29/09/2010

Dear Friends,

Karibu! It is time for an update from Kijabe.

We are learning some Swahili words. Karibu means welcome—to which the polite response is Asante (thank you). Habari means hello/how are you; in Tanzania, the response is nzuri, but in Kenya (at least in this area), one responds mzuri. I was taught the phrase/response by a Tanzanian nurse who is visiting here (and who obviously believes I need to acclimate myself better to the community)—so when I replied nzuri, the Kenyans had a good chuckle.

Our weather here is quite unlike the common “picture” of Africa. Though we are just south of the equator, our altitude (7200 feet at Kijabe) causes cool nights—blanket weather (sometimes socks as well!) The days have been partly cloudy to brilliantly sunny. What is most amazing to me here is the wind—each late afternoon as the valley cools, the wind from the highlands at the top of our ridge sweeps down to the valley. It begins as a rustling of the trees; by dusk and for a few hours afterward it strengthens until at times it has the sound of a jet engine or continuous rumbling thunder. I am reminded of I Samuel 19 when Elijah looked for God in the wind, then the earthquake, then fire, but finally heard God in the silence. Perhaps my relative deafness is a blessing. J

Leland returned to the US for Julie and Art’s wedding on September 18. He had a wonderful time with family and long-time friends (we are careful not to use the term “old” at our ages). He loved seeing both the bride and groom so obviously cherishing each other and all the people who attended. After he left Pittsburgh, he flew to South Africa for lectures in Johannesburg and Cape Town, returning to Nairobi on 23/9/2010.

The matron of the hospital, Ann Ndungu, graciously hand carried my application for my Kenyan nursing license to the Nursing Council on 23/9/2010. She met with the committee members (having formerly been a Council member herself) and pled my case. She reported to me on Monday 27/9/10 that they wanted to meet with me for an interview—on Tuesday (28/9/10)! So, Leland and I made the trip to Nairobi yesterday morning, arriving at the Council building at 09:20. I was #20 on the list for interviews. I completed another application and paid an interview fee. At 12:40, they asked that I go upstairs—where there was another waiting room full of people. A lady waiting there said she was #10 on the list (having arrived at 07:50). So, it looked pretty bleak that we would be called before they went to lunch from 12:45 to 2 pm. They break for the day at 3:30, so I was envisioning having to drive back to Kijabe and come another day. However, soon after that lady was called, they called my name; Leland came in with me as my interpreter and we had a 30 minute interview, at the end of which I was given a registration number, allowed to pay $400 USD (that, I am told, is a month’s salary for a nurse), and given another application to get my actual license (after I pay yet another fee). From what we could gather, I will not need to do any supervised bedside nursing. So, I thank all of you who prayed about this—the results certainly exceeded my expectations and met my wildest hopes. There is no doubt to me (and to the Kijabe nurses) that God’s hand directed this process.

Humphrey Okechi, the hoped for pediatric neurosurgery fellow, is a step closer to starting—his medical papers have been received and forwarded to the National medical board for review and approval. We hope that he will be able to start in late October. Having had a taste of Kenyan bureaucracy, the word “hope” is chosen carefully.

Leland has started his full operating schedule this week; most children have some variant of spina bifida—but with much more complex features and infections of the open spinal cord and/or cerebrospinal fluid as well. One 2 month old baby has a completely formed finger and remnants of toes within the folds of a large mass covering her back. She has excellent leg function however, so with the needed operation, there is some risk of loss of function.

We have a growing Somali patient population who present language barriers but also some lack of trust in the providers here. One lady claims that her child’s kidney was removed and sold for profit (the child had a burn and so had a graft of skin taken from the lower abdomen). It is sad that there is almost no way to convince her otherwise—and there is some concern about her going back and reporting her beliefs in her community.

We have eaten well so far—many vegetables! However, buying vegetables here can be an incredibly intimidating experience; one has to deal with The Vegetable Ladies. They are a group of about 10 ladies, each of whom sits behind a card table in a concrete block building in the village and sells exactly the same vegetables. Fortunately, only 5 were there the day I shopped—but one has to buy about the same amount from each lady or some will seem angry. I announced loudly when I arrived that I was “just one” that week. I bought carrots, onions, tomatoes, broccoli, cucumber, and potatoes--and when one lady couldn’t make change, she just handed me another zucchini (making 5). I said, “I’m going to turn green!”—to which they all laughed. I hope to be friendly enough with them to get their picture by the time I post the next blog. Most of their vegetables are not home-grown as we had thought; we learned that they all go to the high road on Tuesdays and Saturdays to meet the trucks from Mombassa/Nairobi. It is no wonder then that all the produce is the same.

The new operating theatres are nearing completion; a formal dedication is scheduled for 8 October. Rumor has it that either the President or Prime Minister of Kenya is expected to attend. When the new theatres open, Leland will sometimes have 2 operating rooms, so should be able to accomplish more cases with much better efficiency than can be accommodated now. Construction of our apartment building is also progressing well—we climbed up again last Saturday to measure the rooms. On our way back from Nairobi last week, we bought some living room and dining room furniture which will be made over the next month and then held until we move into the new apartment. We are thrilled with the views overlooking the Rift Valley and will be happy to move to a quieter and less dusty location within the complex.

We appreciate the responses we’ve received from many of you—and are very thankful for your prayers. I cannot explain how much it means to us to know that you are praying for us.

Take care, God bless.

Susan and Leland

Arrival in Kijabe

11/9/2010 (Kenyans use the European date configuration—it really is September)

Dear Friends,

I am not a faithful correspondent, but will attempt to improve on my past record. I wanted to share with you what has happened since our departure from Madison. It is hard to believe that we have been here just over a week.

The summer in Madison was quite hard—we worked well over 50 hour weeks every week at the hospital, then kept busy with cleaning/keeping the yard/clearing out the house in the hours we were home. Despite all of our efforts toward making the house saleable, we were not able to find either a buyer or renter for the house. We seriously misjudged on the day we left and were so grateful for the help of Deb McLeish, a dear friend and colleague at UW, who came to help drive us and our things to the airport. She ended up helping to clean out the refrigerator, wipe off the kitchen counter, run to Home Depot for more rope, and take our mail to the post office.

We left Madison on 31/8/2010 after a 50 minute delay because of a serious thunderstorm (no, Madison was not weeping for us). The departure was also somewhat complicated because the ticket agent inadvertently tore up the receipts for the 10 additional checked boxes (each just under the allowed weight of 50 pounds—our home scale is correct). It took him about 15 minutes to retrieve the pieces from the trash and tape them together. Our connection in Detroit was already tight; we did a variation on the OJ/Hertz theme and found our seats 2 minutes before they closed the doors of the plane. The flight landed in Amsterdam; once again, the connection was fairly tight, and I was pretty convinced that we would be separated from most if not all of the checked baggage (14 pieces in all).

We arrived in Nairobi around 8 pm on 1/9/2010 with ALL of our baggage. I figure that was pretty miraculous. As we came toward the customs agents, with 3 carts stacked Susan-high with baggage, a lady waved to us to come to her station. She thought she recognized Leland from previous visits and started praising God that Leland was back to do God’s work. She said, “Go take care of the children, then tell them about Jesus”. It took about a minute to get through customs, and she never even asked what was in the baggage. Since we had bought some new things as well as brought some expensive medical equipment, we had not looked forward to the customs inspection—so this was another amazing event for us. Leland doesn’t think he ever saw the woman before. We were met at the airport by John Githii, a Kenyan driver who has driven us many times before—it was so good to see his familiar face in the mass of people waiting for travelers at the airport. We spent the first 2 nights at the Mayfield House, a very welcoming and spare place where missionaries and others stay while in Nairobi. At dinner, we sat with a lady who had just brought her two older children from their home in Benin to the Rift Valley Academy (RVA) for the opening of the school year. Whenever she spoke of them, she’d tear up and hold her heart. I realized how fortunate I was to have had my kids home with me while they went to school.

During those two days, we set up an account at the Forex and exchanged US dollars for Kenyan shillings (80 Ksh = $1). We spent several hours trying to arrange phone service for my cell phone (waiting in lines graciously is a skill that will be called upon frequently over the next 3-4 years). Surprisingly, the easiest part of those two days in Nairobi was finding a car—Kamal Jabez, a man who converted to Christianity 22 years ago, arranges car leasing and purchasing for expats and missionaries. We learned quite a lot from him (and others) about buying cars in Kenya. First, if you want to buy a car that is less than 7 years old, expect to pay at least $60K (American)—to cover the cost of importing a car and all the customs/tax fees. Secondly, insurance costs about 7.5% of the purchase price/year. Kamal is able to arrange 7% with creditable insurance companies. There is lower cost insurance available, but that is through independent agents who are notoriously unreliable. Kamal brought two cars to the Mayfield House—our plan was to lease a car for a month, then buy a car. We leased a 2002 Honda CR-V—no money was exchanged, no papers were signed. He said that if we decided to keep that car, the monthly leasing fee would be waived. Kamal also applied for the taxpayer PIN number for Leland that is a necessary item for almost any sizeable transaction in Kenya.

Having been daunted by the Nairobi traffic (as well as the thought of driving on the wrong side of the road—Kenya being a former British colony), we called John Githii to lead us to the Nakumatt/Westgate Mall to do our grocery shopping before driving to Kijabe on Friday. He waited while we did our shopping (and ate a wonderful lunch on the patio of the Art Café—an Italian restaurant in the mall). Then he led us to a gas station and explained how to get to the road to Kijabe. Leland was masterful in his driving (using a driving style I’ll term cautious aggression) and we arrived in Kijabe around 4 pm on Friday 3/9/2010.

It is funny how long it took to pack our 14 suitcases/boxes/containers; it took exactly 75 minutes to unpack everything. By 6 pm, our clothes were hung in closets, our dishes were washed and placed on shelves, and the groceries were put away. Kijabe missionaries have a wonderful way of welcoming new arrivals—they supply a dinner for you in your home the first night, then a family has you to dinner the second night. Millie Bransford had us to dinner on Saturday—with homemade pizza and fruit salad. She also offered a desk and a sewing machine for me to have (not to use—to keep). We picked those up on Sunday afternoon after church.

There are two options for church here: the AIC (African Inland Church) which has an English service at 8:30 am and a Kiswahili/English service at 10:30 am) or the RVA service (not sure when it starts—we’ve always arrived too late to get a seat, so have to find out the time it starts and get there earlier). RVA does not meet the first Sunday of each month—so that Sunday, everyone goes to the AIC; Holy Communion is available that Sunday AFTER the service. Since it was the first Sunday of the month, we went to AIC for a nearly 2 hour service (including communion). The service was packed—they brought in plastic lawn chairs to set in the aisles for the overflow. As in any service, I could not hear the sermon (because of my hearing loss), but I really appreciated the singing—especially the choir’s presentation (dancing/singing to a Swahili song—with Swahili and English words projected in the front of the church).

Although Leland had planned to have meetings and establish relationships this week rather than see patients and operate, that plan was not communicated to the nursing staff who arrange patient appointments. So, there were full clinics with people who had waited months to see Dr. Albright. Needless to say, he did operate this week—and is operating this morning (Saturday) on two patients who came yesterday and need urgent operations. One is a girl who suddenly went blind 3 days ago (after having a severe headache 5 days ago) and the other is a boy with severe hydrocephalus from a large tumor in his cerebellum.

I had been led to believe that I’d have to apply for a Kenyan nursing license before I could see patients, so I waited until I could talk to the Matron (Director of Nursing). That appointment never quite got arranged, so yesterday I went down to see the nurses in OPD (outpatient department) with whom I’d worked the past 2 times I’ve been in Kijabe. Janet Otieno made a call for me; I will know Monday if I can work under Leland’s license (if so, I could start working immediately). If I have to apply for a Kenyan RN license, Leland learned from the hospital administrator that it is a 1-2 year process to obtain an RN license (not the 3-6 month ordeal I’d expected)! He also learned that his emigration papers had been applied for 3 months ago, so he can expect to receive them in the next 1-3 months. I cannot apply as his dependent until after he receives his; if I do not receive my E papers within 3 months (the time on my entrance visitor’s visa), then I have to leave the country—in fact have to leave East Africa and then reenter on another visitor’s visa. If I want to apply for emigration papers on my own, then I’d first have to obtain the Kenyan RN license (remember, that is a 1-2 year process), then apply for E papers. So, the bottom line here is that it pays to marry well.

Spiritually, it has been a meaningful week for me. It is so helpful to be removed from the distractions that inundate our days in the US. We continue to subscribe to the New York Times—which ironically enough was the source of one of the most provocative Christian books I have read recently. David Brooks (not noted for his Christian spiritual musings) wrote an editorial on 7 September about a book by David Platt, a megachurch pastor from Birmingham Alabama. Dr. Platt writes that the “American Dream” that so many in the US pursue relentlessly is completely unbiblical and antithetical to what Christ taught. Because of that editorial, I downloaded and read the book Radical: Taking Back Your Faith from the American Dream. I’d discourage anyone who wants to remain comfortable in life and faith from reading this book. However, if you want to be challenged, please read the book.

Finally, I ask for your prayers for this mission and ministry. We are surrounded by Christians here in Kijabe, both Kenyan and expat missionaries who are trying to carry out what Christ commanded: to go into the world, preach the Word, make disciples. Please pray that we will become part of a community that continues to reach out and minister to the poor, the sick, the hungry. We have been here too short a time to really know the needs; but we take on the following charge: And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him.

Take care, God bless.

Susan