Dinner and Anne's and Dan's

 

The last time I was in Kijabe, the head nurse was Anne Mukweyi.  You can see a picture of the younger Anne in my first posting of this blog.  She is the one sitting a bit further back at the nursing station on the Paediatrics ward. Anne is a very competent Nandi nurse who ran the ward with efficiency and a good deal of wisdom when I was originally at Kijabe in 2002.

Since then we have corresponded.  She got married in 2007 to Daniel who is a Luo.  The social difference between the two tribes was imperceptible until the election troubles of 2007.  The troubles went from election controversies to property violence to murder and then to parliamentary shenanigans since then.  The recent elections earlier this year have finally ended the strife.  Daniel was a district nurse at Naivasha, a town in the GRV north and west of here, when the two first got married.  He now works in Nairobi with an AIDS program funded by the University of Maryland.  They had planned to be married when the troubles started.  Anne was in legitimate danger as she lived “outside the wall,” but on hospital grounds.  Anne’s pastor had urged Anne and Daniel to delay the ceremony because “it was no time for you two to be married.”  Anne and Daniel countered that it was, in fact, the best time to be married…and did.

They have two children:  Favor, 3, and Felix, 9 months.  We spent an enjoyable evening talking politics (Kenyan and American), gas prices, soccer matches and religion while, with infinite patience, Favor’s braids were undone and Felix’s explorations of the mysteries of cruising around a coffee table were observed.  Anne is now the “matron” (read hospital administrator) for the Bethany Kids- Kijabe Hospital, the pediatric ward of the hospital.

We had lamb stew with rice and chapatti (Indian flat bread which has been adopted by Kenya enthusiastically).  Dinner was finished with a glass of hot water.  I walked back from their cottage with the hadadas crying in the trees.

It had taken me a while to identify the owners of the cry: a cross between the croak of a crow and the quack of a large duck.  To my surprise, the calls belonged to a flock of scimitar-beaked, goose-sized, short-legged ibis, the hadada, who, despite their appearance, roost in the foliage of trees.  Their cry is supposed to be “haaadaadaah.”  Were it me, I would not call attention to my deficiencies of grace and beauty. 

I attended staff prayers on schedule and we sang a cappella “What a friend we have in Jesus,” the small group of Kenyans and Westerners mingling their voices in the music of that old good song.  We shared the deaths of patients. 

“All our sins and griefs to bear”

I prayed with Elinor, a Kenyan nurse, for the hopes of a new academic year and completion of her master’s degree.

“What a privilege to carry

 everything to God in prayer”

I suppose I can share a few words about my living arrangements.  I live in Heron House (all of the cottages have bird names with the exception of Pathology House).  It is the designated “boy’s house” and I share it with 3 other docs currently.  One is Matt who is a visiting radiologist from Birmingham.  The hospital has a CT scanner and the films done are generally excellent.  Shawn is a Christian, born in Goa, India, raised in Nairobi and currently a Pediatrics resident at Agha Kahn Hospital, the premier private hospital in the country.  He is doing a rotation in Pediatric Surgery here and for the first two weeks I thought he was a mirage, rising before the dawn and not coming back until I had turned in.  His initial take on Kijabe is the major alteration in work ethic.  He reported that he was floored when he came onto a ward to find a visiting American doc waiting patiently for a patient to arrive.  Private docs wait to be called at home in Kenya.  Prayer before rounds and surgery is a delight for him.

The last housemate is “The Great Oohmmz.”  Omar is one of ten children of a Muslim family and will be entering the government Neuro-Surgery Program next month when he returns to Nairobi.  He is tall, painfully thin, opinionated, gracious and garrulous.  He speaks with authority about most any subject and has the fine grace to make jokes at my expense as I do at his. All food found on the counter is free-range.  Food in the cupboards is safe from predation.

My own health is not as good as it could be as I got a cold and it has caused a flare in my respiratory problems.  I am better but my voice is a croak and I talk all day to its detriment.

The nursery is relatively light but hot (88 F and 60% humidity) and in consequence, wearing.  A baby born 3 weeks ago weighing about 2.5 lbs. with moderately bad lung disease had an initial rocky course.  Her lung disease resolved and she was finally on her upward leg with weight gain and good feedings.  Today she suffered a setback and is on a ventilator.  Please pray for Grace’s baby girl.

“Carry everything to God in Prayer.”

Cultural Sunday at Kijabe A.I.C.

It was a week that came in like a lion and out like a lamb. 

While the weather in Kijabe is cool, never reaching 77F, the weather in the Nursery is always hot and humid.  If it ever gets down to 84F and 60% humidity, I haven’t been able to catch it.  Part of this is construction as it is a long masonry room with one small window to the outside world.  Some of it is crowding, as we get 16 to 20 babies in this space, their mothers, half a dozen nursing students, 4 nurses, three house officers, all the heat generating equipment …and me.  Most of it is an understanding that babies need it warm (true) and a lack of understanding that too much of a good thing is bad (equally true).  The average well, term newborn never goes anywhere without being wrapped in two to three large blankets, having two pairs of socks on his feet as well as woolen mittens, a wool cap, three layers of clothes and a nappy.  The single 4” x 3” square of naked skin allowed to breathe is usually shaded by blankets and solicitous mothers.  Fevers are epidemic.  Not to worry, the treatment is to exhume the baby from his clothes and to wait for him to radiate heat to the environment. It takes hours with mothers clucking at our cavalier exposure of their precious babies.  The down side to the experience is that, as it is in the USA, it is easier to give the baby antibiotics and keep them in the hospital for a week than it is to decide who actually may need the treatment.  This is my task for my remaining few weeks.

Follow-up:  The boy with “measles” had a herpes infection, and has gone home with treatment.  Lydia’s baby is on full feeds but is failing to grow.  Faith has recovered and has been sent back to Eldoret.  We have had two deaths: one a 3 lb. baby who died at 12 days from lung hemorrhage and a term infant with brain damage at birth.  God has shown his grace to our babies.  Please pray for these grieving families.

There were more than enough volunteers to fill beds in the nursery over the last weekend so the beginning of the week was even hotter and more humid than usual.  By the end of the week we were almost not-crazy.

One snapshot: Baby boy of Esther was delivered Wednesday at term (or perhaps a bit more) with no problems except that he was blue, flaccid, unbreathing and unmoving with a slow heart rate.  For those of you who know Apgars, they were: 0, 2, 2, 4, 4, 5, 5, and 7 at 1,5,10, 15,25,35,45 & 55 minutes despite care which I would be happy to see in the USA.  We brought him to the nursery and an hour later he was crying and moving around normally.  Currently he is requiring a little oxygen and we have started feedings.  He has a normal head ultrasound.  Please pray for Esther’s baby.

Today was Cultural Sunday at Kijabe A.I.C. Church.  The five tribes with representatives in the area got together to present how they sang and danced “in the times long ago.”  Each tribe (Kikuyu,

Kamba

, Ambagusii

, Turkana

, and Maasi

) gave a brief explanation of their dominant tribal beliefs, how they have been affected by the news about Mungu (The Lord God, in Kiswahili) and Yesu (a better transliteration of Yeshua than we use) and what words they have put to their own songs. Just to keep this in perspective, the background slide for the Cultural Sunday was a very nice photograph of Stonehenge on the Wiltshire Moors of pagan England. http://www.google.co.ke/imgres?imgurl=http://www.english-heritage.org.uk/content/images/iphone/stonehenge-iphone.jpg&imgrefurl=http://www.english-heritage.org.uk/daysout/properties/stonehenge/&h=201&w=251&sz=1&tbnid=bY2Y_IZzNp5EnM:&tbnh=160&tbnw=199&zoom=1&usg=__X2iHmkqVRGdv_rwEPV8eOwnVf-g=&docid=8eQ3aNfFC-kboM&itg=1&sa=X&ei=G5AHUraDHcnRtAbohIDQAg&ved=0CKgBEPwdMAs

Afterward we were offered samples of their traditional foods (taken in the hand, while the other hand supports the wrist as no gift is so small to need only one hand to support it).  I had: Chickpeas, beans, lentils, greens, corn porridge, sorghum drink (a thick pink, sweet and slightly sour libation) and came back to Heron house well satisfied. 

This whole event was designed to raise 350,000 Kenyan shillings (~$4200) for a combined medical, beneficent and evangelical mission to East Polkot the end of this month. 

My observations have been that in the USA, Africa is viewed as a singular.  It is indeed a complication kaleidoscope of cultures that have their own history.  Tribes have fought and killed each other for generations but have found peace together in the common bonds of being the adopted of Christ, no more nor less than we are.  The past is not forgotten; the blood does not evaporate.  But as a Turkana missionary told us in Kiswahili:

Isaiah 43: “I am the Lord God, your Holy one…your King.  Forget the former things; do not dwell on the past.  See I am doing a new thing! … I provide water in the dessert…to give drink to my people.”

This week please pray for the Kijabe outreach mission to East Polkot, August 22 to 27, for those who will hear the message and for the safety of those who bring the Word.

Scenes and Snapshots

It has been a long week and I am glad for the chance to sleep in Saturday. I went to the mduka (shops) after a late breakfast.  A pineapple, large papaya, onions, field peas, avocado, jam, milk, bread and sugar rounded out my shopping list and just about filled my day-pack.  I looked out on the Rift Valley, the dark Ngong Hills, the clouds and distant rain showers making it a very dramatic scene.  It was marred by myriad power lines, however, and I walked to the far side of Kijabe town to see if I could find the “right spot.”  I came to a road and started down it, toward the distant valley. 

Having hiked alone since I was 11, one learns a certain calculus as to when to go on and when to turn around.  Losing altitude is never good but the road was fair, the surroundings placid.  I passed the local airstrip with massive concrete posts and barbed wire to prevent people from running onto the field, I surmised.  This conclusion was somewhat confounded as a mother cow and calf were placidly grazing the runway as I crested a hill. 

I had finally done the last “If I don’t see a road back to Kijabe at the next turn, I go back,” when I met a man with his wife.  I greeted him with an “Habari” and got the expected “ya Nzuri” when the man spun off a long interrogation in Kiswahili and I had to admit I did not know enough to follow more than half what he said.  His response was typical Kenyan “How is it you are a Kenyan now and you don’t speak Kiswahili?” he said with a laugh.  I had to admit I studied hard but was a poor student and he told me to study harder and I would be speaking well within the month.  We three parted smiling foolishly. It was a long climb back to the Kijabe town road, about 500 feet, and I was hot and sweaty despite the cold blustery weather when I arrived back at Heron house.

 

Kijabe is a place of comings and goings.  People are always just arriving for a tour of duty or just preparing to leave.  This has its advantages if you play your cards right.

 

Saturday, I was invited to my second “we-have-to-empty-the-refrigerator-before-we-leave-dinner.”  Dr. Adrianna Shirk and her photographer husband invited me over …and about a dozen others.  This, at least in part, is due to the metric system.  Jack had done the shopping and apparently ordered ‘mince’ (i.e. hamburger) in pounds and was served in kilograms (1kg=2.2lbs).  When he discovered he had more than twice what he needed, he called for back-up…and we were glad to come for a feed.  Since early days of my mission trips I have made it a habit to carry toy balloons with me.  Most everywhere I go, the sight of a colorful balloon dissolves any pediatric reticence. My supply of balloons rapidly vanished among the gaggle of children and the adults started a pool to see how long between the loud pops and one more sheepish child would come asking for a replacement.  I always seemed to guess too long.  The record was 30 seconds.

Adrianna is a resident at AUB and will shortly finish her training.  She shared with me tonight that she and her husband have applied to be full-time missionaries in Kijabe.

 

A few snapshots:

Faith is a three year-old little girl who was found abandoned on the streets of Eldoret about two months ago.  She was taken into a Christian orphanage and named Faith Kutamaini (literally Hope).  She was found to have a heart defect (PDA) and was sent to Kijabe for her repair which happened this Tuesday.  It was a rocky post-op course as Faith’s condition had been neglected for so long that her lungs had been damaged.  She is still on oxygen now but doing much better.  Please pray for Faith’s continued convalescence and her life in an orphanage.

Since I arrived we have had three babies born weighing from less than two lbs to a little less than 3 lbs 3 oz.  These are small even by USA standards.  Since I was last in Kijabe, artificial surfactant has been added to the pharmacopoeia.  Our littlest one had a tube inserted into her windpipe as a part of resuscitating her at birth.  The surfactant was injected down the tube about an hour later and she was extubated and placed on nasal pressure CPAP.  She has done well for three days and fair for the last two.  We placed my first umbilical line in Kenya (a routine in NICU’s in the USA since early 1950’s) here on day two and so far have not had any complications.  Please pray for Lydia’s baby girl.

I was called to Casualty (i.e. Emergency Dept.) on Monday to see a boy sent in with “measles” from an outlying health clinic.  Other than having no signs consistent with measles, the diagnosis was spot on.  The 18 month-old boy’s tongue was obscured  by a dirty-green fetid and friable coating.  The health center had based its diagnosis on a few spots which might happen with measles but had ignored the fact that he had none of the usual signs (cough, runny nose, typical rash).  I brought a working flashlight and encouraged the staff to look before accepting the story they were handed.  He had a history more consistent with another viral infection and was admitted for two days.  His mother has AIDS but he is unaffected.  Please pray for Joshua.

Please note again that funds may be sent to the “Needy Children’s Fund” to help these sick and very precious babies.

 

Please include “Gessner/Kijabe Needy Children Fund” on the memo line

Checks should be mailed to:

Bay Leaf Baptist Church

12200 Bayleaf Church Rd.

Raleigh NC 27614

USA