Momentum, Challenges, and Purpose : Day 6
The day began early, with most of the team awake by 5:30 AM—rested and ready for another full operative day. Breakfast at the mission house included chocolate banana nut muffins and coffee, followed by morning prayer led by Cole Rutherford.
The morning was unhurried but meaningful. We spent time listening to stories from Kevin Weldon and others about past mission trips into the mountain villages—reminders of the long-standing relationships and impact of this work. Many team members also took time to call family back home, as evening hours in the United States allowed for connection across the distance.
Kevin has even unofficially named our team’s theme song: Work from Home—a fitting and humorous reminder of the work we’ve been called to do here.
We departed for the hospital at 7:30 AM.
Hospital Devotional – Grounded in Creation
The day at the hospital began, as always, with morning devotional.
Worship included “How Great Thou Art” sung in Nepali, followed by “This Is the Day the Lord Has Made.”
James Thomas led the devotional, reflecting on Psalm 19:1—a reminder that creation itself declares the glory of God. He encouraged us to pause and intentionally recognize God’s power and design in all things, connecting the message directly to the meaning behind the hymn we had just sung.
Surgical Momentum
The operative day began with strong momentum.
Case 1 – Total Knee Arthroplasty
Smooth, efficient case
No issues or unexpected events
Case 2 – Total Knee Arthroplasty
Completed without complication
By lunchtime, the team had successfully completed two joint replacements, reflecting continued improvement in efficiency and workflow.
Lunch was provided by the hospital staff—dal bat and chicken—which the team gratefully enjoyed.
Unexpected Challenges
The afternoon brought a familiar reminder of the realities of mission work.
A hospital-wide power outage interrupted operations, delaying sterilization of instruments needed for the third case. What was expected to be a short turnaround became an approximately three-hour delay.
Even after resuming, intermittent power issues persisted, including disruption during a sterilization cycle for instruments needed for the following day. The cycle was restarted and has since proceeded without interruption.
These moments highlight a recurring truth: even with careful preparation, resource limitations and infrastructure variability require constant adaptability.
Pressing Forward
Despite the delays, the team remained focused.
Case 3 – Total Knee Arthroplasty
Completed successfully
No complications
We were also joined today by Dr Abhisekh Girele, a Nepali orthopaedic surgeon trained in India with experience in both Mako and OrthAlign systems—further strengthening the collaborative nature of this mission.
Even in the midst of long hours and complex cases, moments of joy remain.
Throughout the day, British Foster could be found “keeping a close eye” on the OR—quite literally—frequently peeking through the operating room window to check on the team’s progress. Safe to say, no case went unwatched.
Patient Care and Outcomes
The results from the past two days continue to be encouraging.
All patients from yesterday are up and walking.
Pain is well controlled.
Patients are comfortable, functional, and happy.
Today’s first two patients were also able to ambulate with therapy after their spinal anesthesia wore off—an early sign of strong outcomes.
In addition to operative cases, Dr. Tim Randell and Jason Rolfe evaluated two additional patients, both of whom were deemed appropriate surgical candidates and cleared by anesthesia for upcoming procedures.
One especially meaningful moment came from Mrs. Nani, our first arthroplasty patient, who expressed deep gratitude and presented gifts to the team—a humbling reminder of the impact of this work.
Commitment Beyond the OR
As the day concluded, most of the team returned to the mission house. Jason Rolfe and Cole Rutherford initially remained behind to assist with a patient in the PACU who had elevated blood pressure despite good pain control.
Through prompt evaluation and management, the patient’s blood pressure was successfully stabilized, and they were able to return shortly afterward—another example of the team’s commitment to thorough, attentive care.
Closing the Day
Back at the mission house, the team gathered for dinner, rest, and devotional.
Cole Rutherford led the evening devotional, sharing a heartfelt personal testimony that powerfully demonstrated the redemptive grace of God. It was a meaningful and humbling time for the entire team.
Reflections on the Work
A clear theme continues to emerge: the greatest friction point is not clinical—it is systems and resources, particularly sterilization and infrastructure.
Even when fully prepared, unforeseen challenges arise—requiring the team to pivot, adapt, and problem-solve in real time to deliver the level of care these patients deserve.
Yet, through each obstacle, a solution has presented itself.
There is a growing and undeniable sense that we are here with purpose—that this work is being guided beyond our own efforts. The gratitude of patients and families reinforces that we are simply instruments in something greater.
“The heavens declare the glory of God; the skies proclaim the work of His hands.” — Psalm 19:1
We are grateful to be part of that work.
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