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Another beautiful day in Kenya! I am guessing the temperature is in the 70s, with sunny skies most days. We Americans are comfortable in these temperatures and wearing short sleeves. However, the Kenyan people are bundled up in long sleeves and coats and probably think we are insane!

Breakfast brought another taste of Kenyan time. Our team was set to depart from the hotel at 7:30 AM, but the hotel staff did not set out breakfast until 7:15 AM. We ate our eggs, sausage, bread and pineapple in a hurry!

The trek to the Botoro Lutheran Church is quite the journey on hilly, red dirt roads full of ruts. Our driver is pretty amazing with his driving skills on these roads and with the traffic here. I have not seen a stoplight or stop sign anywhere! The villagers literally walk on the edge of these roads as they trek to their destinations. Cows and goats are tied up right on the edge of the road, and market stands are not far from the edge at all. The cars and motorcycles zip by, and there are no lines on the roads, either. A very interesting road construction design!

Today was the first day of the medical clinic. The Botoro Lutheran Church graciously supplied a team of workers to help set up and organize the clinic. We also had multiple translators and several professional workers who assisted with providing medical care. Setting up the clinic in the old brick pastor's house was a puzzle, and we rearranged the pieces throughout the day. You simply have to make due with what you have. Botoro is a small village outside of Kisii, so resources are more scarce.

When we arrived at the site to set up the clinic, there were already people waiting inside of the church to be seen by our team. The children follow us around and just watch us to see what we will do next. Each member of our team worked in a different place: registration to help check the people in; triage to check vital signs and learn about the person's chief complaint; provider rooms to meet with a nurse practitioner, doctor or medical officer to be treated and diagnosed; a treatment room where patients can have various tests run; and then a pharmacy where the patient can get needed prescriptions filled (from the medications we have with us).

My task for the day was to run the treatment room. I ran the various medical tests based on what the providers wanted done. The main tests I performed were malaria tests, blood sugar checks, pregnancy tests and urine tests. I also reconstituted antibiotics and gave them as injections, and there was some wound care that I performed as well. Resources are at a minimum here, so one has to get creative in order to accomplish certain tasks. We are also still waiting for the infamous missing bag—which contains various medical supplies and medications that would be quite helpful now—to catch up with us. The bag is in Nairobi … we are just struggling to get it to us in Kisii. I think we will all rejoice once it arrives!

The treatment room cycled through periods of being busy and periods of downtime. This gave me the opportunity to visit with Catherine, who is the office manager for the LCMS office in Nairobi, and who was assisting me with translation in the treatment room. She is a Kenyan and lives in Nairobi, so I learned many interesting facts about the Kenyan people and culture from her that were very eye opening. I commented on the fact that I felt bad that all of these people were waiting for hours to be seen, and then they continued to wait while we ate lunch (the standard ugali, rice, goat, kale and stew combination), which felt very rude. Catherine reminded me that Kenyan people are very patient, and they do not mind waiting. Time is not a resource to them. They may not have many resources in Africa, but they do have time.

Catherine also explained that forming relationships is more important than continuing to work. Americans are used to working through lunch, but in Africa it is more important to eat with the people and form those relationships. Kenyans also travel great distances by foot. At one point we asked an elderly man how far he had traveled to this clinic, and he said he had walked 20 km! Many of the elderly people did not know their age, which is just interesting to me since Americans keep such great track of this. We did have a 100-year-old woman come into the clinic to be seen. She was quite the character—talking through holes in the walls trying to find her umbrella that she had brought with her. For her, I believe, this umbrella was for both sun and rain protection as well as a walking stick. She did not want to forget it!

Throughout the clinic day we saw around 130 people, and we registered seventy people to go home and return the next day. Even so, the clinic hours ended up running longer than planned, and we worked from about 9:00 AM until 5:30 PM. We cared for some people with interesting diagnoses, including untreated polio in a young child, untreated spinal meningitis leading to paralysis in a young boy, undiagnosed cerebral palsy, malaria and many other random diseases. We are treating all adults and children for ringworm, and many of them have visible signs of having it.

I heard the average rural Kenyan makes $1 per day, and healthcare here is very expensive for them. It costs about 500 Kenyan schillings to see a doctor, which is about $5.80. There are also problems with the health care. For example, there is a dispensary near this village of Botoro where we are holding the clinic. The people take their prescriptions there, but the dispensary has no medications to dispense at this time. I feel that many of the people we are seeing are very grateful for the care and treatment they are receiving.

The evening was spent counting out pills, such as vitamins, Tylenol and Ibuprofen, into individual bags that can be given to the patients we see to take home for various ailments. Dinner was actually on time, and we had rice, chicken, french fries and kale. I am starting to think these are the staple foods for Africa! Devotion time was special as we all shared our high points of the day. God is doing good work through our team.

Jesus went through all the towns and villages, teaching in their synagogues, preaching the good news of the kingdom and healing every disease and sickness. When Hhe saw the crowds, He had compassion on them, because they were harassed and helpless, like sheep without a shepherd.Matthew 9:35-36

Saint John's member Kimberly Pepmiller is in Africa through July 25 with ten other doctors and nurses, lending her medical skills at clinics in Kisii, Kenya, operated by the Lutheran Church—Missouri Synod's Mercy Medical Team.