Blessed by a godly Father

In this day and age, it is no small thing to say "I am so thankful for the blessing of a godly father." My dad (Leo L. Pepper, Jr.) is the very best. And I am truly blessed!

I have learned so much from him over the years, through watching his life, from listening (wished I'd listened more as a teen), from hearing stories from and about him.

Of the many things he has taught me, the first is the importance of loving Jesus.  Dad became a follower of Jesus not long after he married mom (1950) and hasn't stopped following Jesus since. Through his life as a follower, I learned much about authentic Christianity.  Not just about 'religion,' but about knowing Jesus.

He taught me the importance of taking time daily to read the bible and pray.  But even more than that, to ask myself what/how that teaching should apply to my life.  I can still hear his and mom's voices early in the morning (before 5AM) as they read the "Our Daily Bread" together and prayed before he left for work.  I have many mental pictures of dad at his desk reading his bible and making notes.  When he discovered something good, he would share it with us.

He showed us (my brother and sisters) how to love through his loving mom.  This year August they will reach 62 years of marriage!

He taught me the importance of work, of giving your very best at it, of living your faith at work, not just on Sunday mornings. To try to do things, even when you weren't exactly sure how to do it.

He taught me to fix things, to take care of things, and always to return a borrowed item in a condition better than it was when you got it (by cleaning it, etc.).  And not to be wasteful.

He taught me to laugh, and to just plain have fun.  Growing up we had many great family vacations together.  He has loved Sally and our kids and has demonstrated that love by regularly praying for us, through making special things for the kids, and being a fun grandpa.

He taught me to not only love family, but to live in a way that our family name would always be respected.  I'm proud to be a Pepper.

The past 4 years have not been easy for my dad.  He has gone from a very healthy man that walked around Clarksville every morning praying as he went, to now walking short distances with a walker.  He has suffered a lot, he's been through some dark times, yet he has persevered.  I am so thankful for these coming months as Sally and I are living in the same apartment complex as mom and dad and almost daily having the opportunity to spend time with them.  I still have a lot to learn and I am ready for more life lessons from my dad...

I love my dad!

Ultrasonic Blessings

Dr. Justin at KBH

Diagnostic ultrasound is such an essential tool for us at Kigoma Baptist Hospital.  Our primary diagnostic tool is the standard physical exam and history(using our hands and our head), but there are times when we need more.  We have a standard X-ray machine which is great for chest  X-rays and broken bones.  For a number of reasons which I won' t go into, we have very limited laboratory capability.  So, having a working ultrasound machine and ability to scan and understand what you see becomes very very helpful.  It helps us look inside the heart, visualize other organs like the liver, gall bladder, kidneys, pancreas, bladder, uterus, and do OB scans. I and a couple of my colleagues have been scanning using a large, hardly portable, very old machine.  It was working, but as my friend Dr. Justin said, it is like driving a Pinto when you could be driving a Mercedes. There is so much that ultrasound is now being used for.  In the weeks before we left Kigoma Baptist Hospital i was scanning every day evaluating heart failure, fluid on the lungs, liver disease, kidney problems, etc., as well as doing 1-2 OB scans/day. 

But that's not the good news.  The good news is that through our partner organization, Baptist Global Response (http://www.baptistglobalresponse.com/), we received funding to buy a new portable Ultrasound machine!  

Then to top that off, Sonosite Corporation (US makers of ultrasound equipment), provided us with an incredible discount through their global health compassionate care program.  Kigoma Baptist Hospital now has an amazing MicroMaxx portable ultrasound machine with cardiac, abdominal, and intracavitary probes, extra battery, and carrying case.  This machine was designed to take quite a beating and work in all sorts of environments.  Needless to say myself and our other clinicians are excited.

So you want to hear more good news?  Last week I had the opportunity to travel to Mayo Clinic Rochester and attend a four day intensive course on echocardiography (heart ultrasound).  It was  excellent training by some of the world's experts.  (I am so thankful for our mission organization's program to assure we maintain the needed skills and training in our areas of work.)  While at the Mayo training I had a very short hallway meeting with one of the doctors running the program.  I briefly shared with him a few of our challenges a Kigoma Baptist Hospital in regards to echocardiography.  He thanked me for sharing and said 'write to me to tell me more please...'

So I wrote to him after returning to Michigan.  And today I received by FedEx a box with 32 echocardiography training DVDs and a signed copy of his echo book!  All of it  'Complimentary of Mayo Clinic Cardiology Education'. Amazingly huge blessing.  These materials will help me with further training and be used by my colleagues as I teach them what I have learned at Mayo Clinic.

Our prayer is that in the end we will be making better diagnoses, and God willing, with this echo information, better treatment for our patients.  And not only echo, but all types of ultrasound diagnoses with our new machine.

So, while in the USA, in addition to sharing in churches what God is doing in Kigoma Tanzania, I will be reviewing echo DVDs, reading the book, and doing as many echos/ultrasounds as I can.  

As is so often said in East Africa, 'God is good, all the time!'

A brief note: Just so I haven't totally confused some, Sally and I are now in Michigan on our Stateside Assignment until after Christmas.  Hope to see you while we're in the USA.

Daily by His grace,

Larry and Sally

Back in time for graduation!

Sally and I are now back in the USA for our stateside assignment.  As you can see by the pictures, the first event was to celebrate with Kelly her graduation from Taylor University.  We are so proud of her.  We thank God for how she has grown in her spiritual, academic, and social life while at Taylor.  It truly has been a 'perfect' match for her.  Transitioning from academics to working is not easy, especially in the current economic environment.  Kelly is searching for jobs, but for now will be living with us.

So where are we?  We are living in Charlotte, Michigan.  Our apartment is above where my parents live so it makes it easy to check on mom and dad and help them.  They, along with Sally's mom, are getting older and need our help.

So what will we be doing?   Our assignment is to share what God is doing in the amazing work of  transforming lives of the people of Kigoma, Tanzania where we serve.  We will be sharing those stories in churches, camps, missions conferences, medical missions meetings and any place that we are invited.  

Also, this is a time to be with family.  In addition to seeing Kelly graduate, in August we get to see our son Adam graduate from Physician's Assistant/MPH graduate program.  Then in September Adam and Brianne will get married in Midland, Michigan.  So it will be a great summer.

In addition, I will be doing some training in Ultrasound and getting needed continuing medical education credits.  Sally will be getting certified in teaching English as a Foreign Language (EFL) as that will be part of her ministry when we return.

When will we return to Tanzania?  God willing, our plans are to return to Kigoma after Christmas.  This is a longer stateside assignment than our usual, but this is our time to help family, celebrate what God is doing, and share His message of hope.  

How can you get in contact with us?  Right now, email is probably the best as we are still sorting out cell phones.  We would love to hear from you and maybe we will be traveling to your area.

What happen with the water?  Lastly, I am so excited to share that Kigoma Baptist Hospital now has two working water wells.  Thanks to Mr. Don Reed and his team at Open Doors Enterprises, we not only have clean drinking water but new tanks and the water is piped to each of our buildings!  It is a HUGE blessing.  God is good.

Daily by His grace…

Larry and Sally

Faith Dialogues

Ever want to start a dialogue with a friend but weren't sure how to start? Or maybe you wanted to start a conversation but were concerned it would just deteriorate into a angry debate?

This Saturday we will host around 200 interested Followers of Jesus Christ from the Kigoma/Ujiji area and surrounding villages in a training session on how to begin Faith Dialogues. Where ever you live there are lots of "religious people" around. For us, We live in an area among people that share some similar Holy Writings. These shared Holy Writings form a basis for beginning Faith Dialogues.

On Saturday, Sally and I ask that you take time to pray for this group as we learn from someone who has been doing this for some time and seeing God work through it to open eyes and hearts to see the beauty of God in the face of Christ (2 Corinthians 4:4-6). Our plan is not only to learn something new, but to go out and share it immediately that afternoon. Pray too that the logistics don't distract from the purpose.

We are really excited about what God might do through 200 faithful followers...

Daily by His grace,
Larry and Sally

Sent from my iPad

What are you drinking?

How many times a day do you go to the sink, turn on the cold water, and drink, not thinking if it is safe water or not.  Safe drinking water is not something that is readily available in many parts of the world.  

Everyday at the hospital I see kids and adults that are sick because of bacteria and virus contaminated water.  Only a few in this part of Tanzania have safe clean water.  Others rely on buying water that they have been told is clean.  Others just use what they can get.  Even though most know to boil water, they don't because of the cost of firewood or charcoal.  So we continue to treat all sorts of water borne diseases.

But good news!  Don Reed, a missionary with Open Door Enterprises (http://www.everypeople.org/Every_People_%5Bopen_door_enterprises%5D/Water.html)  and his team of well drillers will begin drilling a well for us at the hospital on Monday (12th March).  When they walk away, we will have clean water piped in to the surgical area and for the maternity ward.  We will have one or two large storage tanks and a pump that fills the tanks at 25 gallons a minute.  

Asking that you pray with us for safety as they drill, that the new compressor system will give them even more power to drill, and that they will find great water.  Don told me yesterday that he thinks they will need to drill to about 170 feet.

We are so thankful for Don and Sarah and their commitment to see Tanzanians have safe clean water.  Provided our internet works, I'll post pictures on Monday as the work commences.  

Just remember us the next time you take a deep swig of cool refreshing water…

Daily by His grace.

Larry and Sally

Lots of opinions

Ever talked with a group of doctors and got more opinions than the number of docs? This week I feel so blessed to be part of a group of over 235 medical missionaries from all over the continent of Africa and 105 visiting teaching doctors and staff from the USA/Canada. I have gotten lots of opinions on various "problem cases" that i have been facing at our hospital.

The meeting is the 32nd CMDA gathering. It provides me with a source of CME (continuing medical education) credits which I need to maintain my Tanzanian and American medical licenses. But even more than the great teaching is the opportunity to fellowship with other medical missionaries and talk about various challenges that we face. We are blessed too to have a visiting pastor speaker for our morning chapel service. It is so awesome to sing praises to God together with 340+ health care professionals. It is humbling.

Sally and I are here together as CMDA has a spouse program as well. She has been blessed to be together with 40 other spouses.

We are so thankful for the support we have from our organization to attend this meeting every two years. Well, another lecture is beginning so I better go.

Daily by his grace...

Ultrasound Training in Kigoma

So, what are the odds of an American specialist radiologist giving up 10 days of practice and family to come to the 'far West' of Tanzania to teach ultrasound?  Not likely...but hey, you don't know how God works.  In August, I put a request in through Baptist Medical Dental Fellowship (www.bmdf.org) for help in teaching us how to use our 1997 ultrasound machine.  That month, it just so happened that Dr. Justin was attending a medical missions meeting in Texas (he's from Mississippi) and heard of our request.  He notified BMDF of his desire to talk with us.  We began emailing and he and his family decided that his coming to Kigoma Tanzania was part of their ministry. 

January 23rd he arrived in Kigoma (5 flights from home) and began teaching.  For 5 days he did as many kinds of ultrasound studies as possible on a variety of patients (kids, teens, middle aged, elderly, pregnant, etc.)  In the months leading up to his arrival we had prepared a list of patients needing an ultrasound scan done by him, and also as a way to check my scanning abilities and interpretation.  We have a very busy Out Patient Department (OPD) and so had plenty of other patients to ultrasound.  It was days of hard work as the machine at the government referral hospital is broken and patients were coming for scans.


 Our machine is old but still works.  Justin showed us how to use it to the best of it's capabilities, and our various abilities.  I had been self-teaching for several months and had learned some, but having Justin with us was amazing!  He's a great teacher, very patient, and loves to serve God through his skills and compassionate care for the sick.

We had 5 days together starting with morning coffee, a quick check on the ward before heading to chapel, staff meeting and then a FULL day of ultrasound.  The first three days Justin spent teaching our other staff.  The last two days I did 'immersion' training. Justin had me doing scans with various probes, checking my techniques, correcting bad habits, and helping me to properly interpret what I was seeing.  I have to say it was challenging but fun!  Having this capability really helps us as we have very limited laboratory capabilities right now to help in diagnosis.  Of course, 75-80% of a diagnosis comes from the history, and then more from the physical examination of the patient, and then finally lab and X-ray and other tests help to confirm the diagnosis. 


Besides teaching ultrasound, Justin also shared a bit of his personal life story as to why he had come to Kigoma, his love for God and his desire to follow the example of Jesus Christ in preaching and healing.  I had the opportunity to be his Swahili translator when he spoke in chapel, a first for me.  The staff appreciated his teaching, and especially his story of why he came and how he loves God.


I'm excited to continue to learn more of ultrasound.  I will be doing a one day ultrasound training course this next week as part of the Christian Medical Dental Assocation meeting here in Kenya. I am searching out options to do more training when we are back in the USA later this year. One deficiency of our machine is that we don't have a probe to do cardiac ultrasound.  I am trying to find one through sources in the USA so we can have the capability to do cardiac ultrasound as there is a lot of heart disease in our Area.  Hopefully one day we'll have a newer ultrasound machine but for now, we use what we have. 


Sally and I are so thankful that Dr. Justin could come and help.  We are excited about future collaboration.  Thank you Dr. Justin!


Daily by His grace...

Hit the ground running...

Got back from our whirlwind trip to Michigan, very happy to have seen our family and help out with the care of our parents, and already are going full speed.  Apparently in the month of December, many people in the community have decided that our hospital provides better care than the regional referral hospital and our numbers have sky rocketed. 

From Jan 1st through the 9th we provided care for over 800 outpatients and numerous inpatients.  Mondays have gone from 80-90 patients in OPD to 130-150.  Not to brag but I've treated 420 patients in OPD over the past 9 days.  Part of the increase in patients is because it is malaria season here.  Every day we admit children with high temperatures (often over 103F) because of serious malaria infections.  Almost all families have insecticide treated mosquito bed nets but still kids get bit in the evening before sleeping and so problems of malaria continue.

I thank God that our good reputation continues to grow in the community. We hope sometime this year to reopen the maternity ward to provide even more services to the community.

Sally and I are excited that next week Dr. Justin will arrive from Mississippi.  He will be teaching many of us ultrasound skills and doing as many scans as I can convince him to do with us.  We are so grateful for his willingness to come and help us as it is a big cost in many ways to him and his family.  We have numerous patients booked for scans.  In addition to myself there are 4 other doctors who will be trained and at least one nurse.  Five days of intense teaching will give us a taste of U/S scanning and hopefully will improve greatly my self-taught skills.  We are using an old machine but it is working for now.  We hope someday to get a newer one that will allow us to do cardiac scans as well.  If you happen to know someone with a spare U/S machine to donate to the hospital let me know.

The other thing I am excited about it to have gotten a really cool teaching set of MP3 files from cardiologist, Dr. Michael Barrett.  He graciously gave us permission through the American College of Cardiology to have these training files that teach about heart sounds.  The files called HeartSongs 3 are his brainchild (www.cardiosource.org).  He has a passion for teaching and has helped countless students, interns, and residents to gain the skillls necessary to recognize various normal and abnormal heart sounds.  When I was back in the USA I picked up two MP3 players and now our doctors are listening to the files to improve their skills.  Thank you again Dr. Barrett! 

Finally, I want to share with you about one young boy that I admitted today.  At 4-1/2 he began to have problems breathing in December.  He hasn't been able to play with other kids his age because of fatigue and breathlessness.  He got treated for malaria because of a fever but still hadn't gotten better.  His mom brought him to the hospital today.  He was breating at a rate of 70/min.  His heart was racing at 100.  Yet he was smiling.  One of the other doctors had examined him and asked me to see him too.  We discovered he had a very loud heart murmer and early signs of pulmonary edema (water on the lungs).  We checked his oxygen saturation and it was only 33% (normal >95%).  We admitted him and got him on oxygen that is provided by a machine called an oxygen concentrator.  It takes room air oxygen and concentrates to a higher percentage.  After some medications and the oxygen his saturation had risen to 65%.  By the time I left the ward his breathing rate had slowed down a bit, and his saturation was now 80%.  The challenge now is to get him stablized and then find a way for he and his mom to travel to another hospital for echocardiography (heart ultrasound) and most likely surgery.  Just to share with you what the social challenges are here, the mom has one other child.  The dad is studying in a city about two days away and they don't have the money to take the child to the other hospital.  We will begin tomorrow to encourage them to hold a family meeting so they can determine the way to get the funds to take him to the referral hospital.  The extended family will be asked to contribute. It is the way that things are done here.  I would ask you to pray for this little boy (Kambugwe) and his family. 

Will write more and post some pictures once Dr. Justin arrives and the fun begins.  Meanwhile, I would ask you to pray for all of us at the hospital as we continue to provide compassionate quality care for very needy and sick people. 

Daily by the grace of God...