Jarretts Ministry

Jarrett’s Prayer Letter
Volume 7, Number 10
April 29, 2006

Dear Friends and Family:

Praise God for His provision, protection, and enablement. He is sufficient to meet our every need. We have seen His hand at work again this week in several different ways. Thanks so much for your prayers.
My practice of OBGYN in Indianapolis was very enjoyable, and occasionally, we had the opportunity to save lives in difficult situations. But most days were not so dramatic, even though there were many opportunities to serve God in witnessing and encouraging others. This past Friday, we were able to save six lives before lunch.
The morning began innocently enough as I came up the hill to see when we could do our exploratory surgery for a patient with cervical cancer; the surgery schedule had been too full on Thursday to squeeze in this case, so we hoped for a slot on Friday even though it wasn’t our normal operating day for scheduled cases. Alas, the day was absolutely packed since there was a visiting neurosurgeon as well as a team of an Ear, Nose, and Throat surgeon with his friend, an Oral Surgeon; the latter had planned a long surgery for a woman with a huge tumor on her jaw. These short-term visiting specialists often operate fairly intensively [daily with several cases] since they are here for only 1 or 2 weeks. Many cases are “stored up” for them that require their special expertise.
By 8am both major procedure rooms had operations going and the minor treatment room had a major case started with the surgeon operating with a headlamp and a goose neck lamp for illumination. That left only our operating room in the Maternity department for emergency cesarean sections. I went on to Maternity to find two patients being prepared for emergency cesarean sections. Two patients and one room – a decision needed to be made as to who went first.
One mother was bleeding heavily with a premature baby coming breech; she had delivered by cesarean section twice before and this time the placenta was palpable low in the cervix. She was nearly completely dilated and lying in a pool of blood. The other mother had also just come in with obstructed labor. She had previously required a cesarean section for a small pelvis, and now she was laboring heavily with a big baby. She was completely dilated, but the baby wasn’t coming down. Rupture of her uterus was a very real possible consequence of further delay. The decision was made to deliver the mother who was bleeding heavily first. A potential problem had to take the back seat to an existing problem. I asked the nurse to start a magnesium sulfate intravenous load for the laboring mother in hopes of at least slowing her labor until we could do her cesarean section.
Tony Njoka, the family practice resident who had been on duty the previous night, and I began the first operation. We did it under spinal anesthesia, even though a general anesthetic might be a bit safer for a mother who was bleeding. But she was stable enough to tolerate the blood pressure drop that often comes with the spinal block. As we made the opening incision, the head nurse came in to inform me that the other mother was complaining of severe continuous pain, a sure sign of a rupturing uterus. I asked her to find Dr. Muruka to assess her. We carefully but quickly picked our way through the old scar tissue and found a safe place to enter the uterus. The small baby was delivered by grabbing the feet and guiding it out without pulling so hard as to break something. Even so, it was a difficult maneuver. We then repaired the uterus and closed as quickly as possible. I asked the nurses and technicians to clean the room as quickly as possible, and three of them set about doing that as we moved the patient off of the table and down to the recovery room.
We passed Muruka in the hallway bringing in the other mother who was in severe pain. The baby was still alive; in general, as soon as the tear in the uterus is big enough to expel the baby into the abdomen, the placenta will follow, thus cutting off the baby’s lifeline. We began prepping the mother’s abdomen as soon as she was transferred onto the operating table. The nurses began attaching the monitoring equipment for a general anesthetic. Muruka and I scrubbed our hands and gowned. The anesthetist [one of several of our people who were trained “on the job” years ago by Dr. Steury] came in after taking the first patient to ICU and put the patient to sleep.
We began our incision as soon as he gave the word that the patient was asleep. After opening the abdomen, I could actually see the baby through what remained of the uterine wall – a paper thin membrane, technically called the visceral peritoneum. This layer, only a single cell layer in thickness, was being held intact by the hand of God. As I touched it with my finger, it popped open, and I delivered the baby’s head. The large baby boy cried immediately, oblivious to his near brush with death. The placenta delivered immediately afterwards without any effort on my part to remove it. The uterus had ruptured low through the old incision, and a laceration extended downward through the cervix. But with a few clamps and a quick repair, the patient’s blood loss was fairly minimal. Her uterus can even safely contain another pregnancy in the future, but we will instruct her not to ever try to labor again. We had saved four lives already, and it wasn’t even tea time [mid-morning].
There was a scheduled repeat cesarean section, so Muruka did that with the senior medical student from Altoona, PA, Eric Kephardt. The rest of us began morning rounds. Soon, however, one of the anesthesia staff said that he heard that we were getting a transfer from Longisa district hospital – a patient at full term in her pregnancy who was in a coma after having seizures at home for 12 hours before arriving there. So we hung out around the delivery room to await her arrival.
Our referrals from Longisa have improved in quality as well as quantity. Longisa is a small town on the main road from Bomet to Narok on the way to Nairobi. Bomet is the district capital, but because of the proximity of Tenwek to Bomet, the government placed the district hospital in Longisa. The story goes that when it was constructed, a member of the national parliament lived nearby. It is alleged that he had the water line, which was put in for the hospital, diverted to his home. The portion of the line that went to the hospital eventually failed, so the entire hospital has no running water. Whether the story is true or not, it is a typical illustration of the curse of Africa; men see government appointments as an opportunity to better their personal living status. Allegations of corruption of government are daily fodder for local newspapers.
In this case the doctors from Longisa recognized the severity of the patient’s illness, realized her need for intensive care that they were ill-equipped to offer, and referred the patient to Tenwek. They sedated the patient to stop her seizures and sent her with a competent nurse, an intravenous line running, an airway guard, and a referral note detailing their treatment. It was an appropriate and well-timed referral.
We immediately checked for fetal heart tones and were very surprised to hear a heartbeat of about 100. Although this is somewhat slow for a baby in the womb [normal is 120-160], it indicated a chance to save the baby still existed. We found the cervix only partially dilated, so a normal delivery was too far in the future to rescue the baby. The mother’s chances of survival rested primarily on what had happened already to her lungs during the prolonged seizures and coma state. Aspiration of stomach contents into the lungs is a strong likelihood in this situation. We prepared her for an immediate cesarean section and began antibiotics.
Dr. Njoka and Eric did this delivery which was technically easy. The baby cried right away and is doing well. The mother remained on a ventilator overnight in the ICU with high ranging blood pressures, but by morning she was emerging from her coma and we took her off of the ventilator. Her lungs are sounding pretty good, so we are optimistic. Long term results are usually good after the initial recovery, although we have a mother with a similar story who delivered two weeks ago; she is wandering around the hospital in a confused, psychotic state. She was with us in ICU this morning while we were evaluating Winny, the current patient. She didn’t offer an opinion, however.
Our good fortune stopped with these three mothers, at least so far as patients with immediate life-threatening conditions. Some 12 hours later, the same hospital sent in a mother bleeding heavily while still pregnant. They sent no note and no intravenous line; I doubt that a doctor had been on duty at night. This mother was gasping on arrival; that’s how the Kenyans refer to a patient who is taking the last few breaths before death. She could not be resuscitated. The baby was already gone as well, although Dr. Muruka delivered it vaginally, so it must have been nearly ready to deliver when she was sent.
I was able to do the surgery this Saturday morning for my 60-year-old cervical cancer patient although I wasn’t successful in cutting out the cancer. I found that it had spread to the colon and pelvic lymph nodes just out of my reach on the pre-op exam. Other tests hadn’t shown up this extensive disease – I just knew it was going to be hard to get the cancer away from the urinary bladder. Thus, finding it impossible to do a good palliative operation and certainly not a curative one, we closed the abdomen.
The first part of the week was busy in a different way. Saturday, we went to Umoja children’s home with some visitors including Dr. Bill Sasser of Charleston, SC. He is a dentist that has done quite a bit of rural mission work. He has his “office” in a trunk that he takes with him. Any old table, a regular chair, and an assistant to hold the patient is his workspace. He was willing to check the children’s teeth and do some fluoride treatments and cleaning as well as any extractions that were needed.
We lined up the twenty orphans and checked them out. They had remarkably good dental hygiene, so they must be using the toothbrushes that we brought. A few had baby teeth that had never come out that Dr. Bill extracted with a little Novacaine. One had a broken front tooth that needed to come out, and the autistic mute boy needed a couple of teeth extracted. I got the privilege of holding him still with some additional assistants for arms and legs, while the dentist worked to pull the teeth.
After the orphans were done, the staff and Joseph’s children were checked. A workman who was installing the permanent kitchen building had a rotten wisdom tooth that he was happy to have extracted. Dr. Bill just loves to pull teeth. Those whose teeth were still salvageable with fillings were requested to come to Tenwek for follow-up. Bill has been going out with Community Health and the Eye Unit van to different areas and setting up shop. If people are aware that he is coming, he is busy all day. There are many dental needs in the community; however people don’t have the money to come in for care.
On Sunday I drove to preach at a local church near the town of Merigi. It had rained every day and many nights for the previous 3 weeks. Our host, Johnston, had been praying for our trip because of the condition of the road leading to this church, hence his inquiry about our 4-wheel drive. He has been an employee of Tenwek for 22 years. Medical student Eric and wife, Lindsay, Kephardt went with us, and we picked up 4 other Kenyans for our trip. One was a 62-year-old pastor; he was to speak as well. Two girls were singers that had been performing at a crusade in Bomet recently. The other girl was one of our hospital staff from the area around this Tuimiyot Christian Church. We prayed at least three times during our trip.
The drive to Merigi was fine – a high road along the 7200-ft crest of a ridge of hills that begins at Motigo, the mountain just to the east of Tenwek; the sun was shining brightly out of a clear sky. There is also a low road to Merigi that goes down along the valley behind this ridge of hills. Kenduiwa Children’s home is on this low road, but I hadn’t been beyond the home. Johnston informed me that the road to his church was just back down the other end of this road as it left Merigi, so I was driving back towards Kenduiwa.
As we went along, I began to understand Johnston’s concern. The road was nearly washed out in many areas with deep ruts in many places. There was a nice bridge at the bottom of the hill, but it had only recently reappeared above the rushing water caused by the heavy rains. The 4-wheel drive was necessary as we went through a mud bog and up a slippery, muddy, winding, narrow road up the other side of the valley. I think that the hill we climbed is visible from Kenduiwa, but we never went over the top of it to see if I was right. We stopped at Johnston’s home to visit briefly before proceeding another kilometer to the church. We drove off of the road and went down a steep goat path for about 100 yards before getting out to walk to the church. I knew that we would have to leave or at least move the vehicle up to the road before it rained, or we wouldn’t get back up that hill. We crossed a large pasture where a friendly-looking bull grazed. Finally we arrived at a small wooden church building with corrugated iron sheeting for a roof. Only a few people were present, but many people had seen us as we came.
We sang a few songs as various people began to trickle in. They began the traditional greetings and introductions and a few more songs. Although this is a different denomination from the other churches that I have visited, the order of service was the same. When it was quiet for a moment, we could hear another church congregation singing and beating drums across the valley on the side of the hill. There were a few announcements, and I noted when turning around from my front row seat on the men’s side that the church was filling up. It seems that we were only the second white visitors to come since the church’s founding in 1997. Most of the children had not seen white people before since they live so far from the main road. They timidly shook hands or touched my arm. Eventually, over 60 people crowded into the little church on the hillside.
Eventually, I was asked to give the sermon. It seemed that I preached my sermon on caring for widows and orphans with more power than at other times. It also seemed like the congregation was responding to the message; this was evident in the ensuing time when many members came up and gave testimony that they had been moved by the ideas presented. Then the other guest pastor got up and gave a message. Then we were each presented a gift – a decorated gourd for me and a woven basket for him. What was different in these presentations was the song and dance that accompanied the presentation of his gift. The elderly women that gave the basket danced and repeatedly bowed while singing, and then he did likewise in receiving it. Fortunately, I had already received my gift, so I didn’t have to repeat the performance.
As the service passed 3 and 1\2 hours, we kept our eyes on the skies. Some clouds were forming in the west, but our hosts said that those clouds weren’t for us. We went outside the church and planted a tree apiece next to the church. We started towards the car across the pasture, but were quickly beckoned to the lower edge of the pasture where one of the church members lived. We were expected for dinner which didn’t surprise me.
We enjoyed the sunshine outside for 15 minutes until we were asked to come inside the darkened room with mud walls and floors. Some furniture was brought in for everyone to sit down. We then had a traditional meal of rice or ugali; today a choice of starch was available. Some goat meat and broth as well as spinach greens were offered. These country folks ate the ugali with their left hand, rolling the Play-Doh consistency food into a ball and dipping into the greens or broth. Gradually, the skies began to darken to the east, so we begged our leave and headed up the hill.
Thirteen people in the car were too many for the steep hill on slippery grass. I had everyone except an old woman and a child get out; then I had no trouble climbing up the hill to the main road. A few raindrops hit the windshield as we headed up the road towards Merigi where some of the people wanted to go. Finally, the original 9 people coasted into Tenwek ahead of the storm. God had postponed the daily rainstorm until evening in response to the prayers of several people.
For Monday, Pastor Kilel had asked if I could get that afternoon off to go to visit a woman who had recently received Christ. I had mentioned her in an earlier letter. She had come to believe in the God who helped orphans through his people. She lives in a remote area south of Tenwek towards the Masai Mara. There were a few errands to run along the way – dropping off Alice and some of the orphans who we picked up on leaving Tenwek, stopping at the bank to see that the check that we brought last month had “matured”, and visiting some orphans along the road as we encountered them. David Kilel knows many of them and where they live.
On the road south towards Kabosan, we stopped to visit a family that I have seen twice before, including the very elderly grandmother who was taught by some the first missionaries who came to this part of Kenya in the 1920’s. Those who would criticize the evangelization of unreached tribal groups in the world which has the effect of changing their culture should read some of the early history of this area. In Then and Now in Kenya Colony, the memoir of Willis Hotchkiss who came as one of the first missionaries in 1895 reveals the terrible living conditions of the early Kipsigis people. He wrote “The Kipsigis hut is the last word in utter discomfort and filth. It is a caricature of a home. Its only opening is a hole less than three feet high and the same in width. A ceiling four feet high, above which their grain is kept, compels the inmates to shuffle about on their haunches. Imagine a space twenty feet in diameter, in which from a dozen to forty goats have spent the night along with its human occupants, and you get some idea of the indescribably horrible state of things. Now close that one opening which serves as door, build a fire in the confined space, add to it the heat from the beasts, add also the pungent odor of goats, and you have a situation that beggars description. Small wonder that the mortality among infants is around eighty percent.” His description of their moral degeneracy, sanitary habits, and depravity needs little imagination. The introduction of the gospel has had a tremendously uplifting effect on conditions in this part of the world. Even last Sunday, one of the Kenyan nursing officers who led the worship service gave testimony to his thankfulness for the early missionaries. Although the Kipsigis have made great progress in their cultural development over the last 80 years, the description of the house sounds very much like a Masai hut even today, although they build them slightly higher, and don’t store grain above their heads.
But I digress. We headed south from this home to an area where I hadn’t been before. The town of Sigor was several kilometers further over a gradually deteriorating road. I know this town mainly from the bad condition of some of the patients who have come from here, like the woman in a coma who came yesterday. She must come from near here. The road heading east out of Sigor had no consistent stone base. It was mainly a lot of ruts in black cotton soil with some rock base in sections. When this kind of road is wet, it becomes nearly impassible. I told David that we would need to get back over this section quickly if it began to rain as it usually does this time of afternoon. Some rain clouds were on the horizon.
We noticed a pregnant lady and a man who was walking with her away from Sigor. David thought that we should pick them up. We drove along several kilometers as David and the man talked in Kipsigis. We dropped them off at a junction where they were heading a different way. The lady smiled brightly at me. I asked David what they had been talking about. He said that the man was considering becoming a Christian, and that a man was coming to their house that night to talk to him. David had been encouraging him. It seemed perhaps another divine appointment.
As we approached the farm where the lady lived, I asked David how he knew where this place was. He said that he used to do follow-up visits of patients that had been counseled at Tenwek. He had ridden all over these roads on a motorcycle. Once he had chased a hippo down this road on his bike, but couldn’t catch it. I asked him why he wanted to catch it – he said for the meat!
The widow lady was waiting on the road, and she had invited 50 others to hear what we had to say. Since I had no speech prepared, I couldn’t wait to hear what I was going to say to these folks. We were fed some rice and meat first, since it wouldn’t be polite in the Kenyan tradition to have a guest without feeding him. I declined the water, since I had no idea whether it had been filtered. About 30 flies buzzed around the table at all times. They also served a soft drink in a bottle which I kept covered with my hat. I also declined tea since we were a long way from the end of our journey.
Most of the people were widows and orphans. One was a man who was raising 15 children after his wife died. The others were from a sister-in-law. David Kilel patiently wrote down the names and ages of all the children present. We had all gathered in the yard, and the people sat down all around in front of us. David and I both gave speeches. I gave my testimony and presented the gospel. David translated it into Kipsigis. After our talks, most of the people came up to David individually and told him about their circumstances. He says that this happens wherever he goes and preaches. There are 8 or 10 people outside his office every day. There really is no end to the needs here.
One of the girls, a sophomore in high school, was the child of a widow. Her name was Sharon and she spoke English well enough to talk with me as the others talked to David. She attended a local day school, but wanted to be assisted to attend a boarding school. She couldn’t study at night due to lack of light, and had recently been chased by elephants while walking the 4 kilometers to school. She said that it was a terrifying experience. I don’t even like barking dogs.
As the clouds darkened, we could see heavy rain to the west and to the east. We seemed to be on a dry island in the middle. Lightening streaked across the eastern sky. It was also getting dark as it was about 6:00 by now. Only 30 – 45 more minutes of light remained. We declined more tea and walked back to the car about a quarter of a mile away, climbing fences and dodging cow pies as we walked along with the crowd. Several orphans including Sharon got into the car with us. We drove back up the bad road as a few rain drops hit the windshield.
We dropped off people at their destinations. Finally only Sharon remained and we were driving away from her home where we had been. She was continuing to plead her case with David. She was a good student and very needy. We were both led to acquiesce to her request to assist her from the Education Fund. She was overjoyed.
Although it was getting very dark, we drove east towards the rain and Longisa to stop at a boarding school to pay fees for Hassan, one of the students we support. I had visited him last year. We met with the headmaster who is a strong Christian; his wife works at Tenwek. We left quickly as it was starting a bit of rain and we had some more bad road to go over before reaching the paved road. The rain held off until we got onto the tarmac; once again God held off the rain until we were safe.
The next day David and I left about 5pm to visit another family of 8 orphans who were living in the dead parents’ home. Again, we encouraged the children ranging in age from 23 to 8 to trust God for everything, and to walk in His ways. Some were attending church. The oldest had recently stopped drinking and smoking, so God was at work in his heart. They had nothing to eat that night and no blankets, although they do have some crops that were coming along. I gave them about $10 which will help only a little. And we told them that we could help with some clothing. Again, we were protected from heavy rain as we slogged through a wet field to visit the house.
On Thursday evening, all four orphanage directors met together for the first time to discuss mutual problems and ideas. We hope to continue these meetings in the future. The greatest problem facing each children’s home, other than the food shortage at the present time, is the chronic problem of how to pay the workers. Each home has a matron, a cook, and a guard. This is a combined salary need of 5,000 KSh [about $70] per home per month. It is hoped that each home will have an income generating project that may help to defer this need in the future. Please pray that we can find a way to meet this need at the present time. Reliable workers are a must at the homes.
We have received a donation for the posho mill for Kenduiwa. The chickens are maturing at Kitoben and Umoja, but haven’t begun to lay eggs yet. Bosto’s new goats are not here yet, but are on the way. It looks like this may be a help for the other homes if we can get more goats. God is answering your prayers for these things. The World Orphans organization approved the request for a second dormitory for Bosto. I’m not sure when these funds will actually arrive. Kenduiwa’s application is pending. We were able to pay off their additional land with a donation. All in all, things are going well; there are many challenges each week, but God is faithful.
This is a holiday weekend as Kenya celebrates its independence from Britain on Monday. Dr. Myers has been gone with my vehicle since Thursday. I hope that he gets back safely with it on Monday, because we plan on driving to Nairobi on Wednesday to pick up Amy and Elissa. We intend to return to Tenwek on Friday. They leave the USA on Tuesday, May 2, flying out of Indianapolis. Please pray for their safety as they travel. I’m on call this weekend and have had two more emergency cesareans while typing this letter this afternoon and evening.
Marty and I will help to lead the worship service next Sunday. The theme of the service is prayer. I have sections on “Who is God” and “What is Prayer”, while Marty does a segment on “Approaching God in Prayer”. Please pray that we’ll be able to glorify Him in all that we do and say.
Our container of equipment has still not arrived at Tenwek. Several new visitors come this week. It seems like we’re entertaining visitors every week, but that’s a blessing, not a burden.
Thanks so much for your prayers and support.
Serving Jesus with you,

Paul, for the Jarretts in Kenya

Jarrett’s Prayer Letter
Volume 7, Number 9
April 15, 2006

1 Cor 15:3-4

For what I received I passed on to you as of first importance: that Christ died for our sins according to the Scriptures, that he was buried, that he was raised on the third day according to the Scriptures NIV

Dear Friends and Family:

Happy Easter! He is Risen, just as He said. We are celebrating our 8th consecutive Easter weekend in Kenya. Tomorrow, Lord willing, we will have a sunrise service. Most of the Easters here have had beautiful sunrises, but not all of the previous 7 as I recall. Both Good Friday and Easter Monday are holidays in Kenya and many churches have big celebrations.
Today we held an Easter egg hunt in our back yard for children of all the missionary families and of some of the Kenyan staff who are our next door neighbors. It was a bright sunny morning despite a soaking rain yesterday and last night. After Marty told the Easter story with puppets and props, we piled things in the car and headed for Kenduiwa Children’s Home for a repeat of the message. Most of the visitors and many of the missionary adults headed for the prison in Bomet to share the good news of Jesus.
Marty, Rachel, and I took flannel graph materials, papers, crayons, a cake, and some candy gifts with us to the children’s home. Twelve-year-olds Rebecca Spriegal and Nick Manchester went with us as they had not been to Kenduiwa before. The road to Kenduiwa was questionable after all the rain this week, but I had confidence in the newly repaired 4-wheel drive. We knew it would be difficult to complete our visit before the afternoon rain began, as we could see the clouds forming over the forest.
We had a good time sharing the Easter message with the children. Most seemed to know the Easter story very well, but for some of the newer children, perhaps this is the first year they have heard it. There were 20 orphans there today along with 3 of Director David Koech’s children. And there was a 15-year-old girl, Winnie, whose mother is single. Winnie’s feet are deformed, and David has observed her walking 4 kilometers to her secondary day school each day. He has invited her to stay at the children’s home in the evening during the school week.
The orphanage is doing fairly well. David has bought enough bags of corn to last until the harvest which may not be until September since the planting was delayed. The water tank was installed and filled to overflowing with clear rain water. They have purchased another point [1\10th of an acre] next door for additional garden space, although they still owe the neighbor $50. David’s idea for a “seed project” is to purchase a posho mill; that is what they call a diesel-powered grain mill that everyone needs to visit regularly to grind their corn into meal. The alternative is to spend half a day pounding a bag of corn with a large club the size of a fence post. I watched our neighbors doing that all morning yesterday. David thinks that they would have enough income from the mill to purchase food including all their sugar, a basic ingredient in a Kenyan’s diet. A posho mill costs about $2,000. This income generating idea might not work as well for the other homes if there is an existing mill nearby.
We were eager to leave before the rain began, but we were there at lunch time, so it was necessary to have a bowl of rice and a cup of tea or risk offending the very gracious Kenyan people. It is such an ingrained custom that it is nearly impossible to decline the hospitality of food. David says that in the older Kipsigis society, the mother of the house wouldn’t even come shake your hand in greeting until you had been fed. We made it to the car and down the hill before the heavy rain started. Our car has a roof, but the front windshield leaks so much that the driver and front seat passenger get pretty wet if it starts raining. We made it up and down the muddy hills back to Tenwek without using the 4-wheel drive except on the hill up to the children’s home.
The rainy season is in full swing. It is raining hard nearly every afternoon, and sometimes through the night and evening. We’re accustomed to the sunshine in the morning when it’s warm, but then the rain clouds roll in, sometimes into a cloudless sky, the temperature drops, and the fireworks begin. Lots of thunder and lightening and sometimes hail are nearly a daily occurrence. It would be hard to remember that there was a drought a few months ago except for the people who are constantly requesting assistance for food. The cows have gone dry. Food prices have risen for those who have to buy food. It is being said that the effects of this drought will be felt for many years to come, although I believe that the Tenwek area will likely recover much sooner. Many herdsmen have lost their entire herds in the northern part of Kenya.
The orphanages are all surviving, albeit with a lot more help from the visitors and missionaries of Tenwek. Local resources have been exhausted so that churches and individuals that have been helping in recent months have been unable to do so recently. There are several prayer requests for these homes.
Both Kitoben and Umoja have chicken projects that are underway, but they have hit a snag. The Peace Corps is the NGO that sponsored this “seed” project. The children’s homes were to put up 1\4th of the money, which basically meant constructing a fairly elaborate coop [by Kenya standards]. The Peace Corps was to buy the 300 chicks apiece and provide feed for the first 5 to 6 months until the chickens were laying eggs. Then the chickens would hopefully be producing enough eggs to feed the children and provide income for buying the chicken feed and some additional food for the children.
The US volunteer who was here for the past two years recently left. Her replacement is allegedly interested in schools, not chickens. The funds that were on deposit at the feed store are now exhausted after only 3 and 1\2 months. Each home is left with 270 very hungry chickens. At each home, the chickens consume 300 lbs. of growth feed a week which costs $32, and that ain’t chicken feed. The price of layer’s feed goes up a fraction more when they actually begin laying eggs. A conservative estimate is that the chickens should produce a profit of $200 per month for each home.
Through the help of our supporters and those of the other missionary families, we have been providing a monthly food allowance for Kitoben of $400, which is about 2\3 of their need; therefore, the chicken feed crisis is a real budget breaker. We felt it was unwise to allow the chickens to starve, and they aren’t big enough to eat, so we have banded together to buy feed to keep the projects going. In the meantime, I have been attempting to get the address of the Peace Corps volunteer in the States to see what light she can shed on the whole thing. It isn’t right for them to have abandoned the project in midstream, and perhaps there is another explanation such as malfeasance on the part of those in Kenya who might have been left in charge of the funds. I’ve met with the local facilitator who seems honest and helpful. Or perhaps a miscalculation occurred, but the project’s prospectus is fairly clear on the anticipated expenses.
Please pray for the chicken situation: that the hens will stay healthy and begin laying eggs soon. No bird flu has been reported in Kenya at this time. Pray that the Peace Corps will fulfill its pledge to see the project through to its completion, even if it means reimbursing the children’s homes for the expenses incurred – those funds would have gone to the children in one form or another if not used for the chickens.
Umoja’s monthly expenses are about half of Kitoben’s since there are about half as many children there. Regular help for Umoja hasn’t been budgeted by us, since there has been more local assistance in past months from local churches. But this has dried up and the director has pleaded for help on a more regular basis. Likewise, Kenduiwa and Bosto have needed emergency relief. We have been reluctant to be seen in the community as the deep-pocketed supporter for all the homes so as not to inhibit the continuation of and development of local church and community support, but the current situation has required us to help all four homes.
Chuck and Amy Bemm took some of the Community Health staff to Bosto yesterday and did fluoride dental treatments and HIV testing. Praise God that all 20 girls were negative for HIV. The new kitchen was functioning well, and the goats were doing great. More goats are now being purchased since I gave them money from our supporters for these additions. A dairy goat costs about $110 currently, which I believe includes some of the transport costs from South Africa. I want to learn a bit more about the goats before seeing about getting some for the other three homes. I want to be sure that adequate security, pasture, buildings, and fences are in place before dropping off any goats.
Continue to pray that local churches will come alongside Alice to help support and administer Kitoben. Pray that the toilet project can be completed. Other than providing lip service, the contractor has abandoned us completely just at the final point of completion. We are looking for someone to complete the work. Pray for the development of an overall site plan for Kitoben and Kenduiwa. Pray that the Worldwide Orphans charity will fulfill its pledge for funds for additional dormitories at Bosto and Kenduiwa.
We would also ask your prayers regarding the possibility of hiring an assistant for David Kilel. We need to have clear ideas on a job description for this person. There is a need for someone to visit the orphans in the various schools as well as visit the homes of orphans when they are reported to us; it would be nice to follow up on those who have already been seen. David’s schedule is very busy, so an assistant could greatly expand our ministry. This would require funds for a salary, and perhaps a motorbike. There are several graduates of Bible school that need a ministry that would have some salary attached. A volunteer is also a possibility, but his or her productivity would be greatly limited by having a day job. This type of position would require a lot of travel in daylight.
In past letters, we have asked for prayer for the two containers of equipment necessary for opening the new operating theatre building; they also contain many of our ministry supplies – soccer balls and Bibles. Recently, the Ministry of Finance waived the huge tax bill that had been imposed on the hospital. That was an answer to your prayers.
The hospital administrator has made countless trips to Nairobi to facilitate the release of the containers. This week he took the letter from the Ministry of Finance to the customs people. The letter stated in effect that there was no longer a claim on the containers in Mombassa and that they could be released. Now a problem arose that the containers are no longer in Mombassa since they had been brought up to Nairobi some time ago. The customs people therefore refused to release the containers referred to in the paperwork. This means more trips to Nairobi for our administrator to get the paper work corrected; it’s not just a matter of picking up the phone and calling someone.
The delays have also meant that the people who were to come from the US in March to install the technical equipment no longer have time in their schedules; another delay of six months is therefore possible. It makes one wonder whether there is spiritual warfare involved in these delays and refusals. Please pray that the containers will be released and that the technicians will be able to come soon to install the equipment.
This week marks the return of the family practice registrars [residents] from their formal teaching in Eldoret. It is the first time that I have met two of the three men. One of them, Tony Njoka, is assigned to the OB service for the next several months. This means additional night call responsibilities for me for “backup” of this individual until we are certain of his surgical and obstetrical skills. Most obstetricians give up deliveries sometime after age 60 and leave them to the younger folk. Please pray for stamina for me; I do notice a touch more fatigue at the end of a long operation.
I am noticing more and more AIDS patients at the hospital and on our service particularly. I mentioned in the last letter that two of our staff were stuck by needles used on AIDS patients. Right after I wrote that, two visiting doctors were exposed to the virus – one through a slight scratch with a solid needle and another with blood splashed in his eye. They also have started the preventative drugs. Our chief surgeon, Dr. Mike Chupp, was not mentioned by name in the last letter; now you can pray for him specifically by name that he won’t contract HIV from his more serious needle stick. He is feeling better while on the medication, but each of the doctors notices the side effects of nausea and fatigue.
There may be a higher purpose in some of these exposures. The procedure for an accidental needle injury is for the patient to be tested as soon as possible for the HIV virus. The exposed person is to start the drug immediately while the test is being completed; he is also to be tested to be certain that he isn’t already HIV+. If the results of the patient’s tests are negative, the drug is no longer necessary. If the patient is positive, he or she is asked if he wishes to know results, but the staff continues the preventative treatment for a month.
One of the injuries occurred in a woman that I operated on for her fourth cesarean section. She appeared completely healthy as did the baby, but she had refused the prenatal screening for HIV at an earlier time. After the technically difficult portion of the procedure was over, I allowed the assistant to close the abdominal wall. During the process of closing the skin, he scratched himself with the tiny needle. Now that is a very low risk exposure, since a solid needle contains only a surface coating of some blood cells, and it has already penetrated a latex glove before breaking the skin. But the protocol has to be followed.
In this case, the woman was discovered to have the HIV virus. She decided to be informed of the test results. Now she is aware that she and probably her husband have a disease that will ultimately kill them unless the Lord returns soon. But they can now be followed in the heavily subsidized clinic and start ARVs [anti-retroviral drugs] that will greatly prolong their lives and maintain their health – perhaps long enough to raise their children to maturity. And the baby will be fed formula instead of breast milk, which will greatly lessen his chances of getting the virus from his mother. The visiting doctor took great consolation in these facts; he is able to look at the benefit to six people as a result of his “sacrifice”.
Mary, an elderly patient was admitted to our service last week. She was discovered to have what appears to be endometrial cancer [of the lining of the uterus]. But she also is very sick with massive fluid accumulation inside her abdomen [ascites], probably from the cancer. During the course of her work-up she met with a chaplain and accepted Jesus as her Savior from her sins.
I wanted to operate on her, but the anesthetist was concerned that she would die during surgery due to her frail condition. After lengthy consultations with the family members, for now, the surgery is postponed and perhaps cancelled. Please pray for wisdom for all in the management of Mary’s case.
Rachel’s hives seem to have finally run their course. We’ll probably never know for certain what was going on; sometimes a viral infection will cause hives, and maybe the little scabies parasite was the cause. We wondered about food allergies. Rachel is thankful that she isn’t allergic to mangoes, which was our last theory before the hives just disappeared. Thanks for your prayers for Rachel.
You probably get tired of hearing about the adventures we have using our 1991 Mitsubishi Pajero. It actually might be nice to go somewhere without breaking down, but then we wouldn’t be reminded of God’s constant care on our behalf. Marty and Carol Trachsel took the car down to the Mara Safari Club last weekend to take some visitors for their safari experience. Marty and Carol are given travel agent rates, so they take advantage of the opportunities. Marty enjoys ministering to the staff of the Mara Safari Club. Our car is used to take the visitors to the Mara since its high wheel base and 4-wheel drive make it ideal for this trip over some pretty rough terrain along a fairly deserted stretch of road. I’ll let Marty continue the narrative of their return trip.
God is so good in the midst of trials. Even though our car broke down 20 minutes after leaving the club (yes, even after nearly $1000 worth of repairs 2 weeks ago in Nairobi and a repair of the suspension bar at Tenwek after the ride home from Nairobi), I had recovered from some sickness so the delay of an hour and a half in our trip did not bother me—thank goodness. Also, the Lord arranged all kinds of help for us. We had one of the safari club staff with us who needed a ride to Bomet. He used his cell phone to call the safari club mechanic – no one was answering the phone at the front desk. Two of them came in about 30 minutes to see what they could do. Ours was a rather sad looking car—the whole left front frame was sitting on the wheel as the bolt that holds the torsion bar in place had fallen through a rusted out portion of the car. Oh dear!!  Those sweet men took a heavy duty bolt off their safari car and temporarily repaired our car so it could be driven to Tenwek. Now we need to get the big hole welded. God is so faithful. It is so amazing that out in the middle of nowhere with a major breakdown, we were only delayed that short time. There’s nothing like a great adventure to remember and appreciate God’s sovereignty and faithfulness.
Back to Paul’s letter. Our Tenwek mechanics repaired the torsion bar; welding broken parts seems to be their specialty, since replacement parts are not available locally. So, the car rolled along just fine today over the rough roads, although Marty didn’t like the sound of the 4-wheel drive –said it sounded like the bottom was falling out of the car. My being partly deaf may have its advantages. I’m trying to be a little more careful not to hit the bumps at too high a speed. Maybe I should try visualizing carrying a load of eggs.
While Marty was gone last week, I worked on a sermon on Psalm 73 for the Tenwek Chapel service which I gave on Palm Sunday. The Sunday after Easter, I’ll preach again at a local church using my caring for the widows and orphans message. A patient attendant from the Orthopedic Ward, Johnston, has asked me to preach. He asked ominously, “Your car does have 4-wheel drive doesn’t it?” I can’t wait to see where we’re going on the other side of Merigi. I know the road to Merigi is good, but – beyond? I have several more requests to preach in May and June. It will be difficult finding a time when I’m not on call or traveling to Nairobi to pick up our daughters who are coming in three shifts during the month of May. It starts with Amy and Elissa coming on May 2nd. I believe that we’re as excited as they seem to be about their visits.
Thank you so much for your prayers and support. We hope that you have a blessed Easter and are even more aware of all the Lord has done for you. You also have angels surrounding you even though you may not give them as much exercise as we seem to give ours.
Please write to us; we enjoy hearing from you.

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

Personal Support can be sent to World Medical Mission, PO Box 3000, Boone, NC 28607. Be sure to include our account #2355 on the check.
AGC Tenwek Area Education Fund [sending orphans to school or orphanage support] contributions: Checks payable to and send to: Christian Foundation of Indiana, 8445 Keystone Crossing Blvd, Suite 200, Indianapolis, IN 46240. Indicate for Tenwek Education Fund or specific orphanage support on a separate piece of paper. They periodically send us a check through a courier coming to Tenwek, and the money is deposited in an account in Bomet where our pastoral committee can withdraw and distribute the funds using three signatories.