Cover Story

Serving a God of miracles

"Serving a God of miracles" Continued...

Issue: "Daniel of the Year," Dec. 18, 2010

Soon a parade of specialists made their way to Kijabe at Bransford's request, and Bransford was finding ways to school some former patients in what he was doing. A Chinese surgeon from Los Angeles taught Bransford how to implant shunts to drain fluid for hydrocephalus and spina bifida patients. Ear, nose, and throat doctor Jim Wade began making regular visits to perform cleft lip and cleft palate repairs-in 10 years, Bransford said, he has done over 1,600 at Kijabe.

In 1998 Bransford contacted Dr. Leland Albright, then chief of pediatric neurosurgery at Children's Hospital of Pittsburgh and one of the world's leading researchers in cerebral palsy. Bransford was trying to locate a textbook edited by Albright. When he told Albright about his cases, Albright said, "Why don't I just come out?" That began annual trips, where Albright did surgery in three-week stints while training doctors and nurses.

Today Kijabe is a sprawling complex with six different units, nine operating rooms, and over 200 beds. In addition to general medicine, the hospital specializes in orthopedic care and treating children with physical disabilities. That's in large part because Bransford started BethanyKids in 2001, a nonprofit based in the United States and Canada that runs the orthopedic program.

Through BethanyKids the hospital now has the only accredited program for pediatric surgeons in East Africa, and a complementary program for nurses. In 2009 it performed more than 2,500 operations on kids with severe disabilities. Each month it runs 10 mobile clinics to outlying areas, including refugee camps in the north where over 300,000 mostly war-displaced people from Somalia, Sudan, Ethiopia, and Eritrea live. "We are the only hospital that is doing this kind of work between Cairo and Cape Town," said Bransford.

The work doesn't end with discharges. BethanyKids has set up a network of volunteers throughout Kenya to do follow-up care. That includes basic preventative procedures for infection, checking on post-op care, and discipling patients in the gospel. Through that follow-up, Bransford said, volunteers see hundreds of converts to Christianity each year.

What's also unique: BethanyKids runs the program for just under $1 million a year. A spina bifida operation that costs $50,000 in the United States costs $500 here, and Bransford receives the $70 shunt (along with many other supplies) for free.

But as Bransford likes to say, "The only sure thing here is change." This fall Dr. Albright arrived at Kijabe to assume Bransford's role as professor of pediatric neurosurgery-making way for Bransford's anticipated stepping away from full-time duties at the hospital in 2011 (he changes the subject if the word retirement is mentioned)-and a likely move back to the United States.

"Our role is reproducing ourselves, whether it's spiritually by leading people to Jesus Christ or medically in trying to find people . . . willing to use the skills they have and leverage them into more skills," Bransford told me.

But he and others at Kijabe worry that U.S. medical education isn't preparing doctors for work in Africa and elsewhere. U.S. training is "state of the art," said Bransford, and doctors end up with an education so expensive they can't afford to think of serving anywhere except a specialty practice with large fees and steep overhead: "We need to say, "What's in that for Africa? What's in that for the poor, the hurting, the unsaved?"

Mark Newton, an anesthesiologist coaxed to Africa by Bransford, has served at Kijabe for 14 years. He believes in the longer investment: "This hospital is like this because people have committed for long periods of time. Dick's been here a long time." Doctors who come for short or long periods, said Newton, also need to train others. "The educational system that's built up here is the result of doctors staying here and working and investing in the next several generations."

I asked Bransford, are you worried that a new generation will commit three to four years to a place where you've made a 40-year commitment?

"My concern is not skills. It's relationships. With the type of work we do, if we don't have that bond with the moms or the parents, we really can be hurting, not helping," Bransford said. "That's part of the threat to us-and part of the privilege. Part of what keeps you driven here is building relationships. And it's hard. But if you have people without relationships, no matter how good they are medically, they won't succeed."

Relationships are front and center at Joytown, where Bransford, his surgical duties curtailed, now spends at least one day a week. BethanyKids took over helping to operate the boarding school 10 months ago when Kenyan government support dropped off. Started in the 1960s by the Salvation Army, it has a defunct swimming pool once used for therapy, a wealth of stray wheelchairs in disrepair, and only three physical therapists with two assistants to cover the needs of 340 mostly primary-school-aged disabled children.

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