All Creation Proclaims

And just like that my time at Tenwek has come to an end. It was not what I thought it would be but what the Lord had planned. I was able to help the pediatric team in the hospital for a few shifts again before leaving. It was a pleasure to work alongside them and to even see how the team has grown and improved since my last visit. My last week at Tenwek we did have a few kids that ended up in the ICU. One a small child with a well-known congenital anomaly that is usually found pretty quickly in the US. Essentially his bladder could not empty like it should and over time fluid built up in his kidneys and caused damage and enlargement. He came in very sick with kidneys that were failing. So, his electrolytes were very off as well as his blood pressure. You may not be aware, but kids rarely have heart or circulation problems that cause high blood pressure. In children the most common cause would be problems with the kidneys. The kidneys are a fascinating organ and honestly do some very incredible things to keep us alive. Part of that is regulating how much fluid is in our bodies- if we pee out more fluid or hold onto it. They also filter out waste products and excess electrolytes and give feedback to the body on how high the blood pressure should be. This kiddo had an interesting problem that is not very common in kids. His systolic blood pressure (top number) was SUPER high for his age and height, but his diastolic blood pressure (bottom number) was so low I was worried he was about to crash on me. So, at the same time he had both hypertension (too high) and hypotension (too low). We had to give medication to lower his blood pressure because when it is that high there is a risk of a stroke, but we also had to give fluids to raise his blood pressure and keep him from crashing. Thankfully the Lord has begun healing his kidneys and he is doing much better now! 

Our other child in the ICU came in with systemic varicella zoster. You may recognize that as the virus that causes chicken pox or shingles. But this was to the max! His lungs had fluid in them and he had a liver injury all from a virus that many in the US take for granted. Thankfully, he also is doing better for the time being. Every time I go to Tenwek there is a wide array of pathology that is both interesting and sad. Malaria, HIV, Guillain Barre Syndrome, Trisomy 13, fatal diaphragmatic hernia, graft vs host disease, lots of meningitis, malnutrition and pneumonia, several with pulmonary hypertension and heart disease either congenital or from rheumatic fever. But what is so nice to see is that even halfway around the world in a culture that is very different than my own people are worshiping and praising the same God! It never ceases to amaze me how you can find those who follow the Jesus of the Bible all over the World. And how hungry people are to know Him! 

Romans 10:19-20 “Since what can be known about God is evident among them, because God has shown it to them. For since His invisible attributes, that is, his eternal power and divine nature, have been clearly seen since the creation of the world, being understood through what He has made. As a result, people are without excuse.” This passage is talking about how creation proclaims that there is a God and therefore no one has an excuse to not worship the Creator. Just before coming home, I went on Safari. I saw lions, zebra, giraffe, elephants, all kinds of antelope, cape buffalo, hippos, and monkeys. His creation is truly astounding and points to a Creator that is even better! You see there is a God who is great and loving and perfect. But sin has messed this world up in incredible ways and keeps us separated from Him and we ALL sin (Romans 3:23). Yet, God in His mercy sent Jesus to pay our penalty for sin so that we could have fellowship with Him again (Romans 6:23-24 and John 3:16). But this restoration is only for those to repent of their sin (agree that they are sinners and turn from their sin) and place their faith and trust in Jesus to save them (Acts 3:19, Romans 10:13). Creation in all its beauty and magnificence is shouting at us to believe in Christ. Are you listening? I urge you, if you have never sought this Creator God, do so today. Ask Him to show you His glory in the creation around you and He will. But then repent and believe! Colossians 1:23 says “the Gospel has been proclaimed in all creation.” Have you heard? 

The Purest Milk

Tenwek hospital is located in Bomet Kenya. Home to the Kipsigis tribe, it draws people from all over Eastern Africa for various surgical needs. On rounds the other morning we were discussing how it can be difficult for families here to understand that sometimes it is actually better for a sick person to NOT eat for a short time for various reasons. For example, before having surgery it is very important that the person NOT eat for several hours so that when they are intubated there is much less risk of complications. Or if they are really really sick sometimes we do not put food into the gut because we want the body to use all its energy to heal or because the gut itself is sick and cannot digest food. In these instances we still give nutrients through an IV but just not through the gut. Culturally here at Tenwek this is hard for families to understand and often they will sneak food to their loved one while in the hospital and staff have to be very diligent to watch and to educate. So, yes, there are certain times where eating is not the best thing for a sick person. But, I think we can all agree, for the most part, that our bodies need food and nutrients in order to heal and that when someone wants more food this is typically a sign they are getting better or growing. Not to mention how we need food for normal daily functions and activities when we are well. 

1 Peter starts out chapter 2 like this, “Therefore laying aside all malice, all deceit, hypocrisy, envy and all evil speaking, as newborn babies, desire the pure milk of the Word, that you may grow thereby, if indeed you have tasted that the Lord is gracious.” There is a lot here but I think you know where I am going. When I am sick with evil desires, or lying or living a hypocritical life the nutrients of the Word of God do not access my heart and help me grow. Here as with any illustration it does break down some because even in sin the Word of God does not return void, so where as food given to someone very sick can sometimes make them worse, the Word of God never has such an effect. But someone who is in sin may need a very broken down form of the Word for a time until they can receive and grow from pure milk. As a Christian, growing in my faith and walking with the Lord means casting off, running away from, and leaving behind sins that hinder me from coming to Him. By the power of the Holy Spirit in us we are to strive to be kind, honest, pure, and content which would be the picture of health in the Christian life. And as this is happening we will have a natural desire and longing for the nutrients of the Word of God. This is how we know that we are growing in our faith. However, this really only occurs in those who have ‘tasted that the Lord is gracious.” This is one way of saying it is only for those who are truly believers. Children of God have been offered the Bread of Life and tasted that He is good and gracious and keep coming back for more! 

Another quick note on this section. I was struck this morning as I thought on the Word of God. This chapter begins with the word ‘therefore.’ And, as my pastor growing up used to say, “when you see a therefore, find out what it is there for.” The therefore to begin chapter 2 references back to the section that ended chapter 1 where Peter quotes Isaiah 40:6-8, “All flesh is like grass, and all the glory of man as the flower of the grass. The grass withers, and its flower falls away, but the word of the Lord endures forever.” Every time I come to Tenwek I am confronted more often with the reality of death for every one of us. Our lives truly are but a vapor. But the glory of man is also a vapor and will not last. As Solomon says over and over it is all vanity. Our jobs, houses, bank accounts, cars, you name it, all the glory of man is vanity and will pass away to be forgotten. Governments, politics, supreme court decisions, and wars fought and won or lost, all of it is vanity. The ONLY thing that stands the test of time is the Word of God, and how I praise Him for it! With all that is going on in our world today that feels like it is being turned upside down, the Gospel and the Truth remain! I don’t know about you, but especially because of this ( i.e. therefore) I crave the Word of God because I need Truth in the midst of such chaos where people are so confused. And, I crave it because I have tasted, and oh how incredibly sweet and good, gracious, merciful and pure! There is nothing else that satisfies! I pray that if you have not tasted and seen that He is gracious, that He would even now draw you to Himself. And for those of us who have tasted, I pray we would continue to come thirsty to the well of living water and stand firm on the Truth that never fades away and will remain constant and unchanging no matter what happens in this crazy world! 

Better Than Gold

1 Peter 1:7 says “that the genuineness of your faith, being much more precious than gold that perishes, though it is tested by fire, may be found to praise, honor, and glory at the revelation of Jesus Christ.” What truly is the greatest gift or assurance we could have? Safety? Health? Security? Our culture today would say these things in an instance. Who doesn’t want assurance that they will be safe from robbers, or will live a long healthy life free of disease, or that no matter what happens they have enough money in the bank or alarm systems, or friends that it will be okay. Who doesn’t want some sort of insurance that will take care of us no matter what happens? But the Bible tells us something very different. 1 Peter makes is clear that we will go through trials and unexpected storms. That sometimes we will be robbed or stolen from, sometimes we will get sick, sometimes our money will run out, our friends will abandon us. I read a post on social media today where a women wrote how she would have saved Daniel from the lions den, or Ester from her difficult situation, or Jesus from the cross. If she were the author of the story of history then she would have stopped the pain and suffering. But, she recognized that in so doing she would have stopped the king in Daniel’s day from turning to God, and stopped Esther from saving her people, and kept Christ from saving the world from sin. Too often I find myself always wanting to ‘fix’ the broken situation and stop the suffering trying to take things into my own hands. But that is not always good or right. 1 Peter reminds us that these trials are doing something and they have a purpose. Just like example after example in the Bible we see that God divinely controls every detail and uses every bad thing in His people for something greater. As a follower of Jesus, my greatest assurance is that I am His and nothing can separate me from His love (Romans 8), that I am sealed by Almighty God into His family, free from sin, forgiven, and that when this life is over perfect harmony and unity with God Himself are in store forever! Wow! So much more than any security or wealth or relationships on earth I am secure for eternity! When God allows His children to go through trials and sees them through to the other side, when we can praise Him in the storm like Job instead of cursing Him then we can be assured that we are His. And this is the greatest peace and comfort. 

 

Now, let me say a few things to go along with this. I am not saying that when we see someone going through trials that we ignore them and do not try to help as that is in no way loving them. As they have need we are command to help our brothers and sisters. But, we also lift them up to the Father earnestly, fervently asking that He would intervene on their behalf, strengthen and encourage them and use it all for His glory and their good. And as the Lord shows us how to help we obey but doing it all under His guidance, submitting to His plan. I also want to point out that for those who are part of God’s family we have ultimate security, safety and even wealth that is far beyond anything earthly. I am simply showing that as 1 Peter 1:7 tells us, going through and coming out of trials praising the Lord is one way that God shows us we are His. And it is reason to rejoice even in suffering. 

 

We have had somewhat of a turn of events here at Tenwek this weekend. Most of the week was rather chill though we have had some infants in the NICU that are pretty sick and not doing well. Our kiddos with meningitis are all improving as are our kiddos with pneumonia and most with heart disease. Several have been able to go home over the past few days. In typical God fashion one morning this week we had a student present on nephritic vs nephrotic kidney disease and then had a child come in with nephritic disease overnight. It was a sweet blessing of the Lord to remind us of this disease and how to treat it as this child came in. He is also doing better now thanks to the Lord. Our call team Friday night attended a delivery of a baby with diaphragmatic hernia. Since women do not routinely received prenatal ultrasounds here they had no idea the baby would have a congenital malformation. The baby cried immediately after birth which is normally a very reassuring sign but quickly decompensated and became blue and purple. Our team tried all the things but ultimately the baby passed away because he could not breathe. The xray showed that only the right side of his diaphragm (the muscle between your lungs and your gut that helps you breathe) had formed and his intestines were all up in his lung cavity on the L side. Because of this his lung on the left side did not form and his heart was pushed all the way over into the left side of this chest so that only very very small amount of lung on the left side of his chest had developed. Inside the womb he had everything he needed provided by His mother, but on his own he could not survive. I cannot begin to say why God would allow this baby to develop this way in his mother’s womb or why he brought them to Tenwek even though there was nothing our peds team could have done to give him a chance at life. But I know my God is sovereign and He is good. And I know that just like this infant when I am in Christ and He in me I have everything needed for life and godliness through the knowledge of Him (2Peter 1:3), but on my own, apart from Him I am missing organs vital to life. We have 4 other babies in the NICU and one on the peds wards that I am very concerned about. Some of them really seem like they truly will not get better and we are talking about palliative care with the family. It is a hard thing to know when to stop trying to prolong life and recognize that there is nothing more we can do but allow the family to grieve. Please join me in praying for these families and for our team to have Godly wisdom to know when to push harder for more medical treatment and care and when to stop and ‘do no harm.’ 

 

On another note, I tested positive for COVID yesterday. There has been a small outbreak in our peds ward and now I can no longer assist with the team in the hospital in person. I am doing fine with only cold symptoms but am now forced to assist from the side lines. The Lord has been so very gracious through even this and is providing for my every need. Please also join me in praying that covid would not continue to spread through our patients, staff, or other guests here at the guest house where I am staying. Please pray the Lord would sustain and strengthen our peds team to be able to carry the load with less people. He is oh so good, and I am looking forward to time to sit at His feet. 

Day 1 Again

My team and I arrived at Tenwek yesterday afternoon. It has been wonderful to see some good friends and familiar facies. Many hugs all around as I was finally able to settle in and unpack for a while. The Lord graciously allowed me to sleep all night making jet lag minimal (possibly because we were just so tired). And today I jumped right in with rounds. I’d like to say it was if I had never left, but wow I’m a little rusty on some of my inpatient pediatric knowledge. But thankfully I had some time to look up some things and adjust plans as the day went. During my time here there is also a neonatologist visiting which is a tremendous blessing! Neonatology (all the little sick babies) is a totally different world even than pediatrics and it is by far my weakest area. So I am super pumped that she is here to help with our sickest and smallest babies. 

            Our team has about 25 or so kids in the pediatric wards and step down units and about 27 or so in the NICU. Many of the kids on the peds ward have heart disease, heart failure or pulmonary hypertension causing heart failure. We have some with bacterial meningitis and some with pneumonia and some with malnutrition. It has already been a taxing day on my brain (in a good way) and I have been exercising areas of my memory that seriously need to be dusted off! I can honestly say though that some things today came easier than I expected like riding a bike. As I have mentioned before though the peds team here is incredible. I’m happy to come assist and give them a break, but they make it easy to jump in and help. So all in all a good first day back to working at Tenwek hospital. I’m praying the Lord continues to give me what I need to serve and love well. Praising Him for safe travels here , a great team to work with, and a good first day back. 

And We're Back

This Fourth of July morning I am writing from a country I was unaware existed just 48 hours ago. I'm currently about 30 hours into my travels back to Tenwek hospital. Lord willing we will get to Nairobi later today and to Tenwek tomorrow afternoon. I started this trip fully expecting some setbacks with how crazy the airlines have been recently. It has made the extra day of travel less annoying but still annoying nonetheless. This extra time does give me time to sit and reflect and try to refocus before jumping into a busy hospital. Last year’s trip was hard. I think my expectations are a little different this go around, but more than anything else I need to meet with the Lord in a personal way. It feels like I left my life back home in chaos and there has just been a lot going on. There are various things weighing heavy on my heart. Situations I cannot fix or even really help much. So, even before I am in similar situations facing children who are dying or very ill I already have a heart that is desperate for the living God. I have no control over anything and it is forcing me to lead into the Lord. So, as I sit here for a long lay over and wait I’m praying the Lord would help my unbelief and give me grace to trust. Right now and in the next 2 weeks there are and will be people and situations that I cannot fix or make better. I am and will not be enough. But I can even now cry out to the God who sees on their behalf and have open hands and a willing heart to serve as He calls. 

            For those of you going on this journey with me I will be going through 1 Peter on this trip. And today I am meditating on the joyous Truth that I am kept, secure, and held by the Power of God and that these trials now and those coming are temporary, purposeful and produce faith that is far more precious than gold. Would you join me in praying that the Lord and His Word would permeate my mind and heart and be my main focus even above all the medicine and especially above all the trials.