Kenya Day 4: Surgery Begins

The day began early, with the town already awake before sunrise. By 6:45 AM, our team was on the road to Nyamira County Referral Hospital, most dressed in scrubs and ready for the first day of surgery.

Trucks carrying medical equipment pulled through the hospital gates as patients arrived for admission. Inside, operating rooms were opened, supplies unpacked, and teams began preparing for the day. As expected, there were early adjustments as local workflows and visiting teams aligned, but with each case the process became smoother.

By midmorning, the surgical suite was active. Surgeons, nurses, anesthesia staff, and volunteers moved between rooms, transporting supplies and assisting where needed. Some patients who had not been screened the previous day waited quietly in registration areas, many accompanied by family members. Some would wait hours, and some would not be seen that day, but they greeted staff and volunteers warmly as people passed.

Between cases, surgeons continued screening additional patients in clinic spaces. Lunch was brief and informal, often eaten standing or between responsibilities. By late afternoon, the pace had steadied, and the waiting areas gradually thinned as screenings concluded.

Patient Story: James

Among the day’s patients was James, a sixteen-year-old boy who arrived with his mother, Lydiah, after traveling by bus at significant personal cost.

James was injured in a motor vehicle accident when he was three years old while traveling with his parents from Nairobi to Nyamira. All three were hospitalized for weeks. James’ father later died from complications related to the crash, leaving Lydiah to raise James and his three siblings on her own. Once a preschool teacher, she has since taken whatever work she can find while managing her own injuries and the demands of single parenthood.

James’ facial wounds never fully healed. Lydiah kept bandages on his face for years. When James was nine, doctors attempted a repair, but significant scarring and deformity remained. She shared that people are sometimes frightened when they first see him, though those in her village know him well. James enjoys soccer and singing and waited quietly in the preoperative area with his mother beside him.

Dr. Carol Ann Aylward met James in the preoperative area and marked his face with a surgical pen while he stood, allowing her to see how gravity affected the contours of his face. She explained the surgical plan carefully to both James and his mother—how she would release scar tissue pulling his eye and lip downward, reposition affected structures, and use a skin graft from his abdomen to complete the repair.

During surgery, dense scar tissue around James’ eye, nose, and mouth was excised to release long-standing contractures. His eyelid was repositioned, his lip tightened, and remaining defects were closed using a skin graft secured with progressive tension sutures to support healing.

James is now recovering in the male surgical ward, with Lydiah remaining close by. Resources are limited—food, bedding, and seating are scarce—and she has spent nights sleeping upright in a chair beside him. They will remain in the hospital until later this week, when his bandages and drains can be removed.

The first day of surgery was long and demanding. Systems were tested, adjusted, and improved as the day unfolded. Patients were seen. Operations were completed. For families like James’, care arrived after years of waiting.

Tomorrow, the work continues.

Byron

Gloria