Always Mercy, a nonprofit, Christ-centered organization dedicated to helping the poor and needy of Kenya, was founded in 2022 by Pamela Boehle-Silva, an RN and a Lutheran deaconess from Rocklin, California.

Rehema Open Door Hospice and Palliative Care Center: the first and only such facility serving 5 million people in the area of Kenya’s Homa Bay, is its main focus.

You can learn more, as well as about the organization’s history, mission, and other projects, at

It all started in 2006, when Pamela was invited to Africa by the Evangelical Lutheran Church of Kenya. At the time, the continent was in the grip of the HIV/AIDS epidemic.

Supported by her local congregation, Holy Cross Lutheran Church, and accompanied by seminary professor Arthur Just, she made the long trek.

“That first trip — culture shock!”

From the beginning, her favorite part was the home visits.

Pamela had dealt with death and dying before in her work as a nurse, but this was on another level: stripped of all Western medicine trappings.

There, she witnessed firsthand the devastating effects of poverty, shame, and stigma.

There, the women broke her open.

“They’d go into the mud hut of a sick person singing beautiful songs. They’d always bring something, even though they had virtually nothing themselves: a bag of tea or sugar, a handful of maize.

“They opened the door for me to cross the threshold into a ‘terrible beauty,’ as it were. I witnessed an overwhelming love and I wanted more of that even though it was painful. Because this wasn’t about me.”

With the support of Holy Cross Lutheran and numerous other supporting churches, organizations and individuals, Pamela has returned many times over the years — including three trips in 2022-23 alone — bringing Christ’s love to the deaconesses, pastors, and people of Kenya.

Her second visit was in 2008, again with professor Just. In light of the AIDS crisis, they educated church workers on palliative care, combining nursing skills with theology.

“Dr. Just taught about Luke and how the women cared for Christ’s body, both while he was alive and after death.

“They already had the body-mind-spirit connection, in the fullest imaginable sense: the women just hadn’t put a name to it.”

One difficulty was that death and dying, though daily realities, were simply not talked about. 

“There’s kind of a mythology there that if you talk about something you bring it on.”

But leading a discussion one day, Pamela broke the subject open. “A Kenyan deaconess tentatively raised her hand and — in an incredible act of courage — told about the death of her father. She’d never said this out loud.

“Then another woman raised her hand and told the story of her husband, who had died of AIDS. So we had this room of collective grief. Stories that had never been spoken, even to each other. These women had been suffering in silence. The power; the gift of that.”

The following year Pamela and Just gave a seminar on grief and loss. Always, the needs of the community guided their choice of subjects.

In 2011, having obtained a seminary-trained master’s degree, Pamela became a Lutheran Church-Missouri Synod (LCMS) deaconess.

In 2012, she instituted a water-filtration bucket system clean water program.

She and her colleague Pastor Chuchu also went to visit a Christian named John: a big, strong, handsome soccer coach with a huge festering wound on his chest. No pain meds. He was suffering from Stage 4 breast cancer, but the doctor had never told him because — this is another oddity to us Westerners — a physician who delivers bad news then gets a bad reputation.

“He grasped my hand and said, ‘I’m dying, Sister.’ I said, ‘I know, John’ … I got to sit and pray with him, but he passed away nine months later.”

Hospice care tends to be stigmatized in Kenya, so few such facilities exist. “Some feel that taking up end-of-life care indicates that you’ve lost faith in the power of a healing God to cure your illness.”

But Chuchu dealt with situations like John’s every day. He and Pamela realized they had to do something to help.

Thus, the idea was born for Rehema Open Door Hospice and Palliative Care Center.

Step by step, God led the way. The people showed up, the money appeared.

“By 2022, we’d found land and drilled for water, and 1 ½ years later we have a clinic building serving outpatients. Now we just need to build a kitchen before we can have overnight and long-term guests.”

Pamela hardly knows how it happened. “Even if this is all we ever finish, we have a clinic. We’re doing outpatient palliative and hospice care. That’s not for nothing. We’ll do the work that God puts before us. If it’s going to happen, it’ll happen.”

But the crown jewel consists of the women of Kenya, who have become Pamela’s teachers, mentors, and dear friends.

“They are selfless beyond anything we can imagine. Yet they always felt inadequate, as if they weren’t doing enough. If we’ve done nothing else, I think Dr. Chuchu and I have been able to show them that they embody Christ and his mercy.”