Home going

New Home for Cynthia & Faith

Well we are still in the" motherland" airport (Schiphol) waiting our flight so let me recap the last week at Tenwek.  It is always hard to say good bye to people as they cannot understand why we cannot stay longer!  It was also a week of funerals.  Our colleague, Elijah's mother had her home going on Monday and Tuesday.  Kenyan tradition is to pick up the body and have a relatively short service at the hospital chapel which is near the morgue.  Then a funeral procession takes the body to the home place where the person resided and the burial takes place the next day.  It was a very large funeral attended by about one thousand people. Marv and  I did not go to the funeral  as he was covering the hospital and we were both attending the service for Selena, the mother of the twins I have been caring for.  Words do not describe the wailing and the tears for this sweet mother.  Her four older children were inconsolable.   

The next day I brought the twins, Cynthia and Faith to a Baby Center about an hour from Tenwek.  It is run by the African Inland Church and is a beautiful place.  Currently about 52 children between the ages of one month to six years live there.  I was impressed by the cleanliness and the warmth of the care givers.  Saying good bye to those precious babies who had become part of my life was painfully hard.  Oh that I was 30 years younger, I might have taken them home with me!  But it is the best solution for now until the family can make a rational decision about their future.  I am trusting the Lord to help them do this.  

On Thursday, i avoided going to the nursery as it was too painful to see the babies empty cribs.  Instead I ran errands, said good bye to lots of friends, and began to pack for the trip home.  On Friday morning I worked with Solomon, the physiotherapist at the children's special needs clinic.  Betsy and Penny will. Be surprised that he wants to hire me to be his assistant!  It was a great morning.  Solomon does an amazing job with limited resources to instruct and encourage these moms.  My friend Suzie handed out recyclable diapers and rubber pants as another practical ministry.  Solomon is convinced that the Faith Fund which Penny is working so hard at is making a huge difference for these children. He continues to distribute wheel chairs every 

Friday afternoon.  As a result of these chairs he is seeing fewer wounds, more socialization for these children, and  in some cases ability to go to school.  What a blessing this fund is!  Thanks  to everyone who has contributed as you are changing lives.  

On Friday night we had a St Patrick's Day party at the "kipaganga" or the community gathering place.  It was a great way to  see everyone before leaving the next morning.  

So another tour to Kenya has ended but sweet memories remain.  There is much to pray about as I journey home.  So I have physically left Kenya but part of my heart remains with my friends there.  Lord willing, we hope to return.

Thank you for following our journey.

With love

Miriam

Short Note from Nairobi

We are sitting in the Nairobi airport waiting for our midnight flight to Amsterdam!  Such fun !  It is amazing to people watch here which is one of my favorite pastimes anyway!  What a diverse wonderful world we live in!  We have been without power a lot in the last few days at Tenwek and so it has been impossible to type and send a blog.  I will try and tell you about our last few days as soon as I have more internet access in Amsterdam tomorrow morning.  Let  me just say that the time has flown by and that we both felt good about our time at Tenwek.  I always wonder how the Lord is going to use us and somehow it always works out although in different ways each year.  We are so fortunate to be in good health and able to make this journey!

Miriam & Marv

A Place of Songs

German Songs & Pastry

  

Tenwek - A Place of Songs

The question for us on returning is always, “How was your trip?”  A more difficult question that I always ask is “What did I learn, how was it different, how did my perspectives change?”  The answers are never quick.  Sometimes they come in the form of a video, but in the meantime, here are some reflections.

This year I have felt more like the “stranger” than in previous years since we left in the middle of a “travel ban” and will be returning during a new one.  Going to a distant country and getting visas this year seemed like more of a problem.  Maybe it was always an issue and we just never noticed. This year was a more “political” year because we are questioned about what is happening in “your country?”.   At the same time there is polarization and suffering in Kenya secondary to the strikes of health care workers and teachers* in the government institutions.  These barriers seem impenetrable and present in both our countries.

This time I have been moved by the music that I hear and sometimes sing each morning when I enter the hospital around 7:30 am.  Small groups of nurses in each clinical area will be singing familiar hymns of faith.  It is a wonderful Kenyan sound that I will miss!  What if we had more music in our lives?  How would that shape our day?  Would that act shape our relationships into something more fulfilling than what we have come to expect?

This last week I attended a “good bye” party for a German medical student couple who have been here for 4 months.  Beside having some wonderful German pastry and coffee, we celebrated with singing in German and English in this beautiful place called Tenwek.  The word “Tenwek” has many meanings, but one of the oldest is “a place of songs”.  This place lives up to its name.  The strength that you find here is sustained by the songs that have surrounded us while we were here.

My initial response to “How was your trip?” is it was difficult but that what lasts are not the barriers and the problems, but the beauty and resilience of the people who live and work here,  It is the beauty of their faith that sustains them and it is a powerful witness to us as we return to the United States.  The future of caring knows no travel ban or boundaries.   

See you soon,

Marvin

For I am sure that neither death, nor life, nor angels, nor principalities, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.

Romans 8:38-39 (RSV)

p.s. *The doctor’s strike ended in Kenya on 3/14/17.  The resolution must be followed by reconciliation that will also be challenging.

https://www.capitalfm.co.ke/news/2017/03/kenya-health-sector-icu-doctors-end-100-day-strike/

A Tough Week

View from the Guest House, Tenwek Hospital

Heidelberg Catechism

Lord’s Day 1

Q. What is your only comfort in life and in death?

A. That I am not my own, but belong body and soul,

 in life and in death to my faithful Savior, Jesus Christ.

This has been a tough week.  There has been a lot of sorrow.   When a mother dies it is particularly sad.  The mother of the twins that I have been caring for passed away on Wednesday.  Miraculously she had rallied on Monday and we were all encouraged.  She asked to see her babies and we brought them to her the next morning.  She was able to see them and know that they were doing well.  That night she took a turn for the worse and there was nothing more that could be done for her.  She had endured 5 operations, ventilators, immeasurable pain, and her body finally gave out.  How she fought to stay alive for her children.  

Let me tell you about her.  She was a poor woman who lived in a rural village about an hour from Tenwek.  Her sisters tell me that she was a good woman with an enormously big heart always willing to help others although she had little herself.  She was a single mother of four in addition to the twins.  Recently she had married an older single man as he needed care.  Her life was on a good course.  She had a cesarean section for premature twins at another hospital and developed an infection.  She had been healthy up until then.  When she arrived at Tenwek she was very ill.  She was carried for by multiple teams of caring, Christian physicians, nurses,  and respiratory therapists.  

Now the family will meet to discuss her funeral plans and the plans for the children.   Thankfully she has a wonderful extended family and they will make the best decision possible.  Taking on the responsibility of newborn twins and four others is no easy task.  Please, keep this family and the children in your prayers.

Our hearts are heavy but we rejoice in the good news that this Christian woman is with her Savior.  

Miriam

Assumptions

Kanga Cloth

Karibu mgeni - “Welcome Visitor”

It takes time to get to know another culture. You have to be there and sometimes be uncomfortable and make mistakes.  You have to recognize the assumptions you bring from your own culture that have previously been invisible.  So after my 9th visit to Kenya, here are some of my learning experiences:

 “You are Welcome” (used as greeting)/“Welcome back” / “Welcome Home”

Underlying, these Kenyan greetings is a deep ethic of hospitality.  They are all genuine whether with a close friend or stranger.  You will hear the greeting “You are Welcome” many times during the day.  It creates an atmosphere where relationships can grow.

Relationships take time

In the United States  we look for quick results and relationships.  That is not the way it works in Kenya.  I needed to slow down to the rhythm of this place.  It seems to fit with my advancing age.  The resulting relationships have been a real gift!

Community/Individual

In the United States, the individual is the focus whereas in Kenya the community is the basis of who you are.  For me, it is an important reminder when I return and face the reality of how isolated we can become.

Consensus/Winning

The solution to a problem in Kenya is not by winning but is usually found in consensus.  In the U.S. we see the solution as being “won” by convincing a majority.  Consensus takes time.  

Age 

We are “seniors” in the U.S. and “old” here in Kenya.  “Old” in Kenya is a respected characteristic.  They see in us as a possible vision of their future.  That is both a wonderful gift and a responsibility.

I am sure that more time here will reveal more assumptions that can so easily be hidden.   I am thankful for the opportunity to be part of this wonderful community that has become a  second “home”.

Marvin

Tenwek

Suffer the little children...

For you created my inmost being;

    you knit me together in my mother’s womb.

I praise you because I am fearfully and wonderfully made;

    your works are wonderful,

    I know that full well.

My frame was not hidden from you

    when I was made in the secret place,

    when I was woven together in the depths of the earth.

Psalm 139: 13-15 (NIV)

Jesus said, “Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these.”

Matthew 19:14 (NIV)

On Monday I officiated at what I hope is my first and last funeral.  Little Ashley Faith had lain in the morgue for a week while the powers that be decided what should be done with her body.    Since she had been found in a dumpster in a town about an hour away we tried to see if that town would take responsibility for her burial. They would not.  The town nearest here agreed to bury her in their potters field for a price.  

After her bill at the hospital was cleared by a benevolence fund we piled into a Tenwek truck and were off to Bomet.  There were five of us initially; two social workers and a friend of theirs, the driver and me.  After several stops to pick up more papers, an additional passenger with the gate to the cemetery, and to pay the burial fee of 1800 shillings or approximately $18.00, we were on our way to the cemetery.  It was quite a route over rocky “roads",  past the new Bomet sewage plant, and the new stadium (who knew they had a "football “team), until we finally reached the cemetery.  

It was a beautiful open field that overlooked a stream.  We walked for quite awhile carrying Faith in the little cardboard box which was her casket.  After descending a very steep hill we came to the little open grave where we were to lay her.  For some reason it fell to me to officiate.  I prayed for clarity and something meaningful to say.   The words of Psalm 139 came loud and clear and I read them with a meaning I had not experienced before and will never forget. "For it was you who formed my inward parts; you formed me together in my mother's  womb."  When I was being made  in secret, intricately woven in the depths of the earth.  Your eyes beheld my unformed substance ......". We prayed and then respectfully  buried her little body.  Her soul  had long been with her maker who blessed little children.

It was time to leave and take the scenic route back to the hospital.

Miriam

My Day at Tenwek

It has been a few days since I have written so I will try and catch up!  My daily routine stays pretty much the same this year.  I go to the nursery at 9AM for baths and a feeding, I go back at noon and 3 PM and sometimes 6 PM.  Feeding  these premies takes at least an hour.  We feed with little cups once they are old enough to suck; hopefully without falling asleep!   Before the cup they are fed with feeding tubes that go through their little noses directly into their stomach. We fill a syringe with formula or breast milk the mother has pumped and connect it to the feeding tube.  The  breast itself is introduced as soon they are able to suckle.

It is imperative that a baby be able to breast feed since many places do not have sanitary water for formula.  Unfortunately the two sets of twins that I am helping to feed are getting formula because their mothers are critically ill.  Both sets are girls.  One set is named Cynthia and Faith; the other set is Precious and Gracious.  The grandmother of Precious and Gracious is a darling woman who speaks very little English.  We mostly communicate with body language and hugs.  The other twins are cared for by an aunt who is equally competent and also speaks little English.  Please pray for the twins' mothers, Selena and Irene.  They are both so needed in this world for these twins and for the other children they have at home.  They are so sick.  

Of course I love being with the NICU nurses who have become my friends over the years.  I add a bit of humor to the situation mostly because I sweat profusely!  It is very hot in the nursery and I am naturally a "sweater" anyway.  I go through at least two tops a day and my hair looks like I just got out of the shower after an hour in there!  The nurses love asking questions about the U.S. and my family.  They say that I am their mother and the Nanya to the babies.  I love that!  

Till next time....love to all.

Miriam 

PS I am typing by candlelight since  the power has gone off!  No problem!

Graduation

“Don’t be weary child keep looking”

Every time you cross my mind, I break out in exclamations of thanks to God.

Philippians 1:3 (MSG)

Two days ago,I heard the reflections of the current graduating class of interns at Tenwek.  I heard some wonderful stories of learning and its challenges.  The educational mission has been a key to this institution.  It is an exciting time here.  The same will occur in March in the United States with the results of “the match”. 

Yesterday evening we celebrated their completion of the internship.  There was food, photos and thanksgiving!  This internship has been in existence since 1996.  What has been rewarding to see is the growth of the educational mission with more interns, clinical officers and residents.

Like all longterm objectives, one year celebrations don’t really capture the impact of the effort or outcomes of the graduation festivities.  It is only the “down payment” on a promise of transformation.  This profession requires persistence as well as resilience.

Thanks be to God for these graduates and their contribution in the future.

Marvin

Hage, M. L. (2012). Techniques and Transformation.

http://healingagents.blogspot.com/2012/02/techniques-and-transformation.html

Hage, M. L. (2012). Kingdom Learning.

http://healingagents.blogspot.com/2012/02/kingdom-learning.html

Caps are a Hit

Ladies at First Presbyterian your caps were a big hit!  

When I got to the maternity hospital this morning lots of the moms we standing outside waiting to go to the nursery because it was being cleaned.  It seemed like a perfect time to tell them about the caps and to distribute them.  I told them that these caps had been made by ladies in my church and that they were made with lots of love for their babies.  I shared that my friends in the U.S. also love Jesus and that is why they make these caps for tiny babies in Kenya.  The world is so small; women thousands of miles apart and from very different cultures share maternal love!  We also share the love of Jesus for these precious babies.   

Thanks for the knitting ministry of First Presbyterian Church!

Miriam

Ashley Faith

For you created my inmost being;

    you knit me together in my mother’s womb.

Psalm 139:13 (NIV)

Ashley Faith died in my arms last night.  This premature one month old who was found abandoned in a dumpster is now in heaven where she has found her eternal home.  Her only home here on earth was a little wooden box with a light bulb to keep her warm in the Neonatal Intensive Care Unit at Tenwek Hospital.  There NICU nurses loved her, missionaries held her, and last night her pediatrician and I sang Jesus Loves Me  to her as she struggled to breathe.  She never had any earthy clothes except for the knit cap that was lovingly made by dear women from my church and she will be buried with that colorful cap.  But she will rise with heavenly garments!

Her earthly mother forsook her but through Gpd’s providence I was blessed to be her earthly Nanya for a few days and to cuddle, caress, and hold her tight.  Thanks be to God for the gift of this precious child.

 See what great love the Father has lavished on us, that we should be called children of God

1 John 3:1 (NIV)

Miriam

First Week

Where has the week gone! There is a lot to catch up on.  

We were quite shocked on Monday morning when our driver arrived in a Toyota Corolla rather than the usual van that has always picked us up.  Somehow as only Africans can do we were able to get four huge suitcases, two small suitcases, and the three of us in the car.  The problem was we still had to go grocery shopping for our month’s supplies.  Off we went to the Butchery, the vegetable market, and the grocery store.  All the while I was shopping I was thinking of the small car and as a result I did neglect to get some things I wish I had now.  Our driver kept reassuring me “no problem” that it will fit!  And fit it did after a fashion!  I wish you could have seen me in the back seat surrounded by suitcases and groceries!  Of course the two men in the car seemed quite comfortable!:):)

Four hours later, windblown and stiff from being in one position, we arrived at Tenwek.  We are assigned to an apartment called Twiga (giraffe) because it is on the third floor of the guesthouse.  It is a one bedroom apartment and serves our needs perfectly.  Climbing to the third floor is a great way to get some extra exercise.  I am going to get help with carrying the water up  and doing the laundry.  The added bonus is our beautiful view of the countryside; the green hills covered with tea bushes. 

Marv was immediately off to get his hospital badge and to get us onto the internet.  I began unpacking but was pleasantly interrupted by people stopping by to say “Hi” and greet us in the hospitable Kenyan fashion.  Fortunately we eat at the guesthouse dining room for the first couple of days so I did not have to think about cooking!  It is fun eating there as you meet people from all over. We have a Duke resident here from Taiwan, 2 German medical students, an orthopedic surgeon from Texas, and a large group of Cardiac surgeons and nurses who are doing amazing surgery here in rural Kenya for two weeks.  

On Tuesday I was off to the nursery to see friends and find out if they had something for me to do!  It is always a joy to see my nurse friends in the Newborn Intensive Care Nursery (NICU)  and today was no different!  We did not get to chat much as the nursery is bulging at the seams now.  There is a baby who was abandoned and so I was assigned to love and cuddle her.  Not a problem!  However, she is not doing that well and I covet your prayers for this little one who is a child of God . The name she has been given by the nurses is Ashley Faith.  I will keep you up to date on her progress.  As always the nursery temperature is very hot and I perspire like you would not believe. It is so embarrassing as none of the Kenyans seem to be sweating.  Oh well it is what it is and we just laugh about it.   

On Thursday I helped with some children from the Baby Centre in Nakuru who came to Tenwek for medical appointments.  There were six of them and most of them had special needs so it took six of us to get them through their day.  The Baby Centre is an amazing place.  It rescues babies from infancy until they are adopted or placed in foster care.  Right now they have 60 children in residence.  Sadly the missionary wife who was such a wonderful leader passed away about a month ago of breast cancer.  Her husband is currently in the States.  We mourn with him and with all the staff and children at the Baby Centre as they cope with this enormous loss.

Yesterday after time in the nursery in the morning I was able to go with Solomon, the physical therapist here, to visit a school for special needs children in Bomet. After that we delivered a wheel chair to a very remote area.  This wheel chair for a child with cerebral palsy will be life changing.  He has never been able to sit by himself before. Now he can watch what is going on and his mother can feed him sitting up.  We dedicated the wheel chair and thanked God for the donors who had given it.  I will be telling you more about the special needs clinic as time goes on.  

It is now Saturday morning and we are relaxing.  There was a wonderful rain last night for which we are so grateful.  The drought is very serious.  We hope you all have a relaxing weekend!  I will try and make these blogs shorter but there is so much on my heart and so much to tell!  

Love to all of you,

Miriam (as I am known in Kenya) and Marv

Go Blue

as

Staff Entrance

Center of the Medical Universe

A big surprise met me on my first trek up the hill to the hospital yesterday morning.  There is all new signage for the entrance and for the various departments.  The best part is that they are painted in my favorite colors…maize and blue!  There is no question that it was picked for a reason!  Tenwek provides care in a challenging environment and a key to that mission is education!  

This month I, along with others,  will continue to work on the curriculum for a residency in Obstetrics and Gynecology.  I have been a participant in many curricula but what is challenging is designing one in another environment and culture.  We have to be sure that we make a local difference in the care and outcome for Kenya.  In other words, the design has to meet the needs of the communities that will be served.  

I feel blessed to be able to participate in this Tenwek educational effort. Go Blue!

Marvin

p.s. Maize and Blue are the school colors of the University of Michigan, my medical school and residency alma mater.

Amani

We are here!  After much anticipation and packing we arrived in Nairobi about 10PM local time.  We got through customs easily which is always good as it can be difficult at times.  In Kenya we are eight hours ahead of you in the states to give you an idea of the jet lag we feel today.  It is a gorgeous day here at the Amani Gardens Guest House where we stay in Nairobi.  It is about 70 degrees, a gentle breeze, and the blossoms are in full bloom. 

Amani means peace in Swahili and is an amazing place to stay.  It was formerly called the Mennonite House and serves as a guest house and respite spot for missionaries and NGO workers from throughout this part of the world .  We had breakfast with a family who is transitioning from the island of Mayotte (near Madagascar) to England.  As so often happens we discovered ten degrees of separation within minutes of sitting down with a delightful family of five.   The wife graduated from Calvin College (my alma mater) and her brother practices in the same group that our son practices in, Emerge Orthopedics, in North Carolina.  I learned a great deal about Mayotte , an island I had never heard of before.  It is largely Muslim and so their mission was relational and one of planting seeds of Christianity among this population.  Who knows where those seeds will take hold in the years to come.  

Today we are going to spend the day relaxing in this wonderful climate.  Tomorrow morning we will be picked up around 9 AM and go grocery shopping and butcher shopping for our tenure here.  There are some groceries available at Tenwek but it is good to stock up here with those things that are not available.  We will also get our Kenyan phone sim card so that we will have a local phone available.  About noon we will leave for the 3-4 hour trip to Tenwek.  This is the harrowing part of the entire trip because the roads are extremely overcrowded and dangerous.  There are also many18 wheeler trucks on part of the journey which are coming from the port of Mombassa and going into land locked countries like Uganda.  We are always thankful to arrive at the peaceful mission station called Tenwek where we will serve for 5 weeks.

Many of you have wondered if there will be interest in what is happening in the USA.  Let me just say an emphatic “yes” and we have only been here a few hours.  Most people are concerned and confused about the situation.  Maybe more on this later after we have been here awhile.  Stay tuned!

Marv and I will be alternating writing this blog.  As you can tell his ideas are much more philosophical than mine!  I just love telling you about my life, experiences and feelings.  Hopefully the combination will serve as a journal for us to remember our time here and for all of you to learn a bit about this part of the world and what the Lord is doing here.

Much love to all,

Marv & Miriam

Getting There

“Travel light. Comb and toothbrush and no extra luggage..”

 Luke 10:4 The Message (MSG)

It looks straight forward…two 8 hour flights.  What isn’t so obvious is the planning, background, logistics and packing.   Packing is a real exercise of facing limits!   What is limitless is the support and prayers we feel and trying to remember to “pack light”.

Marv & Micki

Yes!

Are you going to Africa? Yes, is the answer and we will be leaving on February 10th.  A better question is the purpose and how that can best connect with your lives.  Blogs are one way to tell the story.  What we would like to encourage is more conversation.  Marv will look at ways to communicate in addition to this blog.

There are number of options: Skype, WhatsApp, FaceTime, Instagram, etc.  Realtime communication confronts the reality of an 8 hour time difference (+8).    We will try and work on these details with the staff at First Presbyterian Church.

Stay tuned and keep us in your prayers,

Marvin & Micki