Family Vacation

We took a short vacation in Nairobi this week.  It was nice to be able to do some of the fun, touristy things in Nairobi without having to rush to get groceries and hurry back home before dark.  Here are some of the highlights from our time there.

We fed, rode & ate (I know that is strange) ostriches at the Maasai Ostrich Resort.

We witnessed this male ostrich doing his mating dance.

We visited Paradise Lost where we went into a cave, climbed rocks around a waterfall, had a picnic and rode a boat.

We went horseback riding.  This was a first for all of the kids and they were very excited.

 It was great to have time to play together and rest together.

An Overdue Update

We are back from a nice vacation and are getting caught up on things we've neglected - like this blog.  I will post some pics from our vacation soon, but first we wanted to share some prayer requests with you.

Here are some things we’d love prayer for: Praise for Ken and Sarah Muma's return and prayer for their transition back to Kijabe (they’ve been in South Africa for the last year doing the final part of training).  Ken will be joining Erik as his partner in the pediatric surgery department.  Sarah will be working as a pediatrician at the hospital. Ken and Erik will be taking the COSECSA exams in pediatric surgery (September is the written, December is the oral) Pediatric Wing – for timely completion and the provision of the necessary funds to make this happen. For ways to be able to be strategic about medical/physical and spiritual outreach, especially to non-believers from other faiths in the region. Wisdom in interviewing and selecting the next fellow-level trainee in pediatric surgery We really appreciate your prayers and are so thankful for you. Stay tuned for some vacation pics - including pictures of our ostrich riding experience!

Faithfulness - by Erik

My mentor and friend, John Tarpley, lives by aphorisms and one of these is: “the only way not to spill water is not to carry water.”  As a surgeon, this is so true.  Complications are intrinsic to practicing surgery, and while we can’t avoid them completely, we work hard to minimize and eliminate them where possible.  These complications can be incredibly discouraging and at times almost paralyzing.  I read once that God doesn’t call us to be successful; He calls us to be faithful. I’ve attributed this to Mother Teresa though I suspect she just passed it on and I caught it along the way.  I’ve held on to this proverb as I’ve struggled to deal with complications throughout my training and practice as a surgeon.  This is part and parcel of being a physician, and particularly a surgeon – I’m far from unique in all of this.  I hurt with families when their children suffer and especially when they die.  We can’t understand God’s plan sometimes, but I trust and believe that He is faithful in and through all the hard things in this life.  

Just recently I operated on a newborn named Wanjiku with a condition called intestinal atresia.  This condition can manifest itself in a wide spectrum of presentations but fundamentally is a congenital blockage of the intestine.  A unique thing about this girl was that I had operated on her brother, the family’s first-born child, a little over 2y ago who had the most extreme manifestation of the condition.  Despite all our prayers and best efforts, this newborn boy died not long after birth.  When Wanjiku was brought to Kijabe Hospital with the same condition, I could see in her father’s face the concern and fear that she might suffer the same fate as her brother.  As we prayed together before Wanjiku’s operation, I too felt the trepidation of what I would find at operation.  In the operating theater I was able to inspect the intestine and found Wanjiku to have a much less severe form of atresia and right then I said out loud, “thank you, Lord.”   Everyday at Wanjiku’s bedside after the operation, I found Mom and/or Dad caring for her and I could tell that while they hoped and prayed for the best, their past experience caused them to fear the worst.  Wanjiku’s post-operative course was wholly and completely uneventful.  She sailed through the first few days waiting for her bowel to start working and then quickly advanced on feeding.  She was discharged home and came to clinic this past week gaining weight and looking great.  Her parents even then were cautiously optimistic, worried that other complications might ensue.  As we talked about their son’s death and their daughter’s current progress, I saw in them hearts that had suffered and hurt deeply as they grieved the passing of their son.  However, they expressed real belief and trust in God’s faithfulness - their faith having been tested and strengthened in the Refiner’s fire in a way that no one would ever choose.  I see them and their beautiful daughter and I praise God not just for the gift of Wanjiku and her recovery from surgery, but also for the faithfulness of a God who loves us and calls us to himself.  Even when we are not successful, He is faithful.  

(Wanjiku’s parents have graciously agreed and encouraged me to share their story on our blog.  They gave permission for me to post this picture of Wanjiku at her first clinic visit.)

A Happy Ending

It’s a pleasure to work here in Kijabe, Kenya for so many reasons.  Like any physician working in a resource-challenged environment, those of us here at Kijabe Hospital see more than our fair share of patients with late-presenting and difficult to treat problems.  We grieve with the families amidst tragedies that in another context might not be so devastating or even much of a problem at all.  The upside is that we are much more acutely aware of the reality of our constant need for Christ’s Hand to lead us and keep us going.  There are certainly joyous times as well where we get to smile with families and celebrate God’s healing here in this life.  

Today, we celebrated with Hiram and his family as he was discharged from the hospital.  This 3-year-old boy was bitten in his groin a couple of weeks ago by a neighbor’s dog.  When he showed up at the hospital, he had multiple puncture wounds from the dog’s teeth, but he also had no pulses in his leg indicating that the bites had injured the main artery going into his leg.  As we prepared to take him to the operating room, we went to the lab to make sure there would be blood available.  Unfortunately, there was no blood compatible so we began calling around to folks at the nursing school and at Rift Valley Academy (RVA).  Jeff, a dorm parent at RVA, came down immediately to donate blood.  After a 5 hour operation in the middle of the night to reconstruct the main artery in the leg, Hiram was taken to the ward with pulses in his feet.  He has recovered steadily and began taking some steps over the last 2 days.  As I think about all the pieces that went into saving his leg :

1.     Well-trained anesthetists available in the middle of the night to put a 3 year old to sleep

2.     Folks like Jeff who make themselves routinely available to donate blood

3.     Friends and colleagues like Rich who came to the hospital at 4am when he wasn’t on call to bring his Doppler machine and to give me some good counsel

4.     Nurses who care all day and night for patients like Hiram

5.     Hiram’s family who were able to procure some anti-rabies medicine from the national hospital

6.     Resident physicians who are eager and willing to learn and help out with patients

7.     The Hand of God guiding all of us to bring His Kingdom on earth as it is in Heaven

I’m exceedingly grateful, humbled, and honored to be able to get to do what I do here in East Africa with friends, colleagues and fellow laborers in Christ.

Hiram's mother has given me permission to share his story and this photo with you.

An Overdue Update - from Erik

2014 has continued to be a busy time at the hospital.  We’re seeing healing and heartache, joy and frustration.  These are all part of life on this earth as we await our Savior’s return. We continue to pray for His Kingdom to come on earth as it is in Heaven.  

Some of the highlights of these last few months are:

1.  Edmond & Francine Ntaganda and family!  Edmond is a trained general surgeon from Rwanda who joined the pediatric surgery fellowship program here in January.  He and his family are an answer to prayer as we prepared in 2013 to accept the next fellow trainee.  They have two children and will be in the program for 3 years, anticipating graduation at the end of 2016. Edmond will become the first Rwandan trained pediatric surgeon. 

2.  Rick Jackson.  In January, Rick was gracious enough to come out to Kijabe for 2 weeks to help me with some complicated anorectal malformation patients.  Among other more “routine” cases, we operated together on 5 girls with cloacal malformations (Amanda doesn’t like me to get too graphic on the blog, so if you’re interested in what this is, you can view details here or here).  His time here was invaluable for me and the trainees as he greatly helped to “build capacity” as we care for these complex patients.

3.  Ron & Suzanne Sutherland. Ron and Suzanne have been out to Kijabe a number of times and over the years have invested heavily in the care of patients, the training of residents, fellows and consultants (like me), and the procurement of the necessary equipment to do the endoscopic and microsurgical work of pediatric urology.  Approximately 40% of the pediatric surgical work at Kijabe is urologic.  Without Ron and other pediatric urologists like him (including Lynn Teague who will be visiting in the Fall), we would not be able to care for these kids. 

4.  Doug Barnhart.  Doug has been a Godsend, willing to come for a couple of weeks at a time to relieve and cover for me.  I was able to attend the Surgical Society of Kenya meeting at the end of April as Doug watched over the service.  He’s already scheduled his 4^th visit to help cover me in December of this year.  Many thanks to Jill and his kids who graciously let him globe-trot!

5.  Mike & Rosemarie Matlak.  Over the last 4 years, Mike and Rosemarie have spent about 2 years at Kijabe to help sustain the training program and invest in the lives of the children and mothers in the hospital.  Mike is a pediatric surgeon and has been an invaluable colleague to me and the program as a whole.  Rosemarie’s gentle spirit and deep love for Christ are played out as she spends hours alongside Chaplain Mercy loving on and encouraging the mothers and their children.

We’ve been able to experience Christ’s healing – physical and spiritual – in the lives of our patients.  As always, we are privileged to be able to be the hands and feet of Christ and grateful for all He is doing. 

A Story of Survival

Many of you have heard about a baby who presented to Kijabe Hospital before Christmas with a condition called gastroschisis.  This is a problem where the abdominal wall doesn’t form correctly and at birth the child has the intestines on the outside.   This is a difficult problem to treat, but in developed countries, the survival is ~95%.  Unfortunately in the less developed world, like Sub-Saharan Africa, the survival is far below this and likely less than 10%.  This particular child was at a hospital 100s of kilometers from Kijabe where there weren’t the necessary resources to care for him.  Amazingly, at 4 days old, he and his mother arrived at Kijabe hospital with his intestines wrapped in gauze.  I told his mother that his chance of survival was far less than 50% but that we would do all we could to care for him.  He had a very rocky hospital stay over the course of almost 2 months, but  through the power of prayer and the work of our Lord in his people, this baby boy left the hospital yesterday!  He’s got some recovering still to do, but Mom was all smiles as she was preparing to take him home.  

I am so grateful for all of you who have been praying for this child.  He is a testimony to God’s healing power and he is an answer to prayer.  

By His grace, we’ve now had 3 children with gastroschisis survive at Kijabe Hospital.  Just yesterday, another 4-day-old child with gastroschisis was transferred to us.  We continue to covet your prayers for this child and so many other children who come through our doors everyday with difficult and sometimes desperate problems.  Thanks for being part of not only the physical but also the spiritual work in the lives of these kids.