Hi Bob and Judy! Happy Jamhuri day! On December 12 Kenya celebrates the day it became a repupblic.

I am glad for a little break, it seems like things have been quite busy. You could say that I jumped back in the deep end, operating three days per week and taking call. I had noticed from previous years that the first two weeks of December are busier than usual, as people want to get everything "done" before the holidays. I expect one more busy week and then things will wind down quite a bit until after the new year.

To tell the truth I couldn't be happier, I missed working with residents so much. It's a special balancing act, knowing exactly how much autonomy to give to a trainee. They need to be left alone a bit to hone their craft, but you have to be right there when they are uncomfortable and need help. Through it all we have to keep the patient safe, and of course the operating room can't get backed up with slow operations either.

We've had some wild times already. A mass casualty with 8 patients from the same accident arriving all at once. Two needed surgery that night, we didn't' sleep at all! A seven month old with intussusception of the bowel when all the pediatric surgeons were out of town.

Infections, injuries and tumors of the head, neck, chest, abdomen and pelvis. And a daily encounter with an old friend who exclaims "You're back!" and tells me they have been praying for Adam and how is he doing? Yes, it's good to be back.

December also means another thing in Kenya: Graduations! We had one of our residents graduate, an excellent surgeon from Liberia named Dimingo Gomez. I actually hired him as a resident 5 years ago. Now he's done, but moving on to Pediatric Surgery fellowship here at Kijabe before he returns to Liberia. Actually during the graduation I looked around the room and was struck by how many of the surgeons there had been under my training at some point, going all the way back to 2007. What a joy and a privilege it is to be part of this process. I truly feel like I'm doing what I was made to do.

We are really looking forward to the holidays. Adam and Gabi will arrive next Saturday, along with Adam's girlfriend Diana. A friend of Gabi's will follow shortly afterwards. We'll show them our country, including the mandatory safari after Christmas. It's been quite strange to be a family of three instead of five and we are looking forward to being back together. Actually Gabi will stay with us for a few months at least, we are really looking forward to having her around.

I am hoping to upgrade our laparoscopic equipment so that I can pass on some of the skills I learned in Los Angeles to the residents. Our equipment is in sorry shape though; I am quite sure we could do more and teach more with some newer, better working equipment. If you'd like to help with this one time need, you can donate through https://friendsofkijabe.org where a donor will match all donations 1:1 until the end of the year. I'm hoping to raise around $30,000, anything above that will go to help a graduating resident start a laparoscopic program of their own at some other hospital.

We are so thankful for your support. It allows us to be here doing this work. We wish you all a very Merry Christmas!

Rich and the Davis family.