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

In Memory of E

Yesterday I experienced yet another Kenyan cultural first, although this one was one I wish I could have avoided. I attended my first Kenyan funeral. It was for a patient and a friend.
E was a wonderful Christian woman who I actually met last year when I visited Kapsowar. She and her husband ran a convenience shop just outside of the entrance to the station and I enjoyed many conversations with her when I would go for little things needed at home. She always welcomed me with a smile and often a hug. I soon realized that she and her husband were both wonderful Christian people and it was a joy getting to know them.
Soon after I arrived this time, she came to see me. She had been having some bleeding and pain and had been seen by another doctor without an answer. After evaluating her, we decided she needed a hysterectomy. Although things had looked fairly normal (except for fibroids) pre-op, it was clear when we did her surgery that she had cancer. Her surgery went well and afterwards I sat down with her husband and daughter and explained what I had found at surgery. At the time, I hoped it would be an easily treatable cancer. A few weeks later, we received the pathology report back and it said metastatic cervical cancer. Worse than I thought, but still able to be treated.
We arranged for her to go to Nairobi for radiation treatments. Nairobi is the only place (and only one hospital in Nairobi) where you can get radiation therapy in the entire country of Kenya - a country of approximately 40 million people. People are often put on a waiting list and wait up to a year to begin treatment. Thankfully she was able to start fairly quickly and things seemed to be going well, with a few minor setbacks that are common to radiation/chemotherapy. However, a couple of weeks ago, she became very sick and had to be admitted to the hospital. While she showed a little improvement, on Feb. 9th, she became worse and peacefully went on to be with the Lord.
I was devastated when I heard, although thankful at the same time that she was no longer suffering. My heart ached for her husband, who had loved her for nearly 40 years. She was only 55, so young. She left behind 8 children and 5 grandchildren. My only consolation was that she is now with her Lord and Savior and reunited with so many loved ones.
Her funeral was yesterday. Her family is large and very connected in this community, so the turnout was huge. People came from all over Kenya. The ceremony took place in a field by their house and there were probably 500 people seated everywhere. A funeral is much different here - it lasts several hours (I was forewarned to go late so I wouldn't have to sit for so many hours). Probably 20-30 people got up to give speeches remembering E and her contribution to their lives. Songs were sung. Members of Parliament were even there. There was a viewing - much like at home. Then a sermon was given about how death is not final for those of us that know the Lord. Her casket was then driven up to their home and she was buried in a small plot of land by the home.
As I looked around, I couldn't help but be struck by the differences. It was more of a spectacle here. On the flipside, though, the way they do it here gives so many more people an opportunity to express to her family what she meant to them. What a testament to her life! All you had to do was look around and you could see that she was an amazing woman who touched all that she came into contact with. As I spoke with her husband, you could see the pain in his eyes and my heart broke. At the same time as his pain was evident, though, he said that he knew God was sovereign and that He would get them through this. I praise the Lord that even in the midst of such pain, He brings hope. Please remember E's family in your prayers as they struggle to recover from this loss.

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

Brackenhurst CMDA Conference

So, I've decided that I am in heaven in Kenya. I am currently at Brackenhurst conference center in Limuru, Kenya (www.brackenhurst.com) for a continuing medical education conference put on by CMDA (the Christian Medical and Dental Association). The purpose of this conference is to provide continued education that is up-to-date and pertinent to physicians on the continent of Africa (and beyond) so that we can be good physicians and provide the best possible care for our patients. It is so interesting and topics like "Treating Malaria in Pregnancy" and "Snakebites in Africa" can be found here. What CME conference in the States would provide these?
Another perk to being here is the coffee shop. It's located in a building that is all windows on one side that overlooks the beautiful grounds. And, they have very American food! Yesterday I had nachos for lunch and today I had chicken burritos with chips and salsa! I hate to take so much joy in food, but when you go without certain foods for 6 months, it suddenly becomes very tasty :) They also have ice cream, which is very hard to come by where I'm at. So, I'm planning on partaking of that tomorrow.
Yet another blessing of being here is I've been able to see many friends - mostly other post-residents. It's been joked about that so many of us are in Kenya right now (2 at Kapsowar Hospital, 5 at Tenwek Hospital and 5 at Kijabe Hospital), but I have to say that it is wonderful knowing that I have all of these people here with me. We have become pretty close and it's wonderful having a surgeon, an opthalmologist, a pediatrician, 2 family practice docs, one ID doc, one med/peds doc, one orthopedist, and 3 other OB/GYN's that I can call with questions. It's like our own little multi-specialty group :) During the conference, I am staying with one of the other post-residents and having dinner with the Shirley's, another post-resident family. So, it has been a wonderful time of rest, education, networking, and spending time with friends - both old and new.
There is such a wealth of wisdom and experience here. I'm getting to learn about all kinds of things from both people from the US and greats in the world of medical missions. We (me and the other 2 OB/GYNs here with SP) cornered the OB/GYN that lectured the other day to drill him with more specific questions. He was so gracious and sat and talked with us over coffee for about 2 hours. He also gave me some vacuums (to pull babies out) which is awesome since the ones I have at Kapsowar are metal and we achieve a vacuum with a bike tire pump.
I went to a session yesterday morning about spirituality and medicine. It was very insightful and convicting, as we talked about not forgetting the most important part of being here - sharing the love of Jesus Christ with those we serve. It's so easy to get caught up in the busyness of seeing patients and figuring out what is going on with them without all of the normal resources and forget the most important thing - evaluating and addressing their spiritual state. And this doesn't just apply overseas - it should be just as important to people in the Western world as well. One of the speakers spoke about the verse in the Bible that says (paraphrased) "In all that you do, whether eating or drinking, do it to the glory of God." His point was that if all that we do has the potential to glorify God, then all that we do has the potential to not glorify God as well. So, is it possible to do "sinful ministry" - i.e. ministry that is really not glorifying to God. I'm doing meaningless ministry if I save a woman's life physically but don't ultimately save it by making sure she knows Christ as her savior. It was very convicting to me and something I pray I will remember each and every day - especially during the busy ones.
I have almost another week left of the conference and look forward to all that I will learn during that time.