EPC of Plant City

Dear Ministry Partners,

August has come and gone, and still Kenya waits for rain.  This is the third year in a row of below normal rainfall and inadequate harvests.  People are suffering and a recent report suggests that 10% of Kenya’s population may already be in need of food aid.  The local AIC church continues to collect food donations and money (and we continue to contribute to the effort) in order to provide desperately needed food to the most deprived families.

Lack of rain is now causing other spin-off problems.  Most of Kenya’s electric power comes from hydroelectric sources.  The water table, lakes and rivers have dropped to dangerously low levels and Kenya is no longer able to generate enough power to meet its current needs.  Power rationing has been implemented across the country.  Here at Kijabe, our power is cut off from 8am to 6pm three days a week.  The hospital, schools and Bible College rely on expensive diesel-powered generators to produce the electricity needed on those days.  We are fortunate to have such a backup system already in place.  Other institutions and businesses are not so fortunate.  The SIM headquarters in Nairobi just last week completed installation of a backup power system with large industrial-size storage batteries and power inverters wired into each of the offices.  They are expecting this to be a long-term problem, and every indication suggests they are right.

Tented camps still house thousands of homeless families displaced from their communities by the inter-tribal violence following the 2007 elections.  Below us in the Rift Valley, the tents of one distant camp can be identified as a multitude of tiny white dots.  We hear that the residents of the camp have given up any hope of returning to their former homes and are banding together to attempt to buy the land where the camp now sits in order to be able to start building more permanent dwellings.  They have decided to establish their own community.  Most of the residents are Kikuyu, but one Kisii widow with no other support has appealed to the church for help so she can pay her portion of the community effort. The church is asking for contributions, not wanting her to think that because she’s not Kikuyu she can’t even belong to a community of internal refugees!

Please pray for Kenya.  Conditions for most Kenyans are not improving and in fact life appears to be growing steadily more difficult for the majority.  Many have lost faith in the seemingly ineffective “grand coalition” government, and fears are mounting that an eventual outbreak of civil violence may be drawing increasingly close.  Pray this does not happen.  Once violence breaks out there is no telling how long it may take to contain it again.

Meanwhile the hospital remains as busy as ever.  Last week Bob enjoyed a change of pace overseeing general medicine patients on the men’s ward instead of remaining in the outpatients department.  The hospital needed him to fill the gap between the departure of a short-term visiting doctor and the arrival of a long-term doctor returning from home leave.  He enjoyed making daily rounds with the interns and discussing various aspects of patients’ evaluations and care.  One of the patients on which a consultation was requested on Saturday ended up being the subject of yesterday’s case presentation.  Bob was very proud of the good job done by the presenting intern.

This week Bob is back in the outpatients department, where there continue to be many opportunities for ministry.  Today Bob prayed with a middle-aged woman who has been mysteriously losing weight for a year.  She has been to many different hospitals and clinics and has now come to Kijabe in the hope of finding some effective help.  Pray for wisdom and discernment as Bob oversees her workup and treatment.  Pray too that Christ will be glorified in her life as she is brought under the ultimate care of the Great Physician.

Hope continues rounding on patients once per week with the AIDS team, is still analyzing the initial data from her nutritional research project, and just yesterday completed and sent out the daily AIDS prayer guide for the month of September.  We hope to be able to begin posting these prayer guides soon to our web page.  Meanwhile we have been informed (just today!) that the international HOPE for AIDS web site will also start posting these monthly prayer guides.  After sending out the guide for August, Hope received an enthusiastic email from Canon Gideon Byamugisha of Uganda, founder of ANERELA, the African NEtwork of REligious Leaders infected or affected by AIDS.  He called her a “prophetic voice” and strongly encouraged her to continue her work to inform AIDS-focused prayer efforts in Africa.

Sorry this is longer than intended, but as you can read there is much going on, and this has only scratched the surface.  The Gospel is wholistic, with not just spiritual but also physical, mental, emotional and social impacts.  We work for and pray for total transformation wherever the Gospel is preached and lived.  Thank you for joining us in this work through your prayers.

Blessings,
Bob and Hope

Dear Prayer Partners,

As I write this I am thankful for a lovely fire in the fireplace behind me to offset the dreary and constant chill of the past few weeks.  My feet were like ice this morning and the hot coffee I guzzled didn’t quite make it all the way down into my toes.  Doesn’t quite sound like your usual image of Africa, does it?  But here we are south of the equator and well over a mile in elevation; so as most of you are enjoying a warming of the weather we are putting on extra layers of clothing, donning sweaters and lighting fires.

But we don’t hear anyone complaining about the cold.  That’s because cold means rain, and rain means food and crop income.  So on the whole we see a lot of happy people these days – or would, if we weren’t living so close to a hospital!  On the other hand, this is also the season when colds and flues abound.  Hope is fighting chills, a scratchy throat and nagging cough; and I am sneezing a lot and carrying paper tissues in my pocket!  (And by the way, just yesterday we learned that the first case of “swine flu” has now been confirmed in Kenya.  The case was found in Kisumu – for those of you familiar with Kenyan geography!)

So as I sit here with a cheery fire to my back and a steaming cup of coffee in my hands, I will imagine you across the table from me, a matching cup in your hands and the firelight reflected in your eyes (or on your glasses, if you wear them) as I report to you about the ministry we share together.  This will be short, as we are also soon to start drafting our next quarterly “Carter Chronicles,” which I hope to have out by mid-month.

First, some follow-up from our last ministry update:

The S*mali man who needed surgery but was refusing due to the influence of a “friendly” spirit has been prayed with and ministered to several times.  He finally agreed to have the surgery and was believed to be “in his right mind” by his family, who brought him to the hospital yesterday.  But as he was about to be put to sleep he suddenly refused, saying it was all of the devil.  His family is very discouraged.  Please continue praying for “Abraham” and his family.

Due to the sensitive nature of the information, I have been unable to get permission to post the story of “Mahmud” on our web page.  If you want to read this remarkable story, send me an email and I will send it to you as a PDF file by email attachment.

Now for a look at what’s been happening this past month:

I (Bob) have been pretty busy for the most part with my duties at the hospital.  Since I spend most of my time consulting on outpatient cases and patients being admitted through our Casualty Department (“Emergency Room” in American English!), I see a lot of people but don’t generate many complete stories.  I see a lot of interesting pathology here, as I have said before, but you probably don’t want to hear all the details!  When I consult on a case, I pray that my role will benefit not only the patient but also the clinician (clinical officer, intern, registrar, etc.) who asked me to see the patient.  This is a teaching institution, so ideally every consultation is a learning opportunity for the clinician requesting it.

I say “ideally” because we are handling roughly twice as many outpatients as the facilities here were designed to accommodate.  Without adding more rooms, we can’t add more clinicians; so the clinicians are often hard pressed to see all the patients in the time available.  Teaching takes time, which seems often insufficient.

So one of the things I am doing here is to facilitate dialogue among the clinical officers, nurses and attending physicians on how we can improve the functioning of our outpatient services.  This needs to be a team effort and we need to develop some consensus on the way forward.  Consensus building takes time, and there is still much ground to cover; so your prayers concerning this issue would be highly appreciated.  Meanwhile, you can also pray for a meeting this Tuesday morning that will focus on several of these issues and will hopefully bring together many of the key stakeholders.  This is not a contentious issue; just a complex and difficult one involving many people with various concerns, roles and points of view.

Hope has been enjoying her involvement with the AIDS team, making rounds on admitted AIDS patients and participating in their care.  She feels like she is learning so much and is looking forward to increasing her clinical involvements.  Technically, she is a “student” while awaiting her Kenyan registration as a clinical officer.  This means that all her orders have to be co-signed by one of the doctors on the team.  This is not a problem, as in fact she feels like a student, and it gives good opportunity to discuss many issues and learn even more from the highly experienced medical staff on the team.  (Even Bob would love to have this opportunity!)

Meanwhile Hope is also continuing her nutritional research project, which we described in the last update.  She hopes to finish the clinical data gathering by the end of July.  Then she will begin community-based data gathering, making home visits to families at risk.  The research statistician attached to Kijabe is excited about the work Hope is doing, and believes that her findings may be publishable.  That would be nice, but her main goal remains to produce solid evidence useful for mobilizing nutritional resources to benefit the community.

Josiah’s broken collar bone has healed well, although he will remain with some deformity – which should reduce somewhat as his shoulders broaden.  To his delight, he was able to play in the last two regular season games, plus in a “friendly” after that.  He is looking forward to finishing his junior year in just two weeks, and is actively pursuing his “college search.”  Do any of you faithful alumni want to recommend your alma mater to a budding rugby-playing engineer?

Just as a reminder, you can visit our web page for additional stories and reports, as well as pictures. The link is Http://carter.with.sim.org.

Thanks again for all of your faithful prayers as we serve the Lord here in Kenya.  They are essential to our work.

Blessings,

Bob and Hope

Bob and Hope Carter are serving the Lord as medical missionaries in Kenya.

You can learn more about Bob and Hope at their blog here.