Leaving Tenwek

Another brief stay at Tenwek ends. Some thoughts:

1. It is hard to leave. Difficult to say why, but I think medicine where you have limited resources is very fulfilling. Just as in US practice, there are always cases where you wish you could have done better, but overall things went well.  The endoscopy team is so high functioning that I could step in and be fully engaged on day 1. They put the needs of the patients first every day. 

2. The full time Tenwek missionary staff are great ambassadors for Christ. They also reflect very positively on America's willingness to help those in need throughout the world.  Watching people win hearts with love and compassion is incredible. As a visitor, we are honored to participate in small ways. 

3. There have been innumerable Mayo docs there for short term trips. There are many parallels between Mayo and Tenwek. Surgical foundations, not for profit, large number of patients coming long distances and high expectations among others.  There are huge differences in resources, but I think there similarities. 

4. Between the trip to China earlier this year and this visit to Africa, I have developed even more respect for Shelley's dogged determination to try to make a difference in children's lives, one child at a time.  It was really cool to see her advocate for Sarah and other children.  It was also great to hear how she bonded with the other moms in the nursery and witnessed to them by being there at all hours. 

PS-Sarah spent the night with us, our last night at Tenwek!

We are back in the US.  No internet the last few days in Africa, so will add a few posts to review our last few days

Images from Tenwek

We have been taking pictures while walking around and thought you would enjoy these pictures from the Tenwek campus

Friday Morning

We took a visiting pastor up to see the nursery and Sarah last night.  He and his wife have a heart for adoption and we pray that God leads them in the direction he has ordained for them.  Sarah is a beautiful little girl.  Many are asking if we or others are going to try to bring her home, but there are specific rules in Kenya and adoption is not possible for non-residents.  Shelley has arranged other moms and grandmoms to help care for her while she is here at Tenwek, which will give her a better start on life.

Thursday

Hard to accept that tomorrow will be our last day working on this trip.  I feel bad leaving, but think we have been helpful and it has certainly been worthwhile.  Finished work a little early today and went for my first run here.  It is around 6600 feet here and there isn't a great deal of oxygen.  Here is a screen shot about what my GPS watch said about it.

On the left is a map.  I zoomed out so you could see where we are (the red dot) in relation to the rest of East Africa.  The right is the up and down of my little 2 1/2 mile run.  It did hurt a bit!

I think I wrote about this before, but here are a few general images/facts about Tenwek.

In the late 50's and early 60's these two small buildings were the clinic and hospital.  The first full time doctor was in 1959.

Now, it is a full service, major referral and teaching hospital with a full-time medical staff of both missionaries and Kenyan nationals.  While the challenges here are innumerable, it is a shinning light in this part of the world.

Wednesday

Just after we got back from feeding Sarah this morning,  the phone rings.  It is a doctor from casualty (ER). They have a 2 year old vomiting blood with a hemoglobin of 4 (for non medical folks that is REALLY low). He has been sick for 3 months, but only vomiting for 3 days. I went to morning devotions and asked for prayer since my Peds endoscopy experience is minimal to say the least.  He was sedated by anesthesia and we used a very small scope. His mouth, esophagus and stomach were full of blood, but after I washed the blood away, everything looked normal. On the way out at the very top of the esophagus, there was a long, brown thing and everyone except me knew it was a LEECH!  Apparently people get oral leeches from drinking bad water and rarely they go further. We took the scope out and prepared to try to pull the leech out. After going back down, the leech detached and fell into the child's mouth and was retrieved by anesthesia. We kept it alive in the GI lab and many people came by to take pictures and video.  Must not be too common since the whole hospital knew about it by this evening. The awesome thing is that the child will be fine (as long as he is more careful drinking from the river).  I do love working at this place.

The rest of the day was routine Tenwek GI with 3 more cancer stents, one of which may be treatable with surgery!  On ICU/medicine call tonight.

Waiting for endoscopy

I have a great video of him swimming in the bowl, may have to wait until we get home though

My day with Community Health

To say that I am worn out is no exaggeration!

The day started with Sarah's 6 AM feeding, then laundry (there is a whole blog post on that from the last time we were here), then another feeding and then I got the privilege of getting to go with the folks from Community Health to make baby/immunization and OB visits.  We visited very rural parts of Bomet where suffice it to say, I was the first Caucasian person that both the children and the mothers had seen.  I could hear the children giggling from where they were hiding behind the trees and the bushes.

The pictures say it all!  It was a wonderful day and I am so thankful to have had the opportunity to spend the day visiting the mothers and the children and getting to meet new friends.  I hope to get the opportunity to go again.

Now it is time to go feed Sarah again!

A little one getting her polio vaccine.

Before check-ups, we prayed with the moms & littles.

Time to weigh the little ones.

Shot records.

The dispensary.

Perhaps the bumpiest road I have ever been on!

Gladys & Davinna

Tuesday

After a busy Monday, today was calm. We started out by walking up to the hospital at 6 to feed Sarah.  We came back down to our room and had our usual breakfast (granola and yogurt) then back up the hill for conference and endoscopy.  Only one cancer to stent today. An interesting thing about endoscopy here is that we try to avoid biopsies since it more than doubles the cost (all are sent out with a 10-14 day turn around).  Also, all attempts are made to reuse things as many times as possible. Good cleaning techniques are in place and I am very comfortable with the condition of everything.

A slower day allowed more talk and fellowship with the staff.  Spent some time discussing treating your spouse well (which can be a problem here and in many countries).  One of the staff leads a men's Bible study at his church and we talked about using the analogy of the bridegroom/bride relationship between Christ and the Church and how husbands should love and treat their wives like Christ treats us (Ephesians 5:25-27).

Shelley is very busy feeding Sarah every 3 hours, it usually it takes at least 30 mins.  Tomorrow she is going to visit a local orphanage with Tenwek Community Health.  Community Health was established at least 30 or 40 years ago and has made a huge difference in the area.

I am on call for the medicine wards tomorrow night so have been reading up on TB and meningitis some today as well.

 Nice view looking out of the nursery

 Another flower for Ellie (outside our room on the way to the hospital)

The Chapel

Monday

Well, all I can say is what a day in endoscopy. My apologies to those who are not medical, but we must have seen 6-8 esophageal cancers, stented 2 of them, could not get a wire down to stent two more, 2 tracheo-esophageal fistulae, a gastric cancer, an obstructing duodenal cancer along with esophagitis, gastritis and even one normal endoscopy!  The endoscopy team is sharper than ever.  I am very happy to be here, but did get down in the dumps mid-day seeing so many relatively young people facing an inevitable early end to life. In the end, the palliation with the stents, possible treatment for acid and H pylori disease, the provision of a more definitive diagnosis and the spiritual support offered here is making a huge difference in the lives of so many.  I learned today that the Board here is considering a major expansion in the next several years and I can see even bigger and better things down the road.  Please visit www.tenwekhospital.org

"And what does The Lord require off you?  To act justly and to love mercy and to walk humbly with your God" Micah 6

 On a less serious note, the mangos here are delicious!  Nothing like the ones at home!

My Job

The last time we came to Tenwek, we brought our girls who were then 10 and 7.  The girls and I had a great time exploring the area.  Because of the girls ages, I really was not able to volunteer in the community.  This time the girls are not with us and today, I was assigned a job that goes right along with the work that I have done as a mom for the last 26 years and the work that I do with Grace & Hope for Children.

A baby girl was born last week an Tenwek.  She was abandoned.  She did not have a name so I named her Sarah.  I have the privilege of getting to hold her, feed her and love on her while we are here.  Sarah is a tiny sleepy little thing.  It takes a while to wake her up and because she is such a little sleepy-head it takes even longer to feed her!  I feed her out of a tiny cup.  Never would I have imagined that a one week old little one could drink out of a cup but it actually goes quite well as soon as Sarah wakes up.