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4th week

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 My last week has been full as I try to get all my patients cared for before I leave.  On monday I performed endoscopic sinus surgery on a needy patient with one sided disease.  This is always a red flag that something sinister could be the cause.  fortunately this patient had what appeared to be benign pathology.  She had polypoid disease extending from the front of her nose all the way posteriorly into the pharynx.  All the equipment worked well and I am thankful for a working endoscopy tower.  This is a great need as 2 of the towers I have used in the past are now not working. In the afternoon, I performed a tympanoplasty to repair ruptured ear drum.  This patient has considerable bilateral hearing loss due to ear drum pathology and previous failed surgery.  All went well and hopefully we will be able to tackle the other side next visit. Wednesday, I did my first mastoid surgery this visit. This patient has been waiting 2 years for her surgery. The drill and other equipment was all
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3rd week

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 My eyes continue to be opened to deeper and deeper levels of poverty here.  As the financial effects of COVID continue to depress this economy, health care resources are affected also.  The national governmental insurance costs from 150-500 shillings a month (roughly $1-$4.00 a month).  Many of my Kenyan patients are unable to afford this amount.  NHIF is covering less and less procedures pushing the cost of health care onto the family and their tribe.  The government is delinquent in making payments to the hospital which pushes the hospital debt greater and greater.  Bills aren't paid and hospital suppliers are refusing to provide needed operating room supplies.  I have performed a number of cancer biopsies but reports are delayed.  NHIF approval which used to take 48 hours now takes weeks.  Cancers which were manageable are growing.  The picture below is of a patient that sought local herbal remedies for his cancer because medical care was unaffordable. Patient with nasopharynge
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Water Filters

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 I arrived safely last week and thankfully the water filters that I shipped also arrived safely.  The ability to ship the filters is truly a 'game changer' for water filtration projects.  I had a wonderful meeting with THCH (Tenwek Hospital Community Health), they reach into the communities and support pregnant women with vitamins and baby supplies, they provide vaccinations for the children and also partner with local churches for outreach.  THCH has picked two large churches for a water filter outreach.  Each church has its own evangelistic outreach, and they will find those folks that are in desperate need, usually the elderly.  They will share the Gospel and set them up with buckets and a Sawyer water filter. Tenwek Hospital has allowed me to ship filters directly to their supply room so I can now keep the 'pipeline', so to speak, filled.  We tried this for a while, but the project sputtered as I was limited to what I could bring over from the States and I was comin
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Second week March 2024

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 This has been a different kind of trip so far.  I have taken many biopsies of obvious tumors and I am still waiting for results.  The national health insurance NHIF has also been more difficult to work with on this trip.  In the past we would have approvals for surgeries within 48 hrs but now we are waiting weeks.  They are refusing coverage many times requiring us to resubmit and wait again.  Despite these hurdles I know God is in everything and we have been working at a steady pace.  I operated 3 days this week performing a number of small cases including repair of an ear drum, tonsillectomies, ear tubes, tracheostomies, removal of a nasal mass and endoscopic nasal polyp removal.  Everyone has done well which is a blessing from the Lord in this environment.    My general surgery resident in ENT clinic         Preparing for tonsillectomy                                    50 year old male with large ulcerated neck cancer that has spread                                    to the spine
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First Week

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 I arrived safely after an arduous journey.  I did get questioned at customs again and needed to pay a Tarif but it was a reasonable rate this time.  I have been without internet until yesterday so I apologize for a late update. My first week was quite busy in clinic as I screened patients for upcoming surgeries.  We has some late nights but it is great to be back serving the Kenyans.  I have performed multiple biopsies on various tumors.  Unfortunately there is no pathologist here so the biopsies can take up to 3 weeks for results.  We will make daily calls to try to move up the cases urgently. This patient was ecstatic!  He was diagnosed with severe hearing loss in both ears.  I fit him with a digital hearing aid and he was able to hear clear for the first time in years!  They live 5 hours away and were so blessed! This is a typical thyroid goiter for this region.  She underwent evaluation of her vocal cords in preparation for upcoming surgery.  This will be a tough one to be done al
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On my way

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  I am starting the long journey to Tenwek today 2-24-24 and should arrive by Monday night 2-26.  A long journey through Europe to Nairobi and then a 5 hour drive to Tenwek on Monday.  I am confident God will care for me along the way. Philippians 2:12 "Therefore, my dear friends, as you have always obeyed-not only in my presence, but now much more in my absence-continue to work out your salvation with fear and trembling, for it is God who works in you to will and to act in order to fulfill his good purpose." I am in His hands and He will fulfill His purpose. Thank you for your prayers, Chase
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3rd Week

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" For our heart rejoices in Him, because we trust in His holy name." Psalm 33:21 The Lord was truly present caring for his people on this trip.  There were many barriers to care this trip but God made a way as we persisted in advocating for the people.  The Kenyan health care system is undergoing an overhaul.  They are in a time of transition presently and this is making it quite hard to get approval by NHIF (governmental insurance) for surgery.  We often needed to submit for prior approval 3-4 times per patient.  This created a lot of work for my resident and clinical officer but with persistence those that we believed God wanted us to operate on were accepted.  The line of patients waiting for ENT surgery is still long, but in a way this is God beckoning me to return. Remember the patient with the large maxillary cyst?  He remained in the hospital for over 10 days as he recovered from surgery and settled finances.  He always seemed to have a somber face.  As I spent time wi
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