Tuesday, May 17, 2011








Habari Friends,

It is Saturday; I am taking a few minutes to write while the clothes are drying. We have a renewable energy clothes dryer—it is called a clothesline. Because it is so windy today, the clothes dry in about 75 minutes. I have discovered that “permanent press” doesn’t work well without an automatic dryer…amazing the things we Westerners take for granted.

Although it is still “the rainy season,” we have mostly sunny days with rain sometimes at night. There is great concern in Kenya because the “long rains” during April and May have not delivered the rainfall that was expected. Many are predicting continued food shortages and rising prices for food and gas. Food prices for Kenyan staples (maize flour, milk, rice, potatoes) have risen between 15 and 33% since January. Many of our patients live on the edge of starvation in the best of times; we fear that we’ll see even more malnourished children and mums.

The rise in the cost of living is causing anxiety among the Kenyan politicians; they fear that people will become desperate—and politicians aren’t very good at controlling desperate people. Here in Kijabe we are not isolated from this—two weeks ago an armed gang of men invaded the Casualty (Emergency) Department, beat the security guard, and robbed the people there (staff and patients). All the hospital staff were quite shaken by that—it has never happened before at Kijabe Hospital. Here in our Quadplex, the contractors have installed security gates at the two entrances to the building. However, there is no lock on either gate as yet—and from the way the gates are constructed, I’m not sure anything other than a padlock will work—so we’ll either be locked in or out. Not ideal. Maybe the appearance of the gates will be a deterrent. It will also deter visitors—there is no intercom to alert us that someone wants to come up. So some yelling may be in order.

In April, we started worshiping at Nairobi International Lutheran Church. It is a wonderful group of people—most are from countries in Africa. Sam Wolfe, a pastor who worked for 30 years in Tanzania and 7 years in Frankfurt, was called to minister to the church. On Good Friday, he preached about the Last Supper, when Jesus told the disciples that one of them would betray him—and each one asked, “Is it I, Lord?” Pastor Wolfe then applied that to us today—am I the one who passes by a hungry child, am I the one who fails to visit the sick and those in prison, am I the one who doesn’t clothe the poor? His Easter sermon was from Mark 16: 1-8 where the women discovered the empty tomb and left “trembling and bewildered.” We tend to see the joy of the Easter story and forget how terrifying the empty tomb was to the women and the disciples. While we are in the midst of circumstances, they can cause us to tremble. In hindsight, we can see God’s hand leading us through those times.

Whenever my kids were little, if we were lost or if things were a little unsettling, I’d tell them we were having an adventure. Well, we had an adventure this month. On two occasions the week before Palm Sunday, I’d awakened during the night with a gripping (really excruciating) pain that almost made me pass out both nights—but the pain lasted only 10-15 minutes, so I just went back to sleep. On Palm Sunday, I awoke with right upper quadrant abdominal aching pain that grew during the day—by midnight, we decided to go to Casualty where the Australian surgeon, Peter Bird, met me, diagnosed cholecystitis (gall bladder attack) and gave me a shot of pethidine (Demerol in the States) that caused me to not remember the walk back to the Quadplex (LOVELY medicine). Early the next morning I had an ultrasound confirming the diagnosis and by 10:30 am was in theatre (alas, not acting) having a laparascopic cholecystectomy. Much to the nurses’ amazement, I went home that evening (Kenyans aren’t acquainted with same day surgery). The bill for the entire adventure was $500. Paying the bill was yet another adventure; they lost my “file” (medical record) twice in the same day.

Avoiding an “open” operation allowed us to leave for the States on 4/27/11 as planned. We spent 2 days of rest with our dear friends, Deb and Barry McLeish in Madison, then worshipped on Cantata Sunday at Luther Memorial (fantastic music with organ, strings, brass, and tympany). Leland and I gave a presentation in the adult Sunday school—I realized afterward that I’d just given a missionary talk at my church just like the lady who inspired me as a child--Miss Emma Snyder, a missionary nurse who worked in the 1950’s with lepers in Nigeria! That was a “wow” for me. The rest of the week was spent in Chicago—we rested and visited with my family, all of whom were present for Michael and Marisa’s engagement party hosted by her parents.

Leland spent some time reviewing the operations done since we have come to Kijabe and BKKH. In the first 7 months, 869 pediatric neurosurgical cases were done with an average of 124/month. Two thirds of the cases are related to spina bifida and hydrocephalus; the other third is a mixture of tumors (brain and spinal cord), encephaloceles, lipomyelomeningoceles and others. Our work is exceeding the amount budgeted by BKKH by about $10,000/month. While in Chicago, we met with Scott Ward of the Medtronic Foundation who visited us in Kijabe in November and has been instrumental in arranging funding of a wireless internet system to be installed in Kijabe in June as well as that for our neurosurgery fellow, Humphrey Okechi. Scott calculated that each operation and hospitalization costs an average of $228. Remarkably, the Sunday School children of Luther Memorial Church dedicated their weekly offerings for this past year to the children of BKKH—they raised $228.42. Others who have been incredibly generous have been nurses and staff of American Family Children’s Hospital OR who have donated proceeds from “Dog Bones For CAT Scans”, gathered outdated medical supplies, and given sacrificially from personal funds. Luther Memorial Foundation awarded the Neurosurgery Patient Subsidy Fund of BKKH a generous grant. We feel quite grateful to all who support the children and are praying for God’s guidance in finding ways to make up the monthly deficit.

We were blessed with visitors this past month. Sandi Lam, who just completed her pediatric neurosurgery fellowship at Children’s in Pittsburgh, spent 4 days here and did 17 operations. John and Maggie Tarpley, close longtime friends of Leland’s, visited Kijabe to facilitate an international outreach option for general surgery residents at Vanderbilt. Tom Steineke and the physican’s assistant who works with him, Peter Parcells, covered for us during our absence—though we were able to visit with them briefly the day they arrived (the same day we left). We cannot describe how wonderful it is for us visit here with people from the States. I have come to realize how important it is for people to come here and see for themselves not only what we do here, but the patients and families that we treat. Most people who visit and see the needs have described that their lives have been changed by what they see here. So, we invite people to come visit us—but, expect your life to be changed.

People have asked if it was hard to come back—and, yes, it was hard for me to leave my children. My granddaughter really doesn’t understand who IS this lady who looks a little like her mom and is called “Shosho”? But when we arrived back in Kijabe, both Leland and I felt that we had come home. We are energized by our work here. We feel that we are exactly where God has led us. In my devotions each morning, I read a portion of M. Craig Barnes’ An Extravagant Mercy. In his essay on Mark 1: 16-20, he talks about how the story of the Bible has been about people on the move—whether that means a change in relationships, job, aging, or relocating. He says, “…the point of following Jesus [is] not to get to a new place. The point of following Jesus is to follow Jesus. Along the way, we come to understand that our identity is found not in where we are but in the Savior who is leading the way.”

Thank you for your prayers, your support, your friendship.

Susan