Awaiting Baby Ariella

The Jones family are awaiting a new addition - Baby Ariella.  After several scans, we are pretty certain this one's a girl, and Hudson and Jude chose the name Ariella, a beautiful name.  Needless to say, we're all pretty excited and have seized the opportunity to throw a party :)
Last weekend, with the help of Kyle's sister who was visiting and 2 very special visitors from World Medical Mission - Mary Elizabeth Jameson and Gail Gambill - we threw a special baby shower for Vanessa.  It was so great to be able to decorate with things from home and give Vanessa a special afternoon.  We even had pink M&M's!  Also, I invited some Kenyan ladies from our women's Bible study.  They don't do baby showers - they have a party for the mom and baby after the birth.  So this was a new experience for them.  They all wanted to know why it was called a "shower" when there was no water involved, and I had to admit that I don't actually know why.  It was so special to have them here and share our different cultural traditions.  One of the most special moments was when they sang a song for Vanessa to celebrate the blessing of her new baby (see video below).  It was a great afternoon enjoyed by all.
As a side note, I also so enjoyed having Mary Elizabeth and Gail here!  They both work at World Medical Mission - Mary Elizabeth with the post-residency program and Gail works in placing short-term physicians on the field.  They were a huge encouragement and we enjoyed a few days of slumber parties :) 

Gail and I were so proud of our diaper cake.  Apparently you're supposed to have 50 diapers at least to make it - I had 20, so we made do :)

It was an explosion of pink!

Me and Vanessa

Ariella's first baby doll, courtesy of Laura

All the ladies!

Me and my Kenyan mom, Michal

A Good Day

Yesterday was a good day.  Sometimes it feels like I see so much heartache that when I have a day like yesterday, it is very refreshing and makes me remember why I love being here and serving the women of this community.
First thing in the morning, a woman came in laboring.  I saw that she had had a C-section with her first baby and the baby had died.  I also noticed that she was very small which is probably why she couldn't deliver normally the first time.  I asked her what had happened with her first, and she said that she had labored for a long time and the baby became distressed and they took her for a C-section, but it was too late - the baby died.  Given her stature and the bad outcome the first time, I told her that I did not think labor was a good idea for her and we should proceed with C-section.  Also, the baby was breech, yet another reason to not risk it.  She quickly agreed, her mother-in-law took some convincing (as per usual).  We took her for C-section (in, by the way, our maternity theatre which is now functional! - see pic below) and delivered a healthy baby boy.  He required some resuscitation, but is now doing wonderfully!

Our wonderful operating theatre, right on maternity.  No more wheeling patients up 3 hills for a C-section!

While the first patient was being prepared for her C-section, I saw another patient for a follow-up visit.  I have been following her the entire pregnancy.  Her first two pregnancies ended with stillbirths - one at 7 months and one at 9 months.  It's hard to know what caused them - records are not available.  However, from what she told me, I thought it was possible that it was due to a clotting disorder of her blood, which would make blood clots more likely and "kill off" the placenta during the pregnancy, leading to death of the baby.  At home, we would send a whole battery of tests, which would cost hundreds of dollars.  First of all, most of these tests are not available here, and second, even if they were, none of my patients would be able to afford them.  So, I did what we often do here, and just empirically treated her with daily aspirin, which thins the blood.  For the rest of the pregnancy, she saw me frequently and we did several ultrasounds, rejoicing each time that we saw the baby was growing well.  Yesterday she was 39 weeks and the baby was doing well.  I suggested we go ahead and induce her labor, since we had a healthy baby and I didn't want to risk anything happening to the baby.  She readily agreed and a mere 3 hours later also delivered a healthy, screaming baby boy.  Her smile said it all.  Praise God for His provisions and for healthy babies!

He works in SPITE of me

On Mother's Day, I had the opportunity to speak in the church service that takes place each week in the chapel at the hospital.  It is mostly attended by patients in the hospital and their families, but occasionally some of the missionaries go there as well.  I have to be honest - I wasn't real excited about doing it.  I don't feel like I'm qualified to be preaching and wasn't quite sure what I was going to talk about.
I have been studying the fruit of the Spirit with some of the ladies here through a Beth Moore study.  Recently we studied patience and the week of homework and the video session that went with it really spoke to me.  We learned about how God calls us not only to be patient with our circumstances, but most of all to be patient with others.  Our example for this is God Himself.  How patient He is with us!  He's patient to allow as many as possible to come to Him before returning to earth.  He's patient with us despite all of our many failings and loves us in spite of them.  Most of all, if we aren't patient with others and forgiving of them, it only hurts us, not them. 
So, I decided to share this with them.  Actually quite fitting on Mother's Day, as mothers have to exhibit unlimited patience with their children.  At the end of the message, I emphasized again the patience of the Lord, that He doesn't want one person to cherish, and shared with them that if they had not yet experienced God's forgiveness, they could receive it that day.  When I asked who would like to experience that forgiveness and receive Christ as their savior, 8 people raised their hands!  After the service, they stayed and received Bibles and counseling from the pastors.  They also continued to receive follow-up while in the hospital.
I share this with you to show that the Lord can work in spite of us at times.  Despite my lack of enthusiasm leading up to that day, the Lord was able to work.  Imagine what He could have done had I had more joy in my heart about this opportunity!
Please pray for Justin, Musa, Philemon, Joshua, Colleta, Veronicah, Christine, and Sarah as they continue on this exciting journey!

Easter Fun

This year for Easter, we decided to have a big turkey feast.  You see, turkey is a rare commodity around here and since we had seen some frozen ones recently in Eldoret, we decided that it would make a good centerpiece for our Easter dinner.  So, a couple of weeks before Easter, as I was headed back from Nairobi, I stopped in Eldoret to get our turkey.  There were 2 - both a little bit more than 9 kg (about 19 pounds).  Well, I thought, we'll just have leftovers.  Little did I realize that it might not fit in any of our ovens.  Thankfully, though, it just fit and we had a lovely dinner with all the missionaries here (about 16 people).  Before partaking, we enjoyed watching the Jones boys do their Easter egg hunt.  They enjoyed it immensely - as you can see from the pictures below.

Laura's annual bunny cake

Jude showing off one of his finds

Isaac was amazed at his eggs

Sally, a medical student visiting from the UK, trying to fish out an egg that had fallen inside the tree

The boys after the hunt was over

Reflections

As most of you know, I will be leaving Kenya on June 24th to return to the States for 1 1/2 to 2 years.  This is in order to finish the application process with a long-term sending agency, raise full-time support to return here, and collect my cases for and take (and hopefully pass!) my oral boards that would then make me fully board-certified.  I am looking forward to returning home for a time and seeing everyone there.
As I now have less than 2 months until departure, I have been reflecting on how different my life will be over the next 2 years.  I have grown used to many things here that are much different than how things will be in the States.  I have come to appreciate many things that seemed strange to me when I first came.  I have developed significant relationships here that I will miss when I'm gone.

Some of the things I will miss:
1. Walking to work every morning and living close enough to the hospital that I can walk in
2. Getting to sit outside of theatre (the OR) and seeing this view while waiting for a case to start

3. People greeting me by name on the way into work, walking to the market, etc
4. The simpleness of the pace of life here
5. All of my dear fellow missionaries here

I have also realized that I have gotten used to asking my patients certain questions that probably wouldn't go over quite so well at home.  Here are some examples:
"Are you your husband's only wife?"
"How many shillings do you pay to get here?" - Easiest way to determine how far away from the hospital they live
"Will your family allow you to have a C-section?" - the mother-in-law is very influential and often the biggest obstacle to a patient having a much needed C-section
"You should not be climbing trees while you are pregnant" - said to a patient who had fallen out of a tree when she was 14 weeks pregnant and broke her hip
"Do you have another family member who can chop firewood and fetch water for you?" - part of my talk about bedrest with my pregnant patients who have high blood pressure
I'm sure there are many more, but that's all I can think of for now.

Another thing that will most definitely be different will be the presentations of the patients.  To highlight this, I'd like to share 2 stories with you from this past week.  While they both have elements of tragedy, I think they speak to the tenacity of the people here and to the need for quality and compassionate medical care.

The first patient, T, came up from the valley after having pushed at home for a few hours with her 4th baby.  Her baby was breech and she had been able to push the baby out but it had become stuck.  By the time she walked to find a vehicle and then made the 2-3 hour journey to Kapsowar, she was writhing in pain and exhausted.  Another doctor was on call and when she arrived, he did an ultrasound which showed massive hydrocephalus (fluid in the brain) which had enlarged the baby's head so much that it could not pass through the birth canal.  Unfortunately, her baby had already died by the time she reached us.  The doctor on call called me and asked me if I had ever done a destructive delivery.  I said no (and I hope I never have to) but told him that I thought I knew something else we could do.  I had never done it before, but had had it explained to me.  When I got to the hospital, I found her writhing in pain in the labor bed and begging us to help her.  I confirmed the other doctor's findings on U/S and decided to proceed with a ventriculocentesis - a procedure to drain the fluid from the baby's head so that she could deliver normally.  It was actually quite an easy procedure technically and her relief was nearly immediate.  After a large amount of fluid was drained, she was able to deliver the baby.  As I comforted her over the loss of her child, she grabbed my hands and praised God for saving her.
The second patient, J, came from Kaloa, a town in Pokot near where we do our mobile clinics.  She had begun bleeding heavily at 8 am.  Her family had to find a motorbike for her transport and then get her to Tot, the closest health facility.  When she arrived there, she was bleeding even heavier and had become very weak.  They transported her to us in an ambulance.  By the time she arrived here, she had lost nearly her entire blood volume.  Her blood pressure was barely obtainable at 60/20 and her heart rate was 140.  She was  barely responsive.  I arrived and sent her husband to donate blood as we only had 2 pints of blood in the entire hospital (which was a bonus - I though we had none).  We started pumping fluids into her as fast as we could through 2 IV's.  Her hemoglobin came back from the lab - it was 3!  (It should be 12 or above)  I did a quick ultrasound to try and determine the cause of the bleeding - the baby had died and there was a large placental abruption (the placenta had completely detached from the uterus).  Her bleeding was still brisk and after getting some blood started, we took her to theatre.  On the table, her heart rate continued to race.  Thankfully the surgery went well and we were able to get her bleeding under control.  After several liters of IV fluids and 3 pints of blood, she began to stabilize.  The next day, her hemoglobin was 4.9 (after 3 pints of blood!) and there was no more blood in the hospital and no more relatives to donate.  Thankfully she is stable, so we will just have to let her body recover.  She, too, thanked me the next day and I told her that we both needed to thank the Lord that He had gotten her here in time.  30 more minutes and she would have died.

These are not situations that I will likely encounter in the States, but they are not uncommon here.  In a way, I am very glad that I will not have these type of situations for a time - they are physically, mentally and emotionally exhausting.  But on the other hand, what an opportunity to see God's provision and protection!  I know that J is alive today because the Lord protected her.  I have seen Him work miraculously in her life.  I think, in a place where there is so much technology and medical know-how, I will have to search harder to see this (or perhaps just work harder to set aside my own preconceived notions and see what God is doing around me).  I encourage all of you to look for God's work that is all around us every day.

A Life-Giving Gift

Greetings on this Good Friday.  I pray that all of you join me today in remembering the sacrifice that Christ made for us in order to give us life.  On this day that we remember the ultimate life-giving gift,
I would like to tell you about an exciting opportunity to provide the life-giving gift of water.
As most of you know, we have been serving the Pokot people in Lodengo through mobile clinics.  The people there are amazingly resilient as they survive in the harshest of circumstances.  One of the most
difficult struggles they face is that of how to obtain water.  East Pokot is a very dry and hot place.  Drought is common.  The people in Lodengo and the surrounding villages have to walk at least 8-10km to
get water and carry it on their backs to their homes.  In times of significant drought (like right now), they have to walk up to 20km to find a water source.  As you can imagine, this is not an easy thing to do.  Often times, then, they get water wherever they can find it - including stagnant puddles.  This leads to significant diarrheal
diseases, especially for children. 
This past Tuesday a geologist went out to Lodengo and found a place a well could be drilled - right near the spot where we want to build a health center!  The drill will be ready next week to begin drilling the well.
The cost of the project is $10,000, which includes a generator and electric pump that will be required to pump the water uphill into a large water tank.  I have agreed to share the cost with another missionary family here, the Jones family.
Would you consider contributing towards the $5000 I need to raise to provide the people of Lodengo and the surrounding communities with access to life-saving water?  Even a small contribution can make a huge difference in the life of a child or a pregnant mother.  I am hoping to have the money raised in the next 2-3 weeks.  Any help you can give would be greatly appreciated!  God bless and may you all have a blessed Easter weekend!

If you are interested in contributing to this project, you have 2 options.
1. Mail a check made out to Samaritan's Purse to:
Samaritan’s Purse
Attn: Post-Residency Program
P.O. Box 3000, Boone, NC 28607
Please be sure to write "Project Account #003655" in the memo line of
your check.

2. Online donation: go to
www.samaritanspurse.org/index.php/giving/wmm_doctors/ , type in my
name and follow the directions

Here are some pics from past Pokot trips.

Deliveries with a purpose

This past weekend, we headed to Lodengo (in Pokot) again for another clinic and time of encouragement with the people there.  Our times there, while at times difficult (it's very hot, there are a lot of flies, and sleeping is never a good experience) have been some of my best times here.  The people are such an inspiration to me - they persevere in spite of very difficult circumstances, have literally nothing, and truly desire to try and better their lives.  We are so excited about the changes we see going on there and the changes that are to come in the future.
One of the most exciting changes is that this time I was told that the women there are now desiring to deliver in healthcare facilities as opposed to at home.  Previously, nearly 100% of the women in this area were delivering at home with untrained birth attendants.  Because of this, infant mortality rate is extremely high in this area and many women suffer complications of childbirth.  Now that they are hearing stories like Monicah's (see previous blog), they are beginning to realize the importance of receiving prenatal care and delivering with skilled attendants. 
This trip, we brought back a total of 4 patients with us.  Two of the ladies were admitted straight to maternity.  One was past her due date and told me that her water had broken 2 WEEKS AGO.  The other had a complicated pregnancy history and had hemorrhaged after her last delivery.  So, I admitted both of them, and they both had healthy deliveries.  I was thankful they had come with us, especially because the 2nd one again had a postpartum hemorrhage which we were able to control but would have likely killed her had she delivered at home.  Praise the Lord for healthy babies and healthy moms and pray with me that there will be many more stories like this to tell in the future!

Josephine and me with baby Christina!

Pamela and baby Kipchumba

Karibu Kipchumba! (Welcome Kipchumba)

Yesterday a very special baby was born at our hospital.  In Marakwet culture, a child is given a tribal name which is based on the circumstances of their birth.  There are names for babies born when it's raining, born at night, born in the morning, born at the times when the goats come home, etc.  Boys' names start with "Kip" and girls' names start with "Jep" or "Chep".  "Chumba" means white person, so Kipchumba is a boy who was born when a white person, or visitor, was present.  As you can imagine, over the last almost 2 years, I've delivered many Jepchumbas and Kipchumbas.  However, this one will hold a special place in my heart.
I first met Monicah in September 2010 at one of our mobile clinics to Lodengo, in East Pokot.  She told me her story of how she had lost 2 babies at just 5 months of pregnancy.  She had no living children and was desperate for a child.  When I saw her, she was about 11 weeks pregnant.  The history she gave sounded consistent with cervical insufficiency, a condition where the cervix is not strong enough to hold a pregnancy to term and usually the pregnancy is lost between 16 and 24 weeks.  So, we brought her back to Kapsowar with us and I put in a cerclage - a stitch in the cervix that holds the pregnancy in.  She then went back to Pokot and I prayed that this would be the answer for her.  I saw her each time we returned to Pokot and rejoiced with her that her baby continued to grow and she had no signs of labor.  When she reached 36 weeks, she came back to Kapsowar and I removed the stitch.  I expected that she might deliver soon after that and encouraged her to stay here so she could have a safe delivery.  Nearly all Pokot women deliver at home and because of that have a high neonatal mortality rate.  She stayed here with Mikel (see previous blog posts) and came in Tuesday night in labor.  Wednesday morning she delivered a healthy baby boy - Kipchumba!  Despite no pain relief during labor, she wore a huge smile and gave me a big hug.  You can tell she is completely infatuated with her little one and we are praising the Lord for His blessing in her life.
Thank you to all of you who financially support the ministry here - your generosity helped pay for her initial surgery and for her delivery in a safe environment.  Thank you also to all of you who faithfully pray for me and for my patients here - your prayers are being answered every day.

Me with Monicah and Kipchumba (under all those blankets)

Look at that precious face!

Kapsowar Hospital Construction

A New Nursery and a Tiny Miracle

Well, it finally happened.  Our new nursery is finally open!  Thank you to all of you who donated funds to make this a reality.  We went from a tiny closet for our premature and sick infants to a new, warm, welcoming and much larger Newborn Unit.  I have already noticed that the moms are spending more time with their babies and the nurses are present much more often.  We had a dedication ceremony to dedicate the new space to the Lord and give each of the current infants, and those to come, to Him.  It was wonderful and so great to see the looks on the mom's faces when they saw where their babies were going to be cared for.

Our previous closet of a nursery

Incubators in the new nursery with chairs for each mother

So much space!

Our dedication service

We've already had a graduate of our new nursery.  Abel was born 14 weeks prematurely by emergency C-section because his mother was hemorrhaging from placenta previa (where the placenta is covering the cervix).  I'd had her on bedrest in the hospital because of intermittent bleeding, but that night was different.  By the time I got there, her bed was covered in blood.  I sadly told his mom that we would do what we could, but being only 26 weeks, his chances of survival here were very low.  As I pulled him out, all I could think about was how small he was - until he started screaming!  At 850 grams, he was the smallest baby I'd seen born here and cry, much less survive.  Each day, we prayed for him, and he outdid all of our expectations.  After less than 2 months, he was discharged.  Today, mom took him to Kijabe Hospital (a large mission hospital here in Kenya) for repair of a minor heart defect.  We praise God for our little miracle baby!

Abel the day after he was born.  As you can see, he was barely bigger than my hand.

Dr. Kyle Jones, Tekla, little Abel, and me last week

Christmas - in February?

So, I know it's nearing the end of February, but I figured I should blog about Christmas.  It was, afterall, my second Christmas here in Kapsowar.  It wasn't so hard being away from home this year - although I did miss my family, of course.  I think this was because my mom, sister, and Carson had just been here, and because this is starting to feel more and more like home. 
Christmas started out with the annual hospital Christmas party for all of the staff the week before.  This was convenient, as it was right outside my house.  It was a fun time of games and a live nativity play directed by Vanessa Jones and starring most of the station kids.  It was also a fun time for all of the hospital staff to hang out together.

Isaac Jones dressed up as a shepherd for the nativity.  Shepherds have paci's right?

Agather, one of our cleaning ladies, transferring beans with a straw

Hudson and Jude Jones enjoying the party

I decided to do something special for the nurses that I work with - those on the maternity and female wards.  I decided to have them all to dinner.  However, since this involved about 20 people, I figured it was easier to order out.  So, I ordered some Kenyan dishes from Elegance Hotel (restaurant) and got more than I bargained for.  The rice could have fed about 50 people.  They all enjoyed it, though, and I hope they felt appreciated for all of their hard work.

All the food ready to go in my kitchen.  The big black pot under the counter is the rice.

James, one of our Kenyan docs, with several of the nurses

The guys enjoying their food

Just like last year, on Christmas Eve, we did candlelight caroling around the wards.  It was, once again, a very neat experience and it was so great to be able to bring joy to the patients who were spending their Christmas in the hospital.  Afterwards, we all went back to the chapel and I shared with everyone about the risk that Mary took when she carried Jesus and how we should not allow what people think to sway us from what God has called us to do.  It was a good time of fellowship.

Caroling on the children's ward

Me with a special patient

Christmas morning I got up and went over to the Jones' to open presents.  It was so fun getting to be with my Kapsowar family for that.  After going into the hospital to round, I came back and we had a big brunch with my new favorite breakfast food - pumpkin pancakes.  Yum!  That night, we invited all of the medical students and visiting staff over for a big dinner together.  It was a good day - even though I did get called away from dinner for an emergency C-section.  Ah well.

Hudson and Jude with their stockings

Hudson showing off the Spiderman puzzle I gave him

I made buckeyes for our dinner.  They were great!

Family Visit Part 3 - Safari!

Never in a million years would I have dreamed that I would take 3 safari's in one year.  But, how can I have my family come all this way, to one of the best places in the world for big game safari, and not take them?  Also, April would have killed me if we wouldn't have gone, since she's a huge animal lover.
We went back to Mara Safari Club, which is now my favorite place to go for safari.  Mom and April were very impressed with our tent accommodations and they loved standing and watching the hippos in the Mara River right outside our tent.  We also got to sit on the deck of our tent and watch Calabas monkeys playing in the trees around us.
It was so much fun watching mom and April see all the animals in their natural habitat for the first time.  And, since I've been there before, it was fun to just sit back and enjoy the scenery and the animals.  My other job during our game drives was to hold Carson, which I didn't mind one bit :)  It was also fun to see his reaction to the animals - although a couple of times he got so excited we thought he would scare off the animals!
April was a star animal spotter and at one point our driver joked he was going to hire her.  Her best spot was a female leopard that was hiding in some bushes.  We were very lucky, seeing 3 leopards during our safari.  Even our driver, who does this every day, was excited.  A lot of people don't even get to see one. 
We had a great time relaxing and spending some quality time together.

Back from our first early morning game drive.  Lovin' the Colts outfit!

Warming up in front of the fire

Ready to see some animals!

 

So amazing!

Carson enjoying the big comfy bed

Carson and April with a Masai warrior

Mom after her massage

Enjoying lunch outside

Monkey outside our tent

Family Visit Part 2 - Visiting Kenyan Homes

While my family was here, we received many dinner invitations to various homes.  Kenyans are very hospitable and everyone wanted to meet my family.  We only had time for 2, but they were fun.
My house helper and friend, Ednah, was our first visit.  She had been promising for a long time to teach me how to milk a cow, so we decided this would be a good time for that and make a great surprise for April (who thinks she should have grown up on a farm).  We had a great time visiting with her many family members and eating the burritos she made for us (not quite the Kenyan fare I had told my family about) - I guess she's spent a little too much time with Americans :)  The view from her house is quite beautiful as well.  It was a memorable visit!

Some of Ednah's young relatives

April loved this little baby and playing with all the kids

Everyone wanted to hold Carson

The view from Ednah's house

April learning how to milk the cow

Not as hard as I thought it would be

Ednah, Carson, Mom and April with the newly-milked cow

Mom and April with PART of Ednah's family

Our second dinner was at Michal's house.  If you read my blog regularly, you've seen many pictures from various dinners here, as she is our station wazungu hostess.  She is also my Kenyan mom.  It was fun introducing my two moms to each other!

April and Carson with Michal's boys

My two moms :)