Tenwek, Final Photos

 As you approach the hospital, the sign declares their motto, "We Treat, Jesus Heals" Their everyday words and actions declare their belief in this statement. Above is the main entrance to Casualty, aka ER, with seven beds 2 feet apart. This is the regional trauma center and it can be like nothing you have ever seen.

 The facility consists of a number of building constructed over the last 60 years, connected by outside awnings. Here are two of the newest. In the foreground is the CT scan which opened last year. Behind it is the new Theatre (aka operating rooms). There are five which opened in 2005. The second floor is a small library and conference rooms. The larger, circular building is a large amphitheater opened at the same time and underused. With the new training programs, it was hoped this would be a center for regional medical conferences. That has not come to fruition yet.

 The Guest House for visiting staff and students. There are about a dozen rooms and apartments. Cost is $22/day including three meals. How's that for a deal. You can make out the banners on the railing. Almost all ACC and SEC schools represented. Mike, there's a big "O" with a reddish background. Didn't know if it was Ohio State or Oklahoma.

 Someone was planning my arrival, just outside my door was a homecoming greeting.

Home. Interior of my room complete with mosquito nets. Simple but clean and comfortable.

 If you were at the fountain at the CT courtyard and looked down (about 30 degree incline)  you would see the chapel. These steep sidewalks are filled with patients including those on stretchers being wheeled to x-ray, the GI lab or surgery

 This is the GI lab converted from one of the two operating rooms they had from 1985-2005. I'll share details at a meeting with MGG. Probably the second Fri at noon before we restart the noon CME conference.

 I could share a number of stories about missionaries. This is Barbara Pinkley who came to Africa as a young, single, community health nurse and midwife over 30 years ago. She help establish the nursing school at Tenwek 25 yrs ago. There are now about 24 students/year. The total cost of the 3 1/2 yr program is $7000 including room and board. All graduates are committed to work at Tenwek for, I think, 3 years upon graduation. Because they are so well trained they often go to higher paying jobs after their obligation is completed. At Tenwek, nurses start at about $210/mo and max at about $350/mo. For comparison, general workers make about $60-100/mo.
As always, the goal is to train nationals to assume responsibility. They are essentially there. The school recently hired it's first national principal, one of its own graduates and Barbara is the last missionary on the faculty.

 The new nursing school building was opened in 2000. It has a bigger library than the hospital and it is the cleanest and most well kept facility (with maybe the exception of the hydroelectric plant which I'll tell you about later). What else would you expect from nurses, right? Got to love them!
Below is some of the landscaping. They hired their own team, separate from the hospital. An oasis.

 Above is the GI lab team, photo randomly out of order. There is one RN, Mark, second from left- tallest, thinnest, sweetest among this precious group. Kenyans are a gentle, soft-spoken people. Between that and their unique accent (when they're speaking English and not Swahili or Kipsigee) focus is required.
Man in the sport coat is the chaplain who led devos on Fri morning and met with patients with particular spiritual needs.

 There is a street that stretches about 90 degrees around the parameter of the compound on which you can find all the conveniences of home. Above, Macy's

 Kroger

 The butcher shop.

 There are several events orchestrated by God which had a major impact on the growth of this ministry. The first was a visit by Franklin Graham in 1987 as the head of World Medical Missions. The book tells how that occurred and the impact it has made. There's funny story of the first meeting of Dr. Steury and Franklin Graham who was then a fairly young man. Dr Steury relayed the story of the financial and staffing struggles  of the previous 30 years and the needs to make the mission flourish. Then when Mr. Graham responded, suggesting he could help in a major way, Dr. Steury- so involved in Africa that he had no idea who Franklin Graham was- asked an associate why this young man was so confident!
The next big event was the completion of this dam and hydroelectric power plant in 1987, giving the hospital reliable power for the first time. Prior to that, there was unreliable power for about 7 hrs/day, often needing to be supplemented by generators (the only source of power for many years). Now, it's like the west with electric almost all the time. If there's drought, they have to use the local power at ~ $30,000/month and still unreliable. A second turbine has been ordered and will be running within a year, making them power independent expect during the worst drought.

This is about 200-300 yds from my room and you can hear the waterfall in the still of the night from the balcony.  

 Rapids downstream. Muddy river used for drinking (after much filtration and UV if for drinking), laundry and local bathing on Sat whether you need it or not

 Kids everywhere. In uniform, private schools which abound, used by all who can afford them. Public education approved for everyone about 6 years ago to 8th grade- if available, so not guaranteed. Much overcrowding. Students are committed. No school on Sat and Sun but frequently find them there being tutored by upper classmates.

 Three children approached me with, "Pay for photo?" My response of  "No, this is to show my friends in America how precious you are" resulted in this crowd of responders. 

 The Sat. after I arrived, a group of us hiked a couple of miles and 1500 ft (to nearly 8000 ft) to Motigo. We passed a number of kids along the way with the ubiquitous, "Give me sweets". No "please" or "thank you" when I gave them some of the soft peppermint balls I had specifically brought for them. Lots of grabbing. Well, Captain Cattau saw an opportunity for a little, very little, lesson on discipline.  So, after we got about a dozen following us, I told them there would be no more candy until we got to the top of the hill and only for those who could follow instructions. So, there they were, at the top of the hill, in a straight line, hands out, quietly waiting their turns. These guys are fast studies.

 Unfortunately, this was an very overcast day. I should have made the effort to go up again or know how to use the camera. But, this what I got. Half way up, I took this picture of the Tenwek compound.

 From the top there was a 360 panorama of this beautiful farmland with crops planted on pretty steep inclines with no terracing.

Well, midnight and not a single call from the hospital yet. Another kindness so I could get this out.

I've had to gently correct my Kenyan brothers and sisters when they thank me for the "sacrifice" of being here. During the time God has given me, I've use the talents He has granted me, supported by a wife and resources with which He has blessed me. All that I might have the privilege of being obedient to His call and being used by Him, all for His glory. This was no sacrifice. This was another of God's unending kindnesses, an incredible blessing on several levels.

I hope to have the joy of sharing more with those who are interested in what God is doing in the world. I'm particularly excited for those of you who are medical specialists who have not found a missions venue that fits your medical skill set. This may be just the opportunity for which you have been praying.

Again, thanks for your prayers. 

Thankful to be, In His Grip.
Blessed to be, Yours and His.

Ed Cattau

Coming home- last photos to follow

Dear All,

First, thanks to those who have followed along and, more importantly, prayed. This has been a powerfully impacting 30 days and I have been touched by your words of encouragement, directed by your Scripture references and lifted by your prayers. I am indebted to you all.

This week has been the busiest and had to the potential to be brutal. But, by His grace and kindness of His people, it has worked out well. I mentioned previously general medicine night call is when I am at greatest risk to be stretched physically and where I am least prepared medically. I was only assigned 5 nights the whole month. But, because of how they were scheduled and my need to trade a date so I could leave tomorrow, 4 of those 5 nights were during the last 8 days including Thu and Fri of this week. Well, one of the national docs mentioned on Tue she had a light call schedule so would be glad to take my Thu call. Well, because of a combination of macho and a realization part of the reason I was here was to allow the nationals and missionaries a little break from their usual schedule, I politely declined her offer. Then came Thursday. At 6:30 PM while eating dinner, I got a call about the first medicine admission- 43 yo female, newly diagnosed HIV, now with miliary tuberculosis and acute meningitis- and there's no Infectious Disease doc to call, you're it here! I gave the intern some preliminary orders and said I'd be right there. but, before I could leave the building, I got a call from Dr. Matilda saying she was just happened to be in Casualty (ER) and heard about this patient. Since she was there, is the ward attending and would be assuming responsibility for the patient in the morning, she said she would take care of the admission. And, she noted I not only had three calls this week but there were two in a row and she absolutely could not allow me to do that. She insisted she take call for me that night. Deny a gracious request like that twice? I may be proud but I'm no fool.

That allowed me to pack and get a good night's sleep last night. I'm on call now but even if we get busy, I'm packed and I'll have the long car ride tomorrow to Nairobi and an even longer flight leaving tomorrow night to rest up. God through His people help those who need help! What a sweet kindness to end my time here.

Let me go  back and show you some pictures of Tenwek. If any of you have an interest in reading about modern missionaries and some of the miracles God continues to perform, I encourage you to read, Miracle at Tenwek, by Gregg Lewis. It's the story of how this missionary outpost began a clinic with nurses in the 1930's finally recruiting it's first physician, Dr. Ernie Steury, in 1959. The book is primarily about Dr. Steury and how he and others by God grace have transformed this into the premier mission hospital in Kenya and among the best in Africa. Dr. Steury was the only doctor for 10 years, then one of two for an additional 10 years. With only an internship for post doc training and no surgical residency, he learned how to deliver an amazing spectrum of services, including brain surgery! It's an incredible story of faith, perserverence, hard work and, most clearly, the providence of God. A great read. I'll put my copy in the GEC library next week.

The missionary docs here are also phenomeonal. Russ White, fully trained chest surgeon does it all. Removed a brain tumor yesterday. Their families are equally impressive. Lots of stories to share.

But, before it gets too late and/or I get called to go to Casualty or Theatre (O.R. where they do endoscopy at night) let me get some photos up for you. Because of slow internet, may finish in AM but will get them out before I leave in the morning.

Whoops, just realized I signed on with wrong browser and can't get pictures.
Let me post this and change over to post pix.

Love ya',
Ed

On My Own; Safari #2

Well, this was a uniquely fun day. Lando, the GI fellow, is still on a mission trip and Jack, the surgery resident rotating on the endoscopy service, took a vacation day. That left me to do the procedures myself. We usually do 5 procedures before lunch, sometimes going into the lunch hour (yes, hour) to get them done. Well, we did 6 of the 7 scheduled procedures and I saw 4 patients in clinic before lunch and still had time to do the last one but the GI lab staff wouldn't hear of it. Now, that is what I call MGG efficiency!

The charge nurse is on annual leave so the staff took advantage of it. I went to see two hospital consults and told them I would make a decision about the need to do procedures by 4 PM (regular hours are until 5). I got back (fortunately to tell them we didn't need to do anything) at 3:45 to find the lights out and doors locked!

I took advantage of the free time to start this entry early rather than late at night in anticipation of being on call for medicine tonight. As I think I mentioned, this is the part of this assignment which really has the potential to stretch me big time from a medical standpoint since I don't do general medicine, they have diseases with which I'm not familiar and they have lots of sick, and I mean sick, folks with limited resources.  I'm only on call 5 nights the entire month but, as it works out, 4 of them are over the next 8 days beginning tonight. So, I would ask for focused prayer that I am able to be of help to those He puts in my path. Another example of Him putting us in positions where we cannot avoid acknowledging His sovereign control. I feel like such a weenie after hearing the stories of not only the early pioneer medical missionaries but of the current staff and the things they are able to accomplish with the facilities they have. I'll share some of that next week.

But now, to part two of the safari!

After about 9 hrs in a vehicle including travel time to the savannah, we arrived at our camp. This is the reception area where we were met with cold towels and juice.

After walking through a small hut which houses a gift shop and a business office, you come to the main lodge. As you'll see, the landscaping plan is to keep things as natural as possible. There are no fences to keep the animals out. In fact, I think I mentioned the owner showed us were the elephants had chomped on trees in this area the previous week.

 Off to the right was the dining area. Three great meals per day.

Off to the left was a lounge, bar and fireplace. Straight out between them was a large deck.

This is a view from that deck showing the section of river which as been dammed to give a permanent body of water used by, among other creatures, about 30 hippos. For size comparison, there are two on the water near the left bank at mid distance and several on the bank just to the left of them.

Here's a closer view of our pets. You probably know more people are killed by hippos than lions or elephants.

 Here's our hut and the path leading to it which is simply a strip of grass cut to allow passage. You can see our nearest neighbor to the left, lots of untouched space.

 A view from our deck. From here we could watch a host of the animals we saw on safari.

The interior was a single open space with a half wall separating the bathroom which had a tub and shower looking out the back of the hut. Designed to look like a tent, it was constructed of a lime based material without cement to be more environmentally friendly. Just quoting, don't know the details.

Enough of the accommodations,  let's get back to the animals you came to see.

 This is not your Indian domesticated water buffalo. These guys are aggressive.

 Lots of giraffes in groups of 3-10

 We saw two, single males about 50 yds away but were not able to get close to a herd of about a dozen we saw in the distance at another location.

T

 The only lions we saw were a pair of young males lying under brush to keep cool. This shot was taken from about 20 feet in an open vehicle. Nice kitty!

 Man and beast living side-by-side. The Masai people are semi-nomadic, building corrals out of branches of trees to house their cows at night, grazing their animals with the wild life by day. Lions are still a threat; they appear to prefer cows ?easier to catch. There was a report two cows were killed in another area on this day. The government pays the Masai $300/cow lost to prevent the Masai from seeking revenge and killing the cats.

 Here's a hippo forging the Mara River, the main body of water from which the park gets its name.

 Hippos are like alligators in FL, they can be found anywhere there's water. This is a pond we estimated to be less than an acre in size where we counted 17 hippos. The pond is covered with a green water plant.

 Crocs in the banks of the Mara.

 The Mara R. The crocs on are the near left bank for size comparison.

 One of the few hyenas we saw. Always running. We elected them least favorite animal seen. Obviously, we didn't see any snakes who clearly would have walked away with prize.

A troop of baboons. Aggressive so not approached. This was from about 100 yds.

 Some of the birds of Kenya, for which none I know names. There were lots more but moving too fast. Kenya has the second largest number of bird species of all the countries of Africa.

 Along the Mara.

 Big enough to take down a young Thompson's gazelle

Also saw what appeared to be a type of guinea fowl, doves, swallows, quail.

That's it for the safari. In the next couple of days I'll show you around Tenwek then share some stories of the folks I've met here.

Thanks again for caring and for your prayers. They have been a great source of encouragement and comfort to me. 

Blessed to be,
Yours and His,
Ed

Let's go on Safari (Africa, not Apple)

Jumbo,

Ain't technology grand- if you know how to use it or someone who does? Tom, the IT wiz at our office just loaded another browser on my laptop remotely and it looks like I'm in business.

Less talk, more photos today

The first hour was on the two lane, paved road I traveled from Nairobi. Here's a view of market day at one of the small towns we passed through.

We turned off the main road at a small town with this central shopping area, including the Seven Star Hotel.

The next two hours (45 km) were on a dirt road that here, entering the savannah, was pretty good.

Except for the steep ravines,

a few domestic obstacles, and the washed out segments (and this is the dry season, when it only rains hard 1-2/52- the way they write 1-2 times a week)

We passed some villages along the way. This shows typical construction of mud brick wall and two of three typical roofs, tin and thatched. The third, more common in the Maasai communities were constructed with cow dung.

We finally came to the meeting place to catch our ride with the camp guide. While waiting for him, we made friends with this group. Kenyans are a friendly, soft-spoken. The children are particularly friendly love to have their pictures taken. The only thing keeping them from constantly running (getting ready for the Olympics) was this photo request. Both boys and girls shave their heads until age 18, most men continue to do so.

 Simon, our driver, picked us up about noon on Sat. and was our personal guide until noon on Mon. His English is very poor and the answer to most questions was "Yes" even when completely inappropriate. But, he has a keen eye, knows his plants and animals and was most attentive. The owner made a point of saying he intentionally hired locals to help them advance rather than the more formally educated guides from the cities.

We had a five hour tour on our way to the camp. We stopped for a picnic lunch under the shade of an acacia tree.

This was one of a herd of about 15 zebras who came within 100 feet while we ate lunch.

Let me say now there is no way I could get pictures that do justice to the experience. The plains are enormous, stretching as far the eye could see. And, while there were times we could see no animals, there were places were we could watch over 300 at time. This shows maybe 20-30 in a small part of a 360 degree panorama.

Another angle, with some telephoto of Thompson's gazelle and impala. You may note how many of the species mingle while grazing.

Mix of animals again.

Wildebeests were the most numerous of the animals. This represented those who do not migrate. When the great migration begins in a couple of weeks, there will be millions more.
Warthogs are definitive cuter in Disney animations.

Zebras were the next most numerous unless you lump all the types of antelopes and gazelles together.

It's late and it has taken over 90 minutes to load these few pictures since the internet is so slow.
I will add more animal pix along with views of the lodge tomorrow.

Blessings,
Ed