only are the 2 American OB/GYNs leaving permanently, but the Kenyan OB will be taking about a year off starting July 3rd. This does leave me presently as the only Ob/Gyn. The hospital administrator is working on solutions, and please pray help is quickly found!

If only she could take him home...

Masai Warrior Returns..

Mamusi returned to our clinic 6 weeks after being attacked by a buffalo on the Mara.  He sustained various lacerations to his face and a jaw fracture.

        Myself and my Father-in Law (Opthamologist) attended to Mamusi immediately after the Buffalo Attack.   Today we removed the wires from Mamusi's teeth and thankfully his jaw has healed quite well.  Although, he has probably lost 25 pounds due to having his teeth fixated together for the past 6 weeks.  (An experienced missionary surgeon here told me that tooth fixation use to be a treatment for obesity before bariatric surgery.)  Mamusi has edema below his left eye and may need some further revisions. 

    I think Mamusi was thankful for the treatment.  When he left he cleared his mouth of debris by spitting on the floor of our front office.  I guess he is used to life in the Bush.  I didn't quite know how to respond.."You're welcome?"

Tea and Sugar

Tea and sugar, these were the gifts Janet suggested I bring to Roseline's funeral tomorrow. As Meredith and I walked-up to the dukas to purchase some sugar, she asked, "Why need sugar, Mommy?" I said, "Meredith, Roseline died and went to see Jesus we are getting the sugar for her family." So as we continued walking, she greeted every person saying, "Roseline died, it sad, we get sugar for her daughter." Once we bought the sugar she insisted on carrying it the entire way home saying, "I give this to Diana (Roseline's daughter)." As I was making a poster today for the funeral I read Ps 16:11, "You have made known to me the path of life; you will fill me with joy in your presence, with eternal pleasures at your right hand." Sweet, warm things bring  pleasure, so tea and sugar are indeed the perfect reminders of the eternal joy that awaits us in heaven.  

Baby Hats

Thank you to all at Westminster Presbyterian who lovingly made baby hats for the NICU. Also a big thank you to Laurel for getting these hats shipped. The mothers were grateful and the little ones now warm. As you can see from the pictures we have some babies that barely make 2 pounds. Mothers are required to come every 3 hours to feed, bathe and change their newborn. Some do this for 2-3 months while their little one grows. We previously gave out about 40 hats, then today another 40, and the nurse in charge will distribute the rest, which I think totals over 200 hats!  What a blessing to these young lives and their exhausted mothers. I wish those of you who made hats could've been there! Again, thanks.

Rosalyn

When we moved into our current place we inherited a house helper called Rosalyn. We had heard she was wonderful with children, kind, and hard working. However, during that month she sat around most of the time, seemingly to have no energy for any thing that we asked of here. Soon, it became clear she was sick. We offered to pay for her to go to the hospital and initially she refused. When she finally went, she needed 2 weeks of antibiotics to treat the meningitis. She also needed a CAT scan which revealed multiple brain masses. After looking at the scan I suspected lymphoma of the brain which has a 3 month life expectancy. This Saturday Rosalyn died. Knowing she loved Jesus, we rejoice for her life. However, her daughter is now orphaned and only in primary school. Please pray as friends and family decide how best to care for this little girl. 

Sisters' Update

Amelia is almost six years old.  At times she seems grown-up like when she calls us on the phone at Tenwek to ask "Can I play at Anna's house, " or when she Skypes her grandparents by herself.   Amelia has also figured out recently, "Dad I know who Santa Claus and the Tooth Fairy are, they are really your parents."  But then I realize she is still a kid as I saw her "walking down to our house calmly carrying a newspaper size slice of windshield glass."  Stop!

Amelia now combs her own hair, picks out her own outfits, and is still working on reading.  She is very fond of living in Africa and inseparable with her MK friends.  

       Meredith is 2.5 years old.  Her favorite things now are blankee, pockets, band-aids and the game Pop Beads.  She loves to wear many different pairs of shoes each day, especially shoes that are not her own.   She has stopped calling Amelia Sister and now say's, Ameeeeia.  She is still a good sleeper and napper in her bed net covered crib.  Meredith follows Amelia most places she goes..and has thankfully ended her biting phase.

Meredith favorite thing of all is still her thumb.

New Morning

"His goodness shines like the morning, when the darkness runs from the day. Like the rising sun, His mercies chase the shadows away." What a relief and a praise to see all 3 critical patients from yesterday doing well this morning. Perhaps tonight, I will finally sleep well, although good sleep will probably have to wait until Saturday since I'm on-call. 

Difficult Day

After waking up at 3am last night for no apparent reason, I was worried about being tired during the 9 cases scheduled for today. I had requested an early start and thankfully had the assistance of a surgical resident, a family practice resident, and a ob/gyn resident who are all on the Ob/Gyn service now. 

The first patient began as scheduled, only this patient was 7. It's rare, but ovarian cancer can occur at this age, and she had a large mass suspicious for cancer. When we looked inside the tumor invaded several other organs; with the help of the surgical resident (Agneta who has a particular interest and knowledge of pediatric surgery) we removed all visible cancer.  After that I proceeded with 2 other surgeries, right as I finished and came home for lunch I was pager 999 (Kenyan equivalent to 911). Running back up to the hospital I met an unconscious mother who delivered at home 5 hours prior with retained placenta. She had a thready pulse and no blood pressure. The OB nursing staff quickly helped as I asked for IVs, epinephrine, pitocin, cytotec, blood, oxygen, a heater, packing, and face mask. As we started the 3rd IV line the fluid coming out of her vein was consistent with saline. Thankfully she came with 3 people all of which we sent to the lab to donate blood. After 3 units of blood, 5 liters of NS, and prayer she began to wake-up and was transferred to the ICU. As I was writing her orders Agneta came to tell me that the 2nd woman we had operated on was hypotensive and tachycardic. On exam it was clear she was bleeding inside. We rushed back to the OR, no more blood was available because I had just given it to the post-partum mother, Agneta suggested that we use the cell saver. I found it near miraculous that Tenwek had a cellsaver (a device to autotransfuse this woman with the blood in her abdomen) and even more so that they got it working in 5 minutes. We were able to stabilize this woman, but she is now also in the ICU. 

Things don't always work here (okay most of the time, things feel very inefficient to me). But today, 3 lives were saved thanks to a lot of people. The team worked well. As I reflect on the exhaustion I feel deep gratitude to the staff at Tenwek. Now, I ask God to bring healing to these lives and to protect them from further complications. 

A Long Walk to Janet's House

Janet invited our family to her house for Lunch on Monday.  Monday was Maharaka Day (Kenya's Independence Day from the British).    The walk turned into a 2 hour adventure.

      After two stream crossings, a climb up a steep gully, a rest for the girls to cool off, stoppint to ask for directions we found Janet's house.  

We enjoyed a typical Kenyan meal of rice, beans, meat, Mendazi, and Chai with Janet's family.  Afterwards we walked through their garden and the girls watched Richard milk his two Cows.  Then a long walk back home. 

friends

Cook Book For Sale to Benefit Women's Ministry

Thanks to the many women at Westminster Presbyterian Church who designed, organized and created a cookbook. While I have no doubt that this cook book contains many wonderful recipes having eaten at many of these women's homes, purchasing a cookbook also serves a wonderful purpose. All proceeds from this cook book are going to develop a fund for woman who lose their child during childbirth. 

Let me share a few stories illustrating these woman's lives. Chepkorir labored at home for 48 hours, when her husband finally arranged transport for her to the hospital the baby had already died. Her husband, did not want to pay her bill because the baby had died, so she sat at the hospital for 1 month until finally she was released with her debt. Chepngetich came as a referral from another hospital where she had been for the past 3 days laboring, by the time she was sent it was too late for her baby. She said, "I go home empty handed, no child, and my husband who knows what will happen." Chebet's baby already had passed when she came to Tenwek after laboring days at home. The obstructed labor caused a fistula to develop, so that now she leaks urine continuously. 

Currently, any woman who's pregnancy ends in stillbirth receive pastoral counseling. But each of these women also had different physical needs, some of which money could help. Money for incontinence pads and eventual surgery,  for funerals for their children, for part of their hospital bill, for vitamins, and for transportation home. These gifts to grieving women tangibly express God's love for them.  

So for those of you interested in purchasing a cookbook please contact Laurel via her e-mail llabbe@adelphia.net 

On being relational

I wanted to share an excerpt from the book "Searching for God Knows what" by Donald Miller.  Its a good reminder on the importance of liking to be with people particularly for those that may be natural introverts.

"The most comforting characteristic of Chist is that He like people.  Were somebody to begin a religious system...They would write a book the way Muhammad did.  This would be the most logical way to communicate new ideas. 

 Writing in scrolls was not something that interested Jesus.  He never sat down and wrote a Mission Statement.  Instead, he accumulated friends, and allowed them to write about Him, talk about Him, testify about Him. Each of the Gospels reveals a Christ who ate with people, attended parties, prayed with people, traveled with people, and worked with people.  I can't imagine He would do this unless He actually like people and cared about them.  Jesus built our faith system entirely on relationships, forgoing marketing efforts and spins.

When asked what is the greatest commandment,  Jesus  replies that it is to love the Father, a relational exploit.  He adds to love as well our neighbor.  Christ is saying that the two most important commandments of God are to have in us a relational commitment to God and to other people."

If we look back on the different phases of our lives naturally their are ups and downs.  In my own life times of fulfillment are not associated with money, accomplishments, careers, or security.  Instead times of fulfillment seem to correlate with the strength and richness of relationships in my life; my marriage, my relationships with my children, my extended family, my church and my friends..and of course my relationship with God.   We should be encouraged here and now to invest in these things.

        

Our Places of Ministry

I'm not sure if after 6 months in Kenya we had shared a picture of the Maternity Ward and the Dental Clinic.  Here we are in our respective places.  

      The Maternity Ward is dedicated to Edna Boroff.  Edna was a legendary Nurse Midwife who served humbly at Tenwek for over 30 years.  I think it was estimated that she had delivered over 10, 000 babies.   Edna was responsible for overturning a long standing tragic Kipsigis tradition.  If a Kipsigis mother had triplets it was considered bad luck, and the last of the three was left to die. She took these children in as orphans and through prayer and love was able to eliminate this horrific practice.

Sara spends much of her time (when not operating) in the maternity clinic.  I believe Tenwek maternity delivers over 20 babies daily. They have multiple wards with well over 100 beds.  (I get lost if I am there--and just ask for Doctorie Sara!)   With over 100 preterm, post-term, and active labor patients and families it is always a spectacle of sites and sounds!  I think the patients enjoy sleeping, eating, laboring, and feeding together!  Tenwek also has a Maternal Child Health Clinic to encourage healthy prenatal habits and well baby checks.

This is Tenwek Dental Clinic.  We have two dental chairs- the one I am standing by is where I spend most of my time.  We do similar dentistry you would find back in the States including fillings, crowns, dentures, Root Canals, extractions, and x-rays.  We have a small dental lab, x-ray room, second operatory, front office, and office/chai room.

We see about 20 patients per day.  It is a mix of meeting urgent care needs of patients in pain and giving ongoing dental care to much of the staff and community near Tenwek.

A word of thanks

Thank you to all who take the time to read our blog. We enjoy writing about our experiences. Also, thank you to all who have left comments. It's always fun to read them and encouraging. 

People often express thanks here with small gifts. Some of the interesting things we've received are necklaces, bracelets, eggs, cards, avocados, and pineapples. (I dare someone out there to bring 20 eggs to their gynecologist for performing their wife's hysterectomy.) Receiving thanks feels good and encourages us to keep going. It is not the reason we do our work, but thanks does help motivate when the work is hard, long, or arduous. 

And so, the last time I led devotions for the interns, I talked about Hebrews 10:22-25, "He always keeps his word. Let's see how inventive we can be in encouraging love and helping out, not avoiding worship together as some do but spurring each other on, especially as we see the big day approaching."

Are those extra teeth by the tongue?

     Although we do see many interesting dental pathologies and problems at Tenwek that I have blogged about previously like Ameloblastoma, mouth stuck open from yawning, and buffalo attack jaw fractures; the majority of our patients fall into two categories.  Probably 60% of our patients come in with pain and need a tooth extracted.  30% have gums that bleed and need their teeth cleaned.  The final 10% fall into some other category.  

     We are happy to see all patients and strive to treat all with a Christian compassion.  It certainly is not glamorous cleaning a patient's teeth who has not seen a dentist in 15 years.   You can look at the pictures below if you like (I don't intend to gross anyone out..but hey this is my world!) Cleaning teeth with heavy calculus is appropriately like knocking barnacles off the bottom of an old fishing boat that has been docked for years.   But I have no choice but to put on my eye shield, mask, gown, gloves, and go to work. 

      This patient (you can see the before and after picture) was not at all aware his teeth needed to be cleaned.  He had not seen a dentist in 20 years.  As we proceeded to cavitron off all the calculus attached to his lower incisors he commanded us to stop.  He thought we were removing part of his teeth with the ultrasonic shaking and water spray of the cavitron .  We continued after some reassurance.  As you can see now he has gums that are exposed to light for the first time in decades.  

       Sometimes its easy to want to quit as a dentist or call in for some help!  Often times I doing many things I would rarely do as a dentist back in the United States including taking x-rays, filing, scheduling, and cleaning teeth.

       Regardless, I was encouraged by a family practice physician who reiterated;  just think how much pain is relieved at your dental clinic.

Memorial Day

Happy Memorial Day. Hope many of you are enjoying picnics. Remembering back to last year we had gone camping with friends and were attacked on the trip by lake flies. This year only mosquitos, cockroaches, ants, geckos and lizards to bother us!  

We have 3 more weeks at Tenwek and then move to Kijabe. It is very bitter sweet to think of leaving Tenwek. Things we look forward to are a wonderful school for Amelia, larger dental clinic for Malin, and new people to meet.  Still, we know God will provide for our family no matter where we are located. 

Tenwek Video Presentation

I couldn't download the bigger version of this video. So, the titles are not readable, but hopefully most of the pictures and video speaks for itself. It was created for my parents as they went back to Oak Harbor, WA to share with one of the 3 main churches that support us, First Reformed of Oak Harbor. 

Needing Rest

Exhaustion tends to sneak-up on me. And yet, as I look back on being in Kenyan the past 6 months I shouldn't be surprised. The number are something like this: 62 nights on call, 12 maternal deaths (one my last time on-call), over 250 c-sections, and too many babies who don't live from prematurity, prolonged labor, anomalies, and delayed presentation to the hospital. Malin and I spent a lot of the past three weeks talking about how to balance the overwhelming needs of the hospital and our family's needs. 

In three weeks we move to Kijabe, and I see it as a time to start over trying to be part time. And would appreciate prayer for wisdom in making this happen. Tentatively I plan to reduce to 3.5 days per week and ask that my call frequency be no more than 5-6 per month. The hard part about doing this is I know it means others have to work harder so I can work less. On the other hand, I won't be able to keep up what I've been doing for much longer.  

Work Permit in Hand

Well it's always an adventure going to immigration. Mostly just a really long wait... but we are legal in Kenya for the next 2 years. The girls received their reward for sitting mostly quietly during the process... icecream. I couldn't resist some either. It's very good news to have this in our passports. 

Sisters Playing in the Mud

Tunafundishwa Kiswahilli

At the beginning of March Sara and I began learning the language most commonly spoken throughout Kenya; Kiswahilli.  We are taking 5 hours of language training per week with our (Malimu) Jacken.  We have both individual lessons and couple lessons where we attempt to converse with each other as if we were at the market, church, or talking about our day.   We have been told by other missionaries that language training of any moment on the mission field was the most difficult.  

  Learning Kiswahilli as a couple presents its own unique dynamics.   If you have ever been in a class with your spouse you know what I am talking about.   Sara and I learn at different paces (Sara a little quicker), memorize differently (Malin learns the more obscure words), and pronounce words differently (Kenyans have said Sara speaks Swahilli as if she is Kenyan).  It really gets interesting when Sara corrects me, or I correct her.  Let’s just say as we learn Swahilli we also learn conflict resolution, compromise, and communication.

Sara can say, “We we ni ngonjuwa wapi?”  Where are you sick?

                                   “Saidia mim!”  Help me!

                                   “Kupongezi- Mschinana”  Congratulations, It’s a girl.

    “Nina Mimba?”  Are you pregant?

Malin can say,  “Fungua Mdomo.”  Open your mouth.

    “Kudunga Sindano.”  Giving you a shot.

                                     “Meno Maridadi.”  Beautiful Teeth.

                                     “toa ulimi.”  Stick out your tongue.  

We wish we were learning faster as our lessons will be completed at the end of this month.  Patients so appreciate the limited swahilli we speak and now it is enough for Sara to manage on the Wards and myself in the dental clinic without tying up a nurse to help with translation.  

      We have learned a favorite Kenyan proverb that seems appropriate to our language training the phrase, “Haraca, Haraca, Heina Baraca.”  It translates, hurry, hurry their are no blessings.  

We will be patient and know that “Mungo Anakupenda Sisi.”  (God loves us)

Caterpillar in my Eye!

     Meredith came down with a droopy, swollen, pink, weeping eye yesterday that she constantly rubbed with her pink Blankee to make her feel better.

    Unfortunatly our favorite Opthamologist (Papa) was not available.  Meredith and Sara walked up to Tenwek to see Dr. Ben our Opthamologist at Tenwek.  Dr. Ben and Sara and a couple stabilizing Meredith were able to get "the Caterpillar" out of her eye by swabbing underneath the eyelids.  

     She was diagnosed with corneal abrasion and placed on antibiotic eye drops.  I think she is fine..she just looks a little pathetic.

On not being a "town coward"

     Many of the traditions of the Massai tribe are beginning to change.   One of the traditions that  I still see in many of my Massai patients is the absence of their two lower central incisors (#24, #25).  

At age seven Massai kids are taken by their parents and a knife is placed between their lower teeth and twisted (much like a screwdriver) until the teeth are removed.   If you refuse you are called a coward.

     This tradition I am told was originated by the Massai because of the prevalence of Tetanus..  As you know one of the cardinal symptoms of tetanus is the locking of the jaws together and inability to open the mouth.  If a Massai developed Tetanus he or she could still feed by the gap left on the lower jaw from the extracted teeth.

     This boy had accepted this tribal tradition.    Many we have met refused.  They are called Cowards..and some are excluded from the tribe (although this tradition is dying).  

      At 16 years old a Massai is expected to walk into the Bush and not return for 6 months.  He shall come back in 6 months and after he has killed a lion.  Although this tradition is fading away too (thanks to Game Park regulations) it is still occasionally accomplished.  

     Our drivers a Massai, refused going out into the Bush for 6 months and ran away  to the city.  He told us he was not only called a coward, but also a town coward.  

     I think I might be a town coward as well if I was Massai...

Happy Mother's Day

Thank-you to all the mothers in our lives.  We love you!
        

Direct Flights to Kenya

Visiting Kenya just got a little easier...

Delta Air Lines to launch US-Kenya flights from June 2, 2009

Tagged with: atlanta, delta air lines, kenya, nairobi, united states

Monday, April 20, 2009, 18:36

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Delta Air Lines will start direct commercial flights between the United States and Kenya via Dakar in Senegal from June 2, 2009.

Delta Air Lines’ planned direct service between Nairobi, the capital of Kenya and the country’s largest city, and Atlanta in the United States will operate four times a week – on Monday, Wednesday, Friday and Sunday. The flight will use a Boeing 767-300ER plane with up to 216 seats.

Delta Air Lines was initially expected to start flights from the United States to Kenya in the middle of 2008, which was put off to December 8, 2008, and then finally to June 2009.

The new flight – from Hartsfield-Jackson Atlanta International Airport in Atlanta, the United States, to Kenya – would be the only direct service to the US from Kenya, Bobby Bryan, Delta Air Lines’ commercial manager for West and East Africa, said in the statement.

Bryan indicated that the new US-Kenya flight would provide connections between Kenya and Senegal via Nairobi, where passengers can make use of several connections to other cities in East Africa like Mombassa, Kigali, Entebbe and Dar es Salaam, operated by Kenya Airways, a partner of the SkyTeam airline alliance.

Delta Air Lines has started promoting the United States-Kenya flights by announcing a special introductory fare of US $ 1,789, inclusive of all taxes. However, this fare will only be available on the internet, the airline said.

Other airlines operating in the market charge about US $ 2,000 for a flight to the United States.

Preterm Birth

Thankfully Malin's been keeping our blog the past couple weeks. Since my parents left one week the business of work has been pretty tiring. And I realize I really miss having other colleagues to discuss interesting/challenging cases with. Sometimes I just want the assurance that I'm doing the right thing. For example, most babies under 30 weeks don't survive here. So when a mother arrived with ruptured membranes for 4 weeks at 27 weeks in breech presentation rather than do a C/S (which would be the standard of care in the States) I discussed with her a vaginal delivery that would probably lead to a stillbirth. The baby actually came out crying, but died subsequently in the NICU. And I do believe this was the right decision. However, we're taught in medical school and residency to have evidence to back-up and make our decisions. But most of the statistical evidence just isn't here about preterm birth survival. So a lot of my decision making is based on what I've experienced and I hope that the more I experience the easier and less stressful these decisions will become. 

The diseases we see..

    This chart came from a rural dispensary clinic about 20 km from Tenwek called Kiptuwa.  There health care providers record these statistics yearly and are able to compare incidence rates.  Futhermore, they are able to determine whether public preventative health outreaches such as bed nets to prevent malaria, child vaccinations, prenatal  care, and dietary counseling are working.  Myself and the dental outreach team visited this clinic.  I found it interesting that dental disorders was included as number 12...but not surprised as we extracted many teeth that day.

Backhanded Complement..I think?

  As Sara and I walked up the hill to the hospital after lunch to return to our respective clinic we found Pastor Muchoka coming our direction.  

       "Hello Pastor,"  you look very sharp today.   Pastor Muchoka is our pastor at Bethesda African Gospel Church.  He is an impassioned Christian who comes across natural and genuine at the pulpit.  He also plays the Bass Guitar by ear.  Pastor Muchoka was wearing pin-stripe pants and bright blue shirt.  

        "Thank-you... and you (referring to Sara and I) look like you are increasing," Pastor Muchoka said, as he gestured pushing his shoulders out and bringing them into his to neck to give a larger appearance.

       

Swimming Lessons in Kenya

Swimming lessons in Kenya involve the bathtub--as the nearest swimming pool is at least 80 kilometers from Tenwek.  Meredith prefers the goggles to keep the soap out of her eyes. I'll admit this is somewhat of a gratuitous picture of our daughter...but it is cute!

Our May 2009 Newsletter

Some may see our blog but not receive our Newsletter.  Here is May 2009....

We are called to preach a message where we live, where we work, where we study, where we play, and where we worship.  The message we desperately all need to hear; despite our sin,  God still loves us and desires to bring us closer to him. 

It struck me today that our concerns in Kenya are no different than that of the Christian Community throughout the world.  Sure we have buffalo attacks, Massai mothers who labor for days at home, and we drive 180 miles to get groceries.  But we have friends, patients, missionaries in our midst that are hurting.  You know who these people are or you may be in need right now.  They are the recently unemployed, the parents with wayward children, the elderly who are physically hurting, the single parents who are emotionally exhausted, the professional who has it all together but is spiritually empty, or the outgoing friend who is inwardly  lonely.  

Let us all reach out ... Love Malin, Sara, Amelia, Meredith

The Rainy Season (Amelia & Angela and a broken umbrella)

As you are welcoming the birds, flowers, and sunny warm days back after perhaps after a long winter. We at Tenwek are in the midst of the rainy season.

We asked many Kenyans, when does the rainy season start?  "When it starts to rain,"  was the best answer we got.

      We can now verify the rainy season has begun. We get afternoon and evening showers daily..of what seems like many inches each day.   It is a blessing in Kenya as now Water Tanks for drinking are full and crops like Corn and Tea are growing quickly. There is plenty of water going over the dam to provide hydroelectric power for our house and hospital.

       We experience some of the other aspects of rain.  Our family got stuck three times in a vehicle on the way back from Lunch at Faith's house, our shoes track mud into the hospital and house, and our basement flooded briefly.

 I'm kind of hesitant to show Amelia here with an umbrella.  I'd like to think we are Northwesterns at heart; No umbrellas, just jackets with hoods.

   

Contact Information as of June 29, 09

Goodbyes to Nana and Papa

Nana & Papa left with many tears this morning.  Meredith repeated, " I wanna go to Nana's House."   We were blessed and encouraged by their visit. 

This is their second time in Kenya in less than 6 months (their previous visit coincided with out departure in November).  At that time they were at Christian Lighthouse.  This time we (mostly the grandkids) were able to persuade them to visit Tenwek. 

        Tenwek Hospital welcomed their service.  Papa of course worked in the Eye Clinic and was able to give Dr. Ben Roberts the full time Opthamologist a much needed break.   He provided 3 weeks of clinical and surgical care to patients at Tenwek.   The Eye Clinic was happy to have "Dr. Mark...he very good at the cataract." (Cichowski is a bit difficult for the Kenyans to pronounce).         

  Nana helped out in the Neonatal Unit, rotated with Sara in the Theatre,  and gave vaccinations for children and did prenatal screenings in Tenwek's Outreach clinics. 

Dental, Eye, and OB benefited from the 7 action packers full of opthamological and dental supplies they brought.  

       At home the Meredith & Amelia were entertained with many games of Pop-Beads, reading books, coloring, & Uno with Nana & Papa.  We will miss them greatly.  Certainly the biggest sacrifice of being a missionary families is the goodbyes!

    

A wheelbarrow

      It always strikes me how resourceful the Kenyan culture is.  Nothing is thrown away.  Anything and everything can be used for some purpose.  

   These boys greeted us on a hike nearby Tenwek.  I'm not sure what they planned to carry in the Wheelbarrow, but they were rightfully proud of their tool.

OPG

A prominent need was filled at Tenwek Dental Clinic this past month thanks to many of your generous donations.  People had prayed for many years for an OPG x-ray machine.  God has provided.

      After being in contact with the Massachusetts  Dental Society Dr. Kuyaya found that an Orthopantomograph OP-100 was available for donation by Dr. Miller.  

      What is a panoramic x-ray?  You may have had this x-ray taken before you had your 3rd molars removed.  An OPG or panoramic x-ray (see picture) gives us exactly that; a panoramic snapshot of the the entire oral region.  It is crucial x-ray for diagnosing jaw fractures, finding oral hard tissue malignancies, and locating 3rd molars.  Our treatment at Tenwek is probably upwards of 50% oral surgical procedures.  An OPG is standard in an OMFS office.  

      Tenwek Hospital and this region of Kenya has never had such a machine.  They are costly (20,000 USD).  Dr. Miller graciously donated this machine free of charge, with one catch--shipping!

     As you can see shipping a machine about the size of a telephone booth is not an easy endeavor.  After discussions with Northwest Airlines, World Gospel Mission, Samaritan's Purse, Dr. Miller, and volunteers with the Massachusetts Dental Society we discovered that the machine could be dismantled, crated, and air-freighted for 1100 USD. 

      It was fantastic.    With the help of WGM it cleared customs at Kenyatta National Airport with no further charges as it was marked as a donated item for a Christian Mission Hospital.  The machine as the picture shows arrived by Lori in great condition and careful lifting.  It was soon mounted, installed, electrically converted to Kenyan voltage, and is now in use.  We are using this machine 20 times over per week.  We feel like we are no longer working in the dark.  We also hope it will allow Tenwek Dental to become even more of a referral center.

      Thanks so much for your donations.  Your financial and prayer support is changing the way we do things here in Kenya.  --the Dental Staff @ Tenwek

Our Meredith Hobbit

Definition of a hobbit: gentle, peace-loving, two-to-four feet tall, roundish, jovial face, shortish in the leg, small feet, like to eat two breakfasts.

      Our sister Ana noted that we were raising a hobbit.  Our Meredith eats two breakfasts (first cereal at 6:30 AM and then toast and eggs at about 7:30 AM) and also two lunches (first what we are having and then Ugali; a Kenyan staple of mashed corn.) 

     We are thankful for your prayers as Meredith has fully recovered from her two week sickness from Giardia.  She is keeping everything down she can find.    She is eating, and eating, and eating..even if this picture shows a sad face.  We happily allow her second breakfast

Very Severe Case of Rosacea

Erick Langat; my story

Let me share with you Erick's story.  I find Erick to be talented, and hard-working.  We are praying to find a way for Erick to be able to attend Dental School.

     "My name is Erick Langat. I was born in 1979 in the village of Koijat just 80 km from Tenwek Hospital in Southwestern Kenya.  I am of the                                                       Kispsigis Tribe. I was raised to speak English, Swahilli,                                                        and KiKipsigis.

            In 1997 I finished secondary school in Kakibei.  Even then I was uncertain about my future, but applied to Kenya Medical Training College in Nairobi.  Despite only three open positions for KMTC per district by God’s grace I was accepted.  

In 2003 I finished my studies at KMTC and graduated as an Oral Health Officer.  An Oral Health Officer is trained to treat the basic needs of the Kenyan People.  I am competent providing patient care with dental extractions, scaling of teeth, dental exams, and community dental education.  

After completion of my training I entered internship.  In 2006 I was offered a full time position to work at Tenwek Mission Hospital. I took on the responsibilities of Tenwek Dental Clinic as Dr. Kuyaya the full time Dentist was to leave for South Africa for two years for masters training in restorative dentistry.

I have been content working at Tenwek ever since.  I am happy here as my duties include organizing dental community outreach, tooth extractions, full mouth scaling, dental exams, taking x-rays, and keeping statistics.  

Despite my happiness I feel like God has even more left for me to learn.  I want to expand my training to include fillings, biopsy, crowns, and root canals.  I have a heart for my Kipsigis’ people and felt directed to attend dental school to better serve them.  

Following God’s calling in 2007 I applied and was accepted to Moi University School of Dentistry (one of only two dental schools in Kenya).  I was unable to afford tuition.    Tuition at Moi University is about 450,000 KSH annually (5,800 USD).  My total annual salary would cover less than half that amount.  Student loans are not available for me here in Kenya.  

I sought out funding through Tenwek Hospital with the understanding that for each year of dental school I am supported I am bonded to the hospital for 2 years.  The funding was not available so I was forced to  defer my enrollment.

In 2008 I again sought help from Tenwek Hospital for tuition assistance unsuccessfully.  I was encouraged to apply to a more affordable dental school.

I have currently applied to Makerere University School of Dentistry in Kampala, Uganda.  The tuition is 200,000 KSH annually (2,500 USD).  I will be notified of my acceptance in August.

If I am able to secure funding for entrance into dental school I see myself returning to Tenwek Mission Hospital to serve the Kipsigis people.  I am a Christian and was baptized in 2005.  God has changed my life.  Before Christ I felt like just a human being, a person of the flesh.  Now I feel I am living the Christian Life.

While seeing patients I am lifted up by God’s love.  In our busy dental clinic with patients with complicated dental fractures and infections it is easy to be overwhelmed.  Jesus to me is about help.  When I am burdened I look to Paul’s words in Romans Chapter 8:31-32.

Kimwal nel anyun eng’ tuguchuto? Ngo mi Jehovah Komostanyom, Ko ng’one Kinndaech?  Inendet ne ki ma nire Weririyi ago Kigon inendet agobo achek tugul, tos magonech tuguk tugul eng’ aiybindo koboto inendet.

(What then shall we say to this?  If God is for us, who is against us?  He who did not spare his own son but gave him up for us all, will he not also give us all things with him?)

My faith has called me and inspired me to help the poor at Tenwek Hospital in Kenya.

Docotoriae, they have a patient they want you to see

"Doctorie, "  Erick our Oral Health Officer said as I was in the process of completing a root canal.  

"They have a patient they want you to see in Casualty.  He was attacked by a buffalo."  Erick completed the sentence casually just like,  Doctor Friess the patient for the filling cancelled.

     "OK, I think I'll take a break here and go see this patient."  

I walked to Casualty (ER) to find Mamusi Saii and his father dressed in their traditional red Massai blankets.  

        Mamusi is 16 years old.  His story was that a Cape Buffalo (perhaps the most dangerous animal on the Mara) charged him and picked him up in the air.  During the course of this Mamusi's spear gouged his cheek.  He suffered multiple lacerations to his face, swollen eyelids,and a fractured jaw.  Dad and I saw the patient together.  His eye was responsive to light and intact.  His mandible was fractured at the angle.  

      Erick and I spent the morning wiring his teeth together to stabilize the mandible to allow healing.  Mamusi was extremely courageous.  The entire procedure was done under local anesthetic.  

        He seems to be healing well just 3 days after the attack and plan to send him back to the Mara today.  I hope he stays far away from any further encouters with a Cape Buffalo.   

Ponga

One thing you never want to hear your child say, "Mom, Meredith has a ponga. Mom, Meredith has a ponga! Come!" The landscapers had left a ponga (machete) out and Meredith was running around with it as Amelia chased her and tried to get it out of her hands. Thankfully no one was injured. Meredith was carrying the ponga by its blade and swinging it around. We'll have to remind the landscapers to put these away and out of reach of a 2 year old (or any child for that matter)!

Barbies

When Amelia invited most of the Kenyans in our neighborhood over to play Barbies I was a little curious what they would do. So when I went to check on them and I heard Amelia say, "Alright, Pastor Ken is ready to preach," I was reassured. Indeed the girls made a congregation, church building, pews, and pastor (although I thought it would have been great if the pastor was female). Not to mention they spent hours getting the barbies all decked out for the church service. 

Desperation

Terminating a viable pregnancy is illegal in Kenya. Consequently women go to extreme methods to terminate "unwanted" pregnancies. We had three patients admitted this week for this reason. The first patient was in septic shock, the second patient in renal failure and the third patient in acute respiratory distress. Each woman, eventually shared why she did what she did and the intense remorse each felt. 2 of these women are still in critical condition, and the most critical care I can give is assuring them of God's love, forgiveness and desire to enter into relationship with them.

Preventative Dental Care in the Bush

     Preventative Dental Care such as teeth cleaning and check-ups are a foreign concept in Kenya.   Typically the only time a Kenyan patient comes to our clinic is when there is a major problem; swelling, pain, bad odor, bleeding gums, or a gigantic portion of their tooth missing,. 

      It was a pleasant surprise to meet Jonathan, a Massai who took interest in caring for his teeth. After I told Jonathan I was a Doctoriae Wa Meno-- (Dentist), we visited the Pepper Plant.   He broke off a branch and we stripped the bark from the limb.  "This is a Massai toothbrush.   Scrub your teeth and you will taste the pepper."

     I'll admit the Pepper Plant toothbrush had a winter-fresh flavor similar to Colgate.  Jonathan worked his toothbrush for the next 30 minutes.