Sunday, September 7, 2014

Kenya 2014

Browning here once again. Fortunately for you, this will be the last time I blog for a while. I wanted to take the time to share with friends and family some pictures and stories from my time in Kenya.

My girl and little man sending me off...

Myself and 2 other ER docs from my program (Scott and Chris) spent two weeks working at Tenwek Hospital in Bomet, Kenya. Tenwek is affiliated with Samaritan’s Purse. It is known as one the first missionary hospitals in Africa and has served as a model for many others like it. The motto on the entry sign and the hospital logo reads: “We Treat. Jesus Heals.” This sums up the attitude that is found at Tenwek, and the mission that drives the hospital and all of its employees. We came to serve in Jesus’ name…but I can assure you we were ministered to and encouraged by the local medical students and residents, the long-term missionaries, and even several patients. It is hard to put into words the joy that the Kenyan people exuded.

Tenwek is also an academic hospital- with medical students, residents, and long-term missionaries serving as faculty and administrators. It was absolutely refreshing to be around residents that showed up to work with a smile on their face, were excited and happy to be practicing medicine- knowing it was a privilege to care for patients. I never heard one resident complain. And it blew my mind to see how well the medicine and surgery teams worked together. If you needed a surgery consult, the surgeon would be at the bedside in 5 minutes with a smile. This was incredibly refreshing for me to be a part of.  The American culture of medicine is one that is absolutely saturated by complaining. Everyone complain about long hours, about patients, about their attendings (supervisors), about other specialties. That culture simply did not exist at Tenwek. All specialties worked as if they genuinely wanted what was best for the patient and were willing to do whatever it took to accomplish that. I cannot help but know that Jesus is the reason why. The one word that keeps coming to my mind when I think about those people is JOY. They inspired me to have such an attitude- to be the reason why my workplace feels different and to inspire other people to work with purpose. It reminded me that my job is not simply a source of income…but it is what God has led me to do and equipped me to do for His glory.

 market outside the hospital

hills surrounding the hospital

 hydro-plant: the power source of the hospital

 classic Kenyan meal

We worked in the Casualty (their Emergency Room), as well as took medicine call and covered inpatient wards and the ICU. We really enjoyed taking care of patients…but also teaching their residents. It was definitely a “learn and teach” experience. Their residents are much more comfortable with interesting tropical diseases that we rarely get to see in the states, so we had quite a bit to learn from them. On the other hand, Kenya (and the developing world in general) is developing more and more of a Western lifestyle…thank you McDonalds, Coca-Cola, and television. People eat worse, eat more, and are becoming less active…sound familiar? As a result, Western diseases are becoming more prevalent. We saw a ton of hypertension, diabetes, strokes, congestive heart failure, etc.. These diseases are our bread and butter in the US, so we were able to teach their residents and hopefully make a long-term impact on patient care at Tenwek.

The ER team: me, Aaron (the long-term ER doc), Scott, Chris

one of our favorite patients

teaching a resident how to do a bedside ultrasound

I won’t go into too much detail about medical cases, mostly because I don’t want to bore you to death, but I will just list a few really interesting ones that people with a medical background may appreciate.
-14 month old girl in status epilepticus
-Patient with severe epiglottitis who had a respiratory arrest- we coded, intubated, took care of in the ICU for a week, and discharged him home.
-Patient with stage 4 esophageal cancer causing airway obstruction- requiring intubation
-Echinococcus (hydatid cyst in lung)
-Extrapulmonary TB (tuberculosis)
-Hemorrhagic shock after table-saw injury to leg
-Organophosphate overdoses
-Rheumatic Heart Disease
-Tetrology of Fallot

 The Casualty (Emergency Room)

inside the Casualty

men's inpatient ward

There is one patient in particular I would like to share a little more about…not because we did anything heroic, but because we got to witness God perform a miracle. It was our last day at Tenwek. Chris headed to the Casualty a few minutes ahead of Scott and me. When I walked into the room, Chris was doing a bedside ultrasound of a young woman, in her mid-20s. She had just been transferred from a wheelchair into the bed. She was pale, lethargic, and intermittently passing out while Chris was asking her questions. I put the blood pressure cuff on her and the monitor read 50/20 (normal is 120/80).  Her ultrasound showed a ton fluid in her abdomen that shouldn’t be there. Then we saw a fetus in her abdomen. As we looked further, we could see that the fetus was not in the uterus. This was clearly a ruptured ectopic pregnancy. The embryo had implanted in the wrong location making for an unviable pregnancy and a life-threatening condition.  She was rapidly bleeding out into her abdomen. We called for 2 units of code gray blood. We called OB Gyn, and they had her in the Operating Room within 5 minutes. They removed 3 liters of blood from her abdomen, while she received blood through her IV’s. Within a couple of hours, Chris and I were in the recovery room, watching as she lie in a bed with normal vital signs, having regained her color. God saved a life that day. But that’s not the end of the story…

Before that day, this woman and her husband were destined for eternal death. Through a Kipsigis translator, the good news of Jesus was proclaimed to them. Like all of us, they were born into sin. We all sin and fall short of the glory of God.  And the wages of this sin is death. BUT the free gift of God is eternal life. For all who call on the name of the Lord will be saved. On August 22, 2014, this young woman and her husband recognized that God loved them so much that He gave His son to die the death that they deserved.  And He rose, conquering sin and death and offering this same resurrection to anyone who would turn from their sin and turn to Jesus. How could they not accept this gift that God is offering- eternal life! Praise God for His sovereignty. Only He can take a dying woman, brought to a 7-bed casualty in rural Kenya, and change the course of eternity. We felt incredibly blessed to have witnessed this miracle. I look forward to sharing this story for many years to come.

During the long flight over the pond, I had plenty of time to reflect on our time in Kenya, the people we met and learned from, and the things God has taught me.  I thought a lot about the medical missionaries we served with, and how they are spending their lives. They have spent decades educating themselves and becoming specialized in a profession that people expect and anticipate generous monetary compensation for their years of “sacrifice and hard work.” Many of them left lucrative private practices to follow God where He was leading them.  I was reminded that success in a believer’s life is marked by obedience to Christ- not by how this world defines success.
            “Do not lay up for yourselves treasures on earth, where moth and rust destroy and where thieves break in and steal, but lay up for yourselves treasures in heaven, where neither moth nor rust destroys and where thieves do not break in and steal. For where your treasure is, there your heart will be also.”
-Matthew 6:19-21

Having a small window into the suffering that some of my patients experienced, amidst extreme poverty and disease, your heart breaks a little bit. And it makes you think about the bigger picture of the world that we live in right now- which is marked by pain and suffering. We are living in a day where the Ebola virus is spreading rampantly across West Africa, where planes are falling out of the sky or going missing, where terrorism threatens even young children, where death and disease are prevalent everywhere you go….where will we find our hope? Fortunately we have an answer.
            “Who shall separate us from the love of Christ? Shall tribulation, or distress, or persecution, or famine, or nakedness, or danger, or sword?...No, in all these things we are more than conquerors through him who loved us. For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.”
-Romans 8:35-39

This is the hope that we cling to- the hope that gets us out of bed in the morning, while we live in a world that is filled with pain and suffering. This is the hope that we have to offer others. So to my patients that we could offer few resources, there is still great news. While the treatment of their condition is temporary, we can guarantee them the condition of their soul. And amidst your pain and suffering, there is great reason to have hope. There is a King who wants to welcome you into His family, and nothing can separate you from His love.

Didn't do a safari...but still had some fun the day we left Nairobi

Ethiopian food: should've prayed about this decision before the 24-hour travel home...

Thanks for reading! I appreciate your prayers and words of encouragement while I was away. I hope you have somehow been encouraged by my experience. Please continue to pray for Tenwek Hospital, the long-term missionaries who are faithfully spending their lives in Kenya for the sake of furthering God’s Kingdom, the medical students and residents who are training there, and the patients who are being ministered to. And above all, ask that God’s name would be exalted within the walls of Tenwek Hospital and around the world.