WEEK 5 VIDEO UPDATE

Here are some photos from our recent trip into Nairobi to restock on supplies. We saw lots of local wildlife along the way. Hannah has been teaching preschool here at the hospital and also teaching Bible in the local Kenyan elementary school. Our family has started volunteering at a local orphanage on Saturdays.  We also found scooters for the the boys at a missionary garage sale and they have been riding them everywhere!

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Day to Day Life

I thought I might give a little insight into what our days looks like here now that we’ve been her a little over a month. The boys and I are starting to get in a rhythm- On Tuesdays and Thursdays I have started teaching a 3 year old preschool class for the missionary children. There are five 3 years olds (including Cooper who will be 3 in a few weeks). This is the 3rd week I’ve been teaching them and they are starting to get the hang of our schedule and gelling together as friends. We do calendar time, letter of the week, color of the week, snack, craft and singing. They are a sweet group and I can tell Cooper really loves having “his own class” and is so proud of all he is learning. During this time, Lane goes with Krista (wife of a family practice doctor here) with 3 other 4&5 year olds and they do a kindergarten social studies curriculum and have playtime. I also do kindergarten reading and math with Lane and another little girl Charley on Wednesday afternoons. On other days we play outside, hike down to the waterfall, do crafts inside (I really never used pinterest until I moved here!) and of course…our life saver legos! We are getting to know all the long term missionary families here more everyday and are looking for opportunities to encourage them in any way possible- it is not easy to move your family overseas and homeschool your children full time!

Recently an opportunity fell in my lap to teach Bible 2 days a week in a Kenyan school right up the road from the hospital. This has been a highlight for me as it gets me off hospital campus for a bit as well as introduces me to local life in the surrounding areas. I’m currently in a classroom with 60 (yes 60!) 3rd graders crammed onto benches who only have a pen and some tattered books. Such limited resources and so many children is definitely stretching my creativity as a teacher but they are sweet and respectful and always very excited about anything we do that day. I am following the schools curriculum but have complete liberty to teach it how I want. My favorite part of everyday is when I read them whatever Bible story we are learning from The Jesus Storybook Bible and we discuss how every story points back to Jesus (if you don’t have this Bible for your kids please stop reading this now and go order it! It’s the best!) It just so happened that today’s lesson was the story of the cross- what a privilege to be able to share the truth with them that Jesus loves them enough to die for them and true life is found in Him. Please continue to pray I can communicate these stories clearly and give these children a better understanding of the gospel each time I go.

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Drew is getting more acclimated to the hospital. He has 2 days a week where he operates and the others he is in clinic. He has Kenyan medical residents with him that he is teaching as he goes and has really enjoyed that aspect of the work here. He comes home for lunch most days and does call from home so that is really nice change from residency. There are definitely days  where he feels overwhelmed (see previous posts) by all that he is seeing and the shear amount of loss that happens here but I’m so proud of him and how he is stepping up to the occasion and turning to the Lord in each moment of weakness. The care at Tenwek is much more compassionate and dignifying to women than most government hospitals as they see many woman who have come in mistreated or ignored when seeking medical care elsewhere. Definitely continue to pray for him as he’s tackling some pretty tough surgical cases.

Finally, we are asking prayer for the presidential election being held in Kenya on October 26th. Kenya already had an election on August 8th but the supreme court decided to nullify the results due to corruption in the voting process. Kenya does have a history of rioting and violence during elections so we will be under a travel ban for most of October. – this complicates things as this is right when Drew’s parents were supposed to come. This also makes it more difficult to get food/supplies etc as Nairobi is the main place we get all of that and we won’t be allowed to go. You can specifically be praying this election would pass peacefully as there is a high likelihood people will not be happy no matter what happens since the first election was nullified. We are learning a lot of adjusting to the ways of 3rd world countries and how there’s really nothing you can do except pray!

Starbucks, haircuts and other things I miss!

By Hannah Benac

Lately my dreams have been revealing to me apparently all that I hold dear. A few nights ago I dreamed I was drinking a huge cup of Starbucks coffee and the night before that I dreamed I was getting a haircut at a really nice salon where everything smelled wonderful and I was reclining in a comfortable chair. Every time I wake up, laugh to myself a little and then think about how I can hide the desire for these luxuries in the daytime with my smile and responses of how we are adjusting to living in a 3rd world country just fine, but there’s no stopping your mind from wandering and longing for the familiar in your dreams. There’s definitely a lot of things I miss here but if I were to really be honest with myself, in all actuality, the thing I miss the most is my independence.

The place where we are living truly is wonderful so many ways. Our needs are provided for, we feel safe and the best part is, it’s right down the road from the hospital so most days Drew can come home for lunch. All that’s truly important is present. The housing area we live in is called “the lower compound” and that’s what it is, a compound. We have people that live on all sides of us and there is always someone around. While there’s a sweetness to this (like how my kids always have a playmate or if you need anything you just knock on your neighbors door) I would say this is the first time either of us has lived in true community. Everything you do is seen, known and effects everyone around you. You share all that you have and are completely dependent on others for even the most basic needs (such as getting a ride to town to buy groceries). Some days I am totally fine with this way of life and other days I can feel my spirit fighting against every thing about the systems here.

I see so much need but am more aware then ever of my limitations. If I were to be honest, I’d say I miss feeling self-sufficient. Getting things done is something I pride myself in and it has been stripped from me here. It is leaving me often frustrated and wondering what in the world I’m doing here. I’m finding myself praying these prayers often- “Lord I am willing but you’re going to have to do it.” or “I don’t see a way so you’re going to have to make a way” or “I am at the end of myself, show yourself to me and those around me”. Not so coincidently I just finished reading the chapter in Jen’s Wilkin’s book None Like Him where she discusses the fact that God is the only one that is truly self-sufficient. This truth has never fought its way into my soul more than it has here.

Acts 17:24-28 “The God who made the world and everything in it is the Lord of heaven and earth and does not live in temples built by hands. And he is not served by human hands, as if he needed anything, because he himself gives all men life and breath and everything else. From one man he made every nation of men, that they should inhabit the whole earth; and he determined the times set for them and the exact places where they should live. God did this so that men would seek him and perhaps reach out for him and find him, though he is not far from each one of us. For in him we live and move and have our being.”

The fact that I can’t and only He can is a hard, refining truth. Most days to be honest, I don’t really like learning this one… but if it gives me more of Him then I’ll daily say yes to where He has me. And if that means I get to see more of what He does than what I can do then I’ll say yes to where He has me. And finally, I will pray that He’ll renew a right spirit in me as I wait on Him in anticipation. Lord, do more than we can ask or imagine because you are all the all-sufficient one.

FLESH AND BLOOD

“Flesh and blood cannot inherit the kingdom of God.” – 1 Corinthians 15:50

IMG_0421I hear the stretcher rattle through the doorway and quickly move aside.  It’s occupant, a young man with a head wrapped in bloody gauze, appears to be the latest victim of yet another boda boda (motorcycle) accident and the next patient for the on call trauma team that night.  Although the patient’s gender and location of injury are very different  than those I am accustomed to treating, my thoughts wander to the challenge facing his surgical team and whether or not he will survive the night.  His surgeons walk through the door less than a minute behind the stretcher and I am jolted back to reality.  I try to refocus and finally finish listing our 8 surgeries for the following day on the OR scheduling board before starting the half mile walk down the hill to our house.

The day has been a challenge.  It began by checking on the cervical cancer patient I did a radical hysterectomy and aortic lymph node dissection on the day before.  Praise God she was doing well.  The rest of the morning was spent in clinic where I met three successive patients with aggressive gynecological tumors.  One appears to have early disease and is being scheduled for surgery.  The second, Rose, has a large but resectable tumor and will undergo surgical resection hopefully in the next week or two.  Norah has one of the most aggressive and advanced tumors I have ever seen, consuming essentially everything from her pelvic bones to her rib cage.  The tumor is so large that the ulstrasound machine can’t properly characterize it and we order a CT scan (it’s incredible that we have that as an option here!).  I will likely be forced to tell her that her case is too complicated and refer her to a mediocre cancer treatment center hours away for a second opinion.

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It can incredibly difficult to know with the limited here resources which cases are too big, too risky and too dangerous for the hospital and our team to handle.  I certainly believe we offer a high level of care but dread the thought of relegating a patient’s dying breath to the operating table in pursuit of futile treatment when that time could have been spent at home with their family.  Lord please give me wisdom!

The remainder of my day was spent working on a treatment plan for periviable twins at 28 weeks gestation with stage II twin to twin transfusion syndrome. I take the mother, Joyce, to speak with a visiting cardiologist who determines that the hearts of both babies are still pumping properly (which is a good sign) but this doesn’t change the fact that one baby is “stuck” and severely dehydrated while the other incredibly overloaded with fluid.  Because the placentas of both babies are conjoined, the fate of one is intimately linked to the fate of the other; with the death of one twin posing a 20-30% risk of stroke or death to its counterpart.  To try and prevent this we make plans to remove fluid from around one of the babies, prayerfully hopeful that this will keep the dehydrated baby alive and buy more time for both the twins.  Complications of the procedure or delivery at this point in the pregnancy would make it difficult for either baby to survive in Kenya but given the clinical picture and progressive nature of the twin’s condition, intervention seems to be the best option moving forward.     We will monitor the status of both babies carefully and plan for delivery at just the right time but the future of this pregnancy certainly hangs in the balance.  “This is out of our control Lord,” I pray.  We will treat but you will have to watch over, protect and heal these babies.

Finally, I spend some time after dinner looking into possible fertility treatment protocols at the request of one of the local Kenyan doctors. What a day! I was not formally trained an an GYN Oncologist, maternal fetal medicine or infertility specialist (all of which require three additional years of training in the US), but today I found myself wearing the hats of all three.  The patient problems here are exciting and terrifying all at the same time.  I consistently feel inadequate and unqualified to meet the challenges at hand but am comforted by the words of Don Ford, my director at Kanakuk who often said, “God does not call the qualified, he qualifies the called. God has reminded me of this recently just as he reminded the apostle Paul of this same truth when he said, “My grace is enough for you; my strength is made perfect in weakness.” (2 Cor 12:9, KJV)

So it’s 3 am Thursday morning here and I can’t sleep.  I’m feeling the weight of everything going on and trying to process everything that happened today. We lost two babies in the last 24 hours.  One was delivered by the call team last night with a fatal heart condition and the other died inside it’s mother at 30 weeks before our team could figure out what was going on and make a plan for delivery.  I am on call today (Thursday) then again this weekend.  Who know what the next 72 hours will bring.

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Amidst a newfound heightened awarenesses of my weakness, my inability to make everything and everyone better and of the imperfect power of modern medine, I have gained a deeper understanding of God’s grace and his presence on a moment by moment basis. I sense his presence around the hospital more than normal and I have been reminded, more than ever, that “this world is not our permanent home.” (Hebrews 13:14, NLT) People die at Tenwek on a daily, sometimes hourly, basis which for me has served as sobering reminder that “flesh and blood cannot inherit the kingdom of God.” There comes a point for all of us where we must let go of the lifeblood was have grown accustomed to grasping hold of so tightly.   In the operating room I work with meticulous technique to restore flesh to it’s rightful place, keep blood loss to a minimum and to keep patients alive but more than my best surgical, diagnostic or treatment efforts, more than all of this, His grace is sufficient.  It has to be!  And I’m coming to realize that part of this grace, part of God’s goodness and part of God’s grand plan is at times for him to call people home to his kingdom.  Lord help me to release and let go of the patients you are calling home and give me the wisdom, insight and endurance to treat those you plan to heal.

Please pray for Rose, Norah and Joyce (and her babies) and all that is before them.  Pray that God would get the glory in their lives and through the care they receive. Thanks for your support!

OFF AND RUNNING

We have been in Kenya 10 days and have lived at Tenwek for over a week! Hard to believe. Just as much as the initial transition went smoother than expected we are now experiencing the some of the unexpected challenges of day to day life at a mission hospital.

The OB/GYN service at Tenwek is one of the busiest and most unpredictable in the hospital. Hospital admissions to Tenwek have increased dramatically in recent months due to a national nurses strike which has the maternity unit functioning at double normal capacity. Nurses at government hospitals across the country have gone on strike petitioning for higher wages which has led to a surge of patients coming to Tenwek as one of few places they can still receive care.

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The majority of first line medical care for these women is handled my midwives and medical officers with long term or visiting senior physicians available at all times to staff rounds, perform surgical procedures and attend difficult deliveries.  There are currently 60 patients on the ward, many of them sharing beds or sitting in chairs, and never a shortage of things to be done.   Medical education in Kenya consists of 5 years of medical school followed by 3 years of medical officer training before you can even apply for a 3-5 year residency program!  A good portion of my time in the hospital for the next several months will be spent teaching and training the Kenyan medical officers on pregnancy and gynecologic care.  Some will go on to formal residency training but many will work for remote county health clinics where they will be expected to handle deliveries and perform c-section on their own.   Tenwek is hopeful in the near future to expand their medical education to a formal residency program to further meet the needs of the high risk patient population in the country..

This week we had around 40 patients to see each day and two patients in the ICU; one with seizures secondary to swelling on the brain from severe pre-eclampsia and another with massive hemorrhage (hemoglobin of 3) and septic shock due infection from a elective abortion that was performed at an outside facility days before she arrived to the hospital.  I did a radical hysterectomy for a patient with cervical cancer, a mini-laparotomy for a patient with ectopic pregnancy, was called to radiology to perform a hysterosalpingogram on a patient with infertility and did several c-section in the middle of the night.  I have lots to learn here.  I often feel inadequate, over my head and out of my league.  It is still strange to look around the operating room for help only to find a Kenyan medical student starring at me from across the table.  I am thankful for my training and humbled to be here.   I can confidently say that I have felt the Lord directing my hands and my head as I am in the OR, on the wards or around the hospital.

We are learning about the difficulty of balancing normal life with the great medical need that exists.  During my call day Thursday I saw the boys for 10 minutes before bed then worked until around 330 AM that night.  It felt like residency again.  We are trying to figure out what is normal here and how to remain a family while honoring the Lord in the work that he has asked us to do.  Please pray for wisdom for our family  as we continue to transition over the next several weeks.  I am off this weekend.  Today we went for a hike to to the nearby waterfall and Motigo Tea Factory (below).

Here are a few pictures from around the hospital.  For the medical folks out there this place is amazingly advanced.  They use ICD-10, have a completely electronic medical record, use Ligasure cautery in the OR and have a CT scanner.

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Delivery bay….not the most organized.  Kiwi vacuum available for use

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Grand Rounds lecture hall

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OR supply room with extra Ligature devices…. a nice surprise

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Ultrasound room

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Handwritten instructions for assembly of laparoscopic camera

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Sharpie drawing on the wall of delivery room… postpartum hemorrhage is the same everywhere

On a lighter note, I can report that life as a medical missionary is not glorious.  We noticed when we got here that our toilet seat was very painful to sit on.  We have requested a replacement but have no idea when and if this will ever happen.  Nothing happens quickly in Kenya.  So far the medical tape has been sufficient and comfort has been improved.

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Our 2 bedroom apartment has been great (see pictures).  We have a great view of the sunrise every morning from our porch.   Thanks for your support and prayers.  We feel them daily and are so thankful!

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