Dan, Heather, Jeremiah, Tory, Emma, Tye, Claire, Levi, Josie, Jane and Ethan

Friday, December 28, 2012

New Life: Another “Miracle at Tenwek”

 Jeremiah, age 15.
 Emma, age 13.
 Claire, age 11.
 Levi, age 8.
Chuma, age 1-1/2.

The abbreviated version of the story is this: We are expecting Galat child #5!  For those interested, the extended version (or “the rest of the story”) follows, which includes themes of forgiveness, grace, and second chances. (Note: You may want to read first and “screen” before allowing younger readers to view.)

 Levi, our fourth child, was born in 2004, in the midst of a very busy orthopedic residency at the Mayo Clinic.  A few months after his birth, the chronic exhaustion, stress, financial strain and an element of selfishness caused me to think that perhaps four was enough, and I began to look into more permanent options for “family planning.”  Although Heather was not in full agreement, and my motives were based more on fear (rather than faith in God’s ability to sustain with His unlimited grace), I proceeded with a vasectomy.  However, as time went on, and our stations in life changed, I began to feel a sense of regret at making such a permanent decision.  Additionally, because Heather was not “fully on board” with the initial decision, she carried with her a wound, as this had not been a mutual choice based on prayer and/or a sense of God’s leading, but rather one made out of questionable motives.  As years passed, we both desired to have more children, but were resigned to the fact that this option was no longer a possibility.         

In 2008, prior to leaving for our first stint in Kenya, God began to take me through a refining process (actually, probably better described as a breaking process) as I realized I had a sinful habit-pattern of independent (i.e. God-less and Heather-less) decision-making and that repentance was necessary.  As these various “one-way” decisions were brought to light, I became committed to “making right” these wrongs done towards my God and my wife, and we saw God’s grace pour into our lives as I took these steps of faith.  However, as there was nothing I could do to “make right” the decision to permanently restrict the size of our family, I could only ask Heather for forgiveness, which she freely and graciously gave.     

As a physician, I knew about vasectomy reversals, a microscopic procedure in which the small tubes which were cut during the initial vasectomy are delicately reconnected with suture about the diameter of a hair.  But I thought this was an impossibility, as this surgery is completely elective and entirely expensive (between $5,000 and $20,000).  Additionally, the success rate is not 100%.  Even so, God continued to bring this to my mind, not via guilt, as if I had to pay for my sins by getting a reversal, but rather in a gentle and encouraging way, as if He was saying, “Are you going to trust me?”  So I researched options on-line and even contacted a few places in the U.S.   In August 2009, I was scheduled to travel back to the U.S. for a conference and I thought, “OK, here is my window of opportunity.”  Since Heather had fully forgiven me, she was supportive (yet not requiring).  Thus, we decided to pray (this time together) that if God would work out the fine details, I would have it done while in the U.S. for this conference.   However, the reversal surgeon I had chosen was not available during my “window of opportunity” so I thought to myself, “Good, now I am off the hook” and I put this possibility, with good conscience, to rest.

Shortly after returning from the U.S., I met Dr. Samuel Thompson, a visiting urologist at Tenwek who had come to help with the large numbers of backlogged urology cases.  One Wednesday night, he came to our men’s resident and intern bible study.  Afterwards, I was making conversation with him, and innocently asked, “What is your area of interest in urology?”  His answer almost startled me.  He said, “General urology is what I do, but my real interest is in vasectomy reversals.”  “Really,” I said with a sense of God’s providence at work, and proceeded to tell him a large chunk of our story.  After I finished, he said, “You know, if you could find me an operating microscope, an available operating room, 9-0 suture and microsurgical instruments, I would be more than happy to do this for you right here at Tenwek.”  Suddenly, I was placed back on the hook.  But God, in His mercy, was again overwhelming us, and Heather and I, together, felt like the circumstances were way too specific to not be from God.  So on September 28, 2009, I underwent the first and only vasectomy reversal ever at Tenwek (and perhaps all of Kenya and maybe even East Africa) in an empty operating room in the Eye Ward (which had all the necessary equipment and was providentially closed as the eye team was away for an outreach). 

After three years of waiting without any results (and truthfully, with some disappointment), we thought that perhaps this act was just for the purpose of obedience and faith.  Then, when we least expected it, God shocked us with this news that we are expecting.  We kept it quiet until Christmas Eve, so that we could give the news to our kids as a Christmas present and their total surprise was captured on video (click here to view).  We are thankful to God for this new life, born out of forgiveness, grace and second chances.  And we are so thankful for the ways you have followed our story, supported us with prayer and finances, and simply loved us.  We are imperfect humans just privileged to do our small part in God’s great plan to reconcile us to Himself and to each other.  Please pray with us for the health of this new life, for a safe and healthy pregnancy (Heather is constantly tired and nauseated), and that our family would bring glory to the One who is worthy of our lives.   May God give you strength and blessing in this New Year!

Friday, December 21, 2012

One Life

Yesterday, after a long and tiring day of surgery, I came home to find an email informing me that my brother Mike’s son, Josiah Galat, was found dead with stab wounds outside his campus residence at the University of Toledo.  Shocked by this unexpected news, I grabbed my phone (which displayed several notices of missed calls from my parents) and made calls to my family to try to get more details.  I first spoke with my father, who told me that Josiah called his mom in the final minutes of his life, and then my brother, who was completely exhausted after being up all night, yet reaffirming his faith in Christ and God’s sovereignty.  Last night, sleep was cut short as thoughts and prayers for my brother, his wife and boys flooded my mind.

Today, the work continued at the hospital.  Thankfully, we were able to get four operating rooms, helping to clear some of the patients from the long pre-Christmas queue.  Four new admissions today, however, with more certainly to come.   Tonight, hungry for more information, I found several news articles on the internet which reported that Josiah was involved in an apparent altercation with his roommate that escalated into this tragic event.  The other boy, Erik Littleton, is in the hospital, himself with multiple stab wounds.  Many parts of this story do not make sense to me.   

I spoke with Heather and the kids and we all agreed that, if possible, I should fly back to the states for the funeral, even though it would mean leaving on Christmas day.  As I called Delta, I prayed, asking God to provide a reasonable fare and good itinerary.  For once, Delta was especially kind on the phone and within a few minutes, the ticket was purchased at $1000 less than I was able to find on-line.  So, I will be leaving Christmas evening, and returning to Kenya before the New Year.  God is so good to provide this opportunity to be with my brother and family during this time of grieving. 

As Heather, the kids and I have sat together to process this news, God has opened the doors to some really meaningful conversations.  What we have concluded together as we consider Josiah’s untimely death at age 20, is that we have one life to live which is unpredictable and short, and that Jesus is so worth living this one life for in a radical, “all-in” way.  One day, whether tomorrow, or 70 years from now, we will all stand before our Creator, and give an account for what we did with that one life.    

Please especially keep my brother Mike and his wife Sheila and their other sons (Alex, Mason and Jared) in your prayers.   Please also pray for my travels to the U.S. and that my time with my Galat family, although short, will be very meaningful.   Thank you for your ongoing prayers and support of our family as we continue, in faith, to serve at Tenwek Hospital in Kenya.

Sunday, November 18, 2012

Even in the worst circumstances...

Two weekends ago, I received a call from Seno, the surgical resident on call, who explained that he had admitted a patient with bilateral panga (machete) wounds to both arms.  “It was pretty bad when we washed them in theatre, almost completely amputated on both sides,” he said with less jocularity than is usual for Seno.  Panga wounds from domestic conflicts are, unfortunately, all too common in this part of Kenya, where firearms are illegal, and sharp instruments are usually the weapons of choice.  “We will take him back to theatre on Monday for a second look,” I said.

When patients are attacked with a panga, they usually have tell-tale “defensive” wounds; i.e. cuts on the forearms and hands when the upper extremities are instinctively used to protect the more “necessary” parts of the body, such as the face and chest.   However, when we examined the patient in theatre, I noticed that his wounds were not the characteristic defensive wounds we normally see, but rather higher up at the elbow, entirely identical on both sides, and with multiple skin cuts at the same location.  As the wounds were opened again, Seno’s initial assessment was corroborated.  Indeed, both arms were nearly amputated, but thankfully with the brachial artery and median nerve to both arms spared, which would mean some function if we were able to save the arms from infection or other complications.  As I contemplated the nature of these wounds, trying to think like a medical forensic scientist, I said to the team, “These wounds look more deliberate than normal…let’s investigate further tomorrow during rounds.” 

The next day, I had a meeting to attend, so Dr. Rowe performed morning rounds, and when I reconnected later with him and the team, Glen relayed the patient’s horrific story that he had discovered that morning.  Apparently, the patient was captured by some assailants (the details of course, obscured, as usual), tied at the wrists, and with arms outstretched, had both elbows hacked with a panga, one at a time, in the attempt to cut off  both arms.  “I wonder what he did?” I said out loud as I tried to keep from imagining the sickening events of this scene.  

I noticed that Glen was telling the story with slightly more excitement than I would have expected.  He went on to explain that after the team listened to this patient’s story, he shared with the young man about Jesus, who loved him despite anything he had done or any events that had happened to him.  “The patient gave his life to Christ right then and there,” Glen said with the passion that I so appreciate in him.   The next morning, the patient’s transformation was completely evident, as he was no longer quiet and stoic, but rather smiling, talking with other patients, and exhibiting joy that no solitary human could muster with a story such as his.     

The daily work at Tenwek carries with it a frequent absurdity as we encounter patients with unbelievable stories such as this young man’s.  Just a few days ago, I amputated the arm of an 8 year old boy whose wrist was wrapped so tightly with leather (by a local “bone setter”) that the entire arm became gangrenous.  Yesterday, while in casualty evaluating a patient, the nurses hurriedly rushed a young girl of about 12 on a stretcher into the room for evaluation.  She was covered with dirt, apparently buried alive, and now cold and lifeless.  She was the age of my own daughters.  Another man beat his wife to death before catching himself on fire with diesel fuel.  To be honest, the mixture of emotions that I feel – anger, hopelessness, disbelief, numbness, etc. – when I encounter patients such as these threatens to discourage and/or cause my heart to harden.  But then, God reminds me that even though circumstances may seem senseless, He is in control, blameless, and so able to work all things together for good.  After all, His ways are above our ways, and His thoughts above our thoughts.  So we continue to serve, believing (often despite our feelings) that God is at work all around us here at Tenwek, even in the midst of the worst of circumstances, and that Jesus is the answer to what our hearts truly long for… hope, healing, and forgiveness.     

Thank you for your ongoing support of our family…your prayers truly sustain us in our daily work at Tenwek!                


Saturday, October 13, 2012

Tools for the Toolbox

Patient walking the day after surgery, standing with Dr. Marakalala, orthopedic resident from Botswana training at Tenwek.

Young lady with bilateral femur fractures treated with SIGN nails.

Another patient, up walking the day after surgery.

Happy to have his leg fixed!

Another young man with retrograde SIGN nail.

16 year old boy with Russell-Taylor nail.

X-ray of retrograde SIGN nail.

Femoral Russell-Taylor nail.

Tibial Russell-Taylor nail.

Paul Whiting, orthopedic resident from Tufts, who visited Tenwek in March, presenting our data from Tenwek on open femur and tibia fractures.

Boxes and boxes of Russell-Taylor nails.

All-day job but totally worth it.

"Too-long" nails to be delivered to Cedarville team who will cut nails down to a more useable lengths.

The new orthopedic storeroom is underway! 

One of my most important jobs as a missionary orthopedic surgeon at Tenwek is to ensure that we have all the necessary implants and instruments we need to provide the best possible care for our patients.  Implants and instruments are to an orthopedic surgeon as nails and tools are to a carpenter…without them, our care for the poor here would be extremely rudimentary and subpar.

As the majority of our orthopedic work at Tenwek is trauma-related, we see an exorbitant number of femur and tibia fractures secondary to road traffic accidents.  The “standard of care” for these types of fractures is the intramedullary nail (a long rod placed down the center of the canal, stabilizing the bone while it heals).  At Tenwek, we have two major types of nails: SIGN nails and Russell-Taylor Nails.  Without getting too technical, both of these rods are extremely critical and essential (each with slightly different indications) for treating the numerous femur and tibia fractures we see at Tenwek.

My trip to the States began at the annual SIGN conference, where we presented data from Tenwek on open (bone through skin) tibia and femur fractures treated with the SIGN nail.  Since first introducing these nails to Tenwek in December 2008, just shy of 600 have been performed!  For every SIGN nail done at Tenwek and reported on the on-line database, the SIGN Company replaces these nails at no cost to Tenwek.   Thus, as I left the conference, I carried with me a duffel bag of over 50 lbs of nails and other tools for Tenwek.

After visiting my in-laws and two churches in Phoenix, AZ, I then flew to Indiana to visit our mission agency, WGM, and sort through a massive donation of Russell-Taylor nails provided by Hope Force International.  Donations such as these usually contain a number of “odd” sized nails, either too short or much too long to be used in the majority of patients (unless a dwarf or NBA player).   I segregated two 50 lbs duffel bags of the “choicest” nails (perfect size) for immediate delivery to Tenwek (thanks Todd and Bill!).  Also, I found over 300 nails, size 46cm or above (too long for our patients at Tenwek), which I brought to Dr. Timothy Norman, professor of Biomedical Engineering at Cedarville University in Ohio, who organized a student project to cut and re-machine these nails to more usable lengths.

After several other engagements, including a meeting with the executives of a major orthopedic manufacturing company in Warsaw, IN, I returned to Kenya with 10 checked bags full of orthopedic supplies (which, thankfully, ALL arrived and cleared customs with minimal questions).  And these supplies did not come too soon.  Just last week alone, I personally did 8 Russell-Taylor nails and “team ortho” did another 8 SIGN nails, all in people who would otherwise potentially be permanently lame without these implants.  Instead, these patients were up walking, even the day after surgery, and truly very thankful (see pics). 

These nails provide a significant, yet minority part of our total needs at Tenwek.  And we continue to trust God to provide.   I am humbled by the fact that God is the One who does the work…it seems the harder I personally try, the less fruitful the results.  On the contrary, the more we pray for His provision, the floodgates open.  Thanks again for partnering with us in serving the poor at Tenwek in Christ’s name.  We appreciate your prayers and support!

 Eph 3:20-21 “Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us,  to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen.”

Sunday, October 7, 2012

Eye-Witness to an RTA

While driving back to Tenwek last Friday with Heather and Jeremiah (and two other kids from Tenwek), as I rounded a gentle sloping curve, I saw two odd-shaped objects in the middle of the roadway off in the distance.  Having just returned from a 2-1/2 week, multivariate trip to the U.S. the night before, I was telling Heather all about the events of the journey.  One of the main reasons for the trip was to present data collected at Tenwek related to the huge rise in orthopedic injuries in developing countries secondary to road traffic accidents (RTA).  Ironically, we were about to witness a tragic, first-hand example of this growing problem.

As we drew closer, it became apparent that the two objects lying in the road were a motorcycle and a man, and we were the first ones on the scene.  Pulling off to the left, I assigned Jeremiah, Joel and David to get the motorcycle off the roadway, while I attended to the obviously-injured, middle-aged man who was lying on his side, dazed, with blood pouring from lacerations on his face and scalp.  Normally, in trauma situations such as this, victims are not to be moved until the cervical spine is stabilized with a C-collar.  However, I was worried that as long as we were in the middle of the road, we were both at risk for being struck by a speeding over-loaded passenger van or semi.  So, after running my fingers down his spine without feeling any obvious abnormality, I grabbed the man by his shoulders and dragged him off the road.  As I was pulling, I could feel crepitus (bones moving) in his right shoulder.  

With the motorcycle and victim now off the road, I could examine him more closely, and confirmed the lacerations, and shoulder fracture, and a potential fracture of his right hip (as his leg was externally rotated and he was not able to stand).  Thankfully, it did not appear that he had any immediate, life-threatening injuries.   Trying to use my newly-acquired (but still inadequate) Kiswahili, I asked the man, now a little more lucid, his name, where he was from, and what had happened.  “I was struck while driving my motorcycle and the car just drove away,” he said, the same hit-and-run story I hear so often.    

Without Emergency Medical Services in Kenya, the next concern was getting this man to Tenwek, which was about 50 km away.  A newly arrived onlooker hailed a passing sedan-car taxi, which stopped to see how he could help.  “How much to take this man to Tenwek,” I asked, thinking that perhaps the driver would not take advantage of the situation.  “Yes, please take me to Tenwek,” the victim said.  “My home is only a short distance from there.”   The quoted price, I thought, was bordering on opportunism.   While others helped the victim into the taxi, I reached into my pocket and gave the driver what I had available, and asked him to please help his fellow brother by driving him to Tenwek.  A few minutes later, they were off.

As I got back into our Land Rover, I noticed the blood on my hands, wondered if I would be seeing this man at Tenwek on Monday, and puzzled at the irony, absurdity and seeming senselessness of this event.  A while later, back on the road to Tenwek, Heather said, “I liked seeing you in action…God planned to have you be the first one on the scene.”  Her words took the edge off some of my raw emotions, and reminded me that the events in life, although at times tragic, are not random, or without purpose.  God is in control.  I was also reminded of the reasons we continue to serve at Tenwek...the need is so great. 

Thank you for partnering with us in this work at Tenwek, so that we can continue to provide “compassionate healthcare, spiritual ministry and training for service.”  We appreciate your prayers and support!

Sunday, September 2, 2012

Technology in Rural Kenya

Jeremiah and his Dad in front of the newly arrived C-ARM crate - weighing in at nearly a ton.  Jeremiah is now officially a few millimeters taller than me (and a full 20 lbs heavier).  I fear that soon, I will no longer be able to "take him."

Wheeling the C-ARM into operating room #4 for the "first case," a 40 year old man with a displaced femoral neck fracture that Dr. Rowe fixed with cannulated screws. 

Benard, our excellent IT guy at Tenwek after just setting up the new computer in our orthopedic threatre room.  I spend part of my weekend on call installing the wall-mount system. 

The Galat family is currently in an extended season of visits from friends and family from the States, and we are loving it!  Just recently, Sonny Sazdanof (a chiropractor from Arizona) and his wife Esther, visited for two weeks along with Heather’s parents, Steve and Jill Kinkel.  During the usual tour of the hospital we give to visitors when they first arrive at Tenwek, as I was showing Sonny our facilities, he turned to me and said, “I had no idea.”
Like Sonny, I am sure most people imagine the practice of orthopedic surgery at a mission hospital in rural Kenya as extremely rudimentary, with inadequate facilities and equipment, and, at best, outdated methods of fracture care.  And although we are still not at the level of the typical hospital in the U.S., our technology continues to increase in way that surprises even me.
When I returned to Kenya a year ago, our PACS (computerized x-ray) system was in place and I was overjoyed at the thought of never having to search for a hard-copy x-ray again.  And now, through the donation of a faithful supporter and a company in California, we even have wall-mounted computers displaying digital x-rays in our orthopedic operating rooms (it feels a little like I am back at Mayo!).  Additionally, we just received our newly donated C-ARM which will allow us to perform cases requiring intraoperative imaging simultaneously.  An EMR (electronic medical record) system is even in the works for the very near future.
The reality is, however, that we are still a mission hospital in rural Kenya, struggling to keep adequate supplies to care for the relentless needs that present to our doors daily.  The orthopedic service alone currently has over 40 patients, and in going through the list tonight, we have 17 in the queue needing urgent surgery.  Although we may have the technology, sometimes we lack the trauma implants to even do the work.   But we continue to trust God to provide for all our needs, as He knows them even better than I do.  Just recently, I received an email from a supporter in the States saying that he had received a donation of 5 pallets (!) of orthopedic nails (the same nails we use regularly here at Tenwek for femur and tibia fractures) and he wanted to give them all to us!   
The underlying truth that keeps us persevering is the fact that Tenwek is God’s work…a not-so-small mission hospital in rural Kenya that He is using to glorify His Name.  And that is our underlying purpose for being here…to tell every one of the Hope and Healing that they can have in Jesus’ name.  Thank you for partnering with us!  We appreciate your prayers and support! 

Sunday, July 29, 2012

A New Leg for Washington

Nick, our Kenyan prosthetist, and Allen Dolberry worked together to build 15 prosthetic legs during Allen's 4th visit to Tenwek. 

Washington (with his father) testing out his leg for the first time...although somewhat unsure at first, with a little practice, and with the quality construction of this leg, he should do very well.  Thanks Children’s Health Care of Atlanta.

Washington's dad told me he (Washington) considers me his "mzungu" dad (mzungu being a Kiswahili term for "white")!

Last year, a young boy named Washington suffered a tragic injury which eventually required an above the knee amputation (see previous story entitled “A Father’s Heart”).  After Dr. Tim Oswald (a pediatric orthopedic surgeon who served at Tenwek in 2009 as a short term missionary) read the story, he engaged a colleague at Children’s Health Care of Atlanta, who volunteered to fashion a new prosthetic leg for Washington.  Solomon, our head physiotherapist and Nick, our new Kenyan prosthetist made a plaster mold of the stump, which was then sent to Atlanta via a returning visitor to the States.
The leg was completed and sent with another visitor back to Tenwek last month.  However, the leg was received by some unknown person, and (un)fortunately placed in a very safe, but very obscure closet in the back of the orthopedic ward, perfectly hidden from anyone who would ever want to find it.  God works all things together for good, however, because Allen Dolberry, a prosthetist from Phoenix, was at Tenwek for his 4th visit, and Washington was scheduled for an appointment to see him.  We confirmed that the leg had indeed been brought to Tenwek, and a short search located the prize. 

Washington now has his new leg, thanks to many people all working together to make it happen. Tenwek is one of the few (if not, the only) mission hospital(s) in Africa with a functioning prosthetics and orthotics department.  Allen and his family plan to return to Tenwek for an entire year in 2014 to complete the development of the program with the goal of making it entirely self-sustaining, so that patients like Washington can continue to find hope that ultimately comes through knowing Jesus Christ!   
Thanks for your continued prayers and support for our family and the work being done at Tenwek! 
"Therefore, strengthen your feeble arms and weak knees. "Make level paths for your feet," so that the lame may not be disabled, but rather healed."
Heb. 12:12-13

Friday, July 6, 2012

GSWs, Comfort and Doing the Right Thing

External fixator placed on the left leg helps keep leg aligned while the soft tissue and shattered bone heal. 

We were amazed at how well the bones were aligned despite not using C-ARM or x-ray in the operating room to assist.  Evidence that God was in control of this case.

The right leg fracture was not as severe, but the soft tissue injury was more extensive.  We were able to use a cast to hold this fracture in place.

Last Saturday evening, Heather and I had just settled down in front of a perfect fire, prepared for a quiet evening at home after a long week of intensive language studies and surgery, when my pager went off.  I had almost forgotten I was on-call, and while walking to the phone, I determined to dispatch of this call quickly so that I might return to my respite.  The general surgery resident efficiently rattled off three cases that had already been handled by the on-call team.  A distal radius fracture had been reduced, a closed femur fracture had been admitted, and even an open tibia fracture, secondary to a boda-boda (motorcycle taxi) accident, had already gone to theatre and been “washed out.” 

“I love having good residents on call,” I thought to myself, assuming the resumption of my evening of comfort was imminent.  Then came the pièce de résistance, a universal phenomenon in which residents always “save the best for last.”  “One last patient I want to run by you,” said Liz.  “Go ahead,” I said slowly, trying to hide my reluctance, instinctively knowing what was coming.  “It is an 18 year old boy with gunshot wounds to both legs, with bilateral open tibia fractures.”  Gunshot wounds (GSW as they are called by trauma surgeons) can be very challenging injuries with significant soft tissue loss and shattered bones.  “The patient was already ‘washed out’ at another hospital in Kisii, but we are wondering if he needs to go back to surgery again tonight,” she said, as if almost curious to see what I would say.  For a moment, I almost caved and pushed the case until the next day.  But knowing the poor quality of treatment at certain other hospitals, and not wanting to dump more work on the already over-worked Dr. Rowe, I said “we better take him back tonight.”

It was almost midnight as I left my warm house into the chilly night, being technically “winter” here at Tenwek, a few clicks south the equator, with lows at night in the mid 40s.  While walking up to the hospital, I passed the night watchman who was bundled in a bonafide winter coat, replete with a fur-lined hood.  (I have seen toddlers here dressed in snow suits on 75 degree, perfectly sunny days, reinforcing the concept that “cold” is definitely a relative term).  “I must be becoming more Kenyan,” I thought to myself as a chill ran down my spine, forgetting what “cold” really is having spent five long winters in Minnesota during residency.  When I arrived in theatre, Liz told me the rest of the story.  “Apparently, some thugs broke into the boy’s family home and were slashing his father with a panga (machete).  While trying to protect his father, the boy was shot with a single bullet that passed through both legs, shattering both tibiae,” she said.  “Then the thugs ran.”  She continued, “He was taken to a small hospital in Kisii where both legs were “washed out” in theatre and splinted; he was then transferred to Tenwek for definitive care.”

 After the spinal anesthetic was given, we removed the make-shift splints which were placed at the other hospital, and discovered that both legs were still dirty, indicating that a good I&D had not truly been performed, and wounds hastily stitched with thick, braided suture.  The first task was to thoroughly wash both legs, which was no easy task for only two people (thus prompting a call for chief resident reinforcement).  After a full “prep and drape,” we extended the incisions on both legs, washed the wounds with several liters of normal saline, debrided the dead muscle and tissue, placed a fixator on the left leg, lined up the fractures as best as we could without C-ARM, miraculously closed all wounds with minimal tension, and placed a plaster splint on the right leg, all of which took a little over two hours.  It was one of those cases where we all felt Christ directing our hands, and sovereignly blessing the work.   As I walked home, passed the bundled guard, and entered my still-warm home, I thanked God for giving me the grace and strength to do the right thing for this young man, and set the right example for the residents and staff, despite my strong, fleshly, continuous, selfish desire to remain comfortable.    

This past week, I returned to language study, and today, went to the ward to check on this patient, only to discover that he had already been discharged from the hospital!  Please pray for God’s complete healing in this young man’s life: spiritually, mentally, emotionally and physically.  Thanks for all your prayers and support without which, the work here would be impossible! 

Col. 3:23-4 Whatever you do, work at it with all your heart, as working for the Lord, not for men, since you know that you will receive an inheritance from the Lord as a reward. It is the Lord Christ you are serving.

Saturday, June 16, 2012


(Story told with permission from patient).

Whilst walking home from language class (our family has been engaged in full-time language study learning Kiswahili, one of the two official languages of Kenya, in an attempt to master a language that some call “easy” but which, [being over the age of 40], I call challenging, especially since in Kiswahili there are 8 nouns classes, each with their own “agreements” for corresponding verbs, adjectives, adverbs, linking words, etc.), I heard a voice call out my name: "Daktari Kalad!" (in the local Kipsigis language, the letter G is pronounced with a K, and the letter T with a D).  Quite tired and not too excited to engage in another lengthy conversation in which I attempt to use a little Kiswahili and the other speaker some broken English, I slowly turned wondering who I might encounter.  I saw a vaguely familiar, middle-aged woman who walked toward me with a slight right-sided limp.  “Do you remember me?” she said with a thick, local-vernacular accent.  Trying to buy some time while jogging my memory, yet being savvy enough to use a little deductive reasoning (i.e. noticing her limp), I said, “Yes, you were one of my patients, right?”  A big smile appeared on her face, and as she reminded me of her story, the memory of her accident slowly returned.
In December 2009, while returning with family members from a wedding in western Kenya, just a few days before Christmas, the matatu she was riding in, stuffed with 17 people, lost control, veered off the road, and rolled several times.  One family member died instantly, and several were injured badly, including Amy, who fractured her left femur and right hip.  The injured were taken to Tenwek and Amy underwent nailing of her left femur and ORIF of the right hip the day before Christmas.  Although she was in the hospital for several weeks after her surgery, like so many of our patients, at discharge, she disappeared, falling into the deep abyss that I call “lost to follow-up.”  Now, a little over two years from her injuries, she “reappears,” walking, looking healthy, and now very happy.  “May I come for a visit?” she asked without hesitation.  “You are welcome,” I responded, a little hesitant at what such a visit might bring, yet at the same time sensing God might have something in store.
 A few days later, Amy appeared at the worst time, as I had several workers at our house fixing problems related to electricity and the strong shocks we were receiving while washing dishes (?).   “Can you come back another time?” I asked, probably with a slight look of frustration related to the seemingly endless issues that accompany living in an old house.  “I will come back” she said without the least amount of disappointment, and limped off.  Two days later, she returned, this time with her youngest son, and since I now had time to sit and listen, she told me the rest of the story.  Amy is a tailor by trade, and her husband John had been a pastor with the local Africa Gospel Church.  For several years, they lived on a combined income of only 2000 Kenyan Shillings a month (about $30).  After her accident in 2009, hospital bills, combined with Amy's inability to work, pushed their family into deeper poverty.  To make matters worse, in January 2012, John lost his job pastoring his small church as the members were longer able to pay his salary, and, as a result, also had to drop out of bible school, being only one year from finishing.  What little they did have they were using to buy food. 
As we regularly have people stop by our house asking for food, school fees, and various other sorts of assistance, I was waiting for Amy to “drop the bomb” and ask for money.  However, she did not, and only said that she wanted to stop by to thank me personally for allowing God to use my hands to help her, and to simply ask for prayer.  I happy obliged, and while praying for God’s provision for this family, I felt that perhaps God was asking me to do more than just be her surgeon.  However, I have learned to be more cautious over the years (having been burnt several times) and first thought I should enquire into their situation with the local church to see is their need was truly legitimate.  After asking both pastors at our church about this young couple, they responded by saying, “Daktari, they have true need…if you can help them, please do.”
Long story short, our mission agency is allowing us to use funds from our Galat ministry account to provide the remainder of John’s tuition to finish his degree.  Our hope is that John and Amy will be able to continue in ministry, full-time, proclaiming to others all that God has done for them.  And we are privileged to be a part of their lives, as their story has returned to us, now full-circle after that initial meeting over two years ago in the Tenwek Casualty.  Thank you for partnering with us in this ministry that allows us to help patients like Amy and her family.  We appreciate your prayers and support!

Proverbs 22:2 Rich and poor have this in common: The Lord is the Maker of them all.

Friday, May 4, 2012

God is Able!

The Boy Can Run!
Paul Whiting, stellar orthopedic resident from Boston who rotated at Tenwek in March 2012, visited the home of Kipkoech, the boy with bilateral femur fractures and an open tibia fracture who was treated at Tenwek last November (for previous blog story, click Here).  Paul caught video of Kipkoech running just 4 months after his surgeries!  During the most recent follow-up visit, Susan, Kipkoech’s mother, told us that she did not believe that her boy would ever walk again (let alone run) and as a result of God’s healing work in her son’s life, she placed her faith in Christ and is now meeting weekly with Lori Rowe (Dr. Glen Rowe’s wife) to read and study the bible!

Claire’s Baptism

Our family recently returned from the Coast where we attended the annual WGM retreat.  We had a very refreshing time of rest, fun and spiritual growth…definite highlight for me was baptizing Claire in the Indian Ocean! 
Donated C-ARM on the Way!
Chicago C-ARMS, the company from which we purchased our latest C-ARM in 2010, is donating a second, newly refurbished C-ARM (same model) to Tenwek completely free of charge!  The owner relayed to me that his company was greatly struggling last year (as so many have been in the US).   He is a believer and regularly attends Willow Creek Church.  One Sunday, he was greatly impacted by a sermon his pastor, Bill Hybels, gave on tithing, biblical truths about managing money, and trusting God.  He felt God calling him to step out in faith BEFORE seeing God’s provision and committed the donation of this unit to Tenwek.  In the next two weeks after his email to me about this commitment, his company sold 4 additional units!  God delights in our simple faith!  The C-ARM is about ready to roll, but we are now trusting God to provide the finances to air freight the unit to Kenya.

Electronic X-rays for Theatre

Examples of the high quality x-rays now capable with our digital x-ray system at Tenwek.
When I returned to Tenwek last summer, I was surprised to find that we had transitioned to electronic x-ray viewing throughout Tenwek!  I was very skeptical at first, but this has turned out to be a HUGE blessing for us (e.g. no more hunting for lost x-rays AND image quality had increased exponentially).  Since we no longer print hardcopy x-rays, it is critical for our operating rooms to have computers with monitors in each room (especially for orthopedics).  Perhaps you would join Chicago C-ARMS by stepping out in faith to help us meet these two needs.  If so, send me an email (dgalat@gmail.com) and we can talk.  God is able!

Saturday, March 31, 2012

The Battle for Our Youth

Sunset over the Mara...view from Olderkesi.

The crew...

Pancakes and popcorn for breakfast...

Landcruiser races...only in Africa.

Not sure what this one was called, but the kids loved it.

Preparing for the hunt.

The result of the hunt.

More results...


The boys did a good job of slaughtering the goat (quicky and humanely for the PETA folks).

After the skinning...

Peter and the kidney...not fully sure he actually wants to do it.

The girls hovering over the chargrilled goat. Let's just say this goat was not the most tender specimen, although it tasted good...

Best part of the weekend...building relationships.

And time alone to learn and be with God.

Missionaries often carry varying responsibilities, one of our favorites being the MK (missionary kid) youth coordinators for our sending agency, World Gospel Mission (WGM) Kenya. So, this past weekend, Heather and I, along with fellow missionaries and friends Dino and Janice Crognale, Beth White, and Vera Steury took our junior high and high school MKs on a youth retreat to Olderkesi, a WGM development project in the heart of Maasai Land.

Significant events included a traditional Kenyan goat roast (Mbuzi Choma - chargrilled goat) which the kids themselves slaughtered, butchered and then heartily consumed. Peter White thoroughly impressed all by eating a raw kidney plucked directly from the freshly dispatched goat (although likely spurred on by the small wager I offered him to do so). Because the area around Olderkesi is known to have lions, leopards, Cape buffalo and more, later that same afternoon, the entire tribe went out hunting. Although nothing of significance was seen or bagged, the majority of the boys came back with long, sharp thorns piercing their ear lobes in classic Maasai fashion. Jeremiah unfortunately (“accidentally”) broke off the entire tip of a thorn in his ear lobe and is unable to retrieve it (what next?). Nighttime consisted of campfires, laughter, and general lack of sleep.

Although much fun was had, the focus of the retreat was definitely spiritual in nature. We led the kids through an incredible study in 2 Peter entitled “In the Last Days” which challenged us all to live with watchfulness, purpose, and passion, as our time on earth is short. I am humbled as I imagine what God is going to do with this bunch of regular, yet privileged kids in the future. At the same time, I realize that they are targeted by an enemy who employs false teachers and ideologies with the goal of leading them astray. For now, we were glad to be fighting with them this weekend and trust that God has given them “everything they need for life and godliness.” All our kids, whether here in Kenya, or in the U.S., are in a battle, and we need to fight with them and pray for them continually.

Thanks for all your prayers and support for us here in Kenya. Let's pray for our kids, that God would protect them, grow them, and ultimately raise them up as laborers in His kingdom, for His glory.

2 Peter 1:3: His divine power has given us everything we need for life and godliness through our knowledge of him who called us by his own glory and goodness.