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| Laura's annual bunny cake |
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| Jude showing off one of his finds |
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| Isaac was amazed at his eggs |
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| Sally, a medical student visiting from the UK, trying to fish out an egg that had fallen inside the tree |
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| The boys after the hunt was over |
A chronicle of the Lord's work in me and in Kapsowar, Kenya
Friday, May 6, 2011
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.
Monday, May 2, 2011
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.
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
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.
Friday, April 22, 2011
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.
name and follow the directions
Here are some pics from past Pokot trips.
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.
name and follow the directions
Here are some pics from past Pokot trips.
Thursday, April 21, 2011
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!
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!
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| Josephine and me with baby Christina! |
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| Pamela and baby Kipchumba |
Thursday, April 7, 2011
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.
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.
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| Me with Monicah and Kipchumba (under all those blankets) |
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| Look at that precious face! |
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