Monday, October 20, 2014
Mortein's Doom - "Nothing Kills Faster and Keeps Killing for Longer." Hopefully, not me in the next few days.
The final push...
Right over the hive.
Part of the cleanup.
What better way to end a marathon call weekend at Tenwek, than to tackle the extermination of the massive killer bee hive multiplying in the north wall of our house. I had noticed the swarm of bees leaving and entering the one-inch hole in our siding last week, and thought I would dispatch of it quickly using the Raid Wasp and Hornet Killer we brought from the U.S. for such an occasion. However, despite unleashing an entire can into the hole (from the comfortable distance of 20 feet as advertised on the can), the environmentally-friendly, “green” active ingredients only served to moisten them a bit, and perhaps strengthened their resolve to continue the hive-building in this perfect, cloistered location.
So, today, I thought I should step it up a notch with some cans of Mortein’s “Doom,” the Kenyan kill-anything/everything insecticide present in every missionary household. I am quite sure the active ingredient of this spray is banned in every other part of the world except East Africa. Armed with a can in each hand, I thought I would start from the outside, and sprayed the death-cloud toward the entry point in the siding at a less comfortable distance of about 8 feet. In my passion, I didn’t appreciate the swarm surrounding me, until a few of the dazed bees began to fly into me. At this point, arms flailing, wide-eyed Kenyans watching, I ran to the back door spraying every which way, in an attempt to avoid getting stung.
Needing some “Doom” reinforcement cans, I went to our master closet, which happens to be right underneath the location of the hive. When I opened the door, I was met with scores of angry bees, which had found their way into the closet, looking for anything to sting. Getting the cans from the top shelf was no small challenge, but I managed to secure three more. Failing with the direct frontal attack, I decided to flank them from the top, and preceded upstairs to our second level. Opening the upstairs window (which is set just a few feet above the outside entry hole), hanging out the window, I unleashed other two cans, completely unaware of the effect that the death-mist was having on me, until my nose began to copiously run, my eyes began to water, and I began to feel somewhat dizzy and nauseous. Despite my own Doom-induced haze, I realized I could hear the loud buzzing of the bee-core in the north wall of the house, as the bees were attempting to ventilate the poison gas from their home. I felt the wall where the buzzing was loudest, and noted a one-foot diameter area, which was peculiarly warm compared to the rest of the wall. Finding this “honey-spot” so to speak, I formulated my final strategy.
I managed to find a piece of old screen from our building project, and I securely taped a rectangular section to the inside wall. After taking a deep breath, a final can of Doom by my side, I proceeded to smash a hole in the wall with a hammer, and hit them right in the core, directly over their hive. Protected by the screen, I released the remaining Doom right onto the massive honeycomb, and the buzzing slowly died down. However, I knew that the battle has not yet over, as I was sure that many escaped into our master closet below. Going back downstairs, I opened the closet door and was met by hundreds of Doom-crazed bees. One by one, however, they dropped without a fight, many on the floor, many on the clothes, many on the shelves, writhing bees everywhere, and liquid-condensed Doom dripping from the ceiling. The battle was over. Not one sting. The cleanup was not as glorious.
Tuesday, September 23, 2014
The roadside pit crew repair in process.
Blowing into the cooling system?
Not much to say here.
Thank goodness for the Motor Honey, right?
They pretty much hit the jackpot that day.
Among the few events that cause the most stress in this life of cross-cultural missions, is the unexpected Kenyan road-side break down. Don’t get me wrong… I love our 2003 Landrover Defender. When it is working well, it can go anywhere, as a barebones, no-frills man-truck (as Vera Steury calls it) in which you can forget about listening to music or holding a decent conversation (secondary to the loud hum of its tractor-like, turbo-diesel engine). This truck has brought us safety through many kilometers, including two riots and even random gunfire. However, there is a reason the Defender was considered the ultimate “villain/lemon” in the animated movie, Cars 2.
I had just rendezvoused with Dr. Lauren Leffler, a 5th year orthopaedic resident who arrived in Kenya the night before to serve at Tenwek for 4 weeks. I was going to save her a few shillings by giving her a ride from the Rift Valley Academy to Tenwek. Just the day before, I had gotten the brakes repaired (the pump had failed, causing of complete loss of power to the brakes). So I assumed the Defender was fully tuned and ready for the journey. All was well as we descended into the Great Rift Valley, and cruised across the valley floor, dodging overloaded lorries and miscellaneous wandering goats and cattle.
On the far side of the valley, as we climbed the long, winding western escarpment, I noticed a pungent smell, and, to my dismay, realized this smell was coming from me (that is, my Defender). I then glanced at my marginally working temperature gage and found it was registering in the red zone way above “H.” Before I had time to fully process, the engine literally just quit, and we barely had enough momentum up the steep slope to pull to the side of the road. As smoke started to come from under the hood, I looked at Lauren and just nervously said, “Wow, this has never happened before.”
After opening the "bonnet" and trying to figure out the next step, a motorcycle taxi carrying a spry, 50kg man and his scant bag of tools pulled over. This “mechanic” hurriedly started working on my Landrover without saying a word. The motorcycle taxi driver looked at me and said “Don’t worry…he will fix it. This happens all the time.” After releasing a few hoses, and removing a plug (which had a conspicuous red label next to it reading “This plug MUST NOT be removed”) he poured liters of water into the cooling system in an attempt to cool the overheated engine. Two other “assistants” then arrived with large containers of anti-freeze/coolant, more “tools” and two bottles of Motor Honey (??). After more fiddling, blowing, adding coolant, etc., the chief mechanic explained in broken English that the thermostat needed to be removed, and that it would only be a matter of removing two bolts. Unfortunately, in the process of this “simple fix,” he stripped these bolts, making it impossible to extract the thermostat in the “normal way.” Out, then, came a long screwdriver, which he used in an attempt to blindly open the rusted-shut thermostat through a long, deep hole. After struggling for what seemed like an hour, all of a sudden, he acted as if he got it, and motioned for me to start the Landrover. After much sputtering, it finally started. At this, the mechanic declared the job complete, and he, his two assistants, and the motorcycle driver were ready to “settle accounts.” Their charges were steep, but with little choice, and just happy to have a seemingly working vehicle, I gave them all I had (and even borrowed from Lauren who was patiently enduring this entire ordeal).
The four happy men waved as we drove off (with big smiles on their faces for obvious reasons) and the car worked perfectly… for at least 45 minutes until it overheated again. This time, the situation was more serious as it had started to rain, and it was now fully dusk. Again, within a few minutes of pulling off the side of the road, a miscellaneous mechanic came to our assistance, and with my broken Kiswahili, I communicated what had happened just minutes before. He explained that all that needed to be done was to remove the rusted thermostat, and we would be on our way again. Since the two bolts had been thoroughly stripped by the previous pit crew, I knew this would be no simple task. After nearly two hours, under the illumination of Lauren’s headlamp (which, in the end, was unfortunately stolen by the person holding it for us), rain coming down, he was finally able to remove the stripped bolts and the rusted thermostat. Again, the car started, but now the engine sounded strange, pointing to the fact that the cylinder head was warped from the excessive temperatures. At this point, I didn’t care, and just wanted to get Lauren safely to Tenwek. So I borrowed more money from her, paid this second mechanic for his work, and headed back on the road, which was now very dark and unfamiliar. The gage again registered excessive heats, and the strange noises coming from the engine continued. All we could do was just pray and persevere until finally, after 9pm, we arrived at Tenwek.
So the major question I had for God through this ordeal was this: “Why would You let his happen to me (not to mention Lauren, who I am recruiting to come to Tenwek long term), when I am already overworked, overstressed, overcommitted, and just plain overwhelmed?” His answer came through James 1:2-4: “Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have it full effect, that you may be perfect and complete, lacking in nothing.” Essentially, God was saying, “I am very interested in building your faith, and to do this, in my paradoxical way, I use trials.” God, the founder and perfecter of my faith, in his sovereign love, had used my unfaithful Defender to bring me one small step closer toward a deeper faith in Him. (Mostly, I was just thankful that Heather and Josie were not with us).
So after more repairs, the Galat Landrover is still not functioning at peak performance. The excessive heat also damaged the turbo, and although working, the truck is running at about 50% power. Perhaps it is time to sell the Defender and buy sometime more reliable? Anyone interested in a “gently used” black Landrover?!
Thanks for your continual prayers for our family! We appreciate you so much!
Sunday, August 17, 2014
We are definitely in a season of building here at Tenwek. The hydroelectric turbine expansion, which will more than double the amount of power at Tenwek, will be completed by the end of October. This massive gift from Samaritan’s Purse will provide adequate power for decades to come and allow for future expansion of the hospital.
The yellow turbine provides 340kW of power and has been in operation since 1987. The new blue turbine will provide 520kW of power, more than doubling our current output. Excess power will be sold back to Kenya Power and Lighting.
The penstock water accelerator. Water from the dam passes through this tube which then turns the turbine, and generates electricity.
Speaking of which, the “trainee housing project” was started a few weeks ago (a miracle in itself). Once completed, this 4-story building will provide housing for more than 25 trainees (medical students, interns and residents). The building site is extremely challenging as space is tight, and there is a huge 6-meter soak pit, which needs to be rerouted. And despite recent torrential rainfall, we are still on target to complete this project by the end of the year so that we can accommodate our next group of trainees (current housing is completely full!) Again, Samaritan’s Purse provided a large chunk of the funding for this important expansion (40%), but we are still about $100,000 shy of our goal. Please consider joining our vision of providing solid medical training for Africans by supporting this project (www.wgm.org/tenwek-hospital-housing).
The foundation for this building is being dug entirely by hand.
The Galats are also continuing with our smaller scale “ministry house” (in our back yard next to our house). This building will include two much-needed apartments for visiting staff (and our guests), and also an “upper room” for ministry (replete with a brick pizza oven for feeding hungry residents!). We are so thankful for those who have donated into our Galat ministry account with WGM, as this account provided the funding for this building (www.wgm.org/galat).
Most of the building materials for this house have been sourced locally, including the rough-hewn wood beams used to make the front porch and the block which was hand-cut from a rock quarry.
The workers were pouring the front porch the same day as Josie's 1st birthday, so we took the opportunity for everyone in our family to place a permanent imprint of their feet in the concrete.
Seven pairs of Galat footprints...
Finally, a massive vision is beginning to take shape at Tenwek. For a number of years, we have been dreaming of the possibility of a free-standing orthopaedic "hospital" at Tenwek. After much prayer (and many meetings) the hospital administration has caught this vision and a site has been proposed (a huge hurdle as space is so limited at Tenwek). And a missionary architect just arrived at Tenwek last week (staying for an entire year helping with all these building projects and the master plan). He will be helping us sketch out the concepts for this Tenwek Orthopaedic Center of Excellence. We are trusting God to accomplish this big goal in His timing.
Thank you for your continual partnership with our family at Tenwek hospital. We are approaching the 6-year anniversary of our arrival here, and it is amazing to see what God has accomplished in this short period of time. And we remain here thanks to your prayers and faithful financial support. Thank you for your partnership with us and for sharing our goal of training African orthopaedic surgeons and caring for the most needy, all for God’s glory!
Saturday, July 5, 2014
The groin flap, still attached to the pedicle of skin which contains the artery and vein to keep the flap alive while the new blood supply from the hand develops.
Three weeks later, after division of the pedicle. The new blood supply comes from the surrounding healthy tissues in the hand.
Jack, on the day he believed.
Jack, with his surgeon, new Swahili bible (and "Kick-A" T-shirt)
One of the phrases we use regularly on the orthopaedic service at Tenwek, which seems to perfectly encapsulate the peculiarity of the day-to-day cases we see here, is “You just can’t make this stuff up.” Last month, a 40 something year old man (who I’ll call George) presented to casualty with half his hand blown off by a stick of dynamite. Apparently, Jeremiah was correct when he insisted that there is gold in the hills around Western Kenya (at one point when he was younger, he wanted to ship a large sluice so he could pan gold from the Tenwek river). The patient had lit a fuse (yes, a fuse) on a stick of dynamite and when it didn’t ignite, he went to inspect, and just as he reached out his hand to grab the stick, it exploded and completely blew off his thumb and index finger.
Covering large hand wounds such as this can be challenging. But one of the described methods in plastic surgery literature is with a “groin flap” in which a full-thickness paddle of skin in the groin region is elevated with its blood supply within a pedicle and then draped over the defect to supply new skin to the region of loss. The hand needs to remain still for three weeks while a new blood supply “takes” and so to accomplish this, the hand is literally sutured to the groin. Then, after three weeks, the pedicle is divided and the hand “freed.”
During George’s three week waiting period, a young man named Jack was admitted to the bed next to him with a neglected open, segmental distal tibia fracture from a motorcycle crash. He was first admitted to another hospital where he literally sat without care for 5 days, until his sponsor (who I providentially met at an Indian wedding last February) insisted that he be taken to Tenwek. After several operations, including the placement of an external fixator (pins, clamps and bars), Jack was on his way to recovery.
While on morning rounds one day, I asked Jack and George if they were Christians, and Jack very honestly answered ‘no’ but was interested in hearing more. So, we made plans to meet later that day. But as the work typically goes, I was completely slammed, and had no time to meet with Jack. Unfortunately this scenario happened for the next three days, each day on morning rounds telling him I would find him later, and each day, loosing the opportunity because of work. Finally, one evening I had time to have a cup of chai with Jack in the hospital canteen. Jack explained to me that he was orphaned at age three when his parents were both killed in a car accident, and he literally lived on the streets from age 3 to age 15. Then, he was “rescued” by his sponsor, a Hindu woman who helped him through school, and on to his current employment as a DJ. I explained to Jack that Jesus came for all people, regardless of race, religion, color, background, etc., because we all desperately need a Savior and that through the forgiveness of sin that He offers through His death for us on the cross, we can now have hope. Right then and there, Jack said he believed, and prayed one of the most honest, cool prayers that I have heard in a long time.
Through the randomness and oddities of the cases we see here, mixed with the busyness of work and life, we see glimmers of God’s grace (which continues to amaze). Please keep Jack and George (and all our patients) in prayer that God would heal and restore physically and spiritually. Thanks for all your support and prayers for our family!