Jarretts Ministry

February 21, 2003

Dear Friends and Family:

Thanks for your prayers for our family and for our ministry at Tenwek Hospital. I would like to update some prayer requests and report on answers to your prayers. Things seem to be all right at home. My father continues to make good progress from his surgery, and Beth is reporting that she is feeling well after her Peru trip. Susanna has had some challenges at the house with a broken refrigerator and a nearly impassable driveway due to the heavy snow. Some kindly neighbors have helped her to clear the long driveway.

There continue to be major challenges at Tenwek. We have had a significant malaria outbreak that is stretching our already thinned out staff considerably. We have many mothers admitted to the hospital with high fever, confusion, anemia, and in some cases, loss of their babies. The pediatrics department has lost many children as well.

As you may know, the malaria parasite is spread by mosquito bites. When insect breeding conditions are good, and there are lots of people infected with the disease in the first place, the conditions are right for an epidemic. A newly hatched mosquito feeds on the infected person and gets the malaria parasite into its system. It then incubates the parasite and when it feeds again, it injects the organism into the new victim. People who are bitten repeatedly over their lifetime get some immunity, but children and pregnant women are very hard hit. We have one six-bed room full of pregnant women with malaria, and several other women who are recovering are in less acute care rooms. Many others are treated as outpatients if they aren’t too sick.

Squeamish People Skip Ahead

Malaria not only destroys the oxygen-carrying red blood cells [anemia], but it also suppresses the infection-fighting white blood cells and the blood clotting cells, the platelets. Two of our mothers had nose bleeds this morning from the low platelet count in addition to all the rest of their miseries [headache, joint aches, high fever, abdominal pain, and diarrhea]. One case really topped the others, however. A mother reported to the hospital literally covered with blood and mud. Everline gave the history that she had been bleeding heavily all night at home and thought that she was in labor. The two most serious complications that cause this picture of heavy bleeding at the end of pregnancy are premature separation of the placenta [abruption of the placenta] and placenta previa [the afterbirth located low in the uterus, overlying the cervix]. That means the baby can’t deliver normally without the mother bleeding to death. After examining this mother, I thought she probably had both conditions. The ultrasound showed the placenta was in the way, and the baby was already dead. Everline was extremely pale and her heart was beating furiously. I really wondered if she could stand to lose another cupful of blood. Fortunately, the active bleeding seemed to have stopped.

We began to prepare her for surgery with two intravenous lines running. It took three buckets of water just to clean her up enough to go to surgery. A catheter was anchored in the urinary bladder to get it out of the way [it's right where we make the incision for the cesarean section] and to measure urine output [people who are in shock don't send enough blood through their kidneys to make urine – you have to keep the kidneys open by monitoring the urine volume and giving enough fluids]. I took blood to the laboratory to cross match donor units against the patient’s blood. I also requested a hemoglobin level to tell the amount of blood that was still left in the patient. The lab test said it was 6.2 [normal 12-14]. I knew that it wasn’t really that high because it takes many hours for things to settle down after a major bleeding episode.

As I got ready to leave the lab, the nurse paged me and told me that blood was pouring out again. I grabbed a unit of blood off of the shelf which was the patient’s type, but hadn’t been crossmatched against her for a reaction. We couldn’t afford the luxury of 45 more minutes for the crossmatch. We hurried off to surgery with the blood running in the intravenous line about the same rate that it was running out below. The surgery team swung into action, put the patient to sleep, and prepped her for surgery. I made the normal incision in the uterus and delivered the baby, a perfectly formed boy who had been dead only a short while. But there was nothing that could be done to save him. Our hope was to save the mother. Sure enough, the placenta was implanted over the cervix, but I couldn’t see that it had separated prematurely. Why had the baby died? Usually, it’s the mother’s blood that is lost in this placenta previa condition. There wasn’t time to ponder the question; we weren’t through losing her blood. The incision had extended through the left uterine artery. I had a difficult time getting the pumping artery under control. The patient’s pulse raced faster and faster. The pitch of the heart monitor rose higher and higher, adding audio effects to the unfolding drama.

The scrub tech assisting me must have a bit of attention deficit disorder, I think. He is always looking away instead of focusing on what is happening. Despite 10 years of experience in surgical theatre, he is always slow in getting suture ready or even onto the field from the cabinet to start the case. This day was no exception, despite the crisis. The needle was too small to be efficient [not his fault, that's all we had available]. As I had the field just about dry enough to continue working, he pulled the clamp off the uterine artery, sending the blood spurting everywhere again. I wondered how much more blood loss the patient’s heart could take. I wondered how much more my heart could take.

Finally, I got the bleeding stopped and the incision closed. I had lost more blood than on any cesarean in recent memory. We got the next unit of blood from the blood bank and said a prayer [again]. We started a third unit of blood and then a fourth ordered for the next morning. Urine output had to be kick-started with a diuretic, as the patient was in acute kidney failure.

The next morning, we received the report from the laboratory that the patient had come in with malaria with a moderate parasite load [not just a mild case]. Her hemoglobin was now all of 5.1! It’s no wonder that the baby had died. The malaria parasite had done it again. The malaria was continuing to destroy the remaining red cells that we had been pouring in. Now we had to start quinine to kill the malaria and continue blood transfusions until the whole process evened out. No family members were around to donate blood. Is it too much to call it a miracle that Everline has survived to go home? We thank God for His help as well as for the resources that we do have to care for such critically ill patients.

All but the most squeamish rejoin here

Saturday morning. There is a gap of six hours in the narrative which corresponds to my night on call. During the night one of the mothers with malaria died; this one, who had been bleeding from the nose, was 7 months pregnant. Her platelet count had been measured as low as 8,000. Normal is above 140,000. Below 25,000 there is a risk of uncontrollable bleeding. She probably had a bleeding episode within the brain to cause her sudden death. We had been giving her intravenous sugar to keep her blood sugar up; another side effect of malaria [and the quinine] is low blood sugar. She had seemed to be improving over the three days that we had been treating her, but suddenly, she was gone.

We’re struggling to save another mother who is six months pregnant. We’re not exactly certain what is wrong with her. She has a history of epilepsy and had been seizing continually for 10 hours at home before coming to Tenwek. After receiving anticonvulsants, she stopped having the seizures, but woke up screaming for the next eight hours. Her oxygen levels were also low, which leads us to think that she may have aspirated [gotten stomach contents into her lungs during the seizures]. Finally, she was sedated enough to quiet her down, but she has never been able to communicate. This morning, her oxygen levels have dropped again, and I fear we may lose her. Please pray for her.

Cancer 3, Jarrett 0

I’ve had some disappointments the past 2 weeks on the gynecology service as well. Alice, a fairly vigorous 75-year-old grandmother, had been well until a few weeks ago. Then she began having abdominal pain and poor appetite. Her family brought her to Tenwek where we found a large mass in her lower abdomen. We took her to surgery but were disappointed to find a huge mass of ovarian cancer throughout the pelvis. I tried to remove the bulk of it and freed up the bowel where it had stuck to the cancer causing some blockage, but the bleeding was too intense to remove the entire tumor. Alice actually feels better now that she is able to eat, but her time is short. She is a believer.

On Wednesday, two patients were brought in with cervical cancer. Esther, a 52-year-old mother of seven children, suddenly began draining a lot of fluid from the vagina. I examined her and found a large hole between the bladder and the vagina. This condition is usually from childbirth injuries, but in this case, the cancer had eaten the large hole. The good news is that the drainage will soon stop; the bad news is that it will stop because the cancer is beginning to block both ureters. Already her kidney function is diminished. The most we can do for her is try to relieve her pain and encourage her spiritually.

The other patient, Ebisiba, is 45 years old. Her name is different from many others here because she is from Kisii. This tribal group has a different origin and language from either the Kipsigis or Masai. Someone in her area had done a biopsy of her cervix and referred her for radiation therapy to Kisumu, the fourth largest city in Kenya. The only problem was that no such therapy exists there. The family then brought her to Tenwek.

I examined her and found that there might be a chance to remove the tumor with surgery. The tumor was an adenocarcinoma which doesn’t spread out to the sides quite as quickly as the more common squamous cancer; at best we might give her a few years more. Radiation therapy would be the first choice of therapy if it were available. Only in Nairobi is such treatment available to those who have the money. A typical course of therapy would cost the patient over $700, if the doctors were even willing to do it. That expense is beyond the reach of most patients in Western Kenya. And the doctors at the national hospital have not been helpful in the past with such cases. We don’t know if things have changed with the new government.

After consulting with the family, they asked us to do what we could to help. On Thursday, we went to surgery, but were disappointed to find that the cancer was extending into the pelvic side wall and into the bladder. Ebisiba was heavy enough to prevent us from discovering this on pelvic examination. [Most of our patients are pretty thin, but many from Kisii are actually overweight.] We had to close the abdomen without removing the tumor. Her only hope now is to make the trip to Nairobi for radiation, but her ultimate prognosis on earth is grim.

More interesting cases

Monica is a 25-year-old married woman who came in complaining of swelling of her abdomen. She had never been pregnant in her 7 years of marriage. Several tests didn’t give us the answer as to the cause of her swelling. It seemed to be most like free fluid in the abdomen [ascites], but the ultrasound showed it to be more like an ovarian cyst with multiple pockets. That made it a gynecology case instead of for the general surgery service.

We took her to surgery on Tuesday and found a very confusing picture. The fluid was free in the abdomen. The pocket picture was created because everything was stuck together loosely with adhesions. The pelvic organs were inflamed, but not with the typical appearance of gonorrhea-induced inflammation. Fine little pustules dotted every surface in the abdomen. This looked like the picture in the textbook for tuberculosis. We cleaned everything up, took some biopsies, which will take many weeks to get back, and an AFB smear. This test is just a smear of the fluid onto a glass slide that is stained specifically for the TB organism; it is then read under the microscope in our laboratory. Within two days, we had the affirmative answer. We have started Monica on tuberculosis therapy which she will need to continue for the next six months. There is no guarantee that she will make it, but we are hopeful.

I had a professor in medical school, Dr. Roy Behnke, who encouraged us to do a rectal exam on every patient. He said that if we did, that sometime in our career, we would find a patient with rectal cancer. I believed him, and, as many of my patients will attest, I have done a rectal exam on nearly every annual checkup for the past 33 years. I was still looking for my first rectal cancer.

Emily is a 25-year-old mother with a 9-month old child. She came to Tenwek with a history of abdominal pain, a large mass in her lower abdomen, and no bowel movement for three weeks. The medical people and the surgeons looked her over and felt that the mass was coming from the pelvis. The ultrasound also suggested that it was a gynecologic problem. But when I did her exam, I found what seemed to me to be a large cancer blocking the upper rectum. I suggested a colonoscopy; the surgeons were doubtful, because Emily is so young and the mass is so big. Rectal cancer shouldn’t be the answer. But when the visiting gastroenterologist, Dr. Joel Spraggins, looked into the rectum with his flexible colonoscope, he could see the huge cancer involving over 3 inches of the recto sigmoid colon. Emily will have surgery next week. Dr. Behnke, you were right after all. I never doubted you.

More Spiritual Warfare

There continues to be spiritual warfare here at Tenwek. Please keep praying. Last week, I mentioned that there was disgruntlement among the clinical officers and there had been a brief strike. This situation has escalated to the point that three of the most senior clinical officers have submitted their resignations. There leaving would be a huge loss to the medical work here. One of them is almost solely responsible for increasing the survival of premature babies in our nursery. His work in the nursery has had a dramatic effect on survival rates of the tiny babies. The others are handling large volumes of outpatients with great skill. These individuals are part of the fruit of many hours of medical training over the last four years. Of course, God can use them in other hospitals and perhaps this is part of the plan, but we will be saddened to lose their services here. Please pray for wisdom on the part of our administration and the clinical officers for handling this delicate situation. Poor communication and mistrust are the tools that the devil has used to divide these Christian men and women.

Russ White, our chief of surgery, has announced that at the present time we must limit our surgeries to urgent and emergency cases. Elective cases that can be postponed with no harm to the patient will have to be postponed until sufficient staff personnel in surgery have been hired to meet the present demands. Please pray that this policy will be understood and accepted by all parties, and that staffing needs will be met very soon. I am not able to schedule the fertility restoring surgeries under these guidelines, but most of my surgeries are of the urgent and emergent nature anyway.

The laboratory has been overwhelmed with all the malaria tests and blood banking demands, so that results are very slow in coming to the doctors caring for sick patients. Yesterday, it was even slower. Rosalyn, one of our staff who worked in the lab, died this past week. The hearse came to the morgue today to pick up her body. All day long, staff members were standing around the area of the morgue, waiting and watching. I believe that finally a brief service took place, although I didn’t witness it because I was in surgery. Rosalyn’s husband had died last fall; they leave two orphaned children.

Orphans and Children of Widows Project

The number of orphans in our area continues to increase. The AIDS epidemic continues unabated. The following is a typical history. A man contracts HIV from a prostitute. He brings the disease home to his wife. One parent dies and the other follows in death within a short period of time. The children are left to fend for themselves. Relatives sometimes take in the children, but more often than not, there are no relatives or those who are around can not or will not help.

The Africa Gospel Church is administering the project that we began in July, 2001. Pastor David Kilel is the main contact as he knows so many of the local pastors and is informed about the orphan situations. He is a very godly man with a heart full of love for his people.

Thursday night, he called to ask if he could meet with us. He had a problem weighing heavily on his heart. He was asking for our advice in what to do for the orphans. School registration is in January. We have now enrolled 282 children in school. Of these, 115 are high school students; the remainder are elementary students. With the new government, tuition is free for elementary school, so we have been providing their required uniforms, books, pencils, and supplies. The school tuition is weighted heavily at the beginning of the school year. Payments in May and September will not be so high. The committee has more requests for assistance than they have funds available.

We explored the options that David and the committee had come up with. Only paying half of the fees for the children of widows while continuing to pay all of the fees for orphans would stretch the funds somewhat, although many will not be able to contribute enough for their half. Transferring students already at boarding schools to local day schools would save money, but they would not receive as much food to eat in that scenario. Developing a waiting list to begin new students as funds become available would be a third option. We suggested negotiating a discount with the schools where several children are attending, although the majority of schools have only one or two students. Our best option seems to be to continue to pray that God will supply all our needs. So we ask you to pray with us.

We do have at least $450 in additional funds coming from the US this week. On Tuesday, Karen Adams of the Christian Foundation of Indiana will send the check to a visitor coming from World Medical Mission. Michele Secrest, our new placement director [and friend] will be leaving from Boone, NC on March 1st to visit Tenwek. She is bringing suture, fetal monitor paper, and some other needed supplies [and, just maybe, my new hearing aids]. Please pray for her trip and that everything reaches her in time for her departure.

Marty and the girls have taken a brief holiday and have gone on safari this weekend at the Masai Mara. Please pray for their safety. This also accounts for the lack of editing of this letter. I apologize for the extra commas that would, no doubt, have been deleted. It also explains the graphic medical details that were not subjected to the usual “queasy stomach” test.

Our daughter Rachel has been reading her Bible with great enthusiasm and, seemingly, with increased understanding. This is a challenge for her with her learning disabilities. My prayer is that God would use His Word to heal her mind and thinking processes and that she would be able to apply what she is reading to her life. Perhaps that is a good prayer request for all of us.

Our neighbors, Sam and Rachel Powdrill, are in Thailand. Sam is presenting lectures on eye diseases and surgery at the Christian Medical and Dental Association postgraduate course at Chiang Mai. I have mentioned before what a versatile, talented guy that Sam is. Last week he traveled to Eldoret, Kenya to tune the pipe organ at a large church. He had never tuned a pipe organ before, although he tunes reed organs. The AGC congregation was given the church and organ by the former Dutch Boer congregation whose numbers had dwindled. Who in Kenya would know how to tune the organ, which was probably installed in the 1950’s?

Sam took the visiting eye surgery resident, Ed Sung, with him. [Doctors can fix anything – right?] They drove the four and a half hours to Eldoret last Wednesday afternoon. Thursday, Sam crawled up among the 600 pipes covered with 25 years of accumulated dust and adjusted and repaired relays while Ed played the keyboard. By the end of the day, Sam was choking and his ears vibrating, but the organ sounded great for the large wedding scheduled on Saturday. A visiting eye surgeon from Poland is doing the eye work while Sam is gone to Thailand. Please pray for their safety and for his presentations. Several of our new friends from Papua, New Guinea are at the meeting.

Please continue to pray for our work here. I won’t be tuning organs, but the work is challenging enough in the areas where I am trained. My farthest move out of my field of expertise is my garden that I’m working in. But even there, there are thorns among the roses. I guess that’s not too surprising. We’re told that we shall work for our food by the sweat of our brow in our labors and that the ground will bring up thorns and thistles. The work for our heavenly father is more rewarding, but there are thorns here too.

Laboring with you in spreading the Word and love of Jesus,

Paul, for the Jarretts in Kenya

AGC Tenwek Area Education Fund [sending orphans to school] contributions: Checks payable to and send to: Christian Foundation of Indiana, 8445 Keystone Crossing Blvd, Suite 200, Indianapolis, IN 46240. Indicate for Tenwek on a separate piece of paper.

If you are sending a donation this week, you might want to call Karen Adams [I don't have her number with me here in Kenya, but the Conner Insurance Agency is in the directory] or E-mail her at keadams@conneragency.com

February 11, 2003

Dear Friends and Family:

Thanks for praying for us this past week. There have been some trials this week, as we might have expected. We are thankful for God’s grace and help in all circumstances.

The Cat Burglar

Three days after our arrival, Alicia’s hair-cutting scissors and brushes were stolen from her room. We’re not sure exactly when this occurred, but we thought it was likely during the day when we were either still asleep or out to lunch when the house helper was here alone. It seemed strange, since they were in her bag in a closet in the middle of the house. My theory was that this bedroom is the one with the best view of the backyard where our return could be observed or where no one was sleeping if it were in the early morning when Alicia went out for a walk. In either event, the closet door was open, the bag was open, and the cosmetic bag, which looked like a purse, was gone. No trace of it has been found to this point. We would appreciate prayer for its return.

A week later, we found that Laura’s passport was missing. In checking the safe, we found only the other five passports. Thus begun a general memory-racking and a search of the premises for its whereabouts. Laura brought her passport to Tenwek with her a day ahead of Marty and me. She remembered giving it to me or putting it on my desk outside her room when we got here. I could remember nothing about it from my jet-lag fog. We searched everywhere we could think to look. We searched again. I checked all the areas where others had checked. We asked people at Tenwek to pray and I wrote to ask our Sunday school class at home to pray. I found a lot of dust bunnies and other things that I had forgotten about, but no passport. Our nagging fear was that it had been stolen along with the scissors.

We asked around the compound for advice on when to contact the American Embassy. We had a copy of the passport, so I knew that we could replace it, but how many trips to Nairobi would that mean? We decided that I should contact them Monday night by E-mail’ so after our prayer time, I looked around some drawers and closets that I hadn’t been in yet. I came downstairs to write the embassy, but thought I’d check Laura’s room as I hadn’t been in there yet. I was so shocked when I opened a desk drawer and saw the passport just lying there. Laura had already checked the drawer several times. We were all praising God that night.

Several other families have had thefts recently. Beth White was surprised a few weeks ago to find a large pair of feet sticking out between the mattress and the box springs of one of the children’s beds. More angry than frightened, she confronted the young man who ran away leaving a camera behind that he had intended to steal. Robyn Moore had her spare tire stolen. It had been chained to the wall of her apartment, but one of the young men had chipped away the chain anchor. This general increase in lawlessness around the compound is a cause for concern. It is likely the work of a few young boys. Geoffrey, our prodigal protégé of the last few years, has been arrested again for stealing. He stole the air pump from our car last year.

Back in the Saddle Again

It wasn’t as much of an adjustment for me this term to the medical work at Tenwek. I think the month in Papua in November had prepared me since it was just a 7 week layoff instead of a 6 month period of time away from medicine. I was greeted warmly each time I met a staff member who had worked with me before. There are a few new faces, as some of the staff have accepted positions elsewhere. There is a general nursing shortage in the country since many nurses have been hired to work in Great Britain.

One of the first patients whom I remembered from last term had just delivered. Monica had undergone a surgery in March of last year to remove a large uterine fibroid from her uterus in order to conceive. She had wasted little time in getting pregnant; she was so happy with her newborn son, Kimmutai. I was praising God all weekend for this spectacular result of the surgery. Some other fertility patients had conceived as well, including the wife of one of our staff associates who works in Casualty [Emergency Room]. There are many others waiting to see me in Gynecology clinic on Wednesdays. The first clinic was monstrous with the backlog of patients. I scheduled six or seven major surgeries from that clinic alone.

There is follow-up on some of the choriocarcinoma [placenta cancer] patients for whom you had been praying last year. Tecla appears to have survived this nasty disease. She has had a negative pregnancy test since April of last year. Betty had a persistent mole but couldn’t tolerate the chemotherapy; she is now pregnant and apparently doing well. Both Peris and Grace expired from their disease. I knew that Peris had waited too long to return to the hospital. Grace had responded well to chemo, but we could never get her pregnancy test to turn negative while I was still here. We are thankful that both patients who died knew the Lord, and we will see them in heaven one day soon.

Spiritual Warfare at Tenwek

There seems to be quite a bit of spiritual warfare going on at this time. Employee concerns are high on the list of problems. Not only is there a shortage of nursing personnel; other types of personnel are understaffed as well. Recently, some clinical officers [physician's assistants] who work in the outpatient department went on an illegal strike. They were back on the job by noon, but there was considerable chaos from the ripple effects of their not being there. Operating theatre personnel work overtime to keep up with the demands of the surgical schedule. Twice there have been studies recommending the hiring of 18 or 19 new people to bring the staffing level in line with the workload, but no progress has been made in hiring. This is just for our current needs; a major expansion of the surgical facility is planned to begin this year which will triple the number of operating theatres. Our administration needs your prayers for wisdom and protection.

Some of these issues are obviously “growing pains”. Yet there seems to be little choice but to grow. There is just no alternative health delivery system in our area that is functioning at a high level. As the reputation of Tenwek has spread, there is an expectation of excellence; it seems to be increasingly difficult to deliver care at such high levels. The same problems still exist that we have related in the past. Shortages of supplies such as sutures and medications, inconsistency of the infrastructure [roads, transportation, water, telephones, and electricity], inadequate staffing, lack of education, and general poor conditions of the population that we serve combine to make the challenge here very great. Despite all these difficulties, the name of Jesus Christ is still preached and received by patients. So the enemy will continue to attack, but the Lord is victorious.

The behavior of youth around the compound is another concern. A young boy was recently observed sniffing glue near the volleyball court in the center of our residential compound. The thefts are obviously a concern as well. Poverty, limited educational and vocational opportunities, and hunger can certainly lead to unacceptable behavior. The local church needs your prayer in dealing with these issues.

Clouds on the Horizon

The world situation has its impact even at Tenwek. Two medical families with children cancelled their plans to serve as short-term missionaries here. People seem to be increasingly cautious and concerned about travel abroad. It is true that dangers exist in travel in third world countries as well as Europe, and those dangers will increase with the outbreak of war in the Middle East. It may be necessary to curtail travel in Kenya if war begins unless the new government is able to control an outraged Muslim population. We will appreciate your prayers for wisdom in travel and our general awareness of safety issues if the hostilities begin as seems likely.

Yet we should not worry about the outcome of such hostilities. It will turn out the way God wants according to His plan made in eternity past. If Saddam Hussein is not the most diabolical world leader since Adolph Hitler, I don’t know who is. He and the terrorists that he supports have conceived, created, and deployed weapons of mass destruction that are truly terrible. Who would have thought that smallpox, the scourge of mankind, would be reintroduced following its eradication in the past century? And to what end are these things being done? Can the killing of millions of innocent people, as Saddam obviously intends, justify his plan to destroy Israel? Psalm 33:10-11 says “The LORD foils the plans of the nations; he thwarts the purposes of the peoples. But the plans of the LORD stand firm forever, the purposes of his heart through all generations.” Saddam can not succeed unless it is in accordance with God’s plan. It seems unlikely that God will abandon Israel when He has just brought her back into the land in the last generation. It seems unlikely that God will abandon those who help Israel. God did allow the unrighteous Assyrians and Babylonians in past millennia to be the instruments to punish Israel for her unbelief and sin.

Whatever the outcome will be, we know it will be in accordance with God’s plan. God is still on the throne. And we know that His promises are real and inviolate. Moses has said of God in Exodus 15:13: “In your unfailing love you will lead the people you have redeemed. In your strength you will guide them to your holy dwelling.” I see very precious promises in that passage. God will protect His people until we are safely in our Heavenly dwelling. That doesn’t mean that we will have no difficulties in this life. Indeed, we are promised persecution. So as long as we don’t equate world peace, ever expanding stock portfolios and the status quo with God’s plan for our lives, we may be able to put the events of the world in their proper perspective and pray accordingly. And in the meantime, we can be about our business of participating in God’s harvest of souls.

Prayer Requests

1. My father continues to make a good recovery from his surgery.

2. Marty has encountered many maintenance challenges with her job as “Guest House Hostess”. It is a challenge to care for needs of her family, the local people, and visiting staff. Marty’s trust is in the faithfulness of God’s provision. A favorite quote is “There is no task ahead of us that is greater than the power behind us.” The other missionary wives carry similar loads; all would appreciate your prayers.

3. The workload at the hospital seems very heavy, although I have fewer nights on call. Pray for strength for me.

4. The flu bug is going around. Laura and Alicia are the latest victims. Pray for quick healing and an end to the circulation of the “bug”.

5. I have a possibility of covering the practice of an Indianapolis OBGYN for a few weeks during the six months we are at home. Please pray for all the details to be worked out; it sounds like there will be lots of paperwork for hospital privileges, etc.

6. Beth Jarrett came home from a wonderful trip to Peru which included a heart warming visit with her Compassion child. Pray for Beth as she spends her last few weeks at home before baseball training season begins in Florida. She reported a fainting episode the day she arrived home from Peru, so we pray that she is fully recovered.

7. Continue to lift up our family members who are missing each other during this time of separation. It seems to be the hardest part of serving at Tenwek.

8. Continue to pray for Susanna who is living at home and caring for the many responsibilities of running our house.

9. Remember our Orphans and Children of Widows project. We need God’s wisdom for starting an orphanage. Is this an area that we are to be involved in? Land is available for purchase, but building and ongoing operating costs would be a real stretch from what we have been doing to this date; yet, we don’t want to limit God. It would require a separate funding and administration mechanism from the education project.

We appreciate your prayers and support. The success of all missionary endeavor depends on the prayers of the saints.

Paul, for the Jarretts in Kenya