Vacation

Sorry it has been awhile…the last few days were crazy and the most recent few days we have had to pay for internet. We left Tenwek last Wednesday morning and flew to Mombossa on the coast of the Indian Ocean. The beach was really amazing, and we got to relax and snorkel in the ocean. Thereafter, we have been in London for the last couple of days and have been having a nice time. I’ll post more on these trips as well as general end of the trip reflections…just wanted to give everone a quick update.

Winding down

We are over halfway through our last full week here. We will be working Monday and Tuesday and then heading to Mombossa on the coast of the Indian Ocean for two days before heading out. It’s crazy how fast things have gone. We have been getting a little sad to be leaving…this has really been a fantastic experience. We have met some amazing people, learned a ton, and really grown as a couple and as Christians. This week has been good so far overall. One patient that we discussed previously with TB meningitis that both Sara and I worked with came back by the ward to say hello today. He looked great, completely well. It is definitely gratifying to see patients that sick come back looking healthy. On the sadder side, the patient that has meningitis and possibly rabies died a couple days ago.
One slightly humorous and nearly tragic story from this week happened Sunday night (about 10 minutes after I finished blogging about what a quiet weekend it had been). I was called in that a young guy had been found in a field by his friends after drinking a ridiculous amount of alcohol. He was completely passed out and was unresponsive. His friends had the bright idea that they should revive him by pouring a ton of porridge into him (reportedly about 1/2 gallon). Clearly, being unable to swallow, at least half of that ended up in his lungs. He came in unresponsive and in serious respiratory distress. We suctioned copious amounts of this stuff from his airway and his stomach and had to put him on a mechanical ventillator. Thankfully, he woke up the next morning and was off the breathing tube later that day.
One interesting feature of the hospital is where the patients spend their time. Often, unless the patients are extremely sick, they will walk/wheel themselves outside (IV poles and everything) and sit in the sun. They will do this for multiple hours during the day. I don’t blame them, because the hospital ward is a crowded place. This is also a good indicator about when they are getting close to being well enough to go home. Everyone calls this activity “basking.” A related fact is that patients cannot go home until they pay at least a portion of their hospital bill. Sometimes we will see a discharged patient basking for the next few days while their relative gets the money. This at first seemed a little heartless but the hospital can’t stay afloat unless they get money from the patients. Tonight is my second to last call…amazing that the time has gone so fast.

On-call weekend

As you can tell from the last few posts, my titles are getting less creative…sorry. We have had a relatively uneventful weekend. I have been on call although the calls have been infrequent (as of late Sunday night). It was actually my birthday yesterday, and several people found out through facebook, so a missionary couple cooked us an amazing dinner of fried fish, potatoes and green beans. Also, another group made some cupcakes for us and we had movie night. It was a nice way to spend a birthday. Medically speaking, the weekend has so far been quiet. We admitted a patient that had meningitis (a very common problem here) but also had a dog bite from a rabid dog about two months ago (though had received the vaccine after the bite). His mental status deteriorated to the point where he required support on a ventillator, and has for the last few days. His presentation is more typical for meningitis, though it is about the right incubation period for rabies. The problem at this point is that he is not waking up…keep him in your prayers. He is 28 and his father asks me several times per day how he is doing. All I can say is that we are supporting him, there is no change, and we continue to pray for him.
One other common admission to the hospital is poisoning. Ingestion of insecticide (usually organophosphate) is the most common way to attempt suicide in this area. Thankfully, of the ones that make it to the hospital, we are usually able to save them. It is amazing there is not more depression and suicides given the extreme poverty, high rates of HIV and other illnesses, and other desparate situations. I think that depression and mental illness are severely under recognized and under treated here though. It truly is amazing the difference that is obvious in the people who know Jesus. The hope and joy that He provides really does make a palpable change in peoples’ lives. We in the U.S. often cover up how much we need Him with our facade of having everything together. If we really look deeper though, we all need peace, contentment, and purpose. I think we all realize that money, success, and even family don’t provide this ultimately. I have certainly found this only in my relationship with Christ.

Pictures

For those of you that have been unable to see our pictures from safari, here is a link.

http://www.snapfish.com/snapfish/thumbnailshare/AlbumID=1889487026/a=1466671026_1466671026/otsc=SHR/otsi=SALBlink/COBRAND_NAME=snapfish/

Mid-week

This week has been a good one so far…sorry it has been quite a few days since the last post. I have been busy putting together a lecture for the interns here on oncology. Digression…the internship program here is quite a good one. There are 16 interns, who take 3 month rotations on medicine (clearly the most important rotation), pediatrics, OB, and surgery. There are 4 on medicine now that I have really gotten to know well and really enjoy. They are excellent people with a great base of knowledge (on par with U.S. interns) who really love the Lord. They are well prepared to do many different things leaving internship. They ofter work as general medical officers for two years before going into a residency if they choose to. So, my lecture was on oncology, which is a really broad topic, so we went over some general principles and I gave a brief overview and did not finish a good number of the slides. I have really enjoyed the educational component of the work. From a medical standpoint, we continue to see lots of really sick people, most of whom have gotten better, including an interesting guy who had TB everywhere including in his liver/gallbladder (which is very unusual). This particular family was a joy to interact with, and I have been blessed with some outstanding patients and families this week. Really, I think most of them are great, but I just know the ones that speak English particularly well.
Sara has had a good week in PT. The head PT here and her built a wheelchair that the hospital owned, and he donated this to the handicapped children’s home that Sara went to last week. She is traveling there this morning to give this to the home. We were grateful for the hospital’s generosity…the wheelchairs at the orphanage are in complete disrepair and this should help significantly. She has also had a few more patients recently that speak English, including one family that invited her to come and stay with them on Lake Victoria for a few days (tempting offer).
In other news, my beard is gone. It is contemplating a comeback, however. I’ll try to post tomorrow or Saturday at the latest. Also, to those who are disappointed in the lack of pictures…they are on Sara’s facebook page, we have been unable to load them onto the site. One of the previous blogs has the specific address.

Post-election day

Election day came and went uneventfully. The “yes” side won fairly easily at about 66-34%. The country seemed to react very peacefully. We have not heard of any violence whatsoever. This does not surprise our Kenyan friends and co-workers, since they know themselves to be a peaceful people in a stable country. They view the violence of 2008 as an aberration and as a frightening time not to be repeated. So, thankfully, to this point there have not been any problems.
We have had a good week otherwise. Sara has been working to see if she could obtain some wheelchairs and other equipment for the children’s home, and may be able to find some in Nairobi or have them delivered at least. She has also learned to make chipattis. These are a delicious piece of Kenyan cuisine – basically tortillas but better (or probably about as good as home made tortillas). We have been using these in many ways, including breakfast burritos, pizzas, quesedillas, and just as snacks.
My week has been relatively uneventful. It really is amazing how tuberculosis can manifest itself in so many ways. We have patients with TB in the lungs (obviously most common), brain, spine, abdomen, gallbladder, and bladder. It can affect any part of the body except the hair and nails. Thankfully we are always looking for it, so most of the time we have found it, and the patients tend to do well on treatment. It really has been amazing to see so many sick patients get well. We had a difficult case again that did not get better late this week. A 28 year old who had been previously healthy came in with headache, vomiting, and became unresponsive in the ER. He was put on a ventillator because he was not even breathing on his own. A spinal tap revealed blood – which means he had a hemorrhagic stroke. Despite aggressive care he passed away. It never gets easier telling a father that his son is going to die. However, though I think I tell the difficult stories more, it is more common to have a patient who comes in totally unresponsive, and we figure out he has severe meningitis or some other severe infection, and they get better and walk out of the hospital smiling.
Another weekend is here! They are incredibly relaxing here…we like the Kenyan pace.

Election day

Today is a big day for Kenya…they vote whether to approve a new constitution for the country. Kind of amazing if you think about it, that’s not something that we have done recently in the U.S. As I mentioned previously, the main focus of the constitution is on reforms and changing the structure of the government to more of a U.S. style. Most people like most aspects, though the main controversies revolve around two issues. The first is legalizing abortion if a medical professional states that it is beneficial to the mother (although still illegal otherwise). The second is the legalization of Islamic courts to judge between two Muslim people on issues regarding Islamic law (apparently these courts already exist, the document would just recognize them). It appears the “Yes” side will win at this point.
As for us, we have had a relatively uneventful couple of days at the hospital. Sara was able to work on Tuesday at a monestary that took care of disabled children. A nun and a few other helpers took care of 60 kids (mainly orphans) with minimal funding and very poor equipment. It was really sad to see the kids’ dillapidated wheelchairs, minimal bathroom facilities, and crowded conditions. However, the nun took good care of them and did the best she could. Sara was drawn to this work and will hopefully be able to help them with some equipment that would aid in the kids rehabilitation and in just getting around. There are definitely many situations here that will bring you to tears if you think about them. One other thing that struck her was the nun who lead the monestary gave Sara and the others her best tea and cookies. They tried to refuse since of course they did not have much. However, she insisted on giving, since she felt called by God to give, since she had something. This is clearly humbling to us, since we have so much, and we give so little.