Friday, January 16, 2015

Mzungu Musings

Well it's been pretty much ages since I've been over here on the personal blog. These days I do most of my writing on the official Hope Matters blog. But after an incredibly full and somewhat difficult day today I was putting some thoughts down as I processed my day. I thought I would go ahead and share them here.

Traffic was nasty heading back out of town. But I decided to crank up the music in the Toyota Land Cruiser and drive like a Kenyan. I’ve discovered that the more years one is here, the more erratic the driving becomes. Meaning, you drive like a local. I have a few other mzungu (white) friends who definitely drive 100% like Kenyans. I’m afraid that if you give me another year I might be there myself. I’m getting much closer these days and definitely have my moments.

As the traffic finally started breaking up a bit, I had the music cranked up, and was singing and moving along. This crazy, mzungu, lady, driver just owning the lousy diversion, dirt, roads. And as I realized I was owning the roads I just took it in. Here I am in Africa. In AFRICA. Yes I’m in m eighth year of living here full time now, but sometimes it just hits me afresh. I really live in Africa. I drive in Africa. I shop for my groceries here. I do my business here. I live my life here. I’m not just here on a sight-seeing trip. I’m not here to hand out some medicines and bandaids or hold a come-to-Jesus meeting and then go back home to a normal life in America.  I. live. here.

I’m living my dream. In AFRICA!  And I get to drive a 20-year-old beast of a vehicle over horrible roads, into the most gorgeous sunsets. I get to walk through dark, dark, dark twists and turns in life. I get to step into pain and suffering on a very regular basis. It is my privilege. It is my call. It is my obligation. It is why I breathe. Why I was created. To live and work and serve in Africa. And that’s why I do it. Because it’s what I was made for.

I’m not here to meet a quota. I’m not here to make someone else happy or proud of me. I’m not here to become famous. I’m certainly not here to become rich. I’m here to serve my Jesus. I’m here to live my very life’s purpose. I’m here to perhaps, just maybe, make a positive difference in someone’s life. I’m here to take up the responsibility to be Jesus with skin on. I fail yes. I fall down sometimes. More times than I would like actually. But I get back up. No, HE lifts me back up. He carries me when I am weak. And he has given me the incredible privilege of giving myself away to the people of this amazing and wonderful country of Kenya. May I never forget that truth....

Monday, October 07, 2013

Exciting Changes


I can't believe I haven't posted here since January!  We've had some big and exciting changes in our life.  The biggest and most exciting one being the launch of Hope Matters International.  My husband and I have founded a new non-profit ministry to advance medical and community development work in Africa.  We are heading to the USA to launch the organization at Life Bible Fellowship Church in Upland CA on October 26th.  We'd love to have you there. 

Check out our FB page for more info on the new organization or contact us at office@hopemattersintl.org 

Most of my posting these days is on our Hope Matters Blog.  I'll probably still check in here once in a while, but the majority of my ministry stories will be on the official ministry site. 

Monday, January 07, 2013

The Pain and The Privilege of My Calling



I’m coming off of about five hours of restless sleep this morning. A baby kept me up last night. But it wasn’t my baby. No. It was a baby who had died in his mommy’s womb before I met either of them. I often find that this blog becomes a place of therapy for my soul; somewhere where I can pour out my heart during intense times like this. Therefore this will likely be a longer post. So if you don’t feel like reading through to the end, no worries. This morning I am writing for myself.

Last night we were hosting a back-to-school party at my house for the youth in our life. We also had a few American volunteers over for supper just before the party. As I was feeding my son and the visitors were fixing their plates, someone came running to my back door saying that there was an emergency at the clinic and the nurse on call was asking me to come. I know that this particular nurse is super-capable and if she was calling for my help it was probably bad. 

She actually had three patients come in, in a very short time. She was the only nurse on duty as it was after-hours. Two of the cases she had under control, but one needed me to use my ultrasound skills. It was a young, expectant couple who are not from our community. Just the two of them, no support team of in-laws, friends etc. that you usually see during the birth of a baby in our small community. The nurse explained to me that the mom was in active labor, had been having pains for two days, and had not felt the baby move since early morning. She couldn’t find a heartbeat with a Doppler so she had already set up the ultrasound for me to use.

I am most certainly not a perinatologist, neither am I even an OB/GYN doctor. I’m simply a nurse practitioner who has sought out some extra training for times like this. And it did not take a specialist to see that this full-term baby was not moving in the womb. I located the heart and did not see any movement. I saw something that my non-specialist eyes felt was unusual. It looked like there was a very wide aorta (blood vessel going away from the heart, but I really wasn’t certain. Besides, the point was that the baby appeared to have already died in the womb.

This couple was completely new to our clinic and had received all of their prenatal care elsewhere. I stepped outside with the clinic nurse, visiting nurse from America, and father of the baby. In times like these you have to be so culturally sensitive even as you make medical judgments. I shared with the father that I had some serious concerns about the baby; that we would do everything we could but that I could not guarantee a positive outcome. I asked him if he thought it was better for me to share this information with the wife or to wait. We are in a rural location where getting someone transferred for a c-section is a pretty big ordeal. I needed to know that this mom could hold it together to deliver this baby so that her life was not endangered. He told me that she is a very emotional woman and he felt it would be better to wait and see the outcome before telling her our concerns. These situations are always such a hard call. Whether or not I made the right decision I do not know. But we did not tell the mom.

I recently read about a case in another place in Africa where a woman was referred to a large medical center to deliver because the smaller center had referred her for a fetal demise (same sort of case). In that situation the baby was blue at birth and did not move so they put it to the side and focused on mom. A few minutes later they went to move the baby’s body and found it alive and moving. So I had resolved in my heart to hold on to hope and do my best for this family.

It was not a particularly difficult delivery; her first time, so of course not easy, but not particularly difficult from a medical standpoint. The nurse and I decided that she would manage mom and I would handle the baby. As the baby came through the birth canal I began to suction and do all the things that I normally would during a delivery. But it looked bad. I’ve done resuscitation on many babies, but this one was definitely beyond resuscitation. I walked the baby away from the mom to another exam table. I listened. No heartbeat. I attempted resuscitation for a few minutes all the while knowing that the baby was already gone. I put my hands on the exam table and leaned over this precious baby boy and asked God “What now?” I needed to know that the mom was physically stable before going to see her with bad news. 

The placenta came rather quickly and I knew it was time. I knew that she already had to know something was wrong. I looked up to my colleague and the visiting nurse and told them that I was going to talk to the father and was coming. I shared the news with him. That I had tried, but that the little boy was already with Jesus when he came out of his mommy. We went back into the delivery room together and he wanted to hold the baby but was afraid to at the same time. I helped him. We talked for a minute and then I went to see the mom. She still needed post-partum care but I knew this conversation could not wait any longer. I shared with her that her baby was not breathing when he was born. That his heart was not beating. That I tried but I could not get the baby to breathe or have a heartbeat. That her child was a boy and that he had died.
Oh the anguish. She whispered “My Baby..” in Swahili and then began to thrash and scream. She shouted all of the normal questions that really have no answers. “Why my baby? Why me? I was not prepared for this! I want to die too..” I wrapped my arms around her and cried with her. In a moment like that, there really is nothing more that one can do. My heart broke with this family. 

In my life I have had many pains. One of those pains included losing an unborn child myself.  I did not carry this child to term as this mommy did. I have no idea if mine was a boy or a girl. But I do know the horror of having a doctor look you in the eye and tell you that what you believed and all you had hoped for would not be. 

The passage in Second Corinthians, chapter 2 verses 3 to 4 comes to mind at a time like this. “All praise to the God and Father of our Lord Jesus Christ. He is the source of every mercy and the God who comforts us. He comforts us in all our troubles so that we can comfort others. When others are troubled, we will be able to give them the same comfort God has given us.” (NLT) I’ve always had mixed feelings about this passage.  I ask myself why it is that any of us should need comfort in the first place? Why this horrible, inexplicable, pain and suffering that some are asked to endure?  But in a moment like that moment last night, I find great comfort in the fact that I can truly look these parents in the eye and tell them “I know your pain. I know that it feels like you will just die from it. I have been there. I’m so sorry.”
The job of washing a little body whose soul has left is such a terrible, painful thing. But I did it.  I helped the mother hold her son as she told him goodbye while at the same time hardly believing it could be possible. Her head to his forehead and the tears falling unchecked. I prayed with the family. I asked that God would be the God of all comfort and peace. That they would know His presence and have the assurance that their baby is in the presence of God himself. I looked both parents in the eye and said very clearly THIS IS NOT YOUR FAULT! I asked them to comfort and hold each other as they walk through this unspeakable pain.
As I left them, extremely early this morning, they were discussing where they would bury their son. In this area you bury your loved ones in your backyard. They had recently moved to the area and are renting a small house about twenty minutes away.  They don’t have their own property where they can lay their son to rest. 

My short night was restless as I tossed and turned in my bed. But when I came fully awake I was overwhelmed with thankfulness that I could be there to weep with this family. That I have the honor and the privilege of stepping into peoples lives during their most horrific and vulnerable times. That God can use me as His instrument of peace during times of storms and crises.

Saturday, October 13, 2012

A Special Opportunity


As I continue to serve here in Kenya with Empowering Lives International, it has been exciting to see God work to change and heal both lives and hearts.  Every now and then I meet a special individual or community that has an urgent situation that brings me to my knees and I feel compelled to reach out and share the story. This is now of those times and I wanted to share with you about a special opportunity. I'd like you to meet Karen, an eight-year-old Kenyan girl who loves going to school and playing soccer with her friends. (Picture attached) Unfortunately Karen can no longer play soccer and has a difficult time getting to school and back.  You see, Karen has a hole in her heart.  And it’s a pretty big hole.  Without open-heart surgery she won’t make it to adulthood let-alone finish school, or ever be able to play soccer with her friends again. For the last month I've been praying for Karen and trying to seek out opportunities to get her surgery.

I recently learned that there is a special team of heart surgeons coming to a mission hospital in Kenya to do just these sort of surgeries.  I've managed to get Karen's name on the list for an evaluation which will happen just about two weeks from now.  The team will be returning to Kenya several times next year.  So they will evaluate all of the children needing heart surgery on this visit. Then they will perform surgery for the kids who are deemed to be most critical.  They will return next year to perform surgery on the remaining children.  We aren't sure yet which group Karen will fall into.  But we do know that we need to raise approximately $3,500 to cover transport, housing, and surgical, and hospitalization expenses.  This is an incredible opportunity as I had previously been quoted $50,000 for the surgery.

I would like to ask that you be praying for Karen and her family during this time. Pray that the funds will be provided in enough time to get her seen by this team of doctors.  Pray for Karen to stay strong until she can get her surgery. Pray for a total healing of her body.

If you would like to partner in helping Karen to get her surgery please click here  Once you get to the page you will click on "Ministries/Programs" and choose “Kenya Health” from the drop down menu and then write in "Karen's Medical Fund" in the comment section. All donations are tax-deductible. Your contribution will go towards helping to save Karen's life and giving her, her childhood back.

Thanks for standing with Karen during this challenging time!

Sunday, September 23, 2012

A God Moment

 

This post is a little on the longer side, but I just couldn’t figure out how to cut it down. It was a powerful experience that I believe is worthy of the details.  We recently had a visiting team of nurses and nursing students from UCLA volunteering with us. The team members were anxious to help deliver a baby and were thrilled when late one afternoon a mother came in, in active labor. I wasn’t on call that night and William wasn't expected to arrive until supper. I needed to get home to relieve my babysitter

Right as William was pulling in I got a text from the clinic saying that the patient was pushing. So I headed over to join in. Something just didn’t feel right about the situation. As the patient progressed I decided to do an exam. During the exam I had a hard time knowing just what I was feeling. Was it a baby’s face? Then I felt little digits. I looked at everyone in the room and said “I think I just shook hands with the baby!” Any time it’s not the head coming first, things get a little complicated. So I called in our most experienced midwifery nurse from home to please join our delivery team. I asked if an ultrasound had been performed. The on-call nurse that night happens to be new to the clinic and hadn’t been trained on the machine yet. (As a side note, the mom was 8cm when she arrived so realistically there wouldn’t really have been time to refer her to the hospital anyway.) We pulled out the machine and could not find the head. Doing an ultrasound on a woman in active labor who is pushing is NOT easy. We were not sure if the head was already in the birth canal or up under the ribs somewhere.

So our experienced nurse, Triza, did a manual exam. She looked up and our eyes locked. “Michelle, that was not a hand you shook. It was a foot…” In that moment I believe the same memory washed over both of us. Two summers ago we worked together on what is my most horrific medical experience to date. It was a breech delivery where we lost the baby and almost lost the mom. You can read about it here.

From that point things got pretty wild. I knew that there was a HUGE chance that we were going to need to do resuscitation on the baby when we finally got him or her out. So we put the visiting team into action setting up all of the equipment we might possibly need. Triza and I began talking through that case from two years ago. What could/should we have done differently? What can we do now? We came up with a game plan. It was a HUGE blessing having so many skilled hands in the room. The patient was a young mom who was not cooperative at all. She began kicking and thrashing quite a bit as things progressed. One of the student nurses actually wound up at the head of the bed just trying to prevent her from kicking us in the face.

I sent a few nurses to my office to search my textbooks for any instructions on a footling breech delivery. Every book they looked in advised an immediate C-section. I’ll spare you the details, but thanks to God’s grace and past experience we were able to get the baby out much faster than I was expecting. At one point things were looking a little grim and I asked the visiting team that if anyone felt that they couldn’t handle what was to come they should please leave now. Everyone stood strong!

As I was guiding the baby’s body out, I could feel a slow but strong heartbeat. I knew there was hope! The baby was born blue, motionless, no crying, and no breathing. But her heart was beating, just too slowly. We immediately began team CPR. Part of the resuscitation process involves keeping the baby warm and pumping oxygen directly into the lungs with something called an ambu bag.  Because of the third world electrical wiring we can’t run both the oxygen condenser and heater at the same time. So we had this system going. I would yell out OXYGEN and the nurse in charge of that machine would switch it on, while the nurse at the warmer switched it off, then shortly after we would switch again. I was alternating between doing the respiratory resuscitation and using a special devise to suction out the babies airway while another nurse did the chest compressions. It was a beautiful dynamic. Within a few minutes the heartbeat picked up and the baby began to breathe independently.

Once it was clear that the baby was in the clear, we continued to provide support with blow-by oxygen and heat. It is extremely rare (as in I’ve never had it happen before!) to get an action photo while a situation like this is going on. But once we knew the baby was in the clear one of the American nurses got some pictures. 
Suctioning the Baby's Lungs

Providing Blow-By Oxygen

More Suctioning and Oxygen
 Just after the above picture was taken the power went out in the room. We were all overwhelmed by the fact that the power had stayed on through the entire resuscitation process! One of the team members said it best, “It was a God moment.”

Just this last week the mom brought her daughter in for a well-baby visit. They both looked great. I hardly even recognized the mom. And the baby girl, well she is doing fantastic! She is eating well, moving well, and her reflexes are intact. Here she is!


Thursday, September 20, 2012

To Hurt that We Might Heal....


One of the hardest things for me as a medical provider is inflicting pain to help bring healing.  This summer I became aware of a slum on the outskirts of a small community center just a 20 minute drive from our home.  This slum has over 600 family units living there.  One of the challenges faced in this community is that of chiggers or jiggers.  They are extremely small bugs that imbed themselves in skin and lay eggs there.  They create itching, pain, inflammation and infection that can destroy the tissues in the feet. Because they imbed so deeply in the skin they must be removed using needles and scalpels.  It is a tedious and painful process; but necessary in order to treat the patient. 

This hurting to heal makes me stop and contemplate a bit.  Just as in the medical profession it often takes pain to bring healing, so it is in our spiritual walks.  There are times when we endure emotional pain that actually leads to growth and health.  The key is in sitting still while we allow God to use the scalpel and needles to dig out the root of the problem.  It’s in remembering that He also has the soothing salve and dressings to help heal the wounds so that we might be better off in the long run.

 But let me get back to the main subject of this blog, the community with the chiggers!  Since the discovery of this need, we have been able to make a few trips to do chigger care clinics.  The first time we were joined by a few ELI interns who helped sponsor the outreach.  Click here if you would like to see some pictures from that outreach.  This most recent trip was made possible by a team of nurses and nursing students from UCLA who also helped us with the treatment of the patients.  Our next chigger outreach will take place on October 10th with a few team members from Water of Life Church joining us.  They have also raised funds to help purchase shoes and socks for the patients being treated. 

Walking through the slum with supplies
Tools of the Trade
Setting up the Work Stations

The feet needed to soak before beginning treatment






This little Girl kept screaming at the nurse that she was going to call the police and report the nurse


Making the incision to remove the chigger

And there is the chigger with larva




Bandaged feet and waiting for socks and shoes

We were also able to distribute de-worming medication to the community

At the end of the day I climbed up on the rock behind the church to get a shot of the team with some of the patients and the local pastor