Doing What We Do So Well...

This "Tenwek Phenomenon" has become a passion of mine ever since the day that I set foot in Kenya for the first time in Nov 2008.  It started with a series of emails to my small group in Nashville and close friends and family that were supporting me on my first ever inter-continental missions trip.  I was pretty excited about my first experience over here but never - in my wildest dreams - could I ever have imagined all that this experience would be.

People were pretty fascinated with the original stories I relayed back to everyone the first time I was at Tenwek Hospital.  The emails I sent out to the original 20 or so people were being read by several hundred people across the country by the end of my first week at Tenwek.  So, with the help of my daughter Meghan, I started this blog after my first trip to Tenwek and wanted to continue it real-time WITH pictures this time so everyone who cared to could follow along.

As of today there have been over 1,500 visits to my blog in the past 7 days which is pretty mind boggling to me.  My original intention has always been to bring my experience "home" to all of you so that you can be with me as I go through each day at Tenwek.  Of course I can't do justice to every sight, sound, smell and personality that makes up my entire experience here, but I'll do my best to make that happen, and the pictures sure do help.

Aside from sharing these incredible experiences with all of you, my main objective is to personalize what we are doing here in Kenya at Tenwek Hospital.  So with that in mind I'd like to introduce you to our first patient...



In preparation for our first case on Monday we held a catheterization conference on Sunday evening within hours of the arrival of our final teammates.  The video above shows Dr. Mike reviewing our patient's echocardiography data with the group while we were determining which patients would need to be operated on, what the priority of each patient was and what order they would be done in.

At the end of the evening, it was decided that our first patient would be a 14 y/o girl that had traveled for 3 days on 4 different buses to get here from the Congo because her personal physician knew that our team was going to be at Tenwek doing open-hearts this week.  The patient spoke French and understood a little English while her mother was not able to speak any English at all.


On the day of surgery the patient was brought into the operating room at 8:00.  I started setting up the pump around 6:30 that morning and her repair was going to be a pediatric repair that is typically done on children several years old in the US.  I don't think I've ever participated on a repair of this type on a child this old before. 

The unfortunate thing that we are finding out and the very reason for our continued efforts at Tenwek Hospital is that children are not able to get the surgical repairs that they need because the services are just not available to them.  We are seeing patients every day that have to be told we cannot help them because the relatively minor defect they may have has decompensated to the point that a surgical repair is just not possible anymore.

In the photo on the right Dr. Malik and David, a Kenyan nurse anesthetist are inserting IV lines into the patient's neck after she has been put to sleep so they can administer fluids to her over the next 6 hours or so that she will be in surgery.

After the patient has been put to sleep and all the IV's and arterial lines have been inserted to monitor all of her parameters, she is prepped and draped for the surgical procedure.

Dr. Frank, a pediatric cardiac surgeon who joined the team this year from Florida is shown here during her surgical repair in the operating room.

The photo at the right is of me running the heart-lung machine during her surgery.  During the bypass portion of the surgery, the patient's blood drains out of her body into my pump where I can oxygenate the blood, remove CO2 and pump it back into the patient to keep her alive while her heart is stopped so the surgeon can correct her congenital cardiac defect.

This patient's cardiac condition had decompensated to the point where she was having shortness of breath any time she exerted herself, she had chest pain, heart palpitations, had lost consciousness and her oxygen levels were so low because she wasn't getting enough blood flow to her lungs that her finger, toes and lips were blue.  When I spoke with the mother through a translator on Tuesday, Mom pointed to my scrubs and said her daughters fingers and toes were as blue as my scrubs.

The surgery went very well and the patient was transported to the post-op ICU.  The ICU was a recovery room just 24 hours earlier and was converted by our Pediatric Intensive Care Critical Care Nurses and Physicians.  Most of the equipment that is being used in the post-op care of our patients this week was either supplied by World Medical Missions, the medical arm of Samaritan's Purse or hand carried by our staff from their respective hospitals across the US.

In the photo above left, Dr. Jenny a Critical Care Physician from North Carolina and Steven, a Kenyan nurse are working out the post-op care of the patient based on her most recent lab values while Nurse Dinah evaluates the patients respiratory status in the immediate post-op period.

That was Monday, the picture above was taken this afternoon (Wednesday) just before our she was discharged to the floor, her first step in being completely discharged from the hospital.

This is what we're doing, and this is why we're here....