See the  Updates Page  for an August 2, 2000 update from Kim.

March 12, 2000

Dear friends,

It had been a long and particularly full week for me, so at 6:30pm Friday evening I was glad to be finally heading home for the day. As I made my way toward the door, the medical student in outpatient department called out one of those questions you hate to hear, "Dr. Smith, could you please come look at this for just a moment?" I wasn’t on call that night, but since it was a skin lesion he wanted me to look at, I figured it wouldn’t take very long.

The patient he wanted me to see was a one-year-old Maasai boy with a fever, cough, and multiple, large sores over the chest, abdomen and thigh. I didn’t remember ever having seen skin lesions like those before, but the child looked sick, and something told me I better aspirate one of the lesions and do a gram stain (to look for bacteria).

It didn’t take very long to track down the lab technician, and before long I was looking through the microscope at something I had seen before in pictures but had hoped never to encounter in real life. The short, gram negative rods with bipolar staining looked vaguely familiar, and it suddenly dawned on me that I was looking at Yersinia pestis, the bacterial cause of plague.

I took a moment to catch my breath, and as I quickly headed back to the clinic area, I started doing a mental tally of patients, staff and other workers who had passed through the patient waiting area and potentially been exposed to airborne plague. The first task was to figure out how to inform the medical staff of the problem without causing a panic. Then we would need to start the child on appropriate treatment and set up a respiratory isolation room. Notifying the government health authorities would have to wait until Monday, since our telephone lines had been down for a week. Finally I would need to call home and let Kim know, "Honey, I’ll be home late for dinner; I have to help prevent an epidemic of plague."

I praise the Lord we managed to do everything needed in a short period of time. The child is recovering, and so far no one else has become ill. I am especially thankful for Tim Lewen, the visiting medical student from the U.S. who brought the patient to my attention and took responsibility for getting the names and addresses of the 32 patients and staff who had been exposed and making sure they all received appropriate antibiotic prophylaxis before going home. I am also thankful for Dr. Dana Witmer, our missionary pediatrician with 10 years of experience in Congo, who came over from a prayer meeting on her night off to make sure the child received the best care possible. Finally, I am so thankful for our excellent Kenyan lab and nursing staff who worked with speed and efficiency to manage this situation while continuing to care for the other patients who needed to be seen.

While not all Friday evenings here are quite so exciting, this past year at Kijabe has been filled with examples of the Lord’s provision, protection and power. I want to ask your forgiveness for the many stories that would have strengthened your faith and brought glory to God had we taken the opportunity to share them. So many prayer letters composed in my head never made it to ink and paper in the business of the moment. Kim and I are grateful for your prayers, and praise Him for bringing so many of our patients to salvation during these last few months.

Kim’s Corner

I praise God for a good visit from my mom, brother and cousin in February. Penny was very happy to be surrounded by so many who love her and think that she is the greatest baby. She even learned some Vietnamese and French words from them. We had the opportunity to share with them our home, our work and a little bit of this beautiful land of Kenya.

Praise & Prayer

1) We continue to thank the Lord for our adopted daughter Penny. She will be 1 year-old on March 24. On March 29 we are to present our legal case for adoption before the Kenyan High Court. Please pray that it would be accepted.

2) Last week we received news that we had been approved for a grant from the Elizabeth Glasser Pediatric AIDS Foundation to provide HIV testing and medications for our pregnant women here at Kijabe. This is a real answer to prayer and should result in a significant reduction in the number of babies born with HIV infection in our area. Please pray that we would be able to use this grant most effectively.

3) A team of 15 people from Southway Community Church in Houston, Texas is planning to come out this summer for evangelistic and medical ministry. Please pray that the Lord would open opportunities for the Gospel and would be with the team members as they prepare for this venture.

4) We thank the Lord for accomplishing His work despite our deficiencies, lack of faith and lack of obedience. Please pray that Kim and I would draw closer to Him, love Him more, and be empowered by His Spirit. We are still struggling to learn Kiswahili, build relationships, and develop more of a spiritual ministry here at Kijabe.

Thank you again for your prayers and friendship. Grace be with you all.

December 6, 1999    

Dear friends,

 Merry Christmas from Kijabe. We don't have snow, but it is cold and rainy here, and lately we've had to light the fireplace to keep warm in the evenings. These past several months since our last prayer letter have been full, both with challenges and joys.  Our adopted daughter Penny will be nine months old this Christmas.   Favorite activities include laughing, pulling the cat's tail, and screaming during Sunday morning worship service. Least favorite activity is going to bed. We will begin the legal adoption process in  January. Please pray the Lord would work out all the details.  Recently Nate became the new director for our intern program here at Kijabe Hospital. We have three new Kenyan interns who started in November. Their names are Susan, Alex and Isaac. All are committed Christians and really want to serve the Lord through medical ministry.  We have a weekly Bible study with them and the medical students who rotate through Kijabe Hospital. Please pray that the Lord would draw these young doctors close to Himself and sustain them through the long hours and hard work.  Kim has also started a Bible study for the maternity ward staff.  The fellowship and focus on God's word have helped to nurture a vision for spiritual ministry and a sense of teamwork. The staff are bolder in sharing the Gospel with patients, and we have seen many patients from the maternity ward come to know the Lord since this Bible study began.

What am I doing here anyway?
That's a question Kim and I have found ourselves asking many times over the past few months. For me, the answer to that question this afternoon was, "not very much." I saw a man with a mild upper respiratory infection and a woman with TMJ problems, whom I quickly referred over to the dental clinic. Not very high-caliber stuff for an infectious diseases specialist, huh?  True enough, but what is exciting is what God was doing in the waiting room. The man with the respiratory infection was a fellow missionary, and the woman was a Muslim from Nairobi. As she was filling out her forms in the waiting room (yes, we have forms here in Africa too), she was stumped by the question, "Do you have a personal relationship with God?"   The missionary, who was also waiting to be seen, explained to her what that meant and how she also could have a personal relationship with God. Praise the Lord I was  running behind again today!  I would also like to update you on Sylvester, the HIV-infected man we have mentioned before. His wife turned out to be HIV-infected as well. Kim delivered her baby by C-section, and both mother and newborn son are doing well. We do not know yet whether the child has been  infected with HIV. Unfortunately, Sylvester's health is beginning to fail. He had to stop the donated HIV medications I gave him because of side effects. We have had several visits from him here at Kijabe and had the opportunity for a brief visit to his home a few months ago. We loaned him some books on the Christian life, as well as some Christian music. Please pray that he would grow closer to God and that his wife would trust Christ as well.  

May the Lord be especially close to you this Christmas season. We rejoice in His faithfulness and provision during our first year of ministry here in Kenya. 

Thank you for your prayers.
    
     Nate & Kim Smith

Thank you again for joining with us in this work. How true it is that unless the Lord builds the house, its builders labor in vain.

Nate & Kim Smith

May 1999  Prayer Letter
(additional updates/prayer requests on Updates Page.)

Greetings from Kijabe! On April 16, Kim and I finally arrived at Kijabe. At the time of this writing we have been here 2 weeks and are just getting settled in. Finding our places in the work here and building new friendships are high priorities for us right now. It is clear that the Lord has prepared the way before us, and we are looking ahead to years of effective ministry here.

Before coming to Kijabe, however, we spent 4 weeks at Kapsowar Hospital, a smaller, rural hospital in northwest Kenya. Kim was on-call for maternity 24 hours per day, 7 days per week, and I found myself caring for critically ill infants (having not done any pediatrics in the previous 8 years) as well as adults. Needless to say, it was a challenging experience. It is difficult to put into words all the ways in which we saw the Lord at work. Let try to give you a snapshot by relating the stories of 3 men I had the joy of meeting during our time at Kapsowar.

"But, Daktari, we already prayed with him this morning."

"That’s good," I replied, "but I’d like to pray with him again now."

"Daktari, we prayed with him and he received the Lord!"

That’s how I learned that Ambrose had become my brother in Christ. Ambrose came to the hospital with what turned out to be advanced liver cancer. Medically there was little we could do other than confirm the diagnosis. I prayed with Ambrose when he was first admitted, but it was Charles, one of the Kenyan nurses, who led him to the Lord. A few days later, Ambrose died peacefully in his sleep. Charles himself is almost blind from a progressive eye disease, but he continues to minister faithfully to the patients under his care, both physically and spiritually.

Another man who came to the hospital during our time at Kapsowar was Sylvester. He had severe tuberculosis and malaria. After examining him, I became suspicious that he probably had HIV as well. I spoke with him privately and discovered that he had indeed tested positive some time before. He had not told anyone except his wife. We prayed together and talked about the Lord. He says he has trusted Jesus as his savior. Kim and I left Kapsowar while he was still in the hospital, but he recently wrote a letter to let me know he is at home and is improving. Please pray for Sylvester that the Lord would strengthen him during the difficult times ahead. Also pray that I would find the right words to encourage him as we continue our correspondence.

• for Ambrose’s salvation
• for sustaining us at Kapsowar
• for safe arrival in Kijabe

 

• guidance for Charles, the Kenyan nurse whose vision is failing. He would like to go into full-time Christian ministry when he is no longer able to carry out his duties as a nurse.
• strength for Sylvester as he continues to battle tuberculosis and HIV infection
• wisdom for Kim and me as we seek to balance medical and spiritual ministry

Thank you for continuing to lift us up before the Lord in prayer. Only by His power are we able to accomplish anything of eternal value. May Jesus fill you with His love.

Nate & Kim Smith

February/March 1999  Prayer Letter

Tunawasalimu katika jina la Yesu Kristo  (we greet you in the name of Jesus Christ).  We arrived safely in Kenya on January 14 and after a week of orientation (and overcoming jet lag) have begun language study.  Due to some administrative changes out here, we stayed with our Kenyan family for only one week and are now at Brackenhurst, a Southern Baptist conference center just outside Nairobi, studying Kiswahili full time. Missionary lesson #1: flexibility.  Or, as the Scripture puts it, "In his heart a man plans his course, but the Lord determines his steps" (Prov. 16:9).   Fortunately, God’s plans always end up being better than ours.  We have a strong sense of the Lord’s presence here and seem to be making good progress in language study.

Language study is, of course, one of the cross-cultural missionary’s first rites of passage.  Along with this comes the privilege of making a fool of oneself (perhaps daily) in a language other than (or in addition to) one’s mother tongue.  For example, the other day Kim and I went to the market for supplies.  Kim wanted to buy some bananas, so she asked me how to say it in Kiswahili (big mistake on her part).  Well, what I told her was not exactly correct, so she spent her afternoon asking bewildered shopkeepers if she could clean their bananas.

There are, of course, many other linguistic pitfalls which we have, by God’s mercy, so far managed to avoid.  For example, the Kiswahili words for "to understand" (kuelewa), "to be married" (kuolewa), and "to be drunk" (kulewa) are all very similar.  I’ll let you think up the embarrassing scenarios on your own.

The whole point of this language learning business, however, is to better communicate with the people God has sent us to serve.  Even as we are learning, we are building relationships with the people here.   Our formal language study will end after only six short weeks, but the process of learning to communicate effectively with the people here will continue as long as God has us in Kenya.  Please pray that we would persevere in language study, that we would be able to keep our sense of humor, and that our conversation (broken, convoluted, and frustrated as it may be) would always be "full of grace" (Col. 4:6).

• for safety in all our travels so far
• for many new friends here in Kenya
• for a good start in Kiswahili studies

• continued progress in language study, especially after our Kiswahili course ends
• physical, emotional, and spiritual health
• opportunities to encourage Kenyan believers and to be good witnesses for Christ during our first months here
• God’s protection and care for our parents and families back home

As of this writing, the plan is for us to remain here at Brackenhurst until March 20.  From here we are to go to Kapsowar Hospital in western Kenya for 3 weeks, and finally arrive at Kijabe by mid-April.   Since Brackenhurst is not far from Kijabe, we have been able to receive mail from there.  We also now have a new e-mail address.

Mail address:

P.O. Box 20
Kijabe, Kenya
East Africa

or

email: nate-kim_smith@aimint.org

website: www.webwink.com/nateandkim

We love correspondence of any sort and will do our best to reply promptly. Thank you for you prayers on our behalf. May the peace of Christ be always with you.

Kim & Nate Smith