Jimmy and Chase Miller- Serving Kenya since 2011

 This week has been a time of steady work in the clinic, operating theater and casualty.  There have been some really tragic cases coming through casualty.  My heart breaks for the suffering here.  We see these things in the US but I have such a love for these precious people that I have to hold back the tears when I minister to them. This 38 year old male was so destitute that he cut his throat in an attempt to take his life.  When asked why he did this and does he know Jesus he replied, "Yes I know Jesus but this was satan who told me to do this."  His injury was 7 days before he presented.  He was unable to eat and talk as the laceration was through his pharynx (upper swallowing tube).  He was taken to the OR where we needed to place a breathing tube and repair a large tear in his pharynx.  He has been in the ICU but recovering well.  He has been unable to communicate due to the tracheostomy tube.  This is temporary and will come...

 The country has remained in a bit of turmoil this week as impeachment proceedings for the Dupute continued.  He was successfully impeached on Friday but there has been no political unrest fortunately.  The health care system remains in shambles with no negotiations moving forward.  To give you an idea of what the new health system is suggesting it appears that comprehensive family practice care for 1 year will be reimbursed at 900 shillings (about 7 USD).  The hospital is struggling to survive on a cash only basis.  But we were all reassured to see there is a corruption free zone in Kenya as below! Despite the financial issues I have remained busy in the ENT clinic and operating room.  I have been removing tonsils, laryngeal papillomas, dilating tracheas for subglottic stenosis and removing nasal and sinus polyps. Below is a large benign tumor of the salivary gland that was removed on Thursday.  This was a bit tricky without the usual facial nerv...

Continued political battles in Kenya are monopolizing politician's time rather than more pressing issues of the economy and healthy care.  The impeachment process of the depute passed in the parliament and will  be voted on in the Senate this week.  In the meantime, the economy continues to struggle with high cost of living leaving the poor to struggle to afford basic necessities.  The hospitals have been left struggling due to slow release of funds from the Government.  Tenwek is in a state of major strain from loss of back payments and now reduced daily income as patients are uninsured and lack funds to pay for services.  Its a mess! Somehow God has continued to provide for the needy and this last week I saw many ENT patients and operated for 2.5 days.  The patients have heart breaking stories of delayed care.  So many suffering of treatable diseases.  This week I performed several tonsillectomies, endoscopic sinus surgery, and several biop...

I arrived to Tenwek safely Saturday evening.  This was the easiest trip I have had so far.  I walked right through customs with 2 suitcases of medical supplies and was not stopped!  This was a real answer to pray, Praise the Lord! The country side remains beautiful!  This is a bridge over the Mara River that I passed over on a hike.  The water levels are high even though the rainy season has not started yet.  Although the land looks green and well nourished the health system is in a disaster.  The Kenyan government has decided to change their national health insurance.  They did this with no preparations in place.  The reimbursement fees are lower and what they will cover is much less.  This all stems from a very impoverished country that has still not recovered from the devastation of COVID restrictions.  Tenwek administration has refused to sign the contract with the government so we are in a virtual strike.  Patients are una...

 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 sur...

 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 medica...