third week

The clinical side this week was spent working with Dr Okorie. Chuks is just getting started but all indications are that he will be a great asset for the PAACS program here. He enjoys teaching residents and is a treat to work with in the OR. His wife Caroline is a primary care physician and they have three children ages 2,4,an 6 years old. We invited him and his family to a dessert last night to deliver an official welcome from PAACS urology. Russ and Beth White and the Romicks were on hand to help welcome them. The goal was to communicate the group’s desire to support his work here at Tenwek and to be a resource and help in any way we can. Clinical highlights this last week included using the endoscopic equipment donated by the Karl Storz company. The monitor and video equipment are an improvement over the previous equipment and as good as anything available in the states. Teaching lectures this week will be on both urologic trauma and prostate diseases. Men’s bible study last Wednesday included the Kenyan interns and was over the last chapter of 1Sam. This completed their study on biblical leadership from the book of 1Sam. They now plan a study based on John Piper’s recent book “Don’t waste your life”. As indicated above, Bruce Romick and his wife Barbara arrived here on schedule yesterday and are settling in. They will continue the training and discipling of the PAACS residents for the next month. Our term comes to an end this week with a stopover at Kijabe hospital on the way to Nairobi and home. Bruce and I both want to give a more complete report of our time here so please plan to join us at the GMHC in Louisville in November. We hope to see you there. Thanks for your prayers and support.

Second Week

The clinical work continues to be steady with lots of opportunities to teach work up and management of urologic problems. Case in point was a consult this week from the medical service of a patient with several medical conditions including renal failure and a renal US that showed enlarged cystic kidneys as well as hydroureteronephrosis. The patient denied voiding symptoms. We went ahead and checked a PVR to find out he was in urinary retention with over 2 liters in his bladder Once his medical issues are maximized we will see if we can work him in for a TURP. It was a good opportunity to teach Mesh the unreliability of voiding symptoms to rule out urinary retention and we also went over APCKD. Clinic has also been busy including a boy with severe hypospadias and partial penoscrotal transpositon who we will send up to Kijabe next week to see our colleague Ron Sutherland who will be there for 2 weeks. Operative highlights this last week include a buccal mucosal graft urethroplasty and a nephroureterectomy. Dr White hosted the mid week bible study at his home which was well attended by visiting staff and the African docs in training. It was a nice time of worship and studying the first chapter of Galatians. Frances and I had a nice break this weekend with a trip to the safari club for R&R. Now we are back for another week and Dr Okorie is set to begin clinical work too. As always thanks for your prayers and encouragement

First Week

It has been a good first week here at Tenwek, some of this post will give you a flavor of the experience so far. The overall impression is that the PAACS surgeons are faced with varied and numerous urologic cases that are often at advanced stages. To give you an idea, some of the cases we did this week included a radical nephrectomy, TURBT, TUR bladder neck, cysto DVIU, orchiectomy and orchidopexy. This coming week there is a urethroplasty scheduled among the rest of the cases. Teaching the PAACS resident, Mesh Mwanzia, has gone well with a lot of discussion of the work up of urinary retention, hematuria. She is well versed in SP tube and foley placement. We had an opportunity to introduce her to the use of filaforms and followers, and thorough hand irrigation of a patient in clot retention (not the same patient :). She is learning the components of the endoscopic instruments and the technique of cystoscopy. General instruction of the staff will include 2 didactic lectures this week: urologic emergencies and prostate disorders. With regard to discipling we pray before every operative case and with every patient in clinic along with participating in weekly staff devotions and evening bible study. I am impressed with the aptitude and willingness to learn of the PAACS residents. Dr Okorie arrived here this week and is getting settled in but has not gotten started on clinical activites yet. I am looking forward to working with him and getting to know him better. Overall I am encouraged by the experience so far. Thank you again for your prayers and encouragement.

Arrival at Tenwek

We arrived at Tenwek yesterday safe and sound. We saw the effects of the drought they are experiencing as we were driven from Nairobi to Bomet. However this area has had a fair amount of rain and the crops and cattle look much healthier than other areas. We jumped right in with all day urology clinic today. The assigned PAACS resident is named Mesh Mwanzia, she is a very capable resident who is eager to learn. They have been saving cases for us and we were fairly busy seeing and evaluating patients today. There are urology cases scheduled for tomorrow and I am looking forward to using the new Storz equipment. More on the case mix in another entry. Dr Russ White tells me that Dr Okorie and his wife are due to arrive here today or tomorrow and I am looking forward to meeting and working with him. There are a good mix of visiting medical students, residents, and attendings from all over making for a friendly and congenial atmosphere. I will try to keep the blog updated on a regular basis. Thanks for your prayer and support.

Leaving for Tenwek

We are set to leave for the states Sep 3 with arrival at Tenwek hospital Sept 7 for our approximately 4 week time of service there. We have already been in contact with Dr Carol Spears, residency director and have discussed options for the teaching and discipling of the PAACS residents. We are including in our luggage various things we have been asked to take including items for the missionaries and supplies for the hospital like catheters, a much needed refurbished dermatome and even several prosthetic limbs! We are packing light to accommodate everything. We appreciate your prayers for safe travel and God's provision for all the details of the trip. Our goal is to post regular entries on this blog to keep you informed and allow you to pray effectively.