My missionary daughter returns tomorrow!

My 19 year old daughter, Allegra, returns from her year of mission work tomorrow evening! She posted her last blog entry warning of us of a changed woman! I never expected her to return the same - although I thought she was already wonderful when she left. I hope as we become reaquainted, she'll notice some changes in her Dad as well. You see, I don't think that God is quite finished with me. I've prayed that he make me an ever more compassionate physician and that opportunities to share the love of Christ become more abundant in my personal life and my practice of medicine. I hope I'm not quite the same as when she left.
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Nicaragua becomes a family affair!

In just a few days, my oldest daughter Megan will journey with me to the southern part of Nicaragua as part of a large medical team. Megan is a sophomore at Xavier and will serve as a translator; two years ago she lived in Spain where she had a tremendous cross cultural experience and learned Spanish while living with a loving family.Megan Forwith and friendMegan with her 'Spanish sister', Sylvia

As for me, I'm not quite sure what to expect. This trip, organized through Global Health Outreach (part of the Christian Medical and Dental Association) will have 15 MD's, 5 dentists, a bunch of nurses and support personel and many students. A total of 68 people will arrive on Saturday in Managua to form the team that will venture south to near the Costa Rican border.  This is not a surgical trip, so I'll mostlly be using my medical side. I'm taking a small surgical set with me, just to be prepared! Hopefully, I'll get a chance to share some of that experience. 

Allegra Forwith in NicaraguaAllegra in Chinandega, NicaraguaMy second daughter, Allegra, is spending the spring semester in the northern part of Nicaragua.She keeps a blog at the Adventures in Missions site.  She turned 19 yesterday and reflected on her 18th year of life. I am amazed at the work that God has done in her life. Much like last fall, I will likely find myself in the same foreign country as her, but unable to connect. Seems to bother dear old Dad more than daughter!


 So, please pray for our family and the work God has planned for us in Nicaragua. So many times, I set out on an adventure such as this hoping to bring a positive change, only to discover that the real change occurs in me. I pray that Megan will have that transformational experience through our encounters with the people of Nicaragua. I humbly ask for your prayers for our team and Allegra's team that our talents and efforts can bring the love of Christ to people in need. Please pray for the many medical and dental students that will be part of our team; pray that their lives will be molded by this encounter into lives of service and thankfulness.


One more day...

It's been exactly a month since I returned from my last mission trip. It was my third trip to Africa, the first being two weeks duration, the second was three, and most recently a month. But, despite my increasing time spent there, it was just not enough. Throughout my last day there, people kept coming for evaluation. Most were routine problems, but one lingered in my mind. A lady showed up with a tracheostomy (a breathing tube in the low neck) that had been placed earlier. She had fairly extensive larynx cancer that had not yet spread into her neck but was progressively blocking her airway. The tracheostomy allowed her to breathe below the blockage. Larynx cancer often will not metastasize (spread) until late in the disease. She needed a laryngectomy - which given that she had no evidence of disease spread in the neck, would save her life. But, she had already eaten when she showed up in the afternoon, the OR schedule was full, and  I was scheduled to leave early the next morning. A laryngectomy is not within the skill set of general surgeons. The next ENT to visit Tenwek will likely be in February. The only treatment alternative for larynx cancer is radiation therapy, which is available in Nairobi.  But the costs of travel, lodging, and treatments far exceed this woman's financial resources. If she had only shown up one day earlier, we could have offered her a life saving operation. Instead, she'll return in February with the hopes that her cancer is still surgically curable. 

While this was not as devastating as last year's final day at Tenwek (chronicled below), it serves as a painful reminder of how desperately needed surgical care is in Africa. The mission of PAACS to train and disciple surgeons to serve the poor in Africa becomes dearer to my heart with every day spent there. The long plane rides home gave me plenty of time to reflect - and to begin  planning for my next trip. God continues to open my eyes to see both the need and the ways in which I can help. Your prayers for the people, the young African surgeons in training, and their American mentors are so needed!

Cars, Cats, Kittens, and Kids

Well, I had quite the adventurous weekend. I had no clinical duties Saturday or Sunday so I jumped in with some safari truckThe first of two flat tires!visitors who just arrived and went to Masai Mara for a Saturday evening and a Sunday morning game drive.  In the morning, we arose early to go to a remote area, hoping to see some lion cubs. Before departure the driver had the hood open looking for a sound that he thought was a cat. Sure, enough I soon heard the same meow sound, but we couldn't find a cat anywhere. Perhaps a bird, an engine squeak? We proceeded along without finding the answer.  Half way there it becomes apparent we have a flat tire. giraffes on horizonNo big deal, except when we went to change the tire I noticed a hissing, air leaking sort of sound coming from the rear tire. This was intermixed with more meows that seemed now to becoming from behind the dash board. So, there we sat in the middle of a road, in the middle of nowwhere with two flat tires, one spare, and a hidden cat in or under the vehicle. About 45 minutes later another safari vehicle came and we were able to get two very old tires with little tread to replace the two very old treadless tires that had leaked. Yes, we were now heading further out with no spare and two flats strapped to the back of the Land Rover. roaring lionThis is not the cat that induced fear.

As we get into the area where the lions were known to be, our driver suddenly hears the cat next to his door. The driver radios another driver and the two of them are outside the vehicle, in lion country, looking for a cat. Then, the drivers see a tail - but it turns out these big, burly safari drivers are afrad of cats! No, not the big carnivores we were hoping to see. No, they were afraid of a domestic cat! Wanting to get on with it, I get out and crawl partially under the vehicle, as I am only afraid of the big cats - you know the kind that would feed on a pair of legs hanging out from under a safari vehicle. I see the tail, reach up and grab the rear of the cat and pull - it's a kitten. My size 8 hands cover nearly the entire body of his cute little kitten. 

Crisis averted, I'm anxious to get back into the safety of the vehicle and not become some lion's breakfast. The driver wants me to set the cat in back of vehicle while we drive off!zebras in river Leave, a poor helpless kitten to become snack food! Now, I'm no cat lover, but even I can't do that! So, I casually walk around the vehicle and set the kitten in the back of the vehicle for safekeeping until the safari is over. Crisis strikes again! One of our traveling companions sets a land speed record for evacuation from the third row of a safari vehicle. Before I was even to my door, she had bolted through the middle of the seats and jumped out of the window! Now, she's wide eyed, petrified, and standing 15 feet from the vehicle! Who knew so many people were afraid of kittens! Now, there's a driver and a passanger standing in the savannaugh, refusing to reenter the vehicle because of the kitten! So, I have to retrieve the now frightened kitten from under a seat. So, a brief standoff occured where I decided it was better to leave a kitten for lion food than a pediatrician and safari driver. So, I tossed the kitten out of the car and it retreated behind a bush. Before we could reload, the kitten was back into the undercarriage of the truck and the meows continued.  So, the rest of the morning was spent looking at wild animals, including lions while the kitten purred in fright under our vehicle.  

safari group pictureBack safely at camp! Unharmed by the fierce kitten!

We arrived safely back to the camp and later departed for Tenwek. Our vehicle troubles were not over! About a third of the way back our vehicle begins to smoke - mostly out of the exhaust. smoking truck window viewFirst signs of trouble! It would get worse!

We stop and the driver says that the engine had just been serviced and that too much oil was put in. No problem, it will burn off and we reloaded for the remainder of the trip. So, we thought. The optimist in the bunch pointed out that at least it wasn't raining nor was it dark.

Not 10 minutes later the driver tries to shift to a lower gear and the engine suddenly revs to it's maximum rpm's. The vehicle begins to smoke and one of my companions starts yelling "turn it off, turn it off!"l 

smoking truck frontal viewBut, the engine is not interested in shutting down and continues to roar at maximum rpm like a child throwing a temper tantrum. The next yell was "everybody out!"Naturally, I can't leave my camera gear behind in an emergency so as soon as my friends and I are out of the jeep, I snapped this picture! The driver finally gets the car to shut down by popping the clutch. Our vehicle is officially dead! 

Kenyan children surrounding the truckOur entertainment arrives!We debated walking to the main road with our luggage - one of the locals said it was "not far", only about 10 km. Luckily, we had cell phone service and made a call to Tenwek for help. Word was we'd have help in only 5 minutes! Wow! we must be closer than I thought. We decided not to walk, and just wait it out. Then, it started to rain! Well, turns out time and distance estimation are not Kenyan strong suits. The rain let up and we got back out of the burnt smelling vehicle to find several spectators. Several local men began offering opinions on the problem with the jeep. A motorcyle appeared with some tools. We all agreed we were not risking another ride in the big green smoke bomb, even if they fixed it - which they did not!

Kenyan men of GodKenyan men of GodSo, five minutes was now twenty and we decided to have some fun with the local kids. We started with pictures, moved to videos of them dancing, then to games. We taught them duck, duck, cow because no one here knows what a goose is. A group from a church walked by and we talked with the men and the pastor for a while. We then got back to the kids and traded songs.

We sang Our God is an Awesome God, and they sang the hip bone connected to the thigh bone song - about 5 times. We sang Jesus loves the little children, they sang some Kipsigi song whose title translated to God is a Lion. Literally, two hours passed and we were still playing with the kids when a Tenwek vehicle showed up! 

Kenyan Kipsigi girlsKipsigi girls were happy to see us!crowd of Kenyansthe crowd steadily grew as our wait approached 2 hours!

So, it turned out that our vehicle breakdown was the best part of our trip. Our misfortune turned into a true blessing from God. We shared what we could with the locals, and they in turn blessed up with smiles, laughter and lifelong memories. The six of us and our luggage then crammed ourselves into a Honda CRV - yes, seven adults of in a small passenger car.  

sunset at TenwekThe sunset as we were nearing Tenwek


But we were happy to be moving as darkness was setting in. Turns out we were 31 km from the main road. That's over 18 miles we would have hiked with luggage and darkness setting in! Not to mention, there were two forks in the road and I would have definitely taken the wrong road at the first divergence point.

Our friend from Tenwek, upon hearing of our vehicle troubles throughout the day, asked which one of us was the Jonah? I love a man who knows his bible! So, in the end, we were all happy to have broken down and partaken in God's clever plans! 

Back home again

Sue and Kenyan childThis is Sue, Keith's wife, writing now. Returned this past Sunday and still waking at 4 in the morning. Don't know how others shift so quickly back to local time!

I wanted to also blog during our stay but internet was just so spotty. Then, grand hopes of sharing pictures and stories upon our my return only to find that in all our camera swoping/sharing with others, I didn't come home with the right camera card. So, pictures of my outings will have to wait.

This picture was taken in the church on the hospital grounds. Keith had run up to check on a patient at night and quickly came back to get me. Being the only white people sitting in the back of the church experiencing the praise and worship music and then the preaching in both English and Kipsigis was awesome. This little girl kept running back to me.

This is my second trip to Africa with Keith. Our first one in Feb of 2010 we visited 3 different hospitals in Kenya and Ethiopia. While I loved that, we didn't get an intimate look at any given place. This trip was a bit different. While I was only there for two weeks, I got to know the surroundings and some of the locals more. Not being medical and confined to the hospital, I sought after experiences that Keith never got to experience....

....helping to weigh babies in a village from a scale hung from a tree

....being in a vehicle that is constantly dodging donkeys, cows and people along the rough roads

....going on followup bio sand filtration visits into mud and stick constructed homes

....being serenaded by little preschools singing Jesus songs

....visiting 2 orphanges and witnessing the love the caretakers extend to these kids who have nothing

....seeing the scared look of little ones who had never seen a white person before, let alone a blond

....testing the drinking water from several sources with a testing kit I obtained from Edge Outreach  before going . Most disturbing was a spring that the locals said was "clean water" only to find it has all kinds of bad things in it

....going into some of the local churches with dirt floors, rough wooden benches, & open windows

....being invited as the first white person into a teachers home (by our standards a shack really) who insisted on having us talk via cell phone to her father, mother, fiance' and friend

I found these people who have materially practically nothing, live to survive, but many have the faith as big as the plant from a mustard seed. A great challenge to my faith.

Hope to share more upon Keith's return.