Kenya here I come - again

Ok, so I know it's been a long time since I've blogged. I'm going to try and be better about it now. A lot has happened since last October. I have graduated from residency (whoo-hoo!) and am currently in the process of studying for boards. I put my house on the market and am still waiting for it to sell (prayer request). The Lord has blessed me so much and has opened the doors for me to go back to Kapsowar for 2 years. I will be going through World Medical Mission's post-residency program. I am excited to go, and at the same time, reality is certainly setting in. There are a lot of details to work out and loose ends to tie up in the next 2 months. Also, the reality of upcoming good-byes is starting to hit home. However, I feel blessed to have this time off of work to spend with family and close friends. It is a time I am already treasuring.
I officially leave on August 23rd from Indianapolis. I will spend Aug. 9-15th in Boone, NC for orientation.
Once in Kenya, I will be settling into my house on the "station" (a compound across the street from the hospital) and getting to work. I will be working mainly in the hospital in the beginning. My hope is to help expand the community health outreach at the hospital, focusing on maternal and child health.
There are all sorts of uncertainties ahead, but I look forward to what the Lord is going to accomplish.
Below I've placed some pictures that I didn't get to post before, as well as some from the last few months. God bless you all and I look forward to keeping you posted!

View from the hospital

My future front yard


Edison Hubartt, the latest addition to the Hubartt family. I had the extreme pleasure of delivering him in November. I sure will miss this kid! (And the rest of his family too!)


Me with the fam at my residency graduation.

A Day of Goodbyes

So, the previous blog was actually from Tuesday. Now it is Wednesday, and I have worked my last day at the hospital. It was a bittersweet day as I said goodbye to everyone.
During my morning rounds, Katherine, the head nurse of maternity told me that during chai (tea) today, a hallowed daily tradition, we would all gather so that I could say something to everyone. I figured that meant me and the maternity nurses. Oh no, when I got there, most of the hospital was there. It was such a humbling experience! Someone from each department got up and said something to me. I was given a necklace, a beaded adornment to be worn on the forehead, and an African outfit. They prayed for me. Also, Jean, one of the medical students, brought Emily, my little buddy from peds ward, who finally got to go home today after being in the hospital for 2 ½ months. I was truly humbled by what they said and praise the Lord that He was able to work through me during this short time. They all said that they knew I would be back and also were praying for a husband for me J At the end, all of the women gathered around me and danced and sang a song. I have a video of it – it was great. A true African experience.
I went from that uplifting experience to a tragic one as I scanned a young 18 year old soon-to-be mother and had to give her the heartbreaking news that her baby had a fatal anomaly – ancephaly (no brain development) as well as omphalocoele (a condition where abdominal contents are outside of the body). Her baby’s liver was even outside the body. While I was excited for myself that I actually saw all of these things, my heart broke for her as we cried together over the loss of something she was so eagerly awaiting. We prayed together for peace and for hope and pray that she will know these both in the days ahead.
Ok, so this actually will be my last post. I am all packed and am hanging out with the med students tonight. I will be off at 5:30 tomorrow morning and home around 4 pm Indianapolis time on Friday. Thank you all again for all the prayers and encouragement you have given. I love you all and have lots to share when I return.

An Amazing Couple of Days

What a great couple of days it has been. The rain has gone away and the skies have been beautiful blue with hardly a cloud. I cannot begin to describe how beautiful it is here. I know I've said that before, but it continues to strike me day after day. There's a view on the way from the hospital to my house that is just breathtaking when the weather is nice like this. I think I have about 10 pictures of it, because every time I pass it, I think "This is so beautiful, I have to take a picture."
This afternoon, I sat outside on the grass just outside the maternity ward and played with some of the kids from the peds ward, including little Emily, who I'm now calling my little African Violet, because her personality and mannerisms are so much like Violet's. It was wonderful and I also got to talk to some of the mothers.
Yesterday I had a milestone. I delivered my biggest baby yet. A lady came in to the hospital in labor with her third baby. The nurses called me and asked me to scan her, because she was so big they thought she must have twins. No, it was one baby and I knew it would be huge - I estimated 5 kgs (approx 11 lbs). I contemplated letting her try and have a vaginal delivery, because she had delivered a 3.8kg baby before, but then I saw that she had been circumcised, which greatly narrows the room for the baby to come out. When I saw that, I thought "No way!" So, we talked her into a C-section and boy am I glad we did! He came out a whopping 5.04kg and it was a struggle to get him out even with a C-section. I took a picture with him to mark the occasion :) All the nurses and students were stopping by to see him - he looks like he's about 3 months old and about 13-14 lbs.
Today was also eventful. It started out with me giving a lecture to the nurses about postpartum hemorrhage, which went well and I think was much appreciated. After that we practiced our songs for tomorrow - the maternity ward is leading the chapel service at the hospital tomorrow. During our practicing, one of the medical students called and told me that a patient had come in overnight that had delivered a dead baby at home and was bleeding. I was told that she had had a D&C when she came in and now was in a lot of pain and could I come see her when I got a chance. I asked her if she was stable and she said yes, to just come see her when I was done with rounds. So, when I moseyed over, I looked at the patient and saw that her abdomen was distended and tense - for all you docs out there, she had a surgical abdomen. When I looked through her chart, I found that she had been nearly in shock when she came in, but improved with blood and fluids. She had not had a D&C and had a previous C-section followed by now 7 normal deliveries. So, I was very worried for a uterine rupture, which can be life-threatening. I grabbed the ultrasound and did a quick scan of her abdomen - when I saw fluid (likely blood), I knew we had to head to theater (OR). Unfortunately, they were in the middle of removing a thyroid and there is only one anesthesia machine. So, we waited for an hour - what an hour that was! When our turn came, I did in fact find a uterine rupture (my first) - a very impressive one actually. She also had infection in her abdomen. We did a hysterectomy and the patient is already improved. Praise the Lord for His mercy and wisdom! Sorry for all the medical talk, it's just that this is my way of keeping track of everything that happens, and I know there are some people reading this who are actually interested in it.
As many of you know, I celebrated my 30th birthday here this past weekend. It was nice. I rounded in the morning, went to a Swahili church service (approx 2 1/2 hrs long) which was awesome and I hung out with the medical students that are here. We were invited to the hospital administrator's house for dinner, so I got to eat some Kenyan food, which was wonderful. Here's another interesting thing about Kenya - they are very interested in our elections and they are all Obama supporters! This is because his grandmother lives here and they all think that if he is elected, it will be good for Africa. Whether or not this is true, they are all very much in support of him and watching our politics like they were their own. It was the topic of conversation at dinner that night. All of them are asking if I will be home in time to vote :)
As my time here draws to a close (tomorrow will be my last day at the hospital), I feel sad that I will be leaving. I'm not sad to be at home, as I have a new little "niece" or "nephew" to deliver. But, I am going to miss it here. I could definitely see myself being here for the 2 years after I finish residency and would ask for your prayers as I pray about whether or not to come here. It is a wonderful place and they are doing a great job. There is, however, definitely a gap in women's health care. All of the nurses keep telling me that I must come back. I am excited about what the future holds.
Thank you all for all your prayer support and encouraging words. This will likely be my last blog from here. So, asanti (thank you) and Mungu akubariki (God bless)!

The Lord is Merciful

The Lord was merciful today (Friday). Let me start by explaining my state of mind when I arrived at the hospital this morning. Yesterday proved to me that the previous rains were a drop in the bucket. It POURED yesterday. All of the mud road from the hospital was like a mudslide with water rushing. One of Dr. Larson's daughters, Juliana, had come by the hospital earlier in the afternoon to bring her dad an umbrella. It started pouring when she got here, so I gave her my rain poncho to go home in, figuring that with as hard as it was raining, surely it would be stopped by the time I went home. Boy was I wrong! It actually got harder right at the time I needed to go home. So, I was sopping wet by the time I got home. I had felt a cold starting yesterday during the day, and it hit full force last night. I didn't sleep much because of the cold and awoke with a horrible sore throat. So, I was pretty tired when I headed into the hospital today.
When I arrived, I was told that a woman had just gotten there and was complaining of bleeding since last night. She told us that her and her husband had walked, uphill, all night to get to the hospital, because there is no transportation available at night. She was bleeding fairly heavily and had had 3 prior C-sections. I did an ultrasound and noted that she had a placenta previa (where the placenta is sitting over the cervix). I also noticed that the baby was dead. She and her husband were crushed and said that they had gotten here as soon as they could. I reassured them that this was not their fault. For all the OB/GYN types out there, you're probably starting to have the same thought I did - previa, 3 prior sections, pretty good chance of a placenta accreta at least (where the placenta invades the uterus). So, I quickly called the theater (OR) and told them we had an emergency and found the visiting general surgeon to let him know that I needed his help. To make things more exciting, her hemoglobin was 8 (normal is at least 12). So, long story short, we got her to the OR and I was prepared to do a cesarean hysterectomy. She did, in fact, have a placenta increta. The baby looked like it had been dead for about a week. Her blood pressure at one point was 40/20 and the OR staff was doing a great job trying to keep up with our blood loss. An amazing thing happened - the visiting surgeon I was working with noted that his blood type was the same as hers. Because warm blood is a better resuscitator than cold, he hooked himself up to a blood collection bag and gave a pint of blood that was then promptly given to the patient. Her BP responded immediately. Praise the Lord! We ended up resecting part of her uterus and closing it. She is now doing well (don't worry, we tied her tubes too, so she won't get pregnant again :)) I do fell bad for her though, as she is in a ward with mothers with their new healthy babies and she has empty arms. I pray that she will find peace in the midst of all of this.
Friday night I was on call. So far, call here has been a breeze - I haven't had to go in once. That all changed Friday night. It had rained all day again and was still raining when I got the call that we would need to do a C-section. They said they would call me back when the OR was ready. I got a call a little while later and was expecting them to say they were ready. What they actually said was that another lady had just arrived completely dilated, double footling breech with the feet hanging through her cervix. It was her first baby and a fairly big baby. So, I tried to rush into the hospital. I say tried because it was still raining, I had a small flashlight, and I was slipping and sliding the whole way into the hospital along the muddy path. It was comical, actually. So, I got there and we did both C-sections. The Kenyan medical students that are here came in and helped me and we all had a great time. Both mothers and babies are doing well, PTL!
So, this morning (Saturday), I slept in a little. I am still battling this cold and praying that it goes away before I get on the plane. We were going to walk about an hour to go to an orphanage that is nearby today. However, since it looks like it will rain yet again, the path is muddy, and I am still not feeling well, I thought it best to postpone that. I likely won't get to go before I leave, which is sad, but if I come back here (which is, I think, a very strong possibility), I definitely want to get involved there as I still have a passion for ministering to orphans. I also found out the the wife of the surgeon that is normally here is very involved there.
So, can you tell I'm having a blast? It actually is great and people keep telling me that this many days in a row of this much rain is very unusual. I can't wait to share more with you all!

Rain, Rain, Go Away

Yesterday, I experienced the full force of rainy season in Kenya. It rained most of the day, turning my path from the hospital to my house into a mudslide. Needless to say, the rain boots that I contemplated buying before I came here would have definitely come in handy. I am told that yesterday was an odd day as usually it rains at night only. It then got pretty cold last night – all the Kenyans were bundled up in 4-5 layers. A sweatshirt worked for me :) Today it is very sunny and warm, so that's an improvement!
Things continue to go really well here. I have established good relationships with the nurses here. They are a great bunch of ladies and dedicated to their patients. Also, I have gotten to know the OR staff well and they are wonderful. They are always ready with helpful suggestions during surgery. It has also been a joy working with the Kenyan medical students. Yesterday, one of them scrubbed a tubal ligation with me and I let her do a lot of it. She was SO excited afterwards. Apparently, during their training here, they only get to observe and rarely get to do anything. So, it was great to let her experience what actually doing surgery is like. She is thinking about doing OB/GYN, so anything I can do to encourage her is worth it.
An update on a lady I told you about. Betty, the patient that became very sick after her C-section and was transferred, is doing well. We have heard from her family that she has been discharged from the ICU. Still haven’t heard what the final diagnosis was, but I praise God that He protected her and that she will be able to be there for her new baby.
A couple of days ago, the Lord blessed me through a conversation with Tekla, one of the head nurses at the Maternal Child Health Clinic here. She spoke to me openly about how she ran from her family to avoid being circumcised and about how difficult that was. She also talked to me about her heart for young girls who are still, in some parts of Kenya, being forced to undergo female genital mutilation against their will. They are doing it in younger girls now (8-9 years old) because they fight back less. Even though it is banned by the Kenyan government, it is still being practiced in some tribes, including the Marakwet tribe in this area. She is passionate about reaching out to these girls and hopes to one day have a place where they can come and be protected. She is also passionate about health education and it was great to hear her ideas for how to reach out to the many women in the villages that never make it to the hospital. I really appreciated her willingness to share. It gave me a lot of insight into what women here go through.
Please continue to pray for wisdom and guidance as I search out where I should go after graduating. I am having dinner with the Larsons tonight to talk with them about possibly being here. I appreciate the prayers of all of you who have been faithfully praying for me. God Bless you all!