"Miracles at Tenwek"

Time for more updates from this week. Can't believe it's already Friday and that I'm half-way through my trip already. overall this has been a very eventful and special week at the hospital as it is the transition for all of the interns and residents from one year to the next. There have been many graduation ceremonies and the new class of interns has arrived (Think July in the US!)  Individuals from the Tenwek Hospital Board and the fundraising organization, Friends of Tenwek (based in North Carolina by the way!), are also here to join in on the festivities and plan for the new year.

Wednesday Jan. 13 started off with a wonderful multidisciplinary morning conference. Wednesdays are actually non-medial conferences but rather devotionals, and are the most highly attended by all of the staff. We were blessed to receive an inspirational message by pastor Craker, the gentleman who is a missionary in Taiwan I mentioned earlier and who knows one of the long term missionary doctors here. He spoke about the Christian Church in China. Although Christians are a minority and Christianity remains a persecuted religion, by sheer numbers it is the largest Christian nation in the world! He talked about the framework of leadership in the underground church and how the gospel is spread throughout China. It is comprised of "Gate-Keepers" who oversee Leaders, who then oversee the church members. As new individuals are mentored, they then assume the role of leaders and continue to build the Christian church. He related this leadership model to that of the New Testament, with Paul serving as a gate keeper and Timothy his leader. He encouraged us to adopt this same concept of sharing Christ ourselves, passing along the good news from one person or generation to the next, with each receiver then becoming a teacher, "passing the spiritual baton."

How wonderful and refreshing it was to start the day off in the hospital with a sermon, and such an inspirational one at that! How amazing to set the tone of the day off on the right path.

You then, my child, be strengthened by the grace that is in Christ Jesus, 2 and what you have heard from me in the presence of many witnesses entrust to faithful men[a] who will be able to teach others also. 2 Timothy 2:1-2

Baby Dorothy. My miracle baby! 24 hours old. 

Later that afternoon was a very memorable and perhaps one of the scariest moments of my residency career thus far when I performed CPR for the first time (yes really!) on a newborn and successfully resuscitated her. My intern and I were called to the OR due to a fetus in distress that was requiring an emergent C-section delivery. I was expecting to need to provide some resuscitation but not the challenge that would ensue. The baby was blue, limp, and lifeless without any cry, respiratory effort, or heart rate. It had been over a year since my last NICU rotation but I was glad that I had re-familiarized myself with some basic resuscitation skills over the last week. After bagging the infant was unsuccessful, we then began CPR. I was thankful to have a very experienced intern who confidently began compressions. We continued CPR for about 5 minutes and gave epinephrine, fluids, and calcium. The entire time I was sweating and praying to God to help us revive this baby and guide me with what to do. Just when I began to doubt whether we'd be able to regain a heart-beat in this child one of the nurses detected a pulse. Soon we were able to transport the baby to the NICU on just a bit of supplemental oxygen with nasal cannula. I couldn't believe the miracle I had just been a part of and the honor of being able to save this child's life. I know it was God working through us all that were part of the resuscitation team. I will never forget the experience. We soon learned that the mother had likely had a placental abruption and that all of her former 5 pregnancies had failed in-utero. Finally she was able to bring a child into the world. Although still sick and potentially with some brain injury from the long period without oxygen, the baby girl, now named Dorothy, is doing remarkably well.

Wen (med student from US) and I with one of my Peds patients. 

That night I was on call and thankfully the rest of the night was quite calm and I was able to get some sleep while my wonderful intern Betsy took care of a few things on the wards.




Yesterday, Thursday Jan. 14 was quite busy in the hospital.

I gave a lecture to the interns about fluids and nutrition. I was a bit nervous to present to them and wasn't able to spend much time preparing, but I think it went well and I learned a lot in the process while preparing the lecture as well!.

I then spent quite a long time that afternoon until about 7pm in the NICU taking care of a very unstable baby. My attending and I passed by the NICU in the afternoon and noticed one of our recent admitted baby's with severe sepsis was breathing very fast. The baby had renal failure and we presumed the respiratory failure was due to severe acidosis (high levels of acid) in the blood due to the infect and kidney disease. We stayed to perform many interventions including placing a foley, drawing blood and pushing IV meds, and eventually had to intubate the baby. I was so glad Dr. Opondo was with me. It was a very good learning experience though, seeing physiology in action. The ventilator we used is the only one available in the entire hospital for babies!! It is quite rudimentary but thankfully does the job. I spent some time monitoring a few other sick babies and was able to take time to update some of the mothers when they came in that evening to breastfeed/pump. I am so thankful that the mother of the very ill baby above (baby boy Koros) speaks English fairly well and is a strong believer. I tried my best to explain the condition of the baby in simple terms, and to guardedly emphasize our hopes that the intubation was only temporary while the kidneys recover. She agreed that true healing is in God's hands. I also had a chance to meet the mother of the baby I resuscitated the day before.


Today was a bit calmer overall and was a day very focused on God's presence, miracles, and hope for miracles. This was much needed due to some  diagnostic dilemmas with some patients, and some just not improving.

I started off the day in the NICU checking on some of the babies from overnight who were fortunately quite stable. Then I attended a ceremony in the NICU to honor the donation of an incubator made possible by a high school girl named S mentioned earlier, a girl name Redding.

Anna and I in the NICU. Baby boy "Bett" who survived because of her incubator!

Her father has volunteered here as a neurosurgeon several times and in high school she decided to start project to benefit Tenwek called "Birdies for Babies." A highly skilled golfer, she raised money by having people donate for every birdie she achieved during one season. Through the power of God she ended up making twice as many birdie's as expected and raised $22,000 to buy an incubator for the NICU! This is the only incubator in the hospital that can accommodate very low birth weight infants, weighing less than 1000 grams. She came out this week with her family to see her gift first hand. The ceremony int eh NICU today was very emotional and inspirational. The first baby to have benefitted front he incubator is still in the NICU and she was able to hold the baby in her arms, the baby that her faithful dedication to Christ had saved! One of the staff members even wrote a letter to Anna in the perspective of the baby, which was just heart-breaking. We were all on the verge of tears.  I was just mind-blown at what a step of faith she took at a young age, and how God did so much more than she had imagined! Her gift will now be able to allow 100s of babies born at Tenwek every year to be able to survive or at least avoid transfer to another facility hours away. I realized also how that in the US we don't even realize how blessed we are, especially myself and my co-workers at UNC. There we have state of the art technology and sophisticated equipment readily at hand and don't even think of the possibility of not having an incubator available.

Oh, and not to mention, God Anna and she was actually the top high school female golfer in North Carolina last year! Watch out for her on ESPN soon!

God's presence was definitely needed later this morning during rounds, when little Ezra, the severely emaciated boy with HIV and TB was found to be in shock this morning from persistent diarrhea and unsuccessful efforts to replenish his nutrition. His body is so unbelievably frail and becomes moreso everyday. The life he had in his eyes during the first few days has been absent recently. It's hard to imagine that there is life within. We pushed resuscitative fluids according to the protocol for "Severe Acute Malnutrition," which is also something I'm still trying to learn while here. Most importantly, we took time to invoke God's strength and wisdom and His miraculous healing power as I led the team in prayer over little Ezra.

Chai time with the Peds team. From left to right: Aaron (intern), Dr. Terer, Dr. Opondo, Victor (intern)

George and his wonderful and very diligent father., excited to be discharged! He is the first patient I've ever seen with pheochromocytoma. He's coming back next week for surgery.

This afternoon there was more drama in the NICU when the oxygen tank that baby Koros was using for the ventilator started alarming and malfunctioning, forcing us to extubate (remove the breathing tube) him. Although he did well on just supportive oxygen for a while, he then started gasping and needed to be intubated again, which itself was quite challenging the second go around. Thankfully Dr. Terer was able to finally get the tube in again. We were able to get the machine working but the alarm was still sounding on the oxygen tank. It was very frustrating not being able to contact anyone from maintenance department to fix the one ventilator in the hospital that this baby could use. I felt helpless. After a few minutes of silent prayer one of the interns was finally realized that the simply turning of a knob was able to turn off the alarm. Praise God. The baby is now stable and back on the ventilator. We still hope and pray that his lungs and kidneys recover and take things one day at a time.

Torch lighting ceremony at the surgical residency graduation.

Concluding the day was a very memorable experience when I was encouraged to attend the graduation ceremony for the surgical residency. January in Kenya is like our July, with the educational years transitioning at this time. This was a very special ceremony as it was a celebration of the first graduates of the surgical residency program at Tenwek, which started 5 years ago. The meeting was actually like a church service in a way, with speeches by the Tenwek pastor and singing of hymns. Many prominent speakers gave encouragement to the young physicians, including leaders of the World Gospel Mission, Friends of Tenwek, and African Gospel Church--organizations that support and sponsor Tenwek. The son of the legendary Dr. was also present and spoke! Dr. Stourie was the first physician at Tenwek and focus of the book "Miracle at Tenwek." I had just started reading the book about his father a few days ago and was in awe at being able to see his son in person! Each one of the faculty surgeons spoke meaningfully about the two individuals who were graduating today. Not to brag, but one of the two Tenwek surgical grads was the top resident in a surgical organization comprised of 10 African countries!

At the end the entire surgery program actually gave a beautiful singing performance on stage, lead and conducted by the chair of surgery at Tenwek! So multi-talented! There was also a torch ceremony at the end whereby the graduating seniors lit a torch and each recency class lit a candle for the class underneath them. Overall the entire program was so focused on God and using one's medical career for the purpose of glorifying God--by healing patients an most importantly, sharing Christ with them. I found myself wishing that all such ceremonies in the US could have this same focus--medicine as a ministry. I can already tell that it will be an adjustment coming back to the US and working at a non-mission hospital. I will have to strive to maintain this same sense of higher purpose and spiritual calling in the midst of the secular work environment.