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