17 October 2010

Dear Friends,

Habari. So much has happened since the last update from Kijabe. The President, Mwai Kibaki, dedicated the new operating room suite at Kijabe Hospital on Friday, 8 October. Our hospital was given 4 days notice that he would attend, so in that time, the hospital was painted inside and out, the road from the highway was repaved, new curtains were hung in the wards, all the hedges and gardens were trimmed! We should have him visit more often. The hospital employees were so proud—at the ceremony the Maasai murans (warriors) danced, there was a brass band that curiously played The Star Spangled Banner along with God Save the Queen and the Kenyan anthem, and there were many speeches. I missed the dancing because ALL of the nursing staff left the wards to see the spectacle—leaving the patients with no staff. Ah, things are different here….

I am struck with the fluidity of things…time, dates, spelling, rules. Time is an approximation; if one starts rounds at 0630, that really means sometime between 0640 and 0715. Leland and I joke that church has a rolling start here—although the published “start” time is 0830, things are really underway in earnest by about 0850. Birthdays: in the US, one of the patient identifiers is the birthdate. In Kenya, most Muslim children have a birthdate of January 1 of the year in which they were born. Non-Muslim children may have a recorded birthdate that is somewhere in the month in which they were born—but that date may differ on successive admissions. Names also are fluid—sometimes Stacy is spelled Steicy, Josaphat morphs to Josphat and back again—last names also change spelling from day to day (Muthamni becomes Mutharimi)—making sure what patient is being discussed can be challenging. The nurses also switch patients from bed to bed—so that one day bed 71 is Maxwel, but later that day it is Hosea—Maxwel is now in Hosea’s former bed 81. If you are confused, imagine how we feel making rounds—especially when the staff insists on using only the bed number as the identifier—not the patient’s name. Rules: although there are traffic lights that turn red and green (only in Nairobi), no one pays the least bit of attention; if you see an opening you take it—or someone else will. On our death-defying drive to Nairobi yesterday we were a bit taken back when, on a divided 4 lane highway, we swerved violently to avoid a head-on collision with a matatu (almost always a Toyota van that carries people from town to town) driving in the wrong direction. On the way home, a huge traffic jam caused us to follow everyone else to the other side of the median barrier, so all four lanes were traveling in the outbound direction. It worked surprisingly well until we met the traffic headed toward Nairobi. I’m actually not entirely sure how we got out of that mess, but I do remember it involved frantic arm waving and driving over curbs.

I’ve wanted to share with you more about the children and moms here. You cannot imagine how dearly these children are loved by their moms. Despite having very damaged babies with devastating neurological problems, these moms play with, sing to, kiss, caress, and really delight in their babies. We have an annex with two large rooms containing 19 cots—the moms and babies sleep together (no Kenyan mom would think of using a crib). Although most of the children have had surgery, there is surprisingly little crying—if the baby fusses, he/she is nursed immediately. When a mom needs to use the toilet, another mom watches her baby—in fact, the older children in the ward, if not too sick, play with the younger ones. All the moms talk together and provide support to each other—it is quite different from the US where we are so concerned about privacy and confidentiality. I’m not sure but I think this system works better—at least in providing mutual support. I wish you could hear the moms sing; the chaplain, Mercy Nganga, led the moms in singing the other day—they broke into harmony; the beauty of it brought tears to my eyes.

We do find that we need to get away from Kijabe weekly for a few hours—last week we drove to Naivasha, seeing Maasai herding their cows and goats along the highway. Once there, we had lunch outside and then walked to the edge of the lake—where we saw a bird standing on a rock—which ascended until ears and eye were visible. Then a little farther out along the shore, we saw a group baptism with the hippo submerged about 50 yards away. Gives the term “trusting in Jesus” a new slant.

Kenya is also a study in contrasts—the almost indescribable beauty from the ridge at 8000 ft overlooking the Great Rift Valley with the volcano crater, Mt Longonot in the distance in a blue haze, the rich terra cotta color of the earth, the jacaranda trees covered in periwinkle blue blossoms…the abject poverty of the rural people living amid trash and scraps of plastic bags fluttering in the wind, the donkeys grazing by the highway (giving literal meaning to the term “being at the end of one’s rope”), the tin roofed shacks advertising Blessings Butchery, Susan’s Saloon, God’s Promise Tailoring and Beauty Shop, Gichiengo Omuja Hotel and Butchery, the men pulling carts heavily laden with 10 gallon water containers, women carrying huge bundles of wood on their backs, men handshaping the building stones for the new construction here at the hospital complex.

Some short stories:

Each patient, before surgery, is led in prayer by a surgical team member—sometimes Leland, sometimes Mary, the nurse anesthetist. On Friday, a 14 year old Muslim girl was ready to be put asleep for surgery and she agreed to a prayer. After Mary had prayed, the girl asked, “Why do you pray to your father?”

I traveled to Embu for a mobile clinic, a 3 hour drive (4.5 hour return—turns out Kenyan nurses like to shop too—though this was no mall; who knew people could get such joy out of vegetable shopping?). There I saw a 3 month old girl with a temperature of 42.9 C(it equals 109 F). She was limp, rolling her eyes. She had an unrepaired myelomeningocele and most likely end-stage meningitis. I felt quite helpless—her mother hadn’t money to take her earlier for care, and she would not survive a trip to Kijabe. I doubt she lived through the night.

We saw one boy in clinic—a 12 year old with a complex spinal deformity. Leland needed an MRI to safely plan surgery, and his mom agreed to get one. Fortunately she told a nurse that before she could pay for the MRI, she would have to sell her only goat. We were able to arrange for BKKH to pay for the scan out of the fund we established for just that reason.

We continue to be humbled, challenged, stretched, molded by our days here. We ask for your prayers that God will be glorified through the work of our minds and hands, that He will guide us each moment and give us wisdom, patience, cheerfulness, graciousness in our relationships with staff and patients.

Take care, God bless.

Susan and Leland