Jarretts Ministry

Dear Friends and Family:

Our time here at Tenwek has gone by quickly – doesn’t all of life unless you’re waiting for your 21st birthday? I want to report on our visit to the Kenduiwo Children’s Home, and our last week here. Please click on the link to read the report and some updated prayer requests.

I met most of my objectives for my trip to Tenwek this year. I wanted to visit all of the children’s homes, encourage the children and directors, and assess progress as well as needs. Amy and I wanted to attend the dedication service in Marty’s honor for the girls’ dormitory at Kenduiwo Children’s Home. [Sometimes we spell this Kenduiwa, and it is spelled both ways on signs at the home – this is probably a function of transliteration from Kipsigis to English]. I also wanted to be certain that my medical and surgical skills were sufficient for continued medical missionary service; for that question, the answer is affirmative. The final objective was to assess opportunities for future service; it appears that the soonest I would be needed at Tenwek again is next April; they plan to have three American OBGYN specialists here for the next nine months. Could it be that God will direct me to a different hospital, like Kijabe, in the meantime?

I will let Amy describe the dedication ceremony this past Sunday: We left about 9:30 am for church at Kenduiwo at 10:00. There had not been too much rain this last week, so the road was passable up the mountain to Kenduiwo. As we pulled up to the orphan home, we heard this really loud music coming from the dining hall/ meeting room. It was like a disco beat with a gospel flare. ? — no way to really describe it. But the “Happy Boys Choir” (about 6 of the older orphan boys) did several numbers as did other groups from the three area churches that came for the service. It was great. Groups from the various churches would move up front and start their song. The keyboard player would get the beat going and then add the tones from the keyboard — very nice ?

There were lots of songs, testimonies, 5-15 min. speeches that were opened with “I don’t have much to say because of time…..” [a very Kenyan phraseology ?] but very special. I think Mom would definitely be happy because of the Glory the Lord was given. Sometimes it was very hard and I was crying. It was especially hard because I know Kenyans don’t typically show their emotions, and I was the only person in the room who seemed to be crying — never fun to cry alone! When they asked the Jarretts to come forward and give a speech, Dad was doing a good job and was about to turn to me for my turn, but I think he saw my “NO WAY” look with all my tears and graciously kept talking for us. There were about 250 people all packed in Kenyan style with about 6-8 people on a “4 is comfortable” bench. The service went straight from 10:30-till about 2:30 with the church and dedication all in one.

After the service we went to the dorm and took some pictures with the girls and their new dorm. The bronze plaque is really nice — it says
Kenduiwo Children’s Home
Girl’s Dormitory
in memory of
Mary Martha Jarrett
“Great is Thy Faithfulness O God”
After taking lots of pictures and having the dedication prayer, we went back in the meeting room where the ladies group brought a special treat. They said that if Mary was here, she would have brought a cake, so they thought they should make one for the orphans for her. ? I think they were right! They did a big presentation of it and then had Dad cut it and the three of us try a bite to “test” it for the orphans — nothing like eating a bite of cake in front of 250-300 people — must be how it is on your wedding day. Haha. Then all the orphans lined up and Dad passed the cake bites out (not a huge cake) After all this, we went to David (the home’s director) and Sarah’s house for a typical Kenyan meal — rice, beans, potatoes, and chapattis [flat bread prepared in a skillet with oil]. We finally left about 3:30 and got home after 4:00.

Paul again. Kenduiwo now has 38 children; 24 boys and 14 girls reside here. Seven children are now in secondary school [high school]. The home and children are having a major impact on the surrounding community. Many local church members visit the home and women’s Bible study groups often meet here using the large dining hall\ meeting room facility. Other groups from the community meet here so the home has a high profile and witness in the community. At a time when alcohol use is increasing in many areas following the violence and resultant disrespect of the governing authorities, this community is seeing a decrease; only two families are still brewing alcohol – the others have quit and are attending churches.

The home now has two permanent dormitories, a permanent water tank, the large meeting room, and the older semi-permanent buildings currently used for the girl’s dorm, matron’s quarters, store rooms, and a library room. A permanent kitchen building is under construction with a higher efficiency wood burning stove. The lighting at night is from battery power; a windmill generator is supposed to recharge the batteries, but has not worked since installation. We are looking into repairing the system or hooking up solar panels to recharge the batteries.

The director, David Koech, is headmaster at a local elementary school, which does limit the time he has to pursue outside sources of development such as the director of the Umoja home has been able to do. Nearly all the rest of his time is devoted to caring for the children, who have become like his own children. He has dreams of developing his own Christian elementary school [grades 1-8] which would provide jobs for teachers who would be around the orphans to assist them on weekends and evenings as well as holiday school sessions for the three one-month breaks during the year-round school schedule. Tuition from outside students would support the salaries.

I have long wondered why the children attend different boarding high schools in areas remote from where they live. David explained the system to me: when the students take the national exam at the end of their 8th grade year, they are supposed to list two different school choices in three different categories – national, provincial, and local; then a government education minister chooses somewhere for each student to go and sends out a letter informing them where they will attend. It is a fairly random process.

Schools generally don’t allow parental visitation except on designated days about every six weeks. David and Sarah then have the difficult choice of which of the children they will visit remote from where the children’s home is located; it’s a grave concern for Sarah that each child be visited as often as possible so that he doesn’t feel neglected. Neither they nor the home has a vehicle for their use, so there are transportation expenses for this need as well as for the hospital outpatient visits for sick children and the three who need regular check-ups for their ARV therapy for HIV.

David estimates that their expenses per child per month are $20.00. This is about half of what many organizations request for support for children in their programs. Food costs have increased worldwide and are not expected to decline. Some months the home will receive donations from the local community during harvest, but at other times Tenwek missionaries, Chuck and Amy Bemm, are buying large sacks of rice and corn as well as cooking fat. Soap, Vaseline, and sugar are often requested in addition to clothing and shoes.

They currently do not have a suitable place for visitors to stay. Relatives of the children are encouraged to visit, but a suitable room for them to stay in isn’t available. Even visitors from the States have stayed in less than ideal conditions; David and Sarah would like to put a room addition onto their home for this purpose, but he has very little disposable income with four of his own children in secondary schools.

There are many needs in all of the homes. Anyone wishing to assist in supporting our 116 children in the homes as well as community based orphans with regular or one-time support may send donations to Hope Ministries, Inc. 9902 East 200 South, Zionsville, IN 46077. Administrative costs are covered by a donor so all support reaches those caring for the children.

The pace of my work at the hospital accelerated dramatically this past week. For the past month we have had four consultant level individuals and one junior staff in addition to the four interns. One person went back to the States and two long-term staff went on vacation leaving me with the interns and junior staff member – a workload I was more accustomed to handling in past years. In addition, a visiting pediatrician from the US arrived needing an emergency abdominal operation which shifted some responsibilities for my junior staff. Then the caseload suddenly increased so that I was spending most of my time in the operating room.

On Monday, I did three cesarean sections and an emergency minor operation in addition to rounds and making final management decisions on all the admissions. I went to bed early that night as I was still tired from the long day on Sunday. Tuesday there were four major operations scheduled. I wasn’t pleased with the preparation of three patients in so far as x-rays and units of blood crossmatched; therefore I started with a patient whose wound from two previous surgeries had opened up requiring reclosure.

Peninah is a thin, young woman whose initial surgical finding over a month ago was an abscess inside the lower abdomen. After several weeks of continued fever, one of the other doctors took her back to surgery and found conclusive evidence that the continued infection was due to abdominal tuberculosis. She was started on the four drug combination regimen but her incision wasn’t healing and there was continuing copious pus drainage. Finally we noticed the inner fascia layer was no longer intact and bowel was visible; it was time to go back to surgery. I cleaned the wound and closed it using retention sutures but left an opening at the base for pus drainage. Peninah needs prayer as she is gradually getting weaker. She developed jaundice after starting the medications, probably a side effect of one of them, so she was given a five day rest and started on a lower dose. TB is really a nasty disease and remains a very deadly disease worldwide.

I had done a hysterectomy at the end of the previous week for a strange uterine cancer, but Tuesday’s second case was a more “routine” cancer of the lining of the uterus. This went very well as we saw no evidence of spread or deep invasion. We anticipated that the third case might also require a complete hysterectomy for a large complex ovarian cyst. However, the ovary and tube had twisted themselves until the blood supply was cut off so the tissue was all dead; it wasn’t necessary to remove the uterus or other ovary.

The last case concerned me the most; a 39-year-old mother of four had a large mass completely filling the pelvis and extending to the side walls of the abdomen. It certainly looked like a large cancer of the ovary, but there was no sign of spread to the upper abdomen or chest. The patient was moderately anemic so we gave her a unit of blood which didn’t leave us enough for after surgery if we lost as much blood as I anticipated likely. I decided to postpone the surgery until Wednesday morning when we could start early with blood available; I hoped to finish early enough to get to our weekly GYN clinic later that morning. I asked a visiting cancer surgeon to be available to scrub in with me. I also wanted to have the chaplain meet with the patient as I wasn’t sure she would survive surgery if we got into big trouble. He found that Recho is a Christian.

My prediction was accurate: the mass was a large cyst arising from the area of the right ovary but nearly every surface in the lower abdomen was stuck fast to an adjoining structure. Several loops of small bowel were stuck to the top of the mass and required removal and reanastomosis [hooking the sections of bowel back together in the proper sequence and direction]. I called John Salo, the cancer surgeon, to come help. We worked for nearly three hours to get the uterus and ovary freed up and removed; he worked an additional three hours repairing the bowel. When we had finished, everything looked pretty good with no obvious residual tumor. It will be three weeks before we even know what kind of cancer this was; ovary or fallopian tube are possibilities. After three days, Recho is making fairly normal progress in her recovery.

Thursday I had another hysterectomy for a large fibroid which went well. We did two dilation and curettage operations [D & C] for some very unusual cases; we will also have to wait three weeks to know exactly what the problem was for these two cases but neither looked like cancer. Friday I did an emergency cesarean for twins with the first baby presenting footling breech. Today I did a section for severe fetal distress, but the baby has done well following resuscitation. Six days in a row in major surgery is a far cry from no surgery for 2 and ½ years, but I haven’t felt uncomfortable in any way other than being tired.
My grandson, Nathan, has enjoyed his time here. He and Amy reorganized the shelves of the nursing school library and worked in orthopedic clinic on Wednesdays. He has enjoyed observing orthopedic surgery as well as one of my hysterectomies. He and Amy will go out into a distant community with the Community Health team on Monday. Besides the orphan visits, we have had meals in the homes of some of our staff here, so he has had a pretty thorough cultural immersion experience. He has given instruction in karate to a group of the missionary kids; on Sunday afternoon they will hold a demonstration of their newly acquired skills for parents and the missionary “aunts and uncles.”

Thank you so much for your prayers for our time here at Tenwek and our travel home. We will be saying our goodbyes to our many friends over the next few days. We drive to Nairobi on Tuesday with our flight to London leaving late at night local time. We don’t arrive in Indianapolis until early Wednesday evening – over 24 hours in transit.

Serving Jesus with you,

Paul for the Jarretts in Kenya

Dear Friends and Family:
Today was our surgery day for the Obstetrics-Gynecology service. This evening, Nathan and I went out into an area remote from Tenwek. Please follow the link to the website to read the stories and prayer requests. We appreciate your prayers very much.

I had two major cases scheduled today with three of the “chiefs” gone; the junior staff member, Anthony, was here to do a scheduled cesarean and other cases as they arose. First was a hysterectomy for uterine fibroids, benign tumors that often cause pain and bleeding. Dr. Caleb Maina had scheduled the patient for me to do when he was on vacation, so I had not examined her; I might have lost some sleep if I had done so. These fibroids were BIG!

One decision in my preparation for doing such a case is whether to wear a vinyl apron under by scrub gown. Whereas the drapes and gowns are permeable to all liquids including blood, the vinyl apron is impermeable but also very hot. Neglecting to wear one sometimes results in being soaked to the skin by the end of the case in a very red liquid. I decided to wear one today. Fifteen minutes into the case I was pleading for the air conditioner to be turned on and needing my glasses taped to my forehead to prevent them from sliding down my very sweaty nose.

The large tumors required me to make a very large incision; even so it was difficult to manipulate the large uterus and safely ligate the blood supply. After getting two of the four large vessels and some branches of the uterine arteries, I morcelated [chopped into pieces] the largest portion of the fibroids to reduce the uterus to a manageable size. Then the bleeding was fairly quickly brought under control as I could get at the major arteries more easily.

Now the case proceeded in a more orderly fashion and we finished up. The nurse estimated the uterus weighed as much as a term baby – about 7 pounds. I let my assistant close the incision and disrobed my gown and apron. I was absolutely drenched with sweat but not bloodied. I went home to change clothes and drink some fluids – I felt dehydrated the rest of the afternoon.

Each year I schedule a laparoscopy and afterwards tell myself I wouldn’t do another. It is true that the equipment is improving and the general surgeons are doing a lot of these cases compared to times past. So I asked Jason Fader, a young general surgeon to assist me. We waited three hours to start the case while the electrician repaired some of the equipment that wasn’t working properly, which was better than making the repairs after starting the procedure. We struggled through the case, changing several pieces of equipment as we went until we found a workable [and working] combination. We completed the case, so I am telling myself I won’t do another without a general surgeon in my corner to help. People who do these cases in the US are blessed by coordinated, new or disposable equipment that makes the cases a very nice alternative to open incisions with their longer recoveries.

I finished the day by 4pm to meet Reverend David Kilel who wanted me to go to an area east of Bomet near his local church. He had heard of some orphans in need of help nearby. We parked on the side of the main highway and climbed a gate leading to a lane between corn fields which are beginning to be harvested. Children began to appear from the road, fields, and houses; they walked along with us to the house we were headed for, so it seemed we were expected. We entered the modest, clean house after being greeted by Eric and Sophie Chelule, who owned this house; several of the children were theirs. We sat in their main room with cushioned wooden chairs and tables covered with decorative cloth. Soon, other children not dressed so nicely and some other men joined us. They began to share the story with David, my grandson, Nathan, and me.

Two girls and a boy, ages about 6-12, were orphans. Julius, a man who appeared slightly younger than me, was the grandfather who is caring for them. The children’s father had worked at the Masai Mara game preserve but contracted HIV. He came home sick in 2005 and died shortly thereafter of AIDS. The mother died the following year, having contracted the disease from her husband. The youngest girl is HIV positive and is on highly active antiretroviral drug therapy [HAART] as an out patient at the local district hospital, Longisa. The relationship between Eric Chelule and the father was a friendship dating back to their circumcision class at age 13; that’s the first time I had heard of that being a meaningful ongoing relationship in Kipsigis culture.

Julius, a God-fearing church attender, has one young son in 9th grade and two sons living at home who are drunkards. The next crisis in the family occurred recently when Julius’s wife became so stressed by the situation that she hung herself. Now Julius tries to support the family by farming but has no one to cook for the family. Food preparation is pretty much a full-time job of women in this culture when they’re not working in the garden or doing other domestic chores. He’s too poor to remarry, and it wouldn’t even work for him to hire a woman to cook for him if he could afford it; it wouldn’t be socially appropriate for a woman to be at the home of a single man. I could definitely empathize with Julius in his situation.

An older man, Eric’s father, joined us as we drank chai with the family; we told stories of where we were from and our families. The father asked me if I knew “Mosonik” as I reminded him of this man. He couldn’t have given me a greater compliment. Mosonik [the left-handed one] was the Kipsigis name for Dr. Ernie Steury, the legendary first doctor at Tenwek. I was pleased to say that I had known him.

We prayed for the family’s needs including deliverance of the two sons from alcohol. It may be possible to assist the younger children to enter Mosop Mission School in January when a new school year begins; David will continue to investigate.

As we left, we were asked to stop next door at another home. Karen Chelule lived there with her four small children ages 5, 4, 3, and 2. She is Eric’s sister-in-law; her husband was one of the 1300 people killed in 2008 in the post-election violence. He was working away from home in a non-Kipsigis area and set upon by the local tribe who were in opposition to the Kipsigis people. Karen is a member of David’s church which is trying to assist. Generally speaking, women in her situation are not likely to be asked to remarry; her children belong to the father’s family. Please remember Karen and Julius in your prayers as you think of them.

I was glad Nathan was able to go with me on the adventure; we didn’t get soaked by rain, chased by dogs or bulls, or fall in a creek, but it was a good trip without the extra excitement.

The dedication of the dormitory at Kenduiwa Children’s Home is this Sunday rather than Saturday. Amy and Nathan will visit RVA again on Saturday with Beth White who will drive over to see her son, Adam, play rugby. Please pray for their safety.

We do appreciate so much your prayers and support. We have only two weeks left before coming home and have a lot of activities to cram into the remaining time. Amy is doing a great job of cooking and running the house, so it is very likely Nate and I will survive.

Serving Jesus with you,

Paul, for the Jarretts at Tenwek

Dear Friends and Family:
Amy and Nathan arrived safely this week and have joined me in a small house near the hospital where we are setting up housekeeping for the remainder of our time here. Please click on the link to the website to read about our orphan adventures and prayer requests.
Thanks for praying for Amy and Nate’s travel here this past week. After spending one night in Nairobi and another at Rift Valley Academy in Kijabe, Kenya, they arrived at Tenwek on Thursday afternoon minus one pokey suitcase which came on Friday. Amy’s visit to Rift Valley Academy had a two-fold purpose: visiting with the five missionary kids from Tenwek who go to high school there and meeting with staff members with whom she would be working next year if she is successful in raising support as a full-time missionary with Africa Inland Mission. She will attend an AIM camp in New York in August after which she can begin that process.
Today we set out to visit Bosto Children’s home which is nearly 50 kilometers away over some rough roads. Actually, the road is much improved; the tarmac section has been repaved and the macadam road has been improved because of a tea factory being built about 4 kilometers from Bosto. Chuck Bemm drove his Land Rover into which we packed four visitors, his daughter, Abby, Pastor Elkana Rotich and his wife, Irene, and three Jarretts. Our trip was uneventful until we had a flat tire right in the middle of a small village about 5 kilometers downhill from Bosto.
Chuck and Dan Matthews, who is as adept at changing flat tires as he is with setting broken bones, sprang into action while the rest of us entertained a crowd of small children and curious onlookers. A few inebriated individuals tried to converse with us in Kipsigis or beg for coins. After mounting the spare we noted that the spare tire had a significant sidewall tear which had been repaired when another visitor borrowed it and went on safari. The tire we just lost had a sidewall tear that couldn’t be fixed. Chuck was understandably reluctant to go over the worst section of road with the questionable repair and no spare.
We debated options while making cell phone calls back to Tenwek. No one was available to help us and the only vehicle with identical tires to Chuck’s was in Nairobi, which is the only place one can safely buy quality tires for the car. We settled on a plan where a friend from the village would drive Elkana and Irene, Nate and I, and Dan and his daughter, Jordan, to the Bosto home in his Toyota Corolla station wagon while Chuck, Abby, Amy, and two other guests, Robert and Carolyn would drive slowly back towards Tenwek and stop at Umoja Children’s Home for a visit. At least it would be easy to get home from there if there were car trouble. Elkana negotiated a 3,000 Kenya Shilling fare [$40] for the ride to Bosto and back to Tenwek – a pretty fair deal.
Bosto opened in late 2005 after our home church contributed funds for construction of the permanent dormitory and furnishings. We had a dedication in early 2006 after 20 beautiful little girls arrived to live here. In 2007, 19 boys and 1 additional girl arrived. A second building was erected and serves as a dining hall and study room. A permanent water tank holding 33,000 liters of water was added in 2009. Trips to the river for water are only necessary in dry season, which is fortunate since the river is at least 1,000 feet lower in elevation at the base of the very steep hill situated at the edge of the Mau Forest.
The children sang songs for us and told us their names. They appear well fed and clean; the boys are much less rowdy than when I first met them in 2007. All enjoyed playing with the small toys that Jordan brought for them. Both Dan and I gave a message to the children. We toured the buildings but decided not to stay too late as a rain storm was coming into the area.
Bosto has the same matron, Margaret, who was there at the opening, which is a blessing to the children. A pastor and his wife stayed with the children for about three years but left about a year ago. A new pastor, David Tangus, is now with the children each day. Elkana serves as manager and visits the home regularly as it is near his father’s home; Irene works in the office at Tenwek.
The 5 acres of land for the home were donated by the Litein Town Council after it selected the children’s home project from among 55 applicants for use of the land. Situated at the top of a high mountain, the soil is not good for growing crops, which has limited the success of the dairy goat project. Without the nourishing Napier grass, the goats produce less milk than is ordinarily possible. There are currently 10 goats — 1 male and 9 female.
Currently, the home lacks electricity although there are now power poles at the edge of the property. A donor has pledged the $900 necessary for hook-up and wiring, which should provide light as well as saving money on Kerosene for lamps. This should improve safety and study conditions in the evening hours. The petrol generator used in the past proved too expensive.
The district health commissioner recommended a permanent building for the cooking shed and store house; the semi-permanent building proved too easy for rodents to enter. Currently the stored food is locked in the office building, but the space is inadequate. The home awaits another inspection for its national registration permit. A high efficiency stove in a new cooking facility would conserve funds used for firewood. These additions would probably cost an additional $10,000.
Many of the children are coming of age for higher education; six children are in 8th grade and will sit for the national exam later this year. All are good students and expected to pass. One student is in Form 3 [high school junior]; two others are in technical school learning tailoring and knitting. All students assist in planting and weeding the leased 1 acre garden plot nearby.
I was impressed with the cleanliness of both the girls and boys dormitories. The wooden beds and mattresses have held up well. This speaks volumes to me about the management of the home and the training of the children. They need shelving for personal belongings. Two additional bunk beds are required. The children need new school uniforms. Another long range goal is for a technical school situated on the property where students could learn sewing, cobbler work, and other technical skills.
We bade the children goodbye and drove down the muddy road ahead of the storm which broke after we arrived at Tenwek. Our driver should have been named Dale Earnhardt, Jr. He drove two speeds – fast and way too fast. He also preferred the right side of the road instead of the left where he was supposed to be. Oncoming cars flashed their lights at us and headed for the side of the road. I’m not sure what his hurry was, but World Cup Fever is affecting a lot of the people around here in strange ways.
Thanks for praying for the two new mothers who were on the ventilators, Linner and Betty; God answered your prayers in two different ways. Unbeknownst to me, Linner died just before I sent the request. Her baby stayed in the nursery this week while relatives made arrangements. It turns out there was a second wife in the family who is infertile. It has been decided she will care for the baby and the other children. This is one of the few cases where polygamy seems to have provided a reasonable answer to a difficult problem.
The other patient, Betty, has made a remarkable recovery. I mentioned that she is a nurse in the hospital where her cesarean section was done. She had a seizure and cardiac arrest during the surgery, was resuscitated, and transferred to Tenwek. She was weaned off the ventilator and seems to have recovered all normal functions.
Friday morning Betty was standing at her bedside telling me that she was having some difficulty breathing but was otherwise doing well; we added another antibiotic to help with the lung infection that she seems to be battling fairly well. Later that afternoon I saw the Longisa doctor, Birech, visiting with her and Caleb Maina, my Kenyan OB colleague. Birech told me that Betty had been so far gone that her pupils were dilated. The anesthetist said that it was time to stop the CPR attempts, but Birech pleaded to keep going a little longer. Her heart started beating again and she recovered enough to be brought to Tenwek. Thank you, Lord.
We appreciate your prayers very much. The next two weeks will be busy with some of the doctors away from the hospital. I will try to visit some orphans on Tuesday with Pastor David Kilel as well as talk to him about future plans. He will be retiring soon, so wisdom will be needed for administering the funds for orphans. We will be visiting some of the evenings with national friends in their homes. I’ve planned a surgery on Tuesday to try to restore fertility to one of our staff who miscarried her only pregnancy 12 years ago. Please pray for skill and God’s blessing.
Please continue to pray for the sale of our house. It will be officially listed this coming week. We need wisdom on the timing and placement of the septic system and new driveway. Please pray for my son, Patrick, as he has many things going on in addition to managing our house. Also, please pray for my father, Paul, Sr. who is in the hospital with pelvic pain after a fall from a chair last week.

Serving Jesus with you,
Paul, for the Jarretts in Kenya

Dear Friends and Family:
I promised an update on the orphans we assist through the generosity of our supporters. Please follow the link to the website to read the entire story. We continue to have many challenges in the hospital as well as in our orphan homes, but we continue to find God more than sufficient to meet all of our needs.
I have met with all four directors of orphan homes in the immediate area and have visited three of the homes. I have yet to visit the Bosto home located farthest from Tenwek but plan on doing that next Saturday. I will revisit the Kenduiwa home on June 20 for the dedication of the girls’ dormitory named in honor of Marty. I hope to save time for a report on those two homes later this month.
First, I will report on Umoja (Swahili for “First”) Children’s home. This home is the most successful in obtaining support from a variety of sources. Its location is the easiest to access from Tenwek, so it receives more visitors. In addition the director, Joseph Chepkwony, is a visionary man who has enlisted the aid of some NGOs [charitable, non-government organizations]. The home was founded in 2003 when Marty, David Kilel, and I had met Joseph after praying for God to show us how He wanted us to start a children’s home to care for abandoned children.
By that time, the AIDS crisis had overwhelmed the ability of local families to care for the children of their extended families. Joseph’s mother, who was an orphan herself, donated land, and members of her local church met with us expressing their burden to do something for local children with unmet needs. One of our supporters gave money to build the cement floor of the first semi-permanent building which served as the first dormitory. So you could say that we got in on the ground floor.
Within the first two years, other buildings were erected to serve as a kitchen, food store, dining hall, classroom, and toilet and shower facilities. A security fence and gate were also needed as was fencing for animals. As the orphanage grew, so did the need for staff and other supporters. The home needed a cook, a matron, and a security guard in addition to the services of the director and his family.
Meanwhile, the vision spread and committees were formed to begin the home named in honor of a local evangelist, Paul Kenduiwa, and the home farther north next to the Bosto AGC church. A key ingredient to ongoing support of all three homes was the participation of local churches, particularly those of the Africa Gospel Church denomination. AGC participation made it possible for Tenwek missionaries sent by World Gospel Mission to fund projects at the homes. WGM is the founder of the AGC denomination as well as Tenwek Hospital.
Joseph initially made contact with a NGO called ActionAid. They built a very large water tank to catch and store rainwater — a constant need since there is no local water supply in this rural area other than the river. Even today during dry season people make many trips to the river for water using large containers and donkeys or carry a gallon jug in each hand. Think of going down a steep hill to the river for every drop of water you use in your daily life!
Later we assisted Joseph to build a chicken coop and Action Aid provided the chickens and chicken feed for their first six months of growth. Joseph then developed a market for the eggs at Tenwek and in the local town to provide revenue for the home as well as the ongoing expenses of raising and replacing the chickens. Chickens that stop laying become a good source of protein for the children. There have been many bumps in the road during the learning process, but the chicken project seems viable.
As time progressed, Marty and I met regularly with the directors of these three homes as well as Alice, a Tenwek employee who runs a private orphanage on the other side of Bomet. I will say more about her later in this letter. We shared common problems and needs as well as solutions and failures which was a big help to each home.
When Marty and I went home, WGM missionaries, Dr. Chuck and Amy Bemm, took over the director meetings and in addition developed a fund within WGM to support the homes. During the Bemms’ year on home assignment, Dr. Ben and Jenny Roberts met with the directors. Other Tenwek missionary families, the Whites, Freijes, Renfroes, Manchesters, Chupps, Spriegels, and Galats began visiting the homes. Some of these families organized work teams from their supporting churches in the US to construct permanent dormitories and dining halls at the various homes. Another visitor, Dr. David Hoover, has begun a US charity called Friends of Tenwek which is raising support for building projects at Tenwek and the children’s homes.
We have continued support of the homes through a 501(c) (3) charity called Hope Ministries, Inc. Through this fund, we do some things that can’t be done through the WGM fund including paying salaries of employees of the homes and providing educational support for orphans living in the local areas remote from these homes in addition to some of the children residing in the homes when they become old enough for private secondary boarding schools [essentially the only mechanism for high school education for children throughout Kenya]. Some of the children from the homes have school support through WGM as well.
Umoja now has 37 orphans including some children in boarding schools who return to the home during month-long breaks from school three times a year. In addition, Joseph started a nursery school by hiring a local teacher and enrolling 21 children from the local community who pay a little more than $5 per month in tuition. This generates a small income for the home.
Five of the resident children are HIV positive. Three of these are now receiving anti-retroviral therapy as outpatients at Tenwek through the PEPFAR program, a US AIDS drug program initiated during the Bush administration. One boy has been on the drugs for over 5 years. He was very sickly and weak when I first met him; now he appears as strong and active as the other children, which is a testimony to Joseph’s faithfulness in getting him to clinic and caring for his needs.
During my visit with some guests from Tenwek, the children sang songs and greeted us warmly. When they had first learned of Marty’s illness, they had prayed and fasted for three days as did the children at the private orphanage, Kitoben Vision. The children were very sad when Marty passed away in January and were happy to see pictures of her and my daughters whom they also fondly remember. I gave a brief message to the children and another guest led them in a new song with lots of actions which the children love. We enjoyed spending time with the children playing games and singing.
The new dormitories at the home are permanent buildings with lighting for a few hours at night so that the children can study. The bunk beds have clean mattresses with durable vinyl covers which prevent the soiling that otherwise ruins the foam pads. They still have the metal trunks Marty and I bought for them to store personal belongings.
Joseph is constructing a zero grazing facility for the milk cows as the space at this home is fairly limited. A new permanent dining hall will soon be constructed as well as remodeling the adjacent kitchen. A new, high-efficiency wood burning stove was just purchased by the Galat family’s supporters which should help not only in meal preparation for the many children but also in conserving fuel costs. Each of the homes spends about $75 a month on firewood.
Most recently, Joseph secured a posho mill used to grind maize [corn] for local residents at a small cost. The bright green building serves as an advertisement for SafariCom, a Kenya-wide cell phone network. This company’s foundation provided the diesel-powered mill and the building. Fees for grinding corn or a percentage of the flour will be used in the support of the home.
ActionAid has offered to donate a very nice vehicle to the home, although it is necessary to pay about $1300 to the Kenya Revenue Authority in order to receive it. We are working with the Bemms to see about providing these funds. Joseph would also like to put up some solar panels to recharge the batteries used for lights at night. Most of the children need new shoes at $10 a pair as well as school uniforms. The upcoming harvest should bring some donations of food from local churches, but it has been necessary to buy food for the home during the recent drought which ended in early 2010.
One more story from Umoja deserves telling. In June, 2009, a young Pokot teenage boy from northwest Kenya came to Tenwek for open heart surgery. The Pokot people speak a Kalingen language related to the Kipsigis from the Tenwek area. He recovered from surgery in the home of a local widow. She returned with him over 100 miles to his remote home area not far from the somewhat lawless Uganda border.
Drought was a major problem in most of Kenya last year including the Pokot area. When it became apparent to the boy that he would likely not survive as an orphan at home, he decided to return to Tenwek. Although he is over 6 feet tall at age 13, an older friend thought that he wouldn’t make it alone and decided to come with him. He at least spoke some English and Swahili; his personal goal was to attend school, become a pastor, and return to his people to share the gospel. The boys walked the entire way back to Tenwek.
None of the local schools were willing to welcome this six-foot boy into first grade. When Joseph heard of the problem, he used his position on the local school board to arrange to enroll him in first grade and the older boy in fifth. The boys are living at Umoja and are leaders for the other children as well as a big help to Joseph with some of the physical labor around the home.
Support for the local children’s homes can be sent to Hope Ministries, INC., 9902 East 200 South, Zionsville, IN 46077. Checks should be made out to Hope Ministries. A receipt suitable for a tax deduction will be issued.
On Saturday, June 5, I spent eight hours with the children of Kitoben Vision Children’s Home. Alice Langat, is an employee in the business office of Tenwek Hospital. In her position she became aware of children who were abandoned at the hospital by relatives unwilling or unable to care for these orphans. She took several of them home to her house where they became as her own children.
As the number of children Alice cared for increased beyond the capacity of her small house, some visiting doctors assisted her in purchasing property near the small airstrip near Bomet about 8 or 9 kilometers away from Tenwek. I believe she had over 20 children when we first met. I can count at least 57 children at the present time – 20 in secondary schools and 37 in primary schools. We visited the children at the home each year and sometimes they visited at our home. One child, Vicki, had corrective heart surgery in Nairobi about 5 years ago and we saw her often during her recovery.
Because we have known these children longer than in the other three homes, I know many of their names and have always felt close to them. For various reasons including non-AGC affiliation, before we left in 2006 we had separated the responsibilities of supporting this home financially from the other three homes and gave the responsibility to the founding family who set up their own 501(c) (3) corporation to support Kitoben Vision. That did nothing to change my attachment and concern for these special kids.
Alice arranged for a driver to take us to the home Saturday morning. We stopped in Bomet for supplies for the home. The airstrip is now more securely closed off than in former years. The tarmac surface has been removed so that chuckholes no longer dot the strip. They even have two new prefab metal buildings ready for some future use. We had to climb over a style to cross the landing strip and enter the front gate of the home. I hope that access to the home will be continue to be as unrestricted in the future.
The 37 singing children greeted me in a receiving line. Four different colors of school uniforms were on display. The children are attending different private and public elementary schools.
Alice soon left with Bernard, her brother who assists the children; he was ill and needed attention at Tenwek. Besides Alice and her husband the children are assisted by Bernard’s wife, Evelyn, an unmarried sister, Joyce, who seems very strong, articulate, and apparently recovered from her mental illness, and the grandmother, Pauline Laboso. There was also a cook and another sister, Sharon, who used to live at the home, was visiting with her children. This family flavor has always characterized the Kitoben home; Alice seems to make no distinction in care between her own five children and the orphans. She has always sought out the best schools for them. The children all consider Alice their mother and don’t seem to favor their own biological siblings residing there.
I listened to the children’s songs and poems, most of which I had heard many times before from the older children now away at boarding school. I gave them a message from Psalm 1 about making wise choices in life which Evelyn translated into Kipsigis, the native tongue for all of these children. The older ones speak English but the younger ones are still learning. The children listened very attentively.
I toured the facility with Evelyn. The buildings are all more or less temporary or semi-permanent construction. The soil in the area requires very deep and thick foundations as we discovered in constructing the only really permanent building, a very expensive toilet and bathing facility. This is in great contrast to the other three homes which have either one or two new permanent dormitories costing over $10,000 apiece. Construction of similar buildings here would seem to be cost prohibitive because of the soil. Consequently, the children attend boarding schools even for elementary school. Alice spends a lot of money on fares for vehicles to visit the children at the schools – often for required meetings. Only the youngest children stay at the home when the boarding schools are in session.
After taking tea with mandzis [doughnuts], the children, Evelyn, and I walked the length of the airstrip. None of the soccer balls or jump ropes given in the past have survived, so we walked with the younger children taking turns holding my hands. The older children asked me questions about America. Without my daughters to help me understand the questions, it took several repetitions and stopping still to silence the scuffing feet in order for me to hear well enough. We had plenty of time, so it didn’t matter.
Later we had lunch and sang more songs. I watched Vicki running countless laps around the buildings; formerly due to her congenital heart disease she never could run and would squat to improve her circulation. Alice finally returned around 4 pm and we left the younger children with a prayer of blessing. I had asked about the older children by name, and Alice wanted me to visit them at their local high schools. I was happy to do that so we went first to St. Mary’s school in Bomet where four of the children studied.
I remembered the two seniors [Form 4 students] the best – Peninah and Mercy. Peninah was the oldest of four siblings and Mercy the oldest of six, all of whom have a bleeding disorder, which causes them to bleed a long time after an injury. I have known these two shy girls for a long time. Peninah and her two sisters were always as thin as rails. Mercy and her siblings were more rounded in their features and always easy for me to distinguish from the other children.
Therefore, I was very surprised when this tall, very well rounded attractive girl of 19 came up and gave me the traditional hug with her head first on one side of mine and then the other side. Peninah had really blossomed! Her beautiful smile was still recognizable but the shyness was a thing of the past.
In contrast, Mercy came up slowly, her eyes reddened from crying. She spoke quietly and more slowly. The younger two girls, sophomores, Emma and another Mercy were more reserved as I would have expected.
We stood aside from other people and talked. I gave them the same encouragement from Psalm 1 about purity and wise choices. Alice also gave them a strong “mother” talk to the same effect.
They each were asked to give a word to me as well. Peninah was very bright and articulate and showed the same leadership qualities I had always seen in her. She thanked me for visiting and for help with school fees. Mercy revealed that she was overcome with emotion when she first saw me waiting to see them. It meant so much to her that I had come to school to see them. Now I was the one fighting back the tears. As visitors in this culture, we don’t often appreciate the depth of emotion and appreciation felt by those we visit. [We hope that our behavior does nothing to detract from that appreciation.] All the girls spoke of how much they had prayed for us during Marty’s illness and for my comfort after she died. I prayed for the girls and we bade them goodbye.
We still had a carful of elementary students in the red sweaters to take to an academy in Silibwet. As we passed through the bustling town we braked and honked to avoid dozens of motorcycles carrying one or two passengers as well as pedestrians, oncoming vehicles and occasional animals. We turned down a badly rutted back street passing the large soccer field behind the main street.
We stopped at a fairly new private elementary academy constructed in 2003. As we entered the iron gate, we were met by Wesley, a young man who used to help at the Kitoben orphanage. He is now a teacher. Our students ran and joined 300 of their friends on the school playground. As we passed the nicely constructed and equipped classrooms we descended nicely made concrete stairs as the school was built on a hillside. Drainage pipes allowed good water runoff to a permanent water tank. One needs to have seen many muddy schoolyards in Kenya to appreciate the uniqueness and quality of this facility.
As we reached the last level, Wesley called the students over for a greeting from the visitor – me. They all ran over and lined up quietly and respectfully to hear my greetings given in the name of Jesus. I am very used to making impromptu speeches and sermons with little time for forethought. It’s just a way of life in Kenya.
It was now nearly 6pm. Alice wanted me to greet two boys at Tenwek High School but we decided we would do that today at 2:30. After lunch, I met Alice and walked up the hill from the hospital to the school founded by the early Tenwek missionaries. Evans and Enoch [Alice’s biological son] were called to greet us. We sat on the hillside near the entrance just in case the rain came from the ever blackening sky where lightning played about. The young men, a senior and a junior, got the same encouragement from both Alice and myself and gave their thanks as well. Enoch is truly Alice’s son as he told me all of the needs of the children’s home; the concern for the other children has carried down to his generation.
Alice’s needs are indeed many. She spends a lot of money on car fares as she travels long distances regularly. Neighbors jack up the prices as they see she gets money from foreigners, yet it is never enough to meet all the needs. I could see many of the children would be needing shoes very soon and some of the uniforms were in need of repair or replacement. Alice is taking a course in pastoral training in Nairobi and would love to be able to be at the home full time, but her Tenwek job enables her to meet many of the needs at the home. Having known Alice for a long time, I can see that her care and concern for the children is the overriding rule of her life. Her Christian compassion doesn’t allow her to turn her back on children in need.
The Bemms have received approval from WGM to hire a young man as a pastor to the various orphans. An orphan himself, he is another Wesley who formerly did yard work for their family. They sponsored his education at Kabosan Pastor’s School. He had taken a position over an hour away in Kericho, but he is needed at home to help care for his brother, who is afflicted by a bipolar disorder. The flexibility of this position should enable him to help the brother as well as the orphans at the homes. We offered his services to Alice’s orphans if she felt it would be helpful.
Perhaps you can sense that I am very pleased with the evolution of our orphan ministry in the community. I still need to meet with David Kilel to discuss our community based orphans. He is very busy with the Chaplain’s Training program of which he is the director. I have continued giving lectures two hours each week to his students on the subjects of anatomy, physiology, pathology, and medical terminology. Usually when I see David, he is rushing here or there. Please keep him, the Bemms, our directors and children, and me in your prayers in the days and weeks ahead.
I currently have two patients in the ICU on ventilators. That’s a first for me, but partially because we never had more than one working ventilator in the past. Now we have several, although I have no desire to utilize all of them at the same time. One mother, Betty, had eclamptic seizures during a routine cesarean and needed to be resuscitated. I pray that she will have no residual damage as she recovers, although I have not yet seen movement in her upper extremities. The other patient had a serious infection after a routine minor surgery. We drained literally a gallon of pus out of her abdomen on Friday night and she had not yet recovered kidney function as of yesterday. Her name is Linner.
Thank you so much for your prayers. Sorry for such a long letter, but so much of importance happens here that I covet your prayers for God’s enablement and assistance.

Serving Jesus with you,

Paul, for the Jarretts

PS: Amy and Nate begin their journey here tomorrow. Please pray for their safe travel.

Dear Friends and Family:
Thank you so much for your prayers. I am surviving and enjoying being back with friends at Tenwek. Please click on the link to read the entire message. It seems like my first week here was the busiest in surgery. A team of heart surgeons came during my second and third weeks; as much as possible, other services stepped aside to allow these volunteers to use their amazing skills to do open heart surgeries.
Some days have been busy and others not so much. Even with the heart team gone, I’ve done less surgery the past week –more as a result of fewer cases than of others doing a lot. I probably saved some lives this week without doing the major surgeries, so it felt worthwhile being here for that reason, as well as making some improvements in the OB service.
One day this week, the ultrasound tech called me up near lunch time to see one of our nursing staff who has a fibroid in her uterus. The patient had stepped out when I arrived, so I waited on a chair while the tech was doing a heart ultrasound on an elderly patient. Her daughter was assisting her and introduced herself. She was a teacher at Tenwek High School, and I had helped her in 2001 by delivering her son, whom she named Jarrett. He is attending the Ernie Steury School. That was fun.
This past Wednesday I was on call, so I ran the labor room most of the day to have continuity on call that night. For a change, the labor room was full of laboring patients as we had finally cleared out the non-labor patients needing more intense nursing care. Some were having labor induced and some beds contained two patients. I think there were seven labor patients. On a delivery couch was another patient who three days ago had delivered at home a set of twins, her sixth and seventh children; she had bled heavily afterwards. She hadn’t delivered either placenta and her hemoglobin was down to 3.2, whereas normal is 12-14. They had no O positive blood in the blood bank to give to her. The intern said her cervix was closed down and she wasn’t bleeding any more. We started some Pitocin to see if she could expel the placentas. The nursing matron appealed to the staff for blood donations, but only one unit was received. I expect most had given too recently for the heart team patients. We started the unit of blood.
As I checked on the laboring patients in the late afternoon, I found that a mother of eight had been admitted the night before with complete separation of the placenta and no fetal heartbeat. Abruption of the placenta is a really urgent situation; one must get the patient delivered before she uses up all of her clotting factors trying to stop the internal bleeding. She had been missed on rounds and the admitting intern forgot to mention to anyone that she had arrived the night before and assumed she had been delivered. Wrong – she was just quietly waiting in the logjam in the labor room. Now some 16 hours later, her uterus was as hard as a rock and she hadn’t responded to the Pitocin with any labor or change to the cervix. I took her immediately to surgery for a cesarean section which actually went well despite her having lost two pints of blood inside the uterus. I feared that the uterus might not contract afterwards because of the suffusion of trapped blood throughout the muscle of the uterus. The uterus was purple in color as in the dangerous Couvelaire condition, but it still contracted after the baby was removed. Fortunately there wasn’t any extra bleeding from the incision or venipuncture sites, which happens when all clotting factors are gone.
I returned to the ward to check on Alice, the mother with two retained placentas. I thought it might be necessary to do a hysterectomy. To have retained the placentas so long suggested they had grown into the wall of the uterus during the pregnancy. She had received a unit of blood and her blood pressure was stable, but she was beginning to bleed again. It was clear that she could not withstand continued bleeding overnight with no available blood in the bank to replace the loss; I had to do something. Doing a hysterectomy was possible, although it might involve more blood loss than she could tolerate with her hemoglobin still in the 3 range. I checked to see if the cervix had opened enough for either of the placentas to deliver. Nothing had come out, but I could now get my hand into the uterus to grab part of a placenta. Manual removal also involves risk of hemorrhage, but it seemed the quickest and safest way to solve the problem.
The patient was extremely cooperative as I removed most of one placenta. I was able to insert my entire hand up to mid forearm without her complaining. The placenta seemed to be fairly firmly attached to the lining surface of the uterus but not deep into the muscle. After removing all that I could in that manner and being unable to reach to the top of the uterus for the remainder of the placenta, I decided to look for some instruments to aid the removal process. I went to surgical theatre and found Anna, the Japanese nurse in charge. I had been told by several people that my large curette necessary for this procedure had been lost. Anna said, “No it is wrapped separately as always.” There it was on the front of the shelf! I only needed to ask the right person. With the curette and a pair of ring forceps which were nearly broken with metal fatigue – one ring had a complete crack – I began the piecemeal removal of the placentas.
The joke goes, “How do you eat an elephant?” The answer is, “One bite at a time.” That’s the way I removed the placentas, bringing out one tiny section at a time. A placenta usually has about 13 cotyledons [lobes] and each bite brought out a whole or half cotyledon. It took over an hour of repetitive scraping and grasping chunks of placenta until I felt like I had removed everything. Fortunately, the bleeding didn’t increase throughout the entire procedure.
The following day, the patient still had a rapid heartbeat but was making plenty of urine indicating good perfusion of her internal organs. She received a second unit of blood but not the third as requested. The next day her heart rate was still fast and she was dizzy when sitting up. We kept her in bed and pleaded for more blood. It sounded as if she would get one unit when I went off duty yesterday afternoon. These looked to me like two cases of multiple orphan prevention; both patients should do well.
I was able to get the ward a little more organized by changing some procedures. The nursing instructors granted us use of the small classroom to discuss our cases after rounds. We had been meeting in the middle of the busy hallway junction outside the nurse’s station where patients had to pass through our meeting on the way to the nursery and relatives sat on the bench with us. Discussing cases in such an environment wasn’t conducive to patient confidentiality, especially if the interns talked loud enough for me to hear them.
In my last letter, I had mentioned the problem of our maternity beds being full of patients who were recovering from gynecologic surgeries, medical conditions in pregnant or postpartum patients, and even advanced cervical cancer in an elderly patient. With the nursing shortage, many of our patients were missing vital signs and medication dosages. In contrast the female surgical ward remained one third empty and those nurses were not so busy. After I had left in October, 2007, a decision was made to move these other patients to Maternity to make room for more post surgical and orthopedic patients. That census eventually went down while our maternity census increased dramatically the past five months to the point of having no beds for labor patients who were often walking the halls or sitting on a bench outside the labor room. I discussed the situation with the nurse in charge as well as our OB team. Before the doctors could arrange to go to the medical superintendant with our request, the nursing matron made the decision to go back to the former status of having the gynecology patients in female surgical ward. It made an immediate difference in our overcrowded labor room. Thank you, Lord.
Next I tried to solve the problem of no room to do exams for our patients needing assessment for induction of labor. After rounds, the patients selected for exams are instructed to come up from the big ward room and sit on a bench outside the delivery room while the intern on duty does exams of the cervix. If deliveries are occurring, there is a long wait; many finally go back to the ward without being seen. Others get started on inductions very late.
I discussed this with the nurse in charge and we agreed there was no reason for these routine exams to be done exclusively on the delivery tables. We could screen off a bed in the ward or use the small exam room if it wasn’t in use by the nurses for checks of routine postpartum mothers, as it frequently is. We could even use the private room if it isn’t in use. I hope that this change will allow the interns who saw the patients on rounds to do their own exams rather than selecting one intern who has acute patient care responsibilities to do all the exams all day long while other interns go to clinic. The patients really need to be examined early if they are to have labor induced.
We continue to see patients with serious medical conditions. In my last letter, I mentioned patients with pneumonia and heart failure after delivery. While the heart team was here, the cardiologist examined each of these patients and found each had significant heart disease probably as a result of rheumatic fever damage. Another patient probably had a type of stroke. We had several patients with significant pregnancy induced high blood pressure.
Sharon is a 28-year-old mother of four who has inoperable cancer of the esophagus. She delivered the week before admission and was so weak from being unable to swallow and get food past the cancer that she was unable to walk. The gastroenterologist was able to put in a stent that opened up the esophagus enough for her to be able to swallow. She should survive long enough to nurse this baby until it can eat regular food. Please pray for her; she will enter our hospice program.
Last week I gave a lecture to the interns on malaria in pregnancy. The night of the lecture, we admitted a patient who had all the bullet points in my presentation. Mercy had delivered her first child by cesarean at a district hospital and recovered normally for a few days, but then things started going wrong. She was running a fever, had headaches getting progressively worse, and gradually was more and more confused. The doctors treated her for bacterial infection without improvement and the relatives brought her to Tenwek. If she had an infection, it wasn’t obvious, but she was anemic, had a low normal white blood cell count and a low platelet count. Her blood pressure was low and her lungs weren’t clear. She wasn’t making any urine.
We admitted her to the ICU with a diagnosis of cerebral malaria and gave her fluids that helped her produce a small amount of black urine – black water fever, another sign of severe malaria produced by destruction of red blood cells and clogging up of the kidneys with breakdown products. Although we started quinine, within hours she began to desaturate – having inadequate oxygen levels in the blood. We intubated her by placing an endotracheal tube and suctioned fluid from her lungs which helped but only temporarily. The ventilator kept her going for awhile, but she died by 6pm, less than 24 hours after admission. Sometimes we’re just too late with the diagnosis to help such a serious complication – even for a relatively healthy young person.
I have now visited two of our children’s homes – Umoja and Kenduiwa. Already this letter is too long, so I will make it a goal to write again sooner and give an update on those homes. Both are doing very well. The children look healthy and happy.
Please remember to pray for the sale of our house; we are making final preparations prior to listing it on the market although there is another potential buyer who has seen the property and has some interest. We’re praying for God’s perfect timing of everything. Also, please pray that we can make the necessary repairs to make the house attractive to a buyer but in an economic manner.
Amy and Nathan will leave for Kenya on June 7. Please pray for safe travel for them and their luggage.
Serving Jesus with you,
Paul, from Kenya

Dear Friends and Family:
Thank you for your prayers for my travel and immersion into the busy OB service at Tenwek. Please click on the link below to read the entire message from our website. It is somewhat of an immersion experience– sink or swim as the stream moves along rapidly. My concerns about being swept away were unjustified as I survived the initial week and a half of the busy schedule of difficult surgeries and strange cases and so did the patients on whom I operated. I felt like my skills were intact and my speed in surgery at least no worse than it had been two and a half years ago.
I operated the first day by assisting an intern do a cesarean section for twins where both presented as breech first. I always have found it harder to assist an inexperienced surgeon than do something myself, but all went well. By mid-afternoon jet lag had set in and I was glad for a rest.
Coming back was a somewhat emotional but good experience. There are something like 500 employees at Tenwek with nurses, administrators, cleaners, guards, and many other categories of staff. Having worked at Tenwek since 1999, I know many staff members by name and recognize most by face. They all know me, which means that I must stop and greet everyone that looks familiar. Invariably, I heard how people had been praying for our family; most had heard of Marty’s passing but some were on leave in January and didn’t know. In talking with those individuals, each experiences a grieving reaction, and I take longer to tell what a special three years God gave our family with Marty during her illness and of His closeness during that time. Uniformly, the Kenyan friends express their sympathy very kindly. Perhaps those who have grieved themselves are best able to sympathize with those who are grieving, and many Kenyans have experienced grieving where early death is a fact of life for many families.
I found many changes at the hospital and many more things that remain unchanged. Formerly, the OBGYN service consisted of me, a medical officer intern (MO) – a doctor in his or her first year out of school, a clinical officer (CO) intern — comparable to a physician assistant, and perhaps a junior staff member, family practice resident, or a consultant level OBGYN (American or Kenyan) as well as occasionally a student from Moi, Kenyatta, or an American medical school. That isn’t a large number of people caring for 30-40 inpatients and a larger numbers of outpatients each day.
This year, there are a total of sixteen interns (twice the number) which means our service has two medical students, four interns, one junior staff, and two other senior consultants which means I don’t see or know all of the patients and spend less time with the interns on the service. In two months, I may never even know the names of the other interns not assigned to my service. There are six general surgery residents, some of whom hail from other African nations — a category fairly new to Tenwek. And there are some new FP residents; the former ones have now graduated. With American visiting physicians, residents, and students, there are over 40 people in the morning report meetings instead of 15-20. That makes Tenwek feel very big.
Unfortunately, there are fewer nurses. Recently, the government expanded its community health nursing program as it had built many clinics around the country. That meant hiring over 3,000 nurses with community health training. Since nurses do not grow on trees, many nurses left hospital positions to take these higher paying jobs. It was a good offer for nurses just out of their training at Tenwek. Our more senior nurses would not receive the same level of pay commensurate with their years of experience here, so most remain.
Other hospitals in the area lost nurses as well. The net effect is fewer nurses working on each shift and heavier responsibilities for those remaining. Surrounding hospitals seem to be sending Tenwek more patients as their staffing levels are insufficient to keep some services going. For example, one afternoon last week, a local hospital sent their five labor patients to Tenwek because their operating room was closing for the night. In the long run, the increase in community health programs should be positive but a period of adjustment remains.
My first night on call last Thursday was busy with three straight cesarean sections from 7-11PM. Most c-sections here are complicated by risk factors such as prolonged labor, multiple repeat c-sections, excessive bleeding, or coexistent medical problems such as anemia or toxemia. Many are referred in from distant hospitals or clinics with the attendant delay in transportation or even initial presentation. I was thankful that all went well as I avoided the inherent pitfalls with those complicated cases. I slept for most of the night before being called up to assess another patient for cesarean. I decided she could make it without the surgery and she delivered safely by mid-morning. I finally got to eat lunch after being called away just as I sat down the first time. We began another round of three cesareans in the afternoon of which I did two. The other two senior consultants were not on duty on Friday.
I immediately noticed many more sick patients on the ward. Many more patients were identified as HIV positive; one reason for this may be a more liberal screening program where patients must “opt out” of being tested rather than being given upfront counseling and consent to be tested. Nonetheless, patients with more advanced HIV complications abound. Two patients with active TB were on the ward, and one mother of eight died in the ICU after not responding well to treatment. I have seen many patients with intra-uterine death of the baby before and during labor; fewer working fetal monitors and a lower sensitivity to their use may be having an impact.
Malaria cases are far fewer and the disease is being forgotten as a consideration by our interns. Often we have seen cyclic ups and downs in cases, but wider availability of medications and bed nets may be having an impact. However, we must keep malaria in mind as the effects on pregnant patients and the babies can be severe.
In addition to these sick patients, we have gynecology patients mixed in with the OB mothers as we no longer use the female surgical ward for post operative GYN care. There are too many general surgery cases and too few beds on that ward to house everyone, so our patients were combined in the maternity department. That means increased bed censes, more demands on the remaining nurses, and during my first week more patients per bed.
Another reason for the increased number of surgical cases besides more surgeons and fewer surgeries being done in other hospitals would be the special surgical teams coming from the US to do more “exotic” surgery than has previously been done at Tenwek. A visiting team of heart surgeons and technicians is slowly assembling to begin open heart cases next week. Cases have been stockpiled for their brief time here. Earlier this year an orthopedic team performed multiple joint replacements.
I am again giving lectures for the now more formalized chaplaincy training program headed by my good friend, Pastor David Kilel. I believe there are ten students this year who will receive two months of intense training before beginning service in other parts of Kenya. I give lectures on anatomy, physiology, medical terminology, and pathology [disease conditions] to give them background for their hospital work. The curriculum expansion will mean some additional preparation time for me in the weeks ahead.
I guess my letter wouldn’t be complete without some “never seen that before” reports. First was the case of a term pregnancy in an achondroplastic dwarf, a patient whose head and trunk are normal size, but all limbs are shortened. Average height for a woman with this condition is 4 ft. She required a cesarean for delivery and recovered very quickly.
The only other pregnancy in a dwarf I had seen was in my residency for a “proportional” pituitary hormone deficiency patient, whose name I remember to this day. I don’t think she was much over 3 foot tall. I am using the medical term “dwarf” rather than a more politically correct term.
My next case was yesterday at lunch time. I was called back up to the labor room for a ruptured uterus. The mother having her fifth baby had labored through the night until 5 am when she didn’t feel the baby move anymore and had abdominal pain. She had one previous cesarean section for a delivery in the past, so the presumption was that her scar had ruptured. Her pulse was fast and thready; it was assumed she was bleeding internally from the rupture. She was dirty and muddy from her trip from home. She wasn’t bleeding on the outside, but some blood in the catheter bag suggested a tear near the bladder which is where a cesarean scar often separates or ruptures. The intern could still feel the baby’s head in the birth canal, so we thought perhaps just the body and feet had broken through the scar allowing the placenta to separate and kill the baby.
I took her to the operating theatre where a good friend, Agneta Odera, was the anesthesiologist; she is taking anesthesia training as part of her surgical residency. It was nice to work with her and Hank, an American anesthesiologist, with whom I eat everyday at the guesthouse. They put her to sleep for the surgery since a spinal may make a patient’s shock worse.
I made a high incision and was surprised not finding the baby floating free in the abdomen like in all other rupture cases I have had. I could see bruising beneath the surface of the uterus which was certainly funny shaped, like a two-horned uterus [bicornuate].
I could feel the bruised area of the uterus in the middle of my incision was very thin and made a tiny nick there with the scalpel. The placenta and a foot came out, so I brought the rest of the baby out once I had something to grab onto. After I delivered everything, I could see the uterus had indeed ruptured but in a very unusual location.
Each side of the uterus is supported in its position in the abdomen by several fairly strong ligaments and one weak one which is called the broad ligament. The broad ligaments run the entire length of the uterus on both right and left sides. They are very thin [about 1-2 mm] with a thin layer of peritoneum on each surface, front and back. In between the surface layers are blood vessels, lymph vessels, nerves, and the ureter. Imagine two maple leaves glued together and you get an idea of how thin it is.
The baby’s body had ruptured through the right side wall of the uterus and was pushed out into the thin sac formed by the stretched-out broad ligament. It might be like carrying an 8 pound turkey breast in a very small, thin Wal-Mart plastic sack. I had never seen that before — how many times have you heard me say that at Tenwek?
Amazingly, there was very little bleeding which is probably why this mother survived for 8 hours after the rupture at home. I gingerly inspected the hole that had been created in this ligament. Part of the new cavity went up behind the appendix and large bowel. The hole extended down beside the birth canal and cervix, both of which were torn. That’s a deep hole in which to be sewing, but bleeding was minimal, I was able to repair everywhere there had been a tear. The large uterine artery going through the middle of the ligament wasn’t torn. The larger, round ligament at the top of the broad ligament was torn in two, but it doesn’t have a big artery in it, so it was just oozing. The ureter had not been injured at all. It seemed to be the best possible combination of structures that were hurt and those that weren’t.
I decided it wouldn’t help to do a hysterectomy [and might hurt], so I just repaired everything and put a suction drain into the big cavity that remained where the broad ligament was pushed apart by the baby. The two-horned feel to the uterus was the main body [fundus] of the uterus pushed to the left side and the baby in the broad ligament feeling like the right side of another uterus.
Strangely I don’t think the patient had lost more than a pint of blood. Infection is a future concern, so I started an antibiotic. She looked pretty good this morning, all things considered. With a male nurse translating into Kipsigis, I explained to Mercy how God had had mercy on her allowing her to live through an emergency which would have killed most patients. She should be able to go home and care for her four children. I told her the baby was a boy too big to fit through her pelvis and the uterus had eventually ruptured. [It may not have had anything to do with her having had a previous cesarean as the old scar held together; if the labor is obstructed, the uterus will eventually rupture in a patient having any other than her first child.] The nurse prayed for her; I saw a large tear pool into the corner of her eye as we talked – about as much emotion as is typically displayed by our patients.
Today was another busy morning at the hospital. I did a cesarean for the
placenta previa condition where the placenta comes near or covers the
cervix. We lost a fair amount of blood with it. We have one undelivered mother with severe pneumonia, another with heart failure, another with severe toxemia [pre-eclampsia with high blood pressure] whose baby has already died inside at 24 weeks into the pregnancy. Another mother lost a baby at 32 weeks from abruption of the placenta [premature separation] but she delivered quickly enough to avoid severe complications.
I am surviving on my own with the help of the guest house staff and the other missionaries. The visitors have lunch in the homes of long-term missionaries, at the guest house, and the hospital canteen. Breakfast I can prepare in my room and supper is cooked ahead at the guest house by Livingstone, the head cook. Three times a week, one of the helpers does my laundry at a small extra charge. I don’t have enough clothes, time, or sunshine to do it myself, since it rains nearly very afternoon.
I gave my torn tennis shoes and a sandal to Livingston to take to a duka [shop] to be re-sewn; I splurged about 70 cents for those repairs which should insure my OR shoes hold up the rest of the time I’m here. I was supposed to be on call Tuesday night, but Caleb Maina volunteered to take my call. He had been at a meeting last week and didn’t have any call for two weeks. He seemed very glad to see me. I’ll be on call Friday night and the following weekend.
A good friend, Pastor Helen Tangus looked fine last Monday, but she got sick over the weekend and was in ICU. She’s better but still has some issues they are working on. Please pray for her complete recovery.
I think I will save a good story about our orphans for the next letter. All reports so far are positive. I met briefly with Joseph from Umoja Children’s Home; I will try to go there on Saturday.
Finally, I would ask for your prayers for the sale of our home. The past three months we have been working with a potential buyer with whom we had agreed on a price. But everything broke down after the inspection report and we were unable to reach final agreement. We hope to list the home within a short period of time. We will need wisdom exactly how to proceed. Unless the house sells quickly, we will lose the house in Noblesville we had a conditional purchase agreement on. It is now back on the market, although we can still purchase it at our original price if it doesn’t sell first. We have peace that God is in control.
Our family is doing well although emotions were stirred by the first Mother’s Day without Marty with us here on earth. Please pray for Amy’s trip to Kenya with grandson, Nathan, age 16. They leave on June 7. Flights through Europe are occasionally interrupted by the volcano in Iceland spewing ash into the atmosphere. And British Air flight attendants have scheduled periodic strikes which caused cancellation of half of scheduled flights for several days in April. Our return flight on June 29 would also be under these threats.
Thank you so much for all your prayers and support.
Serving Jesus with you,

Paul, at Tenwek

Dear Friends and Family:

Thank you for your prayers for my travel. I arrived safely at Tenwek at 1:30pm local time. From the very beginning of my trip God gave me assurance of His approval in an unusual way. Please follow the link to the website to read the entire story.
My flight from Indianapolis to Chicago was scheduled for 12:35pm on Saturday, May 1. I forgot to ask you for prayer for the check-in procedure; my approval for a free third bag was not in the computer as it should have been. [We’ll check on that with the travel agent later.] Instead, I paid an extra $60 to bring the second bag of orphan clothing. Otherwise the check-in and security check went well.
We boarded the small Embrair jet on time, but the pilot announced there was a glitch in the onboard computer and a maintenance guy was on his way. Twenty minutes later everyone was standing in line at the gate waiting for a lonely agent to reroute forty passengers. I was near the front of the line and was placed on the next Chicago flight around 2:00pm – plenty of time for my Chicago connection to London.
I took a seat in the lounge and noticed a young man across from me who had a large cat in a soft, portable cage. In all my travels I had never seen a passenger with a cat, so I asked him about the cat while he took it out to reassure it about not being nervous. He told me the cat had never flown before as I had assumed from the amount of shedding hair that was flying around. He said it was 11 years old and weighed 18 lbs. He was taking it home to Nebraska. Then he carried it for a little walk down the hall. He returned a little later with some chewing tobacco which he chewed and spit into an empty plastic juice bottle.
It took the airline a long time to tow away the plane which delayed the incoming flights as well. Our gate still listed my new Chicago flight but they announced a Miami flight would land at our gate and reload for a return trip. Some people were still in line being rerouted and others were boarding the plane for Miami. When the young man returned he got into the line to board only to be turned away by the gate attendant since he was a Chicago passenger.
Appearing agitated, he sat down a few seats away in my empty row. He seemed to be decompensating. Then he addressed me in a louder than conversational voice saying, “I’m an Iraq veteran, an alcoholic, and I really need to lie down and rest. Can you watch me?” I said that I would tell him when they announced our flight and asked if I could pray for him; I put my hand on his shoulder and prayed for peace and rest for him. Then he stretched out on the floor beside me and rested.
Several Miami-bound passengers never figured out from which gate they were departing, so the agent delayed and paged those passengers by name; our gate still said Chicago. Finally they left without three passengers and the Chicago plane came in having been sitting on the tarmac waiting for our gate to open up.
The young man, Ken, got up and started talking about his problems; he was sober but nervous. He’d been a medic for two tours in Iraq often under shellfire. He had come to Indy for a great new job while his wife stayed home at her job in Nebraska until they saw how it would work out for him; it didn’t. He didn’t like alcohol but had taken to binge drinking to kill the emotional pain. He’d been in the local VA hospital but “didn’t receive any help”; he wanted to go to the VA in Nebraska. A middle-aged lady sat down across from us and offered to buy him a bottle of water which he declined.
I asked him if he knew Jesus. He said he didn’t; he had attended church as a child but not since. He had gone to a university and received a master’s degree in history but became an agnostic. He said that he was 30 years old, had made a mess of his life and couldn’t find a way out of his problems. He had studied religion but didn’t see any help in it.
I talked with him about Jesus Christ, using as much scripture as I could remember appropriate to where he was. I told him my testimony. I explained to him that he needed only the smallest amount of faith to confess that Jesus is the Son of God who died for his sins. We probably talked for ten minutes while they cleaned our plane. Finally, I asked him if he would like to pray to receive Christ. He said that he would, so I helped him pray a prayer of confession and acknowledgement of Jesus Christ as his savior.
The lady came back having bought him some water despite his initial refusal. She talked to him a little and gave him some contact information for someone in his home area. Then they announced our boarding, and we four, the lady, Ken, the cat, and I, boarded the plane together. I remembered having put one of my ministry cards in my pocket as I left home [it was on the floor near my desk] and gave it to him. I also called Amy from my cell phone before take off and asked her to have our family to begin to pray for Ken.
He sat two seats behind me, but the lady exchanged her seat to sit immediately behind him in the small aircraft featuring only single seats on our side. She and he carried on a loud conversation all the way to Chicago. I think she was trying to keep him engaged and calm. I didn’t really get the feeling she was a “sheep stealer” but decided to write him a letter explaining about his new birth and the power now residing inside him. My stationery was an emesis bag from the seat pouch. I suggested a brief plan of Bible reading and the need to find a Bible believing church. I told him that God would never leave him or forsake him. I gave him the “letter” as we exited the plane; we were headed for different terminals, and as he thanked me, I asked him to write to me.
I don’t know if I’ll ever hear from him, but I’m praying for God to safeguard the treasure that Ken has been given. Would you join me in that prayer? I thanked God for involving me in Ken’s life. It involved inconvenience and expense to a lot of people to put me next to Ken at his moment of crisis. I thought of it as a great privilege and affirmation that God had planned my trip in such a way for our lives to intersect at Gate B7 in Indianapolis.
Nothing nearly so exciting happened the rest of the way. I met and shepherded a new visitor to Tenwek from Chicago to Nairobi. I slept on the transatlantic flight and all night Sunday, the first night at Mennonite guesthouse. Today we rode up to Tenwek; the road is in wonderful condition almost the entire way. It took only three hours to make the trip instead of four or more hours as when I was last here. We were flying past all my familiar landmarks that I was used to sighting at a snail’s pace.
In the afternoon I went up to the hospital to get my computer hooked up to the local internet. I was greeted by so many of the staff that it took a long time to get up and back to the guesthouse where I’m staying. I’m sure the next few days will be similar given my experience in the past. So many staff members told me how sorry they were about Marty and how much they had prayed. I really felt like I was home.
Tomorrow I plan to go up to the hospital to work. I feel a little rusty but hope that I can shake off the scale and debris and function as before. There are many new faces and names to learn and new problems to face but it’s good to know that God has gone ahead and planned more work for me to do to His glory.
Serving Jesus with you,
Paul, in Kenya

Dear Friends and Family:
I will be leaving for Kenya tomorrow morning and would greatly appreciate your prayers. My flight from Indianapolis is at 12:30pm and from Chicago to London at 6pm Indy time. Please pray for adequate rest and safe travel and that all three bags will make the trip with me. There are also prayer requests for when I get to Tenwek – travel to the hospital and sufficient rest to begin work right away. I’m expected to be ready to work on arrival, so we’ll see how well the 64-year-old body rebounds from the trip I hope to find my surgical skills and stamina at a high level.

Please pray for my daughter, Beth, who will need surgery for an ovarian cyst sometime next week in Charlotte. She probably will be away from her baseball team until released by the doctor.

Please pray for the sale of our home. We had an agreement with the buyer until the inspection revealed the need for a new septic system. We are now seeking additional information on placement and expense along with some other issues that will determine if the buyer is still interested and at what adjustment in cost. My son, Patrick, will be handling all negotiations and details. We hope to have a final answer by next Thursday or Friday. Also pray for the family whose house we have agreed to purchase contingent on the closing of our house. They have been very patient but really want to leave Indiana soon.

Thank you so much for your prayers.
Serving Jesus with you,
Paul, for the Jarretts

Dear Friends and Family:

You haven’t heard from the Jarretts for more than six weeks, but all is well with our family. We do have many praises of God’s provision and some prayer requests. You will need to click on the link to read the entire message which is truncated by the website server.
I made a mostly uneventful recovery and am now completely healed from my surgeries; the surgeon has released me to lift heavy boxes, a timely release in light of the next bit of news: we are moving! More in a minute.
Amy continues to pursue a career as a full-time missionary in Kenya with Africa Inland Mission [AIM]. After passing the initial interview and reference process, she has filled out a doctrinal questionnaire and will send it in soon. She anticipates attending a candidate week camp in New York in early August. If accepted by the mission she would begin raising support following the camp.
Laura returned home yesterday after her 17-day trip to Japan with some exciting news. I’ll let her tell it in her own words: Thank you so much for your prayers for my trip to Japan. I am now back home in Indiana. (I arrived last night)
Praise be to God! I had a really good time in Japan. I was able to meet with two of my past students (who are not Christians) and also with my friend, Manami, whom I met last year when we got our driver’s licenses together.
I was able to go into the sanctuary and up to the 2nd floor of the church building for periods of time without any symptoms appearing from mold exposure. This means I can live in Sapporo and participate in several areas of ministry in the church as long as I don’t live in the church building. I am so thankful to God for opening up this door again!

Another exciting event occurred while I was there: I got engaged!!
Many of you already know the situation, but for those of you who don’t, I will explain just a little for now. My fiancé’s name is Keisuke Noguchi. He is a member of the Grace Church Sapporo. Keisuke works with his dad in the family camera shop where they sell used and new cameras.

Keisuke is very musically talented, and loves the Lord very much. He has always been such an encouragement to me in my walk with Christ.
He and I met for the first time in 2006 when I first went to Japan in August. We served a lot together in the church and became good friends. We have been praying about marriage for a couple years now and Keisuke has gotten to come
and meet my family several times. He also got to meet my Mom, so I am so thankful for that.

Due to various health reasons and family situations, we had not been able to get engaged, but while I was in Japan these last few weeks, my Dad gave Keisuke the blessing to ask me to be his wife. SOOO we are finally engaged!!!!
It has been a long journey having to be separated by physical distance for half of our relationship! BUT God has used these difficult times for the growth of our faith in Him and teaching us to trust in His sovereign timing and plans.

We are excited about the plans that God has for us, and are so thankful to God for opening the doors for us to get married. We are hoping and praying to build a family built on the foundation of Christ, and are excited to serve Christ together as a team.
We are not set on a wedding date yet, but are praying and hoping to get married some time in August of this year, perhaps the 21st. I will let you know the date once we have it decided! We are planning to get married in the States and then when we go back to Japan, we will have a reception there too. I would appreciate your prayers for these next couple months as they will be very busy with the family move and wedding planning in 3 months!! Please pray that God will be glorified in it all, and that He will give us wisdom and direction on each new step.
I thank you all for the special part you have played in my life. Thank you for your love and prayers which mean so much to me! May God’s faithful and sovereign Hand be upon each of you today. He is so Faithful and Sovereign!!
Love in Christ, Laura Jarrett

There are three other major family expansion events planned in the second half of 2010. Becki Burke, Lisa Jarrett, and Debbye Biermann are all expecting babies (in that order). For Becki and Debbye, this will be a second child, but for Lisa it will be number twelve.
I may have mentioned that we had been considering selling our house in the past but didn’t feel that it was something we could do during Marty’s illness. I made the decision to downsize realizing it would be only Rachel and I living here much of the time in the future. With eight bedrooms, we wouldn’t need to change sheets often – we could just move from one bedroom to another which Rachel likes to do anyway, but I prefer my own bed. We started getting things cleared out with the idea of showing the house in spring.
We consulted with some realtors who shook their heads when they saw how much work was needed before we could show the house. The outlook in the real estate market was even more discouraging – there is a three-year backlog of available houses in our size and price range compared to current sales. We prayed and moved forward, feeling that God had led us to defer moving until this time.
Although we hadn’t listed the house or decided upon a realtor, word began to circulate that our house was going to be for sale. Several people contacted us including one couple who wanted to see the house right away. They had been looking at property and houses for over a year and didn’t care that the house wasn’t in showroom condition. I couldn’t even tell them how much we wanted for the house since we hadn’t studied the market. I just knew the replacement cost for insurance purposes which isn’t necessarily the same as market value.
After viewing the property and the house, they said they would like to make an offer, so I had some homework to do fast. With the help of my sons and a realtor friend, I made an offer to sell. We countered back and forth but didn’t reach an immediate agreement.
We decided we had better try to find out where God wanted us to move if the house sold right away, so we enlisted the help of another realtor friend to show us houses in the southeastern part of Hamilton County near some of our kids where Rachel helps with childcare. We looked for two days and found one we thought might work out; in doing so, we learned a lot about the price range and type of house we were seeking.
We put the moving process in the Lord’s hands, took a few weeks off of weeding out, and went to Florida and South Carolina for some family time which was important – the first time we had with Jon’s family since Marty’s memorial service. I slept a lot better on vacation than I had for many months.
We stayed in touch with the buyers by e-mail while in Florida where we saw two baseball games with daughter Beth’s Washington Nationals club. She is now back in Syracuse for her second season with the AAA team.
Before leaving Florida for South Carolina, we reached agreement with the buyers on a price with which we were both happy. We also heard that the house we were interested in buying had sold. We began the selling process by arranging inspections and various other steps including separating our driveway access to the house from the neighbor’s drive for a better future arrangement. We didn’t know where we were going to be living, but figured we were on a “need to know” basis with God. We wouldn’t need to know the answer to that question until we got back to Indianapolis.
We asked the realtor to find some other possible houses where we might move considering the location, price range, and other requirements that we had refined in the earlier process. When we returned, she had found some good possibilities, but one north of 146th and Allisonville really stood out. We put an offer on it which was countered at a level we liked and accepted. We are doing some mold testing on the house to ensure our mold-sensitive kids can live there. Those results will be back by the first of next week.
We hope to complete the closings on both houses before I leave for Kenya for two months on May 1. Our son, Patrick, can sign all documents with his power of attorney if we haven’t closed by May 1. Amy and Laura may end up supervising the move.
We would appreciate your prayers for getting a permit for driveway construction at our current house. This should be a slam dunk since we own the property where the drive will go, but the application is currently held up by a clerk’s workload following his two-week vacation. He won’t answer his phone or return phone calls. Please pray that he will be cooperative and diligent when the contractor meets with him tomorrow at 11 am. This contingency of an out for our buyer also affects the sellers of the new house who could lose that sale if we lost our buyer. Please pray that they will understand this delay which is beyond our control but not God’s.
Also, please pray that all inspections will be completed and any deficiencies can be readily solved. In this process misunderstandings and friction can pop up unexpectedly. Please pray that we will be able to glorify God and be a positive witness for Him through every turn of events. We praise God that He has brought everything together in a manner that only He could. He may show us that He has different plans and redirect us at some point, but we think this is His answer to our prayers.
Please pray that I will be able to get through the secretarial functions for Hope Ministries. I have quite a backlog of paperwork to do after the overwhelming response to the Marty Jarrett Memorial Fund for our orphans.
Please pray for my travel May 1-3 to Tenwek. Also pray for my quick recovery of operating and thinking skills as I reenter the operating room after a 2.5 year absence. Maybe you should pray for the patients. Amy will come on June 7 to help at the hospital; she will bring my oldest grandson, Nathan, with her. We all return together on June 30.
Please continue to pray for our family. All of us miss Marty and feel it in different ways and at different times. Selling the family home of 32 years has also produced emotions and grief again. God has comforted us all through this process as well, but it is still difficult at times.
God’s long range plans for me are still a mystery but will be revealed in His time. I hope to clarify if I will be able to serve at Tenwek following this two-month visit. They may not need another OB doctor for two years after September since others have signed up for that time period. Does God intend for me to serve in Kenya at another hospital where Amy may be serving? Does He want me to continue in medical missions or some other form of missionary service? No answers have come yet, but perhaps it is another case of “You don’t need to know that right now; just trust Me.”

Thank you so much for your prayers and faithful support.
Serving Jesus with you,

Paul, for the Jarretts in transition

Dear Friends and Family:
Thanks for praying for Amy’s meeting and my 7:30 am surgery. You won’t see this entire message without clicking on the link to the website. I woke up in recovery at 9:30 and was home by 11:45. As I am medicated, I won’t attempt to give a full report, nor is any probably necessary, except to say that all went well with the procedures. I’m supposed to be pretty sore for awhile but have my ice packs and medicines set up, and the girls are supervising everything. Please pray for an uneventful recovery.
Amy’s interview with AIM went well. She now will fill out a formal application and begin raising support which is necessary with a long-term missionary agency. She won’t be going this fall to begin service, as they say it takes 18 months average to complete the process. That’s not to say that she couldn’t go with me through WMM if I were to be serving at Kijabe this winter. We’ll see what God has in mind. She is leading a short-term mission trip to Peru this July.
We appreciate your standing with us in prayer [but not standing still].
Serving Jesus with you,
Paul