Monday, December 27, 2010

Cultural Adjustments

Tues, Dec 28th, we will begin our journey back to Kenya. We will begin at LAX in the afternoon, and reach our home in the village on Fri night. From Los Angeles we will fly directly to London, where we have a 23hr layover. Then we continue on to Nairobi where we will spend the first night. Finally on the 31st we will travel by road to our home.

As I begin to mentally prepare for the journey I'm reminded of some of the little differences that always take some getting adjusted too. At first they came as a surprise on re-entering the USA, but now we get to do the reverse on our return to Kenya. Here are just a few that come to mind right away.
  1. Re-Packing my Purse: In Kenya I always carry the following in my purse: toilet paper, hand sanitizer, flash-light, and small umbrella.
  2. Crossing the Street: In Kenya we drive on the left side of the road (as opposed to the USA where we drive on the correct, ahem, right side of the road. It should also be noted that pedestrians in Kenya do not have the right of way. This has resulted in me nearly running some people down when I first get back to America, and then nearly being run down myself when I first return to Kenya.
  3. Weather: Glorious, year-round, 12-hour days and beautiful weather in Kenya! Since being in the USA we have experienced temps that ranged from below freezing, to 114.
  4. Roads/Traffic: William and I were commenting yesterday that we should be thoroughly enjoying our final days of CA driving. I think I would need an entire blog-entry to begin to explain the craziness of driving Kenya.
  5. Food Prep: Here we have so many fast and easy choices. In Kenya you pretty much need to make everything you eat from scratch. This generally does result in a healthier diet though. So there is an up and a down to that one.
  6. Mosquito Net: When I first arrive in the US it is so strange to be sleeping without a net. Now I get to readjust to life under the net again!
One thing that I have found to be universal is our humanity. No matter what color our skin is, or which language we speak, we all have so many things in common. We laugh, we love, we cry, we are human!

Sunday, December 12, 2010

Wrapping Up

Jambo from California! Yes, we are still in the USA. We are wrapping things up and preparing to head back to Kenya in two weeks. Our time here has been extremely productive and we both feel so very blessed.

I've been able to take two courses while here. One for obstetrical ultrasound, and one for colposcopy (an advanced form of women's health-care). I have learned so many new things that I'm excited to take back to the clinic. I really can't even begin to describe how amazing these classes were and how beneficial they are going to be to the work in Kipkaren!

William just got back from a 5-day agricultural convention and symposium in Florida. He was blown-away by the material and the networking that took place. Delegates from literally all over the world attended and shared what they are doing to use agriculture to sustainably feed the poor in their parts of the world. He is also returning to Kenya with new ideas and strategies in mind.

As we wrap up and prepare to head back to Kenya we are going to be sending out our new prayer cards. It's been quite a while since we actually sent out a physical mailing but we want to do so to get the new cards out. If you want a prayer card can you please make sure that we have your most up-to-date address? You can e-mail it to me at

I'll try to be back up on the blog soon with some more pictures and stories about our time here as well as our plans for implementing what we have learned when we return to Kenya.

Monday, October 25, 2010

Our Time in America

William and I are currently in the USA. There are a few purposes to our trip. We are both getting some educational/professional development opportunities. I am taking both an Ultrasound and a Women’s Health course. William will be attending the annual International Agricultural Conference and Symposium at ECHO Headquarters in Florida.

We are also here to raise support for our work in Kenya. As missionaries we raise our own salary and ministry funds. By joining with us financially you can partner in our work and ministry in Kenya. I’ve recently been asked to post some of our needs. If you are interested in partnering with us you can go to our secure donor page by clicking here to make a tax-deductible online donation. Here are some of our current needs:


· We currently need monthly commitments adding up to $500 a month. That can break down to:

o 20 donors at $25/month

o OR 10 donors at $50/month

o OR 5 donors at $100/month

o OR 2 donors at $250/month

o OR of course any combination of the above!


· Financial donations of any amount for our ministry fund. No gift is too big or too small.

· Projector for trainings and presentations (approximately $700)

· Helping to complete a staff house at the clinic so that staff members can be available to provide night and emergency care at the clinic (approximately $4,000)

· Helping to Fund a Village Health Fair (approximately $2,500)

· Sponsor high school education for one of the youths William is mentoring (approx $600/year)

· Medical Equipment: Colposcope, Medication Nebulizers,

· Blood Sugar Test Strips

· Printer Cartridges for ink-jet printer HP92 and HP93, or laser-jet printer HP CB436A 36A

When filling out the form, just choose “Missionaries” and then select “William and Michelle Kiprop” If you have questions or would like to partner in a specific area of our ministry just send me an e-mail and let me know. Thanks so much!

Saturday, September 18, 2010

Snapshots of This last Week

Here are some pictures from this last week. It was an extremely busy one, with some big highs and some big lows. Here are some of the highs and a look at some day-to-day life in our clinic and village.

One of my friends, Ruth, recently had her fourth baby. A sweet little girl named Chepchirchir. I had the privilege of helping in the delivery. She had some complications and wound up needing some extra care. Here Ruth talks about how thankful she is for access to good care when complications such as hers arise. I'm bonding with little Chepchirchir.

During lunch one day in town I decided to snap a picture of the very popular lunch plate of chicken and chips.

More than a decade ago our clinic actually originally started with dental services. A dentist from the USA came and taught some of our villagers how to pull teeth under a mango tree. From there, health care has blossomed in Kipkaren. This week a dream came true as we were given a dental chair/unit by some generous caring people with the non-profit Spanda. We will now be able to expand our current services (deep cleaning and extractions) to offer dental fillings as well. We are pretty excited! The chair/unit will be installed early next week.

Unfortunately we see a lot of wounds in our village. Children here do household chores, just like kids in America. Only the household chores in Kenya often involve sharp instruments for tasks like cutting grass for cows, chopping firewood etc. This little boy wacked his finger with a machete. The nurse who was on call had a very difficult time managing him and the wound so she called me for backup. It took nearly an hour to get the wound closed. His mother, auntie, and grandmother were all in the treatment room. There came one point where everyone was yelling while he was screaming and I was sweating! I asked everybody to stop and take a deep breath. I told the boy that we would wait to proceed until he was ready; and if we needed to wait until the sun went down, that was okay with me. The women all looked at me in disbelief. I explained that he needed to know that he had some control in the situation and we weren't just pinning him down to torture him. A minute later he relaxed and gave me his hand. This picture was taken two days later when he came for a wound check. I've refrained from posting the close-up of the finger.

Well that's it for now. We are actually on our way to America for a few months. Yesterday we made the drive to Nairobi, and tonight we fly to London, then on to CA. We would appreciate your prayers for a safe and smooth journey.

Friday, September 10, 2010


Okay, I realize I am very overdue for an update. I feel like I've been burning the candle at both ends lately in preparation for our trip to the USA. There is a lot to organize when you are going to be away for three months!

The big project hanging over my head right now has been our protocol book at the clinic. I've had it in my mind to write it for about two years now. The hiring of two new-graduate nurses combined with the fact that I'm not going to be around to consult, has prompted me to finally get it done. I feel like I'm back in school writing my comprehensive finals as I pound out page after page of information for treating everything from malaria to retained placentas! It's also a reminder of how it is virtually impossible to know everything about everything. I just hope that the other providers benefit from reading and implementing the book as much as I have in writing it!

So before I get back to my monster project let me just share some pictures from recent highlights.

I was recently blessed to have an intern from my home church Life Bible Fellowship church in southern CA. Christina was with us for two months. Here she accompanied me to a high school girls conference where I was a guest speaker.

Four years ago I shared on my blog about a boy named Patrick. You can read about him here and here. This is a recent picture of Patrick and I as he receives a folder prepared especially for him by someone from my church. Patrick is doing very well and is as tall as me now!

Below are pictures from our first major mobile outreach. We went to a remote clinic and provided dental and optometry services. We treated nearly 150 patients that day!

Monday, August 30, 2010

Goodbye Friend

This morning I just said goodbye to a friend. Between my home and the clinic is a building that is being used by my friend’s organization, The Living Room. It is a hospice. Although I’m not officially a part of the Living Room staff, I regularly do consults and put together care-plans for the patients there. From day one I have called this patient Agui, which means grandpa. He has been at the Living Room for a number of months. I’ve performed a number of his medical procedures and done some of his dressing changes over the months. Every day he has been out laying or sitting under a tree as I pass by on my way to the clinic. I often stop to visit with him for a few moments. Although we shared neither genetics nor the same language, he became my Kenyan grandfather.

An older man, in his early nineties, he has entertained us with his twinkling eyes and strong spirit. There are times when we have actually thought he might make a full recovery. But last month he developed pneumonia and it finally got the better of him this morning. My friend Juli, who is the international founder and director of this hospice, was away this morning. One of the caregivers from the home came running breathless to my office. He rapidly told me in Swahili that it was Agui and they needed my help. I raced down with him to Agui’s bedroom and saw that he was definitely on his way out of this world.

I sat at his bedside and began to stroke his forehead as my mother had when I was a little girl. I then prayed with him. I asked the Lord to be near to him as he made this final journey. I asked for peace of body, mind and spirit. I asked God for relief of any pain or suffering Agui was feeling. I then asked our friend Morogo, the social worker, to pray in Kalenjin. Morogo asked me if Agui would really understand. I replied that we wouldn’t know for sure, but on the chance that he could it was good for him to hear a prayer in his mother tongue. I then invited a few of the other care-givers to join us in the room to sing songs and hyms. As we sang “Rock of Ages” in Swahili Agui took a final breath and then slipped away through heaven’s door.

I can’t tell you how thankful I was to be there in his final moments. There is something powerful about holding the hand of a friend who is about to meet Jesus face to face. It was a holy moment; one that I wouldn’t trade.

Sunday, August 29, 2010


That's how I feel this weekend. Life has been moving at high speed lately and the pace just keeps picking up. The last two weekends I was involved in outreaches of one sort or another. I really will try my best to get pictures and reports up in the coming days.

We have been searching for two nurses for the clinic for a few months now. About three weeks ago we hired a new graduate and this week we hired another new-grad. The most recent hire is William's cousin and this is her first time away from home/school. We don't have the staff housing for her finished yet so she is actually living with us. She is on call this week and because she is brand, brand new I'm doing a lot of after-hours trips to the clinic with her.

Sometime between Thurs night and Fri morning, William's grandmother suffered a stroke leaving her right side paralyzed and taking her speech. The influx of family members has brought us an additional house-guest. Yesterday was William's 35th birthday so we had a small dinner party for him. Talk about highs and lows!

Add to all this, the fact that we are preparing for a trip to the USA. No wonder I feel a bit discombobulated! I will however, try to get at least one more update posted this week. Take care and God bless!

Wednesday, August 18, 2010

Shadrack - A Story of Hope

Lately I have had a few blog posts in my mind. I've just not had the time and/or energy to get them actually written and posted. But I wanted to share about last night's events while they are still fresh.

The young man with William and I in the above picture is named Shadrack. And if you live in Southern CA get ready to be blessed by his presence!! Shadrack's is a story of hope. When he was still a young boy in elementary school his mother died leaving him and his siblings behind. After the funeral, the crowds left and there were three children left standing at the graveside, Shadrack and his two sisters.

David Tarus, William's uncle, approached them and asked what they were going to do and where they were going. They looked up with hopeless eyes and told him they didn't know. At that moment God moved David's heart and he told them "Come on, let's go home." Since that time Shadrack and his two sisters Jane, and Carolyne have truly been adopted into the family. Last year Shadrack finished high school with very high grades. The entire community celebrated with him. This year the doors have opened for Shadrack to attend Azusa Pacific University in southern CA.

Just over a week ago the entire community came together to raise money for his plane ticket to America. It was a beautiful time as people came to commission him from our small village to the USA. They asked him to represent our people and to study hard so that he can come back and make a difference in the community.

Last night was Shadrack's goodbye service. William and I had a long day making a road trip to recruit a new nurse for the clinic. By the time we were getting back to the community it was long after dark and we were both exhausted and worn out from hours of bumping on the rough roads (think Indianna Jones ride for hours on end!). For a moment I considered not going to the service, after all we were several hours late! But let me tell you I am so glad that I went.

The service went on until nearly midnight as friends and family members took time to recollect Shadrack's growth and to encourage him in this new endeavor. Boy did the tears flow! After many, many words of praise, encouragement and advice, Shadrack was given a turn to speak. He went around the entire room personally thanking each person in attendance and telling them what a blessing they had been in his life.

After the speeches were finished and the tears continued to flow, the group stood together to anoint and pray for Shadrack as he was sent out from our community. The picture below is of that prayer time. Friday night he will board a plane to Dubai and then on to Los Angeles. Life is about to change drastically for this young man. Please pray for him as he goes through the culture shock and transition to life as a college student in the USA. William and I are looking forward to spending some time with him on our upcoming trip. That's right, we will be in the USA from Oct through Christmas!

Friday, August 06, 2010

Comedy of Errors

Well it is another day for two blog posts. This one may be a bit long and hopefully make you smile and possibly even laugh. I confess, I'm hoping that writing the play-by-play of my evening will be therapeutic for me and entertaining for you.

As you know from my last post, I was involved in a late-night and early-morning delivery. We are almost 24 hours out from the beginning of my last post. So I was pretty tired this morning.

During the morning delivery the power went off. Unfortunately this is not at all unusual in Kenya. At any moment the electricity could turn off anywhere, and be out from moments to days. Often when it goes out in the morning it will be gone for the day and then return at either 5, 6 or 7PM.

True to form, the power was off all day. But that was okay, I've got an incredible long-life battery on the computer and so I was still able to complete clinic paperwork and our medication order for the month. The day wrapped up nicely and I prepared to head home.

As we were locking the clinic we had a teenage girl arrive who had slashed her toe open with a machete. It was getting dusky outside but with the help of my handy, dandy, headlamp I was able to get the wound closed and give her a tetanus shot.

I got home and wanted nothing more than a shower. I then remembered that there is no electricity. Which means that my electric shower-head will not work to heat the water. Which lead to the internal debate: To heat water on the stove for a splash shower or not? Then I remembered that we use electricity to pump the water to the tank for running water. No electricity = no water. UGH!

I also had plans of baking chicken wings for supper. With my electric oven it seemed another plan was foiled. So at this point I decided that the best thing to do was to lay on my bed for 30 minutes and hope and pray that the power would return by then.

After 15 minutes on the bed I started thinking about what would happen if the power did NOT return. That would mean that I had to go find a bucket to clean out for water. I would then have to pull the water out of the well, haul it in the house and cook supper on the gas range. All of the above activities are better done when there is still a bit of sunlight peaking through.

So I got the water and started supper; 6PM came and went with no power. I gave up on the power returning in time for the chicken to bake and resorted to frying it. As the chicken was finishing up my phone rang. I had a case at the clinic. I should also mention that at this time the skies decided to open and rain.

So after getting the chicken off the stove, and finding an umbrella, I made my way back to the now dark clinic. There I found a 7-year-old boy who had been chopping grass for the cows when his machete slipped and he chopped the end of his thumb. The wound was deep, and went halfway around the digit and into the nail-bed. I just love doing complicated suture cases in the dark! (I hope you can read the sarcasm there!)

So I'm rooting around the treatment desk for supplies and I can't find a suture set. So I pulled out my keys and went to the maternity building to get a needle driver, tweezers, and scissors. I carefully lock maternity back up and return to do the suturing. Just after I finally finish the last stitch, the power comes on. What great timing! (Insert more sarcasm.)

I then remember that I need to give him a tetanus shot and the tetanus vaccine is back in the maternity room. So out come the keys again and another trip to get the vaccine. Finally he has been stitched, wound-dressed, and injected. After a trip to the pharmacy to get him some pain killers he discharges home. As I'm heading out the door a girl shows up with some random red pills in an envelope. She wants to know if she can trade them for de-worming medicine for someone's baby. Only in Africa! I explain to her that I can't trade the pills but that the medicine is only $0.50 and she will need a bottle to put the syrup in. She agrees to come back in the morning.

Now that the power is back on, I'm on a single-track mind. Shower!!! I remember that I will need to pump the water first. So I go out to the pump-house, grab the extension cord and head for the house to plug it in. I then have to run out to the water tower to listen for the sound of water coming in. Because if I don't hear the water flowing the pump probably needs to be primed (which is a whole different blog post for another day). Thankfully I hear the water flowing. So I head in the house to plug in the computer and start charging it.

After the tank has had a while to fill I turn on the sink tap to see how the pressure is. It's just a trickle! What's up with that? So I poke my head outside. I hear water pouring on the ground. This doesn't make sense to me, because if the tank is full enough to overflow I should have some water pressure. I run back inside to unplug the pump. Then back outside with a flashlight and still hear water pouring. I then notice that someone left the outside tap wide open. A neighbor probably came to fill a bucket with water and kept cranking the tap wider and wider. Upon not finding water he or she must have just walked away. So all of the pumping I just did has resulted in a flooded yard. Big sigh.

I close the tap and go back inside to turn on the pump again. By now I'm praying that there is enough water in the well to fill the tank for my shower. Thankfully there is. During the second filling of the tank I call my husband to say "Where are you and why aren't you dealing with this crisis for me?!" He is on his way to a goodbye service for our colleagues who are headed back to the states. No one told me it was their goodbye tonight. Another sigh. But alas it wouldn't have mattered anyway since I'm on call at the clinic.

As I write, I'm now showered and feeling much better about life. I even have to giggle a bit as I imagine Lucille Ball playing the part of Michelle Kiprop tonight. It would be good for some serious laughs I think. Now here's to hoping that there are no more machete injuries, deliveries, or any other chaos tonight!

In Just 12 Hours...

..... we received the official results that Kenya had voted yes on the new constitution, and then in the clinic delivered not one, but two babies! All of this between 9PM and 9AM.

Last night the official results were announced over the radio that the constitution had been approved by the Kenyan people. It will go into effect just two weeks from now. The leader of the "No" campaign, William Ruto, conceded defeat earlier in the day and made a statement that he accepted that Kenyans had made their choice. His peaceful response is a huge answer to prayer as his reaction was watched by many. So far Kenya continues to be at peace. Praise the Lord!

Shortly after hearing the official news, I headed over to assist with a delivery at the clinic. Our two American interns joined Kitur (our clinical officer) and myself in helping bring a baby boy into the world. It was a text-book smooth delivery. Then this morning as I was waking up I learned that there was yet another delivery in progress. The interns ran from the training center to assist yet again. This delivery was quite a bit more challenging but still resulted in a healthy baby girl. At one point we had 11 people in the room with the mom.

The late-night delivery was a friend of mine and this morning's was another friend's sister. So I was extremely thankful that both babies were born healthy and strong. The picture below shows the team of friends and relatives who were supporting and assisting the mom through her labor. Now I'm off to the office to see what today holds!

Saturday, July 31, 2010

Earlier this month our clinical officer, Kitur, I attended a one-day seminar hosted by Mission for Essential Drugs and Supplies (MEDS). This is the company we order our medications and supplies from. It's a Christian organization that does it's best to help get faith-based clinics supplied with quality materials.

It was well-done, and I was impressed with the patient-focus that the company has. Most of the times in the past when I attended a seminar put on by a pharmaceutical company or supplier, it was a big pitch for why you should prescribe their brand name. It was refreshing to hear lectures about how to provide the best quality care for the patient.

I also learned that in sub-Saharan Africa there are only four laboratories monitoring the quality of drugs that are marketed in medical facilities and pharmacies. One of those labs belongs to MEDS where they are vigilant in checking the quality of their drugs. I also learned that up to 25% of medications sold in pharmacies in Kenya are either contaminated or just flat-out placebos. Rather scary! It was a relief to know that the company we order our medications from is working hard to provide quality care instead of just focusing on the bottom line.

Friday, July 30, 2010

Field Trip

Not long ago, the local public primary school decided to have a field trip to our clinic. The purpose of the trip? To see our fish tank!

Thursday, July 22, 2010

Just Checking In

Well I'm definitely not meeting my goal of blogging twice a week. But honestly there has been nothing too exciting to blog about. This week has been one of catching up.

As usual I have under-estimated how long it would take to do something. I remember setting up study sessions where I planned to whip through two chapters and out line both in a set period of time. I would always be devastated when the time would arrive and I would only have completed half of one chapter.

Well thankfully I no longer get devastated if my "to do" list doesn't get completely checked off by the end of the day. Living in Africa has taught me a bit about flexibility. Someone recently recommended putting the item "interruption" on the list a few times. That way you can gleefully check it off when you get called here and there for one reason or another.

I don't dare say that I am completely caught up. But I've made progress. My calendar is updated. I think I'm just about caught up on old e-mails. I have food in both the pantry and fridge. I know what's been going on at the clinic. My updated prayer letter went out yesterday. Our bookkeeping is relatively up to date. And we are planning a big mobile outreach for the 22nd of next month. Although I hoped to have all of this done on Monday (hahaha what was I thinking?) I think it has been a pretty productive week thus far.

Tonight I have an internet chat-date set up with an old friend to talk about the possibility of a special photography project in our village. Speaking of which, hopefully this next week I can break out the camera and get some pictures of our running water at the clinic!

Tuesday, July 13, 2010

Close Call

It's been a while since my last post. I had a family emergency that took me on a quick trip to the USA. But I'm back in Kenya now, and back to blogging. And what a return! I'm doing some serious jet-lag. I didn't have too much on my arrival to the USA a few weeks ago, but I think I'm making up for it now on my return to Kenya. My luggage made it half-way around the world from Los Angeles to Nairobi via London with no problem. But somehow it didn't get on the plane with me from Nairobi to Eldoret. So William and I will be tracking it down tomorrow.

William picked me up at the airport this morning and on our way home we had a very close call on the road. I've shared with many of you how terrifying driving on the roads in Kenya can be. We were almost run off the road by a big truck on our way home. William scooted to the side and let him zip around us. As we followed him he made an abrupt turn into oncoming traffic. He was broadsided by a poor Toyota Landcruiser who never saw it coming. There was no time for him to even attempt to avoid the accident. So we didn't hear any skidding, just the huge impact and the cruiser and truck spinning to the side.

Unbelievably enough no one was killed or even badly injured for that matter. And what is really crazy is that there were half a dozen men riding on the open bed in the back of the truck. My mother-in-law and I were pretty sure that someone would have been killed. William had us sit in the car while he ran to check things out. Since there were no serious injuries I never got out of the car. And we weren't far from a police check so they quickly made their way to the scene. Unfortunately this is a very typical daily occurrence on the roads here.

We were blessed to get a dinner invitation tonight. It is always enough transition getting moved back into the village without having to figure out what to make for dinner that first night. So I'm going to enjoy some fellowship and food then hopefully sleep a bit tonight. I should be back with an update on things at the clinic soon.

Wednesday, June 16, 2010

Been There. Done That.

Getting better at it. But still hate it...

Tonight I was starting to turn my thoughts toward bed when my phone rang. The caller ID showed that it was the new clinical officer (CO) at the clinic and I knew he wouldn't call me at night unless he needed backup.

"Michelle, we have a poisoning, can you come?"

I HATE poisonings. It is how people try (and often succeed) to commit suicide here. There are very strong pesticides and poisons available here that are not so easy to access in America. So when someone wants to kill himself or herself they will often drink poison.

Three years ago I didn't have a clue what to do when someone drank a glass of concentrated pesticides. Now the protocol is becoming second nature.

This case was a 19-year-old young man. The CO and myself were pretty aggressive in his treatment. And thankfully his family had found him and got him to treatment quickly. It didn't take long for him to turn the corner and start improving. This is the second crisis I've worked on with the new CO. And I must say we worked well together. William actually came in the treatment room to give an extra hand. I told him he has no idea what he just got himself into. Cause now I'm taking my hubby with me on future emergency calls!

As I was starting an IV I was pondering differences in practice here. There are the obvious ones, like lack of hospital gadgets, that make life easier. Or the fact that my dog comes with me and I often have to chase him out of the treatment room multiple times during a night encounter. But there are social issues too. Treating a suicide attempt in our little clinic is very different for me than treating one in the ER in southern California. It's somehow more personal, more dramatic. We are in a village setting where everyone is involved in everyone's lives. There is no anonymity. The people I am treating know me and look at me with hope in their eyes. I don't think I'm doing a great job of putting words to it, but it is definitely very different.

The young man I took care of tonight will be fine physically. But the spiritual and emotional injuries will still be there. Please pray for him as his family come around him and hopefully are supportive during this time.

As for me, well I'm gonna wrap a few things up and hit that pillow I was picturing before the phone call came!

Special Patient

Sometimes in the clinic we have patients who we treat on an ongoing basis for a chronic condition. This patient is one of those. I've been treating him for several months for a wound on his ankle. He told me it was a snake bite from the 1950's that never fully healed properly. He has been to various hospitals for multiple treatments without success in the past. Here at our clinic we have been blessed to have some specialty wound care items that were donated by generous medical professionals in the USA. I've started using some of those products on this old grandfather and they have been working miracles. It also helps that he is a model patient. He came in this afternoon for a dressing change and I asked him if we could snap a photo while he was here. I'm trying to be better about carrying my camera in my purse to capture those little special moments in the day.

Wednesday, June 09, 2010

Rough Day

*This is a very detailed and graphic post with material that is inappropriate for children.

Well this is one of those nights where my body wants to fall in bed but my mind just can't stop. And I know if I don't share the day now it won't happen.

Today we lost a baby. Today was the most horrific delivery I have ever assisted in. Really, really horrific. I just can't post all of the details here because it is to horrible. But we had a breech delivery. We didn't know that it was breech until the delivery was way too far gone for us to do anything about it.

As the mom was pushing I kept having doubts about the presentation (which part of the baby is delivering first) but my colleagues kept assuring me they felt confident it was the head. When we could finally see something, I felt confident that it was in fact, not a head. It was a little boy who came boy parts first. He got stuck. Really, really stuck. We did everything we possible could to get him out. Did I mention it was horrible?

There finally came this point where I was 95% sure that the baby wouldn't make it if we hadn't lost him already. The point when I had to fix my mindset on saving the mom because it was coming to the point where her life could be in danger. It takes more than an hour to get to the hospital from our clinic. So once a woman starts pushing it's pretty much impossible for us to refer. But the thought went through my head that maybe we would have to send her even in her current state because we wouldn't have another choice.

Then I had this thought that we needed to use gravity. So I asked everybody to help me get her off the delivery table. We put sheets on the floor and had her squat. Okay, I'm getting a more detailed than I planned. But let me just say that after much work we finally got the baby out. I was already mentally prepared for him to be gone. But I told the staff we would do ten minutes of CPR so that we all knew that we had tried.

After the first cycle of CPR I checked and found a strong heart beat. Since we had a heartbeat we all felt that we needed to do our best. We did two hours of support resuscitation. At one point I actually came very close to passing out. (I passed out on my very first day of nursing school and felt that same feeling washing over me.) I hadn't eaten or been able to use the restroom in over eight hours. I was overheated working over the baby who had the warmer blowing hot air on him. I broke out in a sweat and saw the room spin. Yet it occurred to me that everyone in the room was looking to me. So I asked someone to bring me some water, took a deep breath, pulled up a chair next to the warmer, and pulled it together.

Every time we got close to giving up, the baby would take a few gasping breaths and we would start up again. Finally after the two hours I told the family that we had done everything we possibly could. It was now in God's hands. We wrapped the baby skin-to-skin with his mom while he struggled to breathe. It didn't take long before the gasping stopped. Within fifteen minutes his heart stopped beating.

I laid my hands on his little body and prayed that the Lord would receive his spirit and comfort, love and care for him until his mom would one day join him. It was a horrible, yet somehow holy, moment.

Obviously I'm still processing the day. I would appreciate your prayers for the mama as she has to endure the physical pain of recovering from a traumatic delivery at the same time as she goes through the emotional agony of empty arms.

And I'm frustrated. Extremely, extremely, frustrated. Because you see, we have an ultrasound machine at the clinic. But we have had a terrible time trying to use. We desperately need a professional to come and train our staff on it. It seems like it should be easy, but every time we try, we feel lucky when we find the heartbeat. We have yet to be able to figure out the position of any baby we have tried to ultrasound. If only we knew how to use it! We could do a sixty second ultrasound on every mom who was admitted in labor. Then we would know immediately that a referral to the hospital for a C-section needed to be made. Maybe this baby we delivered today would be happily breast-feeding instead of wrapped in blankets in preparation for his burial in his mother's yard tomorrow morning.

Friday, June 04, 2010

Snapshots from Today

A few posts back I blogged about debrieding a burn on a sweet little girl. She came back to see me again today for another treatment. She got a pre-treatment sticker that she promptly stuck on her forehead. She is improving with each dressing change and soon won't need to come see me anymore.

The water project is going strong. The clinic has been filled with the sound of holes being pounded through our walls in preparation for the pipes that will thread through them bringing us clean water. We are hoping to have running water by the end of this month! Below you can see that fresh water being pumped into a big bucket for the construction use.

It seems we very well may have the most deluxe waiting room for a rural-clinic in Africa. Today we got fish! One of our nurses has a brother who builds fish tanks. He wanted to show his support for the work we do by donating a fish-tank and fish to the clinic! It was installed today and is sure to make the wait to see a provider just a bit more interesting!

Tuesday, June 01, 2010

What Was I Thinking???

So I have lived in Africa for going on three-years now. It's been a year and a half since our last trip to the USA. And on top of all of that I'm a medical professional. You would think that I of all people wouldn't slip up and use unsafe water. For goodness sakes, I battled worms and bacterial infections most of my first year here!

But this morning I was deep in thought as I was brushing my teeth. I had my glass of pure water at the sink right next to me. But for some crazy reason I flipped on the faucet and splashed water in my mouth to rinse. By the second splash I suddenly realized what I was doing. This was followed by a lot of rinsing with the pure water. And the rinsing with pure water was followed by a good gargle with Listerine. Considering I didn't swallow and I quickly washed away the "icky" water I'm hoping I'll be okay. But as I go about my morning I keep having flashbacks to my gastrointestinal issues from my first year.

So note to future visitors, do not drink the water unless it is bottled, comes from the deep borehole, or has been boiled! And I wouldn't mind if you say a little prayer that any buggers that made it to my system die a quick and painful death!

Wednesday, May 26, 2010

Mud or Rainbows?

Lately I've found myself facing some unique challenges. I've found that when these challenges come (and we all know that they always will!) that although I can't always control circumstances, I can choose to control how I respond.

This was clearly illustrated to me in the last week as we had quite a bit of rain. I slipped in the mud one day on my way home from work. I nearly ate it but got my balance just in time. Nevertheless my shoe and foot were rather muddied. As soon as I got home I grabbed the camera to document the moment.

Not long before the mud incident I had found the need to grab the camera to capture some amazing rainbows. With the rainy season we sure get a lot of mud. It can be a pain trying to get from point A to point B. But we also get some amazing rainbows. And the flora becomes lush and green with flowers blooming everywhere.

So it's occurred to me that I have the choice to focus on the mud or to focus on the rainbows. The same applies to challenges when they come our way. Will we see mud? Or will we look up and see the rainbows?

Monday, May 24, 2010

Just Another Day

Well today was just another day in the clinic. Nothing particularly outstanding or special. But I don't often write about what a typical day looks like. In many ways our walk-in clinic probably has some similarities to clinics in the USA.

There are the patients who you know will not take your advice unless it is in alignment with what they already had in mind. There are the patients who started self-medicating before they came to you. Because antibiotics can be purchased over-the-counter here that one can be a bit scary at times. Bactrim is the drug of choice for patients to take one or two doses and then come in a few days later because the medicine didn't work.

Today I was the only nurse in the treatment department. I have to say that my preference is to work alongside another nurse because I strongly believe that two brains are better than one. Especially with some of the crazy things we see. But thankfully I didn't see anything too scary today.

My first patient of the day didn't really want to be at the clinic. She had malaria and clearly felt horrible. I think she just wanted someone to pick up the medications and bring them home to her. She was refusing a physical exam, refusing lab tests, pretty much refusing everything but medicine. Fun stuff!

I made a referral this morning for a two-year-old who is severely developmentally delayed. The mom brought her in because she has a respiratory infection. But she hasn't walked yet, is cross-eyed and doesn't interact with people much.

My typhoid patient of the day was diagnosed at another clinic. The mother of the 10-year-old girl brought her lab results and the medicine they gave her a week ago. She hadn't improved so they wanted another opinion. Well sure enough she had typhoid, unfortunately they were giving her antibiotics for a skin infection. So we started her on a new medicine and hopefully she will turn around quickly.

I had a 19-year-old girl who is finishing HS at a boarding school. She has a menstrual problem and is really embarrassed about her teachers and peers knowing about what she is being treated for.

My toughest case so far today was the three-year old with the third-degree burns on her hand. They aren't fresh burns but she has to come regularly for wound care. I had to pull of some of the dead skin before putting on a fresh dressing. The sweetie is a little trooper. Trembling all over and tears rolling down her face she holds up her hand to me to begin debrieding. I was wishing I had stickers to put over the bandage when I was done.

And the funniest case of the day was the old-man (that is a respectful term here) with the chronic ulcer on his ankle. So the ulcer wasn't the funny part. The funny part was that he told me "I'm here to get my dressing changed from my snake bite." I asked him when he had the snake bite and he told me "1950, and it's doing much better now than it was then!"

Just another day in the clinic. Thank you Lord for giving me this opportunity to reach into people's lives when they are at their most vulnerable. Please use me to make a difference in the lives of each patient I encounter this week....