We left Tumaini today and said a quick goodbye to some of our friends. Fortunately we will stop back by on Friday to pick up a suitcase and deliver some gifts. We were sad to leave but I honestly don't think our stomachs could handle it much longer:(.....we think the e coli had started to set in. We are definitely giving our thanks to God for helping us stick it out as long as we did. The pure lack of sanitation is great for the kids' digestive tracts but not good for our weak American stomachs! Bleach, paper towels, or even a little antibacterial soap do not exist in much of Kenya.
A huge thank you to all who donated baby clothes for the infants. The "mums" were thrilled and just amazed.....speechless is probably the best word. They usually inventory all of the items but when we got them out of the suitcase, they just labeled them as "50kgs of baby clothes" so too many to count! Thank you, thank you, thank you!!!! They picked out outfits for the babies that are currently there and they were all jackets. While we were sweating the babies were in full sleepers and now the winter jackets as this is the start of their "cold" season:).....I guess temperature is all relative. They are going to break ground on the Baby Rescue Center after the rains stop and will be able to adopt from there. The clothes will really go to good use and we saw first hand how precious clothes are here - they really take good care of them.
So now we are back to being tourists and are in Lake Nakuru for the night. For the first time in over a week, our tummies feel full. I can honestly say I have never appreciated chicken, fruit, vegetables, and cheese as much as I did today. Looking at a plate of food that has variety has a whole new meaning....and I say that with complete pleasure. I hope and pray to God that I will not forget what I have seen and what it means to go to bed at night with a full stomach. Guilt continues to be the theme of the trip once we go back to being tourists.
We so appreciate having the opportunity to be on this trip and spend time with our new Kenyan friends. Despite the color of our skin (though I wished I could have changed daily), everyone at Tumaini welcomed us like family. Even during the last few days, the older kids started to talk to us about where they had come from, what Tumaini meant to them, and where their parents have gone. I have no idea what they must feel in their heart and think in their minds. My mom and I are just swimming with ideas of how we can help more and really want to make this place a part of our lives.
Tomorrow we are off to the Masai Mara to see some wildlife. We did see a white rhino today which was awesome! Again, we are very safe and feeling better....many thanks to the makers of Cipro.
We love you all and pray that you are safe, happy, healthy, and going to bed with a full stomach. We look forward to seeing or hearing your voices when we return home. Much love from Kenya, Em
Monday, April 13, 2009
Thursday, April 9, 2009
Hi from Tumaini!
Hello friends and family!
My mom and I are doing just fabulous!!!! We have been at Tumaini Orphanage in Kikuyu since Sunday and we have made lots of new friends. We have had a variety of jobs....playing with the kids, washing dishes in the kitchen, leading a bible study, jumping rope (this was Dianne), clearing a field out at the farm, and trying to teach songs in English.
The kids are amazing!!! There are 53 in total ranging from 2 months old to 19 years. They all have of a different story but nonetheless they are well fed and very well loved. The toddlers just maul us every morning when they see us. They fight over our hair and try to braid it. They are all so sweet and even take great care of one another. We are surviving off of chai tea (where we get our calories), ugali, and githeri - all authentic, cheap African food. No meat for us!! Our health is fine so far which is amazing as the same towels that are used to wipe the floor and handle raw meat are used to dry the dishes. Dianne is struggling with this:). Fortunately, I am the "dirty" one in the Ferrell family so whatever:).
We are staying at the orphanage with the kids in a small storage room with our own bathroom. No mirror though so fortunately we cannot see how rough we look. There are ants everywhere and they have gotten into our food and we are not wanting to touch our sheets, but after yesterday we are staying at the ritz!
Yesterday, we went to the second larget slum in Nairobi called Mathare.....sewage running in the streets and just starving people. We went with a PNP who graduated from Vandy and she and I saw the patients. I treated a couple of ear infections and referred for HIV testing as some had cardinal signs of AIDS. My mom weighed the kids with the social worker and gave out half of a peanut butter sandwich to each. There were kids coming off of the streets so I think we gave out a lot more. At the end the kids started fighting with each other and somehow I was left with the last bag of sandwiches. I was surrounded by about 20 starving kids that were hitting each other and sticking their hands out for the food. It was nothing like anything I have ever experienced. I had to be in my "nurse role" to keep it together but we just wanted to sob. I cannot even describe the amount of guilt we feel now for all of the worthless things we have bought over the years and for being born into the families we were born into...undeservingly. I have no desire to go back to the life I lived before and hope to be permanently changed. The phrase "there are starving children in Africa" has a whole new meaning.
Well, we have to get off the computer which is the social worker's at Tumaini. We miss everyone back home and appreciate all of your prayers. We are safe and can really feel the presence of God with us and the children. Love from Kikuyu, Em & Dianne
My mom and I are doing just fabulous!!!! We have been at Tumaini Orphanage in Kikuyu since Sunday and we have made lots of new friends. We have had a variety of jobs....playing with the kids, washing dishes in the kitchen, leading a bible study, jumping rope (this was Dianne), clearing a field out at the farm, and trying to teach songs in English.
The kids are amazing!!! There are 53 in total ranging from 2 months old to 19 years. They all have of a different story but nonetheless they are well fed and very well loved. The toddlers just maul us every morning when they see us. They fight over our hair and try to braid it. They are all so sweet and even take great care of one another. We are surviving off of chai tea (where we get our calories), ugali, and githeri - all authentic, cheap African food. No meat for us!! Our health is fine so far which is amazing as the same towels that are used to wipe the floor and handle raw meat are used to dry the dishes. Dianne is struggling with this:). Fortunately, I am the "dirty" one in the Ferrell family so whatever:).
We are staying at the orphanage with the kids in a small storage room with our own bathroom. No mirror though so fortunately we cannot see how rough we look. There are ants everywhere and they have gotten into our food and we are not wanting to touch our sheets, but after yesterday we are staying at the ritz!
Yesterday, we went to the second larget slum in Nairobi called Mathare.....sewage running in the streets and just starving people. We went with a PNP who graduated from Vandy and she and I saw the patients. I treated a couple of ear infections and referred for HIV testing as some had cardinal signs of AIDS. My mom weighed the kids with the social worker and gave out half of a peanut butter sandwich to each. There were kids coming off of the streets so I think we gave out a lot more. At the end the kids started fighting with each other and somehow I was left with the last bag of sandwiches. I was surrounded by about 20 starving kids that were hitting each other and sticking their hands out for the food. It was nothing like anything I have ever experienced. I had to be in my "nurse role" to keep it together but we just wanted to sob. I cannot even describe the amount of guilt we feel now for all of the worthless things we have bought over the years and for being born into the families we were born into...undeservingly. I have no desire to go back to the life I lived before and hope to be permanently changed. The phrase "there are starving children in Africa" has a whole new meaning.
Well, we have to get off the computer which is the social worker's at Tumaini. We miss everyone back home and appreciate all of your prayers. We are safe and can really feel the presence of God with us and the children. Love from Kikuyu, Em & Dianne
Wednesday, April 8, 2009
EM Update
I spoke with emily this morning (evening fo her)...She and her mother went to one of the two Slums in Niarobi. She said it was the worst living environment she had ever seen (including Slum-dog Millionaire) and asked me to blog an update. They were accompanied by a bodyguard.
That's all I got. She wanted me to relay that they are safe, healthy, comfortable, and eagerly awaiting the upcoming week.
I am also including another picture, as I think they are neat.
Tuesday, April 7, 2009
State-Side
So I'm back. A could outline in excrutiating detail the trip, from Niarobi to London, then onto Chicago and Nashville...(and the hardest thing in my short married life-leaving your wife in a foreign country with no knowledge of her reunion with her mother and with a 24yo guy that you just met (although he was comforting). Babel (the movie) was going through my mind. So long story short, the sattelite air-phone was a nice option, so I exercised it. Cost: 15 dollars a minute. Hearing your wife's voice and confirming her well being with her mother: priceless.
Fun point of travel: despite alerting B of A of our overseas travel plans, they still locked my debit card. AND AT&T wont allow international calling capabilities unitl your contract is at least 6month of age...(mine was 5mo-so I made sure it was working when I return).
I called Paul (Em's dad and Dianne's husband) and gave him the update. Em and I talk every morning (got up at 04:00 this morning-trending in the right direction). She and her mom are doing great (I will say only this: 2 attractive blond women in a orphanage with 32 children-most of them having never seen someone of their genetic make-up-and the accomodations are not what they were anywhere we stayed before). I'll let her blog when she can...
Working yesterday all day till 18:30 wasn't fun. Missed the NCAA Championship Game (slept through it).
And I am posting a picture...now that we are wireless again...
Saturday, April 4, 2009
Peru Connection
Wow. My wife writes alot. She loves to tell stories. Mine are a little more succinct. While we went to Peru, we met a Kenyan Anesthesiologist named Zipporah. She lives in Nairobi. We met her at the hotel we are staying at (key summary point about Kenya: the demographic spectrum is the most extreme we have ever seen-people living in houses made of cow poop in the Masai Mara and everywhere else emily went vs. the 5 star accomodations (from US and European standards) in the hotel we spent the day at today before my departure. Feeling Guilty was the theme of the day.
Zipporah took us to dinner (funny enough the same resturant Dr. Newton suggested we dine at during our one free evening). We joined her husband and two children (4 and 6 yo) for dinner (it was Zipporah's birthday). The kids enjoyed the sifari pictures and oddly enough they were fascinated with my beard and arm hair(the youngest loved to touch it), much to the dismay of my wife.
Em's mom is on a plane bound for Kenya today, Gerald (the SP driver-all of 24yo-but thinks we as a couple are young as he has never seen such a young doctor come here) is picking us up at 20:15 ( 3 hours away). So Em and I are going to dinner and saying goodbye for the next two weeks.
So no more blog activity from us today. I'm taking the computer to aid with board prep, so I'll blog some when I return. Em has a local cell phone with local and international service, some newly acquired money, and the knife stocksick gave me as a groomsmans gift (for protection). With Gerald, Dr. Newton, Sue, and the rest of our new friends watching over her, she'll be fine. Better than working in Nashville studying for oral boards.
Em is lobbying for some blog time and telling me what to write now. She wants me to add that she may have the ability to blog when she is on her second safari with her mom the latter part of next week.
Zipporah took us to dinner (funny enough the same resturant Dr. Newton suggested we dine at during our one free evening). We joined her husband and two children (4 and 6 yo) for dinner (it was Zipporah's birthday). The kids enjoyed the sifari pictures and oddly enough they were fascinated with my beard and arm hair(the youngest loved to touch it), much to the dismay of my wife.
Em's mom is on a plane bound for Kenya today, Gerald (the SP driver-all of 24yo-but thinks we as a couple are young as he has never seen such a young doctor come here) is picking us up at 20:15 ( 3 hours away). So Em and I are going to dinner and saying goodbye for the next two weeks.
So no more blog activity from us today. I'm taking the computer to aid with board prep, so I'll blog some when I return. Em has a local cell phone with local and international service, some newly acquired money, and the knife stocksick gave me as a groomsmans gift (for protection). With Gerald, Dr. Newton, Sue, and the rest of our new friends watching over her, she'll be fine. Better than working in Nashville studying for oral boards.
Em is lobbying for some blog time and telling me what to write now. She wants me to add that she may have the ability to blog when she is on her second safari with her mom the latter part of next week.
Day trip to the Spina Bifida/Hydrocephalus clinic
Thursday, I had the privilege of tagging only with a peds team to Nyahururu - a town NE of Kijabe. I did not really know who would be going and in what mode of transportation, but I was not expecting to be the only non-Kenyan person....however, I was:).
I was picked up at 6am by a paid driver in his small personal car, Gilbert (social worker from Kijabe), and Jan (a Kenyan nurse on the peds ward). We then drove up the mountain above Kijabe and picked up Mary, another nurse from the peds ward. Thanks to my brothers, I am very used to the back middle seat with my knees pressed together:). I was told the drive would be about an hour and it really was almost 3....this is very Kenyan. Oh, I forgot to mention that I am always early here as well. Driving in Kenyan or riding is a car is pretty scary...there are no lanes really and they have these crazy road blocks with spikes and really high speed bumps without markings.
Once we arrived in Nyahururu, we ate breakfast at a cafe which is kindly paid for by the hospital fund. I had eggs, toast, and a bottled water for about a $1.25. The group spoke swahili the whole time unless the questions were directed towards me.
The clinic was held inside of a nice building run by a Catholic Ministry (if it were not for Christian organizations many of these services would never be offered!) which catered to street kids, substance abuse, HIV tx, and disabled individuals by providing housing and work opportunities. We were located in the "physical therapy gym" and laid out all of the patient paperwork and charts to start seeing patients. Many of the patients were there for a follow-up visit following spina bidida repair or shunt placement as these clinics are set up over a years time all over Kenya by Bethany Kids so families told have to travel the distance to Kijabe. However, there were new patients which was where it got interesting.
The two most interesting ones I saw were:
An emaciated 10 mo male was the first patient with his mom who was also malnourished. He was covered with tons of dirty blankets and when I uncovered to look at his back I saw a very large, unrepaired myelomeningocele that also had a fungal infection on the sac. Wow! - I have never seen this in a child this old as in the states it is repaired in utero now or shortly after birth. This patient had never had any real health care. When I did the exam, it was clear that the infant was flaccid from the waist down and had a neurogenic bladder. My goodness. The mom did not understand the condition and still had hope that her child would walk someday. Jan did a really good explaining this to her in Swahili. She told the mom that she needed to be honest with her so the mom could begin to adjust to the reality of the situation and get involved in a support group. There were definitely tears and this was a blunt conversation (so different from the way we often sugar coat things in the US and well as don't speak in absolutes in order to avoid lawsuits), but hopefully the mom can make the transition. Gilbert set her up with a transfer to Kijabe on Sunday so the child could have surgery next week.
- the sad thing about it is Jan said the dad might divorce the mom or may not even approve of her seeking medical care. There is so much stigma here with disabilities and many of these babies are abandoned. Many of the tribes believe this would be a curse and/or use some form of witch craft/alternative tx for the child, which may do more harm in the end.
The other shocking patient, was a 6 week old whose mom had noticed an increase in head size for about 3 weeks. She went to a local hospital where she was told to go to Kijabe but the family could not afford the transporation. The body of the child was teeny but when I measured the head it was 51cm! Average size for HC at 6weeks is about 35cm and my HC is 58cm as an adult (and I have a large head). This child was sick and needed to have a decrease in ICP! The nurses here are trained to perform a tap of the fontanel and it would have been extremely helpful. The child had been vomiting for a week and only able to eat about 4 times per day. The father did not approve of the mom being there so Gilbert told her to not go back home as he would not allow her to go to Kijabe. She also has six kids at home and is a farmer (many of the women are farmers -a very small operation). The Catholic organization was able to pay for the transportation and she went straight to the hospital.
I saw the infant on Friday in the OR holding area and he was waiting to have a shunt placed. However, this child will never be okay and it will likely not be good for the family.
We gave out lots of folic acid and I walked around in the waiting area giving all of the kids Vitamin A drops. It was incredible.
The hospital treated me to a late lunch which consisted of a whole fish with the head still on:) and chips (french fries) for about $2.75 which was the most expensive item on the menu.
I was unsure whether we would make it home as we had to push the car at one point and traffic was crazy! I got back at 7:20pm and said goodbye to my new Kenyan friends. It was so nice that they let me come along.....as they were probably thinking who is this young looking white girl from America when they first picked me up:).
I have a new passion in my nursing profession.....teaching moms about spina bifida in Africa and giving out folic acid. We have talked to many of the US docs here and it is interesting to see their opinions on funding that is given to Africa. Huge sums of money are given for HIV meds and they say this is good, but they would like to see more money go to prevention programs and to patients who they deem "have a chance of life and are not terminal." Hopefully, I can make this possible some day and really raise some funds to help prevent spina bifida.
Once I got home, Jas and I rushed over to Anne and Robert Mulwa's house for dinner - Anne is the pediatric tutor I have been working with and Robert is a nurse in the peds orthopedic department. The authentic African food was great (Anne knew I did not eat beef) and it was so fun to talk about life in Kenya from a young couples perspective. At the end, we decided that in the US or in Kenya, married couples have the same ups and downs. We hope that they will visit us in the US someday or we will see them when we return to Kijabe.
Friday is our last day in Kijabe and we will head to Nairobi for Jason to fly home:(. I don't think he is ready to go or to leave me! It has been an amazing trip and we have really grown together as a couple. Thank you for following our blog - I am hoping to post some more but I don't think there is wi-fi at the orphanage as there is not hot water.
Much love, Em
I was picked up at 6am by a paid driver in his small personal car, Gilbert (social worker from Kijabe), and Jan (a Kenyan nurse on the peds ward). We then drove up the mountain above Kijabe and picked up Mary, another nurse from the peds ward. Thanks to my brothers, I am very used to the back middle seat with my knees pressed together:). I was told the drive would be about an hour and it really was almost 3....this is very Kenyan. Oh, I forgot to mention that I am always early here as well. Driving in Kenyan or riding is a car is pretty scary...there are no lanes really and they have these crazy road blocks with spikes and really high speed bumps without markings.
Once we arrived in Nyahururu, we ate breakfast at a cafe which is kindly paid for by the hospital fund. I had eggs, toast, and a bottled water for about a $1.25. The group spoke swahili the whole time unless the questions were directed towards me.
The clinic was held inside of a nice building run by a Catholic Ministry (if it were not for Christian organizations many of these services would never be offered!) which catered to street kids, substance abuse, HIV tx, and disabled individuals by providing housing and work opportunities. We were located in the "physical therapy gym" and laid out all of the patient paperwork and charts to start seeing patients. Many of the patients were there for a follow-up visit following spina bidida repair or shunt placement as these clinics are set up over a years time all over Kenya by Bethany Kids so families told have to travel the distance to Kijabe. However, there were new patients which was where it got interesting.
The two most interesting ones I saw were:
An emaciated 10 mo male was the first patient with his mom who was also malnourished. He was covered with tons of dirty blankets and when I uncovered to look at his back I saw a very large, unrepaired myelomeningocele that also had a fungal infection on the sac. Wow! - I have never seen this in a child this old as in the states it is repaired in utero now or shortly after birth. This patient had never had any real health care. When I did the exam, it was clear that the infant was flaccid from the waist down and had a neurogenic bladder. My goodness. The mom did not understand the condition and still had hope that her child would walk someday. Jan did a really good explaining this to her in Swahili. She told the mom that she needed to be honest with her so the mom could begin to adjust to the reality of the situation and get involved in a support group. There were definitely tears and this was a blunt conversation (so different from the way we often sugar coat things in the US and well as don't speak in absolutes in order to avoid lawsuits), but hopefully the mom can make the transition. Gilbert set her up with a transfer to Kijabe on Sunday so the child could have surgery next week.
- the sad thing about it is Jan said the dad might divorce the mom or may not even approve of her seeking medical care. There is so much stigma here with disabilities and many of these babies are abandoned. Many of the tribes believe this would be a curse and/or use some form of witch craft/alternative tx for the child, which may do more harm in the end.
The other shocking patient, was a 6 week old whose mom had noticed an increase in head size for about 3 weeks. She went to a local hospital where she was told to go to Kijabe but the family could not afford the transporation. The body of the child was teeny but when I measured the head it was 51cm! Average size for HC at 6weeks is about 35cm and my HC is 58cm as an adult (and I have a large head). This child was sick and needed to have a decrease in ICP! The nurses here are trained to perform a tap of the fontanel and it would have been extremely helpful. The child had been vomiting for a week and only able to eat about 4 times per day. The father did not approve of the mom being there so Gilbert told her to not go back home as he would not allow her to go to Kijabe. She also has six kids at home and is a farmer (many of the women are farmers -a very small operation). The Catholic organization was able to pay for the transportation and she went straight to the hospital.
I saw the infant on Friday in the OR holding area and he was waiting to have a shunt placed. However, this child will never be okay and it will likely not be good for the family.
We gave out lots of folic acid and I walked around in the waiting area giving all of the kids Vitamin A drops. It was incredible.
The hospital treated me to a late lunch which consisted of a whole fish with the head still on:) and chips (french fries) for about $2.75 which was the most expensive item on the menu.
I was unsure whether we would make it home as we had to push the car at one point and traffic was crazy! I got back at 7:20pm and said goodbye to my new Kenyan friends. It was so nice that they let me come along.....as they were probably thinking who is this young looking white girl from America when they first picked me up:).
I have a new passion in my nursing profession.....teaching moms about spina bifida in Africa and giving out folic acid. We have talked to many of the US docs here and it is interesting to see their opinions on funding that is given to Africa. Huge sums of money are given for HIV meds and they say this is good, but they would like to see more money go to prevention programs and to patients who they deem "have a chance of life and are not terminal." Hopefully, I can make this possible some day and really raise some funds to help prevent spina bifida.
Once I got home, Jas and I rushed over to Anne and Robert Mulwa's house for dinner - Anne is the pediatric tutor I have been working with and Robert is a nurse in the peds orthopedic department. The authentic African food was great (Anne knew I did not eat beef) and it was so fun to talk about life in Kenya from a young couples perspective. At the end, we decided that in the US or in Kenya, married couples have the same ups and downs. We hope that they will visit us in the US someday or we will see them when we return to Kijabe.
Friday is our last day in Kijabe and we will head to Nairobi for Jason to fly home:(. I don't think he is ready to go or to leave me! It has been an amazing trip and we have really grown together as a couple. Thank you for following our blog - I am hoping to post some more but I don't think there is wi-fi at the orphanage as there is not hot water.
Much love, Em
Friday, April 3, 2009
The Peds Ward
Wednesday I spent the day on the peds ward with Dr. Fink (a pediatrician from Memphis), Bob (the clinical officer on the ward who functions like a PA), and one of the Kenyan residents. It was extremely interesting seeing the pathology of the patients admitted, how they are treated based on cost and what drugs are accessible, and really how long people go here before seeking treatment. Surprisingly, there is not much difference between here and home, so I surprisingly felt competent with how to treat some of the ailments. We don't have the tropical diseases fortunately though!
Here is a breakdown of some of the patients I saw:
10 yo male with a history of bloody diarrhea for a week, significant dehydration, as well as a reported weight loss of 10kg over the past month. HIV and malaria tests were negative (not that reliable I heard though) and likely had salmonella. The team came to the conclusion that the report from mom was likely exaggerated. Man though, it did not look like fun being a kid hospitalized for diarrhea as they have to lie on trash bags:(.
11 yo female with a history of shortness of breath and cough for a week. Her CBC revealed pancytopenia and they were trying to rule out aplastic anemia versus leukemia. I was able to assist with the bone marrow aspiration - uhh, not at all like it is done in the States. We gave ketamine and the some of the instruments were half missing. It was very make-shift and it was interesting to see that I was the only one who spoke to the child...definitely no child life services here!
9 mo old male from Somalia who was developing well until he started having a high fever and seizures. His mother took him to a hospital in Somalia where he was diagnosed with meningitis and treated with Streptomycin...which would not do anything for him. He continued to have seizures lasting up to one hour and 15 times per day. After about a week of this, the mom came to Kenya illegally where his antibiotics were switched to effective ones and he is now being fed through an ng tube and is neurologically devastated. Gtubes and nissens are not done here so this child will likely die from either aspiration pneumonia by the family trying to feed by mouth or replacing the tube incorrectly. The family is unable to return to Somalia so now the mom and baby will likely live in the slums of Nairobi where there is a large Somalian population (about 2 million people out of 5-6 million total live in the slums in Nairobi).
9 yo female with a history of right eye swelling and then developed fever and neck stiffness. She had meningitis and was doing very well on day 10 of 14 for antibiotic therapy.
3 yo male with a history of recurrent seizures for the past 8 months who was being treated for malaria - every child coming in with convulsions or history of seems to get treated for malaria. His aunt was his guardian as his parents had passed, and it was interesting to really figure out how to get him daily phenobarb as there is NO health insurance here unless you are wealthy.
12 yo male with a history of ascites and pleural effusions for several months. Jas had provided anesthesia when his lung was tapped showing exudate, which was pointing towards TB but he has not been responding to tx. A different pediatrician than the one I was with was thinking more of a cardiac pathology. The family denied any history of TB or chronic cough - but I have heard to take that as face value...kind of like when parents tell me they only smoke outside:). This poor guy was sick though and the outcome is not good.
9 yo female with a history of severe kyphosis and pectus excavatum. I don't think she had had this evaluated really before and now she has right sided heart failure and pulmonary hypertension. She had come to Kijabe satting 43% and was just sick. The ortho team decided she was not a candidate for surgery because of her heart and the pediatrician was having to translate this to the parents. They inquired about a second opinion from a cardiologist (there will not be a visiting peds cardiologist at Kijabe until July) and the transfer and evaluation in Nairobi would be about 10000+ Kenyan shillings (about $100) - this is huge for the majority of the families in Kenya as they live on about a $1 a day. It is was interesting to see the response of the parents in comparison to those in the US - this father was not angry, he was sad and wanted to know if this could have been treated earlier so he could share this information with others in his community to help treat another child with the same condition sooner. Also, I looked over the little girl and noticied she had a pressure ulcer to her right ear from the oxygen strap....unfortunately, no big deal to anyone else but me:(.
3 mo old female admitted for respiratory distress and had been to the ICU several times. She was doing great, ready to go home, and I think see honestly had RSV bronchiolitis - they are unable to isolate specific organisms here but they still have some of the same bugs.
3 yo female with a history of an abdominal mass which mom had discovered several months prior and was in fact a Wilm's tumor. She had a nephrectomy 2 weeks prior and was now in for chemo - they do follow a chemo regimen similar to CHOP. They have had 4 kids at Kijabe with leukemia in the past 3-4 years and only 1 is still living....all the rest came in so late and had every complication. This little girl was just adorable but did not like us! What amazed me the most is that she is given intravenous chemo through a peripheral IV! I asked if central lines or even PICCs were accessible would they use them and the pediatricians response was no bc the nurses would not be able to manage them and the risk of infections was just too great. The little girl was staying after her chemo because she was having vomiting and no stool....ended up going to the OR the next day due to a bowel obstruction and needed to have adhesions removed.
9 yo male with HIV and lymphoma:(...this little guy Emmanuel was just the coolest. I got to sit with him and his mom for a while before he received his chemo. He weighed nothing but was so stoic and even smiled when we started talking about playing outside. He obviously had complete alopecia and his head was covered with a fungal infection as the kids here really struggle with that anyway. The docs had to put their heads together as to when to give chemo and then add on his anti-retrovirals. He was doing amazingly well and this was his second to last burst of chemo. As expected he received his chemo through a peripheral and no thought of gloves were involved.
So in summary, these are the things I am learning:
Health care is not treated as a right here but a privilege. I am embarrassed to say that I have had the luxury of being picky when it has come to my own health care and I will really think twice before I complain about anything again.
Being in a remote area of a third world country gives you a different perspective about end of life issues. Here the supplies are so limited and they have to really evaluate who needs the supplies the most based on the likelihood of survival. In the states, all effort is made to keep someone alive even if the quality of life is drastically different. This experience has opened up some new conversations between Jas and I about these issues (probably more understanding on my side) that it is okay to let someone go when it is their time and not to not keep them alive for selfish reasons. You see here that the culture, stigma, quality of life, and financial state has such a huge impact and you are really not helping these families by intervening (going to all extremes) on a patient who will become or is already a total care/devastated patient.
Don't take antibiotics unless you need them! MRSA does not exist here, unfortunately it probably will as western medicine moves in. Despite the conditions in the OR, the infection rate is drastically less than the US and none of the operative patients are treated with prophylactic antibiotics....it is incredible to see that! They do have resistance to malaria drugs though as we have resistance to antibiotics.
I think that is plenty for now:). Hope as is well!
Here is a breakdown of some of the patients I saw:
10 yo male with a history of bloody diarrhea for a week, significant dehydration, as well as a reported weight loss of 10kg over the past month. HIV and malaria tests were negative (not that reliable I heard though) and likely had salmonella. The team came to the conclusion that the report from mom was likely exaggerated. Man though, it did not look like fun being a kid hospitalized for diarrhea as they have to lie on trash bags:(.
11 yo female with a history of shortness of breath and cough for a week. Her CBC revealed pancytopenia and they were trying to rule out aplastic anemia versus leukemia. I was able to assist with the bone marrow aspiration - uhh, not at all like it is done in the States. We gave ketamine and the some of the instruments were half missing. It was very make-shift and it was interesting to see that I was the only one who spoke to the child...definitely no child life services here!
9 mo old male from Somalia who was developing well until he started having a high fever and seizures. His mother took him to a hospital in Somalia where he was diagnosed with meningitis and treated with Streptomycin...which would not do anything for him. He continued to have seizures lasting up to one hour and 15 times per day. After about a week of this, the mom came to Kenya illegally where his antibiotics were switched to effective ones and he is now being fed through an ng tube and is neurologically devastated. Gtubes and nissens are not done here so this child will likely die from either aspiration pneumonia by the family trying to feed by mouth or replacing the tube incorrectly. The family is unable to return to Somalia so now the mom and baby will likely live in the slums of Nairobi where there is a large Somalian population (about 2 million people out of 5-6 million total live in the slums in Nairobi).
9 yo female with a history of right eye swelling and then developed fever and neck stiffness. She had meningitis and was doing very well on day 10 of 14 for antibiotic therapy.
3 yo male with a history of recurrent seizures for the past 8 months who was being treated for malaria - every child coming in with convulsions or history of seems to get treated for malaria. His aunt was his guardian as his parents had passed, and it was interesting to really figure out how to get him daily phenobarb as there is NO health insurance here unless you are wealthy.
12 yo male with a history of ascites and pleural effusions for several months. Jas had provided anesthesia when his lung was tapped showing exudate, which was pointing towards TB but he has not been responding to tx. A different pediatrician than the one I was with was thinking more of a cardiac pathology. The family denied any history of TB or chronic cough - but I have heard to take that as face value...kind of like when parents tell me they only smoke outside:). This poor guy was sick though and the outcome is not good.
9 yo female with a history of severe kyphosis and pectus excavatum. I don't think she had had this evaluated really before and now she has right sided heart failure and pulmonary hypertension. She had come to Kijabe satting 43% and was just sick. The ortho team decided she was not a candidate for surgery because of her heart and the pediatrician was having to translate this to the parents. They inquired about a second opinion from a cardiologist (there will not be a visiting peds cardiologist at Kijabe until July) and the transfer and evaluation in Nairobi would be about 10000+ Kenyan shillings (about $100) - this is huge for the majority of the families in Kenya as they live on about a $1 a day. It is was interesting to see the response of the parents in comparison to those in the US - this father was not angry, he was sad and wanted to know if this could have been treated earlier so he could share this information with others in his community to help treat another child with the same condition sooner. Also, I looked over the little girl and noticied she had a pressure ulcer to her right ear from the oxygen strap....unfortunately, no big deal to anyone else but me:(.
3 mo old female admitted for respiratory distress and had been to the ICU several times. She was doing great, ready to go home, and I think see honestly had RSV bronchiolitis - they are unable to isolate specific organisms here but they still have some of the same bugs.
3 yo female with a history of an abdominal mass which mom had discovered several months prior and was in fact a Wilm's tumor. She had a nephrectomy 2 weeks prior and was now in for chemo - they do follow a chemo regimen similar to CHOP. They have had 4 kids at Kijabe with leukemia in the past 3-4 years and only 1 is still living....all the rest came in so late and had every complication. This little girl was just adorable but did not like us! What amazed me the most is that she is given intravenous chemo through a peripheral IV! I asked if central lines or even PICCs were accessible would they use them and the pediatricians response was no bc the nurses would not be able to manage them and the risk of infections was just too great. The little girl was staying after her chemo because she was having vomiting and no stool....ended up going to the OR the next day due to a bowel obstruction and needed to have adhesions removed.
9 yo male with HIV and lymphoma:(...this little guy Emmanuel was just the coolest. I got to sit with him and his mom for a while before he received his chemo. He weighed nothing but was so stoic and even smiled when we started talking about playing outside. He obviously had complete alopecia and his head was covered with a fungal infection as the kids here really struggle with that anyway. The docs had to put their heads together as to when to give chemo and then add on his anti-retrovirals. He was doing amazingly well and this was his second to last burst of chemo. As expected he received his chemo through a peripheral and no thought of gloves were involved.
So in summary, these are the things I am learning:
Health care is not treated as a right here but a privilege. I am embarrassed to say that I have had the luxury of being picky when it has come to my own health care and I will really think twice before I complain about anything again.
Being in a remote area of a third world country gives you a different perspective about end of life issues. Here the supplies are so limited and they have to really evaluate who needs the supplies the most based on the likelihood of survival. In the states, all effort is made to keep someone alive even if the quality of life is drastically different. This experience has opened up some new conversations between Jas and I about these issues (probably more understanding on my side) that it is okay to let someone go when it is their time and not to not keep them alive for selfish reasons. You see here that the culture, stigma, quality of life, and financial state has such a huge impact and you are really not helping these families by intervening (going to all extremes) on a patient who will become or is already a total care/devastated patient.
Don't take antibiotics unless you need them! MRSA does not exist here, unfortunately it probably will as western medicine moves in. Despite the conditions in the OR, the infection rate is drastically less than the US and none of the operative patients are treated with prophylactic antibiotics....it is incredible to see that! They do have resistance to malaria drugs though as we have resistance to antibiotics.
I think that is plenty for now:). Hope as is well!
Kenyan Pain Clinic
So it seems that I have unknowningly helped start the first pain clinic in Kenya. People are coming from all over (even larger metropolitan places) to Kijabe, as we are the only physicans that offer epidural steroid injections. Our treatment scope is limited (by space, resources, imaging modalities and time), but we have also started performing blind sacroiliac joint injections (not done in the US without image guidance because not reliable placement). So now we treat mostly radiculopathies, myofascial pain syndromes, and sacroiliac arthopathies.
As part of my mission, I also had the privelage to lecture to the KRNAs and student KRNAs (see earlier blog for acronym meaning). They are technically very good and are as bright as they come. I would attach a picture of the class (but internet is slow). They main topics discussed were neuromuscular blockade and local anesthetics.
We also expanded their regional anesthesia understanding. We demonstrated successful, stimulated needle axillary blocks, interscalene blocks, and lower extremity blocks including sciatic, femoral, and ankle. This may not sound like a big deal, but with perioperative mortality around 20% nationally, less is definately more. And safer. That is why 80% of surgery here at Kijabe is done under spinal (after it sets up and the block height is stable, less vigilance is required than general anesthesia). These trained KRNAs will go to rural hospitals and educate/promote safer anesthesia and surgery.
As you have probably gotten from emily's blogs, this has been an excellent experience, both personally and professionally. We have helped influence a continent and forged friendships that will last a lifetime.
As part of my mission, I also had the privelage to lecture to the KRNAs and student KRNAs (see earlier blog for acronym meaning). They are technically very good and are as bright as they come. I would attach a picture of the class (but internet is slow). They main topics discussed were neuromuscular blockade and local anesthetics.
We also expanded their regional anesthesia understanding. We demonstrated successful, stimulated needle axillary blocks, interscalene blocks, and lower extremity blocks including sciatic, femoral, and ankle. This may not sound like a big deal, but with perioperative mortality around 20% nationally, less is definately more. And safer. That is why 80% of surgery here at Kijabe is done under spinal (after it sets up and the block height is stable, less vigilance is required than general anesthesia). These trained KRNAs will go to rural hospitals and educate/promote safer anesthesia and surgery.
As you have probably gotten from emily's blogs, this has been an excellent experience, both personally and professionally. We have helped influence a continent and forged friendships that will last a lifetime.
Tuesday, March 31, 2009
Food
The situation of cooking is stil interesting but getting better. I was reassured when I spoke with Sue Newton about the first meals I cooked and she agreed that it takes time to become comfortable. Mainly because there is no longer access to a grocery store...I can buy some fruits and veggies from the local market but no milk, safe meat, or items I am familiar with:).
My family will be pleased to know that the creamed tuna fish has been brought to Kenya:). It is a Ferrell family comfort meal and sure enough one can cook it in Africa. It did not taste the same as the food additives are different here, but I was pleased with it. For example, they sell Sprite but it does not taste like Sprite and the same for everything else.
I have to write a thank you letter to South Beach and Trek Bar Company as they have been our saving grace. The protein bars have supplemented or replaced many meals for the both of us.
For lunch we have peanut butter sandwiches and/or soap, which is nice. Dinner is where the fun begins!
For those who have sent me emails asking about my belly, I am doing better now than I was the first week. I probably have lost some weight, but nothing I can't gain back when I get home:). If I was to have a flare, I know I would be able to get decent tx here from one of the US doctors. Also, when we go to the orphanage they want me to call them asap if I get into any trouble and fortunately they are familiar with my ailments unlike the African docs who have no idea what Crohn's is....I heard that there is a study here in Kenya documenting four known cases among men in the 1960s. They were linking stress to flare-ups, but these men had multiple wives and the greater the number of wives the more frequent number of flares! So if I keep my stress low and stay away from multiple husbands according to the African study I should be a-okay:).
That is all of my thoughts on food for now.....hopefully, Jas will get to try some goat meat before he leaves:). Love to all!!
Back at work in Kijabe
Hello all,
We returned from the Masai Mara on Sunday....it was about a 5 hour bumpy, dusty ride in the Newton's Land Cruiser, especially due to the drought. It was so nice that they drove us and spent the weekend with Jason, myself, and three other residents from Vanderbilt. They have five children (3 biological and two adoptive from Kenya) and it was a big splurge as they are both on missionary salaries. We had to say good-bye to our fabulous tent, hot water, and prepared food....it was funny though that Jason thought we were really going camping and staying in a "tent" in the middle of this reserve! I did not tell him that we would be sleeping in a four poster bed and be served coffee and tea every morning. I am glad I did not though as he was shocked when he saw the accomodations, but he did not bring the right clothes as he thought we were "camping." Oh, the things you come to appreciate and I hope that I don't forget this once I return to my cushion life in Nashville.
We were able to see several towns along the way as we drove through the Rift Valley. Kijabe is up the mountain from a truck stop town where prostitution and HIV is a huge problem. Also, the people everyone are just starving and are having to cut down trees for charcoal. There are absolutely no obese or even overweight people in the villages. The women work especially hard here and they are responsible for making the mud huts if they are from the Masai tribe. The men often have several wives as it is a big deal to get a woman pregnant, even if she is not your wife. I have a much better appreciation for my husband and an even greater appreciation for the family I was born into. Jason and I have joked (probably really not that funny) about how long we would have lived had we been born into a family that lives in the Rift Valley without electricity, food, clean water, or health care. We both have decided that we would have not made the cut for the survival of the fittest. Brad (my brother) and Greg (Jason's brother) might be the only ones from our family who would have made it:). It really is so interesting to see the lives of these people and how they are truely just trying to survive.
For the past two days, I have taught the nursing students about growth and development. In the US, you learn about the worst cause scenarios, but once you get into practice it is not common to see them exist. Here though, the worst case scenario is everywhere. We have spent a lot of time talking about attachment disorders mainly with those children who are living in orphanages and/or their parents have died. Also, malnutrition is everywhere and the supplemental needs of the children are different....standard to receive vitamin A. The role of the diploma nurse here (RN but does not have a bachelors degree) is much more like a nurse practitioner in the states. Because physicians are so expensive, it is much more cost effective to have a nurse run a clinic. I was a part of a lecture yesterday talking about management of fever and Ann (the peds tutor I work with) covered the malaria part. The nursing students use algorithms to determine what the management should be and for example, whether the child should be given quinine (first line tx for malaria) IM or orally or not at all because they come from a low-risk malaria region. It is tough for these students in that they are going to be exposed to so much and have to be responsible for the management of many illnesses, yet they do not have the understanding of why they are doing what they are doing as well as they don't even have textbooks! They are given paper copies of the algorithms and the textbooks are in the library....one pediatric textbook for the whole school! I looked over the neonatal resuscitation info that the nursing students are given and it basically said if you perform ventilations (bag-mask) for 20 minutes then "stop, because the baby is dead." Jason is seeing this in action in the OR as an infant was only bag-masked without any chest compressions or drugs being given until he arrived to help out. I will have to get him to write about the perspectives he is getting on the health care.
I am headed back to the hospital now to meet with the peds ward nursing director, Brenda, who is setting up a trip for me on Thursday to go to a clinic an hour away with the neurosurgeons to evaluate patients with spina bifida and hydrocephalus. Should be VERY interesting.
Love to all and hope you are doing well!
We returned from the Masai Mara on Sunday....it was about a 5 hour bumpy, dusty ride in the Newton's Land Cruiser, especially due to the drought. It was so nice that they drove us and spent the weekend with Jason, myself, and three other residents from Vanderbilt. They have five children (3 biological and two adoptive from Kenya) and it was a big splurge as they are both on missionary salaries. We had to say good-bye to our fabulous tent, hot water, and prepared food....it was funny though that Jason thought we were really going camping and staying in a "tent" in the middle of this reserve! I did not tell him that we would be sleeping in a four poster bed and be served coffee and tea every morning. I am glad I did not though as he was shocked when he saw the accomodations, but he did not bring the right clothes as he thought we were "camping." Oh, the things you come to appreciate and I hope that I don't forget this once I return to my cushion life in Nashville.
We were able to see several towns along the way as we drove through the Rift Valley. Kijabe is up the mountain from a truck stop town where prostitution and HIV is a huge problem. Also, the people everyone are just starving and are having to cut down trees for charcoal. There are absolutely no obese or even overweight people in the villages. The women work especially hard here and they are responsible for making the mud huts if they are from the Masai tribe. The men often have several wives as it is a big deal to get a woman pregnant, even if she is not your wife. I have a much better appreciation for my husband and an even greater appreciation for the family I was born into. Jason and I have joked (probably really not that funny) about how long we would have lived had we been born into a family that lives in the Rift Valley without electricity, food, clean water, or health care. We both have decided that we would have not made the cut for the survival of the fittest. Brad (my brother) and Greg (Jason's brother) might be the only ones from our family who would have made it:). It really is so interesting to see the lives of these people and how they are truely just trying to survive.
For the past two days, I have taught the nursing students about growth and development. In the US, you learn about the worst cause scenarios, but once you get into practice it is not common to see them exist. Here though, the worst case scenario is everywhere. We have spent a lot of time talking about attachment disorders mainly with those children who are living in orphanages and/or their parents have died. Also, malnutrition is everywhere and the supplemental needs of the children are different....standard to receive vitamin A. The role of the diploma nurse here (RN but does not have a bachelors degree) is much more like a nurse practitioner in the states. Because physicians are so expensive, it is much more cost effective to have a nurse run a clinic. I was a part of a lecture yesterday talking about management of fever and Ann (the peds tutor I work with) covered the malaria part. The nursing students use algorithms to determine what the management should be and for example, whether the child should be given quinine (first line tx for malaria) IM or orally or not at all because they come from a low-risk malaria region. It is tough for these students in that they are going to be exposed to so much and have to be responsible for the management of many illnesses, yet they do not have the understanding of why they are doing what they are doing as well as they don't even have textbooks! They are given paper copies of the algorithms and the textbooks are in the library....one pediatric textbook for the whole school! I looked over the neonatal resuscitation info that the nursing students are given and it basically said if you perform ventilations (bag-mask) for 20 minutes then "stop, because the baby is dead." Jason is seeing this in action in the OR as an infant was only bag-masked without any chest compressions or drugs being given until he arrived to help out. I will have to get him to write about the perspectives he is getting on the health care.
I am headed back to the hospital now to meet with the peds ward nursing director, Brenda, who is setting up a trip for me on Thursday to go to a clinic an hour away with the neurosurgeons to evaluate patients with spina bifida and hydrocephalus. Should be VERY interesting.
Love to all and hope you are doing well!
Saturday, March 28, 2009
We love safaris!!!!
Yesterday, we arrived to the Maasai Mara in the south eastern part of Kenya. It is a huge reserve with lots of animals. We are staying at the Intrepid Lodge which is like staying at the Ritz versus we have been at the Motel 6 in Kijabe for the past week. We ran out of hot water on Tuesday....so Jas and I have been extra dirty for a few days and it felt amazing to take a hot shower here last night. I can see that if you go to Africa and just stay in these lodges then you get a very warped view of life here. I am so glad we are working and really seeing the people instead of just being a tourist.
The food here is really good and last night we watched a Maasai warrior dance which Jas and I had to participate in.....I think we looked like the kids in the crowd so we were chosen.
We go on three game drives per day with our driver Raphael for about 3 hours at a time. We have seen so many different animals....zebras, elephants, giraffes (my favorite), various types of antelopes, monkeys, female and male lions, and many more. We have taken about a thousand pictures and still more to come. The most amazing part so far is that on our first trip out within about 1 hour we found 3 cheetahs under a tree resting. We stayed for a while and watched them pick out some prey (two zebras), carefully move in on the prey, patiently watch the prey, and then finally attack! Two of the cheetahs went after the child zebra and the other after the mama zebra we think to send her off. The three then tackled the zebra, one holding it's neck, one standing guarding to ward off any other predators, and one biting aggressively from the zebra's bottom. I was not sure whether to be enthusiatic as they had found something to eat or whether to just vomit. It was so intense and just incredible to watch it from start to finish. It really was agony though to watch at the end because it took so long for the zebra to die....definitely not for the weak stomachs. This morning we went back at 6:30am to see what was left over. The three cheetahs were still there and had just devoured the zebra - their bellies were so visibly full! Our guide said this was unusual because they typically do not like left overs but they are adapting to a changing environment and he thinks it is because of the hot weather and the drought. The cheetahs finally left and we saw some vultures come in. I guess it was good though that they really left little behind! Incredible though!
We head back to Kijabe for another work week tomorrow. I am going to meet Jas now since the sun is setting and the flies are attacking me. Love to you all and thank you so much for your prayers....we feel incredibly safe and secure here in Africa. xoxo em and jas
The food here is really good and last night we watched a Maasai warrior dance which Jas and I had to participate in.....I think we looked like the kids in the crowd so we were chosen.
We go on three game drives per day with our driver Raphael for about 3 hours at a time. We have seen so many different animals....zebras, elephants, giraffes (my favorite), various types of antelopes, monkeys, female and male lions, and many more. We have taken about a thousand pictures and still more to come. The most amazing part so far is that on our first trip out within about 1 hour we found 3 cheetahs under a tree resting. We stayed for a while and watched them pick out some prey (two zebras), carefully move in on the prey, patiently watch the prey, and then finally attack! Two of the cheetahs went after the child zebra and the other after the mama zebra we think to send her off. The three then tackled the zebra, one holding it's neck, one standing guarding to ward off any other predators, and one biting aggressively from the zebra's bottom. I was not sure whether to be enthusiatic as they had found something to eat or whether to just vomit. It was so intense and just incredible to watch it from start to finish. It really was agony though to watch at the end because it took so long for the zebra to die....definitely not for the weak stomachs. This morning we went back at 6:30am to see what was left over. The three cheetahs were still there and had just devoured the zebra - their bellies were so visibly full! Our guide said this was unusual because they typically do not like left overs but they are adapting to a changing environment and he thinks it is because of the hot weather and the drought. The cheetahs finally left and we saw some vultures come in. I guess it was good though that they really left little behind! Incredible though!
We head back to Kijabe for another work week tomorrow. I am going to meet Jas now since the sun is setting and the flies are attacking me. Love to you all and thank you so much for your prayers....we feel incredibly safe and secure here in Africa. xoxo em and jas
Thursday, March 26, 2009
A Day in the Life...
So got up at 06:30, off to the hopsital and into the "theater" by 07:30. All of the rooms (5) are staffed by nurse anesthetists trained by Dr. Newton (pediatric anesthesiologist, mentor and vanderbilt faculty). 80% of the primary anesthetics done are under spinal (subarachnoid block). For the medical people, we are covering dermatomes of T1-S5 (so upper abdominal surgeries). Patients are escorted to the rooms by the circulator, where the KRNA (Kenya registered nurse anesthetist), meets them and begins the monitoring and anesthetic. One thing different that the US: prayer occurs before every surgery. Days go from 07:30-17:30. Wednesday mornings prayer begins at 07:00 and ends at 08:00. The Kijabe hopsital is 150 bed hospital: covers neurosurgery (shunts and myelomeningocele closures), and general surgery (which here includes ENT, ortho, urology, etc). To give you an idea of my days since I've gotten here: I've coded 2 people (one had a non-survivable PE), anesthetized a 3 week old with VACTERL (long pneumonic-google it), treated an eclamptic (pregnant lady having seizure), and emergently fiberoptically awake intubated a patient with an anterior mediastinal mass (not many things make an anesthesiologists ears perk up-this is one of them). If he extended his head he couldn't breath, so ke kept his chin flexed next to his chest). The ICU here only has five beds, 4 ventilators, and ecompasses all specialties. So triage is important. The young man with the anterior mediastinal mass ended up having -nonHodgkin's lymphoma-so after staying intubated overnight we transfered him urgently to a goverment hospital in Niarobi for treatment (chemo/XRT). Let me say this about the drive: Thank God for Moses (our driver): He expertly navigated the dirt rodes to the main single lane highway, weaving in and out of three lanes of cars on a one lane road, and going on the round-abouts against traffic-while I was being thrown from one side of the van (or Ambulance) to the other and desperately holding on the endotracheal tube with Valerie (ICU nurse) bagged-with our RATIONED oxygen source. Monitors included my finger on the pulse and a portable O2 finger monitor. I got back approximately 13 hours later. Just had dinner- all boiled vegetables, pasta tomato sauce, and tuna from a can (yes they have that here too). We are leaving for Safari tomorrow (early in the am). I plan on lecturing next week on chronic pain (yes: they have that here too, and Kijabe is the only hospital in Kenya doing epidural steroid injections (interlaminar-no flouroscopy).
Emily had a good day also...and I'm sure she'll write about it (and probably already did). We will update the pictures as we can (internet is dial-up).
Emily had a good day also...and I'm sure she'll write about it (and probably already did). We will update the pictures as we can (internet is dial-up).
The Kijabe Nursing School
I have just returned home from a long day at the Kijabe Nursing School and I want to share what goes on there. Jas is still in the OR (he has to be exhausted) but I am hoping that I can get him to sit down and write a little about his experiences.
I started class this morning at 8:30 with the same group of students I was with on Thursday. We focused on how to perform a pediatric assessment and walked through the head-to-toe sequence. Afterwards, Anne reassured me that it was very detailed and really want she wants the students to here. I am always thinking to myself "I hope I am doing some good here and presenting the material that the principal wants me to give." The students asked a lot of questions at the end, and Anne told me that this is a very good sign that they paid attention and understood what I was teaching. They really have no textbooks individually or handouts so they must rely on memory and note taking during class....much like what it once was in the US! Afterwards, I sat down with the other tutors for chai tea (they gave me some without sugar today as they noticed that I did not drink my tea on Tuesday:). The prinicipal, Mary Muchendu came in and asked me to sit down in her office for "a chat." She spent a long time telling me about the history of the nursing school as well as the nursing infrastructure in Kenya, which does have some similarities to the US. I am currently teaching at a school that does not award a degree, but rather a diploma in nursing after 3 1/2 years of study and the students are eligible to sit for the Kenyan certifying exam to become a Registered Nurse. She was extremely proud of the new curriculum and had me look over all of the documents. She sent me home with four binders to peruse through and let me know what she thinks. She was so incredibly gracious to me and never was treated commented on how young I look! - it was a great moment.
We had a short break where I ran into two nurses from the US, one of which received her PNP from Vanderbilt in 2006! What a small world! For those reading from Vandy, she knows Terri Witherington, Renee McLeod, Margaret Anderson, etc. and many more of the instructors. Currently, she works for an organization based in Nairobi called "The Least of These" which visits orphanages in Kenya and sets of rural clinics for children. She is such a cool lady and wants me to spend a day with her next week....so I am hoping that will work out.
At 1pm I was invited to have lunch with the students and tutors, which involved standing in line, each person holding their own hodge-podge of plates, to be served out of big barrels, kind of like at a soup kitchen or a refugee camp. I kept trying to say, "oh, I already ate" but that was not working. We were served rice, tortilla, and beef stew, which was really pretty good. Everything tastes fine here it is just more of where it comes from, how it is prepared, and how it is served. I am okay so far though!
Afterwards, we went to church where there was a ceremony for the senior nursing class who is graduating tomorrow. I sat with the principal, chaplain, and medical director. I wish I knew how to video tape on my camera because all of the students were singing acapella. It was absolutely beautiful praise music in Swahili and it is indescribable to have been there in that moment. Several different people gave speeches and towards the end the prinicpal got up to speak. All of a sudden, she starts talking about this visitor who has blessed them with her time and she wants her to come up and give a speech....whooaaa! what, me! So here I am, in the middle of this remote village in Africa, being asked to give a 2-3 minute speech to the nursing school....probably about 150+ African people in the room. I am not really sure what I said....mentioned how grateful I was to be there, have the opportunity to teach, and discussed the importance of being an advocate for your patient as well as how unique our role is as nurses to care for people during their most vulnerable times in life. I think it was okay as the principal seemed pleased:)....I am glad I made it off the stage okay without falling. Some of the students came up to me afterwards wanting me to send them all of the notes and lectures I have on my computer. I love seeing this excitement and passion for nursing!
So the sun has set and Jas has still not come home. I feel guilty in that I have had another warm and cuddly day while he has been in a hot and sweaty OR which was supposed to close 2 hours ago:(. We will see what happened during his day.
Tomorrow in the afternoon we are going on a Safari for the weekend with the Newtons and three residents from Vandy. We are headed to the Masa Mara, which I know is going to be incredible. I will write more probably when we get back. Hope all is well back home and send me emails if you can to let us know how you are doing. It is so great to hear from people and be encouraged about our work here. Love to all!
I started class this morning at 8:30 with the same group of students I was with on Thursday. We focused on how to perform a pediatric assessment and walked through the head-to-toe sequence. Afterwards, Anne reassured me that it was very detailed and really want she wants the students to here. I am always thinking to myself "I hope I am doing some good here and presenting the material that the principal wants me to give." The students asked a lot of questions at the end, and Anne told me that this is a very good sign that they paid attention and understood what I was teaching. They really have no textbooks individually or handouts so they must rely on memory and note taking during class....much like what it once was in the US! Afterwards, I sat down with the other tutors for chai tea (they gave me some without sugar today as they noticed that I did not drink my tea on Tuesday:). The prinicipal, Mary Muchendu came in and asked me to sit down in her office for "a chat." She spent a long time telling me about the history of the nursing school as well as the nursing infrastructure in Kenya, which does have some similarities to the US. I am currently teaching at a school that does not award a degree, but rather a diploma in nursing after 3 1/2 years of study and the students are eligible to sit for the Kenyan certifying exam to become a Registered Nurse. She was extremely proud of the new curriculum and had me look over all of the documents. She sent me home with four binders to peruse through and let me know what she thinks. She was so incredibly gracious to me and never was treated commented on how young I look! - it was a great moment.
We had a short break where I ran into two nurses from the US, one of which received her PNP from Vanderbilt in 2006! What a small world! For those reading from Vandy, she knows Terri Witherington, Renee McLeod, Margaret Anderson, etc. and many more of the instructors. Currently, she works for an organization based in Nairobi called "The Least of These" which visits orphanages in Kenya and sets of rural clinics for children. She is such a cool lady and wants me to spend a day with her next week....so I am hoping that will work out.
At 1pm I was invited to have lunch with the students and tutors, which involved standing in line, each person holding their own hodge-podge of plates, to be served out of big barrels, kind of like at a soup kitchen or a refugee camp. I kept trying to say, "oh, I already ate" but that was not working. We were served rice, tortilla, and beef stew, which was really pretty good. Everything tastes fine here it is just more of where it comes from, how it is prepared, and how it is served. I am okay so far though!
Afterwards, we went to church where there was a ceremony for the senior nursing class who is graduating tomorrow. I sat with the principal, chaplain, and medical director. I wish I knew how to video tape on my camera because all of the students were singing acapella. It was absolutely beautiful praise music in Swahili and it is indescribable to have been there in that moment. Several different people gave speeches and towards the end the prinicpal got up to speak. All of a sudden, she starts talking about this visitor who has blessed them with her time and she wants her to come up and give a speech....whooaaa! what, me! So here I am, in the middle of this remote village in Africa, being asked to give a 2-3 minute speech to the nursing school....probably about 150+ African people in the room. I am not really sure what I said....mentioned how grateful I was to be there, have the opportunity to teach, and discussed the importance of being an advocate for your patient as well as how unique our role is as nurses to care for people during their most vulnerable times in life. I think it was okay as the principal seemed pleased:)....I am glad I made it off the stage okay without falling. Some of the students came up to me afterwards wanting me to send them all of the notes and lectures I have on my computer. I love seeing this excitement and passion for nursing!
So the sun has set and Jas has still not come home. I feel guilty in that I have had another warm and cuddly day while he has been in a hot and sweaty OR which was supposed to close 2 hours ago:(. We will see what happened during his day.
Tomorrow in the afternoon we are going on a Safari for the weekend with the Newtons and three residents from Vandy. We are headed to the Masa Mara, which I know is going to be incredible. I will write more probably when we get back. Hope all is well back home and send me emails if you can to let us know how you are doing. It is so great to hear from people and be encouraged about our work here. Love to all!
Life in Kijabe
We are using a dial-up connection that is really slow (better than nothing!) so my posts are going to be hit or miss. We are really enjoying our time here and each day presents something very new. Here is some info about our life here and the lives of our new friends:
Weather: The best comparison for weather is Tahoe in July and August. It is hot during the day with a pretty intense sun...we are only about a 45 minute drive south of the equator and we are at a 7500 elevation. At night, it does cool down and it is very windy. Everything including Jas and I are covered in dust! Kenya is currently experiencing a drought but it did rain last night for about 5 minutes....I heard the Kenyans praise God today for the rain. It was muddy since all of the road are dirt, but by the time we went to work it was not too bad. I have gotten more sun than Jas and my schedule does not keep me inside all day.
Food: We were spoiled our first two nights here as we ate with the Newtons the first night and had lasagna, fruit salad, bread, etc. The second night we ate with the ICU doctor (trained to be med-peds but going with the flow here) and his wife who is a missionary and a Physical Therapist. She made a Moroccan chicken dish and the word on the street that I am a "selective eater" had reached her. She was so nice to have all of the parts of the meal separate for me without any spice. Last night was my first night to cook....argghhhh!!! I had walked to a section in the village where the women sell fruits and vegetables on the side of the road. I made a new friend, Edita, a nurse from Canada who has lived here for five years and she was kind enough to show me the ropes. We bought a little bit from each vendor so we could spread our money around....the women are so poor. So Jas and I had boiled potatoes and carrots with pasta and marinara sauce for dinner that we had bought in Nairobi. I know you are thinking, hmmm - not so bad and really it wasn't but where the food products have been is a little iffy. We both stood in the kitchen peeling the potatoes with the knife I brought to protect my mom and I at the orphanage:) and there was just this odd smell of poop coming from everything I had purchased. Jas was not too excited about boiled potatoes & carrots, but hey, we are going to boil anything that we eat!!! There is a cholera outbreak about 40 kilometers away from our village and Edita told me oh sure, you will probably get a little giardia while you are here. We are trying to take as many precautions as possible but it is still difficult. I have been boiling drinking water every night as our supplies now that we are in a remote area are limited. Hopefully, I will say my praises everytime I cook at home for having clean water to wash my food with!
The people: The people working at the hospital are very friendly and appreciative of the medical staff that come here to volunteer. The men especially seem to be more talkative than the women. The patients and families at the hospital to me seem very quiet and somber. You would not believe how much I stand out as I walk through the courtyards. There are families lying everywhere in the grass waiting to be seen or for the family members to be discharged. I have seen a lot of HIV, polio, and TB. The hospital is filled with local Kenyans as well as Somalians as there are I think only two anesthesiologists in that country. There are no anesthesiologists in Sudan. Several groups of people from these countries have traveled here for health care and there is a very large group of Muslims here as well. I was told that about 90% of the Somalian men are addicted to a drug that is very potent, comes in the form of a leaf, and the chew on it all day. It is some sort of amphetamine and causes them to be very aggressive...they were easy to spot as they were hovering at the reception desk and wanting to be seen asap.
The peds ward: Oh, the peds ward! It is overflowing with patients. They have about 65 patients and only 4-5 nurses at a time....the director did not believe that the nurse to patient ratio where I work is 1:4. They rely so much on the mothers to care for the children. Edita (nurse from Canada) does infection control, quality control, and performs chart audits twice a year. Tomorrow morning I am giving an inservice on history & assessment to the staff at the request of the peds director, but Edita really wants me to talk about just the importance of orienting the patient to the ward and documenting 2-3 sentences on the status of the patient which needs to be done on the day of admission. We reviewed some charts and she showed me that the minimum standards are not being performed. The nurses are in such a tough spot as they have too many patients, they are stretched so thin, and do not feel the need to chart according to Edita. It will be interesting to see their reaction to me tomorrow as I cannot relate very well to the environment that they are called to work in. One can see that the patient advocacy has been lost and I was told that 6am is when most of the deaths occur among the children as they have not been monitored through the night. The physicians seem to be the only ones that assess the patients and I it takes them awhile to even get to each patient. They need more funding for staff!
There are moments that I have to stop and think "wow, we are in Africa right now. " I had one of these moments on Tuesday as I walked by myself down the dirt road to the market in the village. It is so quiet here and to just look at the Kenyan people pass me by on the road, thinking how different I look from them but how cool it is to be a part of this culture for only a short time. It is truly a blessing to be here and I hope that it is only the beginning of many trips to Africa.
Weather: The best comparison for weather is Tahoe in July and August. It is hot during the day with a pretty intense sun...we are only about a 45 minute drive south of the equator and we are at a 7500 elevation. At night, it does cool down and it is very windy. Everything including Jas and I are covered in dust! Kenya is currently experiencing a drought but it did rain last night for about 5 minutes....I heard the Kenyans praise God today for the rain. It was muddy since all of the road are dirt, but by the time we went to work it was not too bad. I have gotten more sun than Jas and my schedule does not keep me inside all day.
Food: We were spoiled our first two nights here as we ate with the Newtons the first night and had lasagna, fruit salad, bread, etc. The second night we ate with the ICU doctor (trained to be med-peds but going with the flow here) and his wife who is a missionary and a Physical Therapist. She made a Moroccan chicken dish and the word on the street that I am a "selective eater" had reached her. She was so nice to have all of the parts of the meal separate for me without any spice. Last night was my first night to cook....argghhhh!!! I had walked to a section in the village where the women sell fruits and vegetables on the side of the road. I made a new friend, Edita, a nurse from Canada who has lived here for five years and she was kind enough to show me the ropes. We bought a little bit from each vendor so we could spread our money around....the women are so poor. So Jas and I had boiled potatoes and carrots with pasta and marinara sauce for dinner that we had bought in Nairobi. I know you are thinking, hmmm - not so bad and really it wasn't but where the food products have been is a little iffy. We both stood in the kitchen peeling the potatoes with the knife I brought to protect my mom and I at the orphanage:) and there was just this odd smell of poop coming from everything I had purchased. Jas was not too excited about boiled potatoes & carrots, but hey, we are going to boil anything that we eat!!! There is a cholera outbreak about 40 kilometers away from our village and Edita told me oh sure, you will probably get a little giardia while you are here. We are trying to take as many precautions as possible but it is still difficult. I have been boiling drinking water every night as our supplies now that we are in a remote area are limited. Hopefully, I will say my praises everytime I cook at home for having clean water to wash my food with!
The people: The people working at the hospital are very friendly and appreciative of the medical staff that come here to volunteer. The men especially seem to be more talkative than the women. The patients and families at the hospital to me seem very quiet and somber. You would not believe how much I stand out as I walk through the courtyards. There are families lying everywhere in the grass waiting to be seen or for the family members to be discharged. I have seen a lot of HIV, polio, and TB. The hospital is filled with local Kenyans as well as Somalians as there are I think only two anesthesiologists in that country. There are no anesthesiologists in Sudan. Several groups of people from these countries have traveled here for health care and there is a very large group of Muslims here as well. I was told that about 90% of the Somalian men are addicted to a drug that is very potent, comes in the form of a leaf, and the chew on it all day. It is some sort of amphetamine and causes them to be very aggressive...they were easy to spot as they were hovering at the reception desk and wanting to be seen asap.
The peds ward: Oh, the peds ward! It is overflowing with patients. They have about 65 patients and only 4-5 nurses at a time....the director did not believe that the nurse to patient ratio where I work is 1:4. They rely so much on the mothers to care for the children. Edita (nurse from Canada) does infection control, quality control, and performs chart audits twice a year. Tomorrow morning I am giving an inservice on history & assessment to the staff at the request of the peds director, but Edita really wants me to talk about just the importance of orienting the patient to the ward and documenting 2-3 sentences on the status of the patient which needs to be done on the day of admission. We reviewed some charts and she showed me that the minimum standards are not being performed. The nurses are in such a tough spot as they have too many patients, they are stretched so thin, and do not feel the need to chart according to Edita. It will be interesting to see their reaction to me tomorrow as I cannot relate very well to the environment that they are called to work in. One can see that the patient advocacy has been lost and I was told that 6am is when most of the deaths occur among the children as they have not been monitored through the night. The physicians seem to be the only ones that assess the patients and I it takes them awhile to even get to each patient. They need more funding for staff!
There are moments that I have to stop and think "wow, we are in Africa right now. " I had one of these moments on Tuesday as I walked by myself down the dirt road to the market in the village. It is so quiet here and to just look at the Kenyan people pass me by on the road, thinking how different I look from them but how cool it is to be a part of this culture for only a short time. It is truly a blessing to be here and I hope that it is only the beginning of many trips to Africa.
Wednesday, March 25, 2009
First day on the job....
First day on the job....
It is currently 7:45pm on Wednesday, March 25th and we just got connected to the internet here in Kijabe!!! Kevin (Kenyan IT guy at the hospital) and I have spent several hours and phone calls on this, but we are up and running (slowly) now. Wow!....we are so spoiled with wi-fi:). I am going to write an update about our first day on the job and then post another for today.
Tuesday, March 24th
Em's 1st day on the job: Dr. Newton walked me to the Nursing School which is located at the back of the hospital property at 8:30 this morning and is pretty nice....really old building with no AC. I met with Anne Mulwa, the paediatric (British) tutor who was very excited to see me which was nice. She took me straight to my first class where I introduced myself to 35 Kenyan nursing students. They are about 18 years old and this is their second month of college...brand, spankin' new. We had some technical difficulties with my lectures but fortunately I brought my laptop and worked from there. I talked for 5 hours with a 15 minute break about Communication and How to take a Paediatric Assessment. They told me I talk too fast and needed to slow down, which stretched things out a lot more.
The students are so young, innocent, respectful, and attentive. I love my students back home and some of you might be reading this:)....but in regards to lecturing to a large group of students this was VERY enjoyable! No one was falling asleep or looking at me like they might harm me for taking time out of their day to listen to a paediatric lecture. I had so much fun talking to them and answering their questions....which were different then what I am used to. In Kenya, the people are typically very conservative and traditional. When we got to the sexual health comment, this was where the majority of the questions were. I have learned that it is very uncommon for Kenyans to get married before the age of 25ish. They typically have children soon after (I am thinking that birth control is uncommon here) so I have received many questions on why I do not have children since I have been married for almost 3 years:)....I am focusing on my career I say! In contrast, they know very little about sexual health and yet they unfortunately know a lot about HIV/AIDS. The rest of the questions focused on how to communicate with mothers who feel guilty about passing HIV onto their babies and are very angry towards the staff. I think my responses were appropriate and useful, as Anne agreed with me. During my break, I was invited to sit down with the other nursing staff...a midwife, the librarian, etc. and have some kind of tea concoction:) - come to find out it was Chai tea. I so wanted to cross my arms as to refuse drinking from the cup at the Catholic church since I thought they were giving me coffee (all I could think about was my poor belly), but fortunately it was so hot I could only take two sips and then it was time to go back to class.
I left the day feeling invigorated and excited about nursing! Anne was so appreciative and pleased with the lectures I had prepared and asked if she could use them in the nursing schools curriculum. I return home after 5 hours of talking to enjoy the hot day in Kijabe and prepare more lectures.
Jason’s first day on the job: Unfortunately, Jason’s day was not so warm and cuddling as mine was…often so typical even at home. His day in the OR went from 8am until about 5pm. He is working in a teaching capacity with the two anesthesia residents who are here for a month from Vanderbilt and with the Kenyan CRNAs. The third patient of the day had been involved in a motor vehicle accident about a week prior and sat in a hospital bed in Nairobi without being operated on. He came to Kijabe to have his fracture repaired and arrested on the table shortly after the surgery began. Jason said he was pretty frustrated as the monitors were not working and he could not get a rhythm on the patient. They shocked him and give him several doses of epi when they did discover that he was in PEA (pulseless electrical activity and a non-shockable rhythm). After 30 minutes of Jas performing ACLS he called the time of death. So when he got home that night and I asked him how his first day was, he stated “well, I had a guy die on me.” It by no means was anyone’s fault as the patient had a PE (pulmonary embolism) due to complications from his fracture, but still never easy. He had another difficult patient his first day….he went to extend the neck for intubation and met resistance. His first thought was “this guy has an anterior mediastinal mass,” which was in fact correct. He was able to still intubate using fluoroscopy but later in the day the tube came back out while the patient was being moved. Jason had to go in later that night to check on him. Needless to say, Jas had a very tiring first day and he could use some sleep!
I am going to post this one now and right some more later about life here in Kijabe. Thanks for reading!
It is currently 7:45pm on Wednesday, March 25th and we just got connected to the internet here in Kijabe!!! Kevin (Kenyan IT guy at the hospital) and I have spent several hours and phone calls on this, but we are up and running (slowly) now. Wow!....we are so spoiled with wi-fi:). I am going to write an update about our first day on the job and then post another for today.
Tuesday, March 24th
Em's 1st day on the job: Dr. Newton walked me to the Nursing School which is located at the back of the hospital property at 8:30 this morning and is pretty nice....really old building with no AC. I met with Anne Mulwa, the paediatric (British) tutor who was very excited to see me which was nice. She took me straight to my first class where I introduced myself to 35 Kenyan nursing students. They are about 18 years old and this is their second month of college...brand, spankin' new. We had some technical difficulties with my lectures but fortunately I brought my laptop and worked from there. I talked for 5 hours with a 15 minute break about Communication and How to take a Paediatric Assessment. They told me I talk too fast and needed to slow down, which stretched things out a lot more.
The students are so young, innocent, respectful, and attentive. I love my students back home and some of you might be reading this:)....but in regards to lecturing to a large group of students this was VERY enjoyable! No one was falling asleep or looking at me like they might harm me for taking time out of their day to listen to a paediatric lecture. I had so much fun talking to them and answering their questions....which were different then what I am used to. In Kenya, the people are typically very conservative and traditional. When we got to the sexual health comment, this was where the majority of the questions were. I have learned that it is very uncommon for Kenyans to get married before the age of 25ish. They typically have children soon after (I am thinking that birth control is uncommon here) so I have received many questions on why I do not have children since I have been married for almost 3 years:)....I am focusing on my career I say! In contrast, they know very little about sexual health and yet they unfortunately know a lot about HIV/AIDS. The rest of the questions focused on how to communicate with mothers who feel guilty about passing HIV onto their babies and are very angry towards the staff. I think my responses were appropriate and useful, as Anne agreed with me. During my break, I was invited to sit down with the other nursing staff...a midwife, the librarian, etc. and have some kind of tea concoction:) - come to find out it was Chai tea. I so wanted to cross my arms as to refuse drinking from the cup at the Catholic church since I thought they were giving me coffee (all I could think about was my poor belly), but fortunately it was so hot I could only take two sips and then it was time to go back to class.
I left the day feeling invigorated and excited about nursing! Anne was so appreciative and pleased with the lectures I had prepared and asked if she could use them in the nursing schools curriculum. I return home after 5 hours of talking to enjoy the hot day in Kijabe and prepare more lectures.
Jason’s first day on the job: Unfortunately, Jason’s day was not so warm and cuddling as mine was…often so typical even at home. His day in the OR went from 8am until about 5pm. He is working in a teaching capacity with the two anesthesia residents who are here for a month from Vanderbilt and with the Kenyan CRNAs. The third patient of the day had been involved in a motor vehicle accident about a week prior and sat in a hospital bed in Nairobi without being operated on. He came to Kijabe to have his fracture repaired and arrested on the table shortly after the surgery began. Jason said he was pretty frustrated as the monitors were not working and he could not get a rhythm on the patient. They shocked him and give him several doses of epi when they did discover that he was in PEA (pulseless electrical activity and a non-shockable rhythm). After 30 minutes of Jas performing ACLS he called the time of death. So when he got home that night and I asked him how his first day was, he stated “well, I had a guy die on me.” It by no means was anyone’s fault as the patient had a PE (pulmonary embolism) due to complications from his fracture, but still never easy. He had another difficult patient his first day….he went to extend the neck for intubation and met resistance. His first thought was “this guy has an anterior mediastinal mass,” which was in fact correct. He was able to still intubate using fluoroscopy but later in the day the tube came back out while the patient was being moved. Jason had to go in later that night to check on him. Needless to say, Jas had a very tiring first day and he could use some sleep!
I am going to post this one now and right some more later about life here in Kijabe. Thanks for reading!
Monday, March 23, 2009
We made it!
Hello all!
Jason and I have made it to Kijabe, Kenya! After a 30 hour trip, we made it to Nairobi last night and were picked up at the airport by Jerald (a super nice driver who works for Samaritan's Purse). We have been labeled as the "very young couple:)." I think it is all my doing though! We stayed in a guest house for missionaries owned by a group of Menonites. The sleep was restless and shockingly I was the Pope who was up at 7:30 and eat breakfast with other missionaries. Another driver from Sam Purse named Daniel took us took the local supermarket to buy 2 weeks worth of food. He directed me to the "meat" section and I found myself staring at a bag of giblets asking him "what is this?" After a stop at the lookout point looking over the Rift Valley which extends from Jordan to South Africa - absolutely beautiful, Jas was attacked by local craftsman and spent most of our cash! We were told though it will feed them for a month...so it is all good in the end. We then made it to Kijabe and settled into our apartment, which our driver was amazed at...so we are very fortunate to have such large quarters. The Newtons came over and took us on a tour of the village and then the hospital. It is incredible and will be a very interesting experience. I start teaching tomorrow on taking a pediatric history and pediatric assessment starting at 8am and Jas will be in the OR. Currently we are at the Newton's house and just finished having dinner with their family. We are off to bed now for hopefully 8 hours of sleep. Our internet will be set up tomorrow so I will send more info after our first work day.
Thank you so much for all of the emails and support!! We are so excited about this experience and appreciate all of the prayers, thoughts, and encouragement. Hope everyone is well!
Much love from Kijabe, Kenya, Jas & Em
Jason and I have made it to Kijabe, Kenya! After a 30 hour trip, we made it to Nairobi last night and were picked up at the airport by Jerald (a super nice driver who works for Samaritan's Purse). We have been labeled as the "very young couple:)." I think it is all my doing though! We stayed in a guest house for missionaries owned by a group of Menonites. The sleep was restless and shockingly I was the Pope who was up at 7:30 and eat breakfast with other missionaries. Another driver from Sam Purse named Daniel took us took the local supermarket to buy 2 weeks worth of food. He directed me to the "meat" section and I found myself staring at a bag of giblets asking him "what is this?" After a stop at the lookout point looking over the Rift Valley which extends from Jordan to South Africa - absolutely beautiful, Jas was attacked by local craftsman and spent most of our cash! We were told though it will feed them for a month...so it is all good in the end. We then made it to Kijabe and settled into our apartment, which our driver was amazed at...so we are very fortunate to have such large quarters. The Newtons came over and took us on a tour of the village and then the hospital. It is incredible and will be a very interesting experience. I start teaching tomorrow on taking a pediatric history and pediatric assessment starting at 8am and Jas will be in the OR. Currently we are at the Newton's house and just finished having dinner with their family. We are off to bed now for hopefully 8 hours of sleep. Our internet will be set up tomorrow so I will send more info after our first work day.
Thank you so much for all of the emails and support!! We are so excited about this experience and appreciate all of the prayers, thoughts, and encouragement. Hope everyone is well!
Much love from Kijabe, Kenya, Jas & Em
Friday, March 20, 2009
All packed and ready to go!
Hi family and friends,
Jason and I are actually packed and ready to head to Africa! Currently, poor Jas is on call at the VA tonight and I have not heard from him so one can assume that the night is not treating him well:(. Fortunately he has 30 hours to catch up on sleep.
We have a variety of things packed....clothes to teach in, scrubs for the hospital, safari clothes, work clothes for the orphanage, rain boots, LOTS of protein bars, peanut butter, textbooks on anesthesia, central lines, laryngoscopes, batteries, and a lot of other supplies that people have sent us to take to the hospital. We will also be meeting up with our friend Zipporah, an Anesthesiologist from Nairobi, Kenya who we worked with in Chiclayo, Peru and Jas is bringing her some pediatric medical supplies.
We will be arriving to Nairobi Sunday night and staying at a local guest house. Monday we will make a stop at a grocery store then head to Kijabe where we will meet up with the Newtons (Dr. Mark Newton is an Anesthesiologist at the Hospital and his wife Sue is a missionary). From there we will orient to the hospital and I will be meeting with Anne, the tutor at the Kijabe Nursing School to go over the schedule for the students.
I hope to keep this blog updated as much as possible and post some pictures. We so appreciate all of the support everyone has shown us in preparation for this trip and it is just overwhelming to think about how much encouragement we have received. Thank you, thank you, thank you! We are excited about this trip and look forward to sharing some stories of our experiences in Africa!
Much love, Jason & Em
Jason and I are actually packed and ready to head to Africa! Currently, poor Jas is on call at the VA tonight and I have not heard from him so one can assume that the night is not treating him well:(. Fortunately he has 30 hours to catch up on sleep.
We have a variety of things packed....clothes to teach in, scrubs for the hospital, safari clothes, work clothes for the orphanage, rain boots, LOTS of protein bars, peanut butter, textbooks on anesthesia, central lines, laryngoscopes, batteries, and a lot of other supplies that people have sent us to take to the hospital. We will also be meeting up with our friend Zipporah, an Anesthesiologist from Nairobi, Kenya who we worked with in Chiclayo, Peru and Jas is bringing her some pediatric medical supplies.
We will be arriving to Nairobi Sunday night and staying at a local guest house. Monday we will make a stop at a grocery store then head to Kijabe where we will meet up with the Newtons (Dr. Mark Newton is an Anesthesiologist at the Hospital and his wife Sue is a missionary). From there we will orient to the hospital and I will be meeting with Anne, the tutor at the Kijabe Nursing School to go over the schedule for the students.
I hope to keep this blog updated as much as possible and post some pictures. We so appreciate all of the support everyone has shown us in preparation for this trip and it is just overwhelming to think about how much encouragement we have received. Thank you, thank you, thank you! We are excited about this trip and look forward to sharing some stories of our experiences in Africa!
Much love, Jason & Em
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