Thursday, March 8, 2012

Sunday, September 25, 2011

Go Big Blue!

We're back in the Bluegrass! Our trip was all we expected, but it is awesome to be back with friends and family (as well as drive a car, access reliable internet, and eat a hamburger!)

Thanks for reading, I hope the blog has encouraged you! We'll probably use the blog periodically-- post baby pictures on here one day or something.


Tuesday, September 20, 2011

Surgery Call

Since September 1st, I have been rotating through General Surgery here at Tenwek. 6 am rounds have never been my idea of fun, but given the option of this or all-day rounds with Internal Medicine—I, like most future Emergency Medicine doctors, would prefer the quick, efficient rounds of the Surgeon. Plus, the Theatre has offered plenty of opportunity for procedures and I have had opportunity to evaluate acute abdomen cases.
My first two call-nights on surgery started out with a bang—literally. Mutatoos are the local public transport buses, and both casualties were the result of mutatoo road traffic accidents (RTA). Over the weekend, I experienced the mutatoo first hand—as I rode in one on our travel back from Uganda. Our bus was packed—with over fifteen Kenyans packed into a twelve person ride. On stops, there always seemed to be one or two guys hanging out the side door who had to jump in as the bus drives away. Fortunately, we arrived safely in Bomet on our bus ride. The individuals below sadly did not reach their destination.
The first mass casualty was on Thursday night last week. We got a call at 8PM that there had been an RTA in Naruk, and that they were coming to Tenwek. A bus of six people had hit a donkey and crashed. The injuries were catastrophic and the morbidity high. They arrived at 10PM. At first I focused on A., a lady who had severe wounds all over her right arm, cold extremities, no pulse she would require amputation that night. The saddest cases, however, were the children. One 5 year old boy (I.) presented having had a traumatic amputation in the field of his whole right arm. When we explored I. arm in Theatre-- glass, dirt, and blood gushed from where his arm should have been. Next a 4 year old girl (L.) lost the right side of her face, sustained a skull fracture, and right arm avulsion, all the while she was crying for daddy. Three more—a baby with open tib/fib fracture and avulsion of ankles bilaterally and two ladies—all required surgery that night. The team was up all night dealing with the tragedy. Dr. Carol Spears, a missionary General Surgeon who trained at University of Kentucky, led the team through the night. Tragedies like this are hard to put in to words; I found my heart broken for I., who will survive but must live through live without an arm.
The second mass casualty occurred two days later when twenty-three patients arrived to the hospital without warning from a nearby RTA. One patient was dead on arrival, another died shortly after our resuscitation efforts were started. Another patient I evaluated sustained a C-spine fracture, and before she had transferred to the regional neurosurgeon, she had lost all sensation and strength below her chest. Multiple dislocations and fractures were noted among the victims.
When tragedies like these occur, it may seem like God is not present. We may cry to Him as the Psalmist does in Psalm 10:1—“Why, O Lord, do you stand afar off? Why do you hide yourself in times of trouble?” or as Habakkuk pleads when Judah is oppressed—Hab. 1:2—“O Lord, how long shall I cry for help, and you will not hear me?” Sometimes there are no easy answers. We ultimately live in a sinful, fallen world, and the beauty of Christianity is the hope found in the redemptive work of Christ. God doesn’t promise all the answers now, but He does allow enough of Himself to be known that we can trust in Him through tragedy, as Habakkuk does in Hab 2:4—“…the righteous shall live by his faith.” Also God can use a tragedy to speak to us, as C.S. Lewis rightly notes, “God whispers to us in our pleasures, speaks to us in our conscience, but shouts in our pains: It is His megaphone to rouse a deaf world." Tragedy opens our eyes up to real life; we are forced to focus on things we would rather not think about in the routine day—life, death, our past, our future. If the Church is present during the tragedy, we can be Christ to the hurting. Our presence in the midst of tragedy is often more meaningful than any grand comments we can come up with.

Sunday, September 18, 2011


Carly here.

It’s been a long time since either Joel or I posted.  Baby Moses ended up making a more permanent appearance at the Hamm residence (although it was less permanent than we would have liked).  We kept him off and on (more on than off towards the end) for about three weeks.  It was my first experience in being a mom, and I absolutely loved it.  I also fell completely in love with Moses and it was pretty heartbreaking to have to send him to the orphanage.  Praise the Lord, he was sent to an orphanage where he is one of two babies, and will receive tons of love and attention.  I heard from the friend who took him that the staff at the orphanage were so excited to be getting him that they started taking pictures of him before he was even out of the car… this comforts my heart.  Short of moving to Kenya for the better part of four years (which would be extremely difficult due to job commitments and med school schedules), there is no way for us to adopt him.  I pray and hope that God will provide a loving home for Moses with a mom and dad who are walking the Lord.  This sweet baby may have been abandoned, but he is so incredibly loved and wanted.

Joel and I are taking full advantage of our last weekend here- he went white water rafting in the Nile, and I went to an orphanage.  Very telling of our personalities, no? :).  Although we both would have liked to accompany the other on their trip, we both chose what we knew we would not regret.  Joel got to ride 8 hours (one way) on a bus to and from Uganda and I got to be spit up and peed on to my heart’s content… at least that may have been what each of us were thinking about the other’s trip.  In all seriousness, I am so glad that Joel got to have his adventure and that I got to have mine.  I have always wanted to serve in an orphanage, and I am so thankful for this opportunity.  It’s been slightly harder on me emotionally than I expected, especially now that I am personally connected to an orphan, but I’m thankful for the experience nonetheless.  The orphanage where I’m visiting is a good orphanage… but it’s still an orphanage.  It’s not a home, it’s not parents, and there’s just no way that these kids can get the one-on-one love and attention that they need and crave.  The children need moms and dads, they need forever families, they need homes, and they are absolutely powerless to do anything about it.  Have I mentioned that I'm becoming more and more passionate about adoption?

I have always wanted to adopt, from the time that I was very young, and this trip has only magnified that desire.  It’s given both me and Joel new eyes in this area, especially after caring for and emotionally connecting with an orphan.  As much as I would like to adopt rightNOWthankyouverymuch (today would be day three of the past two and a half weeks that I have gone without crying about Moses), I know that God’s timing is perfect, and we trust in that.

Joel and I can’t believe that our time in Kenya is coming to its end.  We head out Friday morning and will arrive home around midnight Friday night (with the time difference it’s roughly 24 hours of traveling).  We’ll fly from Nairobi to Amsterdam to Detroit/Atlanta (can't remember which one it is at the moment, and my email isn't opening for me to check) to Louisville, then drive home to Lexington.  We have exactly one hour for our layover in Amsterdam, so we’ll be praying that our flight arrives at the scheduled time to avoid any sprinting through the airport :).

We are so excited to see our families and friends when we get home… we’ve missed you all!  We’re also looking forward to American food again.  I’ve started relying heavily on Nutella sandwiches for meals.  This trip has been exactly the break from cooking that I needed.  Nothing incentivizes you to cook for yourself like eating the same five foods for two months.

The Lord has taught us both so much through this trip, and we can’t wait to share it with you!  We have tons of pictures (lots of which are of Moses- I now understand why people post 400 pictures of their newborns to Facebook… doesn’t everyone want to see how cute they are??) and so many memories.  God is so good, all the time.

Tuesday, September 6, 2011

Our Relaxing Safari Weekend

This past weekend we were relaxing on a much needed break at Masai Mara, in Southwest Kenya. Some of our pictures are below! --Joel and Carly

It's nice to take a break sometimes:

The Great Migration of the Wildebeasts, as they cross the Mara River near Tanzania:

Hamm's back in 2.5 wks!

Tuesday, August 30, 2011

Safety First

The story of the Good Samaritan is told in Luke 10:25-37. The Samaritan was not the first to come upon the wounded man that day-- the first two men "passed by on the other side." Could the the first two men just been afraid? Abandoned man on the highway, stripped, beaten, half-dead-- sounds very dangerous and ... unsafe.
Safety first! It is a mantra of modern suburban middle-class American culture. We avoid the uncomfortable, choosing instead the comfort of our safe schools, suburbs, and streets. We stay away from the inner cities; it's too dangerous! We ignore when millions are starving in Somalia; let's pray for the missionaries (when we remember to pray), especially pray for their safety and safe return to modern American comfort.
Christ didn't play it safe. It wasn't safe to challenge Pharisees, to be with publicans and sinners, to have no place to lay his head even. He wants obedience even in the absence of safety. See Luke 9. Francis Chan, in Crazy Love, proposes, "It is not scientific doubt, not atheism, not pantheism, not agnosticism, that in our day and in this land is likely to quench the light of the Gospel. It is a proud, sensuous, selfish, luxurious, church-going, hollow-hearted prosperity." Ouch!
Extreme poverty has a smell. I smell it now each day in Kenya. One of my earliest encounters with the smell of poverty was in the backseat of our 1994 Pontiac. I'll never forget riding with the hitch-hikers my dad picked up when we were kids. Not only the smell, but the tattered clothes and "help me! i'm homeless!" signs have been embedded in my head since I was a youngster. Associated with this image, are the many spiritual conversations that took place in that car.
Picking up hitch-hikers is probably considered an "unsafe" practice. Most the time we keep driving-- are we lacking in compassion or is this too unsafe for us (or both)? Certainly I think this is situational (as I would never want my wife to pick up a man for example), but I think as Christians we should be actively involved in loving our neighbor somewhere. It will look different to different people. Maybe there is someone near you that you never thought to help, but now can see the need and are not afraid. Again, from Crazy Love, "If I were a non-Christian, would my life look any different than it does now?"
The beauty of the Good Samaritan is as an individual he decided to love his neighbor. He didn't second guess the traveler's choice of road or time of day that he had traveled. He could have easily said, "You shouldn't have traveled here." or "You should have had defense." How often is this our excuse for not helping-- the "they brought this on themselves" philosophy. I do believe it is as important how you help someone as in the fact that you do help them. But, ultimately, we should act. The Good Samaritan didn't question; he acted in obedience even in a dangerous and unsafe world.

Friday, August 26, 2011

Right to Bear Arms

This week, a fifty year old man walked into Casualty (British for Emergency Department) complaining of being shot in the neck by an arrow. He claims he was gardening when a young boy shot him on purpose unprovoked. The arrow went posterior to anterior into the base of his neck. Surprisingly, he was fairly stable, alert and oriented, and talking. The only exam finding was left-sided decreased strength on the upper and lower extremity, but otherwise he was intact neurovascularly. For immediate management, he was hypotensive when he came in and was resuscitated with one liter of intravenous fluids.
We couldn’t assess how deep the arrow had gone until we got the lateral and anterior-posterior cervical spine X-ray films shown below. Obviously, the arrow went much deeper than we had hoped and our patient was sent to Theatre (British for Operating Room) for Exploration and Foreign Body Removal. Dr. Bacon, a trained Orthopedic Surgeon from North Carolina did the surgery since we do not have a trained Neurosurgeon at Tenwek Hospital. At Tenwek, staff members are often asked to work outside of their area of expertise, as in this case. He was able to completely remove the arrow, noting that it had torn through part of the Dura Mater that encases the spinal cord। He said he was unable to determine if the spinal cord had been damaged due to extensive bleeding.

Reports are that the patient is recovering well. It may take a while until we know the full extent of the damage to neurological function. As far as his social situation is concerned, we still have questions about the incident. Stealing in Kenya is a very serious offense. One report we heard was that a woman’s arm was chopped off because she was stealing tea leaves from a farm. Whether our patient’s “gardening” was actually thievery remains to be determined. People are reluctant to go to the police because they know the perpetrator often gets away with the crime via bribery.
Similar incidents are actually not uncommon here in Kenya. In fact, injuries from arrows or spears are more common than gun shot wounds at Tenwek Hospital. Violence occurs whether guns are widely available or not. Guns are outlawed unless authorized by the military. In Northern Kenya, however, arms are quite available, being shipped in illegally from Somalia.
Lethality is an argument used against guns. In the case above, had our patient been shot with a gun, we would have died. However, the purpose of a well-regulated militia, as George Mason puts it is to "prevent enslavement." This requires lethal weapons owned by the citizenry.
The Kenyan staff in Casualty was surprised that I owned two guns and that owning a gun did not require a license in many States in the United States. I taught them some American history about our 2nd Amendment and “Right to Bear Arms.” From discussions with Kenyans, I would argue that Kenya needs reforms in many areas politically as corruption is very prevalent here. A trustworthy military and police force would be a good place to start. Violence broke out in 2007 over election results, but the elections next year are not expected to cause the turmoil they did this year. It is still something we can keep in our prayers.

A few quotes below make clear the purpose of the 2nd amendment:

"I ask, Sir, what is the militia? It is the whole people. To disarm the people is the best and most effectual way to enslave them." --George Mason, Co-author of the Second Amendment during Virginia's Convention to Ratify the Constitution, 1788

"Firearms stand next in importance to the constitution itself. They are the American people's liberty teeth and keystone under independence … from the hour the Pilgrims landed to the present day, events, occurrences and tendencies prove that to ensure peace security and happiness, the rifle and pistol are equally indispensable … the very atmosphere of firearms anywhere restrains evil interference — they deserve a place of honor with all that's good." --George Washington, First President of the United States

"To preserve liberty, it is essential that the whole body of the people always possess arms and be taught alike, especially when young, how to use them."
Richard Henry Lee, American Statesman, 1788

"Those who hammer their guns into plowshares will plow for those who do not."
Thomas Jefferson, Third President of the United States

-- Quotes from taken from: