MIRACLE BABIES

I know I often have sad stories to share from Kapsowar, as many of our premature babies do not survive. I am happy to tell you about 2 miracle babies.

Karen was born a few days ago and came out weighing 800 gms (less than2 lbs). Her brother had died inside of their mother and came out first. They were only about 27 weeks, which here means almost certain death, as we have no way of helping babies breathe here - we can only give them oxygen via nasal cannula. I sadly told her mother that the 2nd baby was not likely to survive either and she graciously accepted that - as most women here do. In fact, I decided not to monitor the 2nd baby's heart rate, as we would not intervene in the case of fetal distress. I did, however, look with ultrasound to see how the second baby was presenting and noted that the heart rate was in the 90's(should be above 120). About 4-5 hours later, she delivered a little girl, who, much to the nurses' surprise, began to cry from where she had been laid to the side about 3 minutes earlier. She is doing great, breathing on her own. She is definitely not out of the woods yet, but we praise God for our little miracle baby. She has spunk,too, as she pulls out her nasal cannula several times a day. Please pray for Karen, and her mother Albinah, as they have several hard weeks ahead.

Little baby Karen

My hand by her - to show you how small she is!

Another happy story is that of Ednah's baby. Ednah presented at about 27 weeks in labor with twins. We attempted to stop her labor, butwere unable to, and she went on to deliver later that day. Again, the first baby died, but the second baby survived and flourished. Under her mother's watchful eye and loving care (and God's blessing), shehas grown well and is now breastfeeding and ready to go home! The smile on Ednah's face always lights up a room - especially when shewas told she could, at long last, take her baby home. We praise God for His blessings and love for these little ones!

Ednah with her daughter

Hudson's 5th Birthday

So, I haven't talked a lot about the Jones family, but I am so blessed to have them here. Their kids are so much fun and I really enjoy fellowshipping (is that a word) with Kyle and Vanessa. After Brandyand Deb left, I spent the weekend in Nairobi with the Jones'. It wasHudson's (their oldest) 5th birthday and we wanted to do something special. On Saturday, I went with them to Splash, a water park inNairobi. It was a great place for the kids to play and we had fun just hanging out, also with another family with young boys who are missionaries in Nairobi. As you can see in the pics below, the kids had a great time. We didn't get in because it was a little chilly. On Sunday, we went to Village Market (the place I've talked about before) in the afternoon. Hudson had fun driving electric Tonka trucks and Vanessa and I relaxed with a pedicure. It was a great weekend to just hang out and have fun and we hope to do it again sometime.

Hudson showing his excitement about being in the pool

Hudson getting ready to test out the slides

Jude (middle child) having fun on the slides

More Safari Pics

Deb and I on the beach at Lake Nakuru

Baboon at Lake Nakuru

Me with a lion right in front of our van

The 3 of us in our safari mini-busA beautiful view of Mt. Kenya A lioness on the prowl Me by Thompson Falls, on the way to Lake Nakuru

Baby elephant - my favorite!

My First Safari

As I alluded to in my previous blog, my friends Brandy and Deb took me on safari the 2nd week of their visit here. We had so much fun and it was definitely an amazing experience! I was expecting it to be fun, but I had no idea how incredible it would be to see so much of God’s creation and to see all of these animals in their natural habitat. Also, it provided a great time of relaxation and fellowship for all of us.

We started out our safari at Ol Pejeta Conservancy, which is a private game park that sits at the base of Mt. Kenya. We stayed at a place called Sweetwaters, where all the accommodations were permanent tents, complete with toilets and showers. It was fun! At Sweetwaters, we saw rhinos, chimpanzees, lots of antelope and water buck, buffalo, zebras and lions. Our driver, Francis, who was with us the entire week, was very knowledgeable and was able to find us lots of animals. He would tell us he could “smell a lion” – of course this was right after he had gotten off his CB radio with another driver who had spotted one.

From Ol Pejeta, we traveled about 5 hours over very bumpy roads to Lake Nakuru, famous home to thousands of flamingoes. We stayed at a very nice place there and were able to see the flamingoes up close, as well as 2 leopards (unheard of per our driver) and more rhinos and antelope. Also, there were monkeys that greeted us in the parking lot and tried to get in our van.

From there, we traveled another 4-5 hours (again over bumpy roads – what else do you expect, this is Africa) to Maasai Mara, perhaps the best known game park in Kenya. It extends into Tanzania, where it becomes Serengheti National Park. This was probably my favorite one. We stayed at a camp called Sekenani, which is not fenced in. So, at night, we could hear elephants and see giraffe. We also had several baboons running over and around our tent at night. It felt like we were truly living in the wild. Not to worry, though. There were Maasai guards with spears posted around the camp to fend off any truly dangerous animals. We also went to an authentic Maasai village one day – the village consisted of one family, which consisted of one father, 11 wives, 52 children, and 300 cows. What a culture shift! It was very muddy as it had been raining quite a bit. We were able to go into one of their homes – hardly room even to move around. We were also treated to an exhibition of traditional dance. It amazed me how different it was from the rest of Kenya, or at least the parts I’ve experienced so far.

We were so fortunate to have a great 5 days on safari. We saw all of the Big 5 (Lion, Elephant, Rhino, Leopard, and Buffalo) and there wasn’t a single animal we wanted to see that we didn’t. Francis told us that were very lucky as not every safari experience is like that.

We then made our way back to Nairobi, stopping on the way at a school that some of Deb’s relatives (through marriage) have started for very poor children. It was a great way to end our time. Saying goodbye was hard, but I am so thankful for the 2 weeks were able to spend together.

Deb in our tent at Sweetwaters

Mother and baby white rhinos

Giraffe at sunset
Just the scenery was beautiful, especially with the clouds andthe sun shining through

The 3 Stooges (Cape buffalo)

Visitors!!

Brandy, Deb and me at the airport in Eldoret

The last week of February, I had my first official visitors! Deb and Brandy are good friends of mine from residency and are both practicing OB/GYN’s in Indianapolis. It was such a blessing to have them here. We had all been looking forward to it for months.

I had scheduled several surgeries for the week they were here in Kapsowar. Not all the patients showed up for surgery, but we had others show up in their place. In total, we did several tubal ligations, 3 vaginal hysterectomies, and a hysterectomy on a woman we thought might have ovarian cancer – it turned out to be a Krukenberg tumor (a cancer of the stomach that metastasizes to the ovaries). One of her ovaries weighed about 15 pounds!

One of our most interesting cases was a woman who came in with a fetal demise. She had had 3 prior C-sections, but with Deb and Brandy’s urging, we decided to let her labor to deliver this baby. The baby delivered easily, but I received a phone call from the nurses that after almost an hour, her placenta had still not yet delivered. Brandy and I headed into the hospital and attempted to extract the placenta. She had the most contracted pelvis I have ever felt (Brandy later concurred) and I could barely get my hand up to her uterus. I struggled for a long time to get the placenta. I looked at Brandy (my former mentor) and I could tell she was thinking “Come on Christina, what’s the problem?”. When my arm finally couldn’t do anymore, I turned to her and said “Wanna give it a try?” She was happy to oblige. She soon realized why I was struggling so much. We both had come to the same conclusion – she likely had a placenta accreta, a condition where the placenta is abnormally stuck to the uterus. This can lead to life-threatening hemorrhage. After struggling for several minutes, we decided she needed to go to theatre, possibly for a hysterectomy. When we got to theatre, her bleeding had started to increase and we decided to quickly attempt a D&C (scraping out the uterus) and if that didn’t work, to proceed with a hysterectomy. We were able to get the placenta out without doing a hysterectomy, but later decided we didn’t know that we really did her any favors, as any future pregnancy could be life-threatening. She was counseled at length about this and decided to have her tubes tied.

Besides the blessing that it was to have 2 other OB/GYN’s here to consult on various cases, it was so wonderful to have my friends here for encouragement and fellowship. It was also really great to show people from home this place I have come to love and the work that God is doing here. I pray that it was a worthwhile time for them. Their first night, we had dinner at Ednah’s (my house helper) house. It was a great cultural experience for them – both having dinner in an authentic Kenyan home and walking back in the rain. We had a great time getting to see Kapsowar and even though I was sick during part of the time, they were adventurous on their own – hiking down to the river and back up the long tarmac road (see my blog about my first long walk in Kapsowar) while getting drenched in the rain.

They spent a total of one week here in Kapsowar and while I didn’t want them to leave, the next week we went on safari, so that was something to look forward to. I appreciate so much their willingness to use their vacation time to come here and serve and I appreciate those who sent things with them to encourage me! I love my St. Vincent family!

Brandy and I operating together
The 3 of us with Laura Rhodes

Deb and Brandy with Michal and her husband, William, wearingthe gifts they received

Mental Health Day

As I said in my last post, one of the great things about being at this
conference has been the time to network and fellowship with other
medical missionaries from all over the continent of Africa. Last
Friday, we (me, the 2 other OB/GYN's in the post-residency program,
and Stephany, a post-resident pediatrician) decided we needed what we
termed a mental health day in Nairobi. All of us have been facing
fatigue and emotional exhaustion at times and felt that we needed a
day to refresh.

So, we piled into Sara's car and headed off to Nairobi - to a
wonderful place (my new favorite place in Nairobi!) called Village
Market. It is a beautiful outdoor mall much like one I've been to in
San Diego. I felt like the little country bumpkin as we walked
through, which I think made everyone else laugh. We first headed to a
coffee shop much like a Starbuck's to get our caffeine fix for the day
- it was very good. We then went to a nail place for mani's and
pedi's - much needed relaxation! It was wonderful. Afterwards we
went to the food court area and ate perhaps the best Indian food I
have ever had. What a treat that was! We spent the rest of the
afternoon just walking around and doing some shopping at the Nakumatt
there (a large grocery store).

While at Nakumatt, I saw a familiar face. It was one of my medical
school classmates whom I had not seen since graduation. After getting
over our shock of seeing each other in a grocery store in Nairobi,
Kenya, I found out that he is working at Kijabe Hospital - the same
place I've been staying with friends for the last week. Just when I
think the world couldn't possibly get any smaller, it does :)

It was a great day of relaxation and female bonding and made me so
thankful to have so many other post-residents here in Kenya with me.
Being with all of these wonderful people for the last week has made me
realize that wherever the Lord places me long-term, I need to be
somewhere with a team of people. The support and encouragement gained
from that, as well as the expanded wisdom base, is invaluable.
Village Market also has a movie theater, bowling alley, miniature golf
course, and water park. I think I will be going back again sometime.

Sharon and I getting our manicures Sara (in the front) and Stephany getting their pedicures The end results

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

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.

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

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