Monday, February 4, 2013

Iron Man

Teenage boys in the U.S. struggle through a lot of issues as they make the transition from little boy to young man.  There are concerns about appearance, struggles with responsibility, questions about identity, and volumes to learn about the proper way to relate to young ladies...

Sunday, February 3, 2013

Greatest and Least--Poverty and Riches

Since we've been here for a few months, I have been mulling over the greatest and the least of a variety of things that we have encountered.  I have certainly seen lab values here that I never saw in the States!  Of course, there are a lot of things that I have never seen before - some don't fit into neat little categories.  I will share a few things that may be interesting....


Highest Sodium Level - 206  (the first sample was "too high to read")

Lowest Sodium Level - 113  (Normal is 135-145)

Most Baboons behind our house at one time - 32 




Highest Potassium - 8.6, really!!  (the first sample was "too high to read")

Lowest Potassium - 1.9   (Normal is 3.5 - 5.5)

Smallest Baby to live at least one day - 590 grams (1.3 pounds)



Youngest Gestational Age to Come to Nursery - 24 week twins



Largest Baby at birth - 4.4kg  (9.7 pounds)

Largest Margin of Defeat for Duke Men's Basketball This Season (so far) - 27  (couldn't resist) 

Most Number of Babies in One Incubator - 4  (they are too big now - only 2 per incubator)  :)

Under blue lights for neonatal jaundice


Longest time bagging/breathing for a baby (for me personally) - 4 hours



Highest Bilirubin - 45 (yes, forty-five!)  (Normal is less than 1.2, in this 12 year old)

Longest hospital stay - 90 days


I love this picture!!  This baby stayed for 90 days and just went home Friday.  The mom (on the right) grabbed me in the hall and urged me to come see the baby and meet her mother - she was SOOOOOOO excited!!!

 Most Number of WBC in spinal fluid - TNTC (too numerous to count), but it wouldn't drip from
       the hub of the needle because the pus was so thick.

Longest Totally Nasty, Disgusting Slug - 5 inches!



Speed same Totally Nasty, Disgusting Slug can travel 1/2 foot - 1 minute, 20 seconds! 

Lowest Platelet Count - 2 (Normal is 150-350)

Lowest Hemoglobin - 2  (Same patient as above - diagnosed with leukemia) (Normal is 11.5 - 14.5)

Latest Dinnertime at Homestay - 10:20pm

Lowest Blood Sugar - 1.2 (According to our US scale, that is 22.  Normal is 70-110.)

Most Milk Purchased at once - 12 liters (I still call the 3L jugs "gallons.")

Most Paid for a Box of Cereal - 750 Ksh = $9.38.  There are some that are more, but I just can't
        stomach any higher cost!  (For anyone who appreciates a pun, take note.....;)   )

Longest Church Service - 4.5 hours (In Machakos - in the Kamba language)

Situation where I have felt the dumbest (this one was hard to choose) - Getting ripped off last week at
        a service station in Nairobi....the guy wiped off the oil dipstick so it looked like I was low,
        charged me double what the oil was worth, and almost sold me enough oil to ruin my
        engine!  Who knew too MUCH oil was as bad for an engine as too LITTLE?!)

Number of Flowers in the Yard - TNTC  (too numerous to count)




Most Number of Powdered Donut Dots Bought - 10 dozen!!!  (Senior Store happens about once a
       month and is the only time to buy American-style donuts)



Largest percentage of body-weight lost in newborn period - 33% in 5 days!  (3.5kg down to 2.35kg)

Most Malnourished Infant - 10 month old weighing 3.6kg (7.92 pounds)



Number of Gessner-Days on Malaria Prophylaxis - 247

Prettiest Sunset...


I couldn't decide which was the best.....

This morning in church, one of our readings was from Proverbs 30:7-9.

Two things I asked of You,
Do not refuse me before I die: 
Keep deception and lies far from me,
Give me neither poverty nor riches; 
Feed me with the food that is my portion,
That I not be full and deny You and say, “Who is the Lord?”
Or that I not be in want and steal,
And profane the name of my God.


In this, Agur is recounting that he asked God for 2 things:  that he would remain honest, and that he would neither have too much nor too little in his lifetime.  I thought about how I was compiling a list of the mosts and the leasts.  It is easy to ask to not have "too little,"  but it is so much harder to ask not to have "too much."  We often feel like we have "too much"....compared to most Kenyans.  Too many things, too much food, too much house, too much money, too many clothes....  Where is the balance?  Having things and spending money in and of itself is not wrong. 

There is a sweet Kenyan woman who helps us in our house 3 days a week.  She told us a few weeks ago that the water company would hook up water to her home, but that it would cost 20,000 Kenyan  shillings (or about $235) up front.  She asked to borrow the money and, of course, we were delighted to give it to her.  What a privilege, actually, to help someone have running water in their home!  I wouldn't have cared, if she didn't pay it back; but this month when we paid her, she asked if we would deduct more than we expected so that she could pay off the debt faster.   I have to say that I really respect that!  What she asked us to deduct is about one week's pay!  I have started asking if I can get her anything when I go to the market - she asks for flour or rice or sugar.  Not fancy - just the essentials.  I think allowing her to pay her debt, but then picking up things for her each week "since I am going" preserves her dignity and her own sense of stewardship of what God has provided.

I think this is one of those things that brings you back to your knees to ask of God,

"Should I buy that?  Do I need that?  Is that too much?"

"Is that wasteful or poor stewardship?"

"Could someone else use that money more? How do I help?"

Lord, give me neither poverty nor riches.  Amen.


Love,
Sarah












Sunday, January 20, 2013

Homestay, Part II

Wow - where does the time go?  I want to finish telling you about some things we saw and did during our homestay in December.  :)

Our new friends' neighbors own a farm about 45 minutes up into the hills from where we stayed.  One day we went to visit the farm - it was beautiful up there!  We were welcomed with open arms by this family.  They have 5 children - the oldest of which is in medical school in Nairobi.  We have learned along the way that Kenyan kids work very, very hard to have the opportunity to get to the universities or professional schools of their choice.  The four years of high school are referred to as Form 1, 2, 3, and 4.  Most kids go to boarding schools for high school (if they can afford the school fees).  They are often IN CLASS by 5 in the morning every day!!!  Tell that to your teenager in the US!  Ted was pretty amazed at that.  Their grades and scores on the exit exams will determine their opportunities.  For instance, if you score well enough to make it into a certain level of the class rankings, you will be accepted to the government medical school, or engineering school, etc that corresponds to that level of ranking.  If you are accepted this way, the government pays the vast majority or all of your tuition.  If you don't score well enough, you can still consider going to a private university for your desired field of study, but the fees are significant.  One of the clinical officers at the hospital (similar to physician assistants in the US) didn't make the government cutoff for medical school, applied and was accepted to a private medical school, but has had to defer due to the cost and isn't sure she can manage it.  The cost is the equivalent of $2000 per term - 3 terms a year for 6 years.....$36,000!!!  As a mom with a son rapidly approaching college, I can tell you that I would love for college and medical school combined to come with that price tag but, in Kenya, that is a dream killer.  But, I digress....

This is the porch leading into their house on the property.
They had a large covered strawberry field.  Strawberries grow year-round here!  That makes up for no blueberries, sort of.
The road was 2 lanes, but the bridge was not!

On another day, we drove over to Lake Naivasha, which is a large fresh water lake with much wildlife.  It has traditionally been a popular watering spot for Maasai herdsmen.  It was also used between 1937 and 1950 as a landing spot for the Imperial Airways' flying boats (seaplanes) in their flights between London and South Africa.  Many of the usual places to view the lake were flooded due to some recent rains, but we enjoyed seeing many new places and people.  Everything is an experience here, so you just keep your eyes open!

Women walking on the road carrying water - that is probably about 15 pounds of water on their heads!

There is YMCA in Kenya - Rotary, too, but that photo was terrible.

This was a very creative lamp post at the entrance to a park by the lake.  The head is the lamp, and the clothes are actually metal - making it look like a Maasai herdsman.
All of the kids.

I love this photo of a boat down by the lake.  It makes me think of God looking down from heaven at Jesus on Peter's boat.

This shows the degree of flooding of the lake.  This building is normally on dry land and can be rented for various functions.

On one of the last nights of our stay, it was a very important holiday called Jamhuri Day.  It is the day that Kenyans celebrate their country becoming a republic in 1964, and it is traditional for them to roast a goat or sheep.  Roasting a goat or sheep is also something they would do for an important guest.  It was a privilege to be included in such an important event for their family, and we were honored to be a part of it.  Let me walk you through the preparations, in case you would like to try it at home.

Here is the goat prior to preparation.  This one was delivered from the butchery, not the backyard.

First, a machete is used to hack the goat in half lengthwise.
Then, the machete is used to make smaller pieces that can fit more easily on the fire.
These smaller pieces are put onto the fire in the fireplace.  Our friends do have an oven, but cooking it over the wood fire produces the right flavor and is also cheaper than running an electric oven for that long.

After the cooking is completed, the meat is sliced from the bone...

and served with carrots and ugali.

Here is everyone at the end of our stay (Rick took this photo, so he is not in it).  They are a delightful family, and we look forward to seeing them again, since we live so close.  We plan to visit the cafe they were building in front of their house, once it is up and running. :)  I will let you know!

Homestay 2012
Lots of love,
Sarah

Mark 1:16-20 
As He was going along by the Sea of Galilee, He saw Simon and Andrew, the brother of Simon, casting a net in the sea; for they were fishermen. And Jesus said to them, “Follow Me, and I will make you become fishers of men.”  Immediately they left their nets and followed Him.  Going on a little farther, He saw James the son of Zebedee, and John his brother, who were also in the boat mending the nets.Immediately He called them; and they left their father Zebedee in the boat with the hired servants, and went away to follow Him.

Monday, January 7, 2013

What a way to welcome the New Year!!

We didn't really do anything terribly exciting on New Year's Eve - okay, like nothing.  Do we blame it on age, new culture, or fuddy-duddy status?  I'll leave that up to you...

BUT, on the morning of New Year's Day, we got a very fun phone call to welcome in the bright, shiny new year.  Rick answered the phone, and it went something like this:

"Hi Rick, this is Pete.  [one of the surgeons]  I was passing through theater and saw some commotion - 30 week QUADRUPLETS were just born.  Can one or both of you come help?"

So, Rick and I threw on clothes and ran up to the hospital (and it is actually UP).  Before I left the house, I went to tell the kids (who were still in bed) where we would be.  Anna asked why we were both going, and I told her we both needed to go because 4 premature babies were just born.  She sat straight up in bed and said, "From the same woman?!"  Pretty funny and not an unreasonable question.

Here are the babies on the one resuscitation warmer in the theater/OR:

So cute!!


 Once they got to the nursery, they could spread out to two babies per warmer. :)  They did beautifully and are still doing great!
























Here they are in their own corner of the nursery - they will be here a while.  Their names are Victoria, Precious, Angel, and Joy! :)  Please pray for an uneventful period in the nursery, so that they may be discharged home as healthy babies, and that the parents can afford the massive bill that will come at discharge. :(  For now, we will focus on the joy of the event and praise God that they are doing so well so far!!





Love,
Sarah

Thanks be to God for His indescribable gift!  2 Corinthians 9:15







Tuesday, January 1, 2013

Christmas in Kenya

I think I will interrupt the Homestay "report" to share with you about Christmas in Kenya, before 2012 runs out!  :)  (News flash:  2012 ran out here while I was working on this, and the internet went down...so Happy New Year!)


I was really surprised by the lack of outward reminders that Christmas was approaching.  First of all, it is very warm here.  Ok, that wasn't surprising, but it was surprising how it influenced our feeling about the time of year.  On Christmas Eve and Christmas afternoon, it rained and the kids played outside barefooted with friends - much more summerish than winterish.  So, we've had to adjust to the "backwards" seasons. 

Emily took these photos on Christmas Eve - a double rainbow!

Flowers blooming in our yard
Summer squash growing like crazy in our garden (shamba).  They grow a lot of zucchini here, but not summer squash - my parents sent these seeds from the States. :)


Then, there were just so few decorations!  Even in church, there was no advent wreath, no tree, no garland, etc.  Of course, there is nothing wrong with this - it is just so DIFFERENT.  That is true of many things here - not wrong, just different.  In our home, we borrowed a fake Christmas tree from someone on home assignment and decorated it with a few ornaments that we brought from home as well as ornaments sent by our Sunday school class back home. :)  Also, we brought our Advent wreath from home.  I often forget to buy purple tapers in October or early November (you would think that I would get it together after so many years!!), so I usually scramble around trying to find them right before Thanksgiving.....after everyone else has already bought them.  Ironically (because almost everything is harder to find here) this year I had no trouble finding purple candles in Nakumatt (the big supermarket chain).  We also decorated our windows with winter and Christmas window clings that a friend had sent to us - kind of funny, considering the weather, but it made us feel closer to home, and that was good.

Our tree, decorated

Christmas cookies - we brought sprinkles from home!

The girls decorating cookies!

A tree in a section of the pediatric ward - even with functioning lights! ;)

We did make a family trip to the Masai market early in December - a chance for everyone to finish up their Christmas shopping.  The Masai market is a huge open air market for Kenyans to sell their handicrafts.  It moves between different locations in Nairobi, but it is the same vendors.  It was definitely a cultural experience for the kids!  They are not used to the aggressive tactics that are commonplace here.  "May I help you?" in Hallmark or Belk's, and "No, thank you, I am just looking." is not even in the same galaxy as this!!  However, the people are friendly and talkative, if you can manage not to be intimidated.  They are always complimentary of Kijabe Hospital, and many of them have some first-hand experience in the hospital.  I don't go to the market much, but I hope to be able to greet the same people again when I go.  It is always nice to recognize people in a new place after you move. :)

The weekend before Christmas, the kids and I (Rick rounded that morning) went up to RVA to help pack the "Christmas hampers"  for 60 of the neediest families around Kijabe.  Evidently, this is a tradition, and the families (many elderly, widows, and grandmothers looking after grandchildren) are known by some members of the AIC Kijabe Church or the staff at the hospital, RVA, or Moffat Bible College.

Packing boxes of rice, sugar, wheat flour, maize flour, cooking fat, salt, tea

Anna and Ted :)


On Sunday evening, we went to a service at RVA and sang Christmas carols.  That was really nice - sadly, we brought very little Chrsitmas music with us.  At home, we have a CD of traditional Christmas carols that is introduced by a man talking - the kids were always so annoyed by him talking, but they miss it terribly here!  So funny and totally unpredictable what is missed, but I think it is really the familiar that is missed.

On Christmas Eve morning, we went to deliver the hampers to the families in the area.  At some of the homes, we asked them how we could pray for them.  Many had individual requests, but they ALL asked that we pray for their children to have jobs.  The unemployment rate in Kenya is 40% (yes, forty percent!!), and it weighs very heavily on those affected.

One woman's house was insulated very neatly with cookie wrappers

This was her stove - notice the dirt floor

This grandmother is raising her grandchildren

This house is plastered with mud on the inside and outside

This was one of the neatest yards we saw, their clothes were clean but tattered, and this grandmother radiated joy!
The man standing in the doorway was a widower who lives alone in this complex of homes.  A very proud man with so little resources - he walks with a cane and is stick thin.
On Christmas Eve evening, we went to sing carols in hospital.  We visited the pediatric ward, not surprisingly, and the kids gave out candy and silly bands that a friend had sent with us to Kenya.  The children and the parents loved them (although the silly bands were definitely new to them!) and very appreciative of our visit.  Rick and I were thankful for our kids to see the children on the pediatric ward and to interact with them as kids - they wanted to go to all the areas that kids (not babies) are admitted to.  :)  There was a service in the hospital chapel after the caroling and visiting - not our usual candlelight service that breaks all sorts of fire-codes for occupancy, but poignant nonetheless.  I hope to be able to go with the kids to the hospital and give out treats again - we don't have to wait for Christmas! :)

On Christmas Day, our kids slept later than any previous year - don't know whether to chalk that up to adolescence or the very different feel of Christmas here - and we opened presents, rounded in the hospital, and had another family over for Christmas Dinner.  They had just returned from several weeks in the States the night before!  It was a wonderful time to share Christmas together, although punctuated episodes of running to the hospital during which two children died.  So difficult here to separate life and death into neat little packages - you realize the reality of "the slender thread of life,"as my microbiology professor used to say in medical school.  It makes the truth of the Christmas Story and the need to share Christ's love with others feel even more urgent...although it is no more urgent here than in the US or anywhere else in the world.

Merry Christmas and Happy 2013!

Lots of love,
Sarah

1 Thessalonians 5:2
For you yourselves know full well that the day of the Lord will come just like a thief in the night.





Sunday, December 30, 2012

Homestay, Part I

As part of our orientation with AIM, we were required to spend some amount of time staying with a Kenyan family.  Often, this part of the orientation is done soon after ABO (our three weeks in Machakos), but we finished ABO not long before the kids began at Rift Valley Academy and we didn't have time.  So, it was planned for the beginning of the kids' first break from school - the first half of December. 

The family that we stayed with was perhaps different than you would imagine us being placed with - probably at least upper middle class in terms of economics and quite well educated.  While they may not represent the "typical" Kenyan family historically, they may better represent the way Kenya is heading....more on that later.  They live just outside of a town about an hour from Kijabe, and they run a sort of hotel/guest house out of their home.  He is a school administrator and she is a decorator.  They have two teenage daughters who were home from boarding school in the Nairobi area.  They are building some small shops (dukas) on the front of their property which abuts the highway, so they were quite busy with that during our time there - we learned that this couple has a history of being quite entrepreneurial.

This is their family room/kitchen area where we took our meals with them.  We ate around this coffee table - 9 to 12 people.  They usually take their meals here or in front of the television in the evenings.



They cooked many Kenyan dishes for us, which we were delighted to try.  In the States, we probably ate more vegetarian dishes than the average American, so we really enjoyed trying many of the bean dishes and mostly vegetable stews.  Each of us discovered new foods that we enjoyed.  Probably the quintessential Kenyan dish is ugali and sukuma wiki, and we had it several times.  Ugali is maize meal and water, heated and stirred until is becomes a dryish mass - jokingly introduced to us as "white cake," but it is more true than not.  It is sliced into wedges and served like cake.  Sikuma wiki is actually shredded kale - it sometimes has added onions or carrots or spinach, and is cooked in "cooking fat."  To say that there is a lot of cooking fat used in Kenya is somewhat of an understatement. 

Ugali and sukuma wiki
Ok - to be honest - Emily did look at me like she was in front of a firing squad every time we were served ugali, but that girl ate it!  So proud of her. :)


So, I mentioned that they run a type of guest house - mainly for nationals traveling in-country.  Our space consisted of two rooms, a bathroom, and a main room - it was their biggest area, as the other areas were one bedroom each. 

The girls shared the twin bed; we had a double bed; Ted slept on a mattress in the "main room."

Bathroom - the sink and shower were to the left.  Space was roughly 4x5 feet.  They even had an instant hot water maker on the shower!
Door to bedroom - I never asked about the holes in the door.  The bathroom door had similar holes that were patched.  Kenyans are very good about recycling, and I suspect that this wood had been reclaimed from another project.
Door to left leads to bathroom; straight ahead is "main room."  Note the depression in the floor...we assumed for catching water that could overflow from shower (shower drain was a two inch hole in the floor).
This family employed a house worker, which is the norm for middle class and above families.  This woman worked for several hours sweeping, mopping (with a cloth), and weeding with a machete - and this was her posture throughout!  I don't know how their backs can survive the stress!
The first day we helped to sand new bed frames for the rooms.
The first couple of days the hot water/electricity did not work, so we washed hair and bodies in a basin - probably a lot more typical of most Kenyan situations.  

We taught them how to play (or at least throw) American football.  If you refer to "football," that means soccer to most of the world.


The day before we left for homestay, we received a package from dear friends in the States that contained a game called Spot It.  We took it along with us, and it was a wonderful ice-breaker as well as a great way to pass the down-time while we were there.
We took some walks while we were there to the surrounding dukas (shops).  This one was called Adam's Supermarket and was one of the largest dukas that I have seen.  Usually, dukas are small spaces with LOTS of things for sale - this one was quite spacious with relatively few things for sale.  Notice the sparsely stocked shelves.  The power was frequently out, but it was sunny enough to see inside.

Diapers for sale

There were diapers, even Pampers brand, for sale.  The fact the many of the packages were opened - presumably because they sell them one at a time - was a metaphor for the way so many Kenyans live.  They live on what they earn that day, and they spend only what they need right away.  At home, I frequently buy in bulk (think Sam's, Costco, Walmart, etc.), thereby saving through the bulk discount and not having to shop for a while....but Kenyans buy just the gas they need for that trip, just the food they need for that meal, or just the diaper they need for that, well, need. 

There is much to share about our homestay experience, but I will share more next time.

Lots of love to you this New Year's,
Sarah

“These things I have spoken to you, so that in Me you may have peace. In the world you have tribulation, but take courage; I have overcome the world.”” John 16:33