Moving forward

I have a one year position in general surgery at Johnson City Medical center in Tennessee.  We'll see where we go from there.

Please pray

I don't have a job.

I have reapplied.   We will find out more on Wednesday.

Daniel

God's Confirmation

Tonight I had the privilege of recapping the last year of my life in an interesting interaction. I met a 3rd year medical student aspiring to orthopaedics. Knowing little about him, I expected to be minimally helpful, but desired to give back some of the many gifts of information God had ordained in my life.
After talking awhile I found out that he went to a Christian college, had a similar background as I do, and is facing many of the same challenges as I was with resume gaps. It was too cool to share all of the ways God had blessed me in the application process. All of the connections, all of the moments of triumph, all of the failures. I got to initiate a process of perfecting the application for a person that would struggle to get into this highly competitive field, but with an incredible God, proving all things are possible.
I know if I don't get the job (as we will find out job or no job tomorrow, where I'll be going is Friday) this process had meaning. I know my life has purpose and the reiteration of being able to help others in the mean time is supremely rewarding.

I'm amazed.

My ole Kentucky home

Man this is a sight for jet lagged eyes.  I am fortunate enough to have survived chaos.  Let's pray this week is less spontaneous.
Things that make America great:
Drinkable water from a faucet
Hot showers
Steak and seafood
Crosswalks that drivers pay attention to
Southern accents
Collegial team spirit
Powerful car engines
Airplane pilots landing skills
Public education
Interstates

Amazing race here I come

Delayed 3 hours leaving Kenya.
Longest security check in Paris. With a 45 minute layover. Strollers were flying. 
15 minutes late and see a Delta plane leaving. 
Last person to board last Delta plane in France.
Wake up in California to a snowstorm in Denver with a cancelled flight.
On phone with United for 25 minutes.
Flight from Lax to Louisville.
Call cabby.
He's there before my luggage is packed.
Stop for natural gas.  Fueling is universal for cab drivers picking me.
Three cards didn't work.
Used my card.
On the road again.
Prepared to battle at LAX.  What a trip.

2:30am Wakeup

I wake up to mass confusion and a PA message in Swahili.
5 minutes later a guy wades through a sea of people and says, "Flights leaving Paris after 10 am are going to make it"
The flight is now over 3 hours delayed and my 4 hour layover in Paris has been erased.  We will see.  

Out of Africa...well almost

After having a good day with Dr. Emily and family in Nairobi, I am thankful for peace in Kenya, the American election process(no matter how flawed it may be), and coming from a place that I am proud to call home.
I am just passing through today, and quite fortunate to be a day earlier than the revealing of election results from Monday's contest(a runoff may be needed).  19 people died on polling day from a radical group(largely unrelated to the election, they are from the Mombassa costal region that I have been nowhere close to on this trip and were know about before the attack).  The majority of the country has been peaceful.  God is blessing Kenya.
I don't ever fear to cast a vote.  I vote by mail or electronically and it is counted.  It takes 25 minutes. All things I take for granted.
As I sit here in a very nice (and well protected) airport, I am notified that my flight is delayed.  No worries.  It is Africa, nothing happens on time.  This is the second of six flights to get home.  Hakuna matata.  My stomach is starting to get angry.  I have prayer and cipro.  Life is very nice from the African perspective, even though most of us Americans would consider it less than ideal.  There are many things we can respect and learn from this way of life.
I love when a country thrives because the majority of people love Jesus and therefore respect their government's authority.  Ethiopians are proud.  Kenyans are too.  I am proud, to have a wonderful home on the Earth and a greater one for beyond this life.

Last Night in Addis Ababa

Please continue to pray for the Kenyan election as the ballots are yet to be counted.  I am leaving Ethiopia tomorrow en-route back towards the states. 
Here in Ethiopia I am leaving many new connections and opportunities for further partnership.  It was an ordained time to have spent with people who love God and have a heart for communicating that to His children.  I have appreciated the time to witness and be part of many interesting and unique African ministries.
I will be doing some reflection (and sleeping) on the flights home.  I plan on giving as many updates as possible where internet access can be found.
I look forward to reconnecting with many of you in the near future.  Please stay tuned for prayers as next week is probably the most unique sending process one could ask for (the Residency Match).  This time I will find out what kind of doctor and where I will be training.  An exciting time is in store!

Thank you all for your continued support.

Lots to cover

Saying goodbyes is always difficult for me.  I have a tendency to become attached.  My time at Tenwek was fruitful, learning lots about myself and orthopaedics in the developing (but not 3rd) world.

One of my favorite interactions was with a patient that was in a serious accident (many fractures and polytrauma).  He was seen at an outside facility before being transferred to Tenwek.  At Tenwek I was his first contact with our orthopaedic team and I put a traction pin in his leg in the Emergency Room.  Not quite the most fun thing for a patient who is mildly sedated yet still in excruciating pain to have a rod put through their bone with a Dewalt drill (sterile technique).  I was pretty sure he hated me.
After the stabilization of his pelvis during the first major operating room procedure, he became quite interactive with the team, smiling and joking at every interaction.  His excitement to stand up with two broken legs, yet to be fixed, made the staff and I wonder if he was 100% with us mentally, but that turned out to just be his nature. 
The next day one of his family members gave him a mirror.  This was quite an event. His face was marred, yet not destroyed; his ear was bulging with a hematoma which was likely infected from the first hospital's repair with incorrect sutures; and some of the scabs were now coming off showing unpigmented skin.  He had many questions that I could reassure we would fix the issues upon his last surgery.
I got to be part of the OR team for his remaining fracture fixation as well as ear repair.  The surgery went well.
The recovery days following I started to see even more of a friendship develop.  The day before he discharged he gave me the most genuine of compliments. "You treated me as if I were your own father."  I didn't know that orthopaedics would induce me to tear on rounds.
He was a believer before, but his ability to translate let him be a point person for many others care while they were on the ward together, I know having an impact in each of their lives.   He was truly grateful that God provided his healthcare.

Interactions like this one is the reason medical missions makes sense.  Life changing interactions on both sides of the white coat.

I feel like every patient is a VIP in a mission hospital.  Since we are all God's creation, I find there should be minimal distinction except medical/surgical emergent need.  Scripture is very clear in James 2 that we are to not treat people differently if they are wearing jewelery or fancy clothes, lest we are making a worldly judgement.  Treating everyone with this high level of priority is exhausting.  There great strength provided to bridge this gap.

God provided some awesome opportunities to connect with those who have been doing international missions for most of their life.  I interviewed for both Orthopaedics and General surgery programs.  Prior to my trip I was unsure what "God's will" was in this choice.  All my education and life experience to this pointed towards orthopaedics, however there are many places general surgeons can serve where orthopaedics is too specialized.  It is very reassuring that when a general surgeon who has done orthopaedics for 12 years says, "If I could go back again I would do orthopaedics".  This sealed my ranking of programs.

I love followup.  I was able to see churches thriving ministering to Muslims, street children being rehabilitated, and clinics in the poorest areas providing high quality healthcare that was once only a prayer.

I left behind all of this, praying for a peaceful election(tomorrow 3/4/13) in Kenya, to enter a new land to me.  Ethiopia, is rich with tradition of its own.  They are very proud to be the only African country to never be colonized (however they were occupied by Italy for 5 years).  From the first moment there is a distinction from Kenya in this place.  The people are unique.  The injera(napkin bread) is full of aroma.  Addis Ababa is under construction.  It is like Kenya meets Egypt, which makes sense geographically, with a distinction in Amharic language to confuse any fringi(white foreigner).  Faiths here are Orthodox, Protestant, Catholic and Muslim.  The government is trying to be independent, but accepts assistance from almost anywhere. 

What have I been doing in Ethiopia?  I have helped American missionaries working at a Korean hospital, visited empowerment projects, observed clinics that are in need of short term assistance and done my best to encourage the difficult work.  Staying on the college campus has been nice to continually be connected with the students that my friend, Holly Garrett, has in class.  

Playing sports is universally enjoyable.  I have had opportunities in both countries to use volleyball, or wallyball, to build relationships.  Many of the things that tie us together can be used for God's glory.  The one request from the street boys in Ethiopia was for some time to play football(soccer). It could be a very powerful motivator for behavioral change.  There are many groups doing missions with sports including two cool missionaries that stay here on this campus.

All of these experiences are building a network for the future of the Kingdom.  It has been a very blessed time of preparation.

Last night I was writing by candlelight when the power came back on around 8:15pm (12:15pm est).  The connection was spotty, but I got to watch my Louisville Cardinals defeat the Orange.  I'm excited for March Madness.   Go CARDS!

Sunday Treat

I was able to visit a friend's church, eat lunch with the family and take lots of pictures in the process.

Getting back to the guesthouse I had some responsibilities to take care of.  Now being a longstanding resident, I have been giving hospital tours.  A really awesome family from Tennessee have came with two small kids, and finally another medical student has arrived!

The most exciting part of my day was facetiming with Mt. Olivet Church in Williamstown.  God is doing some amazing things in a really active part of the body of Christ.  The love and support they/you provide is capable of sustaining the tough challenges of doing medical missions.

Its time to start another week.  I'm praying for remarkable outcomes in all of our lives because we have trust in the Lord almighty.

Long Overdue....

So surgery at Tenwek is going well.  The orthopaedic team is very busy, often having over 40 patients on our service with 10-15 or so needing a non-elective surgery at any given time.  I have worked hard.

Today was very restful.  I woke and talked to a very nice lady who with her husband was helping in a village for 6 months when she was handed a 15 month old that weighed less than 5 pounds.  For the short story she started taking care of the child that a grandmother couldn't raise and her twin sister was also brought for IV fluids and food.  She has 100% family approval for adoption with a commitment to raise the children as dual citizens, but is still fighting a custody battle with the Kenyan government adoption program.  Her husband and other children have been in the states and have been divided off and on for the last 1 year with another 6 months+ to go.  Please pray for this family.  The girls are adorable and doing well.

I have had really a dose of what residency could be like.  Lots of logistics in managing patients, helping make decisions on care for patients, changing dressings, updating medications, teaching patients and helpers on how to take medicines, participating in surgeries, holding reductions, casting fractures at 2:30 am, answering questions about homeopathic herbal remedies, scrubbing legs, sewing up ears, and getting questioned by American chief residents.

I love it.

Last weekend I went to Kisumu and saw people from my trip in 2009.  It was such a blessing to surprise Mary(she has her son with her now) and Ephantus(the new program director, Oke is back in Nairobi and has a second child), and ride along with Jakes (who is much more confident in his English).  So many great things are happening there.  17 children are off the streets and no longer snorting glue, 19 churches are involved up from 5 before, a new rural location is added, a medical clinic is supporting the healthcare needs of the many people involved in this growing empowerment movement, and  many widowed ladies are now able to provide for their children.  The impressionable elderly lady that proposed to me 4 years ago is doing well and still leading her church in giving and service while raising many of her grandchildren.  The focuses are shifting towards vastly expanding the work to prevent children from getting to the streets by using their church family as a network of support.  God has blessed this ministry immensely.

Many of us on the orthopaedic team (including two attendings, a short and long term) are leaving this week.  Please pray we are able to help as many people as possible and that Lord would use the work to glorify His name.  Pray that the census would reduce so that those left will not be overwhelmed.

God continues to bless me with great mentors and conversations about what faith journeys look like when you surrender your own wants and desires.  I am thankful for the time to tangibly be molded during this crucial transition point in my life.  He has also given me many people to encourage out of the abundance He blessed me with.

Check back.  More to come tomorrow!

The Greatest Entitlement

I have seen a patient in Kenya struggle with some of the same hard times many Americans face daily.  Getting assistance from the government or other organization is really appealing.  Kenyan social services are not nearly as generous as ours.  These were some of my patient's thoughts:

-Someone else has it "more fair" because the system helps them.
-If I could just get help with not having to pay my taxes then I would have more money for...
-I am a victim of my situations

Longing for these things rob us of our joy, hope and trust that God alone can provide for our needs. Here is how I think Christians can radically look at the situation differently.

-God has me in this situation with a purpose.
-How can I give abundantly out of the struggles God has helped me overcome.
-I am empowered by my Savior to bring light in a dark situation.

Let's trade worldly traps of dependence on aid for eternal entitlement.  Salvation through Jesus Christ is the most sustainable life-giving program ever created, we all should desire it more than any provision on the earth.

Church

I went to the missionaries church today.   It was very nice, but not as charismatic as most African churches.  However, a 5 year old boy was playing the drums very well (and I am told he has been doing so for about 3 years!).
I took a walk down to the hydroelectric generation plant situated on a 75 foot waterfall.  God's provision is incredible.
It was great to see a lot of your faces on facetime.  Technology makes the world feel very small.
We are gearing up for another busy week, please pray for continued rest and health, giving thanks for the gifts that have come thus far.
 

Kiddos in Spica Casts

So today was restful.  I woke and rounded, later than on weekdays, and was left with a task.  A family was promised to go home by today, but on a busy service, promises are often forgotten in the medical community.  Doctors rely on comfort levels when making judgement calls like discharge dates.  I had remembered an earlier conversation with this dad that had indicated he needed to be home soon, and his son was indeed ready to go minus some casting that we needed to do.  Cast technicians work M-F like in the states.  After reminding the surgeon of his promise, he told me we would walk over and try to find someone to cast (something that would never happen in the States).  God provided a willing person with the time and resources and I was charged by the doctor to help put this cast on.

Please pray for this boy.  He has an infection in his bones, it could cause him to loose walking function for the rest of his life if it does not clear.  He has had surgery to remove what was bad that could be seen and he is on antibiotics to help clear the blood.   Our team treated, but only Jesus, the great physician, can heal.  We protected his leg with a cast for the treatment process to be facilitated.

So the patients leg is protected and he is home in his bed tonight.  I thank God for the small part that I was able to play in today's adventure.

Ps:  Cute kids get even cuter with whole body casts.

Persisting through pain

Kenyans are tough people.  Most of the procedures are done here without general anesthetic, which means spinals, local and monitored anesthesia care are the mainstays.  We have got to do some incredible pain revealing procedures which brings great joy to both patient and medical staff.

Sleeping under a mosquito net is painful for me, but I know that it is a good thing.  Another great thing about Tenwek is that the high altitude means a very low chance for malaria!

Hope all is well in the states.  I really pray to sleep well tonight as I will be taking call this weekend.  Also praying there are not too many machete wounds to fix.

God's Connections

So.  I've rotated at places in the states with surgeons that work at Tenwek and other mission hospitals without ever knowing that this was the case except when I walked into their OR and started talking.  Met people who have like interests in international surgeries (that also happen to be chairmen or program directors).  I have left interviews with new connections into the international surgery community.  Today, revival broke out in the recovery ward, people were asking for bibles, recommitting their lives to Christ.  It just so happens the american doctor here rotated with one of the surgeons that I know was a former missionary surgeon.

God is too cool.  I could seriously not be hired into a residency come March and know that exactly what happened during this time was God's will.  Life is incredible when we let God take over.

Let's take off the veil the world puts on and experience the Christian life fully.  This is my prayer for us today. -2nd Corinthians 3: 12-18

Day 1 of Ortho at Tenwek

I loved it.  It is so cool.  Lots of crazy stuff in clinic.

Arrived at Tenwek

I'm here and made it safely.  The drive is awesome through the rift valley.  I had a long discussion with the driver (also a Daniel) about what it looks like to find God's calling in your life.  We are very similar (of the Kikuyu tribe - they named me Kamau last time), and his aspirations were neat to talk about.  He along with many of the students I have talked to at the missions conference in St. Louis all seemed to be frustrated when asking this question "How do I find God's calling?"  the typical response is "Pray".  I know prayer is the most powerful tool that God gives us for finding discernment in our lives, and we are supposed to be praying continuously, and if you get the chance to come to Africa you can see what this looks like.  These people pray!  So, my response is this:

   Not only pray, but look for God's response intently.
   What strengths and talents did He bless you with?
   What situations have you been in that you best serve in the Kingdom mission?
   What mentors did He allow you to be introduced to?
   What challenges have you overcame with God's help?
   Where do you feel most at ease in living the Christian life?
   Where could you find persecution for presenting the gospel? -Matthew 16: 24-25

These are thoughts that have worked for me.  What has God used to express His will in your life?

Prayer at LIA

What a blessed day.

Picked up at 8:30 Kenyan time. (10:00).  Jakes as the driver.   Such a long overdue reunion. Prayer was impactful using genesis texts on the sovereignty of God, his desires to control the spirituality of our lives and ability to redirect humanity that has strayed.  Powerful.  James oke is back at Nairobi office and has another son of 6 weeks old.  So good to follow up on programs that have multiplied in Kisumu.  19 churches up from 5, 17 street children in homes! God is so good.

Kibera and kisumu have medical clinics with Kenyan doctors and dentists full time!  Went to Kibera to meet them.  So awesome and so much potential to help the worlds most vulnerable with healthcare in Jesus' name, using a Christ inspired model.

More to come but I'm using an iPad with the power out.

Travel to tenwek tomorrow.  Please forgive a day without a post in advance.

Relaxed Sunday

Woke up at the guesthouse with an odd feeling that 4 other people were missing.  Otherwise a very uneventful day.

Made it!

Had great flight mates from Finland.  Arrived early with all my bags (praise the Lord).  Dr. Emily and Dansun picked me up.  I am very thankful for all the prayers.  Please rest easy all those who were concerned.

Amsterdam

I'm over half way there, and very thankful for the open seat next to mine and much appreciated extra space on the 10 hour flight.  However, there were two small children using my seat as a playground from time to time.  I am very thankful for the ease of solo travel.

Last night in California

It was awesome to be so blessed with a wonderful final interview at Loma Linda.  As I prepare to board the planes back to Africa, I am very excited for many opportunites. 

I submitted my rank list of programs I am most interested in doing my residency at.  Another milestone in a medical students life.

I was truly guided through the entire process and am very thankful to now be done with my end of the work.

Another adventure is awaiting and I'm going to need your prayers throughout the upcoming 6 weeks.

Asante sana,

Daniel