Within and Beyond the Walls

"Good morning Damaris, what've you got?" I say in a hoarse whisper, trying to not wake up Erin and the boys.
"I have a 5 year old here in casualty (Emergency Room) who was hit by a lorry (semi truck).
"At 1:30 in the morning?" I reply as I rub the sleep out of my eyes.
"No, it was earlier in the evening.  He is a transfer from Kisi hospital and he just got here.  So far he has been hemodynamically stable, but has a tire mark on his left flank and is complaining of abdominal pain.  His abdomen exam is soft and minimally tender.  I checked a trauma X-ray series and the chest X-ray looks like his stomach is in his left chest. I think he has a ruptured diaphragm and we need to take him to theatre (operating room).  All his other studies and labs are normal."
"Ok, I'll be up in a second to have a look at him and the X-ray.  You are sure that's all he has after being hit by a lorry?"
"So far.  See you when you come up the hill."

I arrived to casualty to find a cute little Kipsigi boy laying on a stretcher breathing a little too fast.  His dad was seated next to him looking concerned and a little overwhelmed.  Just then, the little guy turns his head and vomits on the floor.  My eyeball test told me that Damaris was right and that we were going to be operating soon.  I went and looked at the X-ray and sure enough, stomach bubble way up in the chest.

As is the custom here, we said a prayer with our little patient before he went to sleep.  As we bowed our heads, all you could hear was the "beep, beep" of the heart monitor.  "Lord, be with us during this operation and guide our hands and minds as we do your work here on earth."
Truly the Lord was with us in that early morning hour, and He had been with that small boy earlier in the evening too.  We found a ruptured diaphragm with his stomach, colon and part of his small intestine in his chest.  Fortunately, the tear had stopped just short of his inferior vena cava (the major vein that enters the heart), as an injury to this vein would have been fatal.  We also found a large tear in his pericardium (the sac that holds the heart) but nothing wrong with his heart.  Both were easily repaired and miraculously we found no other injuries.
God in his sovereignty was there and protected this little one as he was waking too close to the road with heavy traffic.
God was there when the health care provider at Kisi made the decision to send him to us at Tenwek. Often times these patients just get admitted to the district hospital and sit there for days until something terrible goes wrong.
God was there in the theatre guiding Damaris and I as we explored his abdomen and chest.
God will be there as the chaplains minister to this boy and his dad while he recovers in the hospital.
And God will be the with you as you continue to pray for the ministry of our family and of Tenwek hospital.

The story of our little patient is a great example of how Tenwek's medical ministry is paired with the spiritual ministry in order to provide complete healing.  However, the ministry opportunities here extend beyond the walls of the hospital, just like they do back home in the U.S.

We were sitting on our front porch talking about spiritual matters when I decided to pop the question, "Would you like to come over here every Sunday afternoon and study the Bible together so we both can grow closer to God?"  I posed this question to a young man named Moses, a 24 year old who we have come to know here at Tenwek.  He is a husband and the father of a one year old girl, and he and his little family live in a shed behind his brothers house.  Moses was born into some tough circumstances, and has also made some poor decisions in the past.  However, he claims to be a Christian and is looking to put his life back together.  His brother is letting him and his family live in his shed, and if Moses can hold down a steady job, he will be able to break the cycle of poverty and restore relationships, provide for his family, and fulfill his purpose of having a right relationship with God.

 Meet Jack Okumu.  Most people have to look up to see his face, and when you do, you immediately notice his big smile and warm personality.  You have to really listen when he speaks because his soft voice usually speaks words you want to hear.  Jack is a fourth year general surgery resident, is married to Damaris (a different Damaris) , and has a son named Adrian.  He is from the Luo people of Western Kenya, which is the same tribe that President Obama's father was from.  (Ironically all Kenyans were very excited when Obama was elected president of the United States, but now many have changed their opinion..including many Luo.)  I have had the awesome privilege of teaching (and learning from) Jack on a daily basis.  Besides being a very good technical surgeon, he is also a caring physician with a good heart who treats his patients well.
Jack decided to go to medical school after working in a hospital being a file clerk.  He initially studied accounting, but changed his mind when he observed the physicians in the hospital and how they were respected.  He wanted to be respected like that.  Many years later, Jack now has that respect, but not just because of his position, but because he has earned it through compassionate care and a Christ-like attitude.

In a year and a half Jack will leave the PAACS program here at Tenwek a fully trained, well rounded, extremely competent general surgeon.   If this truly is the next generation of Kenyan surgeons, the country is fortunate.  Once he graduates, he hopes to practice at a district hospital close to his family and take care of his people.  He will instantly become a leader in the community, and his impact will extend far beyond the walls of the hospital.  It is exciting for me to see that the time and energy invested in Jack by PAACS faculty will pay off and begin the process of reforming surgical care across the country of Kenya and the region of East Africa.


It is because of generous and prayerful people like you who are willing to support adventurous and able people like us to minister to patients with diaphragm ruptures, neighbors like Moses, and residents like Jack.