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