Saturday, February 23, 2008

Final Week at Tenwek & Safely to Nairobi

Saturday - Saturday, February 16 - 23, 2008
Steve & Alene visit the school.
Sharing time with Robert & Betty.
Dedicating the tank site and being honored by Wesley & Charity.
A special celebration at Tenwek.
Steve’s final week at the hospital.
Alene’s week in ministry.
Safe travel to Nairobi.
[Note: Alene has been very busy preparing to preach on two Sunday’s (2/17/08 and 2/24/08) and with ministry and packing this week. We knew that the internet access was poor and decided to “experience” this final week in Kenya and not have journaling (aka blogging) interfere with our experiences. Alene will blog more soon.]

Saturday, February 16, 2008

Steve: This is my third and final day off during our 26 days at Tenwek Hospital and we certainly made the very most of it….even if it didn’t start off quite as expected. Wesley had arranged for a driver, Josea, to be available to drive us to our “appointments” today and as Alene and I watched Josea’s car drive up the valley and around a curve, it stopped out of view for several minutes. A bit later the sputtering sedan vehicle drove up and with a slight bit of hesitation we got in. With all of the political turmoil lately the gasoline has been expensive, at times unavailable, and apparently yesterday it was not clean. Josea nursed the clutch and gearshift to safely get us up steep inclines and around deeply-rutted and boulder-ridden roads. (Halfway through the day the car ran quite smoothly with a cleaned out carburetor.)

I was blessed to be able to go to the primary school where Alene had spoken 8 days ago and to see each of the girl’s classrooms. The timing was perfect as it was the mid-term parent-teacher conference day and each student was required to have a parent accompany them to school today (Saturday). Wesley’s daughter, Alene, is very young, but she and the other students in her class are already learning some challenging language and arithmetic skills. Her teacher (as well as Mercy’s teacher) pointed out each girl’s strengths and where improvement is needed. (In contrast to the USA, they are very focused on each student’s class ranking even in primary school.) I was able to witness the quality of the school and the dedication of the teachers as well as the obvious priority that parents have made to send their children to this private school. It was great that I could also briefly meet with the school superintendent.

Forget about seat belts and child/infant car seats here in Kenya! We just gritted our teeth as Josea had a women and 4 young girls sit in the passenger front seat while Wesley, Alene and I sat in the back seat. Fortunately the lady only rode a short while to the gas station, but the 4 small girls remained in the front seat. After filling up with some “good gas” in Bomet (or at least “better”) we had a brief meeting with Charity’s brother at the bank. There was quite a line (I mean a “queue”) of people waiting to see the tellers, but we were told that these three lines were nothing compared to the usual ten lines! Oh, what we’ve grown to take for granted! Otherwise, at a quick glance it looked very much like a USA bank with “Personal Bankers” and “Credit card/ATM card application” desks, etc.

Josea delivered Alene and me at the home of Robert and Betty Chepkwony, where we enjoyed their generous hospitality. Robert is one of the endoscopy nurses and we had kept in touch after our time at Tenwek in 2006. For this mostly hilly area, Robert has a very flat piece of property. His love of trees was very evident with multiple borders made up of thirty-foot tall trees. They raise a variety of crops, vegetables, fruits, milk cows, and chickens. In contrast to the Koech household, their proximity to a larger village has enabled them to have some modern conveniences with electrical power and running water out to their tank. The electricity saves a lot on their kerosene (called “paraffin” here), which was needed in the lamps for Robert to do his nursing upgrade studies (to the equivalent of an R.N.) and for the children to do their homework as well. Robert and Betty also have clearly made their children’s education a high priority. Robert demonstrated a merging of cultures as he expressed his desire that all three of his children have an excellent education to be able to do whatever and live wherever they desire, rather than expecting his son to settle next to his father. It was a delight to meet their 8-month-old daughter, who is yet another “Alene”! We were treated to chai and a delicious meal after playing a bit with the children. It does help to feel you know a family better after sharing time in their home. Hopefully some day we’ll be able to have some of our Kenyan family join us in Colorado!

Our chauffeur, Josea, then drove us to Wesley and Charity’s for a very special afternoon. We dedicated their “dairy” buildings with the shaded stalls and milking stall with feed storage. Access to water is very difficult (three trips daily down a very steep hill with the cattle to get them to drink out of the river). To improve their ability to have healthy cows year-round, a tank is to be installed to store water next to the “dairy,” and today we dedicated the land for the tank to God’s glory. For my part, I shared Deuteronomy 8:6-9a, 10-14, and 17-18 plus Psalm 127, verse 1 – “Unless the Lord builds the house the builders labor in vain.” Wesley and Charity have continued to dedicate all aspects of their lives to the Lord and certainly will continue to do so. We helped plant some seedling trees as a remembrance of our family connections.

I was most blessed and humbled by Wesley and Charity literally treating me as “an honored man” by making a sheepskin seat for me to use as I was adorned with a cap made of monkey fur, an ornate staff/walking stick and a bulbous traditional Kipsigis club (similar to the ones still used by the Tenwek Hospital security guards).

Alene was also honored as she sat in her own sheepskin seat as Charity clothed her in the traditional drape and head wrap and gave her the decorated gourds of honor (kalabash).

Wesley’s focus verses for us included Jeremiah 51:20 – “You are my war club, my weapon for battle – with you I shatter nations, with you I destroy kingdoms.” He also shared Job 1:5 as reminder for all of us to take time to sacrifice and honor God after times of feasting. We celebrate with great joy our special connection with this family. I know I will return to their home “soon,” but it was with a heavy heart to leave today knowing that I’d not be back during this trip.

Sunday, February 17, 2008

Steve: We shared a peaceful walk this morning as birds gave us a beautiful serenade. We parted ways with Wesley as her escort for Alene to attend to her pastoral duties while I attended to my medical duties today. As we start our final week at Tenwek it is sentimental to reflect on sights and sounds and experiences unique to this setting. I was able to attend the worship service this morning and share my “last Sunday farewell.” Dr. Ben Roberts’ sermon focused on 1 John 4:7-21 and that we are loved by God, are assured of His love, and are called to demonstrate that love to others. I’ll even miss the worship service’s unusual mixture of hymns from the early 1800’s and guitar-accompanied praise songs from the year 2000!

Two “angels” (visiting staff, Miriam Wanjala, and Clinical Officer Intern, Alfred Mutai) graciously helped get me through the medical rounds on our 40 people today!

Alene preached today at a church in Kapkesiego (near Mugango) with Pastor Wesley’s excellent assistance in interpreting.

Monday, February 18, 2008

Steve: Those cared for at Tenwek Hospital give a new perspective on “patience” in being a “patient.” Our Endoscopy scheduled patients are just told to report on a given day in the morning with no specific time indicated. Then they are seen on a “first-come first-served” basis. However, emergency patients and in-patients may potentially delay scheduled procedures further. With this system it is not unusual for some patients to wait 3-4 hours for their scheduled procedures! (Many patients back in the USA are upset when I’m 15 minutes late!) The Tenwek Endoscopy team is very appreciative of my services this month, which has greatly helped the patient procedure flow. Normally, without visiting physicians the Endoscopy team may often have difficulty getting the surgery physicians to perform the procedures in a more “timely” manner. With the turmoil subsiding here in Kenya there are more patients reporting for endoscopy exams and we’re averaging now about 7 endoscopy patients each day. (Of course, I still need assist with the medicine rounds with 2 students and 2 interns.)

We rejoiced today with no cancer diagnosed for any of our endoscopy patients! [With the very high incidence of esophagus and stomach cancer among our patients this, in fact, was my only day without a cancer diagnosis.]

Alene visited and evangelized with Wesley in the Mugango area. They were blessed by the witness of a Kisii tribesman, whose house and carpentry business tools were destroyed by a fire started last month by Kipsigis tribesmen. As his house burned he prayed with his family for forgiveness for the perpetrators and he continues to pray for them. He is rebuilding his life and some of the arsonists have come forward to help him in the process. His faith and forgiving spirit are a testimony to us.

We enjoyed a delightful dinner with Dr. Chuck and Amy Bem. They shared about their ministry to orphaned children, which emphasizes providing them with a good education. For only $400.00 a child can get their education and room & board for one year. This certainly should help to break the cycle of poverty. Contributions of any amount are accepted at:
World Gospel Missions
P.O. Box 948
Marion, IN 46952
With checks to “World Gospel Missions” and designation on the memo line: “Bemm ministry – orphan school.
[Thanks for letting me put a “plug” for a worthy cause.]

Tuesday, February 19, 2008

Steve: I had asked the Medical Superintendent, Dr. John Spriegel, for advice on needy areas at Tenwek Hospital and he showed me today the very meager equipment available for the dentist, Dr. Peter Kuyaya, to use in the Dental Clinic. At Dr. Spriegel’s suggestion I directed 4/5 of the generous contributions from my home church (First United Methodist Church) plus those of other donors be used to help purchase sorely needed dental equipment. The other 1/5 of the contributions will be directed to the needy esophageal cancer patients, who require placement of the $225.00 esophageal stent.

Alene continued in ministry with Wesley today and shared with the Kisii man (seen yesterday) how his forgiving witness moved several of us at Tenwek to contribute to the re-building of his home and purchase of replacement carpentry equipment. He in turn was blessed to receive a Kisii Bible from Dr. Bemm.

We enjoyed another wonderful dinner out at the Spriegel’s home tonight with a chance to get to know John and Linda and their children a bit better. Linda has been coordinating a growing Kipsigis women’s Bible study program.

This was my last night on call and started out and ended with unsuccessful resuscitation attempts. The severity of illness continues to be evident.

Wednesday, February 20, 2008

Steve: I learned today about the significance of the “ceremonial cup” in the Endoscopy unit. Dr. White used it today as he has for hundreds of patients to have their first drink of water immediately after a stent is placed across their esophageal cancer. It was very moving to see the emaciated man have his drink from the “ceremonial cup” today and know that there will be an improved quality of life for him in the coming months.

During this final week of “last’s” it was amazing to celebrate a “first” for Tenwek: Dr. Fritz and Elaine Westerhout’s 50th Wedding Anniversary! He is an OB/GYN physician who has served with his wife here multiple times over the years. They are again serving for several weeks and thought they might just have a quiet evening to themselves on “their day,” but Lisa Kuyaya learned of this day’s significance and set up a fantastic feast for about thirty of us including traditional Kenyan dishes and some Kenyan wedding rituals. One ritual was that during the wedding (or in this case the anniversary) celebration the couple was draped with a colorful cloth keeping them near each other throughout the evening. The food and company was exquisite and we all appreciated learning more about Fritz and Elaine’s lives together and their sage advice for us. There was no Champagne, but the sparkling grape juice was a great substitute as we toasted the couple……Alene and I will need to reserve the room for our 50th in 2025!

Alene worked hard today in getting a good start on packing up for our return trip.

Thursday, February 21, 2008

Steve: Our internet connection has only allowed a glimpse of email subject lines for many days and an inability to read and send out any email messages. So, we called up Clara to at least get a “We’re OK” message in the blog. As she shared in the blog, we too were moved to simultaneously view the lunar eclipse from two sides of the earth! We truly are connected on this planet.

We on the Endoscopy team were blessed today to diagnose a small esophageal cancer, which proved to be operable with hopes for a cure for an older woman. (This is in contrast to the usual late-stage cancers for which we can only offer palliative stenting.)

Alene continued her ministry with Pastor Wesley today and she has us pretty well packed up now.

Friday, February 22, 2008

Steve: Well, it has finally arrived – my last day of service at Tenwek Hospital! Although the days have been very full and breaks rather limited, it does seem that the time has passed rather quickly. I’ve become much more comfortable treating patients with diabetic coma, meningitis, tuberculosis, deep venous thrombosis, and many other infectious and general medical illnesses. I continue to admire the dedicated service of the Tenwek Hospital medical team to many very ill patients.

Dr. White kindly allowed me to view the surgical procedure with the successful removal of the woman’s small cancer that we diagnosed yesterday. Praise God! I’m amazed at the surgical procedures performed here. Dr. White’s next surgery was to open up a tight mitral heart valve! (They are not yet doing any heart valve replacements.)

At my final endoscopy procedure we diagnosed esophageal cancer in an elderly woman whose family had driven her 200 km (about 130 miles) for care here. We were able to dilate her narrowed esophageal opening and it was gratifying to see her drinking “Krest” (like 7-Up) on the medical ward. Care will continue after my departure as Dr. White will place her stent on Monday. Then she, too, can have a deep drink from the “ceremonial cup!”

We enjoyed lunch with Wesley and Charity and farewells to staff and colleagues here. It was great to have time for a sentimental walk around the Tenwek area on this very pleasant evening. Down at the dam we saw evidence that this truly is the “dry season” with a very low water level exposing a lot of earth. So far, there still was water flowing to keep the hospital’s generator functioning. Just as we pray for life-restoring rains here, we pray for a fresh influx of physicians to continue the medical and surgical services after this “dry season.”

We again reflected on how very close we were to not being able to come to Tenwek at all in late January and we again gave thanks to the Lord for allowing us to come during the “window” of travel opportunity to provide much appreciated service. Alene’s plans to travel with the Tenwek Community Health team to outlying villages was not possible, but it opened up wonderful other opportunities for her to share in ministry times with Pastor Wesley. Alene feels like she’s just had an intense month of seminary training and I feel like I’ve had an intense month of residency medical training!

Many ask us if we will return to Kenya and we hardily reply “Yes, Lord willing!”

Saturday, February 23, 2008

Steve: Along with Dr. Osteen’s family of six we flew out from the nearby dirt airstrip on which we’d landed 4 weeks ago and were again able to fly on the “big” 15-passenger aircraft. It was a true blessing to have Wesley and Charity and family join us for our farewells at the airstrip. Seeing a plane this close was a novel experience for their children. It has been a blessing to share so much time with their family. We again marveled at Pastor Wesley’s familiarity with so many in the area and promptly learned that our assigned driver was not only familiar, but related as a 1st cousin to Charity.

The Lord continues to watch over our coming and going with a smooth flight, excellent views of the terrain, and a safe landing in Nairobi. We are now at the Mennonite Guesthouse in Nairobi. I’m keyboarding in the gazebo out on the lawn while Alene prepares to preach at two services tomorrow at Harvest Centre Fellowship in Nairobi. (I will share some words as well.) It is a valuable time of transition and reflection here in this peaceful setting.

We had originally hoped to share some time with Bishop and Mrs. Wachara’s families in Western Kenya during the coming days, but the political turmoil necessitated canceling those plans. Our return has been moved up to depart Nairobi late Sunday night with a 9-hour lay-over in London before continuing to Denver. Lord willing, we are to arrive in Colorado on Monday evening. We look forward to the extra days to catch up and be refreshed.

We thank all for answered prayers for our safety and wonderful opportunities for service and ministry in Kenya.
We ask for continued prayers for a lasting peace in Kenya.
[Thank you for your understanding during our very poor internet service.]

Peace to all!

“The Lord will watch over your coming and going both now and forevermore.”
Psalm 121:8
--Steve & Alene

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