Medical Mercy Kenya Clinic day 4

(Part 2)

Unconditional love. And more. What would you say if God reached out to you, pointed the way to go, whispered in your ear and said, “Hear Me”? Would you go, would you go willingly even though you didn’t know where you were going and would you say “yes I hear You”? Today was a day that God pointed, spoke and we listened and went.

 

Several years ago, I met a wonderful man by the name of Julius who was a community health physician. He had polio and wore a leg brace on his right leg. As the story goes, after he toured me through his clinic, I began to walk back out to the car when I heard children laughing. I turned back and asked Julius where that was coming from. He took me to the back of the clinic and there was a safe haven for physically disabled children with their own makeshift wheelchairs and more. It has been there ever since and it has grown and that is where we took the little girl we saw yesterday. Julius and his physical therapist did a quick evaluation, and accepted her as a patient. A CT scan for $70, and two weeks full room and board for both grandmother and the child where there will be a full medical assessment, physical therapy plan implemented and more, for…wait for it…$35. This little girl who for whatever reason had a significant neurologic injury, was now embraced by those who will not only take care of her, but care about her and care for. Unconditionally.

 

We ended out first part of our medical mission today. We are off to go to Masai Mara for a safari, then 10 of us will be continuing to the most northern part of Kenya: Turkana.  A remote area, truly bush country. We will fly there on Mission Aviation Fellowship planes, two of them, one for our supplies and one for us. We’ll land on a dirt clearing after making a low pass to make sure there are no animals and then land. We start our clinic right after we land.

 

The team of 23 US and 6 Kenyan healthcare workers, 2 country directors, and 2 security guards worked tirelessly seeing hundreds and hundreds of children. We did what we came to do: serve and to be present when present.

 

I’ll be back on the blog in few days when we arrive in Turkana. More children to see. More to serve. Wait for it…

 

In all things give thanks,

 

David

 

(Photo credits: Brandon Cunningham)

Medical Mercy Kenya clinic day 3

(Part one)

Unconditional love. How often have you felt it? Needed it? Wanted it? Had it? Our God offers it and gives it to us all the time, but we often put up a barrier and block it from entering our hearts simply because we are too self-centered, self-assured and self-absorbed that we don’t want it or need it. What a shame. And then there are times when we see the same unconditional love given by humans to other humans. What gives? It’s relatively simple: there are those who give of themselves with no want or need for anything in return. They are comfortable with who they are and with what their purpose is in life. They don’t have to seek it nor wonder if they have it. It’s just there. Just like the grandmother of this three year old girl who came to us for help.

 

The cries were loud, persistent, high pitched and unyielding. With each wail, her arms extended outward at an abnormal angle, fingers rigid, hands arched back almost touching her forearm. Her back arched, her head flopped back, and her legs limp. This grandmother and the child’s caretaker, held her, stroked her head and whispered in her ear. She quieted. The child’s mother was absent, having run away after a fight with her husband. She may return the grandmother said, but was not convincing. So what happened?

 

At the age of seven months this child fell out of bed and was never the same after that. Unable to walk without assistance, floppy legs were the reason, the child never progressed through her normal milestones. Her head was big and probably has hydrocephalus (“water on the brain”). The grandmother was clearly loving, engaged and committed to this little girl. Hospitals and doctors were not able to make a diagnosis or help. Here’s what may have happened. She fell out of bed, may have had brain damage from the fall itself and may have stopped breathing with a period without oxygen. All the same, this little girl is significantly disabled.

 

What struck me was how loving and caring this grandmother was. She was openly loving, giving of herself. We spent a great deal of time with them, asking questions in order to find reasons for why the child was like she was. We prayed with her and then I promised to help them see a local doctor that I know who may be willing to care for this child, find ways to make her life a little better and to ensure that she receives the care she deserves. I couldn’t do anything less. Unconditional love as strong as that grandmother’s, is something that deserves acknowledgement and thanks. Not unlike God’s unconditional love for us. We know its there and give thanks for it.  I’ll be back tomorrow evening with an update.

 

In all things give thanks,

 

David

 

(photos credit: Brandon Cunningham)

Kenya Medical Mercy Clinic Day 2

Life is what life is. We are dealt a hand of cards, and how we play them is up to us. That’s called free will. Sometimes we win and sometimes we loose. And sometimes, regardless of the hand we’ve been dealt,we make it work even though it is a lousy hand. I learned a lesson about that today.

I saw him as soon as I got off the bus. Short in stature, large head for the size of his body, short arms and short legs, and stubby fingers. Short limb dwarfism or achondroplasia is what he had. I expected him to be an outcast from the large number of his peers, some 350 of them that were waiting for us to see them (we saw 330 children and few adults by the time the day was over). I’ve seen this before. If your not like everyone else, you don’t belong and you are cast out. But surprise, surprise. I found him to be engaging, playing with his peers, and some even taking him under their wing so to speak so as to be able to keep up with the soccer game that was going on. I spent a lot of time with him, doing a physical, talking about how things were in school, his friends, and if he felt like he was different. For a 10 year old boy, his answers were mature and to the point: “I am a little different, but so is everyone. I like everyone and they like me.” Life is what life is. In other words, we make do with what we have. We play our hand. This young boy, played his well and I was very proud of him. He accepted who he was and was not ashamed. And by being bold and accepting, those around him accepted him as well. I wonder how well we would do if we were faced with having to play a bad hand. 

In all things give thanks,

David

(photo credit: Brandon Cunningham)

Kenya Medical clinic day 1

So long and so far away. Well, not really. 80 kilometers and 2 hours and a half to get to where we were going. Dirt roads, with ruts and holes, made the progress slow. And so the question is posed: how far do we go to help those in need? The answer: as far as we need to.

 

This being the first day of clinic for our team, the start was a little slow. The electronic medical record system failed due to a router issue so we went back to paper. A little spiritual warfare ongoing. Not willing to accept defeat, we said fine, and got out our pens and went back to old school record keeping. So there Satan.

 

The children were for the most part moderately healthy, with evidence of malnutrition the main finding. Skin rashes, scabies, worms and some upper respiratory infections noted. So all in all, a relatively good day. Except…wait for it… the child with only one shoe and the child with fainting spells or as we found out, seizures. I’ll tell you about the child with “fainting spells”. Eight years ago, for no apparent reason, he started having seizures, each lasting 30 minutes or more with a postictal period (unconscious period of recovery after a seizure) of up to three hours. He was been seen by a neurologist and started on an anticonvulsant. He has not attended school for last 3 years. So what now? He is clearly mentally challenged, shy, withdrawn and afraid. He sat in front of me as I examined him, his eyes never looking up. Speaking in gentle tones, I reassured his mother and him that with some minimal changes, he would one again be able to attend school. All that is needed is an adjustment of his medication, some one-on-one care with a special needs teacher and an opportunity for him to belong to the community. But truth be told, it isn’t going to happen. We’ll adjust his medications, but there is no special needs program or a special needs teacher in the project that we are in. Remote is what remote is. Bush country is what bush country is. So you say then, what did we accomplish? Well, the answer may not be what you want to hear. His seizures will eventually be under control, but he may not go back to school. Stigma is a big part of this culture. If you aren’t normal, you’re not welcomed. What we did accomplish was that after a long while of just sitting and being present when present, he looked at me and smiled. And so did his weeping mother. She told us that this was the first time in a very long time that he smiled and thank us. She thanked us for not pushing him away because he was “broken”. It’s not what we bring, but what we leave behind, isn’t it?

 

In all things give thanks,

 

David

Kenya Day 1 - the orphanage

On the border of Ethiopia and Kenya, a mother cries out. She is in a refugee camp, alone, afraid and pregnant. A baby cries out, weak and softly. She delivers a baby with a small head, a baby with microcephaly. She turns and looks at her baby and closes her eyes and weeps. As the baby is being attended to, she climbs from the cot that she just delivered on, and runs from the tent. The placenta is still in her. The baby is now abandoned. 

In another part of Kenya, a baby is born prematurely at 29 weeks, the mother is single, poor and homeless, and gives the baby up. Craniosynostosis or a condition where the baby’s sutures should be open allowing for the brain to grow, are fused. Surgery will be needed.

These two babies are cared for in an orphanage. Caring hands and loving hugs are what each of them are receiving. Medical care will be futile. The cost for corrective surgery will be prohibitive and the child with microcephaly will pass in a few weeks. 

You may have heard me say before that there is a difference between taking care of someone and caring about and caring for them. These two abandoned babies are receiving all three types of caring, the most important of the two, they are cared about and cared for. Little can be done as the funds needed are not there. This orphanage has a strong foundation of loving care givers but limited financial resources. And so these two babies will live a short life, but a life full of unconditional love and caring. 

We’ve started our medical mission and there is a reason why we went to this orphanage today. We prepared our hearts and our minds for the caring that we will give to those who come to us in our clinics starting tomorrow. And as for those two babies, I left with a sense of sadness knowing that there will be little that can be done, but joyful that there are people here who will give of themselves without question. It’s what they leave behind for those babies. Intentionally being present when present with kindness and love.

In all things give thanks,

David

(pictures taking with permission and credit to: Brandon Cunningham)

Kenya May 2016: Say it like it is

Say it like it is. Why do we go and why do we care? I’ve been asking these questions for several years now, and the answers are becoming more evident. The answers are simple: we go because we are told and we care because we care. Not bad answers are they. No need for explanations, for arguments, for neither a display of defensive maneuvers nor a liturgy of words. Just say it like it is. So I’ll do that.

 

We leave for Kenya in a few days, 27 of us from the US, meeting up with our 11 Kenyan partners, 9 of whom are our healthcare workers who we trained several years ago. We’ll be traveling to Kajiado for the first part of our medical ministry, and then a small group will travel to the northern part of the country, bush country, in Turkana. We’ll see those who come to us and give what we have, leaving behind the most important aspect of human caring: genuine kindness.

 

There is always the question as to whether genuine kindness is good enough. Shouldn’t we be giving medicines, ensuring continued good health, hygiene, clean drinking water and all things related to a better and healthier life? Of course. And it should be sustainable. But the reality is, all of that is hard to come by, no matter our best intentions. Some of it may flourish, but some may not. So what can we guarantee will be sustainable? For me it is the time we spend with those who come to us, giving them our undivided attention, recognizing them as persons, smiling, holding their hand, listening and yes, hearing their story, being intentional, accountable and giving them the dignity of being who they are without judging or question. Simply, being present when present.

 

That is what we will be doing. It’s not hard. It just takes commitment and a willingness to give unconditionally. Say it like it is: it’s not what we bring but what we leave behind.

In all things give thanks,

David 

India Clinic day 6

What is done, is done. 1460 patients seen, 99% of them children, travelled to 4 different projects, diagnosed, treated and gave out medications to all of them, and we’re done. But interestingly enough, we are asking for more. We leave tonight to come back home, and few if any of us, are anxious to leave all the children we saw and cared for. Yes, we are anxious to return to our families, our homes, and our lives that are so different than what we saw here. It is the time we spent with the children that gave us the drive, to crusade, to try and makes their lives better by getting them healthy enough and to feel strong enough to get up in the morning and face their day of poverty. So, were we successful? In the book “Covenant Medicine: Being Present When P:resent”, I write about the four actions that we need to take when we establish a relationship with our patients: action (how will we change and improve our relationship with our patients), listening (listen to our patients silently), intentionality (focus on the patient, purposefully and willingly), and commitment (treat patients with dignity). Simply put, be present when present. We did all of that. As I watched the 22 members of the team rally forth, doing all four of those aspects of caring, I was wonderfully awed at their unselfish giving of themselves. And the children…I was wonderfully awed at how they came to us, neither of us being able to speak each others language, courageously, openly and with trust that only is seen when an unspoken covenant relationship is established. 

I thank the US team members and the India team members for all that they have done. “Being present when present. What a wonderful way to practice medicine.”

In all things give thanks,

David

India Medical Mercy clinic day 5

The smile is what caught my eye. Bright, genuine and confident...as long as she had her scarf on. I hadn't seen what was below the scarf, but did think it unusual for a young girl to be wearing one. There had to be something. The bald patches told it all.

I examined her as she came towards me. Her clothes were of average quality, she stood barely 4 feet tall, and her smile paraded before her. Sitting across from me, she continued to smile until I asked her if it would be okay for me to look at her scalp. She mumbled and the warm smile turned to a frown, her eyes diverted to the ground and she became uncomfortable. I looked at her scalp and then scrolled through WebMD, skimming over the details of the type of balding it couldn't be. I shut down the tablet staring straight ahead pondering the consequences of what I was going to say. Smiling, hopefully in an attitude of assurance and without judgement, I had made a diagnosis. Not the one that would yield the best result and a smile from her, but one that was going to cement her fears. What mattered was that her situation was a worst-case scenario that could play itself out later in her life.

This all started when she was about 5 or 6 years old. She is now 12. Her hair fell out in clumps and had been that way for years with no effective therapy that she tried. This is alopecia areata which may be reversible with hydrocortisone, but no guarantee. I gave her a bunch of tubes of it. So why you ask, am I sharing this with you? Because you need to know that because of where you live and because of what you have, you'll never find yourself where she will find herself when she gets older.

I asked her if I could take her picture. This is a sensitive issue, balancing her dignity and telling her story so that others can learn. I struggled with the decision and eventually felt that she would understand. In just a few short minutes we had a covenant relationship, trusting me to do my best to help her.

You need to know that because of her baldness she may never marry, be stigmatized and marginalized, or worse yet, she may marry a much older man who cares nothing about her or for her. A forced marriage. The simple truth is that a dysfunctional society makes up rules as it goes along, blindly hurting many because no one is interested in making things right.

I am trying to be careful in keeping this non controversial. So you ask, what is the lesson here, the learning point, the reason for this blog post? It's this: we are lucky for who we are, for what we have and for where we live. What we have is better than good. For many here in India, what they have is worse than bad. For this young girl, I wonder what life will bring her. I hope that it will bring at least some good. Her smile will not allow anything less.

In all things, give thanks,

David

India Medical Mercy clinic day 4

Oh, happy days! I saw her staring at me and wondered what her story was. I was in an administrative mode, meeting with the school pastor, talking to a missionary from Kentucky, and making notes for the report that I eventually would have to write. Others were tending to patients, and I to my paper and pen. But I kept looking at her as she made her way slowly forward in line to be seen and she kept looking at me. I knew there was a story there, a tap on the shoulder of "take notice" because "I have something to tell you." I couldn't resist. Getting up, I pulled her out of line and took her aside and with an interpreter asked a simple question, "tell me a little about yourself." And there it was. The story.

She is 6 years old or there about, living a life that she described as "happy." No prompting from me. She goes to school, loves her family, wants to be a "Doctor" (okay, I pushed her in that direction a little bit) and loves to eat. No complaints, life is good, happy days ahead. Go figure. After yesterday, this was a breath of fresh air that needed hand clapping, hugs and a little dance of joy. How wonderful to see the good side, and an attitude of acceptance for what little is given us.

I hugged her and put her back in line, walked away, singing a tune...oh happy days!

In all things give thanks,

David

India Medical Mercy clinic day 3

Where does it hurt?

I noticed her right away. She was sitting in a row of children but she wasn't really there. Her eyes were distant, her affect depressed and her face showed a distant picture of a difficult life. As I examined children, one right after another, I wondered if the odds would be for her to come to me. I counted off the children sitting in the row, watched the other doctors and nurses who were examining children, counting off as they finished, still wondering if she would be my next patient. She was.

"How are you feeling?" I asked looking at her drawn face. She didn't reply.

"Does anything hurt?" I tried again.

The answer I got back was what I was hoping not to hear. For some reason it was clear why she looked the way she did, and for some reason I knew why. And I didn't want to hear it. Her wide eyes gave some of it away, her affect confirming it. She hadn't eaten dinner last night, nor lunch, and this afternoon, had had only a small glass of milk. They had no food. She lived with her mother, her older brother, and her grandmother. Her father had traveled to New Delhi to find work and to send money back. He was a farmer but his land had been taken away by the government in order to build a building. And you ask, how can that be? It is what it is.

This community is poor, even more than poor. When I asked "does anything hurt", she had no answer because after a certain point in time without food, it doesn't hurt anymore. She was one of the community children we saw after we saw all of our OCM sponsored children. I wonder how many more like her there are.

I sat back and thought for a minute just what this all means. We've all asked this question before of God: why do You let things like this happen? And I for one, have never gotten an answer. We are on our 3rd day of clinics and have seen more than I can ever write about and have more questions for God that are queued up waiting for answers. What I do know is that when I ask the question "where does it hurt", I find myself answering my own question: "my heart hurts."

You would think we would give her money to buy food or even give her some food if we had some. But there is some danger in that. Being singled out in a community that is impoverished brings animosity and jealously. We could put her and her family in great harm. So the best that we could do was to explore ways to feed the whole community. Not so easily done.

I asked her if I could take her picture and she said yes. I tried to show it to her, but she looked away. I wonder why. She went on her way, with some prayer and some vitamins and as I watched her leave our makeshift medical clinic, my heart hurt. These are the hard times we face when we come to serve and these are the times that I ask the hard questions of God waiting for an answer. God, I'm listening.

In all things give thanks,

David