tag:blogger.com,1999:blog-82879182474961104022024-02-07T19:21:19.013-08:00Back to the Ends of the EarthThen he sent them out to tell everyone about the Kingdom of God and to heal the sick. ~ Luke 9:2Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.comBlogger19125tag:blogger.com,1999:blog-8287918247496110402.post-72631015561106449522015-04-04T00:34:00.002-07:002015-04-04T00:34:22.249-07:00Conclusions in Kijabe<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<br />
<div class="MsoNormal" style="margin-left: .5in;">
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.<o:p></o:p></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-89611164314487249372015-04-04T00:33:00.000-07:002015-04-04T00:33:23.033-07:00The Heart of a Servant<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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 4<sup>th</sup> 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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in;">
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. <o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<br />
<div class="MsoNormal" style="margin-left: .5in;">
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<o:p></o:p></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-41105991291540646092015-03-28T10:24:00.003-07:002015-03-28T10:24:34.404-07:00Things I've Learned in Africa
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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: <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpFirst" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">1.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<br />
<div class="MsoListParagraphCxSpLast" style="margin: 0in 0in 8pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">2.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">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. :)<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt 0.5in;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt 0.5in;">
<span style="font-family: Calibri;">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.
<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt 0.5in;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt 0.5in;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt 0.5in;">
<span style="font-family: Calibri;">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…<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpFirst" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">3.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in;">
<span style="font-family: Calibri;">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. </span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="margin: 0in 0in 8pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">4.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">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. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt 0.5in;">
<span style="font-family: Calibri;">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. </span><o:p><span style="font-family: Calibri;"> </span></o:p></div>
<br />
<div class="MsoListParagraph" style="margin: 0in 0in 8pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">5.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">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. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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…<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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!<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt 0.5in;">
<o:p><span style="font-family: Calibri;"> </span></o:p></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-8322207548522203382015-03-27T12:50:00.000-07:002015-03-27T12:50:06.094-07:00The city that God built...
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">We were stunned yesterday to receive some difficult news
from a couple back home who are dear friends of ours.<span style="mso-spacerun: yes;"> </span>Their four month old son mysteriously passed
away sometime in the night.<span style="mso-spacerun: yes;"> </span>Naturally
this came as a terrible shock and we hate we cannot be there with them during
this difficult time. <span style="mso-spacerun: yes;"> </span>Join us in prayer
that they will receive comfort from The Comforter as they journey through this
heartbreaking time.<span style="mso-spacerun: yes;"> </span>The words of Psalm
56:8 seem incredibly close: “You keep track of all my sorrows.<span style="mso-spacerun: yes;"> </span>You have collected all my tears in your
bottle.<span style="mso-spacerun: yes;"> </span>You have recorded each one in
your book.”<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> Say a prayer for Aaron and Kayla that God's presence will be ever sweeter and all the closer in this trying time.</span></span></div>
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<span style="font-family: Calibri;">Earlier in the day yesterday I had an opportunity to meet up
with one of my favorite people of all time, Pastor Steve Njenga.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>I was so thrilled to see Pastor
Steve and we caught up on nearly five years since we had seen each other
last.<span style="mso-spacerun: yes;"> </span>The last time our paths crossed
was as he passed through North Carolina during a whirlwind trip of speaking
engagements.<span style="mso-spacerun: yes;"> </span>Nevertheless it was such a
blessing to discover all the things that had taken place these last few years.<span style="mso-spacerun: yes;"> </span>Who could have known that the greatest
surprise was yet to come!<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">We toured a bit of Naivasha while his wife Mary was on her
way to meet us from work.<span style="mso-spacerun: yes;"> </span>Naivasha has
grown immensely since I was there previously.<span style="mso-spacerun: yes;">
</span>It seems as if multitudes have flooded the busy city as of late.<span style="mso-spacerun: yes;"> </span>Indeed I learned that many people settled
there after the period of great unrest following the election violence of
2008.<span style="mso-spacerun: yes;"> </span>New businesses have cropped up in
every corner and it seems as if the Kenyan economy is growing in wonderful
ways.<span style="mso-spacerun: yes;"> </span>Once Mary arrived we too shared
some wonderful memories of old as we journeyed to Eburru.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">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.<span style="mso-spacerun: yes;"> </span>My memories had not faded too greatly as the
roads there seemed all too familiar.<span style="mso-spacerun: yes;"> </span>I
saw the same groups of baboons, impala, gazelle, rock hyrax and occasional
warthogs that used to oversee our treks through the mountains.<span style="mso-spacerun: yes;"> </span>Eburru is a unique location indeed as it is
positioned near nine extinct volcanic craters.<span style="mso-spacerun: yes;">
</span>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.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">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.<span style="mso-spacerun: yes;"> </span>Smiling at my surprise Pastor Steve jumped
out of the van to begin our tour.<span style="mso-spacerun: yes;"> </span>We
first started with the multi-purpose dining room and auditorium.<span style="mso-spacerun: yes;"> </span>He told me that during the year they have conferences
from groups back in Nairobi that meet there.<span style="mso-spacerun: yes;">
</span>Directly behind the auditorium is the kitchen where they prepare daily
meals for 351 students.<span style="mso-spacerun: yes;"> </span>We stepped into
the on-site bakery where a lump of dough roughly my size was being converted
into countless tasty loaves.<span style="mso-spacerun: yes;"> </span>That
massive amount of dough, I was informed, would make enough bread for just three
days.<span style="mso-spacerun: yes;"> </span>After tasting a portion of one of
the loaves I figured I could probably make it all disappear a bit faster!<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">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.<span style="mso-spacerun: yes;"> </span>After that
we crossed over to the newest building, a dorm for the boarding students with a
capacity of over two hundred.<span style="mso-spacerun: yes;"> </span>The top
floor is in the process of being finished and it is a building that easily dwarfs
the others.<span style="mso-spacerun: yes;"> </span>The rooms inside are cozy,
full of amenities and complete with study areas and lounges.<span style="mso-spacerun: yes;"> </span>A dorm mother watches over the ones that are
there presently, some hailing from as far as Mombasa.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">Leaving the dorm we passed by the large cement water tank
that supplies water for the entire operation.<span style="mso-spacerun: yes;">
</span>Water is extremely scarce in this area as the only sources are rain and
condensed steam.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;">
</span>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.<span style="mso-spacerun: yes;"> </span>Drilling a well here finds no water, only
steam, much like what is found in Hell’s Gate.<span style="mso-spacerun: yes;">
</span>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.<span style="mso-spacerun: yes;"> </span>This provides an additional 5,000 liters of
water per day.<span style="mso-spacerun: yes;"> </span>That water is probably
some of the best in the world as it is produced by nature’s own distillery.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">We then passed by the classrooms for the children grades 1
through 8.<span style="mso-spacerun: yes;"> </span>They were gathering back
together after their lunch and I had a chance to share with the seventh grade
class.<span style="mso-spacerun: yes;"> </span>Some asked questions about
America including our diet and a number of questions regarding snow.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>After sharing with a
few students we moved on noting how well behaved and brilliant they all
are.<span style="mso-spacerun: yes;"> </span>To go to school, especially one as
nice as this, is a privilege and one the students seemed to readily understand.<span style="mso-spacerun: yes;"> </span>They work hard and have excellent instructors.<span style="mso-spacerun: yes;"> </span>Pastor Steve told me that they ranked above the
national standard of scholastic excellence last year.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">We toured the quarters where the teachers live there on site.<span style="mso-spacerun: yes;"> </span>Due to the remote location it would be
difficult to live elsewhere and make the journey to the school every day.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>Everything about the facility
is nothing short of brilliant and well on its way to becoming a fully self-sustaining
community.<span style="mso-spacerun: yes;"> </span>Even the children take part
in chores that enable the work to be accomplished and completed in a
streamlined fashion.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">As I stood there talking with Pastor Steve I was nothing
short of amazed.<span style="mso-spacerun: yes;"> </span>His vision and heart
for this place is tremendous.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>The stories of
how God has miraculously provided are myriad and only a book of size could
document them all.<span style="mso-spacerun: yes;"> </span>Pastor Steve had a
goal of not only reaching the residents of Eburru with the gospel but improving
the entire community in the process.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">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.<span style="mso-spacerun: yes;">
</span>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.<span style="mso-spacerun: yes;"> </span>To be with him was to be with a true
visionary whose only limit is the size of his God’s ability to provide.<span style="mso-spacerun: yes;"> </span>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.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">He told me that he announced to the most recent church he
planted there in Eburru that they would preach to the world.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>The scope of what I saw
yesterday was incredible.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">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.<span style="mso-spacerun: yes;"> </span>He speaks with great wisdom and yet with such
humility.<span style="mso-spacerun: yes;"> </span>He shared that he has never
asked for money or resources, something that is remarkably true.<span style="mso-spacerun: yes;"> </span>In actuality it is even difficult to learn of
what the needs may be even when direct in asking.<span style="mso-spacerun: yes;"> </span>God has just connected him with people who
are impassioned by the God he serves.<span style="mso-spacerun: yes;"> </span>Not
long ago he came to the United States and had 60 speaking engagements in only three
weeks.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>As he related
it all to me yesterday, he said, “I’m a nobody, what could I share with these
important people?<span style="mso-spacerun: yes;"> </span>So I just shared what
I know…Jesus.”<span style="mso-spacerun: yes;"> </span>It is clear that
everything he is involved in really is just a testimony to the goodness of God.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">Needless to say I had plenty to ponder and process as we
began the trek back to Naivasha.<span style="mso-spacerun: yes;"> </span>The
work of the Lord in Eburru has been incredible; it truly is the city that God
built.<span style="mso-spacerun: yes;"> </span>When we arrived back in Naivasha Paul
and I departed with some delicious samosas and a heartfelt farewell.<span style="mso-spacerun: yes;"> </span>We jumped in a matatu and headed back to Mai
Mahu, Paul’s home town and the city just below Kijabe in the valley.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;">
</span>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.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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.<span style="mso-spacerun: yes;"> </span>This
did not bode well when we added an additional passenger on the already dragging
motorcycle.<span style="mso-spacerun: yes;"> </span>The 125cc machine groaned
under the weight of three people as it zigzagged and lurched up the impossibly steep
incline.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;">
</span>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.<span style="mso-spacerun: yes;"> </span>In the distance one could almost
make out the shape of Eburru’s peak, stretching toward the heavens, connecting
with her divine source. </span></div>
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<span style="font-family: Calibri;">For more information you can visit <a href="http://www.davidshope.org/pastor-steve/">David's Hope</a> to find additional updates on the work taking place in Eburru!</span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-19049034506955446412015-03-25T10:51:00.001-07:002015-03-25T10:51:09.826-07:00Wazungu Worship<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgD6aH3U8RTMXnPsvd4NiTajGyUSq-ncy0Bg8E_o3fuxuxhOXW6hKic9FhC7XG3s1tICrAOq0DN2zhzfL_9AWWbXYS-Ow6Pj2roT_qalxFUUJ-bYMxZwkwK9brfvF_h1jSWfu-WPphBlFaL/s1600/masaai+church.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgD6aH3U8RTMXnPsvd4NiTajGyUSq-ncy0Bg8E_o3fuxuxhOXW6hKic9FhC7XG3s1tICrAOq0DN2zhzfL_9AWWbXYS-Ow6Pj2roT_qalxFUUJ-bYMxZwkwK9brfvF_h1jSWfu-WPphBlFaL/s1600/masaai+church.jpg" height="240" width="320" /></a></div>
<br />
<div style="text-align: center;">
Here is a picture of us with AIC-Kitet at worship on Sunday! </div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-80405164098523284322015-03-25T10:38:00.001-07:002015-03-25T10:38:24.508-07:00Zebras, Massive Power Tools, and Tiny Babes...
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<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">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…<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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…<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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). <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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). <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">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!<o:p></o:p></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-31913915453882625212015-03-23T11:42:00.001-07:002015-03-23T11:42:25.057-07:00"I bless the rains down in Africa..."
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">We awoke this morning with the confirmation that last night’s
clouds were in fact carrying rain with them.<span style="mso-spacerun: yes;">
</span>Last night some strong winds blew in heavy looking clouds that were a
direct answer to prayer.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>As I type these words I hear Toto’s song
Africa playing in my head.<span style="mso-spacerun: yes;"> </span>The rains
indeed are a blessing and an answer to no few prayers here in Kenya.<span style="mso-spacerun: yes;"> </span>May they settle in for some time to replenish
and refresh this parched land.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;"><strong>Saturday:</strong></span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Teresa had this last weekend off, her only two days free
from hospital work during this entire month.<span style="mso-spacerun: yes;">
</span>As such we decided we would venture out for a bit of fun around Kenya.<span style="mso-spacerun: yes;"> </span>We departed Saturday morning for one of the
nearby parks, Hell’s Gate.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>In my mind was Jesus’ words that
He would build His church and the gates of hell would not conquer it.<span style="mso-spacerun: yes;"> </span>Armed with this scripture we continued onward.<span style="mso-spacerun: yes;"> </span>Apart from the evil monikers the park
actually contains a broad sample of Kenya’s animals and picturesque
landscapes.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">We saw some of the classic animals including zebras,
gazelle, impalas, buffalo, kudus, baboons and even a lone giraffe.<span style="mso-spacerun: yes;"> </span>After driving through the park for a short
while we continued the journey on foot through the deep gorge carved out long
ago.<span style="mso-spacerun: yes;"> </span>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. <span style="mso-spacerun: yes;"> </span>They charmed more than a few of them out of
our lunch stash.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>I am not sure how I missed it or maybe I was just
dreaming but wasn’t the Lion King an animated film?<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Never the matter, we carried on through the gorge and came
out near some power stations where our good friend Richard has been
working.<span style="mso-spacerun: yes;"> </span>He gave us a tour through one
of Kenya’s cutting edge, green power generators.<span style="mso-spacerun: yes;"> </span>According to what we were told these
facilities of “free energy” could supply over ¼ of Kenya’s electricity needs.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;">
</span>This steam powers turbines that then convert the energy to electricity sent
out to the far reaches of the nation.<span style="mso-spacerun: yes;">
</span>The particular facility we were in generated 105 megawatts just by
harnessing the earth’s geothermal forces.<span style="mso-spacerun: yes;">
</span>The whole business was particularly exciting and we were honored to have
a tour of one of the many green power facilities in Kenya.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Carrying on from there we came to Hells Gate’s newest
feature, a hot spring spa.<span style="mso-spacerun: yes;"> </span>Whatever you
have in your mind about what this may look like, immediately erase it.<span style="mso-spacerun: yes;"> </span>I assumed this would be a small hole off a
dusty road where there was a bit of hot water.<span style="mso-spacerun: yes;">
</span>Imagine our surprise when we saw a round circular cement pool at least
fifty feet in diameter filled with sky blue comfort.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>Apparently this
is the only hot spring of this caliber in all of Africa.<span style="mso-spacerun: yes;"> </span>It truly looked as if we had left Kenya and
gone to a fancy resort in Dubai.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">After the spa we made a quick ride over to Lake Naivasha for
a boat ride.<span style="mso-spacerun: yes;"> </span>While there we came uncomfortably
close to some full sized hippos, tipping the scales at 3 tons our guide
opportunely mentioned.<span style="mso-spacerun: yes;"> </span>We also saw birds
seemingly numbering in the thousands with every variety you could imagine.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;">
</span>After all we had much to prepare for as our Sunday promised to be of
even greater excitement.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;"><strong>Sunday:<o:p></o:p></strong></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Yesterday we had the supreme privilege to be back in the
Maasai church, AIC Kitet.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>When we arrived the children had already
gathered and were practicing their songs outside the metal-roofed, stone
sanctuary.<span style="mso-spacerun: yes;"> </span>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.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Shortly after our arrival some Maasai ladies whisked Teresa
away outside the sanctuary and dressed her in traditional shukas and loads of
beaded jewelry.<span style="mso-spacerun: yes;"> </span>Our Maasai friends also
gave her a new name, Nashipae, which means “joy”.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">I did have a chance to share a few words but what can you
share when so many have said it far better already?<span style="mso-spacerun: yes;"> </span>I shared from the Sermon on the Mount and
spoke of the hope we have of great reward in the life to come.<span style="mso-spacerun: yes;"> </span>Despite the difficulties of this life, we
know that God’s kingdom seems to stand in direct opposition to that of this
world.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>That
brings an entirely new light to the differences of American Christianity versus
that which Jesus communicated.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>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.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">After a tremendous time together we journeyed to the house
of Pastor Richard for a meal and some additional fellowship.<span style="mso-spacerun: yes;"> </span>Our new friend and driver Paul came along
and could not stop commenting on the kindness and warmth of Richard
and his family.<span style="mso-spacerun: yes;"> </span>We ate a wonderful meal
prepared by Richard’s wife, Evelyn and shared numerous memories, some old and
some new.<span style="mso-spacerun: yes;"> </span>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.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">We made our way back to Kijabe through the winding roads and
bid farewell to our friend Paul for now.<span style="mso-spacerun: yes;">
</span>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.<span style="mso-spacerun: yes;">
</span>We rolled back into our place of residence only minutes after another
dear friend had arrived.<span style="mso-spacerun: yes;"> </span>Connie Donlon,
who I had the honor of working in the Kibera Slums with, had come for a
visit.<span style="mso-spacerun: yes;"> </span>What a blessed time of
reconnecting with those who God is using mightily here in the beautiful country
of Kenya!<o:p></o:p></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-11956412717576014512015-03-20T11:20:00.003-07:002015-03-20T11:20:45.871-07:00Close quarters, an afternoon hike (with MORE monkeys), and new friends<br />
<span style="font-family: Calibri;">Wednesday I said goodbye to my internal medicine team and my
patients that I had been caring for, and transitioned to the world of
pediatrics. Currently I’m working in the nursery which is the equivalent of a
level 2 NICU back home. We have patients on cpap (although the set-up is much
different but simply brilliant), tube feeds, and German monitors. The room is
about 12ft by 15ft and accommodates about 17 babies, their mothers, about 5-6
nurses and our team of 5. Needless to say it gets a bit crowded. Furthermore,
because we need to keep the babies warm, the room stays about 90 degrees all
the time with no air flowing through. It has allowed to me to feel as though I’m
truly practicing medicine in Africa. <o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">As with any NICU, it is a completely different world. I’m
fortunate that I just finished my upper level NICU rotation back home, as next
week I’ll be helping a first year NICU fellow from Canada with attending
duties. Yesterday I got to go to a c-section and learned that usually the
medical officer interns attend deliveries by themselves and resuscitate the
babies. I realized how pampered I am at home with such knowledgeable nurses and
RT’s…and NICU attendings always available to assist. Just as with medicine last
week, I know I will be stretched in many ways. I’m learning that Kenyans have
quite different protocols and standards with their infants, but it has been
encouraging to have each mother so engaged in her baby’s care. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Today I was granted my first afternoon off since arriving.
Scott and I were very excited to have the chance to explore Kijabe for the
first time together since my tour of the area has thus far consisted of the 150
meter walk to the hospital from our house. We walked down below the hospital on
a search for hyenas, a view of the valley, and the many exotic plants that
exist on the side of the mountain. We also visited Rift Valley Academy which is
a world class African boarding school where missionary children attend. It is
just about 150 meters up the mountain (opposite the hospital) from our house.
We walked a trail around its 100 acres and discovered a few stray cows, several
colobus monkeys, and some fantastic views through the valley. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">While strolling about, we ran into a delightful couple from
Iowa who are serving as teachers at RVA. We exchanged some polite banter and
they kindly offered to have us over for dinner (after having talked to us for
about 3 minutes). We spent the evening in their home with another couple
serving as teachers from Pennsylvania and their many delightful children who
just wanted to be held and play with my hair. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">After homemade pizza and cookies, we sat down on their couch
to stream a March Madness game. As the couple were avid basketball and Iowa
State fans, I learned that my dear UAB beat Iowa State yesterday. Go Blazers! (They
joked that had they realized I was from UAB before inviting us to dinner they
would have kept their mouths shut….something to be said for inviting someone
you just met to dinner).<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"> </span>It was such a treat
to be allowed into their home and to watch such an amazing internet connection
in Africa (our own here in our house is not nearly as effective…). However,
more than the food and television, we were blessed by their wonderful
hospitality. In fact, since arriving in Kijabe, we have been invited to lunch
or dinner at least 2-3 times a week. People here have been so willing to open
their hearts and their homes to us. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">It reminds me of the church in Acts where people shared all
that they had and met daily together to break bread. (In fact, almost everyone
here has offered to let us borrow something or stop by whenever we need
anything). <span style="mso-spacerun: yes;"> </span>I was challenged today to
continue with a spirit of hospitality when we return to the states. Many of you
have probably noticed that Scott and I are both introverts and tend to prefer
to stay at home by ourselves...or focus on our own busy schedules. However, I
know the Lord has blessed us with so much and we have been so blessed here…I
was reminded I should be doing the same for others. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Tomorrow I am fortunate to have the weekend off, so Scott
and I will be exploring the Kenyan countryside with an old friend of ours. We
are excited to see what we will get in to. Pray for hydration and safety as we
attempt to make it off the mountain for the first time since arriving! Also,
look forward to some good pictures and stories to come!<o:p></o:p></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com1tag:blogger.com,1999:blog-8287918247496110402.post-28421770894882584192015-03-18T10:44:00.002-07:002015-03-18T10:44:38.205-07:00Medicine is a universal language
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">I’m not sure whether I have made it clear in my other
writings about Kijabe, but this is a training facility where Kenyans are educated
both in medicine and in the Word to go out and fulfill what I have personally
felt to be my life’s calling from Luke 9: “to preach the gospel and heal the
sick.” <span style="mso-spacerun: yes;"> </span>Therefore I have had the privilege
of learning from our US equivalent of other fellow residents and trainees. We
sit in lecture together, run to the lab together, and look after one another’s
patients. I’ve been so thankful for their kindness in taking me under their
wing and never complaining over the plethora of daily questions that I have. <span style="mso-spacerun: yes;"> </span>I’ve come to consider them my friends in just
the few short days I’ve had the chance to get to know them.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"> </span>Last night our
attending (a hospitalist from California) had them all over for a pizza party. It
was so exciting to sit around and hear the banter that we all shared. I
realized that medicine is medicine everywhere. There was a common bond amongst
us as we commiserated over medicine consults to perform history taking for
ortho (sorry for the insult to my surgical friends…you know how it is…), nurses
not charting appropriately (again, sorry for the insult to any nursing friends…some
of them are very good here, but you know how the chatter goes), and all of the
other things that residents laugh about when they are tired and overworked. It
was thrilling to me to watch as we sat and laughed all the while a few checking
their smart phones and looking at facebook pictures. Even though we live in
very different places, our worlds are not so different. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Beyond our common bond of medicine, it has been exciting to
share a common thread of the Spirit. To know that we all love the Lord and seek
to glorify Him with our work has been both fulfilling and challenging. One of my
fellow teammates and I discussed a patient who had passed in the night the
other day before rounds. As we stood on the ward, we reiterated what the Lord
has been impressing on us about striving for eternity and knowing that our
medicine is only a small step in showing someone God’s love rather than being
able to reverse the inevitable. After our conversation ended, I looked at her
and concluded, “We have just had church this morning!” <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">I know that many of my fellow residents in the states and I
also share the same relationship with the Lord. I wanted to come to Greenville
in part because I knew I would be challenged to remember to love on my patient’s
with Christ’s compassion there. However, I fear that in my busy rush to get
things done, I don’t share this part of my heart with my peers as much as I
should. I am challenging myself to continue to share with patients and
encourage my fellow workers in the field to bring honor to our Lord as we work
for “things unseen.” <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-62172182397783704042015-03-18T10:43:00.003-07:002015-03-18T10:43:49.622-07:00Monkeys, Hyenas and Dust Clouds...Oh My...
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">As the days seem to pass all too quickly here in Kenya I
thought I might take a moment to reflect on the past few.<span style="mso-spacerun: yes;"> </span>After a busy weekend we slightly recovered
with the start of this second week here in Kijabe.<span style="mso-spacerun: yes;"> </span>Teresa has had no lack of opportunity or work
as she has been in the hospital every day since arriving.<span style="mso-spacerun: yes;"> </span>Tomorrow marks the shift from the medicine
side of the hospital to the pediatric side which she will be involved with
until our departure.<span style="mso-spacerun: yes;"> </span>Monday evening we
had a wonderful time during the weekly dessert night for the missionaries who
serve at the hospital.<span style="mso-spacerun: yes;"> </span>It truly is a
blessing to have such a wonderful community of individuals passionate about the
Lord as well as the work to which He has called them.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">I also had an opportunity to work with Moffat Bible College
both Monday and today.<span style="mso-spacerun: yes;"> </span>Today I got to
sit in on their chapel service which happens to be one of the last for this
semester.<span style="mso-spacerun: yes;"> </span>Their school calendar is a bit
different than American schedules and next week will mark their exams and
semester’s end.<span style="mso-spacerun: yes;"> </span>Nevertheless, this
chapel service was a bit out of the ordinary as the president of the college
wanted to handle some “housekeeping” matters.<span style="mso-spacerun: yes;">
</span>His remarks included a warning against “Pentecostalism” around the
college which I later learned included students having marked outbursts during
their meetings, rolling around on the ground and slapping the walls with their
raised hands in some wild display. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">He also shared that the fellows should have a shaved head,
look smart, pay their fees on time and not wear open toed shoes.<span style="mso-spacerun: yes;"> </span>His presentation about open toed shoes was
most entertaining as he stated that God created men to keep their feet covered
because no one wants to see their feet.<span style="mso-spacerun: yes;">
</span>On other hand God permitted women to wear open toed shoes because their
feet are generally more delicate and not as off-putting as a man’s.<span style="mso-spacerun: yes;"> </span>This was met with raucous laughter by both
the men and the women in attendance.<span style="mso-spacerun: yes;">
</span>Lastly he warned the students against putting too much information on
“the Facebook” as people do not want to see them kissing other people or see
their posts about silly, insignificant things.<span style="mso-spacerun: yes;">
</span>I chuckled a bit inside as the exhortations from the president seemed
remarkably similar to the words shared in American schools, albeit in a
different cultural presentation for sure.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Additionally we continue to make great connections with
people here and recognize what a small world it truly is.<span style="mso-spacerun: yes;"> </span>I met a fellow this morning who is teaching
at the Bible College who went to Furman University and previously served as a
chaplain at Greenville Memorial Hospital.<span style="mso-spacerun: yes;">
</span>How wild to fly halfway around the world and meet people who have the
same reference points as you.<span style="mso-spacerun: yes;"> </span>Crazy
enough I was talking to a fellow just last week who referenced eating at Wade’s
in Spartanburg and I had to check to make sure I was still in Kenya!<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">I went out earlier this week for a walk and found a
beautiful view of the Rift Valley on the edge of Kijabe just a bit west of
here.<span style="mso-spacerun: yes;"> </span>I found a few mischievous monkeys
swinging about in the trees, curiously looking to see if I had anything they
could steal.<span style="mso-spacerun: yes;"> </span>Those here who live on the
opposite side of the hospital from us told us that they have to be overly
cautious as the monkeys will find a way into their houses and take whatever
their little paws can get a hold of.<span style="mso-spacerun: yes;"> </span>I
also stumbled upon a few signs of a local hyena or two which I had no knowledge
of being around Kijabe.<span style="mso-spacerun: yes;"> </span>I do not think
they come up quite as far as the hospital but we were warned to keep an eye
out.<span style="mso-spacerun: yes;"> </span>At this point I am not sure what to
do if we do see a hyena but I have played out a few scenarios in my mind where
I use various implements to either poke out his eyes or break one or two of his
legs.<span style="mso-spacerun: yes;"> </span>Otherwise the natural world here
in Kenya continues to delight.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Despite the beauty of this land, do join us in praying for
the people here in the Rift Valley as the delayed rains have caused increasing
problems.<span style="mso-spacerun: yes;"> </span>I heard a report today that
not only are people’s gardens drying up but they cannot even find basic
vegetables and food at the markets.<span style="mso-spacerun: yes;"> </span>Water
is a resource that is all too scarce.<span style="mso-spacerun: yes;"> </span>Also
due to demand the prices of things have dramatically increased bringing
additional strain to families that already are struggling.<span style="mso-spacerun: yes;"> </span>One fellow was telling me today that a Maasai
was asking for water and when some was brought to him he first poured a bit
into a basin for his sheep and he drank some himself only after they had a
bit.<span style="mso-spacerun: yes;"> </span>Life here is hard forcing the
precious people of this land find a greater dependence upon their Creator.<span style="mso-spacerun: yes;"> </span>May God bring them both spiritual and
physical rain as He nourishes a world in need of His renewal.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">Scott<o:p></o:p></span></div>
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<o:p><span style="font-family: Calibri;"> </span></o:p></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-24285946204369460922015-03-16T11:46:00.001-07:002015-03-16T11:46:23.947-07:00The most interesting call weekend I have ever had…
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<span style="font-family: Calibri;">DISCLAIMER: The following post is quite lengthy and filled with
medical jargon. It was written more for my own remembrance and mental cleansing
after a long weekend. However, if you want the important point, Scott tells me
you can just skip to the final paragraph and get all you would ever need. (Although, I find the rest pretty interesting too...</span><span style="font-family: Wingdings; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-char-type: symbol; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">J</span></span><span style="font-family: Calibri;"> )Thanks for reading! </span></div>
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<span style="font-family: Calibri;">As I mentioned in my last blog, this weekend I was charged with
the responsibility of rounding on the internal medicine services and overseeing
the admissions by the interns. Being not far from their training myself and not
knowing the girls I was privileged to work with, that meant that I came in to
see each of their admissions with them as we worked collaboratively through
their presenting symptoms. Since in Kenya healthcare is only available to those
that can afford to pay up front, many people present very late in their illness,
and many only when they are on the brink of death. Needless to say, the
admissions were fairly complicated. However, I was excited to tackle the
weekend and see everything from falciparum malaria to classic ST elevation MI
(massive heart attack). <o:p></o:p></span></div>
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<span style="font-family: Calibri;">Since I have already relayed to you most of Saturday’s
events, I would like to walk you through my last 24 hours: The morning began
with rounds by myself on our critically ill patients. One patient who had been
admitted overnight on Friday was not faring well, as her pulse was in the 160’s,
her blood pressure was in the 200’s and her breathing had become labored. She
was admitted with known HIV, a diagnosis treated much like stage 4 cancer here.
Therefore, a collaborative physician decision was made that she was a DNR, as
the likelihood of her surviving was slim. She was being treated for liver
failure of unknown origin (suspected to be from either her AIDS medications or
some herbal concoction she had received from a traditional healer). <o:p></o:p></span></div>
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<span style="font-family: Calibri;">Hepatic encephalopathy is not a diagnosis we are unfamiliar with
in the US, but she was not responding in the way I would have liked. Therefore,
I did what any confused resident is likely to do…I went back to the drawing
board and attempted to make a differential for altered mental status in an HIV
patient. I did not have the benefit of any prior health history or a CD4 count.
I’ll spare you the details of my varied list, but I systematically tried to
rule each in or out, and decide how, or if I could treat them. Unfortunately,
lab tests on the weekend are hard to come by and basic at most. Imaging is
limited to ultrasound or x-rays unless a patient is stable enough and wealthy
enough to make a trip for a CT or MRI to Nairobi about 2 hours drive one way
(not an option in an unresponsive patient without an airway). Therefore, I
started antibiotics empirically to treat any of the possible infectious causes
we were not treating, and prayed for the best.<o:p></o:p></span></div>
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<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"> </span>I realize as I’m typing
this you probably thought that after reading 2 paragraphs about one patient, I
would have revealed to you her mystery diagnosis, but alas even today she
remains a mystery on the brink of heaven. I write this only to demonstrate the
mental anguish of watching a patient deteriorate in front of you without the benefit
of knowing what is ravishing her body, and the frustration of limited resources
(AND lack of knowledge on my part…I was thankful that our senior attending
returned today to add her own clinical expertise!). <o:p></o:p></span></div>
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<span style="font-family: Calibri;">While attempting to seek other physician opinions about the
lady above yesterday, I came upon a pediatric code in the ICU. It was so much
calmer than any I have seen in the states (no code stat junior called overhead,
and no pharmacy, chaplain, or scores of scared residents to crowd the room).
Since there was only the nurse and one pediatrician present (one bagging and
one doing compressions), I quickly offered my services. They requested that I
run to the blood bank to seek the blood they had ordered to transfuse him. It
occurred to me as I ran through the hospital that this is a situation I have
only seen in movies. When I arrived and urgently requested the blood, the lab
tech sluggishly checked the progress and told me that it would be 30 more
minutes. To this I replied, “It’s an emergency…the baby is dying right now!” He
finally agreed to let me have what was available for an emergency protocol but
only if I could go back to the ICU and get the blood carrier. I felt much like
a ping pong ball, but the baby survived the code. Unfortunately this morning I
curiously passed his room to find it empty. I don’t know the details since I’m
not currently on the pediatric service, but I know he is frolicking in heaven
unbound by tubes and lines today. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">After my adrenaline calmed down from running through the
hospital, I made my way toward the gate to go home for lunch. However, I
stopped by the ER to see if any interesting admissions were coming our way. The
clinical officer (PA) was so happy to see me and showed me an EKG of a patient
who had presented with chest pain. He had classic tombstoning ST elevation in
the anterior leads (massive heart attack for my non-medical friends). These
patients are usually whisked away to heart cath in the US before we ever have a
chance to see them. Unfortunately, a cath is not available in our hospital
where a cardiologist is only here once a week for clinic. We initiated typical
therapy for a heart attack and I was excited to be able to teach the clinical
officer. I learned later than thombolytics are sometimes available to treat
these patients, but unfortunately, our hospital was out yesterday. He was
admitted to the ICU team and I moved on to the next patient. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">A 50 year old lady with known HIV had presented with altered
mental status, vomiting, and left sided weakness. On her exam, she was quite
stiff and unable to move her left side at all. With her right arm she was
persistently performing repetitive motions which made me concerned for partial
seizures. We were highly suspicious of a space-occupying lesion, stroke, or
infection. Her family was unable to afford a head CT, so we decided to treat
for meningitis empirically, knowing that a lumbar puncture would be very risky
in her. They planned to consult with family members and attempt the head CT the
following day. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">After getting her settled, we were called about a patient
with a likely bowel obstruction and a sodium level of 103. Next, was a patient
with chest pain after previous history of a heart attack. Following him, our
team was asked to see a 16 year old girl with known focal segmental glomerulonephritis
and pyelonephritis (kidney infection) on immunosuppressants. Then, we admitted
a lady with seizures and hypertensive emergency. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">After finally getting each of the above settled it was about
1:30am and the clinical officer quietly asked for my opinion about 2 other
patients in the unit “since I was there.” He briefly told me their stories
concluding that they likely both had pulmonary TB (number 1, 2 and 3 on the
differential here for any patient). I asked to see their x-rays and I examined
both. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">The first gentleman had the largest, most nodular liver I
had ever felt. He had an ultrasound that showed 2 focal masses and a x-ray that
looked like diffuse metastatic lung cancer (although to the credit of the
intern, it also looked like military TB, ARDS, or PCP …all very likely causes
of his symptoms). He was hypotensive and had signs of infection on his labs. We
concluded that he likely had metastatic lung cancer and potentially ARDS as the
result of an infection he may have acquired while in and out of the hospital. I
attempted to stabilize his shock and moved to the second patient. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">The second gentleman was very thin and frail, with a blood
pressure of 86/50 and saturating 75% on 15L of oxygen. On his admission vitals,
it was recorded he had a sat of 32% on room air. He had clubbing (signs that he
always had low oxygen levels) and was in mild distress. The intern described
his x-ray as “unusual” but he wasn’t sure what was going on. Taking it to the
light box, it became quickly apparent that he had a moderate pneumothorax with
a white out of the right lung and diffuse patchy infiltrates in the left (one
must learn to become a radiologist here, because that is another subspecialty
we are lacking). <o:p></o:p></span></div>
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<span style="font-family: Calibri;">Because of the hypotension, I was concerned that he was
developing a tension pneumothorax and potentially had a lung full of blood
since that’s what he had been coughing up for the last week. I called the
surgical resident to place a chest tube and then the intern and I prepared to
do a needle decompression (something I’ve only read about but never actually
done). It was slightly anti-climactic, but it did buy us time until the other
physicians arrived. The ICU covering attending came and performed a bedside
ultrasound to look for signs of cardiac compromise from the collapsed lung
(thankfully there were none). After that, the ICU team took over. Unfortunately
when I went to find the patient this morning to follow up, he was nowhere to be
found. Another soul with the Lord after a long night. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">After about an hour of long awaited rest, I went back to
round on my patients for the day. I walked into our unit to find the nurses
coding the lady I had admitted with HIV, seizures, and left sided weakness.
Again, it was actually a bit calmer and more organized than those in the US. I
took over the lead from the intern who was bagging and we tried to think
through what might be going on. Unfortunately after about 20 minutes, she too left
this world to be with the Savior. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">I sat down with her family when they came to visit this
morning, and it was odd how at peace they were with her passing. They knew she
had been suffering with AIDS for nearly 10 years and calmly acknowledged every
word without so much as a question about what happened. Given that her acute diagnosis
was still unknown, I was amazed at their acceptance that God is in control. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">I keep seeing over and over again this contrast between
American and Kenyan culture: Kenyans believe in a spiritual universe. Whether
people know Jesus or not, they still realize that there are powers greater than
us at play. They understand that as physicians we are entrusted with knowledge
and expected to use that as the gift that it is, but they do not blame us or
question when bad things happen. They know that we do our best, but sometimes
it is time for the suffering in this world to be done. <o:p></o:p></span></div>
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<span style="font-family: Calibri;">After the conversation with the family, my call shift was
finally over and it was time to begin the day with traditional rounds. As is
customary on our team, we prayed to begin the day. I shared with them this
verse that the Lord has been impressing upon me this weekend: “That is why we
never give up. Though our bodies are dying, our spirits are being renewed every
day. For our present troubles are quite small and won’t last very long. Yet they
produce for us an immeasurably great glory that will last forever. So we don’t
look at the troubles we can see right now; rather we look forward to what we
have not yet seen. For the troubles we see will soon be over, but the joys to
come will last forever.” – 2 Corinthians 4:16-18. I realize that medicine and
physical things are only temporary. I’m not going to lie, I was pretty beat down
this morning after feeling futile for so many patients. However, the Lord
reminded me that we work for eternal things. We touch patient’s hearts and
souls, and the love that we show them will last far longer than any medicine I
could ever give. With that I am encouraged, and the journey continues!<o:p></o:p></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com1tag:blogger.com,1999:blog-8287918247496110402.post-56599455693832787942015-03-15T07:31:00.001-07:002015-03-15T07:31:15.935-07:00Sunday in Suswa...<span style="font-family: Calibri;">This morning was filled with great excitement as I got to
meet up with one of the fellows I missed the most since being gone from Kenya:
our Maasai friend Richard.<span style="mso-spacerun: yes;"> </span>It has been
eight long years since we last saw each other and the reunion was certainly a
blessed one.<span style="mso-spacerun: yes;"> </span>As we chatted over some
chai he shared the ministries and jobs he has been involved in, how his family
has grown and how God has provided in miraculous ways.<span style="mso-spacerun: yes;"> </span>Just after 10:00 we left to make our way to
Suswa, a Maasai town at the base of the extinct volcano Mt. Suswa, down in the
Rift Valley.<span style="mso-spacerun: yes;"> </span>We wound around a
serpentine road that looks as if it once was a suitable path for transport but
has now been mostly reclaimed by nature.<span style="mso-spacerun: yes;"> </span>No
words can quite describe exactly how treacherous the road is but with the skill
of Richard’s driving and the grace of the Lord we made it to the valley floor.</span><br />
<span style="font-family: Calibri;"><o:p></o:p></span><br />
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<span style="font-family: Calibri;">The equator passes just north of us here in Kenya and there
are not really seasons as we think of them.<span style="mso-spacerun: yes;">
</span>Instead the year is punctuated by the short rains and the long
rains.<span style="mso-spacerun: yes;"> </span>The short rains come in the fall
and the long rains usually begin in March and are scheduled to arrive any day
now.<span style="mso-spacerun: yes;"> </span>Once in the valley it became clear how
little rain has fallen since last fall.<span style="mso-spacerun: yes;">
</span>The plants there are all thin leafed to maximize the scant amount of
moisture they can gather when water is available.<span style="mso-spacerun: yes;"> </span>What’s more they are all covered with thorns
that make the American briars look like a joke. <span style="mso-spacerun: yes;"> </span>The lack of rain has caused everything to turn
to dust, which is then gathered aloft in immeasurable amounts by the wind.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">About forty five minutes into our journey a stone building
with a shiny tin roof appeared, seemingly out of nowhere on the left side of
the road.<span style="mso-spacerun: yes;"> </span>It was so dry and we were all
so parched I thought it was probably a mirage but it just so happened to be our
stopping point.<span style="mso-spacerun: yes;"> </span>We drove right up to the
side of the building and could hear the shrill sounds of Maasai worship coming
from within.<span style="mso-spacerun: yes;"> </span>As we walked in I am afraid
my white skin caused a minor distraction but not enough to take away from the
heartfelt praise that was already taking place.<span style="mso-spacerun: yes;"> </span>I am convinced that the Maasai will be
holding classes in heaven to teach worship to those who were a bit too stiff
back on earth.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Everyone was an active participant in their worship and instead of staying in the plastic chairs that were lined up in the back of the meeting place, they all gathered at the front of their sanctuary dancing and jumping in unison. As they sang their jumps, stomps and whirls churned up the
dust from the dirt floor where they meet.<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>This continued for some time with
a speaker system producing a rhythm pumped in from a keyboard on the side.<span style="mso-spacerun: yes;"> </span>Brian, the boy playing the keyboard, and
quite adeptly at that, could not have been more than twelve years old.<span style="mso-spacerun: yes;"> </span>The scene was nothing short of glorious as it
was clear what everyone had come for.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">As the service continued occasional wind would whip up the
dry dust through the open windows coating everything in a light tan color.<span style="mso-spacerun: yes;"> </span>My black bag that I carried with me quickly became
khaki colored and somehow dust particles filtered into every page of my Bible.<span style="mso-spacerun: yes;"> </span>While sitting there the passage from Psalm
143:6 came to mind, “I thirst for you as parched lands thirst for rain.”<span style="mso-spacerun: yes;"> </span>The longing for the nourishment of the land
was strong but not as strong as their passionate seeking after their God.<span style="mso-spacerun: yes;"> </span>A time of testimony came and a number of
people shared, praising God for the simplest yet most profound things.<span style="mso-spacerun: yes;"> </span>Following that came the time of offering
where no ushers or plates were mobilized but rather the entire church ran to
the front to deposit their shillings in a bag.<span style="mso-spacerun: yes;">
</span>They came not out of guilt or ritual but rather joy for the opportunity
to give back to the God that grants them life.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Having an opportunity to share I read from John 10,
telling them of how our Savior is a herdsman just like they.<span style="mso-spacerun: yes;"> </span>However, it is He who is the best herdsman
and laid down His life for His sheep.<span style="mso-spacerun: yes;"> </span>We
had a tremendous time of reflecting on the goodness of our shepherd and His
provision for us all.<span style="mso-spacerun: yes;"> </span>With a few more
announcements the service reached its end and it was only 2:00pm.<span style="mso-spacerun: yes;"> </span>It honestly did not even seem that long but
we disbanded quickly as the wind had been turned up a few more notches.<span style="mso-spacerun: yes;"> </span>The dust clouds seemed like
what I had seen in pictures from the great dust bowl years ago in the
Midwest.<span style="mso-spacerun: yes;"> </span>As everyone scattered we jumped
in the car Richard borrowed to drop his kids off at their house in an attempt to
save them from the wind.<span style="mso-spacerun: yes;"> </span>We stopped at
the local Suswa hotel, grabbed some meat and chapati and were back on our
way.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Heading back to Kijabe we passed two significant accidents
on the road and rejoiced that we were not involved as they both happened right before us.<span style="mso-spacerun: yes;"> </span>Winding our way back through the bush we made
it to our connecting road and headed back up the mountain to Kijabe.<span style="mso-spacerun: yes;"> </span>At one point the other passenger and I had to
get out of the car and push due to the combined difficulty of the incline, the scant
power of the car and the added weight of us two passengers.<span style="mso-spacerun: yes;"> </span>Nevertheless we reached Kijabe safely and
said our farewells.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"></span>A</span><span style="font-family: Calibri;">s I sit here and
reflect on the day it reminds me of the overwhelming abundance and ease of life
in America and at times the lacking commitment to Christian life.<span style="mso-spacerun: yes;"> </span>Here in this harsh environment some walk for
over an hour through the dust, biting wind and bea</span><span style="font-family: Calibri;">ting sun to meet together and
praise the God they serve.<span style="mso-spacerun: yes;"> </span>One Kenyan
said it well, “Here in Kenya we have much poverty but great spiritual
wealth.<span style="mso-spacerun: yes;"> </span>You in America have much wealth
but great spiritual poverty.”<span style="mso-spacerun: yes;"> </span>I think he
just may have a point.</span></div>
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<span style="font-family: Calibri;"></span> </div>
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<span style="font-family: Calibri;">Scott<o:p></o:p></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com1tag:blogger.com,1999:blog-8287918247496110402.post-26028909646774552112015-03-14T11:01:00.001-07:002015-03-14T11:01:40.642-07:00Things I have seen in my first half-week
<br />
<div class="MsoListParagraphCxSpFirst" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">1.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">TB meningitis<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">2.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">CNS lymphoma/toxoplasmosis<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">3.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">HIV<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">4.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Necrotic diabetic foot infections<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">5.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Pelvic abscesses<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">6.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">DVT/PE<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">7.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Probable metastatic <span style="mso-spacerun: yes;"> </span>breast cancer (with classic peau d’orange
appearance)<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">8.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Multiple cases of likely lung cancer<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">9.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Pneumonia<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">10.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">PCP<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">11.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Pulmonary TB<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">12.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Acute coronary syndrome<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">13.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Congestive Heart Failure<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">14.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Diabetes <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">15.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Hypertension<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">16.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Viral meningitis<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">17.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Severe septic shock<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">18.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Benign euthyroid goiter approximately 7-8 inches
in diameter causing airway deviation<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">19.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Status epilepticus in an adult male with
congenital hydrocephalus s/p shunt->brain abscess->osteo of the frontal
bone-> removal of the bone->large defect in the head permanently->seizures<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">20.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Insterstial lung disease<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">21.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Septic shock secondary to abdominal abscess in a
woman 16 weeks pregnant<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">22.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Stroke<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">23.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Diabetic leg ulcers<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">24.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Severe electrical burns<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">25.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Dental abscess with facial swelling<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">26.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Liver failure<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">27.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Hepatic encephalopathy<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">28.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Renal failure<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">29.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Pulmonary hypertension<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="margin: 0in 0in 8pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: Calibri;">30.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: Calibri;">Septic joint infections<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">As you can see, it is a myriad of common internal medicine,
infectious disease paradise, and very late presentations of disease unseen in
the US. I’m sure the list will continue to grow…but I just wanted you all to be
reassured that I am learning lots! Thanks for your support and prayers as I try
to stretch my brain and depend on the Lord to teach me what I need to know
about this intricate human body he created!<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">P.S. Find attached this picture of the sunset over the Rift
Valley that Scott took while I was attending in the ER! </span><span style="font-family: Wingdings; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-char-type: symbol; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">J</span></span><o:p></o:p></div>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJWFbCfi64zYWDKk8pOzX5msZL82LHfl-_Ph3z1uuvBRzvjwkz4sHij4FgforsEOm1LQuESGc20_O8id9P1Der3g2tpYkmL77cuFkxDzlkFLKFy1ORqe6myBUDvL9WhrdHbegUrdqwXCtl/s1600/Sunset+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJWFbCfi64zYWDKk8pOzX5msZL82LHfl-_Ph3z1uuvBRzvjwkz4sHij4FgforsEOm1LQuESGc20_O8id9P1Der3g2tpYkmL77cuFkxDzlkFLKFy1ORqe6myBUDvL9WhrdHbegUrdqwXCtl/s1600/Sunset+2.jpg" height="145" width="320" /></a></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-61759978504751379832015-03-14T11:00:00.001-07:002015-03-14T11:00:08.173-07:00My first day as an attending...
<br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Today after merely 3 days of working with the interns and
learning the hospital system, I stepped fully in to my role as on call
attending…for the next 48 hours. My morning began leading rounds with my team
where I was pleased to be able to impart some wisdom about meningitis management,
INR monitoring, and HIV opportunistic infection prophylaxis. After completing
rounds, my team of two left the hospital promptly at 9:30am not to return until
Monday morning (nothing in the hospital runs on Sundays except for the lucky on
call attending who rounds on the team by themselves). I can’t blame them,
however. They work up to 120 hours a week, often taking call every 2-3 days on 3
different services at once without the benefit of going home mid-day when they
are post call. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">After seeing my sick step-down unit patients by myself, I
spent my afternoon helping my intern with admissions and putting out fires on
the wards (i.e. status epilepticus in an adult male with congenital
hydrocephalus s/p shunt->brain abscess->osteo of the frontal bone->
removal of the bone->large defect in the head permanently->seizures). It
has been both terrifying and invigorating to be given so much responsibility
and the ability to teach the interns, and likewise to learn from their vast
knowledge of both medicine and Kenyan culture.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"> </span>I feel that in only 4
days, I have already grown so much as a physician and a person as I try to
rationalize through each differential (in an world with HIV where anything is
possible), pay keen attention to my history and physical (in a world where diagnostic
tests and limited and no prior electronic history is available), and think
through the absolute need for a test and what it will change (in a world where
the patient has to pay upfront for everything I order). It also has been
liberating to practice in a culture where records are kept for strictly a means
of communicating thoughts rather than to please insurance company reviewers and
coders (who do not exist). On the flip side of the coin it has been difficult
for the anal-retentive in me to watch interns cover nearly every patient in the
hospital without a list, any form of check out, or way of determining what
happened overnight. Overall let’s just say that this is a culture not bogged
down with administration or logistics work. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">To sum up Kenya, I would say they are a beautiful group of
people who are relationship oriented contrasted against our American mind-set of
being task oriented. For example, on Friday after rounds we all went to the
cafeteria and had chai (tea) and manadazis (think cake donuts). We sat for an
hour and a half while the team relayed to us the stereotypes of each of the 42
tribes in Kenya, the political climate after the tribal unrest of 2008, their
views on marriage and dowries, and their hopes and dreams for the future. As I
soaked it all in, I felt as though in only 3 days, I was having deeper
discussions with my team than I ever had back home (and I feel like my fellow
residents and I are pretty friendly people…still). All the while I thought
about how I would traditionally have been scurrying around trying to tidy up
orders and check on patients during that time. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;">Before leaving for Kenya the Lord tried to gently remind me
of this relationship driven vs task driven dichotomy. I too often get caught up
in trying to accomplish my own means on Earth while neglecting to take time and
invest in eternal things like my relationships with others and sharing a word
of prayer with a patient who desperately needs some hope and encouragement. As
a result, I end up stressed and anxious and feeling like my life is lacking the
purpose it was designed for. I’m not there yet, but I’m praying Kenya will be
an instrument to help perfect this concept in my life. </span></div>
<div class="MsoNormal" style="margin: 0in 0in 8pt;">
<span style="font-family: Calibri;"><o:p>Pray for me as my call continues tonight and through-out the next 24 hours...Hoping I know what to do!</o:p></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com1tag:blogger.com,1999:blog-8287918247496110402.post-42913759465887397602015-03-13T12:33:00.001-07:002015-03-13T12:33:17.571-07:00Another Gaze Into Kijabe Life...<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
I wanted to provide
a quick update of life in Kijabe over these past couple of days. Teresa has been busy at the hospital, facing
the challenges of language as well as medical equipment, medications and
hospital policies that all have different functions, names and protocols. However, she is excelling and is blessed each
day with a tremendous opportunity to minister to those that are in need of
physical and spiritual restoration.
Thank you for your continued prayers for wholeness for those patients
she sees. <o:p></o:p></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
While Teresa has
been at the hospital I have been studying a great deal, continuing in the full
seminary requirements of this spring and making plenty of new contacts. I will begin volunteering on Monday at the
Bible College here to assist in whatever way I can. Also I get to catch up with a few old friends
that I had the privilege of working with the last time I was in Kenya. This weekend I will meet up with Richard who,
since I last saw him last, has gotten married, had two children, planted a church
and started a primary school. It is an
honor to be able to watch what God does in the lives of those yielded to Him
and to be able to encourage those we are bonded together with under the banner
of our heavenly Father.<o:p></o:p></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
Additionally we
continue to drink in the Kenyan culture that thrills us so much. Every morning I marvel as the sun crests the
mountain peaks behind us and fills the Great Rift Valley with golden
light. From our vantage point it seems
as if we can see for miles. Keen eyes
can spot the columns of dust from the vehicles traveling the dirt roads snaking
through the valley. In the morning
before the day get hazy you can see small villages dotting the horizon and by
the end of the day when the wind picks up you can see a few dizzying dust devils
swirling their way through the plains.
The weather is beyond a dream as we enjoy a dry 80 degrees during the
days and cool but breezy evenings in the mid-50s. <o:p></o:p></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
The local fare is a
delight and we have been taking in our fill of the Kenyan staples. The market is a seven minute walk away where
we can get the freshest of fruits and vegetables, untainted by the things that
usually cause American food to lack its original flavors. The bananas here are amazing and you have
never tasted such a delight. What is
more, Kenyans are tea drinkers but not Southern Sweet tea, only hot tea
here. The fellow missionaries have been
beyond gracious and they have opened up their homes to us a number of
times. The community seems very much
like that described in Acts where people met daily for mutual edification. Wow I realize that I have gotten carried
away; I was going to attempt a post about how much we are suffering for the
work of the Lord here in deepest Africa but I got distracted :)<o:p></o:p></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
Regardless, thank
you for all the prayers, messages, thoughts and kind words. So many people made this trip possible and we
are indebted to each and every one. We
can sense everyone's prayers and feel as if we are traveling with an army of
saints who are doing the work of the Lord with us at every turn. We are grateful beyond words to be able to be
in a place we love doing the work of a God who loves even more. Blessings!<o:p></o:p></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 10.0pt;">
Scott</div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-11011836138079615392015-03-11T12:48:00.002-07:002015-03-11T12:48:42.447-07:00Hospital Day 1<div class="MsoNormal">
Today began just like any other day in a hospital…with worship
music and an encouraging message during fellowship with other believers…wait.
In a world where a typical morning for a resident involves frantic
note-writing, lab interpretation, and abbreviated physicals with little time
for meaningful patient interaction, it was so refreshing to hear a message this
morning about having faith and depending on the strength of the Lord even in
the toughest of situations, and singing about how mighty and able our Lord is. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
After our chapel service, we started the day on wards. One
patient had unexpectedly passed in the night. Another was decompensating with
an unrecordable blood pressure, respiratory distress and no response to pain.
Her body is slowly succumbing to her HIV, TB, meningitis, candidiasis, and who
knows what else. Unfortunately, because she is a DNR, and there are only 6 ICU
beds in the hospital (for both adults and children), she was not a candidate
for ICU care. We also do not have the luxury of ABG’s or stat labs (most take
at least 24 hours). We moved her to the step down unit and attempted to start appropriate
therapy. <o:p></o:p></div>
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After getting her stabilized, we started rounds with our
team of a consultant (attending), medical officer intern (MD intern
equivalent), clinical officer (PA equivalent), and clinical officer intern. We
saw about 20 patients with diagnoses varying from diabetes and congestive heart
failure to HIV and TB meningitis. I was surprised at the amount of similarity between
our patient population in Greenville on our medicine service and our medicine
patients here. For example, one is being treated for a UTI, but she can’t go
home because her INR from the Coumadin she is on for chronic DVT is
supratherapeutic, and we can’t get her to a facility to have it checked as an
outpatient. Another was a consult from ortho for diabetes and hypertension
management. The issues are also similar: How do we get this patient follow up?
How do we get their chronic medicines paid for? How do we arrange outpatient
oxygen for this lady with CHF and pulmonary hypertension?<o:p></o:p></div>
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This afternoon we
admitted an 80 year old lady with sepsis from a necrotic diabetic foot
infection who also has acute coronary syndrome and severe hyperglycemia. Her
family informed us that she had a stroke several months ago and does not talk,
walk, or feed herself at baseline. This raised the question: is putting her
through an amputation worth the risk, suffering, or financial burden to her
family? In my one day of limited experience, I have already seen that Kenyans
understand the nature of the world and God’s hand in it much more than
Americans. After learning that the woman and her daughters are believers, we
prayed with the family and they calmly told us that they are leaving her in God’s
hands. “You do the treating and God will do the healing,” one daughter told me.
Healthcare here seems to be more humane in a way because there is not opportunity
for futile care. <o:p></o:p></div>
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I know this is only a snapshot of what the month will hold,
but if I learn as much as I did today each day that I am here, I will come back
a new doctor. I am excited to see what my time here will hold!<o:p></o:p></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com3tag:blogger.com,1999:blog-8287918247496110402.post-32076521624951740952015-03-11T12:47:00.001-07:002015-03-11T12:48:59.792-07:00“So now I am glad to boast about my weaknesses…”<div class="MsoNormal">
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These words of Paul have resonated so well with my anxious
heart over the last few days (who are we kidding, since I learned I was coming
to Kenya). Although, I cannot exactly say that I could have been seen as glad
throughout the process...</div>
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Yesterday it all
became very real as we arrived in Kijabe and I started the orientation process.
Realizing that I would be given in one hour the training to essentially run the
internal medicine wards and step down unit team at Kijabe that took about 2
weeks as an intern at my own hospital…I started to panic. Learning to do
medicine at a new hospital with different protocols, formularies, vernacular,
and diseases is quite a daunting endeavor.<o:p></o:p></div>
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Thoughts raced
through my mind: How will I know the standard of care? How will I deal with the
financial difficulties for patients (in a society where they must pay for their
care up front or prior to leaving the hospital)? How will I deal with the
language barrier? How will I know how to treat diseases I’ve only vaguely heard
about in textbooks? How will I diagnose those diseases without the lab tests or
radiologic imaging that I am accustomed to? How will I be expected to teach
anything to Kenyan interns who clearly know more about their population and
treatments than I do?…and the list goes infinitely on. <o:p></o:p></div>
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However, last night I also was introduced to the wonderful
world of missionary community. After my brief and stress-filled orientation
process, I met with the director of internal medicine who kindly invited me and
the attending I would be working with to dinner. All of my questions were not
answered, but I was given such a loving and warm supportive environment by
them. I was kindly reminded of one of my favorite sayings, “Never worry alone.”
That includes not only the other more experienced doctors in the hospital, but
the Lord who is with me each and every day…Jehovah Rapha, the Great Physician
who created each patient I will see and understands the intricate details of
their illness. <o:p></o:p></div>
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He gently spoke to my anxious heart through this verse: “’My
power works best in your weakness.’ So now I am glad to boast about my weaknesses,
so that the power of Christ may work through me. Since I know that it is all
for Christ’s good, I am quite content with my weaknesses and with insults,
hardships, persecutions, and calamities. For when I am weak, then I am strong.”
– 1 Corinthians 12:9b-10. I realized that in my severe lack of knowledge, I am
required to depend on Him for strength, and in doing so He gains all the glory.
I understand now that the month will be tough, but I am certainly not alone. I am
surrounded by physicians, interns, and students that are more than willing to
help answer my questions, and more importantly, I have the Source of all
knowledge with me everywhere I go. <o:p></o:p></div>
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I am working on the glad part, but I certainly will boast in
my weakness for the sake of depending more fully on the Lord. In fact, as a cripplingly
independent person, that may be the most important lesson I learn all month. <o:p></o:p></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0tag:blogger.com,1999:blog-8287918247496110402.post-9957332876780747262015-03-11T02:30:00.004-07:002015-03-11T02:33:17.127-07:00Welcome to Kijabe...<br />
<div class="MsoNormal" style="line-height: 115%; margin: 0in 0in 10pt; mso-layout-grid-align: none; mso-pagination: none;">
<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;">After taking wing from Greenville Sunday
afternoon, Teresa and I got to enjoy a brief passage through Washington DC (who
still had a fair amount of snow) and headed onward towards Zurich,
Switzerland.<span style="mso-spacerun: yes;"> </span>We were granted a smooth
flight and were blessed to watch the sunrise from the air over the gorgeous
snow covered mountains of France and Switzerland.<span style="mso-spacerun: yes;"> </span>The brief layover gave us only enough time to
marvel at the Camel Smoke Lounge where there were in fact no camels and way too
much smoke.<span style="mso-spacerun: yes;"> </span>If you were to imagine a
glass box in the middle of a large atrium, you would be well on your way to a
smoke lounge.<span style="mso-spacerun: yes;"> </span>Also worthy of note, it
apparently kept little smoke within the confines of the lounge as evidenced by the
escaping clouds of smoke.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="line-height: 115%; margin: 0in 0in 10pt; mso-layout-grid-align: none; mso-pagination: none;">
<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;">Never the matter, we got some good sleep on the
way to Nairobi with the most amazing flight with Swiss Air.<span style="mso-spacerun: yes;"> </span>I think we were offered beverages and food
every half hour or so and we consumed it all.<span style="mso-spacerun: yes;">
</span>They even served hot tea that was so strong it ate a hole in the seat
where I spilled a few drops.<span style="mso-spacerun: yes;"> </span>Our flight
ended Monday evening allowing us a front row seat to the sun setting over the
African plains as we taxied into the Nairobi airport.<span style="mso-spacerun: yes;"> </span>The airport has made great strides in
rebuilding that which was lost in a dreadful fire last year.<span style="mso-spacerun: yes;"> </span>Many prayers were answered as we acquired our
visas, got all of our bags and made our way through customs in record
time.<span style="mso-spacerun: yes;"> </span>Stepping out of the airport we
found a fellow holding a sign with our names upon it.<span style="mso-spacerun: yes;"> </span>Jumping in the car with him we navigated the
exciting world of Kenyan traffic to a welcoming guest house.<span style="mso-spacerun: yes;"> </span>There we enjoyed a brief catching up with our
dear friend Connie and then drifted off into a well-earned slumber.<o:p></o:p></span></span></div>
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<div class="MsoNormal" style="line-height: 115%; margin: 0in 0in 10pt; mso-layout-grid-align: none; mso-pagination: none;">
<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;">Monday morning we awoke to the friendly chittering
of African birds and a breathtaking view of the beautiful flowering trees that
Kenya has in multitude.<span style="mso-spacerun: yes;"> </span>Our breakfast
was fit for a king complete with authentic Kenyan chai that we have not been
able to fully enjoy since our last visit.<span style="mso-spacerun: yes;">
</span>After a quick stop to purchase some groceries we were off to
Kijabe.<span style="mso-spacerun: yes;"> </span>The dusty roads through the
Kenyan countryside brought back charming memories from long ago as the hills collapsed
into the Rift Valley to our left.<span style="mso-spacerun: yes;"> </span>We
found Kijabe much like we left it apart from a fair amount of new construction.<o:p></o:p></span></span></div>
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<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;">Our orientation did not take long and we were
introduced to our home for the next month.<span style="mso-spacerun: yes;">
</span>In many ways it is nicer than our own Bradley Estate back in
Greenville.<span style="mso-spacerun: yes;"> </span>It has a number of things
that we do not have: a third story view of the Rift Valley, a gas stove, lots
of closet space and a full ironing board!<span style="mso-spacerun: yes;">
</span>We feel as if we are treated as royalty in this paradise on earth.<span style="mso-spacerun: yes;"> </span>We have already gotten to meet a number of
our neighbors who are wonderfully kind and hospitable.<span style="mso-spacerun: yes;"> </span>Everyone here has been so accommodating and
delightfully helpful.<span style="mso-spacerun: yes;"> </span>Additionally we
spent some time at the hospital getting oriented for the days ahead. <o:p></o:p></span></span></div>
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<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;">Teresa will be busy working in the medicine side
of the hospital for this first week and then will spend the next three in pediatrics.<span style="mso-spacerun: yes;"> </span>She met a number of people that she will be
working with, all who are absolutely stellar.<span style="mso-spacerun: yes;">
</span>There is no lack of need here and no lack of the work of the Lord, only
a lack of resources and workers in places like this.<span style="mso-spacerun: yes;"> </span>These scenes are remarkably familiar as we
hear the words of our Savior who noted that the fields are ready but lacking
the harvesters.<span style="mso-spacerun: yes;"> </span>Join us as we pray for
more workers, not just in the fields of Kenya but of the world.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></span></div>
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<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;">Today will be our first day of active work here
in Kijabe.<span style="mso-spacerun: yes;"> </span>We were at the hospital this
morning bright and early for their weekly chapel service.<span style="mso-spacerun: yes;"> </span>The hospital workers all gathered for a time
of praising the Lord and sharing.<span style="mso-spacerun: yes;"> </span>One
brother shared from 1 Corinthians 15:58, “So, my dear brothers and sisters, be
strong and immovable.<span style="mso-spacerun: yes;"> </span>Always work
enthusiastically for the Lord, for you know that nothing you do for the Lord is
ever useless.” <span style="mso-spacerun: yes;"> </span>It is on this note that
we jump into our duties here and prepare for an exciting Wednesday.</span></span></div>
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<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;"></span></span> </div>
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<span lang="EN" style="mso-ansi-language: EN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Calibri;">Scott<o:p></o:p></span></span></div>
Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com2tag:blogger.com,1999:blog-8287918247496110402.post-75531390607491329782015-02-26T19:29:00.002-08:002015-02-26T19:29:50.466-08:00The Williams Return to Kijabe<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAkH4X6mwbasSoRFWvrGdV9R4CUh0bH658JOpu0BqVObKCIPgj7uSiKzhMdPqHQ0pZKMR2Z4XZzjEd1vDu234dQ4LaFjXAD6njJC71XiTtUnv-dJIsZTNpN6gRdSXijDhwQ4_JIvJ7yHrl/s1600/199706_508702903346_7473_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAkH4X6mwbasSoRFWvrGdV9R4CUh0bH658JOpu0BqVObKCIPgj7uSiKzhMdPqHQ0pZKMR2Z4XZzjEd1vDu234dQ4LaFjXAD6njJC71XiTtUnv-dJIsZTNpN6gRdSXijDhwQ4_JIvJ7yHrl/s640/199706_508702903346_7473_n.jpg" /></a></div>
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<b><span style="font-family: Georgia, Times New Roman, serif;">Habari Yako!</span></b></div>
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<b><span style="font-family: Georgia, Times New Roman, serif;">This picture posted above was added to my facebook page nearly 10 years ago with the caption: "Sunrise in the City that I want to live in one day..." That city is Kijabe, Kenya, and Scott and I are blessed to have the opportunity to return there in just a few short days! As many of you know, Scott and I met in Kenya while serving on a mission trip in 2005. During our month there we fell deeply in love with the people and culture of Kenya, gained a greater understanding of the Lord's future calling on both of our lives (both individually, and now...we realize, collectively), and the seeds of our passionate love story were sewn. Because of some unexpected circumstances during our initial trip, we made an unplanned visit to Kijabe in our time there. We were able to pray with patients and perform chapel services with families. As a young pre-medical student, I was particularly interested in the perspectives of the missionary doctors we met, and soaked in all of their stories about what God had done in Kenya while they were there. Kijabe is home to a large mission compound and a busy hospital that serves much of East Africa. It also is home to a missionary boarding school and Bible college....and it happens to be one of the most beautiful places on Earth. What more perfect place for a former teacher/pastor husband and his doctor wife to end up? </span></b></div>
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<b><span style="font-family: Georgia, Times New Roman, serif;">Scott and I are excited to be partnering with Samaritan's Purse as volunteers in Kijabe for a month. Greenville Health System has also played a large part in allowing me residency credit and supporting my efforts as Scott and I explore a place where we feel the Lord could potentially call us long term. I will be working with both the inpatient internal medicine and pediatrics teams, and Scott will have the chance to work some at Moffat Bible College and visit with some old friends, supporting their ongoing ministries and rekindling relationships that were forged in his year of Kenyan missionary service. We are excited to share with you stories of our journey as it unfolds. We will update you all here as often as we can, and we hope you will join with us in praying for those we encounter along the way. </span></b></div>
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<b><span style="font-family: Georgia, Times New Roman, serif;">I distinctly remember standing on the edge of the mountain overlooking the valley when taking this picture so long ago saying to myself, "I'm coming back here one day." I could never have guessed that my dream would not only come true, but I would get to return with the man who kindled the flame for Africa in my heart originally. Please be in prayer for us as we prepare for what the Lord holds in store! If you would like more information about Kijabe, please see the video link below!</span></b></div>
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<b><span style="font-family: Georgia, Times New Roman, serif;">Teresa and Scott</span></b></div>
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Teresahttp://www.blogger.com/profile/01424577032117115184noreply@blogger.com0