Dr. Leona O’Keefe had recently wrapped up her residency training in California, with a specialty in family medicine. She and her husband, Tim, a mechanical engineer, were enjoying the new adventures of parenthood with their 5-month-old son, Jack.
In South Carolina, Dr. Josh Riggsbee had completed similar rigorous training in family medicine. His wife Sarah, a speech therapist, was relishing her primary role as mom to the couple’s two young children, Chloe, 3, and Eli, 1 ½.
“Whom shall I send, and who will go for Us? Then I said, ‘Here am I! Send me.’” –Isaiah 6:8
Both physicians sensed God leading them toward a career in missionary medicine. The first phase of their dreams came true when they were accepted into World Medical Mission’s highly regarded Post-Residency Program. Launched in 2004, the program has sent 125 doctors and dentists and their families to serve in mission hospitals following their residency or fellowship. The two-year assignments provide opportunities for young physicians to receive valuable experience as they prepare to become long-term medical missionaries.
Most of Nepal’s medical services are concentrated in Kathmandu and other urban areas. For rural residents, steep mountain terrain and poor infrastructure limit accessibility to basic healthcare. Others simply cannot afford treatment.
Tansen Mission Hospital was established in the early 1950s to help meet the needs of people living in the Palpa district of southern Nepal. Because of its reputation for compassionate and quality care, the hospital’s service area now stretches from the western sections of the country to northern India.
In 2015, Tansen admitted over 12,000 patients, performed more than 7,000 surgeries, and delivered 2,367 babies. Over 96,000 patients were seen in the clinics.
She may have one of the most fulfilling jobs in the hospital. Dr. O’Keefe spends most of her time in the maternity ward, helping to bring precious little boys and girls into the world. She also works with gynecological patients in the clinic.
“One of the scariest experiences I have ever had as a physician occurred in Tansen and turned into a beautiful miracle. I was called to the emergency room for a first-time mother who arrived fully dilated and partially delivered. The baby was breech, which always warrants a Caesarean section in a first-time mom due to the extremely high risk of a lack of oxygen to the baby and possibly even death.
“Sure enough, it was a very difficult delivery. The baby’s head became entrapped, something I had never previously had to deal with. I thought for sure the baby was going to die in my hands with the head still inside. I just kept praying out loud and trying. Miraculously the baby delivered and went home earlier than expected and seemed to be completely normal.”
“I’m doing procedures that I didn’t get trained to do in the United States, learning to treat diseases that I only read about, and struggling to communicate in another language. My comfort boundaries have been stretched in plenty of ways.” –Dr. Leona O’Keefe
“Another woman delivered at home, as do the vast majority of women in Nepal. The baby was doing fine but the mother was experiencing severe headaches. Even after she began having seizures, her family said she would surely die if brought to the hospital. Instead, they entrusted her care to local witch doctors.
“Fortunately, someone in the family finally brought her to us three days later. Her postpartum eclampsia was successfully treated, only to be followed by a severe episode of postpartum psychosis. Even our non-Christian co-workers saw that there was a spiritual element at work. The patient and her family were prayed for and witnessed to. The patient later said she recognized that she came to our hospital for a reason and was going home a changed person.”
“There was a lot of learning to be done after finishing my training in the States. You learn how to be a doctor one way, but when you come here, you have to learn how to be a doctor a little bit differently,” Dr. Riggsbee said. “We have less resources here as far as testing and medicines. We see diseases that you don’t see in the United States.”
As a general practitioner, Josh works throughout the hospital. He spends the majority of his days in the medical ward but also assists in the male and female outpatient clinics.
His greatest challenge, however, did not take place inside the four walls of the hospital. After the April 2015 earthquake, Josh joined a Samaritan’s Purse medical team that ventured into remote villages to assess damages and treat the injured. He was in the Dolokha district in May when the second major earthquake occurred.
“We were trapped on a road, and we were surrounded,” he said. “Landslides were coming down on each side of us. We were trying to figure out how to survive as the rocks were coming down, some to the sides of us, some over our heads. When you are facing something like that, you have the opportunity to completely lift the situation up to God and say, ‘We can’t do anything else, God; this is all You.’
“To come through that and to have the provision to hide under a small cliff edge and eventually to be able to run away and get to a safe place, just to know that God was with us the whole way, it was the ultimate high. To see that God is bigger and He has something big for our lives, even if we don’t know it at the time. It’s been neat to see some of the good things that have come out of that experience.”
Tim’s mechanical and biomedical engineering expertise fulfilled an unexpected but critical need at the hospital. Initially his role involved repairing and maintaining medical equipment—practically a full-time job in itself. He also took care of young Jack at home while Leona treated patients in the maternity ward or outpatient clinic.
Before the O’Keefes came to Tansen, plans were already underway for the hospital to construct an underground storage tank capable of holding one million liters of water. When the project manager left, Tim inherited the job.
Around the same time, hospital officials recognized the need to build an on-site oxygen generation plant. Oxygen had always been expensive to haul into the mountains. India’s blockade of fuel and other materials into Nepal made it all the more apparent that Tansen needed to produce its own oxygen supply.
“Some days you feel like this is ridiculous and crazy. Other days you say, ‘Wow, what an amazing privilege it is to be here.’”–Tim O’Keefe
In February, Tim gave a tour of the construction site to Samaritan’s Purse staff from Boone, pointing out the location of the recently completed water tank and discussing the early stages of work on the oxygen plant.
“It’s been a lot of fun to work on these new projects,” he said. “We have shored up our water supply system. We’re going to try to build a new incinerator for our medical waste. These projects are very exciting, and I think it is very important for the hospital moving forward to be able to get some of this infrastructure in place so that we can provide the quality care we want to provide.”
Tansen Hospital recently started a neuro-rehab ward to provide therapy for patients who have suffered strokes or sustained traumatic brain or spinal cord injuries. Many cannot feed and dress themselves. They are unable to walk or even sit up in bed. Some have difficulty speaking or swallowing.
Sarah and Josh are contributing their unique skills to the hospital’s rehab team of therapists and nurses. Without therapy, people with neurological damage may end up spending the rest of their lives confined to a bed, completely dependent on others. The Riggsbees enjoy building relationships with their patients and encouraging them to move forward despite their handicaps.
“We have compassion for our patients. In the Hindu culture, there is the belief that if you have a serious illness, it’s because the gods are disfavored with you. I tell the patients, ‘This isn’t because of your karma. This is something that has happened, and we’re going to help you create a new life.’” –Sarah Riggsbee
“One of the best parts about rehab is you don’t see a patient one time and write a prescription and then you’re done,” Sarah said. “You see them multiple times for therapy. They come back as outpatients after a month or two and then you get to follow up with them and really get invested in their lives.”
Arjun, one of Sarah’s patients, fell out of a tree and suffered a traumatic brain injury. At first, all he could do was open his eyes and try to move his hands. With a combination of physical, occupational, and speech therapy, over time he started moving purposefully and talking again.
“He really turned the corner in recovery one day when he was able to talk to his mother on the mobile phone,” Sarah said. “She was home caring for his siblings while his father stayed in the hospital with him. The day before Arjun’s discharge from the hospital, he figured out how to snap photos on my phone and took lots of selfies, smiling all the time!”
“We don’t have to be fearful for our kids here,” Sarah said. “The neighbors all know them. One day right after we moved here, Chloe and Eli decided to ‘run away’ because they wanted to come to the hospital. The neighbors saw them and told them, ‘No, you have to go home,’ and they brought them back.
“Eli has just turned four. When you ask him, he says he’s Nepali. Eli goes to Little Lambs, which is a Christian Montesorri school in Nepal. The owners of the school actually are pastors at one of the two churches in town. Eli loves it. He started when he was two, so he has almost finished two complete years of school there. He’s got one notebook of Nepali letters that he’s learning and one notebook of English letters. He comes home at lunch time. The Nepali school day goes to about 4 o’clock, but we bring him home at lunch so he can have a little time in English and some time to relax.”
“There are other Americans here, but Chloe was the only American in school with British, Australian, and German kids,” Sarah said. “Her teacher is Scottish. She goes to an expat school on the hospital grounds. It’s called Tansen Tutorial Group. Every year we bring in an expat teacher who teaches all grade levels and all the kids. It goes from age five until age 11.
“It’s been a great experience for Chloe. Today she learned about Australia Day. I go in and teach the other kids about Thanksgiving and how to make pumpkin pie. They have never heard of it before.”
“We were really excited about Tansen, partly because Nepal has so few Christians,” Leona said. “We were really passionate about going someplace where there are not a lot of people that know Jesus. I think over 80 percent of our staff are Hindu, so it’s a neat opportunity for discipleship. I was expecting to be interacting with the patients more in terms of sharing the Gospel, but living out our lives alongside our colleagues who are not believers has probably ended up being more powerful in a lot of ways.”
“I would like to thank Samaritan’s Purse for being so involved in bringing good health to our people. That really means so much to us, especially the love that they show to our patients.” –Dr. Saroj Neupane
The past few months have been an emotional roller coaster for the two American families. After establishing strong ties with Tansen Hospital and the Nepali people, their two-year assignments are wrapping up. The O’Keefes returned to California in March. The Riggsbees head to the U.S. in mid-April.
Both families plan to return to the mission field. For now, Leona and Tim are looking forward to the birth of their second child—a brother for Jack—in June. The Riggsbees desire to go back to Nepal for long-term ministry. Their goal is to raise support to build a rehabilitation/physical therapy center for disabled patients at Tansen Hospital.
These young missionary families came to Nepal to bring hope and healing in Christ’s Name, to build relationships, and to make a lasting difference in many lives. Along the way, the love and graciousness of the Nepali people left an indelible mark in their hearts too.
“It’s been hugely humbling and a blessing,” said Tim O’Keefe. “We will never forget this experience.”