In this annual report, you'll get a snapshot of what we're doing, including updates on our projects.  If you can't see the photos, look for a link at the top of the email which says 'view images' or 'download pictures'.  

2015 Annual Report


Friends, the last year has flown by, and our hearts are full with what the Lord has done in Kijabe.  It's been a fruitful year, filled with joy and delight as we've watched the people we serve grow in Christ and deepen in passion to care for the least of these.  It's been a difficult year, filled with hard work and unexpected grief as we process the rise in terrorism, mourn one of my Moffat students killed in a road accident, and farewell dear friends who are leaving Kenya to return home.  Amidst it all has been the constant presence of Jesus, calling us to deeper trust and active engagement with Him.

Riley (8) and Liam (6) continue to thrive here, enjoying school at the Rift Valley Academy, their chickens and learning to ride a bicycle.  We're still working on swimming; pools are not in abundant supply here!  Riley continues to grow in response to the growth hormone and we consider ourselves incredibly fortunate to be able to purchase it here.  They are a great delight to us.

The following is our Annual Report.  But first... I want to introduce you to Eva.  

I (Andy) met Eva last year, during a mentoring visit to a local pastor.  Eva was his children's pastor, and over the past year had grown lethargic and forgetful, fainting often, and been kicked out of her home due to these physical symptoms.  For a young single woman in a poor rural community--a recipe for disaster.  We prayed together that Jesus would heal her, and reveal the root of any spiritual or emotional causes.  I invited her to come to Kijabe Hospital for an assessment:  they discovered she was suffering from severe hyperthyroidism, and needed surgery to correct it.  

After a fundraising event with her local community and assistance from a Hospital partner, she had saved the small amount (about $300USD) for her surgery, which was carried out late last year.  When I caught up with her earlier this week, the lethargic and downcast woman I had met last year was gone.  I did not recognize the radiant, laughing woman in front of me:  the surgery had been successful, her physical symptoms were gone, she was alert and sharp-minded and had gotten a job in Nairobi as a house-helper so she could save for school fees to finish high school and get a degree.  She had even reconciled with her family!  She said, "When you and Pastor prayed for me last year,  I experienced the presence of God for the first time in many years.  I discovered God as a generous and loving Father, and ever since then I have felt him to be active and present in my life.  I am not angry anymore, I have joy and peace and I am so thankful."

I want you to meet Eva, because for me her story is a snapshot of all of the things we are passionate about here:  compassionate medical care for the 'least of these', mentoring, spiritual and emotional growth.  Someone who was once hopeless is now filled with hope and possibility:  who knows where this young lady will be in twenty years time, and how her life and the lives of those she serves will now be different?  Yes!

As a partner in this work, the following is 'your' report.  These are your projects, and this is your work, and we hope you read this with a profound sense of joy and satisfaction.  As you read, consider this:  none of this work, and very few of these projects would exist if it weren't for your partnership and generosity.  Reflect on that for a minute and think of the people whose lives you are changing.  Thank you!

Financial Update

We are incredibly grateful to have had 100% of our budget funded by generous partners like you for the last two years.  

We're fans of early and transparent communication, and we want you to know when market forces out of our control affect us.  It's been a wild ride the last two years for the US and Australian dollars (the two currencies of our financial partners) which have seen their relative values to the Kenya Shilling fluctuate dramatically.  The net effect on our operating budget?  Due to currency exchange rates dropping alone, we now have about a 10% negative gap between our budget and our committed financial partner support.

If you are an ad hoc financial partner or not yet participating financially in our work, would you consider committing to support us monthly?  You can find info on how to do this here.  Or if you are supporting us regularly, would you consider increasing your support level?

Medical Director

I (Mardi) have been Medical Director for two years now.  In 2014, our mission hospital has seen 110,500 outpatients, admitted 12,000 patients, and performed over 10,000 surgeries.  I have been so grateful to participate in leading the direction of so many different areas of Christ-centred healthcare. 

  • In the last two years, we have grown from 20 to a team of 30 senior doctors - half Kenyan, half international volunteers.
  • In addition to providing compassionate medical care to the vulnerable, we have continued to grow our medical training programs:  we have over a hundred residents and trainees currently learning general surgery,  pediatric surgery, pediatric neurosurgery, orthopedics, family medicine (starts in September), nurse anesthesia and medical internship.  We also have one hundred students in our nursing school.
  • Financial sustainability has been a key focus the last couple of years, and I've been working on using the resources of Kenya's small but crucial upper-middle class population by piloting a private clinic, with proceeds helping cover the costs of the poor.  I hope to expand this at the end of the year with another private clinic based in Nairobi.
  • Developing a collaborative, big-picture leadership team has also been a key priority - our team of 30 doctors and 100+ therapists and trainees are now led by 4 subdivisional heads - medicine, surgery, allied health and diagnostic services - and these 4 people help me draw together and prioritise many interdependent goals, so that as a hospital no single area outpaces the other.

Harvard and Brigham Young published a recent study taking a look at Kijabe Hospital's unique surgical effectiveness as a mission hospital.  This report gives a slice of the the complexity of life at an African mission hospital, and encourages me with how slow, consistent progress can make such a large impact over the long haul.

Team Leader

Since we arrived in 2011, the number of SIM workers serving in the Kijabe area (the Rift Valley Academy, Moffat Bible College, and the Hospital) has grown from 6 to 23 (40, including kids).  A pediatric surgeon, five theological educators, two RVA dorm parents/teachers, one Medical Director :) , a general surgeon,  physical therapist, audiologist and three family practice docs.  When we arrived, there was no 'team' here, and I (Andy) was asked to help build and launch one.

I share the leadership responsibility of this role with a team of three deputies.  In mid-2014 we held a team workshop to align on a set of shared values and goals, and out of that we developed a Team Covenant.  Now that we have the team established and charging forward, I'll be stepping down as Team Leader because Mardi and I have realised it's just too much for both of us to have full-on leadership positions simultaneously... we need to have someone to debrief with!

Spiritual formation, coaching, and discipleship

I have deeply enjoyed three years of teaching spiritual formation and leadership courses at Moffat Bible College.  However, this year I decided to focus my efforts at Kijabe Hospital this year as I was being stretched too thin with my other work (thank you to those of you who asked me, 'are you doing too much?').

This past year I've been able to focus on launching two different spiritual formation groups for doctors and Hospital staff.   They've been deeply encouraging.  We'll be launching our third group in July this year (for the new class of ten medical interns), and a fourth in September.

Additionally, about 30% of my time is spent in 1:1 coaching and discipleship with Hospital staff and Christian leaders from around Kenya.  I was asked to lead a two day "relationship alignment" retreat in April for the Board Members of Kijabe Hospital and Bethany Kids (who runs our pediatric surgical program for disabled children); it was a deep and holy time of discussion and restored relationship.

Water Project:  Completed

Imagine a 285 bed mission hospital running out of water, canceling surgeries, and forced to give immunosuppressed babies unfiltered water...I am delighted to report that you can put your imagination torest!  This year we successfully completed all phases of the Kijabe Water Project:

  • construction and dedication of a new 600 m3 (160,000 gallon) water tank
  • Negotiation of a new supply of filtered, chlorinated water
  • Installation of new piping and valves, converting the Hospital's water supply system to a zoned system for increased reliability

Elimu Housing Project:  Launched

In 2013, we graduated two pediatric surgeons from our surgical fellowship:  Situma and Lebbie, who returned to their home countries of Uganda and Sierra Leone to be the second and only pediatric surgeons in those countries, respectively.  As a hospital, we have enough patients to train many more doctors in these and other critical areas, but not enough houses to put them in.  

The hospital housing master plan, developed in 2011, calls for 6 large buildings, housing 60 trainees plus 24 families at a cost of around US$4m.  It seemed impossible to even get off the ground, but in October 2014 we took a step of faith - we spread the word that we wanted to build the first building, and asked for 100 donors of $6000 each.  

We are grateful to report that as of this week, we have raised $430,000 from individuals and churches, and have finalised the plans for our first 30-bed hostel building to break ground in August.  Please will you pray with us that we would be able to raise the remaining $170,000 in the next few months to enable us to complete this critical project by December 2016,  allowing us to train more family doctors, orthopedic surgeons, and start new training programs in obstetrics, pediatrics and internal medicine?

Sanitation Project:  Construction Completed

After a 12 month wait between the completion of Phase 1 (2.4 km of new piping and manholes) and start of Phase 2 to raise the necessary funds, we commenced construction on the three wastewater treatment ponds last year.  Construction was completed one month ago, and we will commence commissioning in the next month:  decommissioning more than 60 old septic tanks and sending the effluent to our new wastewater treatment ponds!

Our thanks to Inside Infrastructure, the engineering consultancy in Adelaide who developed our commissioning plan and provided invaluable advice. 

Click here to watch a cool flyover video of the project!


Training East Africa's first doctors in children's emergency / intensive care

I've been privileged to help spearhead East Africa's first training program for pediatricians to become emergency and intensive care specialists.  Together with specialist physicians from the University of Nairobi and the University of Washington, we have finalized a curriculum to train doctors at Kijabe and two other hospitals in Nairobi .

This will make Kenya the only place between Cairo and Capetown where doctors can learn how to provide the kind of care that make conditions like Ebola and severe road accidents in children survivable.  As one of East Africa's only two doctors with formal training in pediatric emergency care, I am thrilled to be part of establishing a program that will have such an impact, with our first trainees from Rwanda, Kenya and other East African nations hoping to start in September 2016.   

Medical Gases Project...and others

In 2012, KH received a large grant for a radiology upgrade, and when I started at Medical Director, the project was handed over to me to deliver.  As of this month, we have finished installing this new digital system to take and read x-rays, ultrasounds and CT scans.

In 2013, the hospital oxygen plant started to fail, just as we started building our new 76-bed children's wing.  So last year, Andy led a concept design process to identify - how big a medical gases plant (oxygen, vacuum, and medical air) do we need, now and 10 years from now, and how much will it cost?   The design has now been finalised, and we hope to start this large and complex project soon.

When I return, we will identify new needs and start planning ahead for the next projects of operating theatre and clinic expansions, which may be started by me but will be completed by someone else.

Visiting teams and doctors

We are grateful for the assistance of doctors from all over the world who come from 2 weeks to 3 months to relieve the long-term doctors on annual or continuing medical education leave.   A place like Kijabe is the perfect place to do a "medical missions trip" - treatment of people within a system that can keep caring for them after you leave, training of doctors who will keep learning from others after you are gone.  Last year, over 60 short-term doctors came to make a real difference here.  If your church is thinking of sending people on "medical missions", read some of our thoughts here of some ways to do this well.

Copyright © 2015 Andrew and Mardi Steere, All rights reserved.
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