Well, I have a little bit more time to write now, so I thought I would write about little things that I find interesting here. Before I start, the connection is way too slow to try and upload pictures right now, so I'll just have to show them to you all when I get home.
I just returned from "chai" or tea. Every day at 10:30, everything stops for tea time. It's actually a wonderful time to talk to the hospital staff and it has given me an opportunity to bond with the nurses here. As those of you who know me know, I usually hate tea. Here, however, it is very good. It is made with steamed milk and water and they add some sort of spice that gives it a wonderful flavor. Also, every day with tea we eat manazi, which is basically like a beignet without the powdered sugar. It is quickly becoming my favorite thing here.
I normally consider myself a pretty kid-friendly person in that kids usually like me. Not so much here, though, with the little ones, at least. They just kind of stare at me and I have made several cry. I'm told this is quite normal, though, as many of them have never seen a white person. Dr. Larson tells me that he regularly makes kids scream when he walks through the village.
Women here are tough! You walk through the maternity ward and don't hear a sound. Also, when they leave the hospital to go home, many walk up to an hour or more to go home, carrying their infants and their bags up steep hills along bumpy roads. I think I may now find it hard to feel sorry for many of my patients in the States :)
There are a group of kids that are often playing in the open area in the middle of the "station" (where all the mission houses are). They like to point at me when I walk by and then they say something to each other and giggle. Yesterday as I was walking by, they yelled "Muzungu!", which I knew meant foreigner from a book I had been reading. I then said "Abari" (how are you?) and they replied "Mzuri" (good) and smiled. I think it was a breakthrough!
Everyone here continues to be wonderful. They always stop to say hello and shake your hand (they shake hands like Americans hug). Last night, I had a movie night with the 2 female medical students here from Nairobi. It was a lot of fun. I was also thankful that the usual nightly rain didn't happen while I was walking back to my house.
Well, not much more to write right now. I'm on call today, but right now it's pretty quiet (knock on wood). Later today, Alysia Larson (Dr. Larson's wife) is going to go with me to the town center to experience some culture and pick up a few things.
Hope all is well at home. I'd love to hear from everyone! God Bless.
A chronicle of the Lord's work in me and in Kapsowar, Kenya
Saturday, October 18, 2008
Friday, October 17, 2008
The Hospital
Hello to all. I hope you are all doing well.
I have had an interesting last couple of days. Since my last post, the VBAC that was laboring developed fetal distress and we took her back for a C-section. Even though I knew it was what she needed, I hesitated because it was my first time making the decision myself. Then, the path to get a patient to the theater (OR) from the maternity ward is very interesting. The patient is placed on a "trolley" and wheeled along a bumpy path up two hills to get to the theater! I want to video it so that all of you can appreciate what I'm talking about. Everything went well and mom and baby are doing fine. I then got to do my first vaginal delivery, which also went well. I have to say - the women here are tough! I went into the labor room with 3 women laboring, all completely dilated and they were completely silent. Their pain tolerance is amazing. Wednesday evening I was invited for pizza at the Larson's. It was wonderful. We were also joined by 2 medical students from Nairobi who are rotating here. Then, after dessert (brownies and homemade ice cream), their kids put on a little show for us. It was great! Their house is always full of action - their kids are 7, 5, 2, and 5 month old twins!
Yesterday was a tough day. It started off well. We had 2 scheduled repeat cesarean sections. They both went wonderfully. When we were almost finished with the 2nd one (Betty), the scrub wanted to close skin, so I scrubbed out. After completing the paperwork (yes, there is paperwork here, too), I stuck my head in the OR, and they said everything was fine. So, I headed home to get some lunch. Apparently the nurses didn't have the right number to get ahold of me and were trying to call me. I ran into one of the nurse anesthetists on my way back to the hospital and he told me that they were looking for me because Betty was not doing well. Apparently, after I left, he noticed that she was having difficulty breathing and complaining of chest pain and coughing up blood. Her oxygen saturations were in the 60's (should be 95-100). Despite being on 4 liters of oxygen, her sats were still very low and her heart rate was 140-160. So, I rushed back to the hospital and found her on the maternity ward. Dr. Larson was there as well. She was definitely in respiratory distress, but her lungs sounded fine. We were both worried that she might have a pulmonary embolus, but there is no way to diagnose that here. We switched her to facemask and bumped her oxygen up to 10 liters. Her O2 sat came up to 88%, but she was still working to breath and her heart rate was still fast. After some quick decision making, we agreed to transfer her to Eldoret, where they have an ICU. Remember, Eldoret is a 2 hour, very bumpy drive. Also, we had no guarantees that when she got there, they would have a place for her. So, we all gathered around her and prayed for her. Then, relatively quickly, the ambulance was here and we prepared to send her. A nurse and one of the anesthetists went with her. She sounded very bad when they were pulling off. I talked with the anesthetist this morning, and he told me that she is now stable. Her BP when she arrived there was 220/120, though and her HR was close to 200. Praise the Lord, though, they had one ICU bed open and she got it! Please continue to pray that Betty will make a full recovery. So far, we do not have a diagnosis.
Another patient that has touched me already is Dorcas. She is a very sweet 37 year old lady who came to the clinic complaining of abdominal pain and distention for about the last year. On exam, she was noted to have large pelvic masses and was sent to us for ultrasound. On ultrasound, you can see at least one 12cm mass and on abdominal exam, you can feel mass all throughout her pelvis. She also had a lot of ascites (fluid in the abdomen) on the ultrasound. All of this is very concerning for ovarian cancer. She said that she was unable to eat because everything just came right back up. She was admitted to the hospital and initially the doctor taking care of her drained only a small amount of the fluid to send for diagnosis (will take 2 weeks for the results). However, she continued to have significant pain. So, I suggested that they drain as much fluid off as possible for comfort. Yesterday, they drained 4 liters of fluid out of her belly. She feels much better today and is able to eat. This is only temporary, though. A surgeon is coming today and we are going to discuss the case with him. In the US, it would be a no-brainer - do surgery, then chemo. Here, however, it is a much more difficult decision to make. There is chemotherapy available in Kenya, however she would have to be able to pay for it. Also, it will be a very big surgery and she would have a fair chance of not making it through the surgery or the recovery. So, please pray for her and for us as we discuss this with her.
I am really enjoying my time here. I cannot describe in words how beautiful the area is and the people are just as beautiful in spirit. Everyone keeps asking why I'm only staying 2 weeks. It does feel like a short time. However, I am continuing to pray about coming back here for the 2 years. I could definitely see myself here. We'll see what the Lord has in store.
Until the next post, I hope you all are safe and well. God Bless!
I have had an interesting last couple of days. Since my last post, the VBAC that was laboring developed fetal distress and we took her back for a C-section. Even though I knew it was what she needed, I hesitated because it was my first time making the decision myself. Then, the path to get a patient to the theater (OR) from the maternity ward is very interesting. The patient is placed on a "trolley" and wheeled along a bumpy path up two hills to get to the theater! I want to video it so that all of you can appreciate what I'm talking about. Everything went well and mom and baby are doing fine. I then got to do my first vaginal delivery, which also went well. I have to say - the women here are tough! I went into the labor room with 3 women laboring, all completely dilated and they were completely silent. Their pain tolerance is amazing. Wednesday evening I was invited for pizza at the Larson's. It was wonderful. We were also joined by 2 medical students from Nairobi who are rotating here. Then, after dessert (brownies and homemade ice cream), their kids put on a little show for us. It was great! Their house is always full of action - their kids are 7, 5, 2, and 5 month old twins!
Yesterday was a tough day. It started off well. We had 2 scheduled repeat cesarean sections. They both went wonderfully. When we were almost finished with the 2nd one (Betty), the scrub wanted to close skin, so I scrubbed out. After completing the paperwork (yes, there is paperwork here, too), I stuck my head in the OR, and they said everything was fine. So, I headed home to get some lunch. Apparently the nurses didn't have the right number to get ahold of me and were trying to call me. I ran into one of the nurse anesthetists on my way back to the hospital and he told me that they were looking for me because Betty was not doing well. Apparently, after I left, he noticed that she was having difficulty breathing and complaining of chest pain and coughing up blood. Her oxygen saturations were in the 60's (should be 95-100). Despite being on 4 liters of oxygen, her sats were still very low and her heart rate was 140-160. So, I rushed back to the hospital and found her on the maternity ward. Dr. Larson was there as well. She was definitely in respiratory distress, but her lungs sounded fine. We were both worried that she might have a pulmonary embolus, but there is no way to diagnose that here. We switched her to facemask and bumped her oxygen up to 10 liters. Her O2 sat came up to 88%, but she was still working to breath and her heart rate was still fast. After some quick decision making, we agreed to transfer her to Eldoret, where they have an ICU. Remember, Eldoret is a 2 hour, very bumpy drive. Also, we had no guarantees that when she got there, they would have a place for her. So, we all gathered around her and prayed for her. Then, relatively quickly, the ambulance was here and we prepared to send her. A nurse and one of the anesthetists went with her. She sounded very bad when they were pulling off. I talked with the anesthetist this morning, and he told me that she is now stable. Her BP when she arrived there was 220/120, though and her HR was close to 200. Praise the Lord, though, they had one ICU bed open and she got it! Please continue to pray that Betty will make a full recovery. So far, we do not have a diagnosis.
Another patient that has touched me already is Dorcas. She is a very sweet 37 year old lady who came to the clinic complaining of abdominal pain and distention for about the last year. On exam, she was noted to have large pelvic masses and was sent to us for ultrasound. On ultrasound, you can see at least one 12cm mass and on abdominal exam, you can feel mass all throughout her pelvis. She also had a lot of ascites (fluid in the abdomen) on the ultrasound. All of this is very concerning for ovarian cancer. She said that she was unable to eat because everything just came right back up. She was admitted to the hospital and initially the doctor taking care of her drained only a small amount of the fluid to send for diagnosis (will take 2 weeks for the results). However, she continued to have significant pain. So, I suggested that they drain as much fluid off as possible for comfort. Yesterday, they drained 4 liters of fluid out of her belly. She feels much better today and is able to eat. This is only temporary, though. A surgeon is coming today and we are going to discuss the case with him. In the US, it would be a no-brainer - do surgery, then chemo. Here, however, it is a much more difficult decision to make. There is chemotherapy available in Kenya, however she would have to be able to pay for it. Also, it will be a very big surgery and she would have a fair chance of not making it through the surgery or the recovery. So, please pray for her and for us as we discuss this with her.
I am really enjoying my time here. I cannot describe in words how beautiful the area is and the people are just as beautiful in spirit. Everyone keeps asking why I'm only staying 2 weeks. It does feel like a short time. However, I am continuing to pray about coming back here for the 2 years. I could definitely see myself here. We'll see what the Lord has in store.
Until the next post, I hope you all are safe and well. God Bless!
Wednesday, October 15, 2008
Karibu
Karibu! This is a word I have heard many, many times since arriving in Kenya 2 days ago. It means welcome and the people here are more welcoming than most other places I have been. After LONG plane rides, I arrived in Nairobi Monday night. I arrived at the guest house I was staying at around 9:30pm and promptly took a shower and crashed. Then, it was up at 5:30 Tuesday morning to get ready. I then flew from Nairobi to Eldoret (a 30 min flight), which is the closest big city to Kapsowar. I was met by a worker from the hospital who took me shopping for food and necessities in Eldoret and then we began a bumpy 2 hour drive to Kapsowar. The first half was on paved roads and the last half was on clay dirt roads. I was very thankful that the mud from the rains the night before had mostly dried out!
The drive may have been bumpy, but it was so beautiful! This area is amazing. Very green, up in the mountains. We drove through a forest at one point which seemed like something out of a movie it was so perfect.
So, I finally arrived at Kapsowar around noon on Tuesday. I was shown to my house (yes, I have a whole house to myself) and met the house helper Mary, who is amazing and always has a smile on her face. I then was invited to one of the missionary’s house for lunch. Paul Larson is an FP here who has been doing all of the obstetrics. His wife and children lovingly welcomed me, including placing a handmade welcome sign on my door.
It was then off to tour the hospital and find out what my duties would be. It is a small hike to the hospital, but again beautiful. I am impressed with the work they are doing here with an extremely limited supply of resources. I am now in charge of the maternity unit and from what I hear it has been busy (in fact, right now we have 2 laboring patients and one laboring VBAC). I’m also in charge of doing ultrasounds. I am on call every other night during the week and all weekend both weekends I’m here. I am fine with this, though, as it gives Dr. Larson a much needed break.
This morning I went to a chapel service for all of the hospital staff. It was amazing to hear them lift their voices in song – I just wish I could have understood the words :)
So, things are going well here. I’ll write more soon. Still trying to figure out the internet connection, but hopefully I’ll be able to post pictures soon.
Keep praying!
The drive may have been bumpy, but it was so beautiful! This area is amazing. Very green, up in the mountains. We drove through a forest at one point which seemed like something out of a movie it was so perfect.
So, I finally arrived at Kapsowar around noon on Tuesday. I was shown to my house (yes, I have a whole house to myself) and met the house helper Mary, who is amazing and always has a smile on her face. I then was invited to one of the missionary’s house for lunch. Paul Larson is an FP here who has been doing all of the obstetrics. His wife and children lovingly welcomed me, including placing a handmade welcome sign on my door.
It was then off to tour the hospital and find out what my duties would be. It is a small hike to the hospital, but again beautiful. I am impressed with the work they are doing here with an extremely limited supply of resources. I am now in charge of the maternity unit and from what I hear it has been busy (in fact, right now we have 2 laboring patients and one laboring VBAC). I’m also in charge of doing ultrasounds. I am on call every other night during the week and all weekend both weekends I’m here. I am fine with this, though, as it gives Dr. Larson a much needed break.
This morning I went to a chapel service for all of the hospital staff. It was amazing to hear them lift their voices in song – I just wish I could have understood the words :)
So, things are going well here. I’ll write more soon. Still trying to figure out the internet connection, but hopefully I’ll be able to post pictures soon.
Keep praying!
Tuesday, October 7, 2008
On My Way Soon
Wow - it has been a long time since I've posted. Well, I now leave for Kenya in 6 days. I'm so excited and thankful for this opportunity. As I said in my previous blog, I will be working at Kapsowar hospital as an OB/GYN (and whatever else is needed) for three weeks. This trip has 2 purposes. The first is to be a servant and minister to the Marakwet people as well as hopefully somewhat relieve the long-term physicians that are there. The second is to check out the hospital to see if this is where God would have me be for 2 years starting next summer. I have officially been accepted to World Medical Mission's post-residency program and Kapsowar is a possible place for me to go. Please pray for wisdom as I prayerfully consider this.
I will first be headed to Boone, NC on 10/9 for a medical missions conference at The Cove (Billy Graham's conference center). I'm very excited for this as I know it will be a time of encouragement and refreshing. It will also be a time to reconnect with Dr. Dee Kotschwar, a physician from home who the Lord has used at many times throughout my life as a mentor and encourager in this journey. I'm also excited because the general surgeon who is usually at Kapsowar is one of the keynote speakers, so I will get to meet him.
Then, on Sunday 10/12, I'll leave from Asheville, NC, head to Detroit, then to Amsterdam, then to Nairobi. I'll stay overnight in Nairobi and then take a propeller plane (yikes) to Eldoret. From there it will be a 2 hr drive and at long last I will be in Kapsowar. My duties while there, as I understand them, will be to help run the maternity ward as well as the outpatient prenatal clinics. I'm sure it will be a time of learning and stretching me outside of my comfort zone.
I thank all of you who have been praying for me. I'm really excited to see what God's plan is for me through all of this.
I will be keeping this updated, so please check in and send me comments. It's always good to hear from home! I will be home on Oct. 31st.
Some prayer requests:
- That I would have a humble spirit that is teachable
- Wisdom for how to care for patients in a culturally-appropriate way
- That I would listen to the Lord's leading for the future
- Safety in travel as well as health while there
- My best friend, Amanda, will be 35wks pregnant when I leave and 38 weeks when I return. We are planning on me doing the delivery and I would be devastated if I miss it. Please pray that the Lord would keep her and the baby safe.
I will first be headed to Boone, NC on 10/9 for a medical missions conference at The Cove (Billy Graham's conference center). I'm very excited for this as I know it will be a time of encouragement and refreshing. It will also be a time to reconnect with Dr. Dee Kotschwar, a physician from home who the Lord has used at many times throughout my life as a mentor and encourager in this journey. I'm also excited because the general surgeon who is usually at Kapsowar is one of the keynote speakers, so I will get to meet him.
Then, on Sunday 10/12, I'll leave from Asheville, NC, head to Detroit, then to Amsterdam, then to Nairobi. I'll stay overnight in Nairobi and then take a propeller plane (yikes) to Eldoret. From there it will be a 2 hr drive and at long last I will be in Kapsowar. My duties while there, as I understand them, will be to help run the maternity ward as well as the outpatient prenatal clinics. I'm sure it will be a time of learning and stretching me outside of my comfort zone.
I thank all of you who have been praying for me. I'm really excited to see what God's plan is for me through all of this.
I will be keeping this updated, so please check in and send me comments. It's always good to hear from home! I will be home on Oct. 31st.
Some prayer requests:
- That I would have a humble spirit that is teachable
- Wisdom for how to care for patients in a culturally-appropriate way
- That I would listen to the Lord's leading for the future
- Safety in travel as well as health while there
- My best friend, Amanda, will be 35wks pregnant when I leave and 38 weeks when I return. We are planning on me doing the delivery and I would be devastated if I miss it. Please pray that the Lord would keep her and the baby safe.
Friday, March 28, 2008
Hello Kenya
Sorry I've been gone for so long. My life isn't really all that interesting most of the time, so you haven't missed much. Taking a hint from my best friend, though, I've titled this post "Hello Kenya."
As I'm sure you can guess, Kenya is my next destination. I'm very excited about the doors that the Lord is opening up. For quite some time now, I have known that the Lord was calling me into full-time medical missions. A few years ago, I found out about a program through World Medical Mission (a branch of Samaritan's Purse) that pays doctors that are just out of residency to go to a mission hospital for a term of 2 years. Past that there is no commitment, but of course the hope is that you decide to stay on. It is a wonderful opportunity to go overseas right away and to really be immersed in third-world medicine. I also have thought for some time that I would love Africa if I were to go. So, I contacted WMM and they sent me a list of hospitals that are in need of an OB/GYN.
One of the hospitals is a small one in rural Kenya. It is called Kapsowar hospital. It is a 100 bed hospital and they have obstetric as well as gynecologic services there. Right now, there are 2 family practitioners and one general surgeon. From what I have heard, they are really hoping for an OB/GYN. The surroundings are beautiful. Kapsowar is a small city that is about a 2 hour drive north of Eldoret and about 60 miles from the Kenyan/Ugandan border. I'm very excited about the possibilities.
For those of you who are saying "Wait a minute, isn't Kenya a little dangerous right now?", the situation is improving. I've talked to people and read a lot of news about it and for the time being, they have reached a peaceful agreement. Plus, when has that ever stopped me? Or, should I say, when has that ever stopped God?
The other thing that makes me think that this is all a God-thing is that after I started thinking about this, I joined a new missions class at my church. Guess what our first topic to learn about was? You guessed it - Kenya.
So, mid-October, I'm headed to a medical missions conference put on by Samaritan's Purse, and then I'll leave straight from there to go to Kenya. I'll be there through the end of October. If things go well then, I will likely be headed to Kapsowar for 2 years after finishing residency in June 2009. Though it will be very hard to leave everyone here for so long, I know that this is the Lord's plan and He is paving the way.
For anyone who is interested, here is the link for the hospital: http://www.kapsowar.com/working/tour.html
There is not much on it, but there are some pictures of the hospital, city, and surrounding areas.
So, that's what's new with me. I'm going to try to be a better blogger from here on out. I'd love to hear from everyone again.
As I'm sure you can guess, Kenya is my next destination. I'm very excited about the doors that the Lord is opening up. For quite some time now, I have known that the Lord was calling me into full-time medical missions. A few years ago, I found out about a program through World Medical Mission (a branch of Samaritan's Purse) that pays doctors that are just out of residency to go to a mission hospital for a term of 2 years. Past that there is no commitment, but of course the hope is that you decide to stay on. It is a wonderful opportunity to go overseas right away and to really be immersed in third-world medicine. I also have thought for some time that I would love Africa if I were to go. So, I contacted WMM and they sent me a list of hospitals that are in need of an OB/GYN.
One of the hospitals is a small one in rural Kenya. It is called Kapsowar hospital. It is a 100 bed hospital and they have obstetric as well as gynecologic services there. Right now, there are 2 family practitioners and one general surgeon. From what I have heard, they are really hoping for an OB/GYN. The surroundings are beautiful. Kapsowar is a small city that is about a 2 hour drive north of Eldoret and about 60 miles from the Kenyan/Ugandan border. I'm very excited about the possibilities.
For those of you who are saying "Wait a minute, isn't Kenya a little dangerous right now?", the situation is improving. I've talked to people and read a lot of news about it and for the time being, they have reached a peaceful agreement. Plus, when has that ever stopped me? Or, should I say, when has that ever stopped God?
The other thing that makes me think that this is all a God-thing is that after I started thinking about this, I joined a new missions class at my church. Guess what our first topic to learn about was? You guessed it - Kenya.
So, mid-October, I'm headed to a medical missions conference put on by Samaritan's Purse, and then I'll leave straight from there to go to Kenya. I'll be there through the end of October. If things go well then, I will likely be headed to Kapsowar for 2 years after finishing residency in June 2009. Though it will be very hard to leave everyone here for so long, I know that this is the Lord's plan and He is paving the way.
For anyone who is interested, here is the link for the hospital: http://www.kapsowar.com/working/tour.html
There is not much on it, but there are some pictures of the hospital, city, and surrounding areas.
So, that's what's new with me. I'm going to try to be a better blogger from here on out. I'd love to hear from everyone again.
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