I’m Back!

It has been 6 months since I added to this blog, but things are moving again. When last we met, I had been told by the Registrar’s office that it would be 3-6 months to get the CID (Criminal Investigations Division of the Kenya National Police) vetting done, so the clinic could be registered. Everything else, as far as entering into contracts, setting up bank accounts, equipment purchases, etc. all depended on that. So we waited. I was able to make good use of the time, however, in getting experience that will help me in the clinic when it does get established. My wife Judi and I took an Emergency Ultrasound introductory course in Chicago (shout out to “3rd Rock Ultrasound”-great course), but it was obvious I would need to have a lot more experience before I could use ultrasound meaningfully in Kenya. I had purchased a Butterfly IQ handheld US unit, and practiced with it during the course. For those who don’t know, this is a revolutionary piece of equipment! It is a $2,000 handheld unit that plugs into an iPhone or iPad, and gives results comparable to an $80,000 or more machine that requires multiple probes that cost 10-20 thousand dollars apiece.  But the equipment is only as good as the person holding it, and after 4 days of intense training, I had a good idea of what I was supposed to see, but not a very good idea of how to actually obtain those images.

I contacted several hospitals in the Kansas City area when we got back, and got a positive response from the Research Medical Center ultrasound staff, who agreed to let me come and hang out with the Ultrasound Techs, and with patients permission, use my Butterfly IQ to try to replicate the studies they just had with the real machines. The techs could also critique my technique and offer suggestions as they had time. 

I certainly gained a new respect for the knowledge of anatomy and the amazing abilities of the techs to get the information they do from the studies they perform. So for 6 weeks I was blessed to have that experience, and to be able to dramatically improve my ultrasound skill.  On the weekends, I was working at Appleton City, MO in the Emergency Room, and was able to use my new skills in “real life” too.  In fact, a few days ago, I got an email from Butterfly IQ, telling me I was one of their top users of the Butterfly in the United States, and wanted to get my thoughts on improvements they could make with their product.

I also got to attend the Inmed International Medicine conference in Kansas City, and made some valuable contacts there with other providers and groups that will be helpful in the coming months, and to work on getting the web-based Electronic Health Record we will be using lined up.

But back to Kenya.  After 3 months without any word, Eric Odida, my good friend and local director for the clinic, went to check in at the CID office to see how the vetting was going on.  They told him they do not do the vetting, that it is done by the National Intelligence Service (NIS).  So he went to the NIS, who looked up the reference number and said that the file had not been forwarded to them yet.  Then it was back to the Registrars office, where he was told the requests are forwarded in batches, not sent individually, When he pointed out that it had been 3 months since the application had been accepted, they explained that sometimes applications got overlooked when they were doing the batches, a common problem in such circumstances.  Eric asked if someone could give special attention to our application, and was told that was not a good idea, because it would appear as if someone had taken a bribe and was pushing it, so it could go badly for the application.  He then suggested he would like to speak to a supervisor about it, and was informed that was not a good idea, because the clerks would not want to handle the application, because they knew special notice was being taken, and would be afraid to be associated with it.

Since the logic of that was unassailable, it was back to waiting. As the sixth month rolled around, I received an email with the last page of the application with the notation “KG Approved” written at the bottom.  Eric, who was in the United States at that time, informed me that meant “Kenyan Government Approved”, so I was very excited.  The email told me I should copy the page they sent me and paste it in the application online in place of the original last page. I was not sure what that meant or why that would possibly be necessary, since that had both documents in their possession, so I went back online to the government “e-Citizen” site, the portal to immigration and business registration and all things governmental.  When I got on, I found that I could not get to the 4th page, where the documents were, because an error was now showing on the 2nd page, which was where all of the addresses were listed.  The page had gone through without any problems 6 months earlier, but now brought up only an error message, which prevented any further progress.

So I tried to call the Registrars office in Nairobi.  I did finally get someone, but they could not understand my English, or there was a bad connection, so they told me to e-mail them.  I had already tried leaving a query on the site, but did email directly to the office, and never did get an answer.  Eric also tried to call, and actually talked to a supervisor, who was in a meeting, but promised to return his call.  Follow up calls never found anyone available to answer questions, and back on the e-Citizen website, a message appeared telling me to send them an alternate email address.  I did that, and never got a return email, but the message changed and I was directed to come to Sheria House, the registrars office in Nairobi.  Eric and I both were returning to Kenya in mid-August for a church Women’s Retreat, so we decided it would just have to wait until then.

I will admit, I was getting a little concerned about whether this clinic was actually going to be something that would actually happen, and decided to make it a matter of fasting and prayer.  I am not trying to make any statement of ecclesiastical principle here, but I have found that when I have been faced with life-altering decisions in the past, that if I fast and pray for 3 days, God has always seemed to give me direction.

This time was no different.  After the 3rd day of fasting, I woke up around 4:00 am and felt directed to email a friend with some advice and counsel. After I did that, I was given the thought that I should go back to the e-Citizen site, and replace all of the numbers in the addresses on the page with spelled out words (i.e. three instead of 3).  I did that, and it worked!  I was able to replace the last document in the application, and when I rechecked the e-Citizen site later in the morning, the registration had been completed! So on August 2, 2019 the Mildred Smith Mission Health Center became a legally registered company in Kenya.  

I have no idea whether changing the numbers had anything to do with it, but by God’s grace it was accomplished.