Just Along for the Ride

This patient suffered an open distal tib/fib fracture which was treated with an external fixator at another hospital (what we call a "Kisii special"). 

This fracture was particularly difficult to treat because of the amount of bone loss and angulation. 

Also challenging was the amount of displacement and angulation of the fracture which had been in this malposition for many months. 

The fracture was expertly treated by visiting physician Dr. Frank Bryant, who used one of the donated Biomet plates.  He filled the bone defect with graft taken from the iliac crest. 

Overall, the fixation was solid and alignment anatomic.  Now, the result is in God's hands. 

Since 2012, Biomet, a major orthopaedic implant company, has been supplying Tenwek with critical implants designed specifically for the treatment of complicated fractures that occur in and around major joints (hip, knee, wrist and ankle).  The manner in which this partnership was established was a total miracle in itself (perhaps to be told at another time).  Recently, another orthopaedic company called Zimmer purchased Biomet and the merger is currently ongoing.  Naturally, we at Tenwek have been wondering how this merger will affect our ongoing partnership and the supply of these important implants. 

Being stateside for a few weeks this month, I was honored with an invitation to speak at Biomet’s annual Christmas party.  They mentioned that if I could come, they would also arrange a short meeting with the CEO of Zimmer to introduce him to the work at Tenwek.  So just a few days after landing in America, I traveled to Warsaw, IN, where three of the top five ortho implant companies reside.  The presentation at the Biomet Christmas party was well received as I communicated the blessing they have been for us at Tenwek, and thanked them on behalf of the many patients who been helped with their implants.  

Following the presentation, I traveled across town with the two Biomet executives who have spearheaded our partnership, and we had our meeting with the CEO of Zimmer. As I communicated with him about Tenwek, he seemed to track with significant interest.  He also mentioned that once the plans for our Orthopaedic Center of Excellence become more solidified, that we should meet again.   

God continually reminds me of two things: (1) He is entirely sovereign and (2) He loves the poor.  The orthopaedic work at Tenwek is wholly His, and we just have the privilege of joining Him on this wild ride.   

Thank you for your ongoing prayers and support for our family.   Without it, we would not be able to continue at Tenwek. 

Why We Continue at Tenwek

Last week, on November 20th, we celebrated the 6th anniversary of our first arrival at Tenwek Hospital.  We have faced significant challenges over these last six years and many (including ourselves at times) have asked why we continue to serve at this rural mission hospital in southwest Kenya.  The following article I wrote (which was recently published in WGM's "The Call" magazine) along with this related video, explain why.  Thanks to all who continually partner with us to make disciples of Christ in this small part of the world.

The Cycle of Discipleship

As a young believer in my sophomore year of college, hungry to grow in my new-found faith, and praying for God’s help in this endeavor, a man named Roger, whose passion was to disciple future leaders in the Kingdom, asked if I would be interested in becoming a part of his weekly discipleship group.  At that time, I did not comprehend how God would significantly use Roger’s time, commitment and modeling of true faith to help me grow in a deeper understanding of His Grace.  Because of this experience in true discipleship, my life was forever changed, and as a result, I committed to making discipleship the principle aspect of ministry in the future.

As a missionary orthopaedic surgeon at Tenwek Hospital in Kenya, I have the privilege of caring for medically underserved patients, providing compassionate healthcare in Jesus’ name, praying with patients and encouraging them to walk with Jesus.  However, the greater privilege is the unique opportunity we have to disciple young national surgeons who come to Tenwek for training.   As part of the Pan African Academy of Christian Surgeons (PAACS), whose goal is to raise up African missionary surgeons to reach the most needy patients in Africa, we train general and orthopaedic residents not only in excellent healthcare, but also in a deeper walk with Christ, to help them grow in their own faith, passing on the truths that were built into us, thus continuing the cycle of discipleship in an international context.

Jesus commanded his disciples, the same ones he poured His own life into over a three-year period, to continue the cycle, and go into all nations and make more disciples.   This is God’s design for all of us who would desire to make a true, and long-lasting difference in the Kingdom.  Discipleship is not easy and sometimes even messy.  But by God’s grace, the blood, sweat and tears associated with deep, personal relationship can make an eternal impact in the life of someone who just might do the same for others in the future…the cycle of discipleship.

Dan vs. the Killer Bees

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.

My Unfaithful Defender

The roadside pit crew repair in process.

Blowing into the cooling system?

Not much to say here.

               Lauren was a good sport, and didn't appear nervous once. 

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 5^th 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!