Well, our work is done for now here in Kijabe. My pager is turned in, I am no longer on call, I told my last patient they have HIV, I ordered my last unit of blood that I know will take 3-5 days to get, I have made my final rounds with my faithful medical student Chris from Highwykim, England. It is hard to absorb everything right now and I am currently in the process of "unwinding".
It is amazing the difficulties that these people encounter. It is amazing the absence all those things we take for granted. It is amazing that God loves these people so much but the rest of the world does not.
As we head home we have a new focus that excites me more than anything we have done so far. I will let Amy fill you in on the exciting details. We feel called to change ONE life, the life of a 16 year old named Mary. As you recall, Mary was one of the many kids locked inside a church in January by a rival tribe. The church was set on fire with the intention to kill Mary and everyone else inside. Mary survived and has been here in Kijabe with her mother and others since that time undergoing surgery after surgery to repair and skin graft all the areas affected. We see such potential in this bright, 16 year old girl. Her mom asked us to take her to America where she would be safe and get an education. Mary wants to come as well.
This is our new focus, getting Mary to Wenatchee far from tribal violence, to nurture a young woman who can change the world.
Tomorrow we head to Nakuru to relax, see some animals and more of God's creation before boarding a British Airways plane to take us to London. We are planning on visiting an orphanage in Nairobi. It is hard to not be drawn to the good works being done by such Godly people in this part of the world.
Until London, God Bless,
Mitch
Thursday, September 11, 2008
Tuesday, September 9, 2008
Miriams scarves
Our time is coming to a close here. We have mixed feelings. I have fallen in love with Kenya and it's people. There is a way of life here that we are missing back home. We have been challenged to keep some of what we've experienced here and bring it home with us. I went and saw Miriam yesterday and bought more scarves. She thanked me for helping feed her son. I don't know the full story, but Miriam has a seven year old son. She is unmarried, so she sells her goods two days a week here in Kijabe to support her and her son. She loves the Lord and has an amazing spirit. I walked with her and visited with her and she shared some of her life with me. I was amazed at how fast she walked and hiked up these roads with flip flops on. She's amazing. I hope to see her again before we leave. And Amy--I gave her a BIG hug!! I don't think I scared her...too much!
Blessings,
Amy
Blessings,
Amy
Monday, September 8, 2008
Mary's report
Praise God, Mary is doing well. She did have a staff infection in ther knee and they were able to "clean" it out. Mitch and I went to Bethany's Kids and he got to meet the kids. Mary was back from surgery and looked much better. Her smile was back! I know that your prayers were heard. Mercy is not doing well now and I fear that she has an infection. As we were leaving, a Dr. was coming in to check on her, so I pray that she is alright. I am on my way to go visit the kids again. I hope to have more to share later.
Blessings,
Amy
Blessings,
Amy
The ICU
I just finished two days of call in the ICU. AIC Kijabe Hospital's ICU has five beds. It is reserved for the sickest five people (adults, children, or babies) in the hospital. Many other patients would qualify for ICU care, especially by American standards, but since there are only five beds the five most ill that have a reasonable chance of surviving get the beds. During my two days in the ICU all five beds were continually used.
Miriam was brought to our hospital Friday night from the Somali refugee camp in northern Kenya. Somalia has no government and it is anarchy there right now. The UN has a camp at the Kenyan-Somali border for refugees from the violence. Miriam, 38 years old, started noticing her foot hurting and changing colors a several days before coming. Over the last 3 days the gangrene that started in her foot rapidly advanced up her right leg. She was evacuated for emergent care. On arrival Friday night she could only talk a little due to the sepsis that had set in. By Saturday morning she was completely obtunded. On examination, her right leg was completely dead. The black skin was peeling off leaving only mildly pink and dying black tissue exposed underneath. This process extended from her foot all the way to her groin.
Miriam was taken emergently to the "Theater" (operating room in Kenya) where the orthopedic surgeons did a complete disarticulation with the amputation extending up to her right pelvis. She barely survived the surgery. She was returned to the ICU under my care late that afternoon. Despite all anesthetic being worn off she was completely comatose. We left her on the ventilator. During the evening her blood pressure plummeted despite IV fluid resuscitation and four different antibiotics to fight the systemic infection that was throughout her body that started in her leg. Extremely high doses of vasopressors were required to maintain a safe blood pressure. When I left the ICU about 11:00 pm things were tentatively stable.
At 3:00 am I received a call that she had no heart rate. I ran to the hospital from my apartment and performed CPR with the nurses for a half hour. Despite the CPR and multiple medications, she never regained a heart beat. At 3:35 we stopped CPR and pronounced Miriam dead.
We called her gentle, Muslim family over to the ICU from the guest house. As they entered the ICU I informed first her brother then her husband that she expired. They made a quick visit with her then started to inform her sisters and other family of her passing as they made their way to the ICU.
Quickly, in the midst of their grief, I could see they were pressed by another priority. In Muslim law, all deceased people need to be buried before sundown. They started making calls to figure out a way to transport her to northern Kenya or Somalia for proper Islamic burial. In their gracious and kind way they had two questions for me: first; could they pay the hospital bill later because they couldn't afford it right now and in Kenya bodies are not released until the account is settled. Second, could they get her right leg which must be buried with her according to Islamic custom.
I made a call to the medical director of the hospital and these issues were quickly resolved. They were the most patient, kind and gracious family I have seen in a long time in such trying circumstances.
Unfortunately my two days in the ICU had many other difficult stories. I hope to share them when time allows.
Mitch
Miriam was brought to our hospital Friday night from the Somali refugee camp in northern Kenya. Somalia has no government and it is anarchy there right now. The UN has a camp at the Kenyan-Somali border for refugees from the violence. Miriam, 38 years old, started noticing her foot hurting and changing colors a several days before coming. Over the last 3 days the gangrene that started in her foot rapidly advanced up her right leg. She was evacuated for emergent care. On arrival Friday night she could only talk a little due to the sepsis that had set in. By Saturday morning she was completely obtunded. On examination, her right leg was completely dead. The black skin was peeling off leaving only mildly pink and dying black tissue exposed underneath. This process extended from her foot all the way to her groin.
Miriam was taken emergently to the "Theater" (operating room in Kenya) where the orthopedic surgeons did a complete disarticulation with the amputation extending up to her right pelvis. She barely survived the surgery. She was returned to the ICU under my care late that afternoon. Despite all anesthetic being worn off she was completely comatose. We left her on the ventilator. During the evening her blood pressure plummeted despite IV fluid resuscitation and four different antibiotics to fight the systemic infection that was throughout her body that started in her leg. Extremely high doses of vasopressors were required to maintain a safe blood pressure. When I left the ICU about 11:00 pm things were tentatively stable.
At 3:00 am I received a call that she had no heart rate. I ran to the hospital from my apartment and performed CPR with the nurses for a half hour. Despite the CPR and multiple medications, she never regained a heart beat. At 3:35 we stopped CPR and pronounced Miriam dead.
We called her gentle, Muslim family over to the ICU from the guest house. As they entered the ICU I informed first her brother then her husband that she expired. They made a quick visit with her then started to inform her sisters and other family of her passing as they made their way to the ICU.
Quickly, in the midst of their grief, I could see they were pressed by another priority. In Muslim law, all deceased people need to be buried before sundown. They started making calls to figure out a way to transport her to northern Kenya or Somalia for proper Islamic burial. In their gracious and kind way they had two questions for me: first; could they pay the hospital bill later because they couldn't afford it right now and in Kenya bodies are not released until the account is settled. Second, could they get her right leg which must be buried with her according to Islamic custom.
I made a call to the medical director of the hospital and these issues were quickly resolved. They were the most patient, kind and gracious family I have seen in a long time in such trying circumstances.
Unfortunately my two days in the ICU had many other difficult stories. I hope to share them when time allows.
Mitch
Sunday, September 7, 2008
Prayer for Mary
Please pray for Mary. Mary was one of the many that were injured in the Eldoret church fire in January. These kids are part of the Kikuyu tribe and the Luo tribe attacked their village after the elections. You can Google Eldoret Church fire in Kenya and read more if you want. I have previously mentioned her and 3 others that I have been visiting in the burn ward. When I went to visit them yesterday, Mary was not feeling well. She had a headache and fever. There is a spot on her knee that has recently been grafted and it looked infected. When I went to visit this morning, she was on her way to surgery for the knee. I prayed with her and will try to see her after surgery. I went on onto the burn ward and had a "math" lesson with Anthony and Mercy. We used beads to do our math and then we had "craft time" making necklaces and bracelets with the beads. These kids are so great. As I was leaving, Mercy laid on her bed and said that she was not feeling well. She has a fever. I prayed with her and hope that she doesn't get worse. It is unbelievable what these kids are having to go through.
I will keep you posted on their progress, but would appreciate extra prayer for these wonderful children. They love God.
I am going to a bible study today with the other missionary wives. I am looking forward to the fellowship and encouragement that I always feel when I am with them.
Blessings to all in the States, we miss you,
Amy
I will keep you posted on their progress, but would appreciate extra prayer for these wonderful children. They love God.
I am going to a bible study today with the other missionary wives. I am looking forward to the fellowship and encouragement that I always feel when I am with them.
Blessings to all in the States, we miss you,
Amy
Saturday, September 6, 2008
Saturdays Blessings
Today was another Blessing. I went in the morning to spend time with the church burn victims. We had a great time and they wanted "school" even though it's a Saturday! We had an English lesson and I'm so impressed with how good these kids English/spelling are. Especially Mary. She is VERY bright and wants to be a doctor when she grows up. She could be anything she wants to be. These kids are amazing. It is so easy to get close to these people. They are so loving and warm. As I had the lesson with Mary, we laid on her hospital bed and she hung her two burnt legs over my lap. I had to hold on to them to keep them from slipping off. It felt so comfortable. I don't think we have that kind of comfort with people in the states. It's sad. After "school" I got out my camera to get pictures with the kids. They LOVE being in the pictures and REALLY love taking the pictures. They all had turns taking pictures of me with each of them. They especially love to run over to the camera and view their image. It is very sweet.
When I got back from the hospital, there were two short term Missionary couples waiting on the stairs of our apartment for their ride to Nairobi. One of the couples is heading back home to North Carolina and the other couple are from Australia and are here another 2 weeks. Their ride was very late, so I opened our apartment door and invited them to sit and use the phone, etc. There is a term "Kenyan time" here and apparently when they say I'll be there around 9:00am, that can mean just about anything! It turned out that their ride was still in Nairobi, bringing up some new short term missionaries. I started making lunch for Mitch and I and ended up making lunch for all 6 of us. It was a special time sharing and learning form these wonderful Godly people. I love that we could just spontaneously get together and enjoy time with each other. We get too busy at home to enjoy moments like that. It's unfortunate. We had the British Medical Student over for dinner and had a great time with them. We laughed a lot and they are really neat guys. It's been fun to learn about the different cultures as well as Kenyan culture. What a blessing!
I look forward to telling you about church in Africa! We are looking forward to it!
Blessings,
Amy
When I got back from the hospital, there were two short term Missionary couples waiting on the stairs of our apartment for their ride to Nairobi. One of the couples is heading back home to North Carolina and the other couple are from Australia and are here another 2 weeks. Their ride was very late, so I opened our apartment door and invited them to sit and use the phone, etc. There is a term "Kenyan time" here and apparently when they say I'll be there around 9:00am, that can mean just about anything! It turned out that their ride was still in Nairobi, bringing up some new short term missionaries. I started making lunch for Mitch and I and ended up making lunch for all 6 of us. It was a special time sharing and learning form these wonderful Godly people. I love that we could just spontaneously get together and enjoy time with each other. We get too busy at home to enjoy moments like that. It's unfortunate. We had the British Medical Student over for dinner and had a great time with them. We laughed a lot and they are really neat guys. It's been fun to learn about the different cultures as well as Kenyan culture. What a blessing!
I look forward to telling you about church in Africa! We are looking forward to it!
Blessings,
Amy
Friday, September 5, 2008
The Out Patient Department (OPD)
Good Morning! I thought I would spend a little bit of time sharing some patients I have seen in the OPD. The crowding experienced in the inpatient ward is less when comparing it to the crowding in the OPD. People travel from all over Kenya to be seen for every type of ailment. They wait all day for their visit, labs, and to get their medication to take home for the next several months or until their next visit. The halls and seats in the clinic are always full which leads to people lounging around on the hospital grounds throughout the day. It can be almost a festive atmosphere. Several afternoons the hospital would have people playing music with and an electric keyboard and others singing. This helps pass the time for all the family members and patients that are spending the day at the hospital. This is often followed by and evangelist sharing a message and praying for the people that are there.
A few short stories of patients I have seen;
I saw a 17 year old boy with bad sickle cell disease who was hospitalized earlier in the year for a sickle cell crisis. He was accompanied by his father. He appeared to be 11 years old due to the stunted growth he has experienced from his disease. He and his father were here from several hours away to have his blood count checked and get his malaria prophylaxis and pain medication. All was okay and he went home to come back in two months for follow up. Both he, but especially his father, had infectious smiles and the best spirit...I was immediately drawn to them. I will pray for them and whatever their future holds.
I was asked to see a theology professor and his wife in their 40's from the Congo. They, too were okay, although she was just diagnosed with bad diabetes and we spent a lot of time discussing how she was going to manage her disease back home. I share this because it exemplifies the challenge for people who need basic medical services in the interior of Africa. They had just left Johannesburg, South Africa where he obtained his PhD in theology and they were in Kenya in transit back to the Congo where he was to teach at the University in the Capital. All medical providers are on strike in the Congo, so they are not sure when they will ever be able to see a physician again. Therefore, they made a point to stop in Kenya, a whole different country, almost 1,000 miles away for medical care on their way to the Congo. It makes the inconveniences we face in our health care system seem so trivial.
The last patient was a wonderfully graceful 40 year old male with recurrent lymphoma in his face. It had relapsed after good (but suboptimal) chemotherapy in Nairobi. He was here for another opinion prior to returning to Nairobi. In America with appropriate chemotherapy and radiation I believe he would be cured. Here, I am concerned he will not survive this relapse.
Much more stories exist. Please pray for these patients. They love God with all their heart and I KNOW God loves them, too.
Blessings,
Mitch
A few short stories of patients I have seen;
I saw a 17 year old boy with bad sickle cell disease who was hospitalized earlier in the year for a sickle cell crisis. He was accompanied by his father. He appeared to be 11 years old due to the stunted growth he has experienced from his disease. He and his father were here from several hours away to have his blood count checked and get his malaria prophylaxis and pain medication. All was okay and he went home to come back in two months for follow up. Both he, but especially his father, had infectious smiles and the best spirit...I was immediately drawn to them. I will pray for them and whatever their future holds.
I was asked to see a theology professor and his wife in their 40's from the Congo. They, too were okay, although she was just diagnosed with bad diabetes and we spent a lot of time discussing how she was going to manage her disease back home. I share this because it exemplifies the challenge for people who need basic medical services in the interior of Africa. They had just left Johannesburg, South Africa where he obtained his PhD in theology and they were in Kenya in transit back to the Congo where he was to teach at the University in the Capital. All medical providers are on strike in the Congo, so they are not sure when they will ever be able to see a physician again. Therefore, they made a point to stop in Kenya, a whole different country, almost 1,000 miles away for medical care on their way to the Congo. It makes the inconveniences we face in our health care system seem so trivial.
The last patient was a wonderfully graceful 40 year old male with recurrent lymphoma in his face. It had relapsed after good (but suboptimal) chemotherapy in Nairobi. He was here for another opinion prior to returning to Nairobi. In America with appropriate chemotherapy and radiation I believe he would be cured. Here, I am concerned he will not survive this relapse.
Much more stories exist. Please pray for these patients. They love God with all their heart and I KNOW God loves them, too.
Blessings,
Mitch
The Maasai Market
Today I went into Nairobi with 8 other missionary women to go to the Maasai Market. The Maasai is one of the tribes here in Africa. The other tribe that is slightly larger it called the Kikuyu. We are seeing many of the members of both tribes while we are here, but mostly we are seeing "Kenyans". Back to the Market...
The market is held every Friday in the upper level of a very nice shopping center in Nairobi. Many vendors are there selling their handmade goods. It is standard to barter, so after a while that can get a bit tiring. The goods are beautiful, from wraps, baskets, beautiful wooden bowls, jewelery, carved native animals, etc. Everywhere I walked I heard "sister, sister"-they see my white skin a mile away and believe that the English are all rich, and I suppose we are compared to them. It was a fascinating day and I enjoyed being with the other missionary wives the most. I did quite a bit of shopping and am excited to bring my African treasures back to the states. In light of the past few days, it seems a little selfish, but I consider the blessing in experiencing the culture and spending time with the lovely missionary wives that serve here.
We had dinner (African cuisine) with one of the missionary families that I traveled with today. They have been here over 22 years. They moved to Kenya when their oldest son was 7 weeks old. Dr. Rich is a dentist/orthodontist and has always practiced in Kenya. They are from North Carolina, but Kenya is their home. They are wonderful people and we are impressed with their commitment to this place.
I will be heading over to Bethany Kids tomorrow to start working with the burn victims. I am looking forward to that very much. I also hope to find my Friend Miriam at the local vendor market, my sister-in-law Amy said I should give her that big hug, so I think I will!!
Blessings from Kenya,
Amy
The market is held every Friday in the upper level of a very nice shopping center in Nairobi. Many vendors are there selling their handmade goods. It is standard to barter, so after a while that can get a bit tiring. The goods are beautiful, from wraps, baskets, beautiful wooden bowls, jewelery, carved native animals, etc. Everywhere I walked I heard "sister, sister"-they see my white skin a mile away and believe that the English are all rich, and I suppose we are compared to them. It was a fascinating day and I enjoyed being with the other missionary wives the most. I did quite a bit of shopping and am excited to bring my African treasures back to the states. In light of the past few days, it seems a little selfish, but I consider the blessing in experiencing the culture and spending time with the lovely missionary wives that serve here.
We had dinner (African cuisine) with one of the missionary families that I traveled with today. They have been here over 22 years. They moved to Kenya when their oldest son was 7 weeks old. Dr. Rich is a dentist/orthodontist and has always practiced in Kenya. They are from North Carolina, but Kenya is their home. They are wonderful people and we are impressed with their commitment to this place.
I will be heading over to Bethany Kids tomorrow to start working with the burn victims. I am looking forward to that very much. I also hope to find my Friend Miriam at the local vendor market, my sister-in-law Amy said I should give her that big hug, so I think I will!!
Blessings from Kenya,
Amy
Thursday, September 4, 2008
Amy's day
Today was another great day. I've had many questions asked about the RVA, so I will try to answer some of those. They have capacity for 500 students. They currently have about 325 students from all over Kenya that board there. They have another 100 or so that live in the surrounding area and commute to school. They have a little over 100 staff. The cost for African Inland Mission (AIM) sponsered missionary's is around $1000.oo/term. A term is 3 months. If the family is not part of AIM, the cost is double. I worked there again this afternoon for a couple hours and met a few more of the staff. Everyone is very nice there.
The early part of my day was amazing. I went down to the Bethany Children's hospital this morning. I met with the Chaplain, Mercy and she showed me around so that I can start to work there on my own. I don't know exactly how to sum up the emotions that I felt while I walked through the various wards. A mix of sadness, compassion, joy. There are too many stories to write in one blog, so I will tell you a few for now. I met 4 young children ages 13 and younger-Mary, Mercy, Anthony and Jedidah. They were all in the burn ward. Their church was burnt by a rival tribe while they were worshipping. Over 200 people were injured by the fire. These 4 children have been at Kijabe getting skin graft/surgery for the past 5 months. Mary told me that they will be there another 3 months. I will be taking pictures of these beautiful children and hope to add them to the blog once we have high speed. I talked with Mary the most (her English is very good) She is a beautiful strong young woman, who will have scars the rest of her life, not only physical scars, but emotional as well. She continues to smile and has a joy that can only come from the Lord. I will be going back every day and "teaching" the 4 since they are not in school. I'm sure I will have much more to tell you about these 4 amazing young people.
The second story I will share is when we went to the ward where the babies/children with hydrocephalus stay with their mothers. In Africa these children are considered a curse, so the mission is to share that we are all God's children and these kids are blessings. I met a young mother whose 3 year old had just passed away a few hours before. My heart still hurts for her. I don't remember her name, but God does, so if you could pray for her. She was sitting and mourning with other mothers and their special babies. While I was there a white women came up with an adorable little hydrocephalic African baby in a stroller. Marcus is two and was a twin. The mother took the "healthy" sister and left Marcus in the Hospital. Nora, or "Mama Marcus" became his foster mother and is now in the process of adopting him. He may have a deformity, but once he smiles---all you see is a beautiful mouth and pair of eyes! He is also very smart and understood much of what was being said and done around him. Mama Marcus had come to the hospital to share with the other mothers what their children will be capable of. She showed them how Marcus can sit and is starting to crawl. It was awesome to watch the hope in these mother eyes as they realized that their child is special!!
After my visit, I came "home" and loaded up a pillow case with the gifts that I had brought from the states. As I went through the wards, I felt like Santa Claus!! I gave recorders (flutes), harmonicas, bells, coloring books and crayons and many beaded bracelets that my daughters, Ashley and Casey and nieces, Jaqueline and Kelsey had made--they were a hit!! (Girls---remember the small ones that you made, The mothers wanted those for their babies! They were perfect!!)
I could go on and on about today, I will never forget it, I will try to give you a little more each day and appreciate your continued prayers.
Blessings,
Amy
The early part of my day was amazing. I went down to the Bethany Children's hospital this morning. I met with the Chaplain, Mercy and she showed me around so that I can start to work there on my own. I don't know exactly how to sum up the emotions that I felt while I walked through the various wards. A mix of sadness, compassion, joy. There are too many stories to write in one blog, so I will tell you a few for now. I met 4 young children ages 13 and younger-Mary, Mercy, Anthony and Jedidah. They were all in the burn ward. Their church was burnt by a rival tribe while they were worshipping. Over 200 people were injured by the fire. These 4 children have been at Kijabe getting skin graft/surgery for the past 5 months. Mary told me that they will be there another 3 months. I will be taking pictures of these beautiful children and hope to add them to the blog once we have high speed. I talked with Mary the most (her English is very good) She is a beautiful strong young woman, who will have scars the rest of her life, not only physical scars, but emotional as well. She continues to smile and has a joy that can only come from the Lord. I will be going back every day and "teaching" the 4 since they are not in school. I'm sure I will have much more to tell you about these 4 amazing young people.
The second story I will share is when we went to the ward where the babies/children with hydrocephalus stay with their mothers. In Africa these children are considered a curse, so the mission is to share that we are all God's children and these kids are blessings. I met a young mother whose 3 year old had just passed away a few hours before. My heart still hurts for her. I don't remember her name, but God does, so if you could pray for her. She was sitting and mourning with other mothers and their special babies. While I was there a white women came up with an adorable little hydrocephalic African baby in a stroller. Marcus is two and was a twin. The mother took the "healthy" sister and left Marcus in the Hospital. Nora, or "Mama Marcus" became his foster mother and is now in the process of adopting him. He may have a deformity, but once he smiles---all you see is a beautiful mouth and pair of eyes! He is also very smart and understood much of what was being said and done around him. Mama Marcus had come to the hospital to share with the other mothers what their children will be capable of. She showed them how Marcus can sit and is starting to crawl. It was awesome to watch the hope in these mother eyes as they realized that their child is special!!
After my visit, I came "home" and loaded up a pillow case with the gifts that I had brought from the states. As I went through the wards, I felt like Santa Claus!! I gave recorders (flutes), harmonicas, bells, coloring books and crayons and many beaded bracelets that my daughters, Ashley and Casey and nieces, Jaqueline and Kelsey had made--they were a hit!! (Girls---remember the small ones that you made, The mothers wanted those for their babies! They were perfect!!)
I could go on and on about today, I will never forget it, I will try to give you a little more each day and appreciate your continued prayers.
Blessings,
Amy
The Hospital
Well...Amy has been sharing so many wonderful things, and I know she has more from today to share. But I thought I would add a little to the blog about my time in the hospital. African Inland Church (AIC) Kijabe Hospital is a mission hospital and a teaching hospital. All the doctors including the Kenyan interns and residents are Christians.
I was asked to manage a service of inpatient medical patients. Normally a service is managed by a "team" of doctors to include the attending staff, resident, intern and medical student. Since they are so "short" on doctors, I have my own service without any interns or residents. A very fine British medical student named Chris is assigned to work with me. He started the same day as me so we are figuring out the ins and outs of the hospital together. We have a nursing student assigned to translate for us every morning. Although the official language in Kenya is both English and Swahili, very few patients speak English.
It has been a challenging experience for me for two reasons. The supporting systems that we so depend on in America to care for patients, such as lab tests and radiology tests, are so limited. In addition the scope of diseases that I am caring for is very different.
Now about the hospital. There are two main wards; the men's and the women's. On each ward there are approximately 50 beds, but only four rooms or bays. The beds are so close to each other that it is hard to squeeze by to examine the patient. Patients are in the hall on gurneys. There is one restroom (Choo) for each ward. At the same time each morning the nurses bring buckets of water to each patient with a cloth. Everyone stands up next to their bed and gives themselves a bath with the cloth (if the patient can't stand up and family member is there to help bathe them). Sheets are quickly changed during that time. Breakfast is a piece of bread, a hard boiled egg and milk. There are no trays, the food is just placed on the bed or wherever there is space near the patient. Lunch is often soup brought in a large kennel and scooped into a bowl at the bedside.
Each patient is responsible for the charges they incur. Family members drive to Nairobi to buy medication such as antibiotics that the hospital does not have on formulary and brings that to the ward for us to administer. Once discharged, patients are not allowed to leave until their charges are paid, since once they leave they may never be seen again.
I have seen two oncology consults since I have been here. The first was a 12 year old girl who has a sarcoma on her thigh about the size of a football. The question from the surgeon to me was their anything that could be done to prevent an amputation. Unfortunately there is not. A surgery to perform and complete dis articulation from the hip down is planned for her in the near future. Another was a wonderful, Godly 44 year old man with recurrent lymphoma in his mouth/nose/sinus. He is being sent to Nairobi for salvage chemotherapy (which I do not believe they offer due to costs, etc.)
All medical lectures begin and end in prayer. I experience an amazing Staff Chapel service for all the hospital staff. God is living through these people, they have an understanding and trust in God I hope to have some day.
Blessings to all of you. More to come soon.
Mitch
I was asked to manage a service of inpatient medical patients. Normally a service is managed by a "team" of doctors to include the attending staff, resident, intern and medical student. Since they are so "short" on doctors, I have my own service without any interns or residents. A very fine British medical student named Chris is assigned to work with me. He started the same day as me so we are figuring out the ins and outs of the hospital together. We have a nursing student assigned to translate for us every morning. Although the official language in Kenya is both English and Swahili, very few patients speak English.
It has been a challenging experience for me for two reasons. The supporting systems that we so depend on in America to care for patients, such as lab tests and radiology tests, are so limited. In addition the scope of diseases that I am caring for is very different.
Now about the hospital. There are two main wards; the men's and the women's. On each ward there are approximately 50 beds, but only four rooms or bays. The beds are so close to each other that it is hard to squeeze by to examine the patient. Patients are in the hall on gurneys. There is one restroom (Choo) for each ward. At the same time each morning the nurses bring buckets of water to each patient with a cloth. Everyone stands up next to their bed and gives themselves a bath with the cloth (if the patient can't stand up and family member is there to help bathe them). Sheets are quickly changed during that time. Breakfast is a piece of bread, a hard boiled egg and milk. There are no trays, the food is just placed on the bed or wherever there is space near the patient. Lunch is often soup brought in a large kennel and scooped into a bowl at the bedside.
Each patient is responsible for the charges they incur. Family members drive to Nairobi to buy medication such as antibiotics that the hospital does not have on formulary and brings that to the ward for us to administer. Once discharged, patients are not allowed to leave until their charges are paid, since once they leave they may never be seen again.
I have seen two oncology consults since I have been here. The first was a 12 year old girl who has a sarcoma on her thigh about the size of a football. The question from the surgeon to me was their anything that could be done to prevent an amputation. Unfortunately there is not. A surgery to perform and complete dis articulation from the hip down is planned for her in the near future. Another was a wonderful, Godly 44 year old man with recurrent lymphoma in his mouth/nose/sinus. He is being sent to Nairobi for salvage chemotherapy (which I do not believe they offer due to costs, etc.)
All medical lectures begin and end in prayer. I experience an amazing Staff Chapel service for all the hospital staff. God is living through these people, they have an understanding and trust in God I hope to have some day.
Blessings to all of you. More to come soon.
Mitch
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