Sunday, December 26, 2010

The Best Christmas Present Ever Was A Day Late.

So I am going to start this blog by telling you about Christmas at Tenwek the last few days and leave you in suspense about the best Christmas present ever until the end. This is probably due to some OCD making me tell the story chronologically so here we go. I only worked one day last week - Wednesday. Monday and Tuesday I was in Nairobi Thursday I was sick, I think only my second sick day ever since becoming an RT. Thursday I was cheered up by a package sent by my friends as the Mis, thanks guys, It was exciting to receive all the Dutch Christmas treats and a card with encouragement.


Friday was a day off - I was invited to visit a local orphanage to bring them some Christmas cheer. On the way to the orphanage we stopped and bought them some flour, sugar and other staples, there were a few Kenyan youth with us who shared the Christmas story with them and then we played some games. I taught the kids to play spoons (card game) it was rather interesting as they have minimal experience with cards, and did not realize there was a difference between K,J, and Q, there was also a lot of unintentional cheating going on as they shared the cards with one another. The favourite part was the race for the spoon, so we had fun.




Friday night was Christmas Eve dinner with some friends followed by caroling at church. It is so nice to sing all the well known Christmas Carols, although I did miss Ere Zij God.

Yesterday was Christmas day. I spent it like many of you spent your Christmases I swapped gifts with friends, ate some turkey and other wonderful side dishes. In the evening one of the missionary families shot off some fireworks, this was great. The strangest things about the fireworks was that we shot them off at 730 and it was dark enough - part of living on the equator.

I am writing this on Sunday we had church this morning, Kenya does not celebrate Thanksgiving like North Americans do, so this Sunday was called a Thanksgiving service. It was great to hear how much God has worked here at Tenwek. After church I enjoyed a mango and was talking to my roommate - an OB/GYN Dr here at Tenwek when her pager went off - she was not on call this weekend but called anyway. I was glad she did, for there was a Mom in labour with Quadruplets. I talked to the pediatrician on duty asked if I could help out and than we both ran up to the Hospital. When we got there the first baby had already been delivered normally and was in the nursery doing OK, because the next baby was breech (footling) the mom was brought to the OR for a C-section (we could not find a stretcher so we wheeled her over in a wheelchair). they did the C-section in theater and the pediatrician, intern (1st year residents) and I waited in recovery room for the babies. The intern got the first one dry, positioned, suctioned and bagged and prayed that she pinks up - she did. While she was working on the first one, number two showed up, the pediatrician took care of her same procedure. Now here is the last one - mine same as the others dry, position, suction and bag. She pinked up (for those of you saying "wait only three" remember that one was born before we got there). It was so exciting to be there for this momentous occasion. These babies: one boy and three girls still have a long way to go as they were born at 29 weeks and each weigh about 1 kg, however they are breathing on their own and look OK. For all you medical people: the mom did receive dexamethasone a day or 2 ago which is good for the lung development but we don't have surfactant here. Please pray for these babies. Though there will be struggles this was a great Christmas present, and I still am so excited a few hours later.

I hope you all had a blessed Christmas. The excitement of new birth is really what Christmas is all about- without the birth of Christ we would not be celebrating today. I also learned something (I have learned a lot but I will share this one with you) for all of you saying Christmas is not really when Christ was born and the Christians took over a pagan holiday and made it Christmas. They chose December 25th for a reason, for at the time that was thought to be the winter solstice (longest night shortest day) and once that had passed it symbolized that the light was coming - and Christ is the light. Something I learned here in Kenya where there is no winter solstice.

I have also added some pictures to facebook, some of the same some different see them here

Monday, December 20, 2010

Nairobi

Nairobi: the big city. I am not a big city gal, and according to Wikipedia, Nairobi's population is about three million which I think is the same as all of Alberta. Anyway I traveled to the big city for a important reason my Visitor Visa expired the end of the month, I needed a renewal to stay in the country. I knew that I would be making the trip sometime in December however due to Christmas and other holidays it was thought that it would be best to get it done and over with while the offices were still open. The trip to Nairobi was different than the other times I have traveled; previously I have been in the other missionaries cars and they drive, once we hired a driver to drive the car. However, there was no one with a car heading up to Nairobi, but a friend of mine and one of his friends were heading back to Nairobi on public transport - so I joined them. I have taken the greyhound  before but this was a little different. We started out by car matatu, which I have taken before. This was for the short trip from Tenwek to Bomet (Bomet is the larger town close to Tenwek) We found a matatu and hopped in. Elizabeth in the backseat with three other adults and one or two babies, Todd in the trunk with all the luggage and another lady, I was in the driver seat not driving, that was the driver's job. However I could have reached the brake if I was unhappy with his driving. This is normally a 5-10 minute drive but about halfway we got a flat tire so we all piled out, and waited for them to change the tire, thankfully the spare was not flat (or absent). Once the tire was changed we all squeezed back in and traveled to Bomet. The first leg of our journey done. It was time to get the van matatu to take us to Nairobi.

We went to the matatu stand and bought our seats we bought four seats for the three of us so we could place our luggage somewhere. Than we waited, rather than having a scheduled van leave every few hours they just have a van wait until it is full or close to full and then go. Even though we were one of the first ones in this matatu we did all right as I think it only took 30min before we left. We were blessed with a good diver who was quite safe, and efficient. The drive continued on to Nairobi without any complications.

Once we reached Nairobi we had to find the car we had hired to drive us around the city, this took a few cell phone calls and aimless wandering but we eventually found him. From there we proceeded to a local mall where we window shopped and we also went out for supper, something I have not done for quite a few months (unless you count eating out at a friend's place). From there the driver brought us all to our respective locations.

I stayed at the home of a WGM missionary who is a Nurse Practitioner in Nairobi, it was good to meet up with her as well as a few others who were spending sometime there until their flight left at 3 am. It was great to reconnect and say good-bye once again.

Monday meant a trip to immigration, Jo who works for WGM helped me out extremely with all of this. He is Kenyan and speaks the language as well as understands what I was supposed to do. Otherwise I think I would still be there. Even though he knew what we were doing we started at window four were sent to window five did some paper work, went to back to window four and window six to pay, then handed things in at window three waited for a while and then sent to room fifteen for fingerprinting, finally pick up the my passport again at window five (some of the numbers may be wrong). They will now issue an alien card for me which will probably get completed after it expires. At least that is done.

That was only my morning in Nairobi, the afternoon was spent at Nakumatt, Kenyan Walmart where I did enough shopping to hopefully get me through the next few weeks if not months, because I was coming home alone it meant I had lots of room in the car for groceries meaning i bought for many families at tenwek. The trip home was not nearly as exciting as my trip to Nairobi, I hired a diver to take me back home. As I was travelling alone I was advised against taking a matatu. Back home at Tenwek time to unpack, sort out the groceries, and head out to the Christmas party. I will blog again soon to share more about the holidays here at Tenwek.

Wednesday, December 15, 2010

Turi, Missionary kids and Family #3

I am writing this after a few days away. It was the annual meeting of WGM (the mission organization I am with). Therefore all the WGM staff took off for a few days in order to get things done away from the busyness of the hospital. This is also a time that the WGM family celebrates Christmas, I have found it hard to get into the spirit as the weather is warm and the grass is green but the Sunday before I left this is what I saw outside my living room window
What is that white stuff I see falling?

Yes white stuff except it is hail not snow.
A little hail to get me in the Christmas mood. Monday morning we took off for the 2-3 hour drive to St Andrews School, Turi, a British style boarding school. A great place with lots of room for everyone.
The Dorm where I stayed.

Horses and beautiful blue sky
As I am only here short term the business meetings do not pertain to me very much, however it was very important that I as well as the other short termers (short term meaning less than a year) came along. So important that we did not even have to pay (like the other missionaries) for our stay. Our job was keep an eye on the children. This was a lot of fun I was responsible for four kids ages 9-11 (I think) and we were busy. Played a game of capture the flag with the youth, played random tag like games, ziplined, ran on the jungle gym and were in the pool for 2-3 hours. I do not have any pictures of the fun, I was too busy having fun. I got a great sunburn - despite putting on sunscreen in the morning and after lunch - I am thinking it will fade to a tan and not peel. This is what happens when you are at 8000ft and almost on the equator. Living on the equator does not mean it is 30+ degrees all the time. Actually those inside for the business meeting were wearing sweaters (no AC either) the elevation makes it cool. This is great for playing outside however it does make you have to pause to catch your breath sooner - that's my excuse anyway.

At one point during the day I spent some time with 2 MK (missionary kids)  girls both four years old and it was interesting to watch them play. They decided to play house help, something I have never seen little girls play back home, but they had fun and made me some tasty pizza and mud pies, all in the sandbox.
Tenwek is a large mission compound with many missionaries this is neat as it allows the MK's to make other MK friends. They are a great group of kids. Most of the highschoolers go to RVA a Christian boarding school just a few hours drive from here. The other kids are homeschooled, however, there are a few kids in grade eight so they have class together were one mom teaches english, another art, etc. I think it is so neat, the other kids are taught at home by their Moms (or Dad) but get together  for a regular PE class. I think it is wonderful that they are able to get together with their peers. They also have a band class and they performed for us at our Christmas Party held at Turi boarding school. Smaller than other bands I have seen three trumpets, a flute, a clarinet and the drum. The drummer forgot his drumstick so some tree sticks did the job.We also had a lovely recorder concert as well as action songs, and a hilarious play done by the youth. These kids don't have regular assemblies at school like I did growing up, it was neat to watch them all perform.
The Christmas Program was enjoyable. Many of the missionaries are wonderful singers and I heard a beautiful quartet. After the program was a gift exchange for the kids. Santa Claus came out and handed out the presents that the kids bought for each other.

He was to big to sit on Santa's lap

After presents we had a turkey dinner cooked by the chef at the boarding school and then quickly packed up and headed off. The initial plan was to linger and enjoy some free time at Turi however some of you may remember that back in 2008 there was violence after the election. Wednesday was the day that they announced those whom they intend to prosecute. As there was some fear that this may cause some further violence we all wanted to be home well before dark. We all made it home safe, and in my understanding there has been no violence since the anouncement (however I have no TV or radio so news is rare). Through out the ride we did see a few more police checks than normal and when I arrived back at Tenwek I saw a soldier riding on the back of a Piki Piki (motor bike) with gun in his hands, but all is good.

The big vehicles to get us and all our stuff home, most of the vehicles are 4 wheel drive necessary for some of the roads

All gathered together and having some fun I reflected on Chrismas past (sounds like a line from a movie) and thought I have spent Christmas with my own family but also with my Edmonton family the P's and now here is another family to spend Christmas with. It is neat how I have so many families. For Tenwek is a family for everyone here. Other missionaries are aunt and uncles to the MKs and I feel like there is always someone to visit.
My friend Heather and me.
Tonight is the hospital Christmas party, I am wondering if we will have goat. I guess I shall see. I may have to blog again soon to let you all know. For all of you medical people reading this and others thinking these last few posts Annette has not written anything about the excitement at the hospital - is she still working? The answer is yes. The Hospital is still busy. Things here have become more routine; I am busy making an asthma education video, preparing lectures for the nurses and helping out wherever I can. 



Thursday, December 2, 2010

A busy week

I am starting this post on Thursday I do not know when I will finish it as it has been a busy week. As some of you may know, last Thursday was American Thanksgiving. Living on a mission station with many Americans this is a big deal. Thanksgiving is not a holiday here in Kenya so it was a regular work day, however many of the American physicians did take the day off. As things normally go when you  have less staff than normal things were busy. I ended up running home in the afternoon to raid my stash of nonrebreather masks. I made a stop in the mad dash to consult with the head internal medicine Dr (who was playing football on his day off) to let him know that one of our long term patients was deteriorating and that we had decided not to be aggressive in care. I was soon able to escape the hospital and join in on the football game. I  have not played much football prior to coming here but I am really starting to enjoy it although I do not understand it very well. (Maybe that is what I should ask for for Christmas – Football for Dummies).

The weekend was a trip home – not really home but the weather reminded me so much of southern Alberta (during a drought). I was invited to Olderkesi a mission in Massai land to the Massai people. This was a few hour drive from Tenwek, much more isolated and wild. We had a tour of the garden and were told that they used to go out the gate but now they go out the hole  in the fence where the lions got out. Being remote they have to make their own power and the hotwater heater is a fire under the tank. Being there did remind me of home in someways (though there are no lions at home) the hot dry weather, being able to see for miles, the wind, like a southern Alberta summer. We celebrated Thanksgiving there and had a wonderful meal of everything an American Thanksgiving should have. From Turkey to sweet potata (pronounced with a southern accent). Complete with every kind of pie that you can think of. We have a lot to be thankful for.

The evenings at Olderkesi were night game drives. We all piled in the “van” a few on the roof and drove around looking for eyes. It was neat to get closer to the eyes and figure out what animal went with it. We saw a dik dik (very small deer like animal) I learned its called a dik dik because Richard Richard takes too long to say. We also saw a Ard wolf, bushbabies, spring hares, Thompson gazelles and a few more animals like mice. One of my favourite parts of the drive was when we turned the vehicle off as well as all the lights and stood outside in the middle of the plain. It was so dark and the sky was clear and there were so many stars. I was slightly worried I would get eaten by a lion, as well as fearful we would leave one of the kids behind in the dark. I was the “responsible adult” for the first night meaning me and the teenagers and kids. We did not get eaten or left behind.


We returned back to Tenwek on Sunday night and this is were the busyness set in I packed up and moved down the hill to join a new Doctor coming to us at Tenwek from the States. Since there are now four single young ladies at Tenwek they split us up  2 in each house. It is a nice place with a beautiful view. The bathroom is tiny; you need to walk sideways in order to get in. The move went well although there are still a few things at my last house that I have forgotten. I am sure I will make frequent visits to see how things are in the old neighborhood. The main disadvantage of moving I now have a steeper longer walk to the hospital and that gets slightly annoying when I get paged at midnight (happened my first night at the new place).

Things at the hospital are going well and I am staying busy with various projects such as educating both formal (lectures) and informal (bedside) of staff, trying to find better ways of doing things and the equipment to go with it. I am currently working on preventing VAP (ventilator associated pneumonia) by finding inline suction catheters as well as a way to do oral care. Oral care is a challenge as there are no mouth swabs and our bite block are OPA’s so the nurses think the best way to do oral care is to loosen the ties holding the ETT remove the opa do some care and than do the oral care. I do not like this method as it gives the ETT freedom to move in or out and when we don’t chart ETT position this makes things challenging. Sorry if I confused all the nonmedical people reading this. One of the other projects is a video on asthma education for patients.

Since coming here I have had more than one person say I should stay longer if forever.  A local doctor and nurse (both  male) were plotting to marry me off to a Kipsigis man (local tribe) so I would stay. They figured they might be able to get 150 cows for me: 50 for being a doctor (anybody who works at the hospital is called a doctor) 50 for being white and 50 for having redhair. I think it is a compliment to be worth so many cows but one of the problems with this is my dad would get the cows and then my husband would be dirt poor. I also would have to eat ugali and moresick which if you read my last post you know how unappealing that is. On a more serious note please pray for me as I consider my options. Don’t worry my flight home in March is still booked and I have every intention of being on it however I do not really know what God has planned for me in the next years of my life. I guess if he told me now it would make life less exciting. So I started this post on  Thursday and it is now Sunday, I guess I was busy

The View, I have missed the sky at Tenwek there are to many trees



Hot water heater -  Very effective

One of the pies I helped decorate this one, I really enjoyed the canadian maple leaf the little things on the bottom are acorns

More beautiful sky