First week March 13-18, 2023

 Praise the Lord I arrived safely with no travel issues.  My luggage was marked for inspection but when I ran my bags through the bagger scanner the inspector was asleep!  All the metal instruments and supplies went unnoticed.  This was a big concern as I was transporting quite a bit of expensive equipment including $20,000 of hearing aids.

Kenya has continued to be in a serious draught.  This has driven up the cost of food goods on top of the already inflated prices from COVID.  The country has been obviously struggling.  This includes the hospital systems, like Tenwek, as the government has not been making the government health system payments.  Simple supplies in the hospital are just not available-like paper towels, toilet paper.  Repairs of medical devices are lagging making it more difficult to care for patients.  I have noticed the resident staff moral is low as they struggle to get what they need to care for patients.

                                     waterfall that feeds hydroelectric plant is significantly reduced

                                               Locals are fishing in dried up river bed for food

My first week has been a real challenge.  The clinic was very busy as patients rushed to be seen and get on the surgery list.  The medical problems have been very challenging.  I am focusing on ear surgery this trip.  My first Operating day I cared for a 5 year old girl with acute mastoiditis (complication of ear infection) and a rare disorder Histiocytosis X.  She underwent a very difficult surgery.  If the pathology report confirms this disease she will need chemotherapy.

We also did 2 emergency tracheostomies (surgical airways) for men who were in respiratory distress from cancer of the voice box.  They are both in the hospital waiting for their pathology reports to confirm cancer.  They have advanced cancer and they will lose their voice box if we do surgery.

A young girl 7 year old girl ran into the road at night and was hit by a vehicle.  She has a traumatic brain injury and is recovering slowly.  I was asked to see her for noisy breathing.  She has scaring in her airway related to having a breathing tube in place when she was in the ICU.  This is a difficult problem to care for here as we don't have the endoscopic equipment needed.  We took her to the operating room and dilated her area of scarring.  She is much improved now and I am praying this will continue.

                       We removed a noncancerous mass of the salivary gland in this patient on Friday.

I am also caring for a muslim women who presented with infection at the base of her skull.  This has caused loss of function of many of her cranial nerves and she has formed clots in her main venous system. She has had a loss of voice and trouble swallowing.  On Thursday she underwent a difficult drainage of the abscess by a wide neck incision to gain access.  She will be in the Hospital for 2 weeks to receive IV antibiotics and blood thinners.  I believe the Lord will use this time to minister to her and her family.  I am praying for salvation for this family.  I have had several opportunities to speak about Jesus and his healing power.

                           For the medical people this CT scan shows a high abscess at the skull base

The work is hard and long but my love for the Lord drives me forward each day.  I trust Him to give me all that I need for the day.  Thank the Lord that His grace is sufficient for His power is made perfect in my weakness

Thank you for your faithful prayers. 

Chase Miller