I  woke up this morning and gazed over the Rift Valley from our front porch...it's day #5 of our latest water emergency, and I was struck by how my perspective has changed in a few short months, serving alongside those to whom a water emergency is to be expected, and not something to be shocked by.  Since we've come, we've learned as much as we've contributed.  The Valley is starting to turn brown and dusty again as Kenya moves into drier summer months; dust devils are born and briefly whirl furiously on the Valley floor.  Dust rises from your footsteps on the road and it's starting looking a bit more like the stock images of Africa you see on TV.  

A reminder to me this morning that life has a rhythm; a movement from one season to another.  Sometimes lush, green, and filled with life...sometimes dry, dusty, and dormant.  

And as I reflected, I realised that we've been here nearly a year!  Crikey.

As such, it seems an appropriate time to provide our partners and supporters with a report on the progress made this year, and share some news...
The last 10 months in numbers

  • 1200+ children and high risk babies treated on the pediatric ward and nursery, plus countless children in the outpatient department
  • $5935 raised for the Needy Children's Fund
  • 30+ children provided with echocardiograms, CTs, life-saving insulin, heart surgery and help with hospital bills from the Needy Children's Fund
  • 1,079 kilometres ridden on Andy's mountain bike
  • 1 Project Development Phase completed (Kijabe Water Project)
  • 6 grant applications written and submitted
  • 6 visitors from the US, UK, and Australia
  • 359 hours of leadership and management coaching
  • 90 hours of teaching and 30 future pastors and chaplains equipped
  • 25 trips to the local duka (supermarket) with the kids for a fizzy drink
  • 6 planning workshops facilitated
  • 1 Operational Plan launched, including governance and project management frameworks for 6 capital projects
  • 2 lions.  Seen from a car.
Let's tell you some more about the details!
Hospitalini (Mardi at the hospital)
It's been a year of learning and doing, equipping and updating, grieving and rejoicing.  My goal in working in the hospital is not solely to treat children and send them home - but to be a part of building capacity and confidence in the local African health professionals.  Historically, pediatric patients have been mostly surgical, with busy surgeons trying to keep up with a never-ending tide of children, and short-term general pediatricians attempting to cover the medical conditions.  This has left little time for education of pediatric medical and nursing staff, and no time for vision.  With Jennifer and myself being here at the same time, it has been a joy to be able to start the process of thinking - where are we, and where do we want to be?  

So what's changed in the 10 months since we've arrived?  Getting my head around caring for premature babies and kids needing intensive care, as well as children with malnutrition, rickets, HIV, TB and myriad other conditions I'd rarely or never seen.  Learning to care for them with fewer resources.  Standardising the care of children in the ICU, with clear protocols about how to use our ventilators, resuscitative resources, and how to give nutrition to a near-death baby whose gut isn't working.  We've also spent a lot of time educating our nurses on how to detect deterioration of children at an earlier stage - so that we are being called to assess them before they die, when we have a chance of helping, rather than when it's too late.  

I've started regular "mock resuscitations" with our nurses, whose competence and confidence is improving to the point where the patient is being revived before the doctor even answers the emergency beeper call.  Our interns, who after finishing their training year in Kijabe Hospital, are about to leave us - some for further training, some to be the sole medical officer in remote places such as Sudan - leave us with a wealth of experience.  The "Peds team" (pediatric surgeons, pediatricians, chaplains and pediatric neurosurgeons) were a bunch of people warily interacting with each other 10 months ago, and have become a team of interdependent workmates who rely on each other.

And I realise that I've just begun to get my feet wet.  There is so much more I want to do - I want to improve education and standardised care in our emergency and outpatients departments.  I want to further equip our nurses not only to treat our children with excellence, but to learn to educate each other long after I am gone.  I want to be a part of developing our vision for child health in our catchment area.  I want to help the hospital improve our quality of care and look at our failures and successes critically, continually asking - are we doing well enough with what we have?  I want to learn the language of the failed state to our northeast, because some of our refugee patients speak neither Kiswahili nor Kiingereza (English) - and when a child is at death's door, holding a mother's hands is not enough.

Kazi ya Andy (Andy's work)
My year in two words?  Learning and settling.  Learning my way around stakeholder engagement in an African context, learning how to teach students from 5 different tribal cultures in one classroom, learning how to coach and mentor someone from another culture.  It's also been about settling...making sure the family is settled and safe, finding (and maintaining) a car that doesn't spontaneously combust when you drive through a pothole so large you could hide a family of goats in it, discovering a rhythm of work and life here in Kenya that is so very different from America and Australia.

My teaching this year at Moffat has been an unexpected pleasure.  These students are at the very start of a life of serving God and others, and are hungry to grow and learn how to do that effectively.  To come alongside them at this stage in their working lives is an enormous privilege.  I have taught two classes so far, Spiritual Formation and Biblical Leadership, and have made myself available to teach Greek if they need it.

My father came for a visit a few weeks ago, and I asked him to teach a few of our Leadership sessions on forgiving others and releasing offenses.  Some students were courageous enough to share stories of offenses they had suffered which were just horrific.  One student texted me at 10p that night to tell me that he had dropped everything, and was on a matatu (minibus) headed home.  He had been angry at his father for years for something his father had done, and had decided during class that day that he needed to go home and seek his forgiveness for harbouring offense and judgement in his heart against him.  

When he came back to school a few days later, I could actually see a physical change in his demeanour.  His face looked calmer, more peaceful.  He had gone to his father (who thought he had come home to ask for money for school fees!) and asked for his forgiveness.  He told me, "I have never seen my father cry before.  He had tears streaming down his face, and we are now reconciled."  The power of forgiveness and keeping short accounts in action.  I received his permission to share this story with you.

My work at the hospital is mostly coaching and mentoring some of the managers as well as providing project management support to some key projects.  We have advanced the Kijabe Water Project through the Development Phase, and are now ready to deliver it--pending receipt of funding.  Grant applications have been submitted, and we are waiting and praying.  In the meantime, the projects in the 10 Year Master Plan are being delivered, and there is lots of dust, hardhats, opportunities for tetanus, and work-in-progress around the place.  A new pediatrics building will start construction in coming months, the electrical upgrade has just been completed and two buildings (palliative care, maternal and child health) are currently under construction.  Kijabe Hospital is going to be a major construction site for the next 3-5 years. 

Maisha ya jamaa (our family life)
The children continue to delight, amuse and teach us how to parent, continually wrapping themselves around our hearts.   Riley has flourished in preschool with 9 other four year olds, and is thrilled to be starting official kindergarten in August.  Her best friends are Lisa, Lydia and Ella and her favourite colour continues to be pink.  Liam continues his passionate love affair with trains and cars, requiring the Thomas the Tank Engine theme song as his nightly sendoff.   Riley is learning to ride a bike, and Liam is learning to push a bike around because riding is a little scary.
We have been blessed with visits from Mardi's parents and Andy's dad, as well as friends from the UK and US.  We have received care packages from friends and family, reminding us of people and places we love.  We have celebrated new friends, Kenyan birthdays, Easter and Christmas - and we have been reminded that even though we miss friends and family, home is where we are right now.  And we are grateful.

The news
We made an initial commitment here of around 2 years, and so we've been thinking and praying lately about what to do when this is up.   And we have decided...that we're staying.  For at least another 4 years.

In short, we feel that our work is not done here.  We also feel we are not being called somewhere else.   As such, 'until the cloud moves' (Num 9:17) and we are led elsewhere, we feel we need to continue to do the work of Jesus here.

Are we excited?  Is it scary?  Don't we feel like it's just crazy and foolish to drop our lifestyle in the West and stay in Africa?  Yes, yes, and yes.  But we just can't imagine doing anything else right now.

So what's the plan?  
Well, it's loose, and subject to prayer and lots of details falling into place.  But we think it looks like this at this stage:  
  • We return to the USA and Australia for a short furlough of a few months starting sometime end 2012 or early 2013, starting in the USA and finishing in Oz.  Purpose:  spend time with family and friends, debrief, rest, and share about our work in Kijabe.
  • We raise support and find more partners.  Our financial model and budget changes a lot.  Our budget will roughly double due to medical insurance, school fees, car maintenance, etc.  We are currently self-funding 60-70% of our living and business/ministry expenses over these two years, and this model is not sustainable in the long term.  The net result is that we need to raise more support to cover our new budget.    We'll make our needs known and start to raise support in mid 2012.
  • We sell our household goods currently in storage in Australia, anticipating that when we move back we'll just replace them. 
When Oswald Chambers and his wife, chaplains to the ANZAC troops stationed in Egypt in WWI, were asked how they carried on their work and decided where God was leading, they replied, "Well, we just trust God and do the next thing in front of us."

This is a profound truth for us, now.  Both of us to know the whole plan, not just the next step...partly because we want certainty.  But we are learning that certainty in the spiritual life is not something God is willing to give...and that this, while a challenge and a growth point for us, is a very great gift from the God who is continually shaping us his image and teaching us to be fully human.

So trust God, and do the next thing.  That's what we're going to do.  And we're glad to have you alongside us as we do it.

Andy, Mardi, Riley, and Liam


Thankful for...

1.  Rest and recharge at the SIM Spiritual Life Conference in February
2.  Clarity regarding whether we should stay
3.  Abundant provision for the Needy Children's Fund by generous friends
4.  Solid relationships and trust being built with Hospital staff and leadership
5.  Our children's health and general happiness
6.  A good marriage and finding a sustainable work-life balance

Needs/Prayer Requests

1.  Continued peace and 'right focus' for Mardi as she treats the suffering and dying
2.  Safety on the road and in Kenya
3.  For continued provision for our Needy Children's Fund
4.  That all the pieces would fall into place for our furlough and return to Kijabe in 2013
5.  For the provision of grant funding and corporate sponsors for the Kijabe Water Project
6.  For wisdom for Andy as he commences his role as Deputy Ministry Head--Kijabe Cluster