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!
Wednesday, July 29, 2009
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.
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?
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
Part of the crowdThere 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
Brook of Faith Choir dancing in honor of Kelvin
Patrick in the suit on the right joining the dancersIn 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 serviceThank 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.
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!
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!
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