Monday, August 10, 2015

Where in the World am I Going? A Sneak Peek...

If a picture is worth a thousand words, then a video is worth an entire book.  Last week one of the full time staff at the Hospital of Hope in Mango, Togo sent me this video.  You can watch it here by clicking on this link:  Hospital of Hope.  Here is a glimpse of the place I will be serving in just a few weeks.  [Please do not re-post this video on social media or other blogs.]

Sunday, August 9, 2015

20 days and counting...

In just 20 days I will be leaving for Togo.  Three airline appropriate shipping containers are filled to capacity and sticky notes and "to do" lists surround me.

Many of you have been asking if my family is going with me this time.  Anna and Amber will be starting eighth grade, and Andrew will be heading back to Westmont College.  Michael is working and Teresa will be taking Andrew back to college the same day I leave for Mango.  So, I will be traveling somewhat alone, except that I will be meeting up with an NICU nurse from Banner Good Samaritan (now called Banner University Medical Center - Phoenix), and a general surgeon volunteer and a pediatrician.  Our planes will all converge in Paris so that we can take one flight together to Togo.

As of last week over 180 people are part of my team that have helped financially so that I could purchase the necessary surgical supplies and a new ultrasound machine.  Many others are praying for me.  I am grateful to all of you.

Sunday, August 2, 2015

To Go To Togo!

 Do you know how to go to Togo?  Considering a few months ago I didn't even know where in the world Togo was, I am learning quickly!  

On August 28, 2015 I will fly to Paris where I will meet up with the rest of my team and then continue our flight to the capital city, Lome, Togo.  The next day our team will make an eleven hour drive to the northern part of the country to Mango, where the Hospital of Hope is located.  


Here are some interesting facts that I have learned about Togo and the Hospital of Hope. 

  • The Hospital of Hope opened on March 2, 2015 and on the first day they saw 200 patients BEFORE LUNCH!
  • In the first week that the hospital opened they saw patients from Togo, Ghana, Benin, Nigeria, Burkina Faso and Ivory. 
    • One patient traveled three days (from northern Burkina Faso) and then walked directly into the hospital, found an empty bed, and lay down. 
  • The ratio of doctors to patients in Togo is 4 doctors for every 100,000 patients.  
    • The ratio of doctors to patients in the United States is 256 doctors for every 100,000 patients.
  • 10% of the population in Togo is infected with HIV.
  • The infant mortality in Togo is 78 infant deaths for every 1,000 live births.
  • The infant mortality in the U.S. is 7 infant deaths for every 1,000 live births!
  • Nearly 200 donors have helped to make this trip possible.  Because of an amazing group of donors, I will be bringing:
    • A new portable Sonosite M-Turbo ultrasound machine with two probes.
    • A Designs-For-Vision Daylite surgical headlight.
    • Twelve Standard Register reusable surgical gowns with overwraps for sterilizing.
    • Ten Cook Medical Bakri Balloons (life saving treatment for postpartum hemorrhage.)
    • Eleven Kiwi obstetrical vacuum devices (for operative vaginal deliveries.)
    • Fifty-two boxes of Ethicon surgical suture.
    • Fifty-plus pounds of German stainless steel new and refurbished surgical instruments.
    • Adjustable Allyn Stirrups for the operating room (for doing gynecologic surgeries)
    • Surgical Gloves
    • Obstetric Dopplers
    • Pulse Oximeters
    • Life saving medicines
Thank you for your support and prayers.  I will be returning to Arizona on September 15, 2015.  

Friday, August 1, 2014

Asante Sana...Thank You...

In just a few hours we will be leaving Tenwek Hospital and will be on our way to Nairobi to board our plane to come home to Arizona.  I wanted to make one final blog post from Kenya to thank all of you for your prayers and contributions that have allowed us to come and to serve.

Because of the prayers and generosity of so many people, so much has been accomplished, and will continue to be done here in Bomet, Kenya at Tenwek Hospital.

When we first drove past the water towers of Tenwek Hospital, arriving nearly a month ago, we were eagerly looking forward to seeing how God would have us serve here.  We were so excited to be here.  Thank you.
Late in 2013 I sent out a letter telling you that we were raising funds for an ultrasound machine to bring with us to Tenwek, and within 60 days we had nearly enough money for this portable ultrasound.

Then in December we heard that there had been a power surge at the hospital that had wiped out all of their functioning ultrasound machines.  By February, five months before we even had arrived in Kenya, the ultrasound that you had provided was already at Tenwek Hospital working overtime in labor and delivery and frequently being borrowed by the other medical services at the hospital.  Thank you!
One of the ways that my wife Teresa and daughters Anna and Amber were able to serve was for them to go with Tabitha Ministries and help to finish the walls of a hut for a widow and her six children.  Mudding a hut is a dirty job, and they had a wonderful time helping in this way.  The widow was extremely grateful for their help.  Thank you!

We also had hoped and prayed to raise enough money to provide six widows with milk producing cows, and that we would be able to be the part of a cow dedication ceremony, also through Tabitha Ministries.  

What we saw was nothing short of amazing, as there was an outpouring of love and support for this part of the project.   Enough money was raised to pay for 30 cows!  You all contributed $9,000 to pay for 30 cows, which is such an incredible blessing.  Each month Tabitha Ministries does two cow dedications, after carefully selecting the widow and her family who will receive a cow.  Because of you they have enough cows for these dedications for the next 15 months!!!

The recipients of these cows will now have a way to provide food and money for their children, and their vocation will become the care of the cow.  This is an unbelievable life changing gift to these women and their children.  Thank you!

Two years ago you supported us to go with a medical team into the jungles of Papua New Guinea to be the first western trained physicians to go into the Hewa Tribe.  Since then a documentary has been made of that mission trip.  If you have not watched it, it is a short 30 minute documentary.  Here is the link: Healing for Hewa Documentary.

This past month, while we were here in Kenya, this documentary was released online.  We are extremely grateful to each of you who helped to send us to this remote place.  Thank you!

While we have been at Tenwek Hospital we have formed dozens of new relationships.  Most of the people that we "knew" here were only from brief introductions or by email communications.  Since then we have formed dozens of new relationships.  As we prepare to leave we reflect on the many new friends we have made here, and some of these will no doubt become lifelong relationships.

Dr. Elijah Terer has become a good friend.  Several weeks ago he invited our family to his house for dinner.  We stayed late into the evening, feasting on home grown and home cooked Kenyan food.  His wife, Emily, who also works in the Maternal Child Health (MCH) clinic at Tenwek, is such a good cook.  After dinner they served us the best chai that we have ever tasted.  They said that they had a secret spice that they grow in their garden that makes it taste so good.  (I think it was cardamom).   These kinds of relationships are invaluable as we strive to teach and support the work being done at Tenwek.  You made it possible.  Thank you!

Because of your generosity and giving hearts, we were able to bring donated medical and surgical supplies that would have cost over $200,000 at retail prices and to provide these to the hospital.  Just looking at this picture of me in this operating room, you donated the LED high tech battery powered surgical head light that I am wearing (it is much brighter than the operating room lights that are hanging from the ceiling).  You donated my hat, my scrubs, the surgical gown that I am wearing, and the gloves on my hands.  You donated the suture that I am using on this patient.  You donated the mask on my face.  You even donated the surgical scissors that I used to cut this suture after I finished tying the knot.  We arrived with thirteen trunks of supplies each weighing exactly 50 pounds, and we will leave with a few duffle bags of our clothes.

But even more so, you provided me an opportunity to come and to teach a handful of Kenyan doctors the skills that I have learned.  Because of you I was able to teach them the art of obstetric and gynecologic surgery.  And, I have been able to convey to them the importance of touching their patients as whole persons, not just addressing their physical needs, but also their spiritual needs.  My wife and daughters and I are extremely grateful to each of you.  Thank you!  God bless you.

One of my favorite quotes is attributed to John Wesley.  He was quoted to have said the following:

Do all the good you can.
By all the means you can.
In all the ways you can.
In all the places you can.
At all the times you can.
To all the people you can.
As long as ever you can.

Tuesday, July 29, 2014

Teammates at Tenwek

 Here are some of the people that I work with at Tenwek.  This is Purity and she is one of the medical students that I work with.  She is extremely quiet and soft spoken, but works very hard to take good care of her patients.  In this picture she is acting as my assistant while I am giving a lecture, handing out Tootsie Roll Lollipops to anyone who answers my questions.

 This is Rose.  She is at the end of her medical training, and is an excellent clinical.  She would like to merge nephrology and critical care medicine together and work in an intensive care environment.  Because of her interest in critical care medicine, she cares for all of our patients on our service that are on the critical care units at Tenwek.
 This is Annette.  She is a respiratory therapist from Canada.  She is so talented that the staff at the hospital call her Doctor Annette.  Her abilities to care for the respiratory needs of adult and pediatric patients in the critical care units is absolutely amazing.  She is also a bit of a curiosity here because of her fair skin and red hair.  She has earned the utmost respect from everyone here, and her attention to detail is admirable.
 This is Felix.  He is a clinical officer and works very hard to know his patients very well.  Here he is starting an IV on a patient who is having a postpartum hemorrhage.
 This is Priscillah and she is the nursing director for the labor and delivery unit.  She is a hard worker and takes excellent care of her patients and staff, and works diligently to run her unit.
This is Barbara, and she has been at Tenwek since 1981.  This is a teacher at the nursing school and has taught nursing, public health and midwifery since she first arrived here.  She is a saint!
Although these next few pictures are a bit blurry, they show the many faces of Dr. Mike Davis, who is a Samaritan's Purse Post-Resident working at Tenwek hospital for two years.  He is an incredible infectious disease physician.  Look closely at these three picture of Dr. Davis while he teaches "Monday Morning Medical Math" to the medical students during Grand Rounds.  The topic was Management of Hyponatremia, and he did a nice job of explaining how to calculate the replacement of sodium in severely hyponatremic patients.  As you can tell from these photos, he is very animated.
 Just one of the many faces of Dr. Davis.
 One more funny face, as he reacts to what someone has said.
This is most of my team of medical students.  From left to right are Rose, Felix, Purity, Gideon and Rita.  This was during rounds on Monday, July 28th, 2014. 

Thursday, July 24, 2014

House of Mourning

Ecclesiastes 7:2 says, "It is better to go to a house of mourning than to go to a house of feasting, for death is the destiny of every man; the living should take this to heart."

Several days ago we admitted a very sick 19 year old who had been operated on three times over the past week at a nearby hospital and was referred to Tenwek.  Her first surgery was a cesarean section, however, she was found to have large bilateral ovarian tumors.  It wasn't clear why she had the second two surgeries.  She was then brought to Tenwek.  She was extremely ill with multi-organ failure.  

On Tuesday night I asked the surgeons to see her due to an abnormality found on her imaging, and later that night they did a fourth surgery, only to discover that indeed her abdomen was completely filled with cancer.  On Wednesday morning, after staff devotions, the surgeon, internist and respiratory therapist spoke with our team.  The plan would be to meet with the patient's family and to begin the process of removing life support.  

My medical student, Rose (pictured on the left in the picture), wants to be a critical care specialist or a nephrologist, or both.  She is remarkably talented.  After she had presented this morning in rounds, I spoke to them about how at this point how we now have multiple patients to care for.  Not only do we have our patient who is dying, but now we have all of the family members as patients, as they are suffering and grieving the loss off their daughter, sister, friend.  We also talked about how this is difficult for us as caregivers, and how we despise the face of death, where there is little else that we can do.  

Yet, when we face death; when we go through very difficult times, God uses those moments for us to reflect on our own finite physical lives here on earth.  God uses those times to change who we are, and to cause us to become more compassionate people.  If we go to a party or a celebration, very little happens to us that changes our character; however, when we mourn and grieve, even if for others, God uses that pain and grieving to stir within us change deep inside of us; indeed to make us better people and more compassionate toward others.  

The verse is worth repeating: "It is better to go to a house of mourning than to go to a house of feasting, for death is the destiny of every man; the living should take this to heart."  Please keep this patient's family and my medical team in your prayers today.  

Wednesday, July 23, 2014

...but she is still bleeding.

For the faint of heart, I will wait to share my medical story until the end of this blog, just in case you don't want to look. 

Please be fore warned that not everyone will want to see the third picture on this blog today.

One of the things I enjoy most about serving overseas is spending more time with my family.  Although Teresa is far better at making puzzles than I am, we spent a lot of time together working on this puzzle.  The shades of brown nearly drove me mad!  

Teresa, Anna and Amber spent the afternoon on Tuesday with another missionary physician's children.  Their mother needed to get some time to herself to finish off some reports.  When I walked into our apartment at the end of the day, the kids were piled up on the sofa listening to Teresa read books.  Today (Wednesday), Teresa and the girls are going to mud a hut.  I'm not sure what all is involved with that, but I told them to be sure to wear white!  Hopefully I can post some pictures soon!
On Tuesday morning I was in the morbidity and mortality (M&M) conference at the hospital, listening to my students present several patients and the ob/gyn statistics from last month.  A few minutes into the first patient presentation, my pager went off.  It was the phone number for the labor ward with a 999 after the number, which means it is an emergency.  

I called the number and my medical student, Purity, said in her usual quiet and barely audible voice, that a patient had miscarried and that she was still bleeding.  Little did I know at that moment, but that would be the theme of the day.  It seemed that all day long, everytime I was paged, the conversation would end with the words, "but she is still bleeding."  

I knew that we were in trouble as I walked into the labor ward and followed the bloodied footsteps leading to the last labor bed.  When I walked around the curtain, one of the things that I saw were the shoes of the patient on the floor next to her bed.  I can't show you the picture of what else I saw, but suffice it to say it was 100 times worse that the shoes on the floor.  After doing an emergency dilation and curettage on this woman, we then had a patient deliver a severely anomalous baby and then she had a postpartum hemorrhage.  A previous volunteer had donated a Bakri Balloon device, which is a life saving device for severe postpartum hemorrhage.  I had to pull this prized item from the doctor's locker and used it to save this woman's life, as she had bled so much that she was in the early stages of a bleeding disorder called disseminated intravascular coagulation.  I checked on her at midnight last night and she is doing well after receiving multiple units of blood.  Today I will remove the Bakri device from her uterus.  
Patient shoes on the floor of labor ward.
It is incredibly gratifying to come and to teach and to serve these patients, doctors, nurses and students here.   Thank you for your prayers and support for us to be here.  Please pray for the many patients that we are caring for that are so incredibly sick.  In the United States it is unusual for me to have a patient in the Intensive Care Unit, and here today I have four!