We also wanted to invite you again to adopt an orphan to pray for, or add one if you are already praying.  If you are already praying, we say THANK YOU!  The difference in some of the kids from past years is obvious, and you should see their faces light up when we tell them they each have someone in the USA praying for them! I think it is very powerful to them that someone across the oceans knows their name and what they look like. We have about 30 kids that we still need to connect with people for prayer. 

There was a recent article in Christianity Today about how effective child sponsorship is.  Kids that are sponsored do better in life.  We certainly aren't a well oiled machine here at the Kettler house as far as communication and organization over this goes, but we would love to send you a picture of a child or two (OR a sibling group), along with whatever info we have on them, and have you pray.  If monetary sponsorship helps kids, IMAGINE what prayer sponsorship does!!  

And... of course.... If you would like to support Kitoben Vision Children's Home financially, that would be great!  Financial support can be sent to Nations to Nations, 5101 Lake Jackson, Waco, TX  76710.  Put a note with your check that designates it for Kitoben.  Every penny you send goes directly to pay for education, food, and clothing for the children, none is used for administration.  Some of you generously gave last year, and we have enough to get everyone through 2013.  Hallelujah!  Love to all,  Tom and Anne

We have been back for over a week now. I am at work full time and the business of life has returned. Unfortunately I have been sick for the past week and a half, When your illness originates in Africa it causes you to pause and reflect, but I think it was just a bad cold. I continue to have coughing fits, usually at night but they are decreasing. Anne also came down with a similar virus so we have been slowed but not stopped. I wanted to try and fill in a few of the gaps during our time in Kenya. I have enjoyed the blog because it allows everyone to see many of the places and people we have written about through the years. It has also been nice to direct some of my long time patients and friends to the site. During the first leg of our journey home I went through my journal and a lot of my old notes concerning our times in Africa. It is always good to reflect on the past, the good and the bad. Now that years have gone by, it is more like the perceived good and the perceived bad. Not quite so black and white. I have come to appreciate that sticking with things and enduring together brings about a deeper understanding and satisfaction. It also promotes a deep rooted thankfulness for God and our utter dependence on His "big picture and larger story" way of doing things. Our first trip to Kenya was 1998 and we stayed for three months, followed by two month stints in 1999 and 2000. We then had a hiatus, but worked in Rwanda in 2005. From that time on we have always returned to Kenya; in 2006, 2008, twice in 2010, 2012 and 2013. We have combined our medical work with our work at Kitoben Children's Home. Much has changed in the past 15 years, but amazingly most of the people have stayed the same. One thing that has not changed is that the ride back to Nairobi is always an adventure and the line of cars and trucks that have to be negotiated at the end will cause your prayer life to instantly blossom.

Morning Report occurs almost every day at Tenwek. It begins at 8 am in a large conference room. There are sometimes over 50 people with the majority being doctors and doctors in training. If you show up at 8:00 you might be alone but by 10 after everyone is there. No early bird sayings here. Some speak very softly and you may never be able to pick up what they are saying. Asking someone to speak up does not, under any circumstance work, so I usually smile and watch the new people struggle with thinking they are missing something. I can now confidently say I can understand the majority of morning report. 51% is a majority. One day a week, on Tuesday we have M and M rounds. That is mortality and morbidity rounds. Usually it is morbidity that leads to mortality and the presentations and discussions can be quite lively. That is usually thanks to the surgeons who drill down on what happened fairly quickly, exposing what went wrong and how the care could have been improved. There is no thin skin allowed. It is all about learning and growing and is sometimes painful. I have been on the receiving side of M and M., but not this time. It was most entertaining this year, as instead of the patients dying, they lived, and were even discharged and went home. I was on the edge of my seat as I kept thinking any minute they were going to give us the bad news.

One of the long term doctors has had it with all of the abbreviations used in the meetings. I have talked about this before, but it is worth repeating. SL = sick looking. BM = body malaise, or bowel movement, or bone marrow, or bacterial meningitis, just depends. GBM = general body malaise. HOB = hotness of body. CAP = community acquired pneumonia. NTB = not too bad. MAEW = moves all extremities well. PTB = pulmonary tuberculosis. P*, J*, C*, and O*, with those asterisks signs being the power symbol 0. That means patient with no pallor, no jaundice, no cyanosis and no oedema (british). Then there is also P+ and P++. He went on about how no one understands all of these abbreviations, but I was sure the majority did. The very next day he said that a DPL should have been done on a patient, that is a diagnostic peritoneal lavage. I just smiled.

Follow the ladders...

Some of my favorite signs in Africa are: The Toe Jam Inn, The Lazarus Funeral Home, The Anointed Candy Shoppe, The God Almighty School Bus, Flush Thrice with Vigor, Beware of Low Height Mind Your Head, and one of my all time favorites from the great state of Arkansas, that being a waste removal business, with a sign saying something like, "Our business stinks, but it's pickin up."

We have begun our journey home. We left Tenwek a few hours ago and just passed the "Annointed Candy Shop." I am wondering why in the world we didn't stop there, but now it is too late. What could be better than Annointed Candy!? There are always mixed feelings leaving. This time we made some closer relationships with the other Americans in the guest house because we ate there everyday and played games together at night:)) Hannah is an intern with Tenwek this year, and as I mentioned before, just graduated from Wheaton. She's just Katy's age and I would like to adopt her as my fourth child.  Trouble is she has a family already. Anyway, she was so much fun. I will miss her. Also, Jerry, the guy who helped build the first dam at Tenwek. He was from North Carolina and his deep southern accent and personality stole our hearts. So it was a little hard to leave them, and of course the Kitoben crew.

We visited Kitoben for the last time on Monday. Alot of the older kids have left for school, but those in grade 3 and lower are there and are attending the newly opened "Ketcasa School" right there on the property. I have tried to make an effort to hug each child each time we visited this time around. They were sometimes a little reluctant, but Monday they had warmed up and all gathered around. They approached shyly with chin a little low, one arm outstretched to touch my shoulder and waited for me to hug them. I guess you can imagine that I was trying not to boo hoo loudly. We know the older kids pretty well by now, but there are so many new young ones that I can't keep them straight. I will try to study their pictures when I get home. I need some more people to pray for kids if you are interested. No other obligation and no shame, no guilt, just a picture and a breath prayer when you see it or think of them. One or two prayers a year would be better than none. Alice gave me a complete list of sibling groups this time, so that's been kind of helpful. For some reason, I really want to "see and know" each child, and I want someone else to "see and know" them too. Kind of like with Hagar, God is the God who sees, so I think He wants us to see people too. Some of you are praying for older kids that have grown up, so if you want to add a younger one, let me know.

If you remember, we were thinking about starting a college fund for the kids to take out loans and pay half of back. We pondered it, and decided to just go ahead and open it at Kitoben's bank and let Alice and Samwel administrate it. I went to the bank with Alice this time. Tommy usually does stuff like that because he is better at it, but after some intense discussions with several bankers I think we walked out with an understanding of the difference between dollar accounts, which we opened, and KSh accounts. We wanted her to get the best possible exchange rate. They will write some bylaws for the account, and have the people who borrow sign a document which they will keep at the bank. Someone gave us a gift before we left thru Nations to Nations to do whatever with, so that's what we chose to do. It's kind of exciting really, and Mercy, the clinical officer student, will be one of the first beneficiaries. Right now she owes a lot of money and they won't grade her tests from her first year until she pays.

Tommy hasn't had much of a chance to write, but is planning to do some when he gets home.  Thanks so much for reading along.

Tommy found our first chameleon yesterday.  He is taking a nap on our curtain rods.