A New Kind of Normal

Today was a BEAUTIFUL Sunday in Kenya!  We enjoyed a wonderful breakfast prepared by one of the local missionaries (who has been in Africa for 30 years), attended church service at the hospital church, and took a nice walk down to the river by the grounds.  The weather was absolutely amazing with bright sunny skies, and the view....there's nothing like that.  I probably have fifty pictures of just the hillsides because they take my breath away every time.  So much greenery here!  I'm not sure what I was expecting it to look like, but it's definitely more than I could have imagined.

 View from top of the stairs on one of the hospital buildings

 Laura (England), Emily, Me, Shelley (Washington state)

down at the dam today

I was very excited for the church service this morning because I had no idea what to expect.  We knew it was the English-speaking service (they also have a Swahili-preached service we can attend that lasts around 3 hrs) but we were still unsure of the style of music they would have among other things.  I have to say I was greatly surprised when we opened up the hymn book to begin the service and we sang two hymns I've been singing all of my life.  They then took care of some business (time to elect new officers on the plate for next weekend) and then had a praise team take the stage with a few guitar players, singers, and an adorable little boy banging on the drums (see picture below).  They sang a couple of local short choruses and then "Shout to the Lord".  I was having chills during this time and I LOVE when I get chills during church services.  Music has always held a very special place in my heart and I love the way it can touch you all the way deep in your soul.  It's even better when you can feel that it is God moving through the song and at work inside of your heart. I love the excitement of praise with which everyone sang the local songs and the contemporary song we sing back in America.  The people here worship with such reverence. It excites me!  Even though we are from thousands of miles away, we all worship the same God.  The one, true God.  His children are spread across the globe and it's such a blessing to know we can all come together and praise him together for all the great things He has done for us.  It's just how I imagine heaven :)  I should also mention the sermon today was on spiritual gifts and I believe Mark, Emily, and I are all here because of certain spiritual gifts we have and I hope we are able to share them with as many people as possible during our stay here.

 The Praise Team

Banging on the drums - wonderful job! I took video :)

We are now a week in here at Tenwek and I believe we are all becoming accustomed to a new kind of normal.  We all had our reservations and thoughts of what we thought things were going to be like here, but I think we've all been pleasantly surprised by the conditions under which we live.  I would almost say we are spoiled by all the great meals that are prepared for us and the way they take such great care of us.  Here are a few things I have learned while here so far:
I have learned how to brush my teeth and wash my face using bottled water.
I have learned how to take a scalding hot shower every morning because the temperature will not adjust and I am thankful it is not a freezing cold shower instead.  I have also learned how to keep my mouth shut in the shower so as to not accidentally drink the water (there goes my singing in the shower).
I have learned that sleeping under a mosquito net really isn't so bad.
I have learned that I can live without Mountain Dew (8 days!!)
I have learned how to play around in the dirt and hike in a skirt.
I have learned that the people here are fascinated by white people: they either stare endlessly trying to figure you out or smile and wave like crazy!
I have FINALLY learned how to get toilets to flush around here - they do not have enough pressure so you have to push the handle multiple times in a row to build up enough pressure.
I have learned that there is no hope for me watching any kind of UK Basketball game well I am here, unfortunately.
I have learned that a smile and a warm greeting can go a long way, even with language barriers.
I have learned that there is barely any study time, but I should not let that stress me out and I should enjoy this experience for everything it is worth.  I may never get this opportunity again (even though I pray I do).

Here are some pictures of around our guest house, the hospital, and the Kenya countryside.

 The Great Rift Valley

 My room: two beds with nets and the bathroom in the far corner.  The shower is behind one door and the toilet is behind the other.

Other side of the room: my desk and dresser with a great view out the window

 The MCH Clinic that Emily and I trade off days working

 On the side of the wall walking to the maternity ward: "You knit me together in my mother's womb,....I am fearfully and wonderfully made." Psalm 139:13-14

 The labor room with three beds separated by curtains

One side of a large room in the maternity ward (all the moms were in the nursery for 3 PM feeding time)

God's beautiful creation - I stand in awe!

God Bless!

Be Servants of Men

"Now that I, your Lord and Teacher, have washed your feet, you also should wash one another's feet.  I have set you an example that you should do as I have done for you." - John 13:14-15

So my title for this post and this scripture has to deal with what we did today, but first I want to back-up to yesterday and briefly explain my Friday.  The internet was not working properly last night and wouldn't let me post unfortunately, which saddened me.  Yesterday I was on the maternity ward while Emily worked in the clinic after rounds.  During rounds, I got called in by one of the doctors to observe an abdominal wound closure on a patient that had been in the hospital for a month.  It was a very interesting wound and closure procedure.  The patient will be going home very soon now after waiting so long for this wound to be clear of infection and in the process of healing so it could be sutured.  After that I got to assist with a c-section and tubal ligation, just me and the doctor and the nurse handing her the instruments.  I literally held the woman's uterus in my hand for a good 20 minutes while the doctor sutured and tied. It was very awesome! I am officially cured off all queasiness associated with cutting open people, Woo-Hoo! 

The day slowed down after that with doing exams on a couple ladies on the ward, tracking down labs, and having a couple women need non-stress tests done to see if we need to deliver their babies.  Three women were in labor but not ready to deliver quite yet, so we got ready to go and do a D&C when we got called over to Casualty (the ER) for a women brought in with postpartum hemorrhage.  She was unresponsive so they were running a full code on her.  I helped with CPR while they pushed fluids and blood.  We finally got a good pulse and heartbeat while Seth, the ER doc, talked me through a central line as he did it (quickly!).  Unfortunately, the women coded again and we could not get her back.  I had observed three codes before on a previous rotation, but this was my first time to play a role in the code (as they have full code teams already in place back on the hospital floors at home) and the first time the patient died.  We prayed over her body after she had passed and I found myself tearing up.  I never knew this woman, but it just kind of hit me that this is the first time I've seen someone actually die.  I can't really explain what I felt, a lot of different emotions at once that I don't know how to sum up.  This will definitely be one of those moments that I hope to never forget and I hope if I do see more death, that I never lose those feelings that I had, no matter how mixed they may have been.  I don't want to become immune.  We must always remember that this is a life, someone's loved one.  Even though they may be with God now, there are still people left behind grieving.

Today was a day that was definitely needed after that last experience yesterday.  Mark, Emily, and I joined 9 other missionaries and went to an orphanage about an 1 1/2 hours away to wash the feet of the children.  First, let me just say that the trip to this orphanage was a new experience for me.  The first 20 minutes is on paved highway, but after that it's all dirt, mud, rock, potholes filled with water, and everything else not soft.  There were 12 of us in the vehicle posted below and it was the most I have ever bounced around and had to hold on to something when traveling in a car.  I will never again complain of the West KY or Bluegrass Parkways! I have never been so grateful for pavement in my life!

 12 people and bags and bags of shoes, socks, and shirts

Just an example of some of the road we traveled though not very clear

The orphanage we went to is Bosto Children's Home and it is home to around 40 children ranging from elementary to high school age.  There was 30 kids there today greeting us as we climbed out of the jeep with big smiles and handshakes (or hand slaps, they liked to put power behind it lol).  Dr. Bemm, a long-term pediatric missionary here at Tenwek, invited us along with him and part of his family to wash the feet of these children and to hand out 2 pairs of socks, a pair of shoes, and a shirt to every single one.  He held a short Bible study beforehand telling the story from John 13: 1-17 of how Jesus washed the feet of the disciples at the Last Supper.  The kids were great at answering questions about the story and what God expects from us as Christians and his servants.  He sent His only son here to live and die for us and he is called Lord.  Yet Jesus did not act superior to anyone and he treated everyone equally.  He was many roles but most importantly he served others and we should do the same.  The verses I quoted above explains exactly why we did what we did: Jesus commanded us to go forth and do as he has done.

 SHOES!!

What an amazing view from the orphanage!

With Amos after a good feet wash and new socks and shoes on his feet.

These kids were amazing, as are all Kenyan children.  They have a spirit that is so thankful for everything that is brought their way no matter what troubles or circumstances they have endured.  They are empowering and I hope I am able to bring some of their spirit home with me! One day I hope to bring one of them home with me through adoption :)  God Bless everyone!

Learning a New Way of Life

Habari  everyone! - That is a greeting in Swahili basically meaning 'what's up?' or 'how are you?'  The typical response is "Mzuri" (pronounced like the state Missouri) meaning 'I'm good'.  Emily and I spent some time yesterday trying to learn a few key phrases in the Swahili language so we could have something to say to the patients since very few of them speak English.  Here are some other phrases we learned:
Congratulations - Pongezi
Thank you - Asante
And when talking with close friends, say "Sasa" and "Poa" instead of "Habari" and "Mzuri".

One thing I have really enjoyed here is how amazingly nice and supportive the staff is here at the hospital, both the long-term missionaries and Kenya natives.  We have quickly made friends with the interns and nurses in the OB/GYN department and we all equally love sharing and learning about each other cultures.  In return for them teaching us some Swahili, Emily thought we should teach them some English slang since they already know proper English (they start learning it in Kindergarten here).  So she taught them 'talkin' smack', 'peace out', and 'fo shizzle' which we both admitted to them we don't ever use but it was quite fun to here them using 'fo shizzle' in our conversations.

So the past two days have been very fun and we are learning a ton at the maternity ward and MCH clinic.  Emily and I spent part of yesterday morning being shown around by one of the nursing students and having him describe everything in the delivery room since we hope to be participating in some deliveries.  A couple interesting things about the delivery room here: it is one giant room with two curtains separating it into three separate "coaches" as they call them (beds basically), it used for vaginal deliveries only, and the nursing students and nurses are the ones who deliver these babies.  There are no doctors around unless there is a problem and the way they described that to us is 'if a doctor is in the delivery, you know it's bad'.  They have only one 'theatre' room, otherwise known as a surgical room, where they do the c-sections and all other ob and some gyn surgeries.

 One coach room

We then spent three hours in rounds on the 46 women currently in the maternity ward. Talk about a backache!  Luckily our afternoon included watching a vaginal delivery, my very first one! I was excited...and nervous lol.  I have only passed out once in my life watching a doc suturing a lesion removal on a face back when I was 19, but people who know the story don't let me live it down. So I was trying to make sure I didn't lock my knees and that I moved around a little bit.  I have to say I have toughened up a little bit because I didn't once feel sick, but I did kinda gasp when the baby came out because it was covered in so much gunk as I like to call it (proper medical term, I know!) that I thought it was hypoxic and not doing well as well as there was a lot of blood pouring out of the mom due to a tear that occurred during the delivery. The baby was suctioned and started crying and the mom was sutured up so all was well!  Truly awesome....and disgusting, but I can't wait to learn how to deliver one myself!

One of the small maternity floor rooms with just 6 beds

Some of the other rooms have 12-14 beds

There can be 2 patients to a bed

Watching the birth gave me and Emily the itch to go see the babies in the nursery.  The nursery here is like a NICU back home.  If the baby is well, it stays with the mom in her bed until they are released.  If something is wrong with the baby, then it goes to the nursery and mom is typically not discharged until the baby is discharged.  There were 30 babies in the nursery yesterday and around 10 on the floor with the moms.  Another interesting thing down here is that the babies don't wear diapers.  So in the nursery, most of the babies are laying on a blanket, not wrapped up, without anything covering what's between the legs and pee can shoot out at anytime! Laura, one of the visiting doctors, told me she was walking through the nursery yesterday when she had to jump back to keep from getting wet from a baby.  Gee, I can't wait for that next month!

Just a small part of the Nursery

(picture stolen from Emily because I haven't been able to take my camera up to the hospital yet)

After work, we ran into some local Kenyan children playing and joined them.  We brought them pens, paper, and crayons and spent around 1 1/2 hours with them just sitting on the dirt-covered sidewalk having a wonderful time!  They were coloring us pictures and writing out the names of what they had drawn...in English!  By the way, Kenyans LOVE pens - especially our click-pens!

 Showing off their pens to one another!

Last night we finished up our day with weekly Bible study.  The men have a Bible study group at one house while the women go to another house.  It was a great study on the Psalms and learning about generous grace and generous giving.  One amazing thing about being here is the complete openness with which everyone expresses their belief in God.  We all eat together and we pray.  The staff has morning meeting and we pray.  A family loses a loved one and we pray.  It's so comforting to know all of these people are here for the same reason and that's to do what God has laid out for them and to do it in His name.  The patients are also very receptive to it which means even more because they are the ones that need the prayers the most.

Today was just as fun and more exciting than yesterday, moreso for Emily than myself.  We have decided to split up and one of us cover the clinic with an intern while the other stays on the ward so that we both get equal opportunities and we don't crowd the areas.  There are lots of Kenyan interns and students that have to be taught and they are a priority over us because they are being trained to serve here in their home area.  We are here to learn for school as well, but ours is more about the experience of just being here.  Luckily the interns and students are WONDERFUL teachers as well as the doctors!  Emily got to watch two D&Cs before performing one herself, assist in a hysterectomy, do a few OB exams, and watch triplets be born ALL vaginally!  As for me? I rounded for two hours and then spent my afternoon in the clinic.  We had to do a couple OB exams on patients who were having some bleeding.  One of them had miscarried already at 12 weeks and the other was pregnant with twins at 18 weeks, but she didn't believe she was pregnant (even though her belly measured 24 cm).  The one with twins was at risk for a threatened abortion due to passing clots which we found when we examined her.  Both were admitted to the ward.  The best part of that was the one who had miscarried already was seen by the chaplain to discuss the loss and she ended up giving her life to Christ!  Great things come from tragedy!  In the middle of all that, a women who was resting after her visit ended up having her water break there in the room.  We checked her and the first of three babies was already descending head first through the canal so she was rushed over to the hospital delivery room where no ORs where open.  They ended up delivering all three babies vaginally with the last two being breech (yes, this was the one Emily got to watch).  Amazing day!  Can't wait for tomorrow and then a wonderful weekend of rest!

God Bless and good night from Kenya!

The First Day

After a good night's rest under my mosquito net and an early morning skype chat with my parents, today was my first day in the hospital.  We attended the staff meeting at 8 am which consisted of chai tea and OB/GYN's M&M (morbidity and mortality) presentation for the month then were given a full tour of the hospital.  At first it was very overwhelming and I wasn't sure I could find my way around alone, but it got easier as the day continued.  Emily and I are both set to do our women's health rotation for the first four weeks here, but we didn't find that out until about 10:30 this morning.  We had just arrived in the ER dept, otherwise known as the Casualty dept here, to help out a missionary doctor, Seth, who traveled from Nairobi to Bomet with us when we got the news to report to the maternity ward.  We were both very excited to get this rotation since we were told they "pop out babies like crazy over here" and we were excited to be able to be together the first four weeks while we get our footing.  Both of us are quite anxious people at times (our classmates can definitely attest to that), so this helped to calm our jitters with being here in such a new and different place.

We started by joining the team rounding in the maternity ward.  We were only there for a couple of the rooms (there are several and they are all full) but it took about an hour and a half.  There were several women who had lost babies due to intrauterine fetal demise (IUFD) which is just heartbreaking.  One thing I did learn today is that over here they refer to HIV as ISS, which stands for immunosuppressed state, due to the stigma surrounding HIV.  There were several women with ISS as well as we went through rounds.  After morning rounds, we were sent to the Mother-Child Health (MCH) Clinic.  Unfortunately it was extremely slow at that time so we got an hour break.  We then joined several of the short-term missionaries over at the home of a long-term missionary for lunch - this is how we will spent most lunches during the week and some dinners.  It was a wonderful meal! I am adjusting to the Kenyan food as well as the taste of how they prepare American-style meals because they do have a African flavor to them. They like their spice and I'm not exactly a spicy food eater, but I'm learning to enjoy it. Minimal weight loss is my goal because I can't afford to lose any basically. 

After lunch, Emily and I returned to the MCH clinic and joined the CO interns seeing patients.  CO stands for clinical officer and they are the Kenyan equivalent to PAs.  We saw moms-to-be coming in for regular check-ups and complaints such as abdominal pain as well as women who had suffered losses that needed check-ups of incision sites, etc.  It was a pretty quiet afternoon in the clinic overall.  They said Monday is usually their busy day and so they had been swamped yesterday.  One thing Emily and I both struggled with was adjusting to the language barrier.  We would like to see the patients on our own, but since we need translators (most patients speak Swahili and most of the medical staff speak both Swahili and English so there's no real need for translators), the interns are the best people to do that and they already know what questions to ask and how to take care of the patients.  Both of us are so used to being able to walk in, introduce ourselves, make small talk, and ask our medical questions ourselves that it is an adjustment for us and we are going to have to find out how we can best be utilized. We hope to find out more tomorrow about what our daily schedules will be like and if we will be taking on-call shifts or not.  Today ended right at 5:15 and we were the first ones back to the guest house to enjoy a delicious dinner.  Now it is time to rest up and get ready for another day of learning.

Please pray for the patients here who have lost loved ones lately.  We were told there have been several pediatric deaths lately.  Also, continue to pray for Mark, Emily, and I as well as the other visiting missionaries that we can be a helping hand to the staff and patients here.  God bless!

Kelly

Landed in Africa

After a year of preparing for this moment, I am finally in Africa!  I am at Tenwek Hospital in Bomet, Kenya along with my classmate, Emily Gibson, and her husband, Mark, completing two clinical rotation for my physician assistant program.  Emily and I will be here for 8 weeks while Mark, who is a physical therapist, will be here for 4 weeks.  Tenwek Hospital is a Christian-based missions hospital that operates under the motto "We treat, Jesus heals".  We are all looking forward to the experiences we are going to have here and see how God uses us and teaches us through everything we see and do.  I titled my blog "A Leap of Faith" because this is definitely the biggest leap of faith I have ever taken, but I feel confident that God led me to this place for a reason and with faith I have no fear of what's to come while we are here.

Our trip to Kenya was definitely longer than we expected.  We started by flying out of Cincinnati at 3 pm Saturday to Detroit, spent a couple hours at the Detroit airport, and then flew to Amsterdam.  This is where things started going different than planned.  We were suppose to fly out of Amsterdam straight to Nairobi and arrive at 8 pm local time.  Unfortunately, there was some mechanical difficulties with our plane at Amsterdam and they had to downsize to a different plane.  So around half of the passengers stayed on that flight and the other half of us got put on a different plane to London.  We were suppose to fly out of London at 4 and arrive at Nairobi at 2 am, but we got delayed even longer and didn't land in Nairobi until 4 am.  We waited to get our Visas and luggage and went to meet our driver.....but he wasn't there. So we found a transportation service that could drive us to the Mennonite house we were suppose to be staying at for the night and arrived there at 6 am.  We got an hour and a half of rest before having to get up at 7:30 for breakfast and a quick clean-up and then we headed on our way to the hospital.  It was a 4 hour drive on a paved highway with lots of bumps/potholes and crazy drivers, but BEAUTIFUL scenery.  We were very happy to finally make it to our final destination, but extremely exhausted.  After a brief orientation, we all napped for a bit and now it's 10 pm and we are looking forward to a full night's sleep hopefully.

I hope to post on here as often as possible about our daily activities and what all we are learning, but with a jammed internet provider it may be difficult at times.  Pictures to come later of what we have seen so far, but for now it's off to get ready for our first day in the hospital.  God Bless and good night!

Kelly