A New Season

This year marks 25 years of marriage for Heather and I, and during our engagement in the mid-1990s (imagine me in a pair of cutoff jean shorts, and Heather in her sweet Laura Ashley dress) we could never have imagined the adventure that God had in store for us.  In 25 years, we have moved more than 20 times (often with many kids in tow), living in places as populated as Chicago and remote as Bomet, Kenya.  And in every place, the constant has been God’s faithfulness, mercy and grace for two broken people.  

Shortly after we were married, we sensed it was time for a change, and we entered a new season of life at Trinity Evangelical Divinity School, where I started seminary and Heather (newly pregnant with our now 22-year-old beast of a son Jeremiah) worked in the missions department as the secretary for great missiologists such as Paul Hiebert and Robert Coleman.  Certain of my calling to ministry, but unable to shake the idea of going to medical school, God merged the two into a new vision: medical missions.  The concept of “incarnational ministry” (that is, doing life with the people we are called to serve) so moved us that we promised God that if He would open the doors for us to live this type of life, we would stay long-term, full time, until He directed otherwise.  

Fast forward 10 years, to the end of my orthopaedic surgical training in 2008, uncertain of how or where to fulfill this vision, we received an email about the need for an orthopaedic surgeon at Tenwek Hospital, and through a series of miraculous events, moved our family of 4 kids to Kenya for one amazing, wild, epic adventure. 

More than we could ever have imagined happened during our 10+ years in Kenya: the addition of 3 more children to our family, the start of PAACS orthopaedic training at Tenwek, the unexpected but fruitful transition to Kijabe Hospital, the expansion of PAACS orthopaedics to Kijabe and Ethiopia, the miraculous provision to get board-certified while working overseas, the graduation of three of our oldest kids from Rift Valley Academy, and during the past three years, significant spiritual growth through a renovated prayer life. 

Shortly after our transition to Kijabe in 2016, we began to sense another new season was imminent, as the work at Tenwek was going on well without me (despite many ups and downs), and Kijabe, with its strong core of talented national surgeons, was equipped to continue the PAACS mission well into the future.  As such, we began to pray for God’s direction and asked many of you join with us.   After many years, God has answered and confirmed that our long-term, full-time work physically in Kenya is finished for now, but the global work of teaching, training and discipling national surgeons via PAACS isn’t. 

As part of this direction, God has provided the opportunity for me to join another surgeon in Phoenix named Shane Martin in a private total joints practice.  Shane has been on short term missions’ trips to both Kenya and Tanzania and our mutual goal for the future is to steward our skills and resources to advance God’s kingdom through orthopaedic surgery.  Heather and Shane’s wife Erin are partnering with us too as they meet weekly to pray.

The most amazing part of this new season is that I will remain with WGM as a U.S. based “global worker” as the PAACS Orthopaedics Program Administrator, providing direction, encouragement, recruitment and financial support for the (currently) three PAACS ortho sites and its more than 20 residents.  This role will also include 1-2 trips to Africa annually for 1-2 weeks at a time.  Heather will officially retire from WGM at the end of January to focus her ministry efforts primarily on our family.  

Many of you have financially supported our family, the work at Tenwek and Kijabe, and the PAACS ortho residency programs over the years, and for this, we are eternally grateful.  Through your faithfulness, God has enabled the healing of many patients, both physically and spiritually.  All funds remaining in our Galat Ministry Account with WGM, and any funds given in the future, will be dedicated to the training of PAACS Orthopaedics national residents.  The budget to train one resident for their entire 5-year program is approximately 125K USD!  This is a huge task, but God is able to provide!

Although we are confident, excited and hopeful for this new season of life and ministry, we are also very sad to leave our life in Kenya on many levels, especially our dear friends and colleagues.   But we know that God has ordained this new season, and what He has started, He will finish in a way that is beyond our ability to comprehend (Eph. 3:20).  

Thanks for all your love and support!

Ecclesiastes 3:1 For everything there is a season, and a time for every matter under Heaven. 

Merry Christmas and Happy New Year from the Galats!

Dan and Heather

What an amazing and blessed year 2019 was for our family!  In July, after a three year term at Kijabe  Hospital in Kenya, we transitioned back to the U.S. for a time of furlough.  We are so grateful to be together again with our growing family and are seeing the answer to so many of our prayers over the years.  In 2020, Heather and I will celebrate 25 years of marriage as a testimony of God's continual faithfulness in our lives.  

The Galats!

Hard to believe that we are 11 in our family now (12 if you count our new granddog Hobbs). 

Jeremiah, Tory and Hobbs Galat

 Jeremiah and Tory are doing so well, and are now married almost 3 years after eloping in 2017.  They purchased their first home in May and are busy with school, work and a rapidly growing german shepherd puppy.  In June 2020, they plan to "formalize" their union with a wedding celebration in Alaska (where Tory is from).  We are looking forward to this special time together as a family!

Tye and Emma Dutcher 

Shortly after our return from Kenya, we discovered that Emma and her boyfriend Tye eloped on July 31, 2019, and are now husband and wife.  Although this was quite a shock for us, we see Tye as God's gift to Emma (and vice versa) and we love Tye (he is a perfect fit for our family).  He has an amazing testimony of God's grace after loosing his leg in an accident at age 12.  Determined not to let this define him, he started swimming and is now a member of the U.S. paralympic swim team.  Emma and Tye live in Phoenix, and we love regularly spending time with them.  

 Tye won the gold in the backstroke (and three other medals) at the PanAm games in Lima, Peru this summer.  He is currently training for the 2020 Summer Olympics in Tokyo.  What we love about Tye is that he uses this platform as a way to share the gospel of Christ with many people.

Claire and her roommate Daria.  

Claire began at Princeton in the Fall and is discovering how challenging college is!  All last year, we  prayed that God would provide the perfect roommate for Claire, and He answered far above our expectations.  Daria is from Russia and is on the tennis team at Princeton. She is such a great friend for Claire!   

Heather and Levi 

Levi is now a sophomore in high school at Veritas Preparatory Academy here in Phoenix.  He greatly misses his friends and life at the Rift Valley Academy in Kenya but has been determined to integrate well into school in the U.S.  He played American football in the fall, and would have finished the season had we not discovered a scaphoid fracture from an injury he sustained several months earlier in Kenya.

 Levi had only mild wrist pain despite having a chronic scaphoid fracture.  He required open reduction and internal fixation of the fracture with vascularized bone grafting. 

 Ethan, Josie and Jane

And then there's the three little ones who keep Heather and I young, and perpetually active!  They are loved by everyone in our family.  

A recent total shoulder replacement I did on a patient with severe osteoarthritis

I (Dan) am halfway through my year-long fellowship in adult reconstruction (hip, knee and shoulder replacement) at the Mayo Clinic Arizona.  This has been an incredible learning experience for me, as I gain greater skills in these procedures including Mako robotic assisted surgery.  

We are so grateful for our friends and colleagues at Kijabe Hospital, Tenwek Hospital and within WGM. We are grateful for the years which God has given us in Kenya, and for the things which God has done in and through us.  We are grateful for the growth of the orthopaedic training programs at Tenwek, Kijabe and Soddo/CURE in Ethiopia through PAACS, and amazed that there are now 20 residents being educated in orthopaedics and discipled in Christian maturity.  We are also grateful for you who have been praying with us about the next steps for our family, and God is beginning to clearly show us the way!!  Stay tuned for more updates in the near future, but for now, know that our commitment remains to the healthy growth and development of the PAACS orthopaedic training programs in Africa.  

The PAACS graduates and residents are the future of orthopaedic surgery in Africa.  In my mind, the most strategic way to reach underserved populations (who have massive needs surgically and spiritually) is through these national surgeons. We do this by multiplying ourselves in these incredibly intelligent, skillful, committed, and godly surgeons, who will then pass their knowledge on to others who come after them.  What a privilege to invest in their lives in this way!

Would you consider a year end donation to help support the PAACS ortho residency programs?

May God richly bless you with grace and peace this Christmas and coming New Year!

Endings and New Beginnings

Happy 4th of July from Kenya!

It seems fitting on this cloudy and cold 4^thof July in Kenya to reflect on what God has done in the past three years since we made the challenging transition from Tenwek to Kijabe Hospital. So, I’ve built a blazing fire, and I’m sipping a cup of hot chai as I write, all the while wishing we could be in the U.S. for a blazing hot Independence day cookout with burgers, beans and sweet corn followed by fireworks as the sun sets.  

Change is inevitable, and endings and new beginnings are a common part of this walk with Christ as strangers in this world.  We often don’t take the time to grieve the multiple “deaths” that we experience regularly, and as a result, can get stuck in confusion, disillusionment, and stunted growth.  But if we take the time to be honest with ourselves, and God, we can begin to see the new life that springs forth from the ashes (“Unless a grain of wheat falls to the ground and dies, it remains alone; but if it dies, it bears much fruit. John 12:24). 

If we would have been told 4 years ago that we would leave Tenwek (endings) and start again at Kijabe (new beginnings), we would have thought that would be impossible.  We had worked too hard, invested too much, and planned to spend years, if not decades there.  And I admit, we did not grieve well the loses we experienced and spent many months in a fog after first moving to Kijabe. 

But God, in His mercy, began to reveal the bigger picture of his sovereign plan, and one by one, new beginnings unfolded. In December 2016, Emma graduated from Mercy Multiplied in Nashville and returned to Kenya to complete her junior and senior year at RVA. In February 2017, we discovered we were expecting another child, and Ethan Benjamin was born at Kijabe Hospital on October 11, 2017.  Now he is a little toddler, running around the house and trying to compete with his two, very doting older sisters.  

In March 2017, our oldest, Jeremiah, eloped, and although this was a complete surprise to us, we see God’s hand in this new beginning for him and Tory!

Jeremiah and Tory visited us in December 2017 when we found out the news!

In July 2018, I became the first orthopaedic surgeon to complete the American Board of Orthopaedic Surgery certification process overseas in a mission/humanitarian setting.  In January 2019, PAACS Orthopaedics added two new programs (Kijabe and Soddo/CURE) to join Tenwek (which graduated their first two residents) bringing to total number of ortho residents to more than 20 (of which I have the privilege of overseeing as the PAACS Orthopaedics Regional Director). 

Fasto and Victor as the first two graduates from the PAACS Tenwek program.  Victor is working part-time at Tenwek and Fasto is a fellow in paediatric orthopaedics at CURE Kijabe. 

Francis Mbugua and James Kinyua, the program directors at Kijabe. 

PAACS site visit to Soddo Christian Hospital in Ethiopia.

John Weston, recent graduate from the Mayo ortho residency program, visited us twice at Kijabe and had decided to join the team here. However, when Tenwek lost Dr. Kiprono and Dr. Nugent, he and his family changed gears and decided to make Tenwek their place of service.  They plan to arrive in September 2019!

And as of this month, we will have graduated two of our daughters from high school to send off to college (yes more endings/new beginnings).  

Emma is now a Voice Performance Major at Biola in La Mirada, CA

Claire plans to start at Princeton in the fall. 

The orthopaedic work at Kijabe Hospital thrived over the past three years, and I grew tremendously as I was pushed to more challenging cases such as revision total hip arthroplasty and bone transport for huge bony defects. 

22 year old young lady with gaucher's disease.  She required bilateral total hip replacements. 

Pelvic X-ray of above patient. 

14 year old boy with large femoral bone defect requiring "bone transport."

Pins and rail used to "transport" bone over a distance at 1mm per day to fill the defect. 

And as the Head of Orthopaedics, I was challenged to lead in deeper ways, including a book study for the consultants entitled “Emotionally Healthy Leadership” By Pete Scazzero (in which the last chapter is entitled “Endings and new beginnings.”  Yes, you could say this book has had a profound impact on me!) 

Heather and I also experienced a rebirth of regular prayer and a new conviction for sabbath rest.  We, for the first time in our missions career, began to experience the joy of intentionally leading together, in ministry, from our marriage (yep, another chapter in EHL).  Heather was involved with multiple prayer ministry groups around the Kijabe campus, and we met weekly with a group of peers (couples with young kids, most of whom were 10+ years younger than Heather and I!).  

And we were able to really connect with our older kids during this critical time of development in their high school years.  Many painful endings led us to beautiful new beginnings.  

Over the past three years, we have made more pizzas than we can count. 

Each Friday night, we have between 5-12 students with  large appetites!

Levi was baptized in the Indian Ocean in April 2019. 

And now, in two weeks, we will experience yet another ending as we leave this season at Kijabe, and head back to the States to begin a year of Home Ministry Assignment (HMA).  During this time, I will be doing a year-long fellowship at Mayo Arizona in shoulder, hip and knee arthroplasty.  At this point, we are planning to return to Kenya after the fellowship ends in July 2020, but we have learned to hold plans very loosely and are continuing to ask God for discernment of his will (Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect. Rom. 12:2).

We will miss sunsets (daily endings) like this at Kijabe!

We continue to be thankful for each one of you, who have supported us prayerfully and financially over the past 10+ years we have spent in Kenya.  Without your faithful work in our lives, we would not be here!   

A Beloved Flower

Aimé's case of Blount's Disease or Tibia Vara was quite severe.

X-rays showing that the inside portions of both proximal tibia are severely sloped downward causing the bow-legged deformity. 

Ted (Samaritan's Purse Post Resident in General Surgery) drilling a K-wire to help fix the cut bones. 

After shot of both legs now straight and with good rotation (God was present!)

Aimé Fleury, the Beloved Flower

This past week, I’ve been at Hope Kibuye Hospital in rural Burundi, East Africa participating in World Medical Mission’s first sub-specialty orthopaedic outreach.  The fact that I am even here is a miracle, because in my busyness of life and work at Kijabe, I didn’t even think to confirm that I needed a visa to enter the country (unlike all other African countries I’ve visited where my American passport allows me to buy a visa at the airport).  And so, on Sunday morning, as Dr. Jomo (my 4^thyear resident at Kijabe and accomplice to Kibuye) were about to board our flight, I was denied. “Go on ahead without me,” I encouraged Jomo as he looked at me wide-eyed.  “You get started on cases tomorrow, and I’ll catch up with you as soon as I can,” I said, knowing that to get a visa to join the outreach that week would take an absolute miracle.   

Little did I know, however, that there was a boy in Burundi named Aimé Fleury whose father and mother, along with their entire church had been praying and fasting for Aimé’s needed surgery to correct his severely crooked legs.  And little did I know that after Jomo and I parted ways, he called his Burundian friend Gad, whose father has serious connections in the Burundi Department of Immigrations.  Long story short, by Monday afternoon I had a visa stamped in my passport and by Tuesday morning, I was scrubbing cases with a grateful Jomo and the team here in Kibuye. The repeated response from everyone was, “How are you even here?” as the normal time to get a visa for Burundi is more than 10 days.  

I met Aimé the following afternoon as he was being prepared for surgery; an active, muscular 9-year-old boy with the worst case of Blount’s disease I’ve ever seen.  As an orthopod who does very little pediatric orthopaedics, I prayed to myself, “God, unless you help me with this one, it won't be pretty.”  As the patient was being wheeled to theatre, I met Aimé’s father, who explained that the meaning of his son’s name was “A Beloved Flower” and that his entire church had been praying and fasting for the success of his surgery since Sunday.  It was clear that this son was truly loved, and that God brought him to this small hospital for a purpose.  I relaxed a little as I realized I had no choice but to somehow let God work through our feeble hands to be an answer to the faithful prayers of so many.  

There are times in the operating room when we can sense the presence of God with us, and this was one of those times.  Fixing Amié's crooked legs required multiple cuts in multiple planes to realign, and then stabilize the bones with wires through the skin – all without the benefit of any intraoperative imaging (no C-ARM available at Kibuye).  But after finishing the case, I was pleasantly surprised at how normal the legs looked.  Ted (World Medical Mission post-resident general surgeon at Kibuye) and I bumped fists as all in the room felt like we were on sacred ground.  We said a prayer of healing and protection for Aimé and wheeled him back to his father.  David (Samaritan’s Purse photographer who snapped all photos) showed him the before and after pictures, and his father said in amazement, “Those are his legs?!”

So many deep and humbling lessons from this story: the power of faithful prayers of a small congregation in rural Africa, the love of a father, God’s help and strength in our absolute weakness.  In the end, I was reminded that there is much going on behind the scenes that is so far beyond us (it’s not about us), but as we make ourselves available to God in our weakness, we see His miracles unfold firsthand, as we become the hands and feet of Christ to one another. Not for our glory, but for His alone!  Please pray for Aimé, that he would heal without complications or infections, that he would walk with perfectly straight legs someday, and realize that he is a Beloved Flower of his Father in Heaven.  

Thanks for all your prayers and support!

The Next Generation

Expansion of PAACS

Last weekend, I attended the annual Pan-African Academy of Christian Surgeons (PAACS) annual meeting in Chicago in my role as the Regional Director for PAACS Orthopaedics. Biggest news is that two additional programs will be joining the PAACS ortho family: (1) Kijabe/CURE (where we currently serve) and (2) Soddo/CURE in Ethiopia. In January 2019, the total number of residents will increase to over 20!

The PAACS Orthopaedic Council sub-meeting...13 US-based surgeons committed to the training and discipleship of national orthopaedic residents in Africa. 

The main PAACS commission meeting had more than 100 people in attendance. 

Tenwek

Tenwek will graduate our first two residents, Dr. Victor Sowayi, and Dr. Fasto Yugusuk in January 2019.  After graduation, Victor will be serving at Litein Hospital, joining three other PAACS General Surgery graduates at this mission hospital about 50 kilometers from Tenwek.  Fasto, who is from South Sudan, will God-willing return to his home after a few years of work or additional training.  Dr. Amada McCoy, who recently completed a pediatric orthopaedic fellowship at Baylor, joined the consultant team at Tenwek last month.

Dr. Amanda McCoy recently joined Tenwek as a long-term, orthopaedic consultant.

Kijabe 

The Kijabe/CURE program was approved to come under the umbrella of PAACS.  Although the residency was started in 2008, the consultants all agreed that PAACS would add tremendous value in terms of spiritual ministry, discipleship and training.  We recently held our residency interviews and have accepted three quality trainees into the program bringing our total number of residents to 10.  Dr. John Weston and his wife Ali, along with their two children, Gabe and Grace, will join Kijabe in late 2019. John is currently a chief resident at Mayo Clinic and has been accepted into Samaritan’s Purse Post-Residency Program.  

Dr. John and Ali Weston, Gabe and Grace will join the Kijabe team in 2019.  

John and I operated on this young man who received a total hip replacement for severe hip dysplasia. 

Kijabe CURE residents at our weekly PAACS spiritual curriculum bible study. 

Ethiopia

The new PAACS orthopaedic training program beginning in Ethiopia in January 2019 will involve two sites: (1) CURE Ethiopia in Addis Ababa and (2) Soddo Christian Hospital in Southern Ethiopia.  Recently, in my role as Regional Director, I visited both hospitals in Ethiopia, and was struck by the complexity of cases, and incredible talent of the surgeons at both sites.

The extreme work of the surgeons at CURE Ethiopia to correct neglected clubfoot.

The drive to Soddo was beautiful, roads flanked by red fields of teff, the grain used to make the Ethiopian staple food injera.

Dr. Duane Anderson (middle), a very gifted orthopaedic surgeon, has been at Soddo since 2005.  Dr. Brian Hodges (back row right) joined Soddo two years ago.  The three guys in the front are orthopaedic residents from Ethiopia and Kenya.

Global Missions Health Conference 2018

On the tail end of my quick trip back to the states, I attended the annual Global Missions Health Conference in Louisville, KY, where I taught a workshop on casting and splinting, and gave a presentation on PAACS orthopaedics to an enthusiastic crowd.  The conference was attended by more than 2500 medical professionals and students and was a impactful time of networking, and encouraging this next generation of young men and women called to serve in medical missions.

Instructing on the application of an RJ splint.

Great hands-on workshop.

Demonstrating how to reduce and splint an ankle fracture with Dr. Dylan Nugent as the "test subject."

A+ splints.

Psalms 71:14-16

As for me, I will always have hope;

I will praise you more and more. 

My mouth will tell of your righteous deeds, 

of your saving acts all day long - 

though I know not how to relate them all. 

I will come and proclaim your mighty acts, Sovereign Lord;

I will proclaim your righteous deeds, yours alone.