My Grown-up Christmas List

Are you looking for a way to bless others in need this Christmas season? Heath and Angela Many, missionaries at Tenwek Hospital in Kenya, have a Christmas list for you that will bring hope, joy, and much-needed items to patients and doctors in Kenya. Check out their latest blog post to learn more.

Well friends, here it is…My 3rd annual Grown Up Christmas List!  When I began this wish list three years ago, our second Christmas in Kenya, I was struggling to come to terms with the reality of deep needs all around me in my new life…needs that overnight had gone from being statistics and maps, to patients and neighbors and friends.  I desperately desired to give meaningful ways for my circle in the US to engage with our needs here in Kenya.  You have stepped up in amazing ways to help meet our ministry needs, and we have been so blessed to be the conduit of your blessings to our community!

Last year, through your generous year-end gifts we were able to help purchase a much-needed ultrasound machine for the Surgery Department!  It has been put to great use for improved pre-operative evaluation, post-operative patient care, ultrasound-guided procedures, and resident education.  There were also gifts given toward our local orphan ministry, help in spreading the word about our need for a teacher, and ultimately gifts toward supporting Grace (our teacher) as well.

many 1

Heath using the new ultrasound machine to evaluate a post-operative cardiac patient.
Photo credit: Heath and Angela Many

This year, our wish is to raise enough funds to buy IV pumps for our Intensive Care Units and Maternity (L&D).  This may not sound like a very “exciting” need, but caring for patients who require certain critical medications without an IV pump is incredibly difficult!  It means that we must count and time the drips carefully and readjust the tubing manually to get the drip-count just right for the accurate dose.  Not only is this tedious and difficult, but it is risky for patients as they can easily be given too much or too little medication.

To further express the impact that this has on patient care, Heath will share about one of his recent patients…

My first few calls after we returned to Tenwek were busy ones.  Between civil unrest due to elections and a nation-wide nursing strike we were slammed with surgical emergencies.  Late one afternoon, a woman came to casualty complaining of abdominal pain after spending several days at another hospital.  It was clear that she had some sort of catastrophic problem in her abdomen which would require surgery.  Her blood pressure was low which required the administration of many liters of IV fluid to correct, and after we had done so, we took her to surgery.  While there we found that she had a gangrenous segment of intestine which had perforated- clearly this was a problem that had gone on for days.  During the procedure her blood pressure continued to drop forcing us to start her on medication to raise her blood pressure, and we performed an abbreviated operation so that we could get her out of the OR and to the ICU.  After transporting her to the ICU, she continued to need a couple of medications similar to adrenaline (we refer to these drugs as vasopressors) to maintain her blood pressure.  These medications must be carefully titrated in relatively small amounts to prevent complications.  In the U.S., we use electronic IV pumps to control the rate of delivery of these medicines.  At Tenwek, we have a very limited number of IV pumps and there were none available this night.  So, we mixed up the medicines in large bottles of saline and began the tedious task of counting the number of drips of fluid over a minute so that we could determine the dose of medicine she received and then make adjustments to the rate accordingly.  We spent a couple of hours at her bedside watching her blood pressure and counting and adjusting drips.  Despite our efforts, our patient died a few hours later- her infection was simply too advanced, and she received treatment too late.  However, our experience that night brought to light one of the biggest issues we (and especially our nurses) wrestle with in our intensive care units- lack of IV pumps.  It is clear that we will have a hard time improving the quality of care of our most critically ill and injured patients without suitable IV pumps.

One IV pump costs $1500.  We would like to purchase 25 pumps for use in our ICU and Maternity areas at Tenwek Hospital.  Can your family, business, or church group come together and purchase an IV pump?  It would make a life-changing Christmas gift for a patient in need!

To give toward this project, click HERE.  This goes directly into our ministry account.  All gifts that we receive in December will go toward the IV pump project.  Feel free to contact us if you have additional questions.  We will update you after Christmas with the outcome!

many 2.jpg

Our current IV set-up. Count… the… drip… drip… drip…
Photo credit: Heath and Angela Many

As the song lyrics say, “But Heaven only knows, That packages and bows, Can never heal a heartached human soul.”  We know that our material gifts will always fall short of meeting the deepest need of the soul.  We pray that as we attend the physical needs of the patients under our care to the best of our ability, with kindness and compassion, that we can show the love of Christ, pointing to the giver of all gifts and the healer of our souls.

We hope that your Christmas season is filled with reminders of God’s love and His gift of a Savior in Jesus. Thank you for helping us share that gift in Kenya.

Trauma and Critical Care Training: What Was I Thinking?

Have you ever seen a need, tried to meet that need, and then found that it is way more tiring to fulfill than you had originally thought it would be? Heath and Angela Many are missionaries serving in medical ministries in Kenya. Heath recently wrote a blog post about the need for more specialized training for the residents in the medical education program at Tenwek. The challenging aspect about this need was the long, exhausting hours he had to put in to figure out how best to teach them.

img_09231

Photo credit: Heath and Angela Many

“At some point in 2004, I walked out of the University of New Mexico Hospital with a smile on my face.  I had just completed my last day on the trauma service.  No longer would I be up in the middle of the night taking care of labor-intensive injured patients.  No longer would I sit for hours in the ICU taking care of the sickest of sick patients while others operated on the “interesting cases.” My career path was taking me towards the aspect of surgery that I loved the most—operating, operating, operating. I was happy to be in the OR all day while critical care specialists helped take care of the sicker patients whose care I was involved in.”

I spent the first decade of my career as a busy, private practice surgeon, which meant I spent a lot of time in the operating room.  I loved it.  But as our family transitioned to Kenya it became very apparent that good outcomes in complex surgical patients at Tenwek were hard earned.  Yes, a technically perfect operation is imperative; however, a good outcome depends on much more than just a good operation.  Technically difficult operations could be completed; however, patients who became sick after these procedures or who were admitted to the ICU after life-threatening trauma often times died when they shouldn’t have.

To read the rest of the blog post, visit the Many ministry blog.

2nd Annual My Grown-Up Christmas List

Last year, Heath and Angela Many, missionaries serving in Kenya at Tenwek Hospital, posted a Christmas list on their blog of the greatest needs in Kenya that you could donate to. This year, they decided to make a list again. Is the Lord calling you to get involved in the Manys’ ministry by making a special Christmas donation?

dsc_7448

Photo credit: Heath and Angela Many

“Tis the season!  No better day than ‘Giving Tuesday’ to roll out my 2nd annual Grown up Christmas List!  Even though this year we will have the joy of celebrating Christmas in America, our hearts and minds are still with our Kenyan friends and neighbors.  Throughout the past few years, our vision has grown bigger, our passion deeper, and our excitement greater about what God is doing in East Africa through Tenwek Hospital, our PAACS graduates, and our local Kenyan church.

“Although it has been humbling and challenging to live and work in an area of the world with such great need, it has also been rewarding beyond measure.  I know that our blog has been silent since our return to the US this past summer.  We have found it difficult to express in words the ups and downs of living between two ‘homes.’  Returning to the US with fresh eyes has been interesting!  Maybe we will share more in a future post about the good, the bad, and the ugly of this fresh perspective.  But one surprising outcome of our experience so far in serving as ‘missionaries’ is the amazing way that God has allowed us to connect so many people within our circle (and even beyond) to His work in the world.  Ironically, even though we have ‘less’ by the world’s standards now, we have been able to GIVE even MORE…by being conduits of your blessings which have been given so generously.

“We have been continually amazed at how God has used YOU (our community in America) to bless our community in Kenya!  So in this season of giving, we wanted to again highlight some needs near to our hearts.  If you are hoping to make a real difference with your dollars this Christmas season, instead of more online shopping for more ‘stuff’…consider one of our wish-list items!”

To see their entire Christmas list, visit the Manys’ ministry blog. WGM can also help you find other ways to get involved in the ministry at Tenwek Hospital. Click this link to explore and learn about the missionaries, needs, history, and more.

http://www.wgm.org/tenwek

heath-and-angela-many

 

When There is Nothing More to Do…

Heath and Angela Many are missionary doctors at Tenwek Hospital in Kenya. Heath is a general surgeon, and Angela is an OBGYN. Sometimes in life God takes control, heals, and preforms miracles. Other times God allows for more tragic things to happen, and we, as Christians, are to share our faith and hope and pray that God’s will be done even though it is beyond our understanding. Listen to the Manys as they share a story of trust and understanding in a time of uncertainty and helplessness.

MC

“It was early Sunday morning and our team had been up late the night before operating on a premature infant with an intestinal blockage.  I am usually grateful when there is just one big problem to handle during a weekend of call, but that was not to be this weekend.  At about 4:00 am, I was informed by the senior surgical resident that a woman with extensive burns had just arrived to Casualty (our ER).   I briefly contemplated taking a shower, but instead prioritized coffee intake, then walked up the hill to the hospital.  It was easy to find the patient…her burns extended onto her face which was not hidden by the white sheet which covered the rest of her body.  The resident, Valentine, filled me in on the story:  The woman lying in the bed was a mother to two young children who were playing inside of their house around an open fire.  An open fire is a common enough occurrence in Kenya since it provides the means of cooking in most homes, but what evolved into an uncommon situation was that the two children began playing around the fire with a container of kerosene.  Fortunately, the mother quickly recognized this and took the container from them.  Unfortunately, the kerosene spilled onto her shirt, soaking it thoroughly which was then ignited by the fire.  The fire was quickly extinguished, but not before burning the majority of the skin on her body.  She travelled to a nearby hospital and then was sent on to Tenwek, now some 8 hours after her injury.

“Together, our team examined her.  She was completely awake and alert and was able to have a normal conversation with us.  As expected, she was in some pain, but it was reasonably well controlled.  Her burns were extensive…her back, chest, arms, and face were covered in second and third degree burns.  In total, just over 60% of her skin was burned.

“In the U.S., a patient with a 60% body surface area burn is a challenge…so much so that these patients are usually transferred to a specialized burn center to be cared for by burn specialists.  Surviving a burn that involves 60% of the skin is possible in the U.S., but even with specialized care about half of these patients (depending on age) will ultimately die from their injury.  In western Kenya, where there are no burn specialists and where hospitals are not equipped to take care of a patient of this complexity, the chance of survival is close to zero.  And so, as we are assessing Mary, the extent of her burns and the reality that she will almost certainly die from these burns becomes clear.

“As a missionary surgeon, I am charged with displaying Christ in both word and deed to my patients.  The deed part comes naturally to us as surgeons.  We like to fix things.  We like using our hands and minds to correct a problem so that we can see a person healed.  This paves the way for us to sometimes share, by word, who Christ is.  Often times at Tenwek this is done by our Kenyan chaplaincy staff who can speak into spiritual matters with better cultural and language insights that I can.  I am always grateful for our chaplains because, quite frankly, I am at times uncomfortable doing their job.  I do not want the patient or family to think that the only way that I, the white guy, will provide care for them is if they agree to my religion.  The reality is that there is an imbalance of power between us as physicians and our patients.  We have knowledge, skills, ability, and resources that a desperate patient needs.  Does my sharing of Christ in word coheres a patient?  Possibly.  Therefore, my approach is to display Christ primarily in deed by taking care of a patient’s physical needs.  But on this morning, I have little to offer this patient medically.

“We explained to the patient and her family the extent of her injuries and the likely outcome.  We give them the option of not doing any treatment, of just keeping her comfortable, but they refuse and ask us to do everything we can, to which we agree.  We will need to intubate her- place a breathing tube- for which she will be sedated and communication will be difficult. Valentine, in Kiswahili, asked the patient about her faith.  “Do you know Christ?”  She does not, but after Valentine spends time telling her about who Christ is, she decides to give her life to him.  We all pray together: the patient, her family, and our team.  We prayed for healing and for comfort in the midst of a lot of pain.  Tears flowed from her husband.  After this we wheeled her to surgery…it was the last time she would talk to her family.

“Skeptics might say that her faith was not genuine.  They might say that she was scared for her life, or rather, her coming death.  Some might even say we took advantage of this to achieve our own desires to ‘win people for Jesus.’  However, the only place where we can fully see Christ is when we are stripped of everything.  Only when we realize the frailties of our flesh, the briefness of this world, and the passing of material possessions can we truly see our need for the cross.  And so, very likely, this lady came to know Christ in deeper ways than many of us who have followed Christ for years.  But my role is not to be a judge.  Instead, I am called to be a witness in a time of great need- a need that cannot always be met by modern medicine or years of training.

“All things considered, our patient did well over the next 3 days.  We worked hard to replace liter upon liter of fluid that she was losing because of her burns.  She remained on a ventilator.  We kept her pain controlled with IV pain medication.  On what would have been her fourth day in the hospital, I arrived to ICU rounds to find her bed empty.  She had died during the night.

“Generally, as a missionary, I want to tell of stories of success, stories of great healing where God used me as his instrument to bring someone back from the brink of death.  I want people to applaud the medical work that is done at Tenwek.  This is a human mindset- and one that is self-glorifying.  While there are truly amazing things that happen here, I have come to understand more completely that not all acts of healing are physical.  Not all great interventions involve the use of sterile instruments and suture.  For Mary, healing was achieved apart from these things.'”

PRAY: Please pray for the staff of Tenwek Hospital that they will have the wisdom needed to meet their patient’s physical needs and the compassion to care for their spiritual needs.