Images from Tenwek

"The Mystery of History" at Tenwek. All the children dressed up as their favorite character in history and went from house to house, each set up as a different time period in history, and to get a "treat". Jeremiah was a Spartan Soldier, Emma a gypsy, Claire a Grecian princess, and Levi, Cupid.

Emma is growing up!

Cupid getting ready to shoot his "love arrows."

Justice vs. Mercy

Stolen cell phone in the underpants igniting an extreme case of "mob justice."


The end result of an argument gone very bad.

This morning, on rounds, I was handed a crisp, new “orthopedic service list” by one of the Kenyan medical students, an invaluable tool for tracking our many patients scattered throughout the hospital. The List, kept by our hard-working interns and medical students, includes patient names, injuries and treatment plans. As I quickly scanned the list for any new overnight admissions, one patient distinctly caught my eye: Peter Kipkirui, mob justice victim. The patient had multiple injuries inflicted by blows and pangas (machetes) as a result of vigilante justice, meted out by a group of angry Kenyans. “He must have done something pretty bad,” I thought to myself. I asked the two medical students, Mercy and Justus (no joke), what he had done and they showed me a pelvic x-ray demonstrating what they thought was the reason for this swift punishment. A cell phone that the patient had stolen, and stuffed into his underpants, on x-ray, appeared as a rectangular, outlined skeleton of wires and chips. Later, I was called to the operating room to see a patient who was the victim of another kind of “justice” that unfortunately results from the simple equation: liquor + argument + sharp instrument = severe injuries. The man had the most impressive hand panga cut I have ever seen.

To be honest, as a surgeon dealing daily with injuries caused, in some way, by foolishness, carelessness, jealousy, anger, neglect, greed, etc. (essentially sin), I am tempted to lose compassion, and think, in my heart, “they get what they deserve.” Then, I am quickly disciplined by God as he reminds me of the incredible Grace that was given me, i.e. my sins paid for by the blood of his own Son. It’s a good thing I don’t get what I deserve. All of us receive one of two perfect options: justice or mercy. Either we receive just punishment for our sins…or mercy, embodied in the person of Jesus Christ as we come to Him in faith. The Newsboys sing a song with simple, yet profound lyrics: “When we don’t get what we deserve; it’s a real good thing…when we get what we don’t deserve; it’s a real good thing.”

Eph. 2:4-5 But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions--it is by grace you have been saved.

Behind the Scenes

Meshack, our outstanding orthopedic charge nurse, was notably happy at the amount of implants donated, in total, two pallets of equipment weighing 800 lbs. The man in the red jacket is a hospital chaplain who kept asking, shocked, "You put those big metal pieces inside someone's body?"


Meshack spent two days organizing and inventorying the donation in the orthopedic storeroom.

Brand new Zimmer ITST (Inter-Troch, Sub-Troch) femoral nailing instrument set.

First patient to receive the ITST nail for a proximal femur fracture. The nail is inserted through two incisions each measuring about 2 cm in length.

Post-op x-ray of ITST nail.

Recently, the Tenwek Orthopedic Department received a huge donation of orthopedic implants, sent by a group called Hope Force International. Several folks from different areas of the country rendezvoused in Memphis, Tennessee to pack two pallets of a board assortment of supplies: nails, screws, plates (in total 800 lbs of equipment!), to be used for the orthopedic care of the people in this poor region of Kenya. Amazingly, Fed-Ex air freighted the pallets free of charge (even upgraded to “express service”), thus the total time from leaving the US to arriving at Tenwek was only 8 days…and there were no issues with customs. Just yesterday, we used one of the nails, the Zimmer ITST (Inter-Troch, Sub-Troch), for an elderly woman with a fracture of her femur caused by an erosive metastasis of cancer. Although this will not cure her disease, now that the fracture is stabilized, she will be able to move without pain.

As I reflect on the incredible generosity of not just Hope Force, but the many other companies and individuals who have donated time, resources, and personal finances to supply Tenwek with implants, so essential to the practice of orthopedic surgery, and the care of our patients, I am humbled and thankful. I think of the SIGN nail company, whose sole mission is to manufacture low cost implants for the poor in developing countries…I think of an individual who bought a set of plates for Tenwek with his own finances…I think of a sales representative from an implant company who gathered and shipped screws and plates on his own time and dime…I think of a group of students from Cedarville College and their mentors who are designing a new nail to be used at Tenwek …and there are many, many others.

Together, these people and groups are serving faithfully in the way God has called, all of great significance to the work here in Kenya. It is a challenge for me to be a good steward of God’s provisions for Tenwek, and for all of us to ask, “God, what would you have me do today?” The majority of times, the work God calls us to goes “unnoticed” by the world, and the results of which may never be realized to the fullest extent in this lifetime (much like the Heroes of the Faith from Hebrews 11). But, faith in this matter is key, believing that God has a grand, sovereign plan for the redemption of mankind, yet somehow, paradoxically, God uses our small acts of obedience to His call, behind the scenes, to bring glory to his Name, and advance His kingdom.

Hebrews 11:1 Now faith is being sure of what we hope for and certain of what we do not see.

The Simple Life

Jeremiah, Jamie and Peter hanging out at the newly erected campsite.

Drinking coffee by the mud brick fire pit.

Jeremiah pouring a freshly brewed, and very stout, cup of cowboy coffee, a skill he learned from Grandpa Kinkel.

Remnants of a night of big fun...

Over the past week, Jeremiah has been uncharacteristically efficient with finishing his homeschooling assignments. As soon as Latin, literature, Algebra, and history are finished, he is gone…for several hours. “What is he up to?” I asked myself, and, knowing Jeremiah, I figured it involved something related to digging, chopping, cutting and fire. He would show up for dinner covered with sweat and dirt, smelling like a 12 year old + boy, but with a very contented look on his face.

Yesterday, the mystery was revealed, as Jeremiah invited me to see the campsite that he, Jamie and Peter had been diligently working on for days, tucked in a secluded area, what appeared to be a remnant of the high altitude rain forest that used to cover this area. Entering through the back, and going down dirt steps meticulously fashioned, was the fort, a small clearing created by pangas, with a lush canopy, a mud brick fire pit, and a leveled dirt area for sleeping.

When Jeremiah asked if they could sleep in the fort that night, the answer was easy. “Just be careful,” I said as he was gathering supplies: a bucket of Cokes, two onions for roasting in the fire, a package of marshmallows, a bag of Farmer’s Choice sausages (advertized proudly to be at least 62% meat), a panga, OFF!, and materials for making torches (the OFF! was not for repelling insects). I told Heather that the combination of pre-adolescent angst plus indigestion would guarantee about two hours of sleep for the boys.

This morning, I carried fixings for “cowboy coffee” to the fort for the boys…I figured they would need it. Jeremiah had already fried eggs over the fire, and the site was strewn with the remnants of last night’s events. Jamie was finishing off the last of the hideous sausages, and they all smelled like the open pit fire.

As I walked back home, I recalled the worry I had when we first arrived in Kenya, that our children would, in some way, suffer as a result of being here, not having the same opportunities available to kids in the States. And, there are missed opportunities for our children…piano lessons for Claire, violin lessons for Emma, football for Jeremiah, and, more importantly, missed family events with cousins, aunts, uncles, grandparents. But, we have seen God provide for our children in ways far beyond what we think they need, or what we could even provide. Now, we see the incredible blessing of raising kids in a simpler environment such as this. Without TV, soccer practice, McDonalds, school events, (and, for the first three months even, a vehicle), the kids finally have time to be kids, to use their minds, to create, to explore, and just have fun. Sometimes the things we think we so desperately need actually hinder that which our hearts truly desire. The simple life at Tenwek…not so bad after all.