This was Dr Garrett’s second blog post from Mombasa. The original post was never received due to Dr. Garrett being in a remote part of Africa with a poor Internet connection.

We had a great first day of missionary work at the Lighthouse for Christ Eye Center. It’s very tropical here with large palm trees everywhere. The compound is right on the coast, so we can hear the waves lap up onto the sand from our apartment just up the cliff.

We met Dr. Ibrahim Matende this morning and he gave us a tour of the Eye Centre and introduced us to staff, who are all so nice. I saw patients with Dr. Matende and then on my own this morning in the “private clinic” where patients with means can have a traditional Western style consultation with an ophthalmologist.

This afternoon I saw patients in the “free” clinic where some patients pay about $4 to be seen and most pay nothing. In this setting, most patients are seen by a lower level eye care provider who can diagnose and treat eye disease and perform cataract surgery. I’m still not exactly certain what these practitioners are called. These patients are seen 3-4 at a time in a smallish room where 4 examination stations are separated by some plywood walls and curtains separating them from the other patients lined up along the wall in chairs waiting for their turns.

About 80% of the patients I saw today were Muslim. They all watch the “Jesus” film in the lobby while they wait (and everyone did watch it, according to Allison who was helping man the front desk) and then everyone who comes also meets with Reverend Ghrist and has an opportunity to receive Christ. The staff are all very strong Christians here, and we will be attending one of their daily devotions tomorrow morning.

This afternoon I performed my first cataract surgery and all went well, but it was somewhat challenging due to everything being so much different, and the equipment being somewhat outdated. I spent more time than usual counseling the patients that I examined in the afternoon to help explain their eye problems, and it was gratifying to see how much they appreciated some extra attention even in a free clinic situation.

This afternoon Nancy went to the Mombasa airport to obtain our luggage and was raked over the coals by the Customs authorities who told her she would have to pay $300 to bring the donated soccer balls into the country. She told them she didn’t have $300. So they asked her how much she did have, and she told them $50. So then the duty tax magically changed to $52, which she paid. We found out later at the Center if Nancy had insisted they call Rev. Ghrist, or stood her ground, they probably would have let her go without paying. We were so glad to get our luggage, we didn’t care though!! There are pictures of us sorting through all the items and supplies we brought including the Icare tonometer. The staff is very excited about that piece of equipment, since you can check the eye pressures of children with ease since it requires no drops, and you can barely feel anything during the brief testing. Dr. Matende has a special interest in pediatric ophthalmology and surgery.

Nancy and Allison are going out to one of the church schools tomorrow to do vacation bible school activities with some of the children. Bye and keep praying for us!

Love, Sam, Nancy and Allison

Eye Centre staff

Unpacking donated medical supplies and equipment

Dr. Garrett presents staff the donated Icare tonometer.

Dr. Garrett takes extra time after exam to counsel Muslim patient.

This was Dr Garrett’s first blog post from Mombasa. The original post was never received due to Dr. Garrett being in a remote part of Africa with a poor Internet connection.

Getting ready to turn in on our first day in Mombasa. Pictures show the view out the plane of a river flowing into the Indian Ocean as we make our descent into Mombasa. There are two photos of the view out the Toyota Land Rover as we make our way from the airport, where Sammy, our driver, met us. Notice the woman in traditional Muslim garb. We are in the Muslim part of the city, so many of our patients will be Muslim, with an occasional conversion to Christianity because of the help that some receive at the Lighthouse.

Kenya overall is about 60% Christian, 20% Muslim, 20% other/tribal, but here we can hear the call to prayer/chanting/singing from the mosque’s four times a day. One photo shows the view of the Indian Ocean from the balcony of the compound where we are, with a mosque seen as a white tower in the background. The Eye Centre is just down the street from the government hospital in Mombasa. It is about three acres and contains a modern eye clinic, surgery center, bible school for pastoral training, a church, administrative offices and residences for the director, some volunteer staff and doctors.

It started 40 yrs. ago when a Glendale, California ophthalmologist heard the Lord’s call, sold his practice and moved here to start an eye practice and reach the unsaved. Today we met his son, Tim Ghrist and his wife who now run the Mission including around 50 sponsored churches throughout the coastal region of Kenya. Our luggage is still AWOL, so I’ll be wearing the same clothes I started with, and sharing Nancy’s toothbrush (now that’s real love!!) tomorrow. Last photo is Nancy beneath the mosquito netting getting ready for some shut eye. Keep us in your prayers as we begin the real work tomorrow.

–Dr. G

View from the airplane of a river flowing into the Indian Ocean as we make our descent into Mombasa.

View out the Toyota Land Rover as we make our way from the airport.

View out the Toyota Land Rover as we make our way from the airport.

View of the Indian Ocean from the balcony of the compound where we are, with a mosque seen as a white tower in the background.

Nancy beneath the mosquito netting getting ready for some shut eye.

Today started with a short devotional in the “free clinic” section of the Lighthouse. This consists of a 10 x 18 foot room that has three partitions in it made of plywood that they put up to give a semblance of privacy. Patients are seen at free-standing slit lamps in between the wooden partitions and behind a curtain that is just in front of the chairs where people wait. The staff sang a beautiful folk spiritual hymn to start us off and an older male staff member, who is also a pastor, gave a rousing devotional about taking the Lord’s yoke upon oneself in order to release your burdens to him.

We had an extremely busy day and I saw so much serious pathology, such as eye cancers, perforated corneas, glaucomatous blindness, bad injuries, etc. The sad part is that resources are so limited here, that many bad conditions which would normally be remedied in the U.S are simply not treated here, or the treatment is only designed to save the eye, not necessarily restore vision. For instance, the ruptured corneal ulcer patient I saw today would have been treated today with cyanoacrylate glue or a corneal graft in the U.S., but I have neither, so I put a bandage contact lens on his eye and started him on antibiotic drops. If his eye is still leaking tomorrow, we will either sew his eyelids closed to try and save it, or pull the conjunctiva (clear tissue that covers the white surface of the eye) over the cornea to try and save the eye. It’s very frustrating to not have exactly what I need when I want/need it, since I have built my practice to have those resources always available. In America, our whole society is built on that instant gratification theory, and if I don’t have it, it must be someone’s fault. The people here don’t think that way. The poor people I am seeing seem to more readily accept that things don’t always work out perfectly or for the best. I haven’t seen one complain if we are not able to fix their eye or vision. It reminds me of the “sufficiency of grace” that we as Christians are supposed to feel toward our worldly possessions, even our health. That anything we have is a gift from our loving Father and those gifts should be enough to fill our cup with love for his redeeming Son.

–Dr. G

Dr. Garrett with Free Clinic Staff

Cataract patient I operated on during my first day here. She was all smiles since she could see again after years of blindness.

Just got back from our safari to East Tsavo National Park. The largest park/game preserve in Africa. Saw lions, leopards, cheetahs, elephants, giraffes, hippos, hyenas, impalas, zebras, gazelles, water buffalo, etc., etc. We had a great time enjoying God’s amazing creations and a little time off to relax while we’re here. Now back to the mission at hand!!!

–Dr. G

Family of elephants seen by Dr. Garrett while on safari

Today, I performed laser surgery on one patient for diabetic retinopathy, and operated on 5 patients for cataract surgery (3 for the eye camp). Two of the cases were extremely difficult secondary to the longstanding and hard nature of the cataracts with the patients both being bilaterally blind. The surgeries were successful however and the patients should have good vision again tomorrow when they remove their bandages. One of the 5 cataract patients was only 15 years old and I marveled at how he allowed me to inject local anesthetic behind his eye with him completely awake and unsedated. None of the patients moved a muscle or made a sound during the operations or the anesthetic injection (a note for the faint of heart–we don’t use injection anesthetic for cataract surgery in the U.S., just drops, and we do give sedation!!). They all apparently have a very stoic nature when it comes to enduring pain or a procedure.

Nancy and Allison had some time late this afternoon to visit the white sandy beaches of the Indian Ocean and tonight we had dinner with the pastor (and son of the Founder) of the Lighthouse, Reverend Tim Ghrist and his wife. He oversees the bible school and the fifty Lighthouse churches throughout the coastal region of Kenya. He moved to Kenya with his family when he was twelve. I asked him if he thought his life was over when his ophthalmologist father came home and told them they were moving to Africa. He said no, that he wanted to be a missionary before his father even considered going, and his father told him, “See Tim, I beat you to it!” He said it was great growing up in Kenya and wouldn’t change a thing. It was great praying over the patients today before we operated among a strong band of believers. Definitely helps to strengthen my faith and push me to trust Him and step out for Him. Going on Safari tomorrow for three days to East Tsavo. Hakuna matata!

–Dr. G

Dr. Garrett examines Somalian man

Yesterday we traveled 3 hours North by Toyota Land Cruiser toward Somalia and went to a school originally funded by German philanthropists and run by the government. It looked to be about 200 children. We got stuck in the schoolyard in soft sand and about 50 children mobbed around the truck and pushed us out!! We set up our mobile eye clinic in an open air school room and ended up seeing 52 patients during our stay. We picked up one of the Lighhthouse pastors on our way, and he gave the blessing prior to commencing our clinic which ran for about 4 hours. Nancy checked vision and took a brief history, then I saw the patient, examined their eyes with a high power light source and spectacle mounted telescopes, then checked their eye pressure with the Icare tonometer (which worked great). All this costly equipment was donated by my church family at Baylake United Methodist Church (BUMC) and some of my patients at Virginia Beach Eye Center! When the clinic was over we”" sent three patients by bus back to the eye center in Mombasa for cataract surgery the next day. We then donated 10 soccer balls (all donated by friends, family, and the great people at BUMC) to the school and were treated as a thank you to a lively soccer “football” game played on a huge dirt field near the school.

–Dr. G

Dr. Garrett performs eye exam on Somalian woman in the mobile eye clinic

We had another great day. The morning devotional was about Islam and the Koran and how to connect with the Muslim population we are seeing. Nancy spent her morning witnessing to patients in the “free” clinic and had several great conversations with Muslim patients about her faith in Jesus and even experienced one conversion to Christ!!

I saw several interesting patients today, including an old Ethiopian farmer (with an absolutely gorgeous family) who was injured in the left eye years ago when the whip he was using to drive the ox powered plow caught him in the eye. He was losing his vision in his remaining good eye and a simple pair of glasses was all he needed. I saw another man with an inoperable brain tumor who had lost his vision in his left eye due to un-operated retinal detachment. He now has complete drooping of his right eyelid due to the tumor and cannot open his eye. So he devised an old ragged headband into a strap to hold his eye open. Unfortunately, the tumor has also ruined the nerve that controls sensation to the face and eye, and has caused a central non-healing corneal ulcer in his only seeing eye. His only hope in saving the eye is to keep the eye shut all the time, and then of course he can’t see!! I wonder whether we could have done something more for him if he was in the U.S.

Nancy and Allison visited a church about one hour from the Centre this afternoon which runs an after school program for kids. They taught a lesson about the lost sheep, played games and gave out soccer balls. Some pictures are included. Both were very touched by what they saw.

I think one of the joys we are receiving in making this trip, is the realization that the human contact portion of what we do as missionaries, is really the essence of our relationship with Christ. He went out into the world to heal, love and fellowship with the lost, least and forgotten and then asked us to do the same as his only hands and feet on earth. I used to think I could stay right there at home and because I was helping people there; that was enough. I don’t think that anymore…

I had the good fortune before I came out here, to make an Internet acquaintance with Mother Superior Ursula, who is in charge of all the nuns, their convents and their charitable activities in Kenya, Tanzania and Uganda. She is based here in Mombasa, and came out to see me today as a patient at the Eye Centre. I gave her a good exam and later she took us to her convent nearby for tea and homemade donuts!! We had a great time meeting her sister’s, hearing evening prayers being sung by the nun trainee’s (I’m positive they have a better more formal name for them, but can’t remember it) and learning about all their great charitable activities. While at the Centre, Ursula was able to meet both Dr. Matende and Reverend Ghrist, so hopefully some long lasting connections have been made.

Tomorrow we are going out on our rural eye camp about 2-3 hours away, so I’ll sign off for now.

–Dr. G

Mombasian boy (left), Dr. Garrett with his daughter Allison and Mother Superior Ursula (top), Mombasian children (bottom)

Well it’s been an interesting travel adventure so far…..We waited in the plane at Norfolk International for an hour waiting for weather to clear near our first destination–Boston. We made it to Boston with 15 minutes to spare and ran thru the airport to make our flight to Amsterdam, and then waited an hour to get on the plane!! We had good flights to Amsterdam and then to Nairobi. All of us were able to sleep a little on the plane. We got to Nairobi about 8:00 pm local time (about 3:00 pm EST), made it through immigration after waiting in line about an hour, only to find our luggage was still in Boston and an airline workers strike had cancelled our flight to Mombasa. They put us up in a nice hotel in Nairobi, but we were only in bed for about three hours before having to take the bus back to the airport. So we’re here waiting for our short flight to Mombasa, praying that we’ll make it today!! Some of the medical supplies I brought are in ice packs and I’m afraid are going to be ruined because of the delay. Our luggage won’t get there till some time tonight. Everyone here has been very nice to us so far, so we are hanging in there. More later….–Dr. G