Monday, December 28, 2009

Malaria Update and Info

Well I'm very pleased to announce that I'm finished with malaria! Unfortunately I transitioned from malaria into a case of pneumonia. I'm still fighting the pneumonia but taking a turn for the better. Your prayers for continued healing continue to be greatly appreciated.

In the last week or so I've been asked quite a few questions about my malaria. Here are a few and some of their answers:
  1. Isn't there a vaccine against malaria? Were you immunized? No, as of this time there is no vaccine that can prevent malaria. So no, I've not been immunized.
  2. What exactly is malaria? It is a parasite that gets into the bloodstream. Because it is in the bloodstream and the red blood cells, it pretty much has effects on the entire body. The type of malaria I had is called Faliciparum and is actually one of the worst of the four types.
  3. How do you get malaria? The parasite is carried by the anopheles mosquito. The mosquito bites an infected person and then becomes an infected carrier. It takes about a week to ten days before that mosquito can bite an uninfected person and spread the infection. Once an individual is bitten by the infected mosquito it takes a minimum of seven to ten days for the parasite to multiply enough for symptoms to begin.
  4. Why is it that Westerners get so much sicker than nationals when they get malaria? I became so sick because of a few factors. Firstly I had never had malaria in my life and so thus I had not built up any immunity or natural resistance to the disease. My immune system was overloaded and didn't know how to effectively fight, causing me to become very sick. Secondly I had a resistant strain of malaria. So the first and even second-line drugs I was given were not effective in killing the parasite. I required the strongest IV therapies available in order to knock the parasite out.
  5. What are the symptoms? Basically the worst flu of your life! It usually starts with a headache then moves into high fevers, chills, body aches, vomiting and diarrhea. Some people also get lung and kidney involvement. At it's worst it can invade the brain causing cerebral malaria which is often fatal. I did not get cerebral malaria. My fevers were staying in the 104 range while taking medications that are supposed to lower fevers. Because my immune system was so overloaded from trying to fight the malaria I also wound up with a urinary tract infection, respiratory infection and tonsillitis before I was admitted to the hospital.
  6. Now that you have had malaria are you immune to getting it again? Unfortunately no, many of the cases that I treat at the clinic are individuals who have had malaria dozens of times. However, with each exposure to the malaria the immune system theoretically should be a bit stronger and more effective in fighting it.
  7. Are there medications that can prevent malaria and do you take them? Although no drug is a 100% sure thing, there are medications that you can take to help prevent malaria. I highly recommend that anyone traveling to a malaria endemic area take these medications. However because I live in Kenya and plan to be here long-term it isn't so practical for me to be taking these strong drugs for every day of my life.
Hopefully this helps answer some of the questions you may (or may not!) have about malaria. If you would like more information you can click here and check out what the CDC has to say about the disease.

Thursday, December 24, 2009

Malaria

The last ten days I have been battling malaria. This is by far the sickest I have ever been in my life. I started out taking first-line anti-malarial oral drugs. They had no impact and my fevers were soaring up past 103 so the decision was made to switch me over to Quinine. After three days on quinine I continued to get worse with temperatures rising above 104. At that point (on Sunday) the nurse who was treating me referred me to the hospital.

I was admitted to Medi-Heal Hospital in Eldoret shortly after arriving. My white blood cell count's were nearly four times normal. My malaria test was highly positive even after five days of strong treatment. I also had a urinary tract infection, respiratory infection and tonsillitis.

Within 10 minutes of my agreeing to be admitted I had an IV started and was given no less than six drugs. When it was at it's worst I actually dreamed that I was in heaven and was disappointed to wake up. After three days in the hospital I was starting to improve a bit and we realized that we wouldn't be able to pay the hospital bill if I stayed an additional night. So I fought to be discharged with my IV in place.

So for the last few days I've been receiving IV infusions from home. The fevers and chills are completely gone now. I'm just about as weak as a newborn kitten though. I continue to fight this respiratory bug and have a difficult time even thinking about eating anything. I would greatly appreciate your prayers as I continue to try to fight this thing.

Monday, December 14, 2009

All in a Day's Work

After a great trip to the coast with my hubby, parents, and baby sister I'm back to work. And let me tell you, work is in FULL swing! I'm on call for seven nights straight. The bummer about being on call here is that you still put in a full days work regardless of what happens during the night.

I'm hoping and praying for a restful night because today (besides being our second wedding anniversary) was a pretty full day at the clinic. Here are just a few of the MANY cases that I treated today:
  • A retained placenta from a woman who delivered at home. She arrived on the back of a motorcycle and was half carried to the maternity ward. The blood dripping down her legs clued me in that it might be a complicated case. The removal (by yours truly) actually went very well and she was able to head home just a few hours later.
  • The family who came for a follow-up visit for a wound. It was a crazy hand wound. I could see that it had been stitched all over the place. Turns out there was a family fight and the ladies hand got pulverized as a result. Oh, by-the-way, these people happen to be some of my immediate neighbors.
  • The mom who had her five-year-old stick out his tongue at me. She then explained "The witch did that to him." The tongue looked very normal to me so I asked her to explain. She told me that when he was bewitched he had stones and sand put in his stomach at the same time. She told me this had happened on Thursday. I asked her if she was sure there were stones and sand there; and if they were, how did the witch get them there? She told me that they aren't there anymore because the traditional healer removed them through the skin with his hands that same afternoon. So I verified, "you aren't actually here because of the tongue or the stones?" No, he has malaria. Go figure!
It certainly wasn't a boring day at the dispensary. Now let's hope for a nice, calm, and boring night!

Thursday, December 10, 2009

Belated Birthday



William and I took Ashley out for a belated birthday celebration while we were in Malindi. We took public transport to Watamu and had lunch together. We ate at what William and I call a "Real Kenyan Place". We knew it was a real Kenyan restaurant because my conversation with the waiter went something like this:

Waiter: What would you like?
Michelle: I'll take the pizza (there are lots of Italians on the coast so pizza is findable there!)
Waiter: Our tourist season has been low this year so we aren't making the pizza
Michelle: Okay, then I'll have the chicken
Waiter: We don't have any chicken today
Michelle: Can I get the mushroom soup?
Waiter: We don't have that either
Michelle: What do you have today?
Waiter: Chips (french fries) and sausage
Michelle: That sounds great, can you add an ice cream?
Waiter: Sorry, we don't have any ice cream
Michelle: Okay, no problem, we will all have chips and sausage

I learned a long time ago when eating at a real Kenyan place to not even bother reading the menu. It's better just to ask what is actually available.

After lunch, Ashley and I went into one of the world's leading snake research centers. It was pretty amazing. We saw some incredible and deadly snakes. Ashley got to handle about four of the non-venomous ones.

Friday, December 04, 2009

Malindi Madness



What an amazing week it's been so far! I'm in Malindi (a coastal town in Kenya) with my hubby, parents and sister. My parents have a Time Share in America that they were able to trade a week in Palm Springs for the week here. So here we are in tropical paradise soaking in the sun.

Yesterday we decided to travel to Watamu in search of some good snorkeling. We found out that it would be $100 to take a taxi round-trip. That sounded ridiculous to us so we opted for public transport for less than a quarter of that cost. Now there is something you should know about public transportation in Kenya. It is way cheaper. I mean WAY cheaper than private. But I think that you just might pay for it in the years it takes off of your life. I think my parents should get an award for their incredible flexibility and good attitude about yesterday's journey.


I pulled this picture of a tuk-tuk off the web to give you an idea of what they look like.

We started by getting into two different Tuk-Tuk's. A tuk-tuk is kind of like a modified motorcycle that looks a bit like a motorized partially-enclosed-tricycle. The tuk-tuk drivers took us to the local stage where we could catch a matatu to Watamu. I realize I am speaking Greek here. So a matatu is a 15-seater Nissan Van. But let me tell you, they cram a lot more than 15 people in them.

Another picture off the web. Often they drive down the road at full speed with people hanging out the side.

My mom bravely climbed up in the matatu and then proceeded to climb in-and-out, in-and-out as passengers kept needing to disembark. We finally arrived in Watamu and were dropped off on the opposite end of town from where we needed to be. So after a lot of loud and animated discussion (At times like this I am SOO glad I have a Kenyan husband!) we got in some more tuk-tuks to be taken to the Kenya Wildlife Services (KWS) station. Along the way a boat captain heard that we were wanting a glass-bottom boat for snorkeling. So he jumped in our tuk-tuk and told us he would arrange for his boat to pick us up. We agreed on a price and proceeded to the KWS gate where we payed our entrance fees.

My assumption was that there would be a nice little marina or at least a gangplank of some sort where we would walk out to our boat and head out on our journey. Nada! We walked about half a mile to a totally deserted beach. We then waited on the beach for a half an hour as our captain kept promising us that the boat was on the way. Well the boat finally arrived and we waded out to it.



Then the motor wouldn't start. We sat in the boat for another 10 or 15 minutes while they tried to get the boat to start. It finally started and we were on our way.


We went to the old-coral-reef at the end of the Watamu Marine Park. Mom, Dad, Ashley and I snorkeled and enjoyed interacting with dozens of beautiful tropical fish. William admired the fish from the safety of the boat.

Heading back we basically did the same trip in reverse. We stopped for lunch at a restaurant on the beach. While we were eating, the fishing boats started coming in with the day's catch. We marveled at the tuna, snappers, and barracuda that were hauled across the shoreline.


On our way home we got mobbed with people wanting to carry our snorkel gear while trying to transfer from a tuk-tuk to a matatu. It was quite an adventure for Mom and Ashley! Luckily we were able to get the two of them in seats with the matatu driver of front. At one point on the journey home there were eight bodies in the second row (designed for three). Five adults, a kinder-gardener and toddler as well as a baby. At that same time there were three guys hanging out the open door as we drove down the road. After a minute or two a lady in the back row offered to hold the baby. So the baby got body-surfed to the back to sit on a strangers lap.

All in all it was a fabulous day! As I said before, I was impressed with how the Kerns clan held up in Kenyan public transportation. They are super troopers!

Monday, November 30, 2009

Cattle Dip Crisis


Two nights ago I got a phone call from William that he was rushing a small child to the clinic. He told me the child had just been pulled out of our local cattle dip. (Pictured above. It is a channel full of water and chemicals used for killing ticks on cow's hides.) Five-year-old Mercy was not from our community. She was here visiting her Aunt and Uncle on a big adventure to have a sleepover with her cousins Joylynn and Jerom.

As her auntie was preparing dinner Mercy and Jerom went outside to play. The story was narrated to us by four-year-old Jerom who told us that Mercy jumped in the cattle dip. He said that once she got in the water she started screaming and splashing. Jerom ran to get help and grabbed the first man he could find.

The man saw her floating in the dip face-up. He jumped in and pulled her out. The village screaming alert was started around the same time she was pulled out. Several of ELI's sustainable agriculture students arrived on the scene about that same time. These students were trained in our First Aid and CPR course back in October. They immediately began performing First Aid. William arrived as Mercy began to cough and vomit. He transported her to the clinic via ELI's ambulance.

I arrived just moments after Mercy did. There was a huge crowd gathering at the clinic and a few women and girls were screaming/crying. As I reached the exam room I found that Mercy was also screaming. At that point I heaved a huge sigh of relief. A screaming child is a good sign; it means she is healthy enough to scream.

Her lungs were miraculously clear and vital signs were stable. We stripped her down to her skin and scrubbed her with soap and water from head to toe. She was also given medications to help counteract the effects of the poisons from the dip. It was an adrenaline packed night that thankfully ended well. Mercy returned to the clinic for a follow-up the next morning and was doing great.

* As a follow-up to my last post, the woman and her baby were taken to the village chief. He felt that the best course of action was to involve her family. The baby was taken to the family so that they could be given the option of raising the child should they want to do so. I haven't heard anything else about the little boy so I'm assuming the family chose to keep him.

Friday, November 27, 2009

Rainforest Retreat

At the beginning of Thanksgiving week William and I took my parents and sister to our favorite getaway, the Rondo Retreat, in the Kakamega rain forest. We spent several days hiking, relaxing, and taking in God's amazing creation. Here are some highlights.


Dad taught William how to play chess.


Mom and Dad relaxing on the porch of our guest house.

William and I at the edge of the forest.


One morning we went for a long hike and climbed a peak in the middle of the forest. It was quite a climb but the view was worth it!

Ashley was thrilled that we got to see bats inside a cave.



Dad and Ashley on top of the peak.


Ashley pretending to be a lioness in the grass.



This rain forest is full of monkeys. This one is a colobus.

Wednesday, November 25, 2009

Social Work

Several times in the last two years I've longed to pick up the phone and call a social worker to come in and rescue me and my clients from some crazy situation. One of the beautiful things about life in the USA is that we have lots of safety nets. Those safety nets simply don't exist here in Kenya.

Last night my family and I were on our way back from a few days in the Kakamega Rainforest. It is one of my favorite getaways and I'll try to get some pictures of our trip up later today or tomorrow. We were on our way home and just a few miles from our house when I got a phone call from the nurse I left in charge at the clinic.

He informed me that a woman had delivered at the clinic and was saying she did not want her baby and would not take him home. I was requested to come and help deal with the situation. Abortion is illegal here in Kenya so when women want to terminate a pregnancy they usually try to do it on their own. Often women will drink laundry soap or take an herbal concoction. In this case the mom told us she had made two unsuccessful attempts. She made it clear that she had no interest in the baby boy whatsoever.

Our staff told me that they were afraid if they asked her to take the baby back to her family that she would throw him in the river. We didn't have any formula on hand and it would have been impossible to get any until the next day.

It was one of those situations where you take a deep breath and pray.

After much discussion I proposed that we buy time by asking her to stay overnight and have someone stay with her and the baby. Then we would have some time to think and pray through the situation. She agreed and I brought her a hot meal.

Word began to get out that there was an abandoned baby and we had several infertile women come forward asking for the baby.

These are times when I thank God for my incredibly wise husband. William pointed out that things needed to be handed in a very legal way so that no disasters would come up in the future. No one from our community knew this woman. For all we know she could show up in a month suing us for stealing her baby. He proposed that we take her to the chief's office and have her sign papers to relinquish her parental rights. So that is exactly what we did this morning.

We also sent the families interested in taking the baby to the chief. I'm not quite sure how it will all work out but I was thankful that the chief was willing to get involved in this case. So often I get in a situation like this one and think to myself "We need to call in some help" and then I remember that I am the help that was called!

Please join me in praying for this precious baby boy. God obviously has a plan for his life! Once I know where he winds up I'll let you know.

Thursday, November 19, 2009

Holy Moments

I always wonder what people's perception is of day-to-day life on the mission field. Quite honestly many days are just hum-drum routine days. But every now and then I have a moment that I would simply have to describe as holy.

This week has been a bit hectic. I have my family here which is WONDERFUL but I'm trying to manage working this week at the same time. On top of that we had a major plumbing disaster last night which resulted in needing to have the pipes dug up and replaced today. So in the midst of the craziness I rushed home to grab some things before heading out to meet my family at an ELI function. As I was leaving I was told that there was a lady outside looking for me. When I stepped outside I recognized her immediately.

Back in September we had this one crazy week where we delivered like 8 babies in just one week. For our little dispensary that is a big deal. (I know my labor and delivery friends in the USA are rolling their eyes!) Well one of the pregnant woman who came in that week did not deliver at our clinic but was referred out.

I instantly connected with this mom from the moment she walked in the door. I'm not sure exactly what it was about her but we just hit it off immediately. Her name was Jackie. She had walked about three miles to get to the clinic. Her mom came with her. She had been a university student and was abandoned by her boyfriend when he found out she was pregnant. But nonetheless she seemed really excited about having her baby. When I checked her prenatal record I found that she was super early. On exam she was 5cm dilated which meant she was in true labor and there was very little chance of stopping it.

I explained to her that she absolutely had to go to a big hospital. I told her that she was in true labor and I couldn't stop it. I was straight-forward with her and told her that at this stage the baby had an almost zero chance of surviving if she delivered in our clinic. If she delivered in the hospital there might be some chance but I couldn't make promises. She began to cry. Her and her mother told me that they had about $5 between them and that was all they had. Period.

I stepped outside for a moment to let them talk. When I came back in they told me that they were going to walk home then pray and wait and see what happened. I told them that they absolutely could not go home and that I was not chasing them out of the clinic but that I knew a delivery at our site would have a bad outcome.

This was one of those moments where God didn't have to speak in an audible voice. It was very clear that I needed to get this woman to the hospital. So I reached in my pocket and handed her the cash for transportation to the hospital and to be admitted. I laid hands on her and prayed for her and the baby. Then we put her on the back of a motorcycle and sent her on her way.

Well this afternoon as I walked outside it was none other than Jackie standing there with her baby boy. I immediately got goose-bumps. It was an overwhelming and beautiful moment. She told me that she had to come show me her son. She is looking for work and trying to find a way to support him. I promised her that I will keep my eyes and ears open. Jobs are so hard to find right now. I prayed with her and for her son. I told her that God obviously has a great plan for this little one because the odds were totally against him. He truly is a miracle and looking into his little eyes was a holy moment.

Tuesday, November 17, 2009

Spoiled

I'm feeling a bit spoiled as I write today. My parents and sister Ashley arrived on Sunday afternoon. They were very surprised and overjoyed to see me at the airport in Nairobi. We had a wonderful afternoon together and came up to the village yesterday.

Well last night became my birthday and Christmas all rolled into one. They had brought gifts for my my birthday last month as well as Christmas presents for William and I. My mom even had a cake mix and frosting to have a little party last night.

And I think the icing on the cake of the day was my sister Ashley making some efforts to reconcile with my husband William. Ashley and I have always had a special relationship. And when I moved to Africa Ashley blamed it on him taking me away. She hasn't exactly made life easy for them when they have been together in the past. Last night before heading to bed she told William that she was jealous of him but that she wanted to let that go and be friends. It was a wonderful way to end the day.

So today I'm in the office at the clinic trying to get paperwork caught up and things in order so that I will be able to make my getaway for our planned family vacation. I was internet-less for three days so it's quite a bit of catch up! I just got a call from one of my maternity clients who insists on seeing only me. I assured her that I'm in the office today and she is on her way. So we shall see what the rest of the day and the week hold in store for us. But I can tell you that my heart is full of joy to have part of my family here with me. And for the rest of you, I wish you were here with us!

Saturday, November 14, 2009

Quick Update

So I've been getting requests for an update on the rabies situation. Thus far both Pasadena (the cow) and Socks (the dog) are doing fine. They both received post-bite care from the vet. We have separated Pasadena's food and water source from the other cows. We are hoping that no news is good news at this point. I think we will wait a few more weeks till we say that the coast is completely clear. But so far so good! Socks actually had puppies within a week of the bite. They are adorable and she has been a great mom. Hopefully I'll be able to get some pictures up after my parents and Ashley get here with the new camera battery.

Speaking of which, we have less than 24hrs until they arrive! They should be landing in Dubai as I type this. They will spend the night there and then catch a flight to Nairobi tomorrow. They don't expect to see me until Monday at the domestic airport near our village; but I'm surprising them and meeting them at the airport in Nairobi. So shhhhh, don't anyone call them up and tell them!

Friday, November 13, 2009

Perfect Timing

I have to say that in the last few months I've gained a much greater appreciation for health-care professionals who do lots of night call hours. Since September I've been doing more scheduled call nights than ever before. I've learned that it is not easy to put in a full-day's-work and then see as many emergencies as arise during the night only to be back for another full-days-work the following day.

We've been in the midst of some staff transitions which is why the call schedules have been switched up again. Thankfully things seem to be evening out now. I actually won't have to do a long stretch of on-call nights again until mid-December. Praise God! I'm just one of those people who does not do well with sleep deprivation. I don't think I've ever successfully pulled an all-night in my life.

Last night I had two cases. One around 9PM (sewing up a child who had been kicked by a cow) and another at 1:30 in the morning (pre-term labor). I think the toughest thing about being on call is knowing that you are the only one to handle the situation. There is no support staff, no one to consult with, no assistant to help you hold a piece of skin in place while you sew it back to where it is supposed to be. It's just you and the patient.

In the past few weeks I've been feeling a bit drained. I have to say that I'm ready to step away for a little break. It's been a great year, but it has also been a super busy year with tons of teams, interns, and major happenings at the clinic. One of my colleagues in the USA frequently asks me "Michelle are you getting any time to rest?" I have to confess that I usually skirt the question because the truth is I don't have time to rest very often. But Diana I have good news for you, I have rest scheduled on my calendar!

At the same time as I'm beginning to feel weary I'm also feeling thankful for God's perfect timing. You see tomorrow I'm traveling to Nairobi to meet my parents and baby sister at the airport. They are flying in and staying through December 10th. The first two weeks they are here William and I will still be in full swing in both our jobs. But after that we are getting a chance for some rest and relaxation with my family. God worked it out just perfectly so that our new nurse at the clinic, Percival, could finish her orientation just in time for me to get away. It is perfect that just as I'm feeling a need to be refreshed my family will be arriving. It's perfect that while my family is here I'll be able to take some time to step away from my normal daily activities and spend some time of refreshment with them. And I've also recently been reminded of God's incredible provisions as he uses his people to meet our needs. As we head towards Thanksgiving I'm finding I have so many things to be thankful for.

Friday, November 06, 2009

A Time to Sew

Ecclesiastes in the Bible says that there is a time for every season. It seems that we here at the clinic have moved into a season of sewing up wounds. People in our village are finishing up the harvest season which means a few things.
  1. They are using more sharp instruments.
  2. They have cash in their pockets from selling maize.
  3. Said cash is being used to purchase alcohol.
  4. Alcohol is leading to fights involving sharp instruments.
Get the picture?

The other night I got a knock on my window that there was an emergency at the clinic. It just so happened that the electricity was out that night. Let me take you on a rabbit trail for just a minute here. I have to confess that if you ever came to Kipkaren and used a head lamp I was probably snickering to myself at how funny you looked. I realize that probably makes me a terrible host, but I think that walking down the road with a headlamp just looks a bit dorky. However a few months back I had to deliver a baby in the dark and a USA team member came to the rescue with a head lamp for me to borrow. It was amazing! We have since had several headlamps donated to the clinic. I keep one of them on my nightstand for night-time powerless emergencies.

So I get this knock on my window and I'm heading to the clinic with my oh-so-stylish headlamp when I begin to see drops of blood on the ground. It is pitch black out so my headlight is the only illumination around. I felt like I was in a movie following a trail of blood. It lead me, you guessed it, to the clinic!

The first person I met was a mom who had just arrived with her sick baby. I could see the baby was sick but not critical. So I told the mom that I needed to find out where the blood was coming from before attending to the baby. I found a slightly intoxicated young man who had been attacked with a knife. The attacker went for his throat and he fended the knife off with his hand. His thumb was pretty sliced up but not life or limb-threatening. So I had him hold pressure and moved on to see the baby.

After taking care of the malaria baby it was back to Mr. Knife-Wound. It took me about an hour to sew everything up using the super-duper headlamp. There were at least half a dozen people in the room all giving their input throughout the process. Every now and then I wish for a good old American hospital where you can throw the crowds out and use some good modern technology (like electric lights for example)! As I was putting in the last stitch the power came back on. Great timing!

While still on the subject of wounds, let me ask my praying friends to be praying for a young man named Kimeli. He is in his early twenties. Last weekend he was assisting a friend of ours with cleaning up after his harvest. They were using a wood-chipper to grind the maize stalks. Well you may be able to imagine where this story is going. At the end of the day they were finishing up and Kimeli decided to toss one last bunch into the machine. It kicked back a bit and instead of looking for the stick they use to push material in he used his hand. He lost the hand completely. Thank God there was a vehicle on site that was able to drive him immediately to the closest medical facility. He was then transferred to a hospital in Eldoret. I understand he is being discharged today. Your prayers for Kimeli and his family would be greatly appreciated.

In fact please pray that this wound season comes to a quick close. Thanks for all of your ongoing prayers, encouragement and support!

Tuesday, November 03, 2009

Pix

For the last three months we have not had a working camera. Last week we had a visiting Physician's Assistant in the clinic. I noticed he liked to take a lot of pictures I asked him if I could steal a few. He gladly gave them up. Here are some highlights from last week.


Rex: Our Clinic Mascot



Alfred is one of the boys in our Children's Home. He was slashing the grass near his home with a machete-type tool when he slipped and slashed his leg instead. I'll spare you the gruesome before-the-bandage pictures. But I will say that he was a super trooper and didn't even flinch during the hour of suturing through three layers of muscle, tissue and skin!!


Receiving a donated splint on behalf of the clinic.



Our Sheep and her little Lamb. Too bad the sheep wasn't up for posing for the camera!


A special Children's Day hosted by a team from CA for the children at our Children's Home and ELI School Brook of Faith.

Friday, October 30, 2009

Prayer Walk

We recently said goodbye to a team from Water of Life Church in CA. On their first day in the village I shared with the team that I've had it in m heart to do a prayer walk through our ELI sites here in Kipkaren. The team was enthusiastic about the idea and asked to join me. So on their last day here we met for a prayer walk through Kipkaren. We started with a team debriefing time up on a rock with an amazing view of the valley. We ended the debriefing time with prayer for the community of Chebaiywa and her surrounding communities.

After breakfast we went to the school to pray at Brook of Faith. The teachers actually called all of the students out and we shared together in a time of worship. Then we had a student, a teacher and a team member each pray for the school, teachers, and children. We thanked God for the school and the difference that it is making in so many young lives. It was a moving time. The headmaster thanked the team and asked that we consider doing this with more teams in the future.

From there we moved to the center of the Children's Home where the team prayed for the parents to have wisdom in raising the children. We thanked the Lord for the children who were formerly hopeless and have now found a future and a hope. We prayed for spiritual, emotional and physical health of the children. We prayed for good opportunities in future education. We prayed that leaders and even future Children's-Home-Parents would come out of this home. We also prayed that the Lord would open doors for ELI to build River of Faith Secondary school for the children to continue their education here.

We then moved on to the Training Center (TC) Garden. There we prayed for ELI's Christian light to shine brightly to all who encounter the TC. We prayed for the animals and gardens to be fruitful. We prayed for the staff and the Sustainable-Agriculture students. We prayed that the TC would be a place of empowerment for both those working there and those who come to visit. We prayed for the conferences and trainings that will take place at the facility in the coming year.

After the TC we headed over to the clinic. We thanked God for the tangible difference that the clinic makes to the people living in this valley. We prayed for the physical and spiritual healing for the sick in our community. We prayed for the staff to be encouraged in their work. We prayed that the staff would have wisdom when treating complicated cases. We prayed that the light of Christ would be a beacon in the village shining out from the Clinic. We prayed for the clinic to move more and more towards financial independence.

And then the team spontaneously took time to pray over William and I. They prayed that we would be encouraged and strong in our work. They prayed for protection over our home and our family.

It was a beautiful time. There is something special about standing on the site where the ministry happens and lifting that ministry up to our Father. Thank you for joining us in praying for this ministry and community!

Monday, October 26, 2009

Rabies Follow-Up

I just wanted to follow up what is going on with the rabid dog situation we had yesterday. The rabid dog was killed after attacking one of our cows and one of our dogs. Both the cow and the dog have been treated by a veterinarian. The vet seems very confident that the injections he has given the animals will assure their health.

William and I are not quite so sure, so we are keeping the dog, Socks, tied up while we watch and wait. I really really hope that she is okay seeing as she got attacked while trying to protect me from the rabid dog. All of our research shows that if cows do get rabies they don't become violent. They just have an appearance of choking and then die. Cows are a huge commodity around here. But we can at least be thankful that Pasadena is the least valuable of our three cows. She is not pregnant or giving milk at this time. So it makes the watching and waiting a little easier. The vet will be coming for another visit for both animals and we will watch and prayerfully wait.

I've talked with the vet about doing some blanket immunizing against rabies in our area. When we asked for the immunization for our dogs about six months ago they told us they won't come unless they have at least a dozen dogs signed up for the immunization and then they never came. I've scheduled a date for him to come and I have assured him that there will be a dozen dogs and that I will pay for it myself. We are rounding up all of our neighbor dogs as I never want to go through this experience again.

My sinuses are just a tiny bit better today than they were yesterday. Thank you for all of your prayers and words of encouragement. We are pressing forward and keeping our chins up!

Sunday, October 25, 2009

One of THOSE Days

Well today I'm having "One of those days". It's only 9AM but feels like it should already be 9PM. For starters I have an evil sinus infection. Nose completely blocked, eyes throbbing, throat raw from the post-nasal drip, the works!

As I was trying to drag my body out of bed this morning I heard a huge commotion outside. People yelling, dogs barking and growling etc. Turns out a rabid dog attacked one of our cows. He jumped up and bit her in the face several times. A big crowd gathered in our yard rather quickly. People were being called to come and help find the dog. About the same time I got to the hill the dog came back. People were throwing rocks at it and then it ran straight at me.

Everyone was telling me to run or do something. But I was just frozen staring at this dog. Thankfully it ran past me. In a flash my dog's were on the scene coming to my defense. Our sweet little mutt Socks (who happens to be pregnant), went after the dog with Tuli (our Ridgeback dog). The rabid dog jumped on Socks and got her leg before she got away.

I was sent to the house for my own safety. About twenty minutes later I was informed that the dog had been killed. Now the vet is on the way to treat our animals. They are telling me that there is a serum they can be injected with. But I always thought that once an animal was bit by a rabid animal that was it, they had to be put down. I'm going to try not to get to worked up over this all until the vet and I have had a chat about the whole thing.

In the meantime I would appreciate your prayers as I want nothing more than to crawl in bed right now.

Saturday, October 24, 2009

Perspective

It is amazing how differently things look depending on where you are looking at them from. I've been in Kenya for just about two years now. When I moved here our house was under construction. I lived with a colleague until William and I were married. Then we moved straight into our little house.

At the time we moved in we had a roof but no ceiling. The walls were not painted yet and we had no furniture to speak of. The kitchen and bathroom were a thought for the distant future. It's been quite a journey but the house has come a LONG way.

At first the house seemed small. But with time I discovered it to be a lovely and actually rather good-sized home. That is until we went to the USA for two months. Some missionary friends of ours warned us right before we headed back to Kenya "Everything is going to seem really small after being in America." As we stood outside the door of our home with keys in hand I kept thinking "Remember it will probably seem small." We opened the door and William exclaimed "Wow our house is small!" However after nine months back home in Kenya I'm back to seeing our home as lovely and actually rather good-sized.

The first time I walked into what would one day be my kitchen I was shocked at how small it was. My first thought was "I have friends with walk-in-pantries bigger than my kitchen! But today I have to tell you that I have a rocking, awesome kitchen! It's finally finished (well almost!) and I LOVE it!

Starting out without electricity and running water gives you a whole new appreciation for those luxuries when they finally come. I actually have a small fridge, oven and stove in my kitchen. I have beautiful hand-made cupboards. And now I actually have a sink with water in it! I think I have one of the world's greatest kitchens!

The bathroom is still a work in progress but is becoming functional. The electric shower (yes I did say electric!) still needs some tweaking before it will be operational. The toilet is somewhat operational. We have to replace something in the cistern because it doesn't sense when the tank is full. So the tank fills up, overflows and floods the bathroom. No problem though. You just run outside, turn the main water line on to fill the tank and then turn the water line off once it's full. Well, no problem unless you forget that you turned the waterline on like 45 minutes ago. Then you just might walk into your bedroom and find that not only the bathroom, but bedroom is flooded. However I absolutely cannot complain because it is GLORIOUS to not have to put on shoes and find a flashlight to go out to the outhouse at night!!

Tuesday, October 20, 2009

A full Day's Morning

Wow it's been a full day and I'm just now finishing lunch. Today is Kenyatta Day (a national holiday here in Kenya) so most of my staff are gone. The nurse who was supposed to be with me had a childcare emergency this morning. I am SOOO very glad that our volunteer receptionist offered to come in even though it was a holiday. I would have been dead in the water without her helping to check patients in, translate and help me dispense medications.

We saw 26 patients before lunch. Some of these were first-time prenatal visits. I sewed up a 2-year-old's nose that had been ripped on a rock when she face planted. Then I drained a few abscesses and quite frankly the rest is a bit of a blur!

Then suddenly our waiting room was completely clear right at lunch time. I can't tell you how miraculous that was. Just as Margaret and I were getting ready to close up for lunch a friend/neighbor/co-worker for ELI walked in. He looked extremely distraught. Now this man does not speak a lick of English. Not even the standard "How are you?" In his distress he was speaking Swahili so quickly I wasn't catching anything. I finally had to look at Margaret and ask what he had said. She told me that his daughter Jemeli is dead. I think Sambai must know the word dead because when he heard it he collapsed into a chair crying.

I've treated 24-year-old Jemeli on and off quite a bit in the last six months. She was a type I diabetic who had multiple complications. I've had her hospitalized a number of times in the last two months alone. I told William two weeks ago that it's been hard to see how much she is suffering. I know now that her suffering has ended, but Sambai's heart is completely broken. Please pray for this dear friend as he mourns the loss of his daughter. William is going with him to the hospital this afternoon to start the process of getting her body released. They won't release her today since it's a holiday so someone will likely take the ambulance to get her tomorrow. She will be buried at home just two houses down from my home.

Now I'm back to the clinic to see what this afternoon brings.

Sunday, October 11, 2009

Special Need

Several months ago I was asked to make up a wish list of things that I would love to have in the clinic. So I did just that. On that list I included a seriously big-ticket item that I never thought would actually be donated. I was once told that when I dream I should dream big. So I included an ultrasound machine on the list.

At the clinic we frequently encounter pregnancies that have some sort of complication that needs an ultrasound. About 70% of the time when I refer a patient for an ultrasound she doesn't go because of the expense and the distance needed to travel to get one done.

Just a few weeks ago there was a patient who I felt pretty sure was carrying twins. She has had a complicated pregnancy and I had already asked her twice to go for an ultrasound. She came in two weeks ago in a lot of pain thinking she was in labor. But on exam she was not in labor at all but was having terrible pain. I told her that she needed the ultrasound and to be seen in the hospital. Three days later she convinced her husband to take her to the hospital. As they did an ultrasound they determined that she did have twins and that one of them had died. They induced and delivered both babies. I couldn't help but wonder what her outcome would have been if we could have done the ultrasound when I first wanted it three months ago.

Well this week we have been blessed with a team from Iowa. They are a crackerjack medical team that we have been looking forward to for quite some time. When they arrived I was absolutely overwhelmed with the volume of luggage they brought. I was even more overwhelmed when I discovered that the majority of the luggage was for the clinic. The team had gone over my wish list and made every possible effort to fill it, including the ultrasound machine! When I asked for an ultrasound I never imagined that we would actually get one!

So now we have an ultrasound machine! We have a few of the team members giving us a two-session crash course in its use. But we really could use someone who knows what they are doing who could come take the time to train our staff.

So I'm putting a call out for an ultrasound tech who is willing to give a few weeks to come to Kenya and train our staff. We are looking into the possibility of hiring someone from a hospital here in Kenya who could come do some training with us. But I would really love it if there was someone who could volunteer to come and spend a few focused weeks really getting our staff comfortable with the machine. If you, or someone you know, are interested please contact me to talk about the possibility of a trip to Kenya. I figure if God can get us the machine he can get us the training to use it!

Saturday, October 10, 2009

Home

A missionary's definition of home can be an interesting one. In many ways you have at least two homes and never really fit entirely into either one. I've noticed a transition in my use of the word home. When I first moved to Kenya I always referred to the USA as home, never Kenya. Then I went through a long phase where one had to really know the context of the conversation in order to know where I was talking about when I said "home". To a degree that's still true. However more and more I find that I use the word home when referring to Kenya.

You know those moments that just strike an emotional cord and give you chills or bring tears to your eyes? I had one of those moments today. We took a team that is visiting here in Kipkaren over to Illula (ELI's other Kenyan village we work in) this afternoon. The children from the Children's Home there had a great welcoming service for the team. During the service a group of children played the Kenyan national anthem on recorders. It was just one of those moments that strikes you in a special and emotional way. This was the first time I've gotten emotional over hearing the Kenyan national anthem. I realized that I'm really feeling a sense of pride and identity with this country and her amazing people.

People in the village have been saying that I'm Kenyan ever since I married William. But every now and then I hear myself say "Well since I am Kenyan...."

I also realized recently that I've been telling some of our visiting teams "William and I have to go back to America in Sept next year to do some paperwork for his green card." Notice the use of the words "have to go"? A year ago I was asking "When are we going to get to go?" What a wonderful, beautiful, crazy journey this has been!

Tuesday, September 29, 2009

Copycat Blog Survey

Okay so I'm going to do something different today and be a copycat. I follow several other missionary blogs and have seen a few do something like this.

I know of a handful people who regularly follow my blog. Then there is another group who want to follow but actually have me e-mail the updates. What I don't know is how many people actually do follow. When we were back in the states I was surprised to have people come up to me and tell me that they read about our work and wanted to meet in person.

So if you are a reader of this blog I'd love to hear about you. Just answer the questions and tell me a bit about yourself in a comment below this posting. Hope to hear from you!

Do we know each other? If so, how?

Ex: we were on dance team in HS
Ex: we went to a nursing conference together
Ex: we are both from LBF church
Ex: we're related

Maybe we don't really know each other, but have we ever met?

Ex: i met you after your presentation at our church
Ex: i checked you out at the register at target

Do we have mutual friends or acquaintances?

Ex: I'm a friend of a friend and she told me about you
Ex: Kevin Kirkland told me about you
Ex: my child went on a mission trip to Kenya

If the answer is no to all three, do we have something in common?

Ex: yes, we both work in the medical field
Ex: i also have a passion for Africa

OK, now do your part and make a comment! It says in small print, comment, right under this post. I just thought it'd be fun to know how we're connected. If you only check this blog from time to time, feel free to comment as well! Even if you've never made a comment before.

Sunday, September 27, 2009

Culture Acclimation

I was thinking about it the other day and realized that I've come a long way in acclimating to life in Kenya. There are things that are just part of normal life that I don't really even think about anymore. But when I took just a few minutes to think about them I realized they may not be quite so normal in America.
  • It feels really weird if I'm not sleeping under a mosquito net
  • I normally sleep through the roosters making a ruckus at 1AM, 3AM, 5AM and all other crazy hours that roosters decide to make ruckuses
  • When hearing a friend mention doing dishes between about ten other things I wonder to myself "How the heck did she have time to wash the dishes?" Um, Michelle, it's this basic machine they have in the developed world called a dishwasher!
  • I never drink water unless it has come out of the ELI deep-borehole, has been treated with bleach, was boiled or is in a sealed and approved water bottle.
  • My husband and I routinely take de-worming medicine a few times a year.
  • I asked my friend if she warms her water before using it for a sinus rinse. She was like "Uh yeah, I turn on the warm tap." I no longer think about the fact that I need to use bottled water which I then warm on my stove.
  • I sleep with a flashlight under my pillow.
  • I always carry toilet paper, hand-sanitizer and a flashlight in my purse.
  • If my patient has a fever and a headache I assume it is malaria until proven otherwise. Although now that I think about it, there is a good chance that it could be typhoid.
  • Straining and boiling the milk that came fresh from the cow is part of my daily routine.
  • At night I check for big lizards before entering the outhouse.
  • I've learned to measure the worth of a cat by how many rats and/or snakes he/she has killed.
  • The other day when watching an American movie I noticed that they were driving on the right side of the rode which seemed odd at the moment.
  • I say sawa (okay) and pole (sorry) all the time, even when speaking to visiting Americans who don't speak any Swahili.
  • I forget that people use something other than their laptop computer to watch movies.
I'm sure that there are many many more but those are just a few off the top of my head.

Friday, September 25, 2009

OB Specialist? My Crazy Week Continues

Wow if I thought my week was crazy by Tues I had no idea just how much fun was still awaiting me!

Nearly fifty people wound up completing the First Aid and CPR course! One of the team members from the Salem, OR team wound up creating a bunch of computer programs for the clinic. I was in heaven with the all of the formulas he programmed into Excel for me. The programs and spreadsheets he put together are going to save our staff hours and hours. Now we just have to get the staff computer literate! I'm hoping we can start computer courses next week with them.

Our measles campaign wrapped up on Wed afternoon with more than 250 children receiving a measles booster and vitamin A dose.

Monday night I started four days of being on call. Now I have to tell you that in August we only had two night cases for the entire month. So I figured I'd be able to handle being on call, while doing my normal clinic duties, while helping host a team, while assisting running a training AND a measles campaign. Let me tell you, I think it must have been a moment of insanity in which I made this decision. But our veteran nurse is on vacation and our brand-new-nurse is on orientation so I didn't think it was at all fair to start her on call in her first week.

Well I wound up with at least one case every night. Some nights were more than one. And I should tell you that in a typical month we deliver between 2 and 6 babies in our clinic. That is for a month okay? Well in less than one week we have had five deliveries!!! What is up with that? At one point this week I made the comment that someone must have put something in the water supply to make all of these women go into labor. Wednesday night's call brought a perfect delivery with a few of the Salem team members assisting me. Oh, I should mention that this delivery took place in the dark using flashlights and head-lamps since the power was out. Yesterday after we had diagnosed a false labor and referred a pre-term labor to a hospital I said that I feel like an OB resident with an additional day job!

After saying goodbye to the team late last night I figured it was my last night on-call for this week and I had already had at least one call every night. What were the chances of really getting called in again? Well 30 minutes after my head hit the pillow (I'm not convinced I had actually hit an actual state of sleep) we got a knock on the door that there was a case at the clinic. It turned out to be.............you guessed it, a delivery!

The woman was about half-way into her labor. I set up for the delivery and was seriously considering heading back to bed and telling them to get me when her water broke or she felt like pushing. But then a vehicle pulled up from the Children's Home with an emergency asthma case. After about an hour I had the child stabilized and headed home so I went back to check on the laboring mama. Well at that point I realized that the two ladies with her did not have a lot of delivery experience apart from their own deliveries of their children. Sometimes women bring a traditional midwife to the clinic with them to assist the nurse (which is always great!) but this was not the case. These ladies were very concerned that it was almost time. After a quick check I realized it was not almost time but that if I went home they were going to be calling me every thirty minutes thinking it was time.

At some point during the night I confess I got a bit impatient and so I started her on a Pitocin drip. I had a terrible time finding a vein to start a line but got lucky with a blind AC stick (for my medical friends out there!). She finally delivered around 6 in the morning. This was my first delivery completely solo. It suddenly occurred to me that maybe this was the reason I had had so many OB cases this week. It was all a warm-up leading to last night. At each previous delivery I had either another nurse or a paramedic from the team on hand. This one I just had two ladies supporting the mom. She delivered a healthy baby girl. Unfortunately she tore pretty badly and I wound up calling in our new nurse to help me close the three-layer tear. And praise God this baby didn't need an resuscitation!

I finally dragged myself home at 7:30 this morning. Thankfully I have a full week before I go on call again. And even more thankfully I think I might be able to actually rest this weekend! When looking at my calendar I realized that this is the last weekend until mid-December that we don't have a team, visitors or some event or meeting going on. So I better rest well.

Oh and as a sad side-note our baby calf Bonita died this morning. I've had so much on my plate that I've been in denial all week that she was sick. I'm still processing that my sweet baby heifer is gone.

I'm not making any summary comments about this week yet because it is not quite over. But I will say I'm hoping for a weekend of down-time!

Tuesday, September 22, 2009

Busy Week

This week has been both amazing and crazy, and to think it is only Tues! We have a team from Salem, OR visiting right now. They are doing a ton of amazing projects ranging from a Pastor's Conference to a course on CPR and First-Aid.

Monday I arrived at the clinic to receive a report from the on-call nurse that we had a woman in labor. We already had patients lining up for treatment AND we were kicking off the First-Aid course. I spent about an hour running like crazy woman and then settled in with the laboring mama.

It was a really tough delivery and we lost the heartbeat about 20 minutes before the baby was born. He wound up being a stillborn but we did CPR for over a half an hour just to make sure. I have to confess that it was a tough way to start the week. I'm convinced that there are some things that will just never make sense on this earth. During the delivery I had prayed for a safe delivery and that mom and baby would both be okay. It's so hard to understand why sometimes God allows things to go the way that they do. This is one of those cases where I really hang on to I Corinthians 13:12. For now we see through a glass darkly; but then we shall see face to face. Now we know in part but then we shall know fully just as we are fully known.

On a more positive note we have over 45 people attending the First Aid and CPR training. So many people wanted to get in on the training that we actually had to split the class and add a day to the training.

And today the clinic is filled with the sound of wailing children under the age of five. But believe it or not this is actually a good thing. We are hosting an anti-measles campaign at our clinic today and tomorrow. We have already seen over 150 children who have received a measles booster vaccines as well as a special vitamin dosing! And we aren't even half-way through the campaign yet. I will tell you though that the sound of about 20 kids all screaming at the top of their lungs at one time is a bit unnerving. I think that tomorrow we definitely need to change techniques. Lining each group of kids all up so they can see the first one get the shot and begin the ear-piercing screaming has not worked out so lovely.

Well that's it for the moment. I'm finishing my lunch break and heading back to the controlled chaos that I love so much! Thanks for coming along for the ride!

Tuesday, September 01, 2009

Overdue Update

I realize that I have done a terrible job of keeping my blog updated. And it's been even longer since I've sent out a general e-mail update! I have recently had quite a few requests for an update on our life, so I'm going to make a brave attempt to be brief and yet still bring you up to speed!

A few months ago, at the end of June, our clinic began going through a time of transition. At that time I was asked to step in and assist with some administration activities. During that season we were already in full swing with teams and interns coming to volunteer for the summer. So over the last few months I've been working with clinic administration, running the Mama-Baby clinic, treating sick patients and coordinating logistics for teams and interns in both Kipkaren and Illula. As my dear Aunt Betty so aptly put it I'm "Running like a cat on a hot tin roof!" The beautiful thing though is that I actually LOVE everything that I'm doing! Some days I just wish there were a few more hours in the day. But I honestly don't know if I have ever felt so satisfied or fulfilled in my work before. It is a wonderful, beautiful, crazy, busy time of life!

William is now working as an assistant to the Kipkaren ELI director. I'm not sure exactly how to describe what he does because it seems to me like he does a little bit of everything. From setting up media presentations, organizing workers at the training center, putting in time in the ELI gardens, driving back and forth to town, repairing broken stuff, managing the guest cottages, to helping sort out village conflicts! I consider him the ultimate fire-putter-outer and trouble-shooter in our area!

We have had quite a few teams and interns come through since May. Just a few highlights from their projects were:
  • Getting the Training Center dorms remodeled
  • Running an incredible optometry clinic
  • Helping to host the annual youth camp
  • Running pastors and women's conferences
  • Reinforcing the walls of the Children's Home buildings
I've had a handful of nurses, students and other medical professionals come and spend some time with us in the clinic.

One recent interesting clinic case I had involved a boy who fell on a stick and has leg impaled with it. The five inch stick broke off and could be felt under his skin but not visualized. I wound up having to use a scalpel to slice the skin open and remove the stick, irrigate then sew him back up.

We have also had some interesting (read crazy-challenging) deliveries lately. A few times I was just praying that we wouldn't lose the baby. One case involved a 15-year-old delivering her first child. I had several interns from the USA assisting with the delivery. As things got really challenging I began to think that the baby probably wouldn't make it. This particular baby was born with the worst cone-head (medical friends please forgive my lay-language here!) that I have ever seen. He was floppy, bluish and not breathing. I just kept thinking that this would be a terrible way for the interns to end their experience if the baby didn't make it. I was praying over him while I worked on him and then he began to breathe. When we have cases like this particular one I always wonder as the baby goes home how he/she is really going to do. Well this particular mom came in today with her beautiful six-week-old son Joshua Kipchumba. Not only does he no longer have a cone-head he is doing terrific!

I can't believe how quickly this year is flying by. This month we are looking forward to hosting a team from Oregon who will be helping with quite a few projects while they are here. In Oct we have a powerhouse medical team coming from Iowa. Then in November it looks like my parents and youngest sister may be coming to visit us!!

I have a passion for preventative medicine and I've been hoping to incorporate more and more education into our work in the clinic. This month we are looking forward to hosting our first education outreach. We are starting with some women's health care classes and hope to move into general educational classes by next year. I'm also preparing for my first meeting with the adolescent girls at our local public school. I've been asked to give a lesson on personal hygiene and sexuality. We have tentatively scheduled Sept 14th for this initial class. Both the teacher and myself are hoping that I can begin building relationships with some of these girls over the next year. We have a pretty high teenage pregnancy rate in our community.

Well so much for my attempt at brevity! Our life is just too full to get it packed into a few paragraphs. I'll try to be a little more faithful in keeping the blog updated. Until next time may the peace of our Lord and Savior go with you today!

Wednesday, July 29, 2009

Out of the Woods

Today has been a super intense day. It's pushing midnight but I know if I don't write right now it won't happen. This morning a friend and family member of William and I attempted suicide. One of the challenges of being a medical provider in a small community that has two medical providers is that you frequently have to care for friends and family.

The patient arrived at the clinic just a few minutes ahead of me this morning. As I walked towards the clinic I saw a vehicle and a crowd. Never a good sign... I heard there had been a suicide attempt and the other nurse was with the patient. When I heard the patient's name my initial response was "no way!" But when I walked in the room I found it to be true.

Our friend had diluted a large volume of a poisonous pesticide in water and chugged it. I honestly don't have much experience with poisonings. His pupils were pinpoint, he was vomiting and dripping sweat. My colleague, Kiptoo had given him a shot of Atropine and induced vomiting. I went to work tracking down the poison and it's treatment.

Kiptoo was running mobile clinic today so less than an hour after I arrived he left me back at the main clinic with the lab tech and pharmacy tech. Everything I read up on the poison said that the first 24 to 48 hours are critical and that respiratory failure can pretty much happen at any point during that window of time.

Throughout the morning we continued to induce vomiting and get him to drink milk to help neutralize things. I was running an IV of normal saline. He continued to be very out-of-it with slurred speech, impaired motor function and pinpoint pupils. His breathing however was holding stable. By lunchtime I was getting pretty frustrated that there had been no improvement and kept thinking about the possibility of respiratory failure. I had given him another dose of Atropine but that was the last dose the clinic had.

I kept wishing that I just had someone with a lot of poisoning experience who I could talk to and get advice. Then it hit me, I have a friend who is an ICU physician at Kijabe Mission Hospital (about five hours from here). So I called her up. And boy did she know poisoning! It seems that in Kenya when someone wants to do him/herself in they typically take poison. She talked me through everything I needed to do and I went back into the patient room with a renewed confidence.

She had encouraged me to keep giving frequent high doses of the drug atropine through his IV. I called our driver (who happened to be picking up a body from the morgue) and asked him to bring Atropine back with him.

During the afternoon I also saw several malaria cases, infected wounds, did a sports physical and removed a bean from a four-year-olds nose! Oh, and we had another critical patient who had to be transferred to the hospital.

At 6:30 this evening my patient's eyes dilated then became reactive to light. I could have jumped up and down for joy. I wanted to shout "He's out of the woods!" but quickly realized that no one would know what that meant. So many people were praying for him today!

The other nurse and myself are taking turns checking on him throughout the night. At my last check I found that he was stable enough for me to remove his foley catheter. We will likely discharge him in the morning.

I spent a few minutes talking with him and sharing with him how important he is to William and I. I told him that when I moved to Africa I didn't know I would find a family here. But that he has become my brother and he means a great deal to me. I had been praying with him throughout the course of the day as I wasn't sure if he would live to see tomorrow.

Please join me in praying for this friend. Pray for healing of his body, mind, and spirit. And pray for wisdom for myself and Kiptoo as we continue to encounter difficult situations like this one. Thanks for reading and thanks for caring!

Tuesday, July 21, 2009

Social Issues

*Please note that this blog posting contains adult content not suitable for children.

As I write today my heart and mind are both very full. It's been an extremely full day today. It seems that I've now been in Kenya long enough that I've really been accepted by the community. It is amazing to me the issues that I'm being made aware of by Kenyan friends. Issues that I didn't even know existed when I moved here! What is really exciting is that since I first started learning about these issues late last year I've had Kenyan ladies approaching me asking me to help them start tackling some of the challenges. Some of these things have been in my heart for a while. I've been waiting for the right timing and it seems that the time is now.

About five months ago a gogo (grandmother) brought her 15-year-old granddaughter into the Mama-Baby clinic we hold every Tues and Thurs. The girl was shy, embarrassed and quiet. The grandmother wanted her to get a pregnancy test. Sure enough it was positive. I've been having monthly check-ups with the young mom ever since.

Today during Mama-Baby clinic she showed up in labor. The exam showed that she was going to have a tough delivery. I won't go into all the details but sure enough, it was a really tough one. This was one that I'm guessing probably would have become a C-section in the states. We wound up doing an episiotomy and pushing/pulling the baby boy out.

The baby needed some resuscitation before he started breathing. The mom looked like she didn't want to have anything to do with the baby. It was a difficult situation. Thankfully there were some very supportive relatives who showed up after the delivery to help take care of both mom and baby.

During the delivery I was running back and forth between the clinic room and the delivery room. I finally had to ask the many moms who were waiting to be seen to wait until the new baby came. They waited patiently. I apologized for the long wait and one woman said "What can you do? A baby comes when he wants to come!"

These teenage pregnancies are always tough cases. When I first moved here I would hear people talking about how "our girls need to be educated" and I always wondered to myself "What about the boys?!". I've since learned that most of our teenage pregnancy comes not from teenage boys but from married men in their 20's and 30's. (Although I still think educating the boys is critical!)

It just so happened (maybe a God-incident?) that one of my friends who is a local school teacher stopped by the clinic to talk to me this afternoon. She wanted to talk about the issue of teenage pregnancy. I told her that one of her students had delivered earlier today. We talked about how many girls are offered clothing items, food or maybe a little less than a dollar in exchange for sex. Most of the men making these offers are older and typically married.

We also talked about how abortion is becoming more and more common in our village. I've seen several post-abortive women with severe physical complications. Abortion is illegal in Kenya but many women seek out medical professionals who are willing to do one off-the-record. Others try to drink soap or herbal concoctions to induce labor. I've heard some pretty terrible stories in the past few months.

My teacher friend pleaded with me to come and meet with the girls at her school. We have set up a date for me to go on September 15th for a health education class. We decided that I should try to start coming on a regular basis to work on building relationships and trust with these young ladies.

I've also got another project in the works related to women's health. Since I first started working with the Mama's and babies I've wanted to increase education in the community. At the beginning of this year I was approached by another Kenyan friend who happens to be a pastor. She asked me if we could partner together to start women's health classes. She will do a devotion and then translate my lesson for me. In the last few months as I would treat women and their children I would ask them if they would be interested in health education classes. The response has been overwhelmingly positive. In fact, last week two ladies asked me when the first class will be held. Helen and I will have our first class with the subject of family planning sometime in August.

I have to confess that there were times last year when I wondered if I was really doing anything worthwhile. I felt that I didn't quite know exactly where I fit in, in both the ministry and the community. But it is absolutely amazing just how much I feel a part of the community now. I have really found my niche and feel like God is using me to touch the people in our community. And to think the adventure has just begun! I look forward to seeing where God will take these new ventures during the rest of this year.

Monday, July 20, 2009

Long Time No Post


Sorry it has been so long since you last heard from me! I promise that I will do my best to very newsy post up very soon. It's been a very full month thus far. But day-after-day I'm reminded that God's grace is sufficient for each new day.

Yesterday someone from a visiting team (awesome team by the way!) snapped this shot of William and I after a church function. The picture was taken in our front yard. I know it's been a while since I've put up a photo of the two of us so I thought I would get this one loaded with a promise of a more thorough update to come soon.

Sunday, June 14, 2009

What a Week

This week has certainly been a full one. I feel like I've been on the run since we got back from Nairobi with my old UCLA friend Ann last Sunday. Here is the day-by-day craziness of the week:

Monday was the Children's Home and School memorial service for Kelvin.

Tuesday was the funeral.

Wednesday I was realizing just how far behind I was getting. Wed was also the first day of "The Great Pharmacy Inventory". Has a scary ring to it doesn't it? It turns out that our pharmacy has not had an inventory since 2002. I was asked by the clinic advisory committee to develop a tracking system and then inventory the drugs. Let me give a HUGE thanks to our interns Kayte, and Joanna, as well as my friend Ann. They spent the day counting pills with me.

Thurs was Mother-Baby clinic followed by more fun in the pharmacy. During the clinic hours one of my pregnant friends showed up sick. After doing a history and physical I started her on treatment for malaria.

Friday morning was, you guessed it, more pharmacy inventory!! Only during the pharm inventory I was called into the treatment room to see the daughter of one of William's cousins. The mother had been force-feeding the nine-month-old baby porridge when she aspirated. (Aspiration is a fancy medical term that means the food went into the lungs instead of the stomach.) By the time I was called in to consult on the case the baby had a fever of 104, and was in severe respiratory distress. During the course of her physical exam I could see her rapidly deteriorating and losing consciousness. Being that it was Friday, our ambulance had taken our HIV patients to the local HIV clinic for their appointments. I called the driver and asked him to drive like the devil to get to the clinic and take the baby to the hospital. As we waited for him to arrive I couldn't help but think "This child is dying in front of my eyes!" The most frustrating thing is that we didn't even have oxygen to put her on. I laid my hands over her and asked God for a miracle before she got in the ambulance.

Friday afternoon I went to do a follow-up home visit on the pregnant mom with malaria. That was followed by a huge goodbye service for our intern, Jeremiah, who hosted a soccer camp at our local public school. Several months ago I heard about Jeremiah's interest in doing something with soccer while here. I simply made arrangements with the principle of our local public school to hold an after-school soccer camp. The farewell ceremony was overwhelming as I wound up being one of the guests-of-honor. I was overwhelmed with the many thanks I received for helping to coordinate the camp. It was a reminder to me that even small thoughts and actions can have deep impacts. (Also a humorous reminder of the many hats I wear!)

Friday evening I learned that Chepchumba was stabilized in the ER and had been admitted to the hospital.

Saturday I headed into town for the day with our interns and my friend Ann. We went to the hospital to visit Chepchumba. This was the highlight of the week! She looked one-hundred, no make that one-thousand, times better!!! Thank you father for working a miracle in this little one's body!

Saturday evening we found out that an in-law to William's brother had gotten drunk, fallen in the river and drowned.

That brings us to today. Our church was meeting at a distant location for their quarterly assembly. Not having transportation we stayed home to rest today. And I must say after this week I was in desperate need of some rest and recharging of my personal batteries. Just as I was preparing to start dinner I got a phone call to come assist with a delivery at the clinic. After a few hours of tough labor the baby girl finally came. She had a bit of distress at birth but was doing fine after a few minutes of warming and stimulating.

My heart is full and I'm more than ready to call it a week and head to bed. After all, who knows what tomorrow may hold?

Wednesday, June 10, 2009

In Honor of Kelvin

Yesterday we had the honor of attending Kelvin Kiprotich Busienei's burial. Often times when leaving a burial I feel a deep sadness and heaviness in my heart. But there was something special about this one. As I left I did feel sad, in fact my heart still aches for Bush, Veronica, and Patrick, but I also felt hope. The service began around 10AM and concluded around 5:30PM. There must have been close to a thousand people in attendance.
Part of the crowd

There were moments for tears but there were also moments of laughter as Bush recalled how he wanted his son to grow up to be a lawyer but Kelvin insisted he would be a soldier and would regularly practice his fighting techniques with his brother.

Several speakers reminded the crowd that Kelvin is now rejoicing with the Lord. We were reminded that when we have a personal relationship with Jesus Christ we can be certain we will see him again. One pastor said "I will say pole (I'm sorry) to the family; I will say pole to the school friends; I will say pole to the neighbors; I will say pole to those who worked with the family; but I will NOT say pole to Kelvin. Because I know that Kelvin is not in pain and is happy to be with the Lord."
Bush and Veronica

Kelvin was a part of the Brook of Faith school choir. The remaining choir members took time to sing and dance in honor of his life. At one point David Tarus called out "Everyone dance and celebrate life!". The children moved into the crowd to bring others to the field to join them in dancing. As I saw Kelvin's older brother, Patrick, join the dancing my eyes filled with tears. It was such a bittersweet moment.

Brook of Faith Choir dancing in honor of Kelvin

Patrick in the suit on the right joining the dancers

In our community when someone dies he or she is buried at home. So as mourners arrived at the funeral the grave was being dug. Once the service concludes, the mourners all proceed with the body to the graveside. Everyone then waits for the burial to take place before decorating the grave.

Presentation of flowers to decorate the grave


The grave at the end of the service

Thank you for all of your prayers and words of encouragement for the family and the entire community during this time. Please continue to lift them up as the loss begins to really sink in.

Monday, June 08, 2009

A Time to Mourn

Our community is experiencing a time to mourn this weekend. Friday night our dear friends and colleagues John (Bush) and Veronica Businei lost their nine-year-old son Kelvin. Earlier in the week he was treated for malaria but failed to respond. The doctors were unsure of exactly what was wrong with him. He was started on strong antibiotics on Friday. Later that evening he passed away in his father's arms.

Kelvin was in standard two (second grade) at ELI's "Brook of Faith" school. He is survived by his parents, older brother, and over three hundred children who he lived, learned, and played with.

Today Kelvin's body was brought home from the morgue. The Children's Home and Brook of Faith students came together to hold a memorial service for him. Several children shared about how special he was. One girl encouraged his brother, Patrick, to be strong and to know that God loves him and his family.

As I looked into Veronica's eyes my own filled with tears. I held her tightly as we cried together. At the end of the children's service Kelvin's body was transported to his parents home not far from our village. Tomorrow we will gather to say a final goodbye and bury him at his parents' home.

Unfortunately Kelvin was just one of three deaths in our community this week. Tuesday morning William's aunt lost her son in childbirth. We also lost a 28-year-old single mother of two to heart failure. Then just yesterday I received word that one of our colleagues had lost a relative and would be going home to be with her family for a few days.

During times like this it is easy to become overwhelmed. Please join us in praying for our community during this time or mourning. Pray that the Holy Spirit will bring comfort. Pray that some may come to know Christ through these tragedies. Pray for wisdom and strength for our staff as we press on during challenging times.

Friday, May 29, 2009

Fighting Polio

This year Kenya has seen a few small outbreaks of Polio. Fortunately none of them have hit our area. This week our clinic partnered with the Kenya Ministry of Health (MOH) to provide an anti-polio campaign in our community. The goal was to provide an extra oral booster for all children under the age of six.

We spent a week putting the word out that the campaign would take place on Tues. The first mamas arrived shortly after 8AM on Tues morning. By the time the clinic closed at 5PM we had vaccinated over 380 children. Talk about a busy day! We saw several mamas come who had never brought their children to our clinic before. It was good exposure for the clinic and the first of what I hope will be many preventative health events this year!

Monday, May 25, 2009

Unwanted Guest

Last week we had an unwanted guest in our compound. I was more than thankful to Musa (William's cousin) who killed it. William came in while I was eating breakfast and told me "The snake is dead, do you want a picture?" Here it is:

I have no idea what kind of snake it is. After Musa beat it, it was pretty covered in mud.

The snake slayer.