Sunday, December 20, 2009

New Gyn exam room

Having a gynecologist at Kapsowar is a relatively new thing – there hasn’t been one here for over 20 years. As such, word is spreading quickly and I’m seeing more and more gynecologic patients, which is a great thing. The not so great thing – there was no good set-up for doing a decent gyn exam (every woman’s favorite thing). I was making do with seeing patients in the ultrasound room and then if they needed a speculum exam, moving them to the OB triage room to a bed with no stirrups and using my headlight for a light. It was less than ideal.

So, one day I talked with Wilson, the head of nursing, about my idea to turn the office on maternity into a good gyn exam room. He was excited about this and ran with it. The old, monstrous computer table was replaced with a new slimmer model. A shelving unit was built for the wall to store textbooks and supplies. A new exam table was built to replace the one I took with stirrups from the outpatient area. I was given soak buckets for speculums. I will soon have exam lights. While it may not seem like much, it is a huge improvement and so much better now for me to care for the women here. So, thank you to those of you who have, and continue to support me. Because of your generosity, women can now be examined in at least relative comfort!



A Real Kenyan Wedding

A couple of weekends ago, I had the distinct privilege of attending my first real Kenyan wedding. It was a special one, too. Many of you might remember me writing in my blog a few months ago about reversing a woman’s circumcision. Well, this was her wedding. She asked me to come and ride in the bridal car with her, which is a huge honor. So, of course I went. Little did I know I would basically become part of the bridal party!

It started early Saturday morning as I boarded a matatu at 5:45am in Kapsowar for the 2 hour ride to Eldoret. I was told I had to be there early, because we were supposed to be in Kitale (about an hour and a half from Eldoret) for the wedding at 10. I was met in Eldoret by Lynn, one of the maternity nurses who was in the bridal party, and we went to Claire’s (the bride’s) brother’s house. There I was greeted by many members of the family (including the adorable flower girls and mini groomsmen seen below) who I was told had all eagerly been awaiting my arrival. It was great to see Claire as well. I settled in while they all finished (or began, rather) their wedding preparations. In true Kenyan fashion, 10 o’clock came and went and no one was even dressed yet. About noon, all the children sat down to eat lunch and about 12:30, the bride and bridal party finally emerged in all their glory. We then all piled into several vehicles that were decorated in flowers for the trip to Kitale. I rode in the front seat of Claire’s car (why the bride wasn’t in the front, I have no idea), which was a very nice Land Rover. After about 1 ½ hours (which included a bathroom/snack stop!), we arrived at the church in Kitale, where needless to say, everyone was eagerly awaiting the bride’s arrival (for about the last 2 hours).

There was no fanfare for the bride’s entrance, as we were so late, and the bridal party hurried right to the front. The service was similar in many ways to a Western wedding – a short sermon, vows exchanged, a kiss. There were, however, many additions, including a gospel choir that sang several songs, including one where the bride and groom danced, as well as several other “mini sermons” by other people in the church. Another thing I was delighted to see were some Pokot (a tribe in Kenya) people in traditional dress – including feathers on their heads, animal skin clothes, and lots of beaded accessories. Claire’s husband is Pokot and so these were his relatives. The Pokot people are a very traditional tribe in Kenya and the Pokot district borders Marakwet (where I live). They are herders and dress if very bright clothing and lots of beads. They also did some traditional Pokot dances at the reception. It was a true cultural experience!

After the ceremony, I was whisked away with the bridal party to a local agricultural center for pictures. Then it was back to the reception, where I was sat with the bridal party to eat. We enjoyed a meal of roasted chicken, pilau (a rice dish), chipate (flatbread), a cabbage salad, and soda. It was wonderful! It was a great day and I was so thankful to get to be a part of it. I’ve put some pictures below.

2 of the adorable flower girls with another relative
One of the mini groomsmen
The bride making her first appearanceThe front of the bridal car
The bridal party arriving at the church
The bride and her parents entering the church
The happy couple
The entire bridal party
Me with Claire
Rose (who will be an anesthetist at Kapsowar soon), Me, and Lynn
A Pokot woman


video

Thursday, December 3, 2009

Trip to Tenwek

Last weekend I decided to get away and go visit some friends at Tenwek Hospital. If you have read much about medical missions, you have probably read about Tenwek Hospital. It was started back in the 1930’s as a dispensary and became a full-fledged hospital in 1949 when Dr. Ernie Steury (a native of Berne, IN) arrived as the only doctor for about 300,000 Kipsigis people. It is now known throughout Kenya and throughout the African continent as one of the premier mission hospitals. It is much bigger than Kapsowar and has more capabilities as they have an ICU, a large NICU, and endoscopy. I have read about, and been inspired by, many physicians who have worked at Tenwek and have always wanted the opportunity to visit.

So, I hitched a ride with Dave into Eldoret (2 hours). Once there, I found a matatu (a 14 passenger van and main method of public transport here in Kenya) to Bomet (where Tenwek is located). I had previously been told that I would need to switch matatus in Kericho, but the driver in Eldoret assured me he would go directly to Bomet. “Ni pesa ngapi?” I asked (how much is it?). 650 shillings he told me. I had been told it shouldn’t cost more than 500 shillings (about $6). I told him this and he said it was more because I was going direct. “Is this what you charge Kenyans?” I asked. He laughed and assured me it was. So, I paid him and off we went. When we got to Kericho, about 3 hours later, he said I needed to change matatus. But wait, I said, you told me you would go to Bomet. No, he said, I needed to take another one. I made him pay the other driver what I had paid him for the remainder of the journey and followed him across several streets to get to the matatu to Bomet. But, I found a seat next to a very nice lady, so I figured it would be easy going from there on out – especially since I had been told Bomet was only about an hour’s drive from Kericho. Little did I know the driver would decide he needed to change a tire and then stop about every ¼ mile to let people off and pick more people up – at one point I counted and there were 26 people in the 14 passenger van! 2 hours and 45 minutes later, I arrived in Bomet. Thankfully, from there all I had to do was take a taxi for about 10 minutes and I was finally at Tenwek!

The people I was visiting were the Cropsey family and Alyssa Pfister, fellow post-resident physicians with World Medical Mission. Our paths have crossed as we all prepared to come to Kenya and we have stayed in close contact. It was great to see familiar faces and have guides around Tenwek, as well as a place to stay (thanks Alyssa!). The Cropsey’s children (Eliese, 2, and Micah, 10 months) were sick the whole weekend, which didn’t bother me, but did significantly impact John and Jessica’s sleep. They were still fun to be around, though, and helped me greatly, as I have been missing the Hubartt kids. We had a great time hanging out and exploring the area around Tenwek.

I was amazed as I saw this large hospital that not only serves as a witness to the many patients they see but also as a training ground for Kenyan physicians – training them to serve God through medicine. I also was extremely blessed by the church service there on Sunday as it was more like home with familiar songs. It was a wonderful weekend and I look forward to going back again soon (2 more post-resident families arrive there in December).


Part of Tenwek's mission station (just one small part - it's
much larger than ours)
The backyard haven at the house where I stayed
Cutey patootey Micah Cropsey
One of the kids on station feeding her chameleon a fly. What
a great way to grow up!
Part of the hospital. The large building in the back houses
the operating rooms.
Me by the sign at the entrance to the hospital - new for its
50th anniversary this year
A nearby waterfall. The hospital gets all of its power from
here - they have their own hydroelectric plant!
Alyssa getting into a book she was reading for the Cropsey kids

Wednesday, December 2, 2009

Saying Goodbye to Friends

One of the great things about Kapsowar is that we always have people coming and going from station. We almost always have medical students rotating here, from all over the world. From Oct – Nov, Kim and Eleasa were here. We were told they were Australian medical students – so I was very surprised when I first talked to them and they didn’t have a hint of an Aussie accent. Turns out, Kim is actually from Taiwan, spent her high school and college years in Canada, and is now in medical school in Australia. Eleasa was born in Hong Kong, grew up in Canada and is also in medical school in Australia. We are quite a multicultural bunch! They were a joy to have here and always provided smiles wherever they went. They are just finishing up their first year of medical school, and so everything was new to them, which was fun. We were so glad to have them here and sad to see them go. For their last night here, we presented them with some Kenyan clothing (see below) and watched, what else, “Australia”.

Another sad goodbye was saying goodbye to Ben and Cathy Sawer. They were here to fill in for Bill Rhodes, the long-time surgeon here who has been in the States (and returns in less than a week). They became like surrogate parents for me here and I enjoyed many long discussions with them, as well as Cathy’s weekly Sunday night dinners (chicken, stuffing, homemade biscuits, veggies, even smoked salmon!). They are incredible people with an incredible story of hope to tell, as they recently lost their daughter to breast cancer. You can read about/hear her powerful story and testimony at www.deathisnotdying.com. They made a lasting impression on all of us here and we were so sad to say goodbye. We’re hoping they’ll be back sometime!

As we said goodbye to the outgoing students, we welcomed 4 more (well, 3 plus a husband J). More to come on them later.


Eleasa (L) and Kim the night of their goodbye dinner
Me with Ben and Cathy



Tuesday, December 1, 2009

The New Theatre and Why We Need It

As many of you know, construction is currently going on to build a new theatre (operating room) building at Kapsowar. This is much needed as we currently only have one theatre (see previous blog about this). Just to re-emphasize our need for more than one theatre, I recently again did a C-section in theatre at the same time as a general surgery case (actually more a plastics case) was going on. This one had a bit of a twist though. At the end of my trying week, a young girl came to the hospital in labor with her first child. She was very young (probably around 14) and along with that somewhat immature and not able to handle labor well. We got to the point of pushing, but she was a very uncooperative pusher, to say the least. I tried a vacuum, but when that failed, it was clear she needed a C-section. So, we headed up to theatre (meanwhile, she’s thrashing on the bed and trying to pull out her IV). When we get there, Drew was doing a repair of some crushed tendons under local, but his patient was on the main operating bed. No problem, we’ve done this before. Only problem – the patient is too uncooperative to do a spinal, so we need to put her under general anesthesia and Drew’s patient is on the bed we need for that. So, we have Drew’s patient get up (while holding his arm above his bed) and Drew stays sterile. We have my patient move from the gurney to the operating table and then have Drew’s patient get on the gurney to finish his surgery. I can’t imagine what that poor patient must have been thinking as my patient continued to be completely irrational. Drew got his headlight so he could have decent light for his surgery, and we proceeded with our C-section. It was comical, now that I look back on it, but once again emphasized our need for more than one theatre.

Below are some pictures of the progress on the new building. It is quite an undertaking, as you can imagine. One of the biggest hurdles is that no materials are available locally, so everything has to be trucked in from at least 2 hours away. One blessing, though, is that it is providing much-needed jobs for people. They work very hard, as you can see in the pictures, for 200 shillings/day – that’s about $2.60. Every morning they have devotions together before starting work, which is providing much needed spiritual nourishment for them as well. I look forward to continuing to share pictures of the progress with you. Please keep the project as well as Dave Peterson, the contractor, in your prayers.


Smoothing out the newly poured concrete
This is hard work, as you can see, and all done by hand
Dave supervising the work in his mud boots - an essential here

Saturday, November 21, 2009

Hope and Belief

This is the beautiful rainbow that I saw just before I sat down to write my last blog. Once again, I’m amazed at the beautiful reminder the Lord gives us of His hope. Thank you all for the prayers and the comments after my last blog. The prayers have definitely been felt! Last weekend was restful and a time of refreshing. During Bible study last Sunday, a comment was made that went something like “Belief is stepping out of the door into the dark”. This really left an impression on me, especially in light of that tough week. God calls us to step into the dark sometimes – to go places we are totally unsure of, not confident of, so that His power can shine. It was an encouragement to me to trust Him even when I’m called into a situation or to do something that I’m not comfortable with or feel inadequate to do. I pray that this thought will encourage you as much as it did me. As a side note, the Lord blessed me with a fairly quiet week this week. I am currently at Tenwek hospital (a large mission hospital in Bomet, Kenya) visiting some friends, which is also a blessing. I’ll post more on that later.

Sunday, November 15, 2009

A Paradox

I am now nearing the end of a weekend of rest after what has definitely been the hardest week I have had here in Kapsowar. I had a wonderful time this morning worshiping with my new church family here and marveling in the sounds of about 200 Kenyan children as they praised the Lord with their voices. And now, as I type this, there's a beautiful rainbow over the valley outside my window - a reminder of the Lord's promise that He loves us and is faithful.
So, this was a very full week. Every day seemed to bring many surprises and emergencies. There were emergency C-sections, retained 2nd twins after a traditional birth attendant allowed a woman to labor at home knowing she had twins, too many D&C's to count including a couple that were in shock. On top of all of that, Ben and Cathy Sawer, who I have written about before, left to return to Canada. They left a hole here on station and we were all very sad to see them go.
The most consuming patient of the week was a 19 year old girl - we'll call her V - who was transferred from a health centre where she had delivered her baby prematurely and then developed postpartum hemorrhage. When she arrived at Kapsowar, she was hypotensive and had a hemoglobin of 6 (should be at least 12). She was given blood and seemed to improve a bit. Then, her blood pressure became high (probably what it was before delivery) and she complained of a severe headache - she had severe pre-eclampsia (toxemia). Who knows how long she had had it. So, I started her on appropriate therapy and she seemed to improve. Then, on Thursday, I noticed that her abdomen was becoming distended. Her exam was consistent with ascites, which can come from the liver being affected by pre-eclampsia. On Friday, it was markedly distended and an ultrasound confirmed that she had massive ascites. We decided to drain some of the ascites to make her more comfortable. As I was coming to do that procedure, I noticed that she all of a sudden was not very responsive, responding only to pain but not able to communicate. This was a definite change from how she had looked just an hour before. We quickly did what we could, but decided she needed to be transferred to Eldoret - a 2 hour drive and the closest ICU. One problem - our only functional ambulance was currently in Eldoret. So, we had to wait for it to get back in order to transfer her. We prayed over her and reassured her scared husband that we were transferring her where she could get better care. As we saw her off, I had a bad feeling. Why had she suddenly worsened? Was there something else I could have done? Should we have transferred her sooner? Only God knows the answers. All night that night, I couldn't sleep. I just felt like something wasn't right. I said so many prayers for V - that she would recover, that her newborn child (her first) would do well, that her family would have strength through this difficult time, that they would come to know the Lord.
I found out the next morning when I went in for rounds that V had died at 3 am. My first maternal death. She was only 19. The unfairness of it all was overwhelming. Why couldn't I have done anything else? Why couldn't I do the labs I needed to do to determine why she had become nearly comatose? Why would a 19 year old be taken away from her newborn child? As I sat and cried, I was comforted by one of the labor nurses and one of the cleaning ladies. They reassured me that this happens here in Kenya and it would be okay. But it's not okay I told them. It's so unfair.
While I will continue to mourn V, I think that the Lord had a lesson to teach me through all of this. First, He is in control and He does have a plan. Second, I am not in control and no matter how much I think I know, ultimately, my patients' lives are in His hands. Third, I have to just trust God that what I am doing for the patients is the right thing and leave the rest to Him.
So, despite the fact that it was an exhausting, overwhelming, and challenging week, I think it will be one that I will look back on as a turning point, perhaps. I now know, more than ever, that He is in control. And I praise Him that after we have come through the flood, He provides a rainbow of hope to remind us that He is there - yesterday, today, and forever.

Friday, November 6, 2009

Mexican and a movie – a great combination

While we were in Eldoret, Ben bought a video projector to give to the local church to use for outreaches. We decided collectively that we should try it out to make sure it worked properly before he gave it to the pastor. So, we made a Mexican feast (it was great!) to share with everyone. Then, we set up the video projector and hung a bedsheet in front of the window and had a theatre experience, complete with popcorn. Thomas, our anesthetist, and his wife as well as Mikel joined as us well. We watched “Miracle” – the movie about the 1980 US Olympic hockey team that won gold. It was a great movie to watch on a big screen. I didn’t think until later that maybe it would mean nothing to Kenyans, but they seemed to enjoy it. It was a good night for all. It never ceases to amaze me how little it takes to really make my day now J It’s going to be tough now, though, to go back to watching movies on my computer – which suited us just fine before the projector came into our lives.

The movie watchers
Our big screen


Kapchesewes Children’s Home

Last weekend, we took a walk to a nearby orphanage. It is a place I have wanted to go to and this is the first chance I’ve had to go. The walk there was, like most hikes here, breathtaking and challenging. But definitely worth it (see picture below).

This is a children’s home run by AIC (Africa Inland Church). It is home to 35 children, 25 of whom are there during the school year – the other 10 go to a boarding school for high school.They range in age from 6-18. Some are there because they have lost both parents. Others are there because their families cannot afford to care for them. They are raised in a loving, Christian environment. For the last 5 months, the “parents” to these children have been Rebekah and David. They are a wonderful Christian couple with 5 children of their own who work there as volunteers. That’s right – they run the orphanage and parent these children for no pay whatsoever. Even though they do not have much money of their own, they give selflessly of their time and their talents to give these children a loving home. There is a tie to Kapsowar Hospital, as both Rebekah and David used to work for the hospital.

At the children’s home, the children learn vital life skills. They are all involved in cooking, cleaning, managing a small farm as well as tending after sheep and cows. All of these things are skills that will serve them well in life here in Kenya. They also are taught scripture and worship songs. As you talk to the children, it is evident that they love the Lord and that they have great goals for their futures. Just a few that I talked to said they wanted to be doctors, teachers, pilots.And they believe that they can accomplish this. Laura Rhodes, the wife of the long-term missionary surgeon here, has established an education fund which allows these children to go to secondary school (high school) as well as to college if they qualify.

While the home is full of love, it is significantly lacking in physical comforts. The children sleep two to a bed in beds that most of us would complain about sleeping in by ourselves. The mattresses are thin and worn and sag in the middle. The blankets they have are thin and have holes. Up in the hills in Kenya, it can get pretty cold at night – even I broke down and bought a small space heater. They also cannot all eat at the same time, because they don’t have enough bowls, plates and cups.

Several people here have been impressed by this place. Just being there, their joy surrounds you and is infectious. There are plans to build bunkbeds and buy new mattresses, as well as build new cabinets for clothes.

I was so touched by these children, as I am by most orphans. There’s just something special about them. I hope to take many more trips there.

The beautiful walk there

Tons of maize (corn) laying out to dry. The kernels will be
ground into cornmeal and used to make ugali, a Kenyan staple food
A bunch of the boys with Mama Brian, Kim and Eliesa (2
medical students)
Me with some of the kids and Dave with one of the sheep
Me and the kids and Rebekah and David (the parents)
The shower


31st Birthday!

So, for the second year in a row, I celebrated my birthday in Kenya (October 26th – I’m a little behind on blogging). It was a very busy day at the hospital that day. However, the night was great and very relaxing. Mikel, one of the hospital employees and our station “hostess” and my Kenyan mom, hosted my birthday dinner at her house. We had about 12 people there and had a wonderful pot-luck feast. Mikel and Drew had made me a cake (see picture below) and they all sang me happy birthday. I was then presented with gifts – Kenyan sarongs. It was a wonderful night spent with new friends and I felt very blessed. I also received several special calls from home that day and voicemails from my “nieces” Violet and Anara. All in all, it was a great day!

The next day, I traveled to Eldoret with the Sawer’s to pick up 2 new medical students from Australia (actually from Canada, but going to school in Australia). Ben and Cathy treated me to lunch at a Chinese restaurant to extend the birthday festivities. It was a wonderful birthday!

My birthday cake
Me in my gifts with Mikel
Part of the gathering - from Left to Right - Trudy Peterson,
Cathy Sawer, Ben Sawer, me, Dave Peterson, Mikel, and James

E.S.

More blogs are coming, I promise. For now, I wanted to ask for prayers for a patient and friend. E.S. is a very sweet lady in her 50's who has become a dear friend. She is also a wonderful woman of God. About 4 weeks ago, I did a hysterectomy on her for abnormal bleeding. At the time of surgery, we were suspicious that she might have cancer, as she had enlarged lymph nodes. I finally got her pathology report back today and she has metastatic cervical cancer. This is a difficult diagnosis no matter where you live. However, in Kenya, where there is only one place in a country of 40 million people where she can get the radiation she needs, it is even more difficult. Especially when the waiting list can be up to one year.
So, please pray for ES and her family. In the last year, her family has spent the majority of their savings to pay for hospital bills for her daughter, who is HIV+ and was very sick but is now doing well. She is unsure where she will get the money for radiation, but I assured her that the Lord will provide. So, please pray for peace as she deals with this news. Please also pray for healing and strength and that we would be able to help however possible so that she can get the treatment she needs. If any of you are interested in donating money for her specifically, you can mail a check to the address listed on the sidebar of the blog. Then please send me a message letting me know how much you sent and that you would like it to go to ES.
Thank you for your prayers! I will give updates as available.

Tuesday, October 20, 2009

My own shamba

In Kenya, a shamba is a small farm or garden. Nearly everyone has one. Not wanting to be left out, I asked Edna if she could help me plant mine, as there was already a spot for it in my backyard. So, I now have a shamba planted. No plants yet, but they should be here soon with all the rain we’ve been getting. Currently, I have the following things planted – tomatoes, basil, cilantro, sukuma wiki (kale), carrots and beans (I think). We have plans to add onions, green peppers, and hopefully pumpkins. So, stay tuned for the progress. I can’t wait to be able to get these things out of my backyard! Now if I could just learn how to milk a cow J I’ve put some pics below.
My backyard
The shamba
The back of my house - a great place to read!

Family gathering and other tales from Nairobi

This past weekend, I took my first trip to Nairobi. This is no small feat. Friday morning at about 10:30, in the midst of a downpour (El Nino has come to Kenya), Drew and I boarded a matatu for the first leg of our trip. A matatu is the main form of public transportation in Kenya. It is either a van or a pick-up truck with the back covered and benches installed. They are built for 14 passengers, but often carry many more than that (see picture below). You see, who needs seats when you’ve got a roof to sit on and a bumper on the back to stand on? Thankfully, we had secured the front seats and I prayed the whole way that we wouldn’t get stuck as the dirt road to Eldoret (a 2 hr drive) was very muddy from all the rain. We had one spin out where the truck spun about 180 degrees and slammed into the muddy bank at the side of the road. Thankfully no one was hurt and we were back on our way in about a minute. In Eldoret, we boarded a shuttle – a much nicer van with assigned seats – for the remaining 5 hours to Nairobi. This actually wasn’t too bad and I was able to see a lot of Kenyan countryside. As we reached the outskirts of Nairobi, I thought, good we’re almost there. So I thought. The next 5 miles or so to the city center took one hour and 45 minutes! The traffic was insane! Definitely the worse I’ve ever experienced. When we finally got the drop off, I politely reminded the driver that he had said he would take us to the guesthouse where were staying. “Oh” he said, “this traffic is really bad. I call you a taxi.” This wasn’t the plan, but I figured we had no other choice. So, a taxi came and said he would take us. When I asked him how much, he showed me what looked like a standard list and said it would be 2000 shillings (about $25). This sounded like an awful lot to me, but I had never taken a taxi in Nairobi before and things do tend to be a little more expensive there. So, we agreed. I later found out I should have only paid about 300 shillings. Oh well, live and learn. Finally, we arrived at the guesthouse at about 8:30 that night – thankfully they had held dinner for us!

The next day, I got up and met Angela, one of the Kenyan medical students that was in Kapsowar last year when I was here. She had arranged a hair appointment for me (I was in dire need). So, we went to a very nice mall and I got my hair cut. We spent the rest of the morning just hanging out and window shopping. It was a blessing and fun to catch up with her.

I then met up with Scott Reichenbach, the director of the Post-Residency Program, along with many other post-residents from all over Africa, including others from here in Kenya (including 2 OB/GYN’s), Zambia, Niger, and Gabon. It was wonderful spending the rest of the day with them – encouraging one another, sharing insights and frustrations, and just relaxing together. It was a huge encouragement to me and I even received 2 bags of chocolate chips (thanks Robin Jenkins!). We stayed at the hotel with them that night and began our long journey in reverse the next morning.

The trip home was much less eventful. Drew did count our max occupancy on the matatu on the way home, though, and we topped out at 26! I think the next time I go, I will stay for a little longer, but I am thankful I had this weekend there.

A typical matatu
Our postresident family (a small portion of us)

Perisi

What a wonderful day today was! It started very slow. You see, today is Kenyatta Day in Kenya – a national holiday that celebrates the first Kenyan president after Kenya became an independent nation. I’ve asked several people what the traditions are on this day and received many answers – family gathers for a large meal, there are public celebrations, the president gives a speech honoring former president Kenyatta and other national heroes, some people even do charitable works. For me, it started out as any other day at the hospital – with one notable exception. I had no patients to round on on the Maternity ward and only one on the Female Surgical ward.

The morning was very slow and after going home for lunch, I ran into Thomas, our anesthetist. He asked me why I was going back to the hospital. “It’s a holiday” he said, “stay home – you only need to go in if they call you.” I seriously contemplated this. I had a lot I could do at home, and with the overcast skies, a nap was sounding pretty good. However, there were things I could do at the hospital and I just had a feeling that I should go in.

Englewood Christian Church, my church in Indianapolis, has decided to make Kapsowar their Christmas project this year. One of the ideas I had was to raise money to pay patient bills. This is a major issue here. Many of the people we serve are extremely poor and even though our prices are what you and I would consider very cheap, they are often a life savings for our patients. The hospital is in a major financial crunch, which has led to them having to lessen the number of patients’ bills that are forgiven. So, the patients are held here until their bills can be paid (they are often completely lost to follow-up once they leave). This means that some are here for up to 3 months after they’ve been officially discharged. As you can imagine, this is a huge strain for them, as many have left children at home and are not earning money for their families while they are in the hospital. So, I thought that this would be a great project.

Since there was nothing happening on Maternity, I decided to go talk to the patients we’ve chosen and find out their stories. My last stop was to the children’s ward. I had a name of a child who had been discharged for 3 weeks and was still here. The bill was only 10,000 shillings (about $140), which is much less than some other children on C-ward. I wondered, is this the right person? Maybe we should pick someone who owes more – surely they can come up with 10K shillings. But, I thought I should at least talk to them. When I saw the mother, I recognized her as someone who I talk and joke with every day. In fact, her 2 year old, Festus, is the little boy on another blog who is still somewhat scared of me. I told her my church would like to pray for her and so I would like to know more about her. Her one month old daughter had been admitted shortly after being born at home for sepsis (infection of the blood). She is now doing well. She told me that she has 7 children, ranging in age from 1 month to 16 years. She is married, but her husband has married another woman (unfortunately a common practice among the Marakwet tribe). He is often drunk and doesn’t take care of the family. In fact, he told her that since the baby is a girl, she should just sell her to the hospital so that she can come home and take care of the other children. They have a small shamba (garden/small farm) and only 2 goats – which makes them very poor by Kenyan standards. To support her family, she tries to find jobs working in other people’s shambas, but often is forced to make illegal liquor to sell for money to support her children. I asked her if she attended church, and she said she did when she could. I asked her if she had ever asked Christ into her heart or if she knew that he could be her Savior. She said she had never done this, because she had no peace. I told her the salvation story and why Jesus had died on the cross. I told her that He can provide a peace that passes understanding. We talked about sin and how each one of us has a need for a savior. I asked her if this was something she wanted and she said yes. So, there in a side room of the children’s ward, Perisi asked Christ into her heart. She was beaming. She then asked me if she could change churches, as no one in her current church had ever told her any of this. I told her we would help her find a good church near her home. I welcomed her into the family in God and was rewarded with a huge smile when I told her that we were now sisters in Christ. I told her that even though she will face many challenges when she returns home, she now can go to her Savior and cast her concerns on him. The chaplains will be visiting her tomorrow and before I left for home, I was able to give her a Kalenjin Bible (the local dialect). I praise the Lord for His providence and for prompting me to go into the hospital when I wanted to take a nap!

Tuesday, October 13, 2009

Stella

Well, for those of you who have been wondering, we took Stella to the OR today for surgery. She is the patient I wrote about that I feared had ovarian cancer. She was very stoic as she came into theatre and said she was ready for whatever we found. We prayed together before she went to sleep and I, especially, prayed for wisdom. I knew the possibility of her needing multiple things done was high and wasn't sure how much her frail little body would tolerate (she weighed in at about 80 lbs - that included the 3 liters of fluid she had in her abdomen). Thankfully, I picked up a new visiting surgeon yesterday. Dr. Ben Sawer and his wife Cathy are from Canada and so nice. We are so thankful to have them here until Dr. Rhodes returns.
So, Dr. Ben and I opened her up. As expected, there was a lot of ascites (fluid). So, we suctioned all of that and I felt in her pelvis, expecting to find a large mass. Her uterus and both ovaries were completely normal! Interesting, we thought. So, we headed to the next most obvious source - her liver (although it had looked normal on ultrasound). It, in fact, was completely normal. As were her stomach, pancreas, and kidneys. Okay, we thought, let's run the bowel. There sat the culprit - we found a tumor of the small bowel, which is exceedingly rare (Dr. Ben has only seen 3 other cases in his 30+ years as a general surgeon). So, I yelled out to Drew "Drew, this is your case now". He scrubbed in and he and Dr. Ben resected about 20cm of her small bowel and put the healthy bowel back together.
So, she had complete surgical resection and we pray that she will do well. At any rate, she should have a much better prognosis than she would have had with ovarian cancer, and won't need any further treatment right now.
So, bwana asifui (praise the Lord!)! Thank you all for your prayers. Please continue to pray for her as she recovers.

Friday, October 9, 2009

Another “little” walk

So, one of my goals while I’m here is to see as much of Kenya as possible and to get into better shape doing it. Last Sunday, I went with Mama Brian (so named because her first-born is named Brian), Drew, and the Petersons on what was deemed by Mama Brian to be an easy walk. I have now learned not to believe this when I hear it! Although, I have to say, the views were definitely worth it.

The walk down to the river (a different part than we had gone to before) was nice and leisurely. It was along a gravel road and wasn’t bad at all. Once we got down to the river, we met a large group of children (see picture below) and had fun joking with them. I even took off my shoes and socks, hiked up my pants, and went walking in the water (it was very shallow).

Then came the walk back. Mama Brian said that since we had to be back to station by 4 (for another commitment), we should take the shortcut. Great, I thought, a shortcut. Little did I know that the shortcut meant that instead of walking up a slight gradient, we would instead just hike right up the side of the hill (really a mountain if you ask me). So, with the help of my walking stick (courtesy of Mama Brian), we hiked up what we figured to be about 1000 feet at a 50-55 degree slope. I had to stop every few minutes. I used the excuse that I’m still acclimating to the altitude (about 7500 feet above sea level), but really it’s just that I’m out of shape. Everyone was great about it, though, and it did feel like an accomplishment when we were done. So, anyone who plans on coming – be prepared for some hikes as I think Mama Brian has become my new personal trainer J


Dave communing with the sheep

Me with the walking stick Mama Brian gave me. The Cherangani Hills can be seen in the background.

Other travelers on the road to the river.
Another sheep pic with the river in the background - it's so beautiful
Kids doing laundry at the river (they were also grazing their cows).