Defibulation

This is a big name for a procedure that reverses the destructive effects of female circumcision (aka Female Genital Mutilation) and I did my first one ever (haven’t ever even seen one) last week. Female circumcision is an extremely destructive practice that unfortunately is still practiced in this part of Kenya, despite the fact that it is illegal. Many people are actively campaigning against it, but it is still being done in the smaller villages. It is, in fact, so common here, that I’m surprised when I see a woman who hasn’t had it done. It is done without anesthesia and under very unsterile conditions. Some girls are as young as 7 or 8 when it is done. For those nonmedical people reading this, basically all of the external genitalia are removed and the woman’s opening is closed over until only a very small opening remains. This causes all sorts of problem for the woman, including giving birth.

About 2 weeks ago, one of the maternity nurses approached me and said she had a friend who had been circumcised as a young girl and was getting married in December. She wanted to have her circumcision reversed prior to getting married, something that is unheard of in her community. She asked if I knew how to do this. “Well,” I said, “I did do a presentation on it in residency and it explained how to do it. I’ve never seen one, but I think I could do it.” So, I met her friend. I was shocked when I examined her – it was the most severe circumcision I have seen yet. She was forced to urinate and menstruate through an opening that I could barely fit my pinkie finger in. What an awful way to live, I thought. As we talked, she described to me how careful she had to be that no one at home or that knew her family found out she was having this done. She would be ostracized if they found out. (I have yet to find out exactly why this practice is still done here, but many Kenyans also find it awful.)

So, last Friday, I did my first ever circumcision reversal (after reviewing how to do it from my presentation – thank you ACOG!). There were about 10 people in the OR watching over my shoulder, as they had never seen one before, either. Don’t worry – no pictures for the blog for this one J It went well, and I’ve seen her back once. She is very happy with the results and couldn’t stop thanking me. What a joy to do such a simple procedure but have such a huge impact on someone’s life. The theatre staff were joking that maybe this will become my new niche here – we’ll see!

Sunday Drive

Last Sunday, Dave Peterson offered to take us for a Sunday drive to the valley overlook. Dave and Trudy Peterson are here from Alaska through Samaritan’s Purse. Dave is a contractor and is overseeing the building of the new OR building at the hospital. Trudy is a teacher and is teaching at the local girls’ high school. They will be here until next summer. It is a blessing to have more people here on station to fellowship with and it has been fun getting to know them.

So, we loaded into Dave’s truck and drove up the tarmac road. Once again, the views amazed me. It is breathtaking to see God’s creativity in this beautiful place. We stopped at Kipsaia at an overlook of the Kerio Valley, which is part of the larger Great Rift Valley. We met some local people who were very curious about us “wazungu” (foreigners) and were more than happy to tell us about their village and the valley. We were even invited to the woman’s house in the picture below, but as we couldn’t leave the truck, we had to take a rain check. We then drove a little farther and stopped again for another beautiful view. In this village, you would have thought we were the Pied Piper by the following of children we had.

It was a great afternoon and relaxing after the walk the day before. Dave says he wants to do this more, and I look forward to exploring the area with them.

The Kerio Valley

Dave, the woman from Kipsaia, me, and Abi

Watching some much needed rain move through the valley

Our following

Dave and Trudy

“It’s not a bad walk”

the “river”

looking up from the river

Some kids on the station

Famous last words. This is what I was told about the walk to the river. Last weekend, Abi, Drew, Isaiah (the grandson of a visiting surgeon), and I walked down to the local river. The walk there wasn’t bad at all, apart from a few steep parts. Once we got there, the view was spectacular (see pictures below). While the water isn’t the cleanest, it was so peaceful to sit on the banks and hear the water rush over the rocks. Isaiah, 15, had fun jumping the rocks and even laughed when he fell in the water – much to the delight of the Kenyans walking by. It is a beautiful spot and I hope to take a picnic down there sometime – Brandy and Deb, maybe when you come?!

When we were ready to head back, I asked if we were going back the same way we came (it had been a pretty steep downhill climb). Oh no, I was reassured. We’re taking the tarmac (paved) road back – it’s a much more gradual climb. Well, I have to admit that it was more gradual. But, it was uphill the entire way – for about 2 ½ miles. For someone as out of shape as I am, it was a feat. What normally takes about 30-40 minutes took us well over an hour. We even got caught in the rain on the way back. It felt like an accomplishment when we finally arrived back at the hospital, but oy, was I sore for the next several days. I keep telling myself that these sorts of walks are good for me – and the views are always worth it. I think next time, though, I will premedicate with ibuprofen!

Edna

So, I have a lot of catching up to do. Two weeks ago, Edna, who helps me out at my house twice a week, invited Abi and I to her house for lunch. When I say she helps me out at my house, I mean that she does my laundry, does some cleaning, does a lot of my shopping and cooks some sort of marvel for us. She is such a sweet woman who loves taking care of others and, much to my delight, loves to cook and experiment with new recipes. She used to work for the Larson’s, a missionary family who was here previously and lived in the house where I am now living. She misses them a lot and I think is glad to be working in this house again.

After church, Abi and I headed to her home to share lunch with her. She lives about a 20 minute walk from here on a shamba (small farm) in a compound with many other relatives. Edna comes from a very large family and I don’t think even she can count how many relatives she has that live around her. She was happy to show us her farm and her cows. She welcomed us into her home for lunch and then walked about 20 minutes to get us some soda (trying to get used to calling it that). Abi and I felt bad that she had gone to so much trouble for soda, but she insisted – typical amazing Kenyan hospitality. We spent a long time talking about her and her family and her life.

After that, we went outside and played with some of her many nieces and nephews. As she showed us her cows, I mentioned that I’ve always wanted to learn how to milk a cow. She said she would be happy to teach me sometime. So, stay tuned for that!

I praise God for Edna and pray that we will be able to develop a meaningful friendship over the next couple of years.

The beautiful view on the walk to Edna’s

A Kenyan chicken coop

Edna and I

Me with Edna’s relatives

Umm, that's not a baby!

I promise I haven't been a delinquent blogger. My friend Amanda has been helping me out by posting my blogs, but she has been on vacation. So, there's a little bit of a backlog right now. There's more to come, though, I promise.
For now, I thought I would recount an interesting experience at the hospital about a week or so ago. I was sitting in the female surgical ward doing some paperwork when they quickly wheeled a woman in that they said was bleeding. She looked quite distressed, so I followed them into the room where we do D&C's. She looked like she was in quite a bit of pain. I spoke to her through the translator and she said she had been bleeding for a couple of days and the night before starting having what felt like labor pains. She said she didn't think she was pregnant, but couldn't be sure.
So, I lifted up her dress to examine her and she had what appeared to be a very pregnant abdomen. I asked her again if she thought she might be pregnant, but again, she wasn't sure. So, I went to examine her and felt a baby's head coming through the birth canal (at least what I thought was a baby's head!). It was at that point she told me she needed to push. So, I quickly told her I thought she was delivering a very premature infant and she should just go ahead and push. We sat there with her as she pushed and as the "baby" started to crown, I realized that it looked very odd. Gladys, one of the nurses, was standing next to me and we both looked at each other. I very quietly said "Gladys, does that look like a baby to you?" She looked at me with a look of confusion and said "No, that does not look like a baby, but what is it?" As it crowned a little more, I realized that it looked and felt like a fibroid (a benign growth of the uterus).
So, I told her to stop pushing and quickly took her to our ultrasound room. Sure enough, she had a uterus full of fibroids (including the one that had prolapsed through her cervix and was trying to deliver) and her uterus was about the size of a 20 week pregnancy. Boy did I feel silly! We took her to theatre later that day for a hysterectomy and she is doing very well.
That is definitely something I've never had happen before! There seems to be a lot of that around here.