Fly

In 1997, Sugar Ray came out with the song “Fly.”

All around the world statutes crumble for me

Who knows how long I’ve loved you

Everyone I know has been so good to me

Twenty five years old, my mother God bless her soul.

 

I just want to fly. . .

 

This is not the song that you would necessarily expect to pop into my head while I am working  out here in Kenya—but several weeks ago, as I watched one of my patients drag her leg into the delivery room, it is the song I heard.

 She was 25 years old. I ran into her on rounds as simply “This is a 25 year old G4P2 @ 26 weeks with PPROM.”  In other words, she was a young mom with kids at home who was 26 weeks pregnant and had broken her water way too early. And she had hypertension—the going thought was that it was chronic. And she had epilepsy. And she had had a stroke at some point. Her parents were gone and she was a widow: her husband had died last year. She wept when she shared that this baby was a product of a rape. I tried to take care of her and her baby—and part of this was doing an ultrasound. This is when I saw her walking down the hall. She walked with a terrible limp. Upon examining her, I saw that her left foot had been terribly scarred and deformed—my intern explained that epileptic patients in the developing world often have these injuries from falling into open fires during a seizure.

 Twenty five years old: when I was her age, I was a young and idealistic doctor, newly minted, and about to start my internship. I had nary a blemish (except for my freckles). I was well loved and loved well. I thought I might save the world one day. My life opened up before me and I was excited to see what it might hold.

 Flash forward to now: watching that young woman struggle with her reality and all of its grimness, all I could think about was her youth, her isolation, and her locked in, closed out world. Few people had been good to her it seemed. She had no mother to comfort her. And I think both of us would have flown away that afternoon if we had had wings. She did leave against medical advice several days later.

 I saw her again two weeks later in Casualty. We were called emergently to see her. She had come back to the hospital with severe pulmonary edema (presumably from severe preeclampsia). We intubated her and we threw every medical thing we had at her. I induced her labor in order to try and save her—and the baby did not make it. But against hope: she DID. After two weeks on a vent, she came out of it. She was neurologically and otherwise completely intact—she had RECOVERED. The OB and the Medicine teams rejoiced. She went home to be with her children. We thanked God for intervening. She was a miracle.

 Two weeks later on, I was in my Gyn clinic when the Medicine attending, a visiting American doctor who had been one of the docs who had worked so hard to help this young woman, came up to me fighting away tears. He stated without preamble: “She is gone—she came back in last night in pulmonary edema. And this time, we could not turn it around. I am devastated.” And I knew he was talking about my patient, our patient—the girl who was twenty five years old and not well loved.  

 

I just want to fly . . .

 

Tragedy.  Cruelty. Violence. Inexplicable loss. Injustice. Suffering and death. Orphaned children. Children gunned down in their classroom a week and a half before Christmas.

 “Why?” my heart shouts, and then the hard question comes again: “Where is your God in the midst of all of this pain?”  When I was twenty five, I think I had more answers—I may have even been arrogant enough to try and offer some of them to people whose shoes I had not walked in.

 But this I know: deep in my heart there is a faith in a man called Jesus. He was born in a filthy hovel to a poor, frightened unmarried girl two thousand years ago. He came to show us that God is love. He came to ultimately overcome the tragedy, the cruelty, and all of this terrible loss.  Early in his earthly ministry, he said as much to some incredulous religious leaders:

The spirit of the LORD is upon me, and because of this He has anointed me to preach the good news to the poor; He has sent me to heal broken hearts and proclaim liberty to the captives, vision to the blind, and to restore the crushed with forgiveness (see Luke 4:18).

And so I keep going. I keep walking even though I no longer can fly. And I trust that my God will ultimately restore all that is crushed: our hearts and His own heart, a heart that loved us so much that He came to suffer and die for us.

 I doubt that Sugar Ray had any of this in mind when they wrote those lyrics. Still, I love that old song.

 

 

 

 

24 hours . . .

On Call

0755 I make my way up the long hill that leads from our home to the Hospital Gate. Up along the broken road, red dirt and busted old pavement, motorbikes, overloaded with passengers, children in school uniforms, women in colorful African prints, stray dogs and scattered chickens, the smell of wood smoke and flowers, bright flashes of birds darting among the purple flowers of the Jacaranda trees.

0805 I reach the doctor’s meeting room for morning report. Consultants, residents, interns and students— flurry of white coats—the sound of English softly accented in a lovely Kenyan lilt, mixed with Swahili and Kipsigis. The phone rings—“Good morning Daktari—they need you right now in Maternity.”

Strange. A senior Medical Officer, who is actually an apprenticed (if unofficial) Ob/Gyn, was on call last night. I wonder what could be happening. I soon find out.

0815 Picture to stay with you the rest of your life: A young mom, lying on the delivery table, a 24 week fetus (I guess the age) who was stillborn, lies on the cart beside her, and the mother’s small bowel has eviscerated out from her vagina—it delivered after the fetus instead of the expected placenta. She does not cry. She does not moan. Like a bird caught in a trap, she is utterly still.

0900 In Theatre. We pray with the mother. We open up her belly. There is a 4 cm laceration on the posterior aspect of her uterus. We pull the small bowel back up through the hole. I figure out the best way the deliver the placenta—the surgical resident undermines it from above and I pull it out from below. I give misoprostol. Pitocin is running. I scrub again and fix the uterus, and learn how to do a small bowel reanastomosis. *

1100 Rounds can finally begin. Forty patients, two hours behind in the day.

1105 Chai time.

1120 We begin in the labor ward. Preeclampsia, trials of labor after C-section, twins.

1130 Stat call to the delivery room: the WORST shoulder dystocia I have ever seen: older mama, grand multip, hypertension, intrauterine fetal demise. I finally deliver the baby by grabbing the posterior arm. I do mediolateral episiotomies out here. Dislodging the baby was pretty awful, but the mom was alright, and we avoided a fourth degree laceration. Fleeting thought—if this baby had not already been dead, would it have survived this delivery?

1145 Rounds start again. Labor room. Room 100 where our immediate post op and post op day #1 patients stay. Our one “private” room. Then the back wards—post ops, Gyn patients, and our antepartum patients. The acuity level here never ceases to amaze me.

1300 I am lecturing on (ironically) “Obstetric Emergencies.” The team is running late. Fortunately, time is a little different out here—it is more or less expected that we will not start on the hour.

1400 I run home to eat a late lunch. Lunch out here is the main meal of the day, and I look forward to seeing my family. I sit down and the pager goes off. Bad strip on the labor ward: the young preeclampic G1 has spontaneous late decels. We do not have continuous monitoring out here—I had requested a NST before we started an induction on this young preeclamptic patient at 34 weeks. We prepare for a C-section.

1500 There is no “thirty minute rule” here. Urgent means ASAP—find the OR team, find an anesthetist. Get the patient prepped. It takes “time and patience” as my son says. Try to rush it. Go on—use words like emergent. Get assertive. Move the patient by yourself. Fuss a little. Fuss a lot. And everything slows down a little more. And you regret not playing by these unspoken rules. Time and patience.

1600 The baby is covered in thick mec—but cries and pinks up.

1700 Finishing the day at MCH (“Maternal Child Health”). Our interns have already handled most of the issues—so perhaps and I can get home. [MCH is an ongoing, M-F, 9-5 walk-in maternity clinic. Run by nursing and a regular clinical officer (equivalent to a physician’s assistant), we help staff it with our clinical officer and medical officer interns. And I serve as the consultant.  I am impressed at how knowledgeable our junior staff is—truthfully, these interns work harder than I have seen interns work in a long time. They see huge volumes of patients, handle tough cases, teach students, study and attend lectures—on call every other to every fourth night working 36 hours straight (oops—you cannot go home post call). And they become really good really fast.  Go figure.]

1800 There are two women with previous scars (this is how we describe previous C-sections) who may be laboring. One has had successful vaginal births before, but she has polyhydramnios and the baby is literally floating. Her random blood sugar was normal but I still suspect she is diabetic. The other has a history of 2 previous sections and was admitted late from MCH.

1830 Up at Theatre. There are three cases from general surgery waiting to go—numbered 1-2-3 on the board. Below, like an unnumbered footnote, are our two patients. Umm. . . I speak with anesthesia—there is only one anesthetist on—we can only run one room right now. OK—but we cannot be fifth as the mom with 2 previous sections is laboring and the baby, and her uterus, will not wait. General surgery weighs in and says we can have the next room.

2100 Home at last after another section. A lot of adhesions—again—but mom and baby are ok. The other lady is not laboring right now. We can wait and do an elective case in the morning.

12 MN Pager goes off. Drat. My clinical officer explains: G7P6 patient with remote history of a C-section followed by successful vaginal deliveries, came in spontaneously laboring at term—heart tones lost, station lost, fetal parts palpated in abdomen, mom tachy.

0030 In theatre, massive hemoperitoneum, beautiful still baby up around liver, uterus ruptured with huge arterial bleeders. Get fluids, get blood. BP dropping. Hands work faster. A lot of prayer. She has six young kids at home. Hands work faster. A lot of prayer.

0200 Patient is stable and going to our recovery room. Adrenaline surge is wearing off—boy I am really tired.

0230 “Daktari, there is that patient with previous scar and polyhydramnios—she is in a lot of pain . . .”

0500 Back home after another C-section. Baby was huge, by the way.

0755 I make my way up the long hill that leads from our home to the Hospital Gate. Up along the broken road . . .

*This lady ultimately did well physically—but her heart was broken.  Abortion is actually illegal here, but  patients obtain them anyway from people in the community who get misoprostol or various herbs for the early pregnancies, and attempt instrumentation in advanced pregnancies. Many come in with hemorrhage that can be fixed with a D&C and blood products. But one presented with renal failure—we think from some herb—and we transferred her for dialysis—but we fear she ultimately died. She was 16. Another had uterine and large bowel perforation—she will live with a colostomy for the rest of her life. She is 17. Family Planning is not readily available to unmarried girls and women in rural areas, and married women cannot use birth control without their husband’s permission. Sadly, whether single, married, or widowed, females in this part of the world do not have a lot of control over when or with whom they have sex, when they marry, who they marry, or what choices their husband makes on their behalf after they marry.

SETTLING IN

    We are now well into our second month here at Tenwek Hospital.  Some days it doesn't seem like it has been that long, and others days we feel like well seasoned missionaries.  Like any move, whether across town, across country or across the globe, there have been moments when we are invigorated by our new surroundings and new challenges, and other times when we are terribly homesick for our friends and familiar surroundings.  However we are comforted by the peace we have in knowing that we are exactly where the Lord wants us to be.

    Joy is very busy with the OB/GYN service.  The need of the women in this part of Kenya is amazing.  In addition to the large number of births this hospital handles annually, she is also seeing women with various forms of cancer on a daily basis, and Joy has also participated in several fistula repairs in her first month.  Joy has been blessed to work with a very experienced OB/GYN surgeon from Vanderbilt University who spent many years working in Nigeria.  Andy, and his wife Judy, really took us under their wing during their stay here and helped us get settled.  Joy is also working with two excellent residents, one of whom is currently training in Greenville, SC.  Jill and I have enjoyed swapping stories about the upstate, but I don't think she has ventured to the Beacon yet.

    Life at Tenwek continues to be busy and fulfilling.  There are children playing everyday and dogs running around, including one very big Great Dane named Zeus. We are very lucky to have a  comfortable apartment with a nice view of the countryside.  We even had a nice big brown slug come in to greet us our second night here!  After several minutes of discomfort/paranoia/disgust, one of the mks (missionary kids) just told us to put on a pair of gloves and put it outside.

  A big part of life at Tenwek is having dinner with friends.  We have hosted two dinners so far.  The first was with a fellow OB/GYN and his wife, one of the long serving nurses, and a family who are adopting two Kenyan girls from a village where they are working to set up a clinic.  The second was a dinner for the hospital staff working on the OB/GYN service.  Joy and I prepared spaghetti, and the Kenyan guests made mandazis (fried donuts) and Chai.

    While Tenwek Hospital is not a town, there are several dukas surrounded the hospital.  The dukas are where we can get sandwich bread, juice, milk, and fresh fruits and vegetables.  There are butchers, salons, and even a place to make copies.  On the other side of the street from the dukas is a hillside field where people harvest vegetables and graze cows.

We hope that these pictures have given you a little bit of an idea of what our lives are like in Kenya.  We both feel very blessed to be in a place with a strong sense of Christian community, both among the missionaries and the Kenyans.  We would ask that you continue to pray for the people in the community and the people who treat and are treated in the hospital.  Finally, we want to thank everyone who has reached out to us through email or facebook.  We love our new friends, but we also miss our friends and family back in the states.  Contact with those who love, care and support us back home helps us to remember that we are merely the tip of an iceberg that is our team serving at Tenwek Hospital.

THE IRWIN’S ARE IN KENYA

     It has been a while since we have been able to update everyone, but we have a good reason.  WE HAVE BEEN BUSY.  In the weeks before flying out, there was scarcely a minute that was not being put to good use.  We were making daily trips to the dump and Goodwill trying to get our house ready for departure, and those trips were accompanied by the also daily trips to Wal-mart, BJ’s Wholesale and the Dollar Store in order to supply ourselves.  In the previous 40 years of my life I never thought I would have to try and figure out how much deodorant I would need for two years.

      At this point I will also offer a bit of advice, in case any of you are thinking of leaving your home for two years: do not try and have your house exterior painted the last week you are in town.  The people working on our home did a wonderful job, but it was an added amount of chaos we didn’t need.  I really wish we had pulled the trigger on that home improvement job about two months earlier. 

      Right now all of you are probably thinking: ‘Joy and Bill are organized professionals, I am sure they were packed and ready to go at least a week ahead of time.’  Oh were it so.  The night before we flew out, we were up to the wee hours of the morning trying to pack our 13 bags plus carry ons.  The interesting thing was there was plenty of space in all the bags, but we kept running up against the weight allowances. In the end, we managed to get most everything packed, and we were ready to go when our ride to Dulles arrived.

     While international flights are never fun (and on a side note, why do they make you troop past the people who get to stretch out on those nice comfy reclining chairs/beds on the way to your cattle car?) our flights went well.  We arrived in the Nairobi airport about 28 hours after we left our home in Richmond.  We were met by one of our neighbors in Tenwek, Dino Crognale,  along with two drivers who were needed to get our stuff and us to the guest house.  Needless to say, we were exhausted.

      The following day, with the help of the Crognales, we went shopping at the Nakamat.  The Nakamat is Kenya’s version of Walmart.  It was an interesting experience shopping to equip a home from scratch, especially a home we had never seen.  In the end, we broke our shopping up into a morning session and an afternoon session, and we probably filled up close to six shopping carts.  We should have tried to get a few pictures of this, but the truth is we were dead on our feet.  After our first day in Nairobi, I think shopping to set up a new home with jet lag and extreme exhaustion should now be considered for status as an Olympic sport, and we never would have medaled without the help of our new friends.

     After another sleepless night in the guest house, it was time to travel to Tenwek.  The last time Joy and I made this trip, it took about five hours over very poorly maintained roads.  I am happy to say that the roads are in much better shape, and the trip only took about 3 ½ hours.  It is a beautiful drive through the Escarpment - think Simba being introduced to all the other animals in the Lion King - and the Rift Valley.  When we last made this trip we saw giraffes walking beside the highway, but this time we only saw a few baboons. Upon our arrival in Tenwek, we were greeted by many of our neighbors, and we had lots of help unloading our new and old possessions.  We were also invited over to various homes for the first several days for meals.  The Tenwek community has truly welcomed us with open arms.

     We have a very nice apartment that we are working hard to make a home.  We have brought lots of pictures of our friends and family that we are going to be hanging everywhere.  It is also nice to be surrounded by our new friends.  It reminds me very much of being back on the Hampden-Sydney campus, where no one was a stranger.  When we walk out of our home, we have two banana trees on either side of the walk, and we look out over the mountain ranges in which Tenwek is nestled.   We are currently in one of the area’s rainy seasons, and there is usually a thunderstorm every afternoon.  However, we have yet to wake up to anything but a beautiful morning.

     Our first full week has gone extremely well.  Joy has been busy at the Hospital.  The OB/GYN service is incredibly busy with all types of cases.  However, she has been blessed with an exceptional Kenyan doctor who has helped her to get her footing and several family doctors, one from New Zealand, who have helped to cover this exceptionally busy service.  The good news is that Joy has been able to come home everyday for lunch to spend time with the family, and she has not been held up at the hospital too late any night.  We would ask you to continue praying for the women of Kenya who Joy is treating, and also to pray that additional doctors will come to provide for these women and their babies.

      In the coming weeks, we will return to Nairobi to obtain our work permits.  Please pray that this does not result in an entire day spent in a government office.  We will also pick up a few things that we only realized we needed after we arrived.  That will be our only excitement for the near future.  We would ask you to pray that Tenwek continues to become more and more like a home to us.  Also pray that we can be good neighbors to those who have already been so good to us, and we can be a good witnesses to each person we encounter along our way.  We have been very blessed by the Lord upon our arrival, and we hope that He is as present in each of your lives.

Until next time,
The Irwins

Leaving on a Jet Plane

LEAVING ON A JET PLANE

     We have a departure date.  The fine folks at British Air, after being provided with sufficient remuneration, have agreed to fly us to Nairobi, Kenya.  They have even agreed to let us spend a few hours in the lovely international terminal of Heathrow Airport free of charge.  So, on October 2, we will depart from Dulles Airport at 6:30 pm, arrive at Heathrow at 6:30 am, depart Heathrow around 10:30 am, and finally land in Nairobi around 9:00 pm on October 3.

     Now that we have our departure date, I am reminded of the recurring cycle that always occurred during college.  I would spend most of the summer looking forward to returning to campus, and  I would arrive on campus to enjoy the bucolic splendor that is Hampden-Sydney.  During this period I was carefree and the world was a wonderful, leisurely place.  Then I would go home for Thanksgiving, and it was upon my return that the sense of dread would descend.  As I drove through the gates of this campus that just 72 hours before had been a sanctuary of peace and contentment, I realized that in just a few short weeks exams would be upon me.  I could think of nothing but the papers that had to be written, the books that had to be read, and the questions which must be answered - sometimes correctly, in order to get through the semester.  (Caveat: This analogy in no way pertains to Joy, or those of her remarkable ilk, who began preparing for the end of the semester on the second day of the semester).

     Today, I feel like exams are approaching, and I will be pulling many all nighters to get to October 2.  Just as one tends to spend a few minutes on the eve of exams wondering where the carefree days of fall went, I have spent some time thinking back to my early days in law.  Today, I tried my last case in the John Marshall Courts Building.  As a young man, it was my success or failure in this building which was the standard by which I judged myself.  I still remember the afternoon I successfully argued a Motion to Suppress before Judge Duling.  Upon returning to the office that afternoon, I declared that I had “arrived” as an attorney.  In hindsight, I realize that the motion was won, not on account of my brilliant legal argument (for I missed the key issue entirely) but because Judge Duling saw the real defect in the Commonwealth’s case.  In essence, my contribution to the case was just getting it on the docket and showing up on time.

     As we are just about a month away from leaving for Kenya, that memory gives me great hope. It reassures me that at this point, all I really need to do is get on the plane.  God will do the rest. Just like those early days practicing law, if left to my own devices I’m likely to miss the issue entirely. 

     As we prepare to leave, Joy and I would ask for your prayers that we remain strong as we finish packing up our home and saying farewell to our friends and family.  While we know that the excitement of arrival will be soon be upon us, we must not let the fear of departure paralyze us. Also, we are thankful for the support, through prayer, donations and positive affirmation, which we have received.  Joy and I truly feel that we are being sent to Tenwek Hospital by our friends, old and new, who share this call to help the women and children of Kenya.

      Joy and I have been privileged to meet with many people throughout the summer and share our hopes for this ministry in Africa.  We have been amazed at the power of the Lord as reflected in so many lives. I was thinking about a family who has experienced a terrible loss. When we met with them, I was able to hear the sorrow in their voices when certain subjects were discussed.  However, what I also heard and saw was a deep and abiding faith in the mercy of Jesus Christ.  Please pray that Joy and I can have that same presence in our lives.  Our friends know that Jesus is with them as they struggle with their loss each day. Spending time with them gave me great reassurance that this same God is with us too--right now in the packing and leaving, and on the plane as we go, and is waiting for us in the place where he has called us.

Clearing Space

     I have heard people say that it is good to move every few years because it is the only way to get rid of all the stuff we accumulate in our lives. I don't know if moving is the only way to do this, but it certainly works. Especially when you are getting ready to make a cross cultural move with only 9 to 10 suitcases. The past few weeks Joy and I have been working hard to clean out our home. A few things will come to Tenwek with us, a few more will go into storage, but most will just go. I have found this process is more time consuming than it should be because so many relics have to be reviewed and remembered. A stack of grade school yearbooks set me back an hour and yielded this classic photo. Opening another box unearthed Eagle Scout memorabilia, and I spent a half hour going down the road thinking about all the life lessons I learned from Laurence Chapman and the perseverance of my parents in helping me earn that rank. We have old toys, pictures and letters that have brought back good memories and a few bad ones. At times it has been fun calling to one another to show off some vestige of our youth or a cherished memento from when we were dating.

      However, it has also been difficult parsing through our lives to make more space.

There have been times when I wonder what we are doing. I ask myself how are we going to leave this all behind, but the answer is also crystal clear in those memories. Everything each of us did, whether alone or together, was God leading us to this point. It was not happenstance that I was so involved in Scouting, an organization which places so much importance on serving others. It was not a random act that brought me into a relationship with the President of Hampden-Sydney College, Sam Wilson, who encouraged me to attend his Sunday school class at a time in my life when I placed little value on early rising on a weekend. And it was certainly no coincidence that kept Joy and me from adopting our son until 2009. Just as God had us waiting for our son, who wasn't even born back in 2007, He did not allow us to knock down the door to service in Africa when we thought the timing was right. He made us wait on Him until He opened the door: He has planned all of this in His time and not ours.

     And so, clearing out the relics has made room--in our house and in our imaginations: how is God crafting our lives now, today? And what new things might He create in these new and different spaces?

All news out of Africa

One of my favorite books is Paul Theroux's Dark Star Safari. My mom gave it to me ten years ago this summer (I remember this because it was the summer before I left for Africa the first time). I sat in the front yard of the home where I had grown up. It was hot, like it is now, and I was in a lawn chair out under our big old maple tree, dreaming of the wilds of Africa and missionary medicine, and listening to the sounds of suburbia: lawn mowers and cicadas. I opened the book and this is the first paragraph I read:
            
"All news out of Africa is bad. It made me want to go there, though not for the horror, the  hot spots, the massacre-and- earthquake stories you read in the newspaper; I wanted the pleasure of being in Africa again. Feeling that the place was so large it contained many untold tales and some hope and comedy and sweetness too- "

A decade of years and about a thousand lifetimes (it feels like) later,  this paragraph still grabs me, but for different reasons. In '02 it was all supposition and mystery and promise--without faces, without memories. "All news out of Africa is bad." It sounded about right to me back then. I was sitting on the lawn and trying to think if I had ever heard anything good out of Africa.

This summer I am rereading the book, and my eyes dart over the first paragraph--but then return to it. It is a great place to start. It draws you in. It makes you want to read more.  But now the first sentence just serves as a place mark for me to remember--the people with whom I have worked, the patients I have cared for, the places I have lived and traveled. And it is largely the hope and comedy and sweetness of that life, of those people and places, that I recall. . .

Hope. Her name was Sidesso, and she was one of the first fistula patients I helped care for. Every day after her surgery I rounded on her, and waited with her for the day when her catheter would be removed. Truthfully, I was afraid with her, because I knew that wonderful and awful and beautiful thing called hope is a tenuous creature, and I did not think I could bear watching something so recently regained, lost again in that terrible pool of wetness which signals a failed surgery. The day arrived, and I remember the look on her face as I approached her bed: she was beaming and young and beautiful and full of--hope--made real by the dry sheets underneath her.

A VVF patient waits for her surgery. Addis Ababa, Ethiopia.

Comedy. And then there is the story of my hike through the Impenetrable Forest in Uganda to see Silver Backed Gorillas . . . For those who know me well, my reputation for tripping is legendary. But here on steep mountains, I could not afford a twisted ankle. So, while my group looked on, I perfected what has become known as the Draper Butt Maneuver. I made it down. I was told that no one, before or since, has seen anything like it.

A legend is born . . .

Sweetness. Bill did not grow up drinking hot sweet tea with boiled milk. I did--and I love it to this day. In Kenya, it is called chai, and is just that--no spices ala Starbucks Chai--just good hot milky black tea and sugar. Problem: when Bill first encountered it, he tried it, and thoroughly disliked it--it actually made him sick to his stomach. Problem: drinking chai is a shared family and community act. It is part of the hospitality of Kenya. For a while, we tried to hide his full cup, and I had to do double duty, drinking mine, then his, and doing the cup shuffle. Until--one day we were visiting with a local family who ran an orphanage on a wing and a prayer out about an hours drive from our hospital. We were served chai. The lady of the house noticed that Bill did not drink his. We tried to explain. She got up and left--for a long time. Had we terminally offended her? About 45 minutes later she returned--with a big unopened jar of Maxwell House freeze dried coffee made in America. We just sat there and tried not to cry. It probably cost her a week's worth of food. Bill thanked her and drank a cup of black coffee. On our way home, he declared that he would never refuse to drink chai again.

Hope, comedy and sweetness. . . All news out of Africa.

A New Beginning

A NEW BEGINNING

Prologue:  Sixteen years ago, a young man starting his legal career met a young woman searching for the path upon which God wanted her to walk.  As the years passed two things became clear:  the Lord was calling the woman to serve the women and children of East Africa, and He was calling the two together.  They were married in 2004, and in 2009 they joyfully became a family of three!  Through all this time, her call to Africa became their call to Africa, and they waited for the right time to serve. 

A NEW DAY DAWNS

At 5:00 p.m. this Friday our family will officially begin our life as full time missionaries with Christian Health Service Corps.  As this event approaches we are filled with the excitement that only a new adventure can bring, and the apprehension that stepping away from all that we have known also entails.  But of this we are certain: our family has been called to help minister to the women and children of southwest Kenya.  As we venture away from our lives as a doctor and lawyer in America, we are stepping out in faith and the belief that Jesus has asked us to go and help relieve suffering and offer comfort where the needs are, well, simply overwhelming.

As Friday passes, we will devote all of our energies to prepare to depart for Tenwek Hospital in Kenya.

OUR FUTURE

Tenwek Hospital is located in rural southwest Kenya, 150 miles from the capital, Nairobi.  Tenwek is the only hospital available to women in this area. It is a major teaching hospital as well, with a school of nursing, and residency programs in surgery and family medicine. Joy is an ob/gyn who loves to teach. She will be caring for women who have often labored for days, and have complications from protracted labor. In addition to obstetrical care, Joy hopes to have the opportunity to treat girls and women who sustain a specific birth injury known as  fistula.  This injury is incurred when women suffer from unrelieved obstructed labor.  This leaves these individuals incontinent, and they are often treated as modern day lepers in their villages.  This is an injury rarely seen in the states, but there are believed to be over a million cases in sub-Saharan Africa with an estimated 100,000 new cases each year. She will also be dedicating her time to teach African doctors how to do what she has been trained to do.

Bill will be working with a newly formed organization helping to raise funds for the hospital and helping with the Tenwek community's efforts to assist the Kenyans living near the hospital.  We also all intend to devote as much time as possible to working with the local orphanages.

SUPPORT UPDATE: WHERE WE ARE AND WHERE WE NEED TO BE

Our immediate needs include completion of our support raising.  While serving at Tenwek Hospital, we will not be receiving a salary. At this time, we have raised almost 40% of our needed support, and we continue to pray that God will move those who hear about our call to join our support team.  To those who are currently supporting our family, you have our heartfelt thanks and prayers.


Total amount we need to raise for two years: $80,000 ($40,000/year)
Monthly support needed: $3,000/month

We need supporters who will pledge $5 or $10/month. We need supporters who can pledge $100/month. We need one time gifts (a one time gift of $5 is appreciated and everything helps!)  and annual gifts.

 PLEASE consider joining our team. We cannot go without you! 100% of your money goes directly to this ministry. Christian Health Service Corps is a 501(c)3 and so all of your gifts are tax deductible.

PRAYER REQUESTS
 *     Please pray for the people of rural Kenya who surround Tenwek Hospital--especially the women who are expecting. Tenwek will be without an ob/gyn from September until we arrive.  Please ask the Lord to care for these women and the medical personnel who will be provide their care.

*     As we begin to pack up our home and prepare to move, we ask that you pray that we find a family who wants to rent our home.

*     Finally, we pray that the Lord will bring more people into our lives who want to join in our ministry.  If you or someone you know is interested in partnering with us please email us: irwins@healthservicecorps.org or donations can be made directly at http://www.healthservicecorps.org . We love to share about our call and this ministry--to individuals and groups--let us know if you would like to meet with us or have us visit your church, or community group!