Sunday, January 24, 2010

Lessons of the Last Month

I've been putting off writing this post to my blog because the thought of putting down the emotions of the last month or so into words was a little overwhelming. But, I know that this needs to be shared. And, for those of you who are faithfully praying for me, you need to know what you prayers are accomplishing and what you can continue to pray for.
It all started the day after Christmas. I went into the hospital in the morning and as I entered maternity, I saw a group of nurses with shocked looks on their faces and James, one of our Kenyan docs, had his head down and was shaking it. "What happened?" I asked. "We just couldn't save her" James said. When I asked who, he said it was the young girl he had done a C-section on the day before (he was on call on Christmas day). She had been doing well and then suddenly became drowsy and stopped breathing. Despite resuscitation, they were unable to save her. She was only 18 and left behind a beautiful healthy baby. An autopsy was done and she had suffered from a very large pulmonary embolus (blood clot to the lung) that was almost instantly fatal. While I felt better that there was nothing we could have possibly done to save her, I still grieved over the loss of this young woman with her whole life ahead of her and for her baby that would never know its mother. The other thing that grieved me was that when I told her husband and family, there was no outrage - no demanding to know what happened or demanding why - there was just acceptance. How sad that death is so common here that the death of an 18 year old is just taken with resignation.
I remember thinking "How can something so horrible happen the day after such a wonderful day?" The following day, at our Bible Study, without me telling him that this is what I was thinking, Bill talked about what happened after the birth of Jesus. Herod had all the boys under the age of 2 killed. "Can you imagine the heartache and the weeping?" He asked. I had never thought about it that way. In the same town where the Savior of the world had been born, not long after, massive unnecessary loss occurred. We are never told the reason for that. Was it part of God's ultimate plan? Likely in some way. Was it because this world is sinful and because of that, bad things will happen? Also very likely. Regardless, we know that God knows the reason why and sometimes that just has to be enough.
Following this sad time, I had some amazing answers to prayer. 2 women I had been following very closely delivered healthy babies. The first had had 4 miscarriages followed by a term stillbirth. So, although this was her 6th pregnancy, she had no living children. I was following her twice a week with ultrasounds and praying that God would protect her baby. She came in one day and the baby had an irregular heartbeat. We decided to go ahead and deliver her and her baby girl, Glory, came out perfectly healthy. What a joy to see her with her miracle baby! We praised God together for her and I can't think of a better name for her. The 2nd woman had lost her first baby during a difficult labor. She had come to me requesting a C-section for this baby and when I did her ultrasound, she had twins! We followed her closely and when she came in at 35 1/2 weeks with elevated blood pressure, we decided it was time to get them out. She delivered a healthy boy and healthy girl and I just saw them in follow-up this week. They are all doing well and mom couldn't be happier! I am so thankful to God for these answers to prayer and to know that He is doing amazing things in the lives of women here.
It is such a roller-coaster, with the joys and the lows. Last weekend, my Saturday started early with a C-section at 4 am. A mom had come in with undiagnosed twins and the 2nd one wasn't coming out. So, we went to theatre and when the baby came out, he wasn't breathing. The team worked hard on him, but was unable to save him. It was heartbreaking. I went home, and about 15 minutes after I laid down, I had a knock on the window from the watchman who said "Daktari, there's a patient who's unconscious on maternity." I quickly dressed and headed back in to find a C-section patient from the night before barely conscious (responding only to pain) and not moving her right side. After evaluating her, I decided she most likely had had a stroke. As I stood there trying to decide what to do next, I hear someone yell "Cord prolapse!" from the labor ward. This means the umbilical cord has slipped past the baby's head and is an emergency requiring an emergent C-section. So, as I ran to do that C-section, I called James to come in and attend to the barely conscious patient. We got to theatre (the OR) quickly and I was told by the nurse that he no longer felt a pulse in the umbilical cord. We proceeded quickly with the surgery, but despite that, this baby also came out not breathing and with a scant pulse. Again, despite over 30 min of resuscitation, this precious baby passed. I cried as I closed the patient. How could I have lost 2 babies that should have survived within the span of a few hours? In the midst of all of this, nurses were coming in asking Thomas, our anesthetist, for equipment to intubate the patient on maternity as she was now not breathing on her own. Following the C-section, Thomas and I went down to maternity and found her intubated, but stable. We decided to transfer her to Eldoret, as she needed ICU care. Unfortunately, I found out that Faith, 19 years old, passed away 2 days after that.
In the midst of all of this, I think it could be easy to question God's goodness. Thankfully, He peppers all of this with glimpses of who He is and with reasons to praise Him. I don't want you to think that all of my time here is filled with sadness, because there are so many reasons for joy! It just seems that this past month, God has been teaching me to rest in the knowledge of Him and that He is our refuge and never changes. I think it is best summed up by something a pastor said in a sermon I heard recently. He was talking about being joyful despite the current circumstances of your life and he said something I found to be profound - "Instead of judging God by what we see in the world, we should view the world in light of what we KNOW to be true of God." This has been a great comfort to me and I hope that it will be to you as well.
Thank you for all of your prayers and encouragement - they are definitely felt. I praise God for the opportunity to be here, despite the challenges, because He is showing me every day how sufficient His grace is.

I'm a real Kenyan!

Getting my hair cut here is not the easiest thing to do. I have recently found someone who does a good job cutting "mzungu" (white person) hair. However, this requires a 2 hour drive. So, needless to say, my hair has, at times, become unmanageable. A few weeks ago I had reached my wit's end with it and decided to give into Mama Brian who had been after me to braid my hair. She did a great job and I enjoyed having it braided for a few days (the braids fell out - I don't think I took proper care of it). Everyone at the hospital loved it and I was told by several people that I looked Kenyan. Not sure how true that really was, but it was great that they enjoyed it. Thankfully, a few days after the braids fell out, I was able to make it to Eldoret for a much needed haircut.

Saturday, January 16, 2010

Happy (Belated) New Year’s!

Mwaka mpia mzuri! (Happy New Year in Kiswahili). So, I’ve been a little delinquent in my blogging lately and I apologize for that. Things are going well here in 2010, although they have been very unusually quiet. I asked about this, as the change is easily noticeable. I’ve been told by several people that it’s because of school fees. You see, in Kenya, parents are responsible for paying fees for the children to go to school as well as buy uniforms and school supplies. If they go to a government school, it is cheaper. If your children go to a private school, though, where the best education is, the school fees often reach 18 to 20,000 Kenyan shillings (about $250-275) – which is a lot of money for Kenyans. The vast majority of this is due at the beginning of the school year, which starts in January here. So, everyone is paying school fees and no one has money to come and see the doctor. Hence, we have been slow. What a choice to make, right?

I had a great New Year’s. I decided to leave Kapsowar for a few days and travel back to Tenwek Hospital to see my friends there, which now includes 2 more families – the Faders and the McLaughlins. Between all of my friends there, I had plenty of kids to play with, which was much needed as I have been missing my “nieces and nephew” (Violet, Anara, and Edison) a lot lately. Between all the families, they have a 4 year old, a 2 ½ year old, two 1 year olds, and an 8 month old. It was great! I traveled via matatu (much smoother than the last trip) on New Year’s Eve and arrived at Tenwek around 7:30pm. We had a great celebration, which included desserts and a new game – the bag game – which somewhat resembles Taboo. Then, at midnight here (3pm CST, 4pm EST in US), we had our own ball drop (see picture below). After that, we all went to bed  We all commented the next day that we are getting old. The rest of the weekend was a great time of hanging out, being able to discuss OB/GYN (Rachel McLaughlin is also an OB/GYN), and sharing our joys and frustrations of the field. It was a very refreshing weekend for me and I thank my Post-Residency friends for sharing their lives and homes with me. Somehow, though, we never managed to get a group picture.

On Monday, the 4th, I headed out of Alyssa’s very early in the morning to start my trek home. Last time, I went out to the hospital gate at 5:45am and there was a taxi right there to take me into Bomet. Not so this time. After sitting out there for about 45 minutes, I was told there was a matatu strike going on throughout Kenya and there might not be a taxi coming. Then, who I thought was a good Samaritan offered to take me into Bomet. However, he then proceeded to charge me 500 shillings (normal is 50 shillings). Way to take advantage of the situation! After that, it wasn’t bad and I was able to get matatus all the way home.

So, that was my New Year’s celebration. As I look back on the last year, it is amazing to me how much has changed. I am now an attending physician (or consultant here) and I have finally made it to my long-term goal of practicing medical missions. The Lord has taught me a lot this year – patience, trust, His provision, reliance on Him, and His goodness. I am so blessed to be here and to see Him in each of the patients that I treat as well as those I work with. Thank you to all of you who play a role in this each and every day! May our Lord richly bless you all and may you come to know the fullness of His love even more in 2010! Mungu aku bariki (God bless you)!

Caleb Fader, Jason Fader, and John Cropsey in our version ofthe Times Square ball drop

Eliese Cropsey (L) and Anna Fader playing in a puddle during abreak from all the rain
Rachel with her daughter, Maggie

Monday, January 4, 2010

Christmas in Kapsowar

I want to thank all of you for the warm Christmas wishes as I spent this Christmas away from my family and friends back home. Thankfully, the Lord provided a wonderful group of people here in Kapsowar to celebrate this season with. And I have to say, it was refreshing to celebrate this season away from the hustle and bustle and consumerism of the West. It really provided an opportunity to focus on the birth of Christ and what that means to us in the 21st century as well as an opportunity to minister in a special way to our patients.

It all started about 2 weeks before Christmas. I wanted to decorate the house for Christmas (as many of you know, it’s my favorite time of year). We had a group of students and one husband from Canada who were here for a month – and a huge blessing from the Lord. When they left Kapsowar on Dec. 19th, they would be traveling around and wouldn’t be home for Christmas. So, we decided to have a day of Christmas decorations, cookie making, and a large dinner. It was great! I got my house decorated (with many wonderful homemade decorations) and they were able to have a Christmas. I had to go and do a C-section in the midst of it, but it was still a great day. Some of the nursing students even joined in on the Christmas fun. One of the workers on station cut a tree for me – it was a bit of a Charlie Brown tree, but I loved it!
Crystal, one of the medical students, and some of the nursingstudents stringing popcorn

My charlie brown tree complete with lights

Some of the homemade gingerbread ornaments

The following week, I became very sick and missed nearly the entire week of work. I’ll spare you the details, but let’s just say I hope I never get it again! I had plenty of well-wishing visitors, though, and I praise God for Jackie, one of the visiting medical students, who basically ran maternity in my absence, staffing things with me over the phone. One bright spot during my sick week was the hospital Christmas party that was held just outside of my house. I was able to go outside and sit with them for about an hour. It was a great time of celebration complete with treats, games, and prizes. They had a blast!
Playing the stomp the balloon game
Several of the hospital staff

Christmas Eve evening I participated in a Kapsowar tradition – caroling by candlelight through the wards. We all gathered and caroled throughout the hospital, bringing the good news of Jesus’ birth to the patients and praying with them. It was such a great night and I look forward to doing it again next year! On Christmas day, I spent most of the afternoon cooking with Laura, which included a wonderful tutorial on bread-making, since my attempts have been less than successful. She cooked up a feast which included turkey, stuffing, mashed potatoes, veggies, cranberry sauce, fresh rolls, sweet potatoes and pumpkin pie made from scratch complete with whipped cream! Laura and Bill, Drew, Dave and Trudy along with their son Lucas, James and I enjoyed the feast (a little too much!) and then spent most of the night just talking. It was a great time of fellowship and I was thankful for everyone there.

So, that was my first Christmas in Kapsowar. While I missed my family back home (especially since my sister Bethany was in the hospital recovering from surgery), I had a great time here.