Saturday, April 4, 2015

Conclusions in Kijabe

As the week neared its end, I was thrilled to be able to spend some time with some dear friends from so very long ago.  My first visit to Kenya took place in 2004 with a small team from all over the US, ready for the wilds of Africa.  We visited Kijabe first and met a fellow and his wife, Pastor Simon Muhota and Margaret.  After a quick introduction, we all ventured to a place called Dol Dol, just north of Mount Kenya with him way back then.

 I was so excited to catch up with them this past Sunday and learn of an orphanage they began.  Pastor Simon told me he would find me Wednesday morning and we would grab a bite to eat in Naivasha and head to the orphanage.

We passed through Naivasha, the New Nairobi it seems, and visited a place bearing the name: Mother’s Kitchen.  This place was an absolute dream and permitted a sizeable meal of ugali and beef stew.  Following our very filling meal we stopped for some ice cream, a definite delicacy in Kenya.  After a single scoop of strawberry ice cream I journeyed with Simon and Margaret in the direction of the orphanage.  As we were traveling, the rain clouds that had earlier seemed congenial from a distance began to unleash their fury right above us.  This was a blessing for the parched lands of Kenya but would bring an unexpected challenge to our journey.

We pulled off the main road to pass through barely distinguishable roads at times, eventually coming to an intersection of two roads.  Although the road we were on was made of dirt, it was packed fairly well and we were able to make some good forward motion despite the slick mud.  Pastor Simon had a four wheel drive truck which had more than enough power.  However, it was the last half mile that would prove the most daunting.  An older woman walking by exhorted Simon in Kikuyu, alerting him to the danger ahead.  Pastor Simon assumed she referenced the roads we were currently on as “impassable,” but she knew something we didn’t.

Turning onto the last road we made the discovery that the entire length had been turned over by some heavy machinery and the soil was as loose as a garden ready for planting.  Due to the spontaneous cloudburst the top inch or two of soil became like soup.  The four wheel drive was scarcely worth anything as any attempt up the hill sent the vehicle either into the right or left ditch that was a good two feet deep.  My heart leapt a little within because it really isn’t a trip to Africa without having some transportation problems in the mud.

Some locals were commissioned into service and using some borrowed shovels they dug a path for the truck, ultimately to the top of the hill.  I think the motion of the truck resembled a sort of sidewinding snake in its trail to our destination.  Nevertheless, as it always does, everything worked out.  Once we crested the hill a beautiful building centered on five acres of prime growing land rose into view.  Entering in through the gate I saw a veritable palace in the midst of this rural area. 

Pastor Simon showed me the cows that produce milk every day for the residents, the numerous chickens that lay the necessary eggs, the garden that produced fresh food for the twenty-four inhabitants and the most recently dug water well that pipes water not just to the orphanage but the community as well.  As we went into the house I saw a beautiful facility than anyone would be proud to call home.  Then came the real tear jerker.

The kids that lived there came to greet us and they congenially introduced themselves.  As they went back to their business Pastor Simon began to tell me their stories.  The majority of the kids were from the post-election violence of 2008.  Many of the children had experienced atrocities that would break even the hardest of hearts.  They belonged to the hundreds of thousands that were displaced from their homes just over seven years ago.  Simon elaborated as one of the quieter boys passed by; he had watched as his father brutally murdered his mother.  The sadness and sorrow of their past lives could only be eclipsed by the great love that they experience in belonging to a home that provides them value, identity and a demonstration of God’s heart.

We spent some time with the kids, shared a bit more and finally headed back to Kijabe as the sun sank into the horizon.  It was so encouraging, as all of our encounters have been over this last month, to see what God is doing through His people here in Kenya.  This orphanage of only twenty-two children and two permanent staff makes an impact upon eternity that we cannot comprehend.  Continue to pray for Abba’s House that these children would not only be provided for but also that they may see their identity in Christ.  For in fact they have been created in God’s image and contain a value granted by him, not by the world that so quickly forgets the suffering.

The Heart of a Servant

I can’t believe it is already April, and our time in Kenya is drawing to a close! Last night, Scott and I started the packing process, as this evening we will be travelling to a nearby city to spend the night with some old friends, and tomorrow we head to Nairobi and board a plane headed for the US. It feels like we just got here, but I also feel that the relationships we have developed are so deep. Furthermore, I know I have grown by leaps and bounds as a physician and as a member of the body of Christ.

Since last I wrote, I have taken a weekend of peds call and spent the week on the peds wards. It has had some definite highs and lows, but I just wanted to quickly recap some of the events of the last week.

On Sunday morning, thankfully, things were mostly in control. The interns don’t round, and no one officially sees the patients unless asked by the nurses, so I was a bit overwhelmed trying to be sure that all of the nursery, floor, and ICU patients were stable. I was fortunate to have a very supportive US physician as my back-up (someone who I worked with as a 4th year medical student at UAB…go figure). It took me the entire day to follow up on labs, discharge any well patients, and attend a few deliveries.

During my lab review, I unfortunately found out that 3 new babies were growing gram negative rods in the blood (consistent with the previous infectious outbreak) in the NICU. Three others were not clearing it, or developing new resistance even with high dose double coverage of antibiotics. It was disheartening to realize that despite our efforts, we were far from having the infection under control. I spent over an hour talking to one set of parents about why this was happening, and I could sense some anguish in the air among all those in the maternity ward as they all feared their baby may develop this dreaded infection.
Later in the afternoon, while attempting to play with ventilator settings on an intubated child in the PICU (it felt so wrong to touch the controls after having so many RT’s give me the evil eye for such back home), I had to call my back up. We stabilized the child in the PICU (who by the way was from the nursery also growing the resistant infection), and I talked to her about the continuing epidemic.

Even though she had been on call the day before and not slept in over 36 hours, she very matter-of-factly stated that she was going home to change into scrubs so that she could clean the nursery herself to help contain the infection (something that had been suggested to nursing staff all week, but had not happened because there were 2 nurses to care for 28 babies). While I attended to the sick babies, she donned a mask and gloves and went to town on the small nursery. Together with the cleaning staff, we worked through the night to scour every nook and cranny of the African dust-filled room. It made me realize that serving in missions as a doctor means not only working to cure disease, but serving as Jesus did…washing the feet of his disciples…or the beds of tiny babes.

To my knowledge, no new infections have occurred since the deep clean. We are still praying for healing of those already affected…but I learned so much about the heart of Jesus that night through the pediatrician I worked with. She was willing to do whatever it took to have compassion on the least of these, no matter what the personal cost.

In the midst of our cleaning, we received a call from our intern on-call (who had been working since Saturday morning). His wife was on the other end stating that she needed to take her husband home because he was sick. For a hardworking Kenyan to leave call meant that he felt very near death. We let him go home, and the doctor I was working with graciously offered to take his pager for the night. Again, a great personal sacrifice.

We had 3 admissions by this time (around midnight) in the ER and the clinical officer and I worked to get all of their orders together. They included a 1 month old with fever and concern for bacterial infection, a child with sickle cell pain crisis on oxygen, and a child with biliary atresia who had had an operation some months ago now presenting with likely bowel obstruction.

After getting them all settled, I headed to my house to use the bathroom and eat for the first time since lunch, and a few hours of rest before beginning the next work day…my first on wards.

I was grateful that the business of the night was mostly related to containing infection and cleaning the nursery, and not with children who were crashing. I was also grateful that I had some wonderful back up. Together we survived the night, and our poor intern got some rest.

It was certainly an experience being on call over the weekend to cover the NICU, PICU, and floor. However, I was reminded so often that I was not alone. The same is true in life. Even when you can’t see someone standing right next to you…there are people to call. The Holy Spirit likewise stands with us throughout all of life’s ups and downs. He goes with us wherever we go and knows all that we go through. As Isaiah says: “Do not be afraid, for I have ransomed you. I have called you by name; you are mine. When you go through deep waters and great trouble, I will be with you. When you go through rivers of great difficulty, you will not drown! When you walk through fires of oppression, you will not be burned up; the flames will not consume you. For I am the Lord, your God, the Holy One of Israel, your Savior.” – Isaiah 43:1-3

Saturday, March 28, 2015

Things I've Learned in Africa

I knew when I started planning for this trip over a year ago that it would be one of great personal, spiritual, emotional, and educational growth. However, I have even surprised myself at some of the things that I have learned over the course of the last 3 weeks. Please allow me to share with you just a few of my thoughts:

1.       I can survive without being connected 24/7: We were told when we signed up to come to Kenya that our housing and the hospital would have wifi readily available. However, that actually meant that there is one room right next to the ICU with wifi and we were given a modem to use for our computer at home. It requires us to pay by the megabyte and usually has a painfully slow connection. Therefore, the tablet and iphone that I brought to use on wifi have been rendered useless. I use the internet for about 5 minutes out of every day to check my email or post a blog. The wonderful thing is that it has required me to actually use my brain when treating patients (limited access to fancy apps and no google or Up To Date to access), and it has helped to me to focus on actual relationships rather than facebook news feeds and constant email checking. Don’t get me wrong, not all of Kenya is disconnected…In fact I have seen people walking aimlessly looking down at their smartphones more than once…but at least a 1 month cleanse of limited technology has proved to me that I can survive…and become less stressed because of it.

2.       I can make decisions about patient care on my own: I realize that many of my peers are getting ready to go out into the real world of medicine at this point (3 years into residency). It’s strange to think that in just a few short months, there will no longer be an attending to ask when you are stumped about what to do. There’s no longer the mentality of “I just have to make sure this patient survives through the night, and in the morning we can sort out what else might be going on with them with the help of the attending.” Thankfully, in med-peds I still have one more year of the attending blanket, but this month has allowed me to step into roles that I would never have at home. Don’t be alarmed, there are still more senior people I can call if I’m stumped, but I am not required to run every decision by them. Some days it has been uncomfortable to think that I’m the only brain pondering about a patient issue, but it has allowed to realize that I depend on a God much bigger than I am, and he has equipped me far better than I realized to handle those situations. It makes me think that maybe one day I really can be a big girl doctor. :)

Just as an example: Today I was rounding with the NICU fellow in the nursery. After we finished rounds, our interns had all gone home (Saturdays are a commodity for those not on call!). The fellow had also left and I was trying to tidy things up for the on call team when the OB intern ran into the nursery to grab me to attend an emergency c-section.

We ran to the OR, and I prepared the resuscitation room for the new baby. Imagine a small closet with an old (but functional) infant warmer and random assortments of donated ET tubes, used suction catheters, glass bottles of unlabeled medications, and other unidentifiable equipment…noticeably missing were the ambu-bag, oxygen connectors, and laryngoscope I would need if the baby were really in bad shape.

At home we have nursing and RT’s to help set up all of our equipment while we wait for the baby. However, here we scramble to do most of it ourselves. After I’ve tried to come up with a Mcguyvor plan for what I can use of the random equipment if I need it in an emergency, the midwife thankfully comes with the proper paraphernalia.

After getting things set up, we went to the theater to wait for the baby. The c-section is solely performed by the intern and after the baby is out, we run down the hall to the resuscitation room and pray for crying.

Today, unfortunately, the baby was very floppy and not crying. We tried to suction and bag, but despite our best efforts, the baby’s heart was not beating. We had to perform CPR (something I have never had to do at home in all the deliveries I have attended). Thankfully, after a brief round of CPR the baby started to perk up and she is doing well this afternoon. However, it was humbling to realize that I had no neonatologist to run things…or to hand the baby over to when I was finished. Needless to say, I have said many prayers in the resuscitation room this last week, and thankfully the Lord has faithfully answered each one. Even when I’m making decisions without other human input I have the Lord right there with me…

3.       I’m so thankful for our ancillary staff at our hospital back home: A friend of mine spent 2 years working at a hospital in Kenya after residency. When I asked her what I should try to get out of residency in order to be prepared for third world medicine, she counseled me to pay attention to what the ancillary staff does, because you won’t have them in the developing world.

When I was on call the other night, the nurses asked me to set up the vent in prep for a patient from the OR. I thought to myself….”I have no idea how to set up a vent (much less a German one…)…the RT’s do that…” When we needed a blood gas on an infant the other day, we had to collect it ourselves. When you need a lab result, you go to the lab yourself to thumb through the giant notebook. When you order an x-ray, you read it yourself. Everything is much more hands on here. It helps me learn more skills for sure, but it also makes me thankful for those we have at home to help us with these very important parts of patient care.

4.       Infection control is a very important part of that ancillary staff: Unfortunately, over the last week we have been battling a multi-drug resistant klebsiella outbreak in our NICU. We have 7 confirmed and 2 suspected cases currently. It has been disheartening to come to the hospital each morning only to learn about a new infant with a fever. We’ve been doing what we can with isolation, gloves, and deep cleaning, but we are still praying for God to stop the spread. Fortunately, most of the babies are doing quite well despite the infection because of early identification. The hospital and administration are doing their best to identify sources and keep from giving it to any new infants, but we are just not equipped either with the space, means, or the nursing attitude of our NICUs in the states to be able to handle the infection the same way.  

It has made me think about the Ebola outbreak. While Ebola is still very far from the boarders of Kenya, I see how in this environment such a deadly disease could spread so quickly. Kijabe is a great hospital with a lot of western influence on its protocols and standards. Therefore, watching the conditions here and thinking about what it must be like in other parts of the developing world of Africa, I can now understand how such an outbreak could occur.  

5.       Life is fleeting: Luckily, death has not visited our nursery this week, but I have been following some of my internal medicine patients who were not fortunate enough to leave Kijabe in their earthly bodies. Even back home this week we received word that a couple from our church unexpectedly lost their 4 month old son to SIDS. We have been heartbroken over the news, and in constant prayer for his parents. It has forced us to face the reality of these mortal bodies we live in. Even the youngest of children cannot escape the face of death. However, we do not despair, because we know that this life is only the beginning. You could get really depressed if you think about the 100% failure rate you face if your goal is simply to keep people from dying in medicine. However, when we shift our goal to trying to help people truly live, both in this life and the next, that is where our true reward comes. Our lives on this earth are short…therefore we must set our eyes on eternity and try to show it to others along the way.  

I could continue on with far more lessons learned, but I fear I have spent far too many words already. Please join us in prayer for the family back in South Carolina grieving the loss of their sweet son. Also pray for all the infants afflicted with infection and pray that we may be able to stop the spread. I would also personally appreciate your prayers, as tomorrow I take Sunday call which includes covering the floor, the NICU and the PICU for 24 hours with no one to round on the patients. I know I have One greater than me to call upon, but I still would appreciate a quiet day…

This time next week we will be arriving back in the states, so also pray for a fruitful week as we wrap up our time in Kijabe!


Friday, March 27, 2015

The city that God built...

We were stunned yesterday to receive some difficult news from a couple back home who are dear friends of ours.  Their four month old son mysteriously passed away sometime in the night.  Naturally this came as a terrible shock and we hate we cannot be there with them during this difficult time.  Join us in prayer that they will receive comfort from The Comforter as they journey through this heartbreaking time.  The words of Psalm 56:8 seem incredibly close: “You keep track of all my sorrows.  You have collected all my tears in your bottle.  You have recorded each one in your book.”  How reassuring it is to have a God whose heart breaks with His people's yet also provides such blessed hope as He will one day restore all that was lost in this life.  Say a prayer for Aaron and Kayla that God's presence will be ever sweeter and all the closer in this trying time.


Earlier in the day yesterday I had an opportunity to meet up with one of my favorite people of all time, Pastor Steve Njenga.  I thumbed a ride with our dear friend Paul and we headed to the Naivasha for one of the best reunions I could have hoped for.  I was so thrilled to see Pastor Steve and we caught up on nearly five years since we had seen each other last.  The last time our paths crossed was as he passed through North Carolina during a whirlwind trip of speaking engagements.  Nevertheless it was such a blessing to discover all the things that had taken place these last few years.  Who could have known that the greatest surprise was yet to come!

We toured a bit of Naivasha while his wife Mary was on her way to meet us from work.  Naivasha has grown immensely since I was there previously.  It seems as if multitudes have flooded the busy city as of late.  Indeed I learned that many people settled there after the period of great unrest following the election violence of 2008.  New businesses have cropped up in every corner and it seems as if the Kenyan economy is growing in wonderful ways.  Once Mary arrived we too shared some wonderful memories of old as we journeyed to Eburru.

To me Eburru is quite the special place as we traveled there at least three or four times when we were here back in 2006 – 2007.  My memories had not faded too greatly as the roads there seemed all too familiar.  I saw the same groups of baboons, impala, gazelle, rock hyrax and occasional warthogs that used to oversee our treks through the mountains.  Eburru is a unique location indeed as it is positioned near nine extinct volcanic craters.  Hot steam vents are still easy to find coming out of the mountains and the same excellent views are available of the Rift Valley, just on the opposite side of Kijabe.

As we drew near to our destination, the view gave way to a wide-spread complex that existed only in imagination when I was there last.  Smiling at my surprise Pastor Steve jumped out of the van to begin our tour.  We first started with the multi-purpose dining room and auditorium.  He told me that during the year they have conferences from groups back in Nairobi that meet there.  Directly behind the auditorium is the kitchen where they prepare daily meals for 351 students.  We stepped into the on-site bakery where a lump of dough roughly my size was being converted into countless tasty loaves.  That massive amount of dough, I was informed, would make enough bread for just three days.  After tasting a portion of one of the loaves I figured I could probably make it all disappear a bit faster!

Exiting the kitchen and bakery we passed through a few rooms, some newly built, that provide storage for the large quantities of foods and cereals they have to buy.  After that we crossed over to the newest building, a dorm for the boarding students with a capacity of over two hundred.  The top floor is in the process of being finished and it is a building that easily dwarfs the others.  The rooms inside are cozy, full of amenities and complete with study areas and lounges.  A dorm mother watches over the ones that are there presently, some hailing from as far as Mombasa. 

Leaving the dorm we passed by the large cement water tank that supplies water for the entire operation.  Water is extremely scarce in this area as the only sources are rain and condensed steam.  The water tank that Pastor Steve built can hold 500,000 liters of water and is filled by a brilliant system running throughout the school complex.  Rain water is channeled from each roof into long gutters where it then travels through an array of underground pipes to fill the massive tank.  Drilling a well here finds no water, only steam, much like what is found in Hell’s Gate.  Working that to his favor, he drilled into a number of steam vents far up the hill to condense the water and pipe it down to the school.  This provides an additional 5,000 liters of water per day.  That water is probably some of the best in the world as it is produced by nature’s own distillery.

We then passed by the classrooms for the children grades 1 through 8.  They were gathering back together after their lunch and I had a chance to share with the seventh grade class.  Some asked questions about America including our diet and a number of questions regarding snow.  It was just as difficult to explain a hamburger and hotdog as it was to describe the nine feet of snow that fell in Boston this winter.  After sharing with a few students we moved on noting how well behaved and brilliant they all are.  To go to school, especially one as nice as this, is a privilege and one the students seemed to readily understand.  They work hard and have excellent instructors.  Pastor Steve told me that they ranked above the national standard of scholastic excellence last year.

We toured the quarters where the teachers live there on site.  Due to the remote location it would be difficult to live elsewhere and make the journey to the school every day.  I also saw the garden where a portion of the school’s food is grown adjacent to a number of cows where fresh milk is gathered every day.  There is even a use for the cow’s other functions as the dung is collected in an underground tank that harnesses the released methane, powering the gas burners in the kitchen.  Everything about the facility is nothing short of brilliant and well on its way to becoming a fully self-sustaining community.  Even the children take part in chores that enable the work to be accomplished and completed in a streamlined fashion.

As I stood there talking with Pastor Steve I was nothing short of amazed.  His vision and heart for this place is tremendous.  I remember some eight years ago as he told me what he saw in Eburru’s future and so much of it has come to pass.  The stories of how God has miraculously provided are myriad and only a book of size could document them all.  Pastor Steve had a goal of not only reaching the residents of Eburru with the gospel but improving the entire community in the process.  As such thus far he has planted two churches, created a dispensary (the only medical facility within a 90 kilometer radius), a mission training center, and a nearly self-sustaining school and conference center, not to mention the great growth in moral, spiritual and economic areas for the entire village. 

I listened with intrigue as he spoke of renovating an old mansion adjacent to the school that would serve as a sort of bed and breakfast as well as housing for other conferences.  He spoke of eco-tourism, starting a high school, creating steam saunas (the only kind in Kenya for sure), bike paths and easy access to the new national park that is being created around the wilds of Eburru.  To be with him was to be with a true visionary whose only limit is the size of his God’s ability to provide.  Eventually he said the adjacent facilities will fully fund the schools while providing people an opportunity to enjoy Kenya’s culture and landscape, thus making it a ministry that is entirely self-supporting.

He told me that he announced to the most recent church he planted there in Eburru that they would preach to the world.  That has already been fulfilled as mission groups have come to visit, observed the great work God is doing and been set ablaze with the Holy Spirit to go back to their homes with greater purpose than ever before.  Pastor Steve sees opportunity with every mission group that passes through as he desires to change their perspective thus impacting the work that goes on back in their own communities.  The scope of what I saw yesterday was incredible.

In listening to Pastor Steve share I felt like I was in the class of life, learning lessons that were worth far more than gold.  He speaks with great wisdom and yet with such humility.  He shared that he has never asked for money or resources, something that is remarkably true.  In actuality it is even difficult to learn of what the needs may be even when direct in asking.  God has just connected him with people who are impassioned by the God he serves.  Not long ago he came to the United States and had 60 speaking engagements in only three weeks.  His travels took him through the south, to Washington DC and even to New York City where he sat down with some rather influential people.  As he related it all to me yesterday, he said, “I’m a nobody, what could I share with these important people?  So I just shared what I know…Jesus.”  It is clear that everything he is involved in really is just a testimony to the goodness of God. 

Needless to say I had plenty to ponder and process as we began the trek back to Naivasha.  The work of the Lord in Eburru has been incredible; it truly is the city that God built.  When we arrived back in Naivasha Paul and I departed with some delicious samosas and a heartfelt farewell.  We jumped in a matatu and headed back to Mai Mahu, Paul’s home town and the city just below Kijabe in the valley.  The skies were growing dark and I still needed to make it back home so I bid Paul adieu for now and commissioned one of the local motorcycle taxis for a ride.  Although I am quite used to being on a motorcycle, I am not so familiar with being a passenger, especially through rough terrain…this was going to be some kind of ride I was sure.

I am not positive but I think the fellow may have been under the influence of some sort of substance due to his peculiar demeanor yet we set off on the rocky road regardless.  This did not bode well when we added an additional passenger on the already dragging motorcycle.  The 125cc machine groaned under the weight of three people as it zigzagged and lurched up the impossibly steep incline.  The ruts in the road dealt with us mercilessly and I felt like sitting behind the two other fellows caused me to be the recipient of the greatest amount of jostling violence.  At long last, and still a mystery how, the motorcycle wheeled into Kijabe with its three passengers and one highly pressured carbonated drink in my backpack.  As I staggered the few remaining paces to our humble abode, the night turned the sky a beautiful dusty orange and an incredible day came to a close.  In the distance one could almost make out the shape of Eburru’s peak, stretching toward the heavens, connecting with her divine source.
For more information you can visit David's Hope to find additional updates on the work taking place in Eburru!

Wednesday, March 25, 2015

Wazungu Worship

Here is a picture of us with AIC-Kitet at worship on Sunday!

Zebras, Massive Power Tools, and Tiny Babes...

Wow, it has been a whole 5 days since I have shared any thoughts about our time here lately in Kijabe! I apologize now for any scattered thoughts as I attempt to summarize the last several days. Since my last post, we have had some Kenyan adventures on the countryside, most of which Scott has already relayed to you. However, I’ll try my best to give you a brief overview from my perspective.

On Saturday, we were fortunate to travel to Kenya’s Hell’s Gate National park (I bet no one would have ever thought that on a mission trip we would travel through the Gates of Hell…). It was very hot and dry (as anyone would expect Hell’s gate might be…) but did allow for some delightful animal sightings. We were graced with the presence of many warthogs, zebras, kudu, gazelle, monkeys, baboons and one lonely giraffe (or twiga as the locals say). After a leisurely drive over the plains area, we went for a quick hike through the gorge where we were reminded multiple times that many have died during the floods that occur with quick rains. Our Masaai friend wisely stated: “In the gorge, you must always hike looking up…” At just that moment I spotted the first dark cloud we have seen since our arrival 2 weeks ago. Fortunately, the rains held off one more day, because it would have been terrible to have been washed away in a gorge flood…

After our hike, we travelled around the park to see where our friend Richard is working with one of the local power companies. They are harnessing the geothermal energy by drilling wells for steam and piping it to power plants where it is converted to large amounts of megawatts for the entire country. While it was interesting to see how it all worked, it was also a stark contrast to see the natural wonders of the geothermal vents paired with the large drilling machinery and miles of piping throughout a national park. It wasn’t quite the undisturbed nature that I was hoping for.

Our friend Richard boldly took us right up inside the plant (that would be a huge security fiasco back home) and right to the base of one of the large drills. I loved the Kenyan attitude that all the workers we met shared. They were more than willing to stop whatever important job they were doing at the moment to explain a bit about what they were doing. While at the drill, we were told they had a goal of drilling down 3km and were only 50 meters from their goal—that they hoped to reach by nightfall. The rig was about 200 feet tall and effectively served as the largest power tool any of us had ever seen. It was comical to me as the only female to watch Scott, our driver, and Richard marvel at its massive power. I felt a bit like Jill Taylor from Home Improvement.

We concluded our time in the park by visiting a geothermal spa that harnessed the natural power of Hell’s Gate in a way that a woman could truly appreciate. There was a large pool with sky blue mineral water being drained right from a steaming natural spring. Unfortunately, we did not have the attire to enjoy its warmth, but we vowed that the next time we visit Hell’s Gate, we’ll just spend the entire day there…

On our way home, we stopped by Lake Naivasha and took a boat ride around Crescent Island, a place where several African staple animals were transported years ago for the filming of Out of Africa. The Lake was much cooler than Hell’s Gate and even presented us with a few drops of rain. We saw several hippos, scores of birds, and more zebras and gazelles. After returning to our home, we slinked into our beds and prepared for our eventful Sunday.

On Sunday morning, we travelled to Suswa to worship with our friend’s church. Scott had been there one week ago, but unfortunately, I had been on call and unable to attend. Therefore, after hearing his stories, I was more than excited about what the morning would hold. We met numerous church members, and I was soon whisked away by several ladies to be dressed as one of them. The ladies adorned me with traditional wraps and beautiful Masaai jewelry. It was such an honor to be consider Masaai for the day. They even gave me the name Nashipae which means “joy.” I answered only to that name for the remainder of the day. In fact, I don’t think I was ever even introduced as Teresa. During the service they attempted to teach me how to dance like a Masaai woman, and we all shared in the excitement of what God was doing in Kenya and in the Masaai.

Afterward, we shared a meal with Richard, his wife Evelyn, their children, and several church members. We were delighted, as one of our goals for this trip was to establish a partnership between Richard’s church and ours in South Carolina. We realize that we all belong to the global body of believers, and we wanted to make a connection that would allow us to pray for and support one another. When we return to Lyman, we are so excited to share what God is doing in Kenya, and encourage our local body to have a global mindset.

On Monday, it was back to work at the hospital. Currently, I’m continuing in our NICU. It has been quite an experience in contrast to my most recent NICU rotation back home. It can be frustrating at times to have a lack of resources or the ability to care for the babies the way we would back home, but it has also been amazing to see what we can do with the little that we have. Right now our nursery is overflowing with about 28 babies (remember the size of the 90 degree plus room that I mentioned before….). Many of them have fallen sick with bacterial infections, so please pray that we are able to contain the spread of infection and that all those currently sick will be healed. It has been a bit busier than my internal medicine time here, but still a great time of learning and growth.

Yesterday, I took my first pediatric call. I was blessed that my intern apparently used to work in the peds department for 4 years. Therefore, he is certainly more experienced than I am. He skillfully handled most of the overnight calls, and we thankfully had only one admission for a 19 day old baby with a fever to the ward. (As an aside, I think the interns perform about 2-3 lumbar punctures a day here in Kijabe…and most of them are perfectly clear…they are certainly much more skilled than we are at them).

As the consultant, we handle all the ICU care ourselves, so I also admitted one young girl to the ICU who had just had an 8.5 hour surgery to remove a large brain tumor that was impinging on her brain stem. Kijabe is a premier neurosurgical center for the country, and I was so thankful for the experience that we have had in Greenville with Dr. Troup’s patients. While I still am far from knowing everything I need to know about caring for this special set of children, our experience at GHS has made me more comfortable with shunts, vent taps (which we needed to be able to do the other day), and post op management. Thankfully, the patient did well through the night with only a few calls down to the ICU for bradycardia (to clarify—we take call from home after the day’s work is done, but since it only takes me about 5 minutes to walk to the hospital, we end up walking down frequently during the night to check on things).

This afternoon I was afforded some early time off to rest. After a quick nap, Scott and I ventured once again to the school located just above us on the mountain, Rift Valley Academy. We took a delightful stroll along their trail and met another teacher in the area. She was from Mississippi and has been serving the last 8 years here. She allowed us to meet her 3 large pet leopard tortoises that she has been caring for since moving here and recounted what a delight it is to teach for the missionary children. Scott and I thought once again about how amazing it would be to live and work here long term one day, as it seems to be the perfect fit for a doctor and her teacher/pastor husband to serve.

For the next several days, I’ll continue my work in the NICU and then move on the pediatric floor. I feel as though I’m ending my stay with a bang, as that is the part of the hospital I’ve been most excited to work in. It’s hard to believe that we have been here over 2 weeks already (it feels both too short for all the we have learned and experienced, and too long for it means that we have already passed the half-way mark of our time in Kenya). We are eager to experience what else the Lord has in store and trying to soak in every moment!

Monday, March 23, 2015

"I bless the rains down in Africa..."

We awoke this morning with the confirmation that last night’s clouds were in fact carrying rain with them.  Last night some strong winds blew in heavy looking clouds that were a direct answer to prayer.  The sprinkle of rain early this morning and the continued mist has allowed the dust to settle a bit and it looks as if the long rains are about to settle as well.  As I type these words I hear Toto’s song Africa playing in my head.  The rains indeed are a blessing and an answer to no few prayers here in Kenya.  May they settle in for some time to replenish and refresh this parched land.

Teresa had this last weekend off, her only two days free from hospital work during this entire month.  As such we decided we would venture out for a bit of fun around Kenya.  We departed Saturday morning for one of the nearby parks, Hell’s Gate.  If you think the name sounds a bit daunting, know that within the park there are several areas equally named including the Devil’s Kitchen and even the Devil’s Toilet.  In my mind was Jesus’ words that He would build His church and the gates of hell would not conquer it.  Armed with this scripture we continued onward.  Apart from the evil monikers the park actually contains a broad sample of Kenya’s animals and picturesque landscapes. 

We saw some of the classic animals including zebras, gazelle, impalas, buffalo, kudus, baboons and even a lone giraffe.  After driving through the park for a short while we continued the journey on foot through the deep gorge carved out long ago.  As we began our hike we were visited by some friendly black-faced vervets that put on a good show for our coconut flavored crackers we were snacking on.  They charmed more than a few of them out of our lunch stash.  As we continued the walk through the gorge we came through an area where we were told by our guide that two movies were filmed: Tomb Raider and the Lion King.  I am not sure how I missed it or maybe I was just dreaming but wasn’t the Lion King an animated film?

Never the matter, we carried on through the gorge and came out near some power stations where our good friend Richard has been working.  He gave us a tour through one of Kenya’s cutting edge, green power generators.  According to what we were told these facilities of “free energy” could supply over ¼ of Kenya’s electricity needs.  The power company has a number of sites where they brilliantly drilled 3,000 meters deep to harness the power of heat and steam coming from within the earth’s crust.  This steam powers turbines that then convert the energy to electricity sent out to the far reaches of the nation.  The particular facility we were in generated 105 megawatts just by harnessing the earth’s geothermal forces.  The whole business was particularly exciting and we were honored to have a tour of one of the many green power facilities in Kenya.

Carrying on from there we came to Hells Gate’s newest feature, a hot spring spa.  Whatever you have in your mind about what this may look like, immediately erase it.  I assumed this would be a small hole off a dusty road where there was a bit of hot water.  Imagine our surprise when we saw a round circular cement pool at least fifty feet in diameter filled with sky blue comfort.  Hot water boiling forth from the earth was collected in a cooling pool which was then pumped into this gigantic circular bowl that was heaven on earth. Unfortunately we had no towels with us but we will not make that mistake again.  Apparently this is the only hot spring of this caliber in all of Africa.  It truly looked as if we had left Kenya and gone to a fancy resort in Dubai.

After the spa we made a quick ride over to Lake Naivasha for a boat ride.  While there we came uncomfortably close to some full sized hippos, tipping the scales at 3 tons our guide opportunely mentioned.  We also saw birds seemingly numbering in the thousands with every variety you could imagine.  As we headed across the lake we even saw the area where they filmed a portion of Out of Africa with transplanted wildebeests and all.  We finally rolled back in to Kijabe just as darkness was falling and, despite our best efforts, we were unable to stay awake past ten o’clock.  After all we had much to prepare for as our Sunday promised to be of even greater excitement.


Yesterday we had the supreme privilege to be back in the Maasai church, AIC Kitet.  After meeting up with our friend Paul, with whom we learned shared numerous mutual friends here in Kenya, we made the journey to Suswa, just under an hour away.  When we arrived the children had already gathered and were practicing their songs outside the metal-roofed, stone sanctuary.  As the morning of worship began people trickled in from rather long distances away as they journeyed to meet with a group of fellow believers not only for mutual edification but also to praise the One that gave them life for another week.

Shortly after our arrival some Maasai ladies whisked Teresa away outside the sanctuary and dressed her in traditional shukas and loads of beaded jewelry.  Our Maasai friends also gave her a new name, Nashipae, which means “joy”.  The morning service had no shortage of that very thing as the meeting seemed to take a page right out of the New Testament church manual.  Although the service had a general order of things the entire morning was peppered with numerous testimonies, words of praise and even a couple of folks who just wanted to sing a song that was on their heart.  As I witnessed the passionate faith of everyone in the service I noted that because each person was a participant there was no room for spectators.  The service they took part in was not built around a sermon but rather the living demonstration of God’s work throughout their previous week.

I did have a chance to share a few words but what can you share when so many have said it far better already?  I shared from the Sermon on the Mount and spoke of the hope we have of great reward in the life to come.  Despite the difficulties of this life, we know that God’s kingdom seems to stand in direct opposition to that of this world.  Those who are poor, mourn, and are persecuted, and yet in the midst of it all turn their gaze towards God, it is these who Jesus said are blessed.  That brings an entirely new light to the differences of American Christianity versus that which Jesus communicated.  We even enjoyed a special time of prayer at the end of the service for some in need, following the Biblical command of coming together and laying hands on those requesting prayer.  It was a powerful time and although I could not see it, I could almost sense their faith reaching out and taking that which they needed from God’s outstretched hands.

After a tremendous time together we journeyed to the house of Pastor Richard for a meal and some additional fellowship.  Our new friend and driver Paul came along and could not stop commenting on the kindness and warmth of Richard and his family.  We ate a wonderful meal prepared by Richard’s wife, Evelyn and shared numerous memories, some old and some new.  It was such an honor to sit in the house of a longtime friend; if we only knew what had been in store ten years ago when we met on a dusty journey to Nakuru we might not have believed it.

We made our way back to Kijabe through the winding roads and bid farewell to our friend Paul for now.  I will catch up with him later this week as we go to Naivasha and then on to Eburru to find Pastor Steve, one of the most warm, loving and brilliant men I have ever had the privilege of meeting.  We rolled back into our place of residence only minutes after another dear friend had arrived.  Connie Donlon, who I had the honor of working in the Kibera Slums with, had come for a visit.  What a blessed time of reconnecting with those who God is using mightily here in the beautiful country of Kenya!