Final Report to the Congregation Final Report to the Congregation of Pasadena Presbyterian Church of Pasadena Presbyterian Church

MISSION TO KENYAMISSION TO KENYAJanuary 9 to February 7, 2009January 9 to February 7, 2009

Michael Nahrwold, M.D.Michael Nahrwold, M.D.

Dan and I spent most of our time at Kijabe Hospital. It isn’t quite as nice as it Dan and I spent most of our time at Kijabe Hospital. It isn’t quite as nice as it looks in the picture, but it is clean and well maintained.looks in the picture, but it is clean and well maintained.

We stayed in this duplex home. There is usually a missionary family there, but We stayed in this duplex home. There is usually a missionary family there, but they had returned to the US for 3 months. It was a short walk to the hospital.they had returned to the US for 3 months. It was a short walk to the hospital.

They put us to work immediately. Dan has a yellow hat and is giving anesthesia. They put us to work immediately. Dan has a yellow hat and is giving anesthesia. Dr. Mark Newton, the Program Director, has the black hat. Surgeons are Dr. Mark Newton, the Program Director, has the black hat. Surgeons are

repairing an aortic aneurysm. The patient would have about a 50/50 chance of repairing an aortic aneurysm. The patient would have about a 50/50 chance of survival in the US. Despite our efforts, she died because of inadequate care.survival in the US. Despite our efforts, she died because of inadequate care.

These are triplets born via C-section. It is hard to see the third baby. His foot is These are triplets born via C-section. It is hard to see the third baby. His foot is just above the doctor’s wrist watch. Mother and babies did just fine.just above the doctor’s wrist watch. Mother and babies did just fine.

This child has a myelomeningocele. We must have done at least 30 of these. The This child has a myelomeningocele. We must have done at least 30 of these. The bulge is removed and closed to prevent infection. These children would die bulge is removed and closed to prevent infection. These children would die

without the surgery.without the surgery.

This is one of the anesthesia supply shelves. Someone needs to sort things out, but This is one of the anesthesia supply shelves. Someone needs to sort things out, but no one has the time and the hospital cannot afford to hire anyone.no one has the time and the hospital cannot afford to hire anyone.

This is a disposable electrocautery pad. It is stuck to the skin and in the US is only This is a disposable electrocautery pad. It is stuck to the skin and in the US is only used once. This one will continue to be reused until it is completely worn out.used once. This one will continue to be reused until it is completely worn out.

This headrest is designed to be reused, but has seen better days. It is discolored This headrest is designed to be reused, but has seen better days. It is discolored from iodine disinfectant. It still works. You just cover it with a clean cloth.from iodine disinfectant. It still works. You just cover it with a clean cloth.

Someone’s personal Bible is always laying around in the operating room. We Someone’s personal Bible is always laying around in the operating room. We prayed over nearly every patient before anesthesia. I prayed over a baby that had prayed over nearly every patient before anesthesia. I prayed over a baby that had

died on the table - not easy. The whole staff attends chapel on Wednesday died on the table - not easy. The whole staff attends chapel on Wednesday morning. Our Monday morning conference included devotions and hymn singing. morning. Our Monday morning conference included devotions and hymn singing.

I have never practiced medicine in a place even remotely like this. I have never practiced medicine in a place even remotely like this.

There is a 6 bed recovery room. When it is full and a new patient arrives, the There is a 6 bed recovery room. When it is full and a new patient arrives, the nurse just wheels the most stable one out the other door. We did a lot of surgery nurse just wheels the most stable one out the other door. We did a lot of surgery

here when we ran out of operating rooms. At Kijabe, you make do with what you here when we ran out of operating rooms. At Kijabe, you make do with what you have. It may not be pretty, but it works.have. It may not be pretty, but it works.

Here is the hospital laundry. The lady in white is standing in front of 1 of the 3 Here is the hospital laundry. The lady in white is standing in front of 1 of the 3 outdoor sinks. Things are dried on the line or on the ground. Relatives do the outdoor sinks. Things are dried on the line or on the ground. Relatives do the patients’ laundry and linens which they supply. All of the OR linens are worn, patients’ laundry and linens which they supply. All of the OR linens are worn,

torn and have holes in them, but they are clean and seem to work alright.torn and have holes in them, but they are clean and seem to work alright.

Most of the instruction for the Kenya Registered Nurse Anesthetist (KRNA) Most of the instruction for the Kenya Registered Nurse Anesthetist (KRNA) students was done in the OR. Here I am teaching Collins while administering students was done in the OR. Here I am teaching Collins while administering

anesthesia. The anesthesia machine behind me is quite complex, and I spent most anesthesia. The anesthesia machine behind me is quite complex, and I spent most of my time at Kijabe teaching the students how it works and how to use it.of my time at Kijabe teaching the students how it works and how to use it.

Usually, I gave instruction on an individual basis to each of the 8 students. Dr. Usually, I gave instruction on an individual basis to each of the 8 students. Dr. Newton does not have time to do this, so it was important for me to be there. Each Newton does not have time to do this, so it was important for me to be there. Each student will return to a poor rural hospital where Kenyan physician anesthesiolo-student will return to a poor rural hospital where Kenyan physician anesthesiolo-

gists will not go because they won’t make enough money. Sound familiar?gists will not go because they won’t make enough money. Sound familiar?

Below are the promises that I made to you before I left for Africa. I had 2 Below are the promises that I made to you before I left for Africa. I had 2 occasions to address large groups of people, once while visiting a Masai church occasions to address large groups of people, once while visiting a Masai church

and once in the Hospital Chapel with all of the staff present. In both cases, I said and once in the Hospital Chapel with all of the staff present. In both cases, I said that I represented the Congregation of Pasadena Presbyterian Church and I that I represented the Congregation of Pasadena Presbyterian Church and I

greeted them in your name. I said that you were praying for me and for those I greeted them in your name. I said that you were praying for me and for those I met and, consequently, you were praying for them. In addition, I tried to share met and, consequently, you were praying for them. In addition, I tried to share

the gospel through my work and prayers and by example. I reported to the the gospel through my work and prayers and by example. I reported to the Evangemissions Committee and to you via e-mail and at each Sunday service. I Evangemissions Committee and to you via e-mail and at each Sunday service. I

performed all my teaching and patient care services without charge.performed all my teaching and patient care services without charge.

I Promised To:I Promised To:

Faithfully represent youFaithfully represent you Share the GospelShare the Gospel Report to youReport to you Provide my services without chargeProvide my services without charge Account for your moneyAccount for your money

Here is where the money went. Nearly all of it was used for travel expenses, but I Here is where the money went. Nearly all of it was used for travel expenses, but I had 45 dollars left over that I gave to an IDP outreach.had 45 dollars left over that I gave to an IDP outreach.

Evangemission Committee appropriationEvangemission Committee appropriation Individual donations from congregation Individual donations from congregation

AirfareAirfare VisaVisa Overnight at Guest HouseOvernight at Guest House Contribution to IDP outreach Contribution to IDP outreach

Self fundingSelf funding

Grand TotalGrand Total

$ 500$ 500 14351435$1935$1935

$1807$1807 5050 3333 4545$1935$1935

$1789$1789

$3724$3724

This is an Internally Displaced Persons (IDP) camp located in the valley below This is an Internally Displaced Persons (IDP) camp located in the valley below the hospital. The white things are tents where the people live. The 2 black tanks the hospital. The white things are tents where the people live. The 2 black tanks hold the only water available. These people were driven from their homes in the hold the only water available. These people were driven from their homes in the

tribal bloodshed following the last election. Kijabe Hospital staff and missionaries tribal bloodshed following the last election. Kijabe Hospital staff and missionaries did an evangelistic and medical outreach the weekend after we left. They want to did an evangelistic and medical outreach the weekend after we left. They want to help the people to settle there and build permanent homes. I donated the small help the people to settle there and build permanent homes. I donated the small portion of your money not used for travel to this endeavor. I hope this is okay portion of your money not used for travel to this endeavor. I hope this is okay

with you.with you.

Here is our flock of KRNA students. They include John M, Rose, John N, Hosea, Here is our flock of KRNA students. They include John M, Rose, John N, Hosea, Jackson, Collins, Luke and Baraca. We thank you from the bottom of our hearts Jackson, Collins, Luke and Baraca. We thank you from the bottom of our hearts for your generous prayers and support. You have made a difference in Africa. for your generous prayers and support. You have made a difference in Africa.

God bless you all.God bless you all.