This will be a problem. We have to renew our passports! They are submitted, expedited, and now we wait.
We are stateside! We would love to see you if you are free. We have a couple goals . . . the most important is a successful install of David at Abilene Christian University. So far this goal is progressing well. The next is to get our passports renewed. This is not going so well. We tried to renew in Kenya, but embassy appointments were impossible to get without an emergency. We have to renew then before we can fly back to Kenya, but we cannot do a fast passport renewal without a life or death situation. We do not have that, and so we have expedited our renewal (read that as expensive!), but even with that, the renewal can take up to 12 weeks. That is better than the 20 weeks for a non-expedited passport, but still not very fast. I am hopeful it will take less than 12 . . . maybe more like six. Is that too hopeful? Please pray for us in regards to our passports.
We are doing some support raising visits. Please pray for that as well. I have very mixed feeling about support raising. I have made new, good friends through the process. God has given us strangers to support our work, and now those strangers are friends. I feel blessed to be taken care of by God and by other Christians. On the other hand, I do not like the humbling feeling of asking for help. One of the things that pulls me to leave the mission field is my desire to take care of my family financially. Knowing I can be in the US working and providing well for Allison and the kids, instead of living much more frugally in Kenya is a weird temptation. I love working in Kenya, yet the desire to be “self-sufficient” and a “provider” are very strong urges. There is tension there. Taking care of your family is a Godly trait, so it is weird to choose a path that hinders that responsibility (at least from a worldly perspective to which I am susceptible). My thoughts on support raising are complicated, and instead of going on, I will just ask again that you will pray that God will provide as he always has so far.
I cannot believe that David is 18 and headed off to Abilene Christian University. He considered and was accepted at several other good schools, but in the end the idea of attending the “Harvard of West Texas” could not be beat. Allison and I both went to ACU, as did Allison’s parents. Both my brothers and most of my cousins attended as did Allison’s brother. My sister-in-laws on both sides are ACU Wildcats. It is the family school. We are very excited, and David will be rooming with his cousin. We are excited about that too. We are sad to see him go, but he is more than ready for the next stage of life. God was good to us when he gave us the responsibility of caring for this young man, and we are excited to see how he will serve God with his gifts in the future . . . (Read our entire newsletter at this link, Coming To The USA! There are some nice pictures as well as some small further updates).
If you know a church or individual that might be interested in supporting our work, we would really like to meet them!
For my recent birthday, Allison invited a few people for coffee and sweets on a Sunday afternoon. I was glad to spend some time with a lot of good people, and I was especially glad to spend time with the Kijabe Hospital Internal Medicine team. We have a great group of American and Kenyan doctors working together to take care of the complex medical cases in the medicine wards, the intensive care unit, and the COVID ward. We deal with a lot of tough cases and some really desperate situations, but there is not a day that goes by without this group giving me something to laugh and smile about.
Our friend Lisa sent this verse to us. Thank you for the encouragement!
Yet this I call to mind and therefore I have hope: Because of the Lord’s great love we are not consumed, for his compassions never fail. They are new every morning; great is your faithfulness. I say to myself, “The Lord is my portion; therefore I will wait for him.” The Lord is good to those whose hope is in him, to the one who seeks him; it is good to wait quietly for the salvation of the Lord.Lamentations 3:21-26
Every year the sophomores put on a dinner for staff and upper class students. Last year it did not occur. This year it looked different, as it had to be outside. Instead of serving tables, they delivered dinners to homes and a few brave souls ate outside the main administration building. We were one of them. This time of year in Kijabe it gets cool at night. So the students sat down on the outdoor basketball court around chimineas. We sat on the porch and shivered. We enjoyed watching the students try and make a go of it under tough circumstances, while we wondered why we were sitting in the cold instead of having it delivered to our house. The food was pretty good too.
I am back in a normal hospital ward for a change, and it feels so relaxed in comparison to the weeks I have spent in the ICU and in the COVID wards. It turns out this is the week of ascites and liver failure. I do not recall ever having so many patients with liver failure at the same time in Kijabe. Alcoholism, Hepatitis A, and still to be diagnosed causes for liver failure fill the wards. I have been opening my computer and looking up possibilities for liver failure and ascites to try and solidify diagnosis. In addition heart failure, intestinal bleeding, and bone infections round out the service.
I am glad to be on the wards, because we have more clinical officer interns and medical officer interns present to know and to train. Frequently I find myself pushed to improve through their questions. This week I am working with one specific intern who begins many of his questions with the phrase “with all due respect”. When I hear that at the beginning of a question, I know that I have possibly missed something and that my intern is feeling pretty secure in questioning a treatment plan. This intern has me on my toes, and it is good. He makes me look into why I am doing some treatments in the manner I am doing them. Have I gotten a little relaxed in a resource limited setting? Am I still pushing for excellence in the care of our patients? He knows what the book says, and he wants to know why what we do does not always match the guidelines. Often there are reasons that are sound because of the financial and logistical constraints of the hospital, but other times I am left with the thought that I should be pushing harder for increased levels of care. In this way it is a good push, despite the discomfort of being questioned. Even as I sit typing the post, I am wondering if all of the internal medicine consultants should get together to see if we should go over our guidelines again to see if we can become less constrained by our resources and push for less limitations in our ambitions.
This is from the Samaratin’s Purse website.
Mission Organization: Africa Inland Mission (AIM)/Africa Inland Church (AIC)
Profile: Kijabe Mission Station was first established by missionaries from AIM as an outpost in 1903. The first hospital at Kijabe, Theodora Hospital, was established in 1915. This served the medical needs of the area until the present complex was begun. The first building of the present complex was opened in 1961.
Today, Kijabe Hospital is a non-profit, 363-bed hospital owned and operated by AIC of Kenya as part of a network of four hospitals and 45 dispensaries. It employs over 900 staff and strives to balance Kenyan and missionary consultants. The hospital offers a broad range of inpatient and outpatient curative services to people from the surrounding farming communities. The hospital includes five inpatient wards (general surgery, medicine for adults and children, obstetrics and gynecology, neonatal care, and rehabilitation), nine operating rooms, an outpatient clinic and 24-hour casualty department, an eye clinic, and a full-service dental facility. Support services include a clinical laboratory, a fully equipped pathology department, X-ray, ultrasound, electrocardiogram, pharmacy, physiotherapy, and central medical supply. Kijabe’s laboratory offers immunohematology, hematology, biochemistry, parasitology, urinalysis, bacteriology, and blood banking services.
The pathology department provides tissue diagnostic services to 37 mission hospitals in East Africa. The OPD provides services for general acute illness as well as specialty clinics in diabetes, orthopedics, rehabilitation, ophthalmology, TB, gynecology, high risk pediatrics, and AIDS. Malaria, pneumonia, TB, tropical diseases, and AIDS are common diagnoses. A Maternal-Child Health Centre (MCH) within the hospital provides antenatal care, family planning, and childhood immunizations. Kijabe also sends mobile health teams to 12 villages each month to provide these same services.
Kijabe is a general hospital and performs more than 200 operations each month. In past years, the most commonly performed operations have included: C-section, tubal ligation, exploratory laparotomy (non-trauma), skin graft, supra-pubic protatectomy, D&C, hysterectomy, ORIF femur fracture, salpingectomy (ectopic PG), sequestrectomy (osteomyelitis), and removal of various cancerous tumors. A dental department was begun in 1978 as a satellite clinic of the main AIM dental clinic in Nairobi. The hospital also trains nurses and medical students and has Community Health Evangelism (CHE) and chaplaincy programs. Because people know they can receive quality care at Kijabe, many are willing to wait weeks or months for their procedures. Bed occupancy averages 80 percent.
Travel: Fly by commercial airline to Nairobi; drive approximately one hour to Kijabe (6 km down a steep, winding, narrow but paved road off the main Nairobi/Nakuru highway). Time Difference +7 hours Daylight Savings Time (EST), U.S.A.; +8 hours Eastern Standard Time, U.S.A.
Location: Kijabe Hospital is located about 60 km north of Nairobi. The altitude is 7,200 feet up on the edge of an escarpment overlooking the Great Rift Valley which extends from the Sea of Galilee to Zimbabwe. People The largest group of people served by Kijabe Hospital are the Kikuyus, although the number of Masai patients has recently increased.
Language: Swahili and English are the official languages of Kenya although local tribal dialects are also spoken. All medical staff speak English fluently, and nurses provide translation to Swahili or Kikuyu. Medical records are written in English.
Religion: The population is primarily Christian (Protestant and Catholic), although some of the more remote tribes practice animism and spirit worship. Muslims and Hindus comprise a smaller portion of the religious community.
Climate: Kijabe is a Masai word meaning “Place of the Winds.” Although strong winds are common, there are periods of calm on most days. The high altitude makes for generally pleasant days (about 80°F) and cool, windy nights (about 55°F). There are two rainy seasons in March–June and October–December. June–August can be quite cool and December–March is typically dry and hot. There can be a lot of mud in the rainy seasons. June––August can be quite cool. December–March is the driest and hottest season.
Housing: Housing is in modern, comfortable homes, duplexes, or apartments which have kitchen equipment, hot water, and electricity. The housing is simply furnished, secure, and near the hospital. Daily housing costs cover electricity, water, security, appliances, and furniture. The Pathology Department has its own apartment for visiting and/or resident pathologists.
Food: Meals are not provided at the hospital so be prepared to buy your own food and prepare your own meals. Most basic items (including fresh foods) that are available in U.S. grocery stores can be found in Nairobi. For More Information Contact Mackenzie Welde by email or by phone at: (828) 278-1371.
We appear to be finishing our third wave of COVID infections in Kenya. I am rounding on the COVID ward this week, and while we started the week with every bed full, as the week has progressed we have decreased our census. The way the COVID ward works is that any patient who comes to the hospital with low oxygen levels, cough, shortness of breath . . . basically any sign of respiratory disease . . . will be sent to the COVID ward clinic, or if they are sick enough they go to the COVID emergency room. When I am working in the COVID ward I cover the COVID ER, the COVID wards, and the COVID ICU. I take care of patients who have COVID pneumonia (not that many currently), but I also have the task to figure out who actually has another disease such as heart failure or some other issue that can look like a COVID but is not. We assess them, and if we determine they do not likely have a coronavirus infection we send them to other parts of the hospital to receive more appropriate care. This week has been a good week. In the past everyone looked like COVID. Now most look like something else and I have been able to move them out of the COVID ward. It is a real relief.
Unfortunately, our fourth wave is predicted for July. We are all praying that despite not having many vaccines in Kenya, that maybe we will avoid the fourth wave.