Keep up with Shay

Last Kenya Blog!

2009-04-22T14:34:00.003-05:00

Sadly, our time at Tenwek is at an end. Shay, Andrew, and I (along with a few others) are leaving to Nairobi tomorrow. It has been an amazing adventure – one of which I will never forget. Overall, it was a very pleasant stay. Although pretty different, it was not scary to come to Africa. Kenyans are very welcoming, especially around Tenwek. Last weekend we went on Safari at Maasai Mara Safari Club. We were told by other people that it was a five-star resort, but we weren’t expecting it to be quite as amazing as it was! It was gorgeous!! The rooms were literally five-star tents with running water, huge beds with awesome mosquito nets and hot water bottles inside the sheets at the foot of the bed! The hippo lagoon was right outside our tent and we could hear them at 5am. Our morning wake-up call was a guy bringing us coffee saying “Jambo! Your coffee’s ready!” So, we arrived (after a very bumpy ride) in time for one game drive Friday afternoon. Saturday, we went on a 6am game drive, went back for lunch and then another in the afternoon. Sunday we had one more 6am game drive before we left. We saw a ton of animals – cheetah, lions (from 10 feet away!! We could hear the “crunch, crunch, crunch” on the bone of their breakfast!), wildebeest, ostriches, dik diks, vultures, hyenas, zebras, giraffes, elephants, gazelles, hippos, antelopes, jackals, cape buffalo, water buffalo. It was also some of the most fun I’ve had off-roading. I don’t think Matt knows what off-roading really is! Haha And inevitably one of our cars got stuck in the mud – took about an hour to finally get them out! The group of people we got to go with was awesome, too. I’ve made some really good friends here that I hope I’ll get to see again!

Last night, we went out to eat at a restaurant in Bomet with Chris Huff’s friends (Internal Medicine Attending at Tenwek from North Carolina). It was a nice hoorah outing before we leave. We had to walk a ways because they didn’t want to get their car stuck on the muddy hill outside the Tenwek gates. And of course, in true Laura style – I fell in the mud…straight on my butt. LoL The guys felt bad (and everyone else had muddy feet) so they got a bucket of water for us to wash ourselves off)

Shay and I have been preparing to leave. We’ve gotten most of our stuff packed. We pulled aside some of our clothes and shoes we wanted to leave here and let the interns pick what they wanted. They pretty much took everything, which helps us have room to bring back more gifts :o) We’ve also been saying our goodbyes and playing wolleyball one last time before we leave – I’ll have the bruises to show my fun times haha. I also did some last minute finishing of my marketing/PR work for the hospital.

Schedule: Thursday and Friday in Nairobi, Saturday and Sunday in London, arrive Monday in Dallas, leave Tuesday for St. Louis – then finally back to Denver May 2nd! Please pray for our safe travels!! :o) Love y’all and I’ll see y’all soon!

Kenya Blogpost #6B

2009-04-11T00:24:00.006-05:00

Sorry I did not get a chance to blog last week. Not everyday was very exciting, although I got to do a couple things. I went to Tirgaga, a tea factory. Since it is government owned, pictures are not allowed. It was fun to see how they make tea out of the leaves, though. Kenya is one of the largest exporters of tea, so that is much of their livelihood. We will be bringing lots of tea back with us for those of you who would like a taste :o) I also went back up to the nursery, not to feed, but just to hold the babies whose mothers are sick. It was easy to stay for a very long time, just holding them in my arms.

Like Shay previously said – it’s hard to see visitors come and go. So far, I’ve had to deal with it 3 different times; when the Jarrett twins left, when Dr. and Mrs. Miedema left, and also when Sarah Wisner left. It kind of makes you want to close yourself off so you don’t get too close when you know everyone will just leave. But then you realize that you’re also a visitor, and everyone has been so welcoming to you when they, as I’m sure, have had the same thoughts. It’s amazing the friendships that develop when God allows you to open your heart.

This week, I got to see my first vaginal delivery while I was shadowing Shay in the hospital. I wasn’t feeling 100% to begin with and Shay assured me she would just be working in the clinic, not doing much…then 10 minutes later… “Do you wanna see a delivery?” LoL I said sure, knowing I probably wouldn’t be able to handle it if I already wasn’t feeling well. I did better than I thought I would especially with it being a difficult delivery. Her rectum was bleeding and they had to cut her vagina. When the baby came out, it was totally blue b/c it had been stuck in the birth canal with no oxygen. I really believe it’s not the actual procedures that make me woozy…I think it’s more-so the atmosphere…the heat, the smell, etc. And possibly when they only have local anesthesia, and you know they’re in pain!

I also spent one day at the Manchester’s house with Theresa Manchester. She is the missionary who runs the Duka La Baraka (“Store of Blessings”) that is located in the guesthouse. Many locals including men, women and orphans make things that visitors can buy. She wanted me to take pictures of and write bios for the artists so that visitors will know who they are when they buy their items. We hope this will serve as a marketing tool. She also said if I have time, she thinks it would be a cool idea to interview and write a story on this Kenyan lady who owns a duka around Tenwek where she trains locals how to sew so that they have a trade. Sadly, our time here is running out. So hopefully I will have the chance.

Friday, I went out with Community Health & Development. Philip’s father is here from North Carolina, and he is a vet. So I went with him and his daughter, and two Kenyans from the clinic. We went to three different rural farms about 30 minutes away to check on their goats. The clinic has this program where they sell 10 goats (9 female, 1 male) to a group of locals (families get together and decide to be in groups together. The group we visited today has about 50 members, 30 farms). They take care of the goats as a group, and breed them until every family has 1 goat. They are not native goats, and are more expensive b/c they are full-bred. They are supposed to keep the goats in little huts that are off the ground, and bring food to them. They also have to make sure the goat feces can drop under the hut, and that the goats do not get around the feces. This is b/c there are MANY MANY worms in the feces that suck the blood from the goats and will eventually kill them. So they have a “zero-grazing” policy, and feed the goats special food. Mr. Hoover was making sure they are actually doing this (they weren’t) so they won’t have to spend so much money on de-worming medicine for the goats that will eventually stop working anyway when they build up a tolerance. Around noon, we went to a food storage that the group has built. Apparently, this particular group is much ahead of other groups they have seen. However, there is not much food left in their food storage. They have made their own b/c of the supposed corruption in the Kenyan government. The government has food storages for when crops are scarce, but last year the food storages ran out early which is supposedly not supposed to be able to happen. The government officials were illegally selling food to neighboring countries and keeping the money for themselves, hence the self-started food storages. The Nyaururu food storage is where this group has their meetings, and during their meeting, we were expected to introduce ourselves and make a little speech. So since Shay wasn’t with me, I couldn’t pawn off that responsibility Haha. Then we went to this “restaurant,” or “hotel,” as they call them. I was told I was expected to eat yamachama…goat meat. I tried to get out of having to order it, but they brought it to me anyway. I ate around it until I was told I have to clear my plate. Not knowing if Wesley was joking or not, and not wanting to offend anyone, I took a few bites. Then I decided to put some in a napkin and slyly sneak it into my backpack. Lessons learned from childhood :o)

This morning, I hiked Motigo at 5am with a big group of visitors! I finally got to see the amazing view at sunrise. I’m not sure I’ve ever seen anything quite so breathtaking! I tried to get good pictures (and some turned out really well), but it still does not do it justice. We also want to climb one more time before we leave, this time at sunset.

A group of guesthouse visitors are thinking about taking a trip to Uganda to raft the Nile, including Andrew. I was contemplating trying to change my flights back home in order to go with them (they are going after we leave). I don’t think it’s feasible this time around. However, I plan on coming back sometime in the future. Then I can raft the Nile, climb Kilimanjaro and go to Mombasa and/or Malindi (the coast)!!

Until next time…which might only be once more till we’re home!

Kenya blogpost #6

2009-04-10T05:41:00.005-05:00

Shay's Week 6 Post

I can't believe we've been here 6 weeks! It's sad to say goodbye to friends who have made our time here so enjoyable - and so many new people have come in the last week or so too! The guesthouse is FULL of people now and at first it's hard to welcome new folks but then I quickly remember that it wasn't so long ago that we were so warmly welcomed too. I came home one night while I was on call and the whole table had people around it -- "hello family!" It's amazing how sharing meals daily really gives a sense of community! I hope I can remember this when I have my own family someday.

This week was a good one. I saw my first tubal ligation under only local anesthesia (ouch!) and did my first vaginal delivery here. I managed to admit 7 patients by myself from clinic when the interns left me there alone, and they marched all of them up to the labor ward and sat them on the same bench. When I come up I saw all my patients sitting there practically on top of each other (there's always room for one more in Kenya!) and it made me feel like I was finally serving a good purpose. Twice this week I walked patients straight from clinic myself to get an idea of what was going on and I had to tell one family that the baby was no longer living but she would still have to go through labor normally since it was almost 38 weeks gestation. The family was so stoic and the Kenyans just seem to accept their fate in a way that helps them move on. In the US we would visibly mourn a long time but here they have to just get back to work. Either they do a better job accepting loss or they hide it better. Other cases from this week: thyroid storm in a 36-wk pregnant woman who is doing ok after a stint in the ICU (pray for that baby and mom!), bilateral breast fibroadenomas that were each the size of bowling balls - she had a c-section and will now be breastfeeding!, a criminal abortion where someone cut the arm of a baby off in order to deliver it (the chaplain note said that mom later accepted Christ), a c-section on a breech second twin.

At morning report there was a surgery case where a guy was walking down the street and was passed by a man who was being chased by two guys. He thought the two were thugs and hit them with a rungu (a club) and it turned out those two were the cops chasing the other dude. The cops pulled out a gun and shot the guy in the chest! It apparently missed all vital organs and the guy is stable -- all for trying to help out the wrong party!

I went for a hike today and ran into my new friends Ednah and Violet. Violet is Ednah's mother in law and they walk a loop every day up near our guesthouse. Ednah carries a stool for Violet to sit on when she's tired - she's in her 70's. They do this for exercise daily and I was so impressed that I stopped to make friends the third time I passed them. Ednah told me, "you steered her actually! When she saw you go by so fast she got encouraged to keep going!" Really, I told her it was the other way around. I went back to the guesthouse for my camera b/c they were so darn cute! I told Violet she reminded me of my grandma :) I'll post their picture.

Tonight we'll have a Good Friday service and then watch The Passion of the Christ. Then I'll take call Saturday and go to the sunrise service at 6am Sunday before having Easter lunch with Drs. Crognale and their daughters. Next weekend we go on safari and then we'll be headed to Nairobi shortly after that and on toward home via London! What an exciting trip! I must say, though, I'm not exactly home sick as much as excited to give several people some big hugs! And there's one in particular that I didn't anticipate missing so much when we planned this trip a year ago...

One miraculous story revisited: I believe I wrote about Cherotich, the 3 year old who had bacterial meningitis resistant to all the drugs in the pharmacy. During her stay, I would go to check on her and find her father with Bible open, sharing with the terminally sick kids in the beds next to them. In case you have a hard time believing God answers prayers, it was a miracle that the CSF culture actually grew out to tell us what we were dealing with! Then we managed to find some vancomycin on the superintendant's desk which saved her life! I was walking out of the hospital yesterday and her sweet father stopped me (they were back for a visit after being discharged) --- I took her from him and felt like I was holding an entirely different child! Praise the LORD for Cherotich -- I'm convinced God has a sweet plan for her life! She's the one in the picture posted here.

I hope Laura posts about her first experience with a vaginal delivery yesterday :)

Praises:
for community and new friends, Kenyan and American and Canadian and Irish!
for the miraculous recoveries that help make the sad cases bearable
for the faith of the people here who encourage me to trust God
for the Son of God choosing to "drink the cup" that was before Him some 2000 yrs ago
for the gift of eternal life we are privileged to share because He defeated death once and for all!

Prayer requests: that we would continue to see God at work here and know His will for the times of transition before us. We're praying Laura can find a job once she gets back to the states with the economy in such bad times. I'm thinking about buying a house in St Louis when I get back too but I'll be crunched for time, so please pray that the details will all be worked out! Also please pray for Brian and me, that we would submit to God's will in all He has for each of us.

It's Friday.... But Sunday's coming!

Love, Shay

Kenya blogpost #5

2009-04-03T15:18:00.004-05:00

Shay's Week 5

"Hey Sha-y, you want to come to prayer time?" my intern named Purity asked me at about 10:15 this morning after we had finished rounding. I said "sure..." as I find myself doing often - never quite knowing what lies ahead. I went with her and one of the OB nurses to the chapel on campus and we walked right up on stage to sing. I was like, wait a minute! Do I have to?? I feared we were going to be breaking out in kiswahili hymns, thinking to myself, I did it again! I can't even READ in swahili, much less try to read music and sing at the same time! Luckily we sang "How Great Thou Art" in English, along with the entire OB team -- the interns (Hillary, Anthony, Ronald, and Purity), about 10 nurses I met this week, and Dr. Sara Cichowski -- another blonde mzungu -- on the piano. And today, for the first time, I felt like I belonged.

I started on the OB service on Monday. I was a little anxious with the new environment, having gotten to know pediatrics and the NICU very well last month. Every morning the whole residency starts with a meeting of sorts -- patient check-out or grand rounds or M&M (doctor-speak for morbidity and mortality, or "what we can do better next time"). After the meeting Monday morning I grabbed Purity b/c I knew I should just stick to her side so she could show me the OB ropes. As soon as I got upstairs, Dr. Sarah told me there was a cesarean section that needed to be done down in theater and I should scrub in. The nurse anesthetist said the prayer (a routine thing before each surgery here, which I LOVE), then Dr. Sarah made the first skin incision and handed me the knife....

It was the sort of "take a deep breath and get over it -- you're doing your first c-section today!" feeling. She showed me how to dissect down the muscle and then pull apart the peritoneum to expose the uterus. Slice, slice slice...fluid! She guided my hand into the uterus, instructing me to keep the head flexed while she provided the fundal pressure, and then baby! Someone suctioned, someone clamped, someone cut the cord, the little boy cried vigorously and a happy birthday was had by all. She left me to close skin and it's nice that each of the last 3 I've sewn up since then looks better than the previous one...

I've seen some crazy anomalies in the last week. One anencephalic fetus, born without a closed spine at the neck; one with a huge omphalocoele plus meningocoele; one incredibly huge hydrocephalus (fluid instead of brain) that I couldn't believe came out by c-section at a nearby hospital. I think in the states we don't see these things as much because we know they're coming and since they're not compatible with life we don't let them carry to term. In addition, most ladies deliver at home here so if they do come to the hospital they usually have a reason to do so. I found myself wondering how it would feel to have a life growing inside you for 40 weeks that had no chance of living its first day outside the womb -- would I rather know what was coming or be like these ladies who found out the same day they gave birth? Is it ethical to do what we do in the states and terminate a pregnancy like that? Sometimes ignorance seems easier.

I did one lady's VERY FIRST pelvic exam yesterday to investigate possible cervical cancer... She was afraid of and ultimately refused the speculum despite having given birth NINE TIMES previously -- at home. Imagine! I tried to reason with her in good humor through a translator, comparing the size of the speculum to the size of her children but she really didn't want anything to do with those stirrups! At the end of it, I just had to say ok and hope she'll let us do a biopsy under anesthesia, submitting to the tenet of patient autonomy, even though the likelihood of her having cervical cancer is high.

I struggle some with the gap in calling things what they are here. In the US we usually work very hard to know what it is we're trying to treat. Given this expectation and common practice, it's difficult for a western-trained physician to work here because the diagnostic capabilities and screening techniques are so limited. There's no CT scan, no MRI, no interventional radiologist, no quantifiable blood tests for pregnancy (urine only), no G/C probes, no pap smears, very few positive cultures... The reagents constantly run out for routine blood tests like PTT, AST, BUN, to name a few. Antibiotics are limited, and there's no way to test for resistance to HIV drugs. The surgeons become the CT scan and as a result, your clinical skills have to make up the difference. Here at Tenwek, it's "typhoid versus malaria versus tuberculosis" --- and with no way to really disprove any, many patients get treatment for all. This will make internship interesting, when I don't have these to fall back on when we otherwise have no clue what's going on! Instead of Dr. Thal's "appendicities versus the field" it has become "TB versus the field." Ah, and no one here says HIV... it's "ISS" or immune suppression syndrome, or it's referred to circumferentially as "this disease" -- interesting.

I'm grateful for your prayers. I've just been incredibly blessed to be in such a community of God-fearing believers and new friends! I've heard testimonies that make my jaw drop at how people really let go of being in control, choosing instead to place their faith in God. I'm also grateful that even the last 5 days have served to make me more confident both in the OR and in the labor ward. I kind of love working here where the standard is not "do everything irregardless of the cost or get sued" but instead the motivation is "we treat; Jesus heals" -- even recognizing our human limitations from the motto of the hospital. It's true! There are a lot of limitations here! But the limited resources serve to remind me that we're never in charge -- even when we think we are with all our technology. We don't desperately try to save every life, either, if the outcome won't ever be good... you quickly realize the importance of weighing cost/benefit in terms of quality of life -- not just for the patient, but for the family and their livelihood. It doesn't make sense to start someone on a ventilator who is never likely to come off and the family literally has to sell the farm to pay for it.

Other crazy cases we've heard about since being here - please lift their families up to God, trusting that He will hold them in His hands... A single mom of three who in a psychotic episode drenched herself with kerosene and set herself on fire - leaving 3 more orphans in Kenya. A family of 3 kids who recently lost both parents and an older sibling to HIV, who just found out that all 3 of them are positive as well. An elderly lady who was mauled by a water buffalo and died a few days later. A young Christian girl who was raped by a drunk man who then shot her in the face at point-blank range with a bow and arrow -- and lived. A young guy in his 20s who was assaulted and somehow ended up with a total transection of his spinal cord at C4, leaving him a quadriplegic. A mother who had quadruplets a month ago and then watched as each one died from severe prematurity and complications. And all the mothers who constantly give birth to babies with neural tube defects like above (probably due to their folate-deficient diets)...

I hope these things don't depress you! They're just some of the things God is using to teach me not to take any day for granted. As I read through the old testament right now I'm amazed at God's heart for the poor, the widows, and the orphans all through scripture! I'm reminded of James 1:27, "Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world."

As the Kenyans say, let us pray "believing and trusting in Jesus' name", remembering the Truth we are told in Psalms 118:5 "In my anguish I cried to the Lord and He answered by setting me free."

May you know in your heart the Truth that sets us free!

Kenya Blogpost #4

2009-03-30T08:56:00.005-05:00

Laura’s week #4

Monday: Christy and I continued our work in radiology. We’re trying to get as much done as possible with the two of us, before she leaves next week. The power went out a couple times in the hospital during the afternoon, which made the machine finicky and stopped producing decent scans. So, we were forced to quit early that day. We decided to go shopping at the dukas (“stores”) outside the hospital. We went around and bought some congas, a scarf and some fabric. We got the tailor to sew the outsides of our congas b/c Christy found out the hard way once you wash them, they start to ravel if they are not sewn. The tailor cost 10 KSH, which is like 12 cents!

Tuesday: Tuesday, I did not work in radiology. Instead, Laura Jarrett and I went to the primary school near Tenwek. We visited a class of about 60 students. They were SO cute! We sang a couple songs with them, read the story of the “wordless book” of Christ and made bracelets with them based on the meaningful colors in the book. After lunch, I did some reading, cleaned up the room a bit, and applied to some jobs online. Shay and I finally decided to push our beds together so we could both have a mosquito net b/c the mosquitoes are getting worse – apparently all over the compound. We have 2 separate ones but just use the same hook since mine didn’t have a hook.

Wednesday: Wednesdays are orthopedic clinic, so radiology is usually very busy. We decided we would go to work a bit early and get some work done before they got too busy. We had about an hour and a half before we had to leave b/c it got too busy. (The scanner is in the same room where they develop the x-rays which is like a darkroom…so every time they take an x-ray, we have to stop scanning and turn off the lights.) Something encouraging, though, was that Alice, one of the Kenyans who works in radiology, said she had scanned about 10 x-rays yesterday after we left – Something we felt really pleased to hear b/c we weren’t sure if our work would even mean anything to them and if they would continue after we’re gone. I don’t think they are really taught organization and importance of protocol in their culture. In the afternoon, I took a nap and read. I was also supposed to stand in on a c-section this week, but had a meeting with Dr. Spears, so I had to miss it. Sara, the OB doctor, said there would be plenty more opportunities. I want to do it before I leave (and possibly witness more surgeries) b/c I would NEVER be able to do that in the states.

Thursday: Thursday was another radiology day; we got a lot done!

Friday: Today, Christy and I stood in on a few different surgeries. We got to see a urethroplasty on a grown man, some sort of throat abcess, and a skin graft on a 5-month-old burn victim’s skull. The latter was the coolest one so far – albeit very sad. I felt a little woozy on the urethroplasty and had to sit out in the hall for a bit, afterwards I watched from the window of the OR. We also got a detailed explanation from the anesthesiologist about what drugs/equipment he uses. I was totally fine on the other surgeries and did not feel sick at all. The skin graft procedure was by far the most interesting, and it’s fairly common to see burn victims apparently. This one was laid by the fire by her mother, and her mother fell asleep while the baby rolled into the fire. I want to see a c-section as well, but Sara had the day off today and was not doing any. But she has assured me that there would be plenty of opportunities. We looked at the OR board and did not see any interesting surgeries planned for this afternoon, so I walked to Silibwet with Sonja and Bob to go shopping at the outdoor “market.” Then we played “wollyball” and “bodyball” and called it a night.

Saturday: Today we climbed Mt. Motigo – a great hike despite the fact that it was mid-day and kinda hot. On the way down, the HUGEST grasshopper I have ever seen in my life flew into my mouth!!! Talk about gross! I also realized my wollyball-induced injuries on my arms…massive bruises and hematoma haha. Hopefully it will heal soon enough. After the hike, Shay and I read and took a nap. Then we woke up and made our very first meal on our own here – pizza from scratch! It turned out really well, and we had game night with Phil, Chris, Dr. Dan, Sonja, Bob, Andrew, Shay and I. We played spades in 2 groups and Dr. Dan brought dessert – m&ms and snickers! Lol Then, more reading before bed.

Sunday: Saturday night I had insomnia, so I stayed up till about 4 am applying for various jobs online back in the states. Needless to say, I was not up in time to make it to church service. I slept till about 10:30, and did some more work on the computer and read a bit. Then Shay and I agreed to take over bible quizzing for Christy and Ed after they leave this week, so we helped them today in order to get a sense of what they’re doing – the kids have to memorize 75 bible verses and next week they have a tournament against the other teams. Our team is currently in 2nd place. Then they had a party; Shay and I manned the volleyball station until it was time for us to go home. The rest of the night, we just hung out. I played Hold ‘em with Andrew and Phil – and won, of course :o) Then I read some more and went to bed. (Although I’m reading a bunch of books at once – the one I can’t put down is Twilight. I didn’t know what everyone was raving about, but it really is a good book.)

Kenya blogpost #3b

2009-03-22T13:00:00.003-05:00

Shay's post --

Thank you all for your prayers! I reminded our friends at Daniel's church today that "the prayer of a righteous man is powerful and effective" (James 5) and I do believe that yours are working in our favor.

I started work in the nursery on Monday, which is really the NICU here, as the well babies don't actually get admitted to the hospital. It has been interesting! I'm dealing with a whole different set of pathology now, including birth asphyxia (where the babies don't have oxygen to the brain for some time -- devastating), necrotizing enterocolitis (where the baby's premature bowel dies and becomes toxic), ISS (immune suppression syndrome, or HIV), and congenital defects. We lose probably a baby a day to these things, which somehow doesn't surprise me given the inadequate prenatal care. But I think I'm getting used to letting people go...

I think it was on Monday that two of the patients I had been following in the ward passed away. In retrospect, it was the mercy of God to bring them both to Him. The one that made me saddest was the 4 year old with leukemia, whose family I had really gotten to know a bit. I walked out of the hospital and saw her father standing with the chaplain. He told me she was with the Lord and I did my best to demonstrate sympathy. I walked down the sidewalk and shook hands with her mother, who said, "she's gone..." and that got to me a bit. It was a sad time but I realized that they were supposed to leave for Eldoret that day, which would have been very expensive and she was so sick it probably wouldn't have saved her. In God's sweet provision, my Bible reading plan included Psalm 116 (please read it!) -- "precious in the sight of the Lord is the death of His saints." I want this psalm read at my funeral, please.

This is also what I shared with the friends at church today when we were asked to stand up and share something with the congregation. We read this psalm and thanked God for the gift HE gives us of eternal life with him. He has set us free from the fear of death by sending us Jesus, and in knowing Jesus we have confidence that we will someday find a peaceful rest that none of us has ever known! Praise to Him.

I've also been learning more about the culture, especially in comparison to ours. Where we value productivity and efficiency, they value relationship and trust. We place our priority on TIMELINESS and they take chai every morning no matter what! We value our privacy, they line up and clap to contribute their offerings at church. We want a week's notice for visitors; they have neighbors over daily to share in their meals. We have a hard time accepting death; they seem to see it as part of life. We like to be called "skinny" and "young" while these things mean you're sick and lack wisdom here. We spend what we do not have; they save for months to send their kids to school. It's funny how we best understand other cultures by comparing them to our own...

One thing that does not change is God -- He is the same yesterday, today, and tomorrow. He is constant across cultures, across language, across our limitations of understanding. Because of this, Daniel, Shadrack, Laura, and I can have conversations about what He has saved us out of that strangely mirror each other's stories. Daniel talked a lot about struggling with his family, growing up one of 9 children with divorced parents, which is a very rare thing here. He talked about how he came to know the Lord and realized that maybe a wife would be a good thing after all. Previously, he had been "tortured by fear" that his family would hurt the way he had suffered. It reminded me of Proverbs 17:1, "Better a dry crust with peace and quiet than a house full of feasting, with strife." I thank God for the sweet home he has allowed Daniel and Anna to build together.

It's funny, I told Laura I would climb Mount Motigo with her (she didn't go last week) in exchange for coming with me to Daniel's church today. When we ended up taking lunch again, she was like, "YOU OWE ME BIG TIME!!!" We'll have to see what that means, as I'm pretty sure she's set on cashing that one in at some point...

One more week of nursery, then off to OB. Hard to believe we've been here 3 weeks! Prayer Requests: For comfort for the families of patients who die. Praise that I'm more comfortable here than I was a week ago! Pray for Daniel's church, that they would continue to be a light to the people of the community and that they would grow in the ways they think the Lord is leading them. Pray for Laura and me, to continue learning about God's faithfulness and provision, even in times of suffering.

Please let us know how we can pray for you!
Love, Shay

Kenya blogpost #3

2009-03-22T12:17:00.004-05:00

Laura's post:
Ohhh, where do I start writing about this week? So, last Sunday as we already told you, we went to church and “lunch” at Daniel’s house. Well, as it was authentic Kenyan food, of course one of us was bound to get sick. I was the lucky one. I spent the first part of the week taking it easy. Then, Shay told me I should take CIPRO to get rid of any GI bug I might have....only to realize I’m ALLERGIC to the drug! I have never been allergic to anything in my life, but I started itching ALL over, scratching frantically. And of course this was when Shay was at work, so she didn’t even know about it till I went up to the hospital to tell her what happened. Then, Sara, the OB resident took me to the pharmacy and prescribed me some stuff to help. LoL The itching was the worst part of it, too. It was worse than the actual sickness :o( So, after a few days of that...I started work again up at the hospital. Christy and I started a new project that hopefully the Kenyans will continue with after we leave. We are scanning all the x-rays into a computer database. We hope to finish all of 2009 x-rays up to the current date, and have them continue with the older ones after we’re gone. Christy also informed me that she calculated all the x-rays that we had re-filed from the other week. It was a total of 35,699 x-rays. And that wasn’t even half of all of them that they have.

Thursday night was Match night (for all the med students to figure out where they will be for residency – Andrew found he will be in Denver!) so we had game night at the guesthouse. All the people our age (and even Christy and Ed) came and we played Apples to Apples and spoons. We also had desserts that people had brought—and Shay’s failed watery Jell-o. haha

Friday night, Shay was on call, so I just rested and hung out with the girls.

Saturday, I went hiking with the Jarrett twins, Sonja, Sarah, Jessica, Christy and Ed. That was nice just to get off the compound. We had to cross the river, so we took our shoes off and crossed, while the locals who were washing their clothes in the river watched us and smiled. Later, Daniel took us to Bomet to go fabric shopping. It was fun to just go galavanting around the “city” and see all the locals. There was a guy on a microphone standing on some stairs with a bunch of people gathered to listen to him. As we passed by (in front of the crowd), he said “Welcome, you are very welcome, our visitors from America.” Then he said something in Kipsigis and everyone laughed. We figured it was about us, so we asked Daniel what he had just said. And he told us that the guy said “See, I understand English, so they understand me.” After some bargaining which Daniel later told us the vendors told him to “stay out of our business” in order for them to charge us a higher price...which of course Daniel did not let them, we sat down to have a coke in a local “hotel” which means restaurant. Then our driver picked us up and we headed home. That night, we had a girls’ movie night at Dr. Carol Spears’ house. We had chicken pot pie and pizza and watched No Reservations...of course we had to choose a chick flick! :o)

Okay...so then it’s Sunday. And Shay...not really consulting with me beforehand...volunteered us to go back to Daniel’s church and house so his wife can teach us how to cook ugali, sikuma wiki, and chai tea. All of which I wanted to do, but not this weekend, especially after getting sick last weekend. So, since Shay could not get anyone else to go with her, I told her I would do it (but she owed me). lol Then she said she would tell Daniel that we had to be back after church – which is a 3-4 hour commitment in itself – but before she got a chance to...he said “I hope you have not forgotten your promise that you would come to my house and learn to cook from Anna.” He said that she was at home preparing. So obviously, I could not say no! So accepting now that it was going to be an ALL day affair, I told Shay she owes me even more big time, especially b/c that meant I would have to eat again...We sat in church, being able to understand every now and then when they translated for us, and sang Kipsigis hymns. Then we had to stand up in front of everyone and introduce ourselves, and were even expected to either sing or give a sermon!! So...haha I obviously made Shay think of something to say. She did, and Daniel translated in Kipsigis for us. Then we sat down and continued. After service, there was a traditional auction in which several people brought offerings to be auctioned off including eggs, onions, and a pumpkin. (Apparently, when Dr. Kydee Sheetz was once there, they brought a donkey and she ended up buying it). Everyone gets in a circle with the assistant pastor in the middle with the offerings. We bought the onions, and then stayed around to talk for a little bit after the auction. Then we headed to Daniel’s house, where we talked and Anna (his wife) showed us how to make the traditional Kenyan food over a traditional “fireplace.” Then we ate and visited some more. It is possible that we could have been there for hours later, but I had told Shay that I needed to meet with Carol Spears about some PR work I was doing for her. So we politely said we needed to be heading home (which sometimes it’s hard to know if we’re being polite or rude b/c they think Americans are so direct and well, rude.) lol Daniel and Shadrack walked us back to the compound, and we gave them our email addresses. We plan to get their address so we can send them copies of the pictures we have taken.

Prayer requests –
*That neither of us get sick this week :o)
*That I will hear good news from Burson-Marsteller about a summer internship in Dallas which I REALLY want.
*That our work here will continue to do good.
*That God will guide me to make decisions for my future and where/what I will be doing.
*For all the patients in need of care at the hospital.

Love and Miss you guys very much!

Kenya blogpost #2b

2009-03-15T10:03:00.003-05:00

Shay's Week 2

Wow, where do I begin? I got really down this week after giving bad news to families about their children. I think the low point was on Thursday, after seeing 3 patients with nothing I could do to help their dying kids -- from lupus, rheumatic heart disease, pancytopenia from some unknown cause. I then walked into the side room to make sure my 4 year old with leukemia had finally left for Eldoret to hopefully get chemo, just to find her lying in bed with fever to 103, clearly miserable and ill. She had been discharged somewhat emergently on Monday but her father has not been able to get money to transport her. "Hopefully Monday..." they told me. I just about lost it. Thankfully, I did not cry, but just sat there with her, holding her, wishing there were something more to do. I thank God that through the generosity of some of the missionaries I was able to print a picture of their family and gift it to them, knowing that her days are likely limited. The way we say it here - to avoid being "direct" and offensive as Americans usually are! - is that "we are doing all we can - she rests in God's hands." Apparently they get the subtle messages.

The things that kept me going this week were the couple patients I discharged home who actually had a good outcome. My little 1 year old that we intubated for croup last week AND the sweetest little 5 year old with typhoid both went home on Friday. I think I couldn't do this job if I didn't have smiles like that to look forward to.

Friday I also did my first bone marrow biopsy on a 14 year old previously healthy young man who now has bone marrow suppression. We're trying to figure out why but honestly so much of me struggled with subjecting him to such an invasive test when his platelets were 8000 and I'm not convinced a send-out test that takes 2 weeks and will likely tell us no more than we already know was worth the risks of bleeding and infection. But we explained it all to his oldest brother, 25, who told me it costs 1400 KSh to travel here (nearly $20) and now he has the responsibility for making decisions for his brother. He cannot afford to go to Nairobi (our suggestion) and was adamant that we do the biopsy here. It dawned on me that this was as much for the patient's sake as for the brother's -- that he needed to know he was doing absolutely everything possible within the limits of the not-so-available funds. I thank God it was a successful tap, "In Jesus' Name" -- according to the brother. He was the one who wanted to take Laura home :)

SO I felt much better Friday afternoon since we were able to make him happy, I did my first successful bone marrow biopsy, Laura cleaned our room to try to cheer me up... and then we played walleyball in the racquetball court with all the MK's. It's like volleyball but you can hit off the walls -- my new favorite sport! We all have bruises down our arms still!

Saturday was equally beautiful -- we got up at 4:15 to hike Mount Motigo in time for sunrise. It was a good hike, not too strenuous, but anytime you're going uphill you feel it b/c of the altitude. It was so nice to get out of the compound!! Later, I made eggs, toast, mango, and banana for breakfast then Laura and I went to an orphanage with some of our friends. It was nice to play with the kids and sing with them. My favorite song involved a dance as well -- imagine: "Thumbs up! Elbows out! Feet apart! Knees bent! Head to side! Tongue out! Turn around!" It was hilarious. If anyone feels called to supply mattresses, school supplies, or tuition to some really great kids, let me know :) After that I slept 10 hours and woke up refreshed!

Ready for today's adventure. Dr. Kydee Sheets is an orthopedist from MN who comes here twice a year and invited us to go to the Kipsigis church and then possibly have dinner (lunch) with her friend. I should have anticipated a long day and feel bad that I told the pediatrician that I would be around the hospital this afternoon...

We stood outside the church for 30 minutes waiting for Daniel, but finally decided we should enter at 10:30 since it was supposed to start at 10. We walked in and realized we'd made a mistake -- that all the students were dressed in green sweaters sitting in the English service that had not yet let out. About 30 pairs of eyes turned around to stare as we sat down and then the pastor asked the visitors to please stand and wave "for the sake of time." Kydee later told us that if we had more time we would have been expected to stand up and give a greeting or even a sermon. They dismissed and I shook probably 100 of the girls' hands as they swarmed around us. I imagine they were about middle school age. The boys did not come near.

So then the church service started and at about 1 o'clock they announced they were to start the "second service" at which time Dr. Sheets was like, "ahh!" and we snuck out as soon as we got an opportunity. I think it went for another hour. We ran into our driver from yesterday's visit to the orphanage, Donald, who tried to find our friend Daniel. He ended up walking with us about a mile down to the river then pointed us up the road to find Daniel's house. After about another half mile uphill, up the winding road, we found Shadrach, Daniel's son, running to meet us.

We were walked up to their house, where we experienced a real Kenyan meal with goat, chipatis (like tortillas), rice, beans, soda, fresh cow's milk, and chai. We visited with the whole family, including an aunt named Rebekah, Daniel's wife, Anna, and their daughter Dorkus, and 2 visiting ladies from the church Daniel pastors (in addition to being a scrub tech at the hospital and farming). Daniel's other 2 sons are away at school, Meshach and Abednego. They gifted us with congas (wraps) and then walked us all the way home in the mud since it had rained all afternoon. The conga has written, "Mola tupe furaha" or "God gives us happiness."

Off to pray with my friend Sarah! Until next time, friends...

Love, Shay

Kenya blogpost #2

2009-03-14T08:25:00.005-05:00

Laura's Week 2:

This week, I mostly worked up at the hospital in radiology. Judy, Christie and I helped re-file x-rays from a tiny room upstairs to a big basement downstairs. It took 2 weeks to finish (the last 4 days of which I helped). They have to use numbers for patients b/c the Kenyan name tradition is kind of confusing. Dr. Manchester tried to explain it to me, but I’m not sure if I can remember it all. They do not have a family (last) name like we do. Instead, they are given one name at birth (which depends upon if it’s a boy or a girl: chep is girl and kip is boy)...then I know they get one when they go through their rite of passage for adolescence, and another one somewhere along the way. LoL But then...there was something about their name changing later in life as well. So it’s very, very difficult for the hospital to come up with a system of filing patients and being able to retrieve old records. I got to shadow Shay in the hospital for a little bit, as well, while she was treating a patient from which she extracted bone marrow. His brother was in the room and said to me: “You need to stay in Kenya. There are 7 siblings in my family, with you there would be 8.” haha He was very sweet, but then I told him he would want Shay in his family b/c she’s the doctor. But he said she was like a “mother” or authority figure to him..even though he is only 1 year younger than her.

Friday, we had a pizza party at the Kipaganga (big gazebo where we have meetings/parties) and all the missionaries came, and the EMI team who showed up that day. They are a group of 12 architects and engineers staying here for 2 weeks. They actually recruited me to help out with their project, so I will be doing some of that next week.

Saturday, we went to Umoja, another orphanage. This one was only about 20 minutes away instead of 2 hours. And this time Shay got to go, as well. The children are all so sweet and very welcoming, as well. They love visitors. We sang with them for a little while, then we played games with a ball that I brought for them. We did alot more visiting with them and actually talking to them this time. When it’s time for me to have kids, I really wouldn’t mind trying to adopt one of these children here. But apparently it’s pretty difficult to adopt out of Kenya. The government has a lot of rules including you must live in Kenya for a short period of time with the child to make sure you fit well together. The head guy said he is trying, but he does not have enough funds to put the children through school. It’s about $250 US a year for one child.

Sunday we are going to a church outside of Tenwek with Dr. Kydee Sheetz. She has been here many times, so she is taking us with her. Supposedly it’s a bit different than what we’re used to, so this should be fun. I’ll write about what it’s like later after we actually get to do it.

I miss the states, and obviously all of y’all. But honestly, I feel so at home here. Even being here we are still living better than most of the Kenyans while on the compound, but I have also realized how many things I just don’t need. I brought movies with me, but I have not missed TV at all yet...I’ve never eaten better in my life (we’ll see if I gain or lose weight in the end haha). Although, I do miss my favorite restaurants and will be wanting a burger and fries when I get home haha. I think I’m just at that point in my life where I need to experience the world and find myself. I do not have any set plans when I get back to the states, but I’ve had a thought in the back of my mind that that’s not where I’m meant to be right now. So God willing, we will see where I end up. But if it allows me to have experiences like these and a life I can truly appreciate, then I’m not even embarrassed by my old junky car ;o) Till next time, I love you guys and miss you dearly.

*Laura*

Kenya blogpost #1

2009-03-08T07:15:00.004-05:00

Arrival success!

The last week has flown by! Things have been very busy -- or felt that way. We got to Nairobi at 9:30 Sunday night and stayed at the Mennonite Guest House, from whence we made precisely 3 phone calls which together cost as much as our room! It was a nice stay. Then we arrived here at Tenwek the next day, after a bumpy and dusty 4 hour drive. The countryside is beautiful here! We started work on Tuesday morning -- I'm on peds this month -- or "beads" as they pronounce it -- or "paeds" as they spell it. I will spend 1 more week on the ward and then 2 weeks in the nursery/NICU. Then I will be doing obstetrics for the next month. Andrew will do internal medicine and then ???

These are some sick kiddos! So far I have seen a few die from bacterial meningitis. I have also seen the most severe malnutrition in my life -- including a 3 month old whose mother died 7 days after birth and now weighs the same 2600 grams she did when she was born. I've never calculated refeeding in a neonate and I have much to learn. I've also seen TB, malaria, typhoid, tetanus, elephant-related trauma, croup, end-stage CHF in a 10 year old due to rheumatic heart disease, a baby with O2 sats of 3-30% at 8 months old due to some congenital heart defect, pneumonia, hemophilia of unknown type, and I actually picked up a leukemia/lymphoma diagnosis in a 4 year old who was admitted for "heart failure"...

Challenging cases! I'll have to write more about what I learn but wanted to just say hi and thanks and we're safe and good :) Laura wrote about her few days below -- she wants to marry a doctor so she can come back and stay and have her own little MK's -- hah!

Prayer answers -- directly, that Scripture has been speaking to me (even 2 Chronicles!), that Laura's software was able to download, that the missionaries have been incredibly welcoming and warm, and that we feel at home. Thank you so much for your prayer support!

Prayer requests -- continued open minds and hearts as we seek to discern how the Lord will use us in this place. For my little girl with cancer -- we don't do chemo here so we will be entertaining how to send her to Nairobi for treatment and have not yet had this discussion with the parents. We can call her CS. Also, for all the babies in our care -- about 70 who need your prayer :)

Love you all! Shay

Laura's post:

Journey to Tenwek:
The flight to London was horrible. It was very hot, with no room (esp. for Andrew's long legs) and my audio did not work. So no video entertainment for me except for the portable dvd player that Sean so sweetly let me borrow. But it also ran out of battery halfway through the flight. Once in London, we had a couple hours before our flight to Nairobi, which was much more enjoyable. We landed, went through immigration and got our bags. Then we met our driver (thank goodness cuz we didn't know what to expect to happen once we got there really). He took us to Mennonite Guest House, where we spent the night and ate a very nice breakfast the next morning. Then a different driver found us (again, thank goodness cuz we weren't sure..lol) and we drove about 4 hours to Tenwek. The roads are dirt, and some are very bumpy. It was interesting to see all the different people and animals on the sides of the roads. We saw a bunch of donkeys (some with people being pulled on carts), goats, a couple monkeys crossing the road, and a few zebras! We also saw the Massai tribe (the ones who wear the traditional tribal dress) herding sheep and cattle. But they do not like their pictures taken, so we have to be careful not to offend them. We stopped in a town called Narack (spelling?) to have tea and samosas--little pasteries filled with spinach and some kind of meat (very yummy!) Then we got back on the road and finally got to the hospital and that's where Day 1 starts.

Day 1
We had lunch with some of the other missionaries and some time to unpack and get settled, then we had a tour of the hospital. It's a little weird and gross for me, obviously cuz I'm not medical. But Shay wants me to stand in on a childbirth at some point. They do not use drugs either, so it will be completely natural....we'll see if i can handle it or if i pass out! haha I will also be helping in the nursury with the premies. They are SOO small!! Some of them are orphans who lost their mothers, and some even have HIV. There's one in particular that was born at 22 weeks...I think it's actually the smallest one there.

Day 2
I just started actually working today. There are 5 different babies that need to be fed through a tube, so I helped with that. Apparently, you need no medical training to help out. lol Although, I'm pretty sure they would never let me do this stuff in the states. Other than that, I could be helping out at school with the missionary kids. There are two other missionaries teaching there. All the missionaries seem very down to earth and nice, most of which have not been here long...the longest since November (Apart from the more permanent ones who have been here for years). I will have to tell you more about them later when I get to know them better. But some who are here with their families actually make lunch for different groups of us. So every couple days we go to a new house to have lunch. Other days we have lunch here at the guest house. We had lunch today at a couple's house who are from Ohio. They have 4 kids...SO cute! The Kenyan children are incredibly adorable, too. They only know a few words in English, so they say it over and over again. Today we were trying to find the house for lunch we were going to and a bunch of them yelled out..How are YOU??? over and over while smiling and laughing. lol We are supposed to have wireless but mine has not been working so far, so I will have to get that working before I can send/post pictures. But I will try!

Day 3
So...I'm pretty sure I won't be able to handle working in the nursury a whole lot more. The last time I went, Shay went with me and I was actually teaching her how to feed the babies through tubes (so that's kinda cool). But I was seriously like 2 seconds away from passing out. It's VERY hot in the nursury (b/c the babies cannot regulate their body temp) plus you have to wear plastic gowns that dont' breath so it's even hotter. Then on top of that, there is a very distinct and disgusting smell that stems from the fact that they do not use deodorant. (36 babies and their mothers in a very small room). It's definitely not the same as working in a nursury in the states where everything would be cleaned and disinfected....I was feeding a baby with Shay, and all of a sudden got tunnlevision and my hearing started going out. I thought I could snap out of it, but then without even realizing it, I said "Shay, everything's black for me right now..." and she took my tray and said "Laura...go outside." lol If I had not sat down, I woulda hit the floor. It's kind of embarassing b/c it's not even like I was watching a procedure or anything. But seriously...that smell! So...now I've been helping in the school with the MK's (Missionary Kids). They are some of the CUTEST kids I have ever seen!! They call me Miss Laura.

Day 4
This afternoon I babysat a couple girls who's dad left town and who's mother could not get out of the OR. Then tomorrow I'm babysitting another family who's parents are going on Safari. It's not exactly helping the Kenyans in the hospital. But it is a big help to the people who are. So if I can help the doctors do their job better, then it's worth it to me. But Saturday, 4 of us are taking a trip to an orphanage 2 hours away and will probably spend most of the day there. I'm excited about that.

Day 5 (Friday)
Today I babysat the Roberts' boys, MK's ages 2, 4 and 7. Let me tell you, they are a handful. haha VERY cute though! They do not have TV here so we had to be creative to find things to do. That's part of the reason why the older kids read so much and they are all very smart, it's kind of intimidating haha. I have been considering changing my career course to teaching since I've been here. :o) I had a conversation at bible study 2 nights ago with Dr. Carol Spears--a general surgeon here (who's very very sweet and not the typical surgeon with a god complex) about how they need PR work such as brochures and a new Web site design. I was so anxious when she said that b/c I know I can do that...but my design software has not been able to install on my computer since I bought it back in December...something about my drivers...or something? So, then last night and this morning I prayed that it would work because I know that's how I could be useful here. And it installed, no problem! So, I definitely am thinking God has a plan for me here. It's a blessing to be able to see how different the lifestyle is here because I feel like it will show me the things that are most important in life and show me how to not worry about the things that are so small in the grand scheme of things.

Day 6
Sarah, Sonja, Judy and I went to Bosto-an orphanage about 2 hours away. It's actually very close to Tenwek, but they do not have a direct route so you have to go all the way around and it takes much longer. This is one of the orphanages that is furthest away, so they do not get many visitors. That's why we chose to go to this one. Jenny Roberts arranged a driver for us. When we got there, the children all shook our hands. We took a tour of the orphanage (which didn't take long cuz it's small). Then us girls got to experience the "bathroom." It is a shack with a cement hole in the ground with 2 raised blocks of cement for your feet to go. Oh, and no tp. Then they all sat down outside where Judy read a bible lesson to the kids and our driver translated for us, even though most of them know some English. After the lesson, we split up in 2 groups and played london bridges, duck-duck-goose, musical "ball" and ring around the rosy. Then we went into the new dining hall (that doesn't have windows or furniture yet) and made crafts. We gave them foam crosses that they could decorate with other foam stickers. They loved it. One even went by me, holding his cross saying "Jesus loves me." Then we brought out a puzzle and bubbles. They loved them both. When I was taking pictures (with my manual digital camera), they could not get enough of that. They do not have mirrors, so many of them do not know what they look like. So they love to look at the pictures after you've taken them. They were all scrambling to have me take their picture. Then...they took over haha. They took my camera (I let them) and they started taking pictures of eachother. The only problem was that it's not a simple point-and-shoot camera. It has a manual focus setting. I tried to tell them and show them how to use it but they didn't seem to care. haha. So many of the pictures from that day are blurry :o) But I know Sarah and Sonja got some good pictures that I will have to get from them. Then it was time to go. We said goodbye to the children and went into the "office" with the head of the orphanage and our driver to have what they call here "chai time." You have chai tea and some bread. We talked with the two men over Chai and signed a guestbook. I brought out my Swahili/English phrasebook so I could say a couple words. The head of the orphanage only speaks Kipsigis and some English. So he was wondering if he could keep it to learn more Swahili and English. I told him no at first b/c I needed it to get around. Then I realized Shay had one too, so I told him he could keep it. He was very thankful. After chai time we headed out, saying our goodbyes and "asante's" (Thank you's) as we went. We made our 2 hour drive back....stopping every now and then to make sure the car had not fallen apart because of all the rocks on the road....it was pretty bad. It took a couple hours for my sight to readjust b/c it was so bumpy. Sarah even got a little carsick. When we got back, we had lunch and played soccer, football, and frisbee with the MKs, some doctors, and even some Kenyan girls (who were playing in skirts and no shoes! And were really good).

Day 7
We had breakfast at Barbara Pinkley's house...something she is known for. She calls the new visitors and invites them over for eggs, coffee, fruit and a delicious cinnimon roll cake-thing. Then we went to Sunday church service. It's actually an African Gospel Church for the employees of the hospital that we happen to attend that is inside the gates of the hospital. Then we came back to the guesthouse where we visited with two Kenyan men (23,21) who Phillip knows (Phillip is a missionary here who is only 18 and came by himself, but has been here before. He is from North Carolina and very sweet and cute. He does Community Health and Development) We gave them fruit snacks and they didn't like them b/c it had too much sugar. But they were so polite and sweet about it. All the Kenyans are very warmhearted people here. And I just finished doing laundry...we have a washer but no dryer, so I line-dried mine and Shay's clothes...while she played ultimate frisbee haha..She's on laundry duty next time...Then I sat down and started writing this entire blog today b/c we haven't been able to yet. Just bits and pieces in emails. So until next time...! Love and miss you all very much!

*side note: Also, something very interesting that I learned is more than half of patients here have HIV. But since there is such a negative stigma attached to HIV, doctors are not allowed to call it that. THey have to say ISS, otherwise if other Kenyans know they have HIV, they will be shunned.

Week 1 of Wilderness Medicine

2009-02-11T17:04:00.003-06:00

Wednesday, 11 February 2009

We have been here at Camp Wesley Woods in Townsend, TN for a little over a week now and I must say this is the best rotation in the US! We are staying in a Methodist camp, sleeping in bunkbeds that will be teeming with kids this summer, and eating 3 prepared meals daily at 7:40, 12:15, and 5pm. I am getting very acquainted with cereal, white bread, and iceberg lettuce. Week one was a bit chilly, with temp in the teens and rain/snow almost daily -- the worst part (sadly!) was sitting for 7 hours of lecture a day in the 52 degree classroom! You know it's cold when you look around and everyone is wearing hats and gloves and drinking hot water to stay warm. Getting ready for the wilderness...

The curriculum is most impressive. So far we have learned about hypothermia, avalanches, hypoxia, frostbite, altitude medicine, animal attacks, toxinology (aka toxicology of naturally occurring things), why I don't want to go to Mars, responding to plane crashes, how not to get lost, how to build fire and shelter when you do get lost, personal locator beacons and how to track them down, tourniquets, food and water procurement, what to think about when setting up a refugee camp, dental emergencies, Cherokee Indians, knot tying.... to name a few. Tonight we will visit the planetarium for an introduction to navigation by the night sky. I have been MOST impressed by the faculty lecturers here -- everyone giving lectures has incredible stories and experiences (many military) about being in the wilderness and what to think about when you're trying to provide medically for a trip overseas, etc. We have been lectured to by folks who have done research on Everest, the man (former president of the wilderness medical society) who developed the medical kit for NASA, paramedics, park rangers (including one very enthusiastic one when it comes to tazing bears and shooting wild hog), the man who leads search and rescue in the Smokys when someone is lost (with stories of many who did not make it). The director of the program, Tom Kessler, used to be in the Coast Guard and worked for decade(s) on an Indian reservation with the civil service as a family practice doc. Needless to say, a priceless team of folks to learn from.

My peers are all crazy awesome 4th year med students from the US and a few Canadian ER residents. There are 2 other family medicine-bound med students, an anesthesiologist, an orthopedist, a couple pediatricians, a couple going into radiology. All the rest are headed for careers in emergency medicine. Everyone is active! The first week just about killed us all, sitting in the classroom with so many beautiful mountains to be climbed! So far we're getting along great, and I've been getting to know my cabin-mates and classmates quite well (despite still not knowing most of the last names!)

Today we did our first scenarios outdoors with the paramedic. MOST FUN I'VE HAD IN A LONG TIME!!!! We split into teams of 7, sent one to be the victim who put on old clothes and got made up like a trauma patient and planted in the woods. My friend Stephanie (the one who actually gets cell service out here and graciously lets me use it to call Brian!) pretended she had fallen and gotten impaled on a stick. They taped the stick to her abdomen, through her shirt and used fake blood all over the place. We ran up to her with the litter, evaluated the scenario, appointed a leader, then took orders to protect her spine, make sure she could breathe and had good circulation, dressed the wound, rolled her onto the backboard, lifted her onto the litter, then marched her down the mountain to "safety" -- ie, the ambulance bound for the ER for more definitive care. A-mazing. I'm patiently waiting for my turn to give my teammates a challenge :)

We also had Sunday off this week and took the opportunity to go for a 9 mile hike in the ice/snow, at a trail called Charlie's Bunyan, part of the Appalachian Trail. I was impressed with how jovial everyone was and what team players this group of Type A med students actually are. One friend, John, loaned me his yak trax so I could walk on the ice, stating that as a North Dakotan he likely had more experience than I did. He was right. In that same vein, my Canadian friend Warren took a picture of me: "I'm going to show my friends -- a real live Texan, eh!" So he's added "y'all" to his vocab and the next time you talk to me I'll likely tack on some useful eh?'s.

Thanks for keeping up with me! Love you guys!

Christmas Break

2009-01-20T12:52:00.003-06:00

We had an amazing Christmas break! We finished up the project for gma's 75th birthday, skied at Monarch (see above, Laura, our brother Matt, Mom, Shay, and Shay's boyfriend Brian), met up with old friends, and celebrated the New Year in beautiful Colorado! For January, Laura is working at Dick's Sporting Goods while Shay is taking it easy and packing for her upcoming months away...

A fun story, for those of you who don't know about Brian... we met at mile 12 of my first half marathon on November 2. I was running with two friends that day, one of whom had a mutual friend we were to meet up with before the race to pray. Since we were just on time to race, I never met his friend. I was running by myself and this cute guy came up next to me at mile 12 and asked, "is this your first half marathon?" I replied, "it sure is!", gave him a high five, and suggested we finish the last mile together. Of 5,000 runners, we realized in talking after the race that he was the one we were supposed to meet up with to pray. We got a kick out of waiting for our friends to finish to tell them the story and we've been telling it since :)

I should have done this earlier...

2008-12-29T18:17:00.001-06:00

Hi Friends,

I wanted to start a blog in an attempt to keep you updated on all the goings-on of my life, including the upcoming wilderness medicine rotation in Tennessee in February, and of course the misadventures that my sister Laura, friend and classmate Andrew, and I will experience during our visit to Tenwek Hospital in Kenya. I promise future blogs will be more exciting! For now, the following dates apply:

Jan 5 -- back to Dallas
Jan 31 -- leave for Tennessee, wilderness medicine
Feb 27 -- travel through Dallas, maybe sleep a couple hours
Feb 28 -- travel to Nairobi, via London
April 24 -- travel from Nairobi to London
April 27 -- leave London, arrive Dallas 15:40
June 4 -- graduate med school
June 13-20 -- Spring Canyon for Rocky Mountain High
July 1 -- report to duty, St Louis, for Family Medicine Residency with the USAF

Thank you for joining me on this adventure we call life!