Thursday, December 25, 2014

December

So sorry, again, for taking a while to post. I had a friend come and visit in November it was great to have her be a part of life here in Kenya. You will read more about this in a future blog - this post is about December, just like everywhere else, December is a busy month here in Kenya. So rather than share by writing I thought I'd share via pictures.
I joined a few ladies for a quick trip to Nairobi to go to the Christmas craft fair. We also went out for a lovely dinner and I tried crocodile - it really tasted like chicken.

As soon as I got back to Tenwek it was off again with most of the long term missionaries for a time of meetings and Christmas celebrations. 

I got up early and saw the sun rise over Mount Kenya, it looks small but its about 175km away 

The youth did a play. It was entertaining, I was the director of this play. They did well.
On the way home we stopped to buy pineapple. This is what happens in this town when you slow down on the road with the window open.

I attended a party for this young man (the one with the garland) he has just completed a coming of age ceremony. I work with the smart looking lady in this photo. 

To celebrate Christmas with the interns I had 16 interns over for a Pizza night. 

I am still helping with the youth and in addition to Sunday afternoon get togethers, seen here, we also had a 4 day youth retreat, (Just during the day we sent them home in the evening)

As a Tenwek community we had a fun eveing of appetizers and some singing. Accordion in Kenya, who knew.

Christmas eve service singing by Candlelight

Christmas Carols in the hospital. 
So it was a busy month, on top of this was normal work at the Hospital I had some quiet weeks but the last week and a half leading up to Christmas has been busy with up to 8 patients on a ventilator. Hopefully things get better soon.

Thursday, October 23, 2014

Secrets and work

Wow, it has been a while since I have written. So sorry. At one point I thought I should see how long I could go without writing a post but that kinds of defeats the purpose of this blog so I better write something. Why so long without writing – I guess life is normal and I am not so quick to think “that would be an interesting blog post”. That being said, I am by no means an expert now at life here. I am still learning every day.
A lesson I have learned the past few months is about privacy and secrets.  To explain this I will give an example. In North America a girl goes on a few dates with a guy gets excited and tells all her friends. Sometimes she will tell all her friends to not tell anyone yet. But usually in a week or two she is fine with the news being out. She also is proud of her boyfriend and a boyfriend is a status symbol and therefore will be mentioned in conversations with friends and co-workers. Here it’s a little different. If someone is dating someone they don’t tell very many people at all. If they do you are expected to keep it a secret – it’s not your news to share and sharing someone else news may be the end of a friendship. Until the couple has met both families and the dowry has been exchanged its not official and therefore not talked about. Even after it is still not your news if you are friends and she wants to tell you take the news and treasure it, but don’t share it. The telling of the whole world via Facebook is much more uncommon.
So I know there are a few Kenyans who read this blog and if I got it all wrong please tell me.
I am continuing to learn about life here and I will never be done.

On another note things have been busy at the hospital I am excited to be having more ventilators as we have added two, soon to be three, Servo 300 ventilators to our vent pool. These are good machines and I am excited to have waveforms for teaching. We recently used the servo to ventilate a 6 month old with bad pneumonia/ARDS. Unfortunately,  despite three weeks on the ventilator this little one did not survive; please pray for this family. Life in the ICU is always up and down with some patients getting better and some not. A few weeks ago we had a big success. It was a weekend and I was helping out the medicine team on call. We had a bad asthmatic come into casualty. We gave her the cocktail of meds we have access to (Ventolin, steroids, Magnesium, she may have even got some Epi) despite all these meds her lungs refused to open up and she was getting tired. I tried bipap with no success. So we had to put this young lady on a vent. Acute asthmatics are some of the hardest patients to ventilate and this lady was the worst I have seen yet. When she was on the vent we paralyzed her to squeeze all the trapped air out of her lungs, gave her ketamine as a sedative – it bronchodilates, and still after a few hours her vent pressures were still in the 80’s. We threw some more meds at her:  aminophylline, more magnesium and of course a continuous stream of Ventolin. She came in on Saturday and started to get a little better on Tuesday, finally on Friday we were able to take her tube out and she could breathe on her own. This young lady took a lot of my time, energy and prayers. I am thankful she finally turned around a week later she went home. She now has medications in her pocket and hopefully she will be able to control her asthma better. If this lady had not made it to us when she did or had gone to a district hospital which do not have ICU care she would have died. I am thankful that God uses us to help people like her.


So that’s a little of what I have been up to. Hopefully in the next few weeks I will have an update for you regarding what’s next. Also I am excited in a few weeks my friend Shawna, who also edits this blog for me, will be coming for a visit. I am excited to show her my life here. Also from a work/educational standpoint we say iron sharpens iron. I have not had a lot of iron to sharpen against so I am looking forward to that as well. 

Saturday, August 30, 2014

Some Excitement (Outside of the Hospital)

Sorry I have not posted for a while but that’s not due to nothing to say.
The other day I did something that I have not done in 20 months. Something you probably do daily without thinking about. Something I used to do daily but when I told my mom I was going to do it here she was nervous, more nervous than when I started to do this alone when I was 16. Have you figured it out? Yes, I got behind the wheel of a car and drove. A few weeks ago I blogged about getting my license but due to vacation, busyness and some fear on my part I was unable to drive until now. I had planned on a Sunday afternoon drive last week but the battery had died so I waited until Saturday to find someone to give me a boost. Like most cars not in North America, it’s a standard. I am thankful I was forced to learn how to drive a stick while in high school, but it has been a while. So driving an unfamiliar car with a recently revived battery – therefore no stalling allowed, and the first time driving in 20 months and the first time driving a stick since 2010 made for an interesting start. Add onto this many motorbikes (who travel more like bicycles, slow and on the shoulder), speed peaks (proper word is speed bump, but are really more like mountains), crazy driving busses, slow moving trucks, and we drive on the other side of the road here it was an interesting trip and I loved every moment of it.
 I am thankful for the long term missionary who left me her car for 6 months, this gives me the time to see how driving goes here and decide if I would like to own a car here in the future. As every 16 year old knows there is a wonderful freedom that comes with having a set of wheels. This freedom allows me to go to the grocery store when I need, visit friends, or give a lecture at a neighboring hospital. All without having to depend on the local transport system or costly taxis.


A few weeks ago I also got a well needed vacation. My Oma (grandmother in dutch) celebrated her 90th birthday in Holland. It is cheaper and shorter to fly to Holland than Canada so this made for a  nice vacation. My parents and my brother and sister-in-law (S & J) also made the trip. It was great to catch up with them, spend some time with Oma and some other Dutch friends and also enjoy the pace of the western world rather than the African world. When we were driving our rental car through the small side streets or the busy freeways I found it very relaxing after the Kenyan roads (see above) while my sister-in-law found it very different than her small town. It was a very relaxing week as Mom and Dad worried about the itinerary and I just had to show up. Some highlights were the birthday party and seeing the Dutch relatives, climbing up to the top in the new church in delft (new in comparison to the old church (1246)) according to Wikipedia the new church was completed in 1496. Anyway, I also enjoyed taking a boat through a town that transports more by canal than by car. It was a great trip and as my flight had a layover in Cairo I can also say I have been there although I only saw the aiport – for 6 hours. Delayed flights are so much fun, due to the delay I also was in Germany, just long enough to make a mad dash from one side of the airport to the other. Since than its back at work, getting to know new missionary families, and just living life.

Happy Birthday Oma

Lovely boat ride passing by old houses and barns

The view from the New church

The stairs, we walked around like this all the way to the top and all the way down agiain

good food, puffertjes, Croquette patat. yum

Sunday, July 27, 2014

3 blog posts in 1

So July has been a busy month with lots happening that makes for interesting reading but no time for writing, I’m finally catching up as I am starting 1 ½ weeks of vacation. I am currently in Nairobi and later tonight will be heading to the airport to see family in Holland. Anyway here is a three for one blog deal

I Lied

So I have said before that I am the only RT in Kenya – I’m sorry I lied. About a year ago I met another RT, a Kenyan lady who trained in the US and then returned home to Kenya to work. She tracked me down via this blog. We met for supper one day and chatted about everything RT related. It was great to talk “shop”. Then a few months ago while in Eldoret (read about that trip here) the neurosurgeon told me there was an RT who worked in Eldoret. I filed this knowledge away and thought – really three of us in Kenya. My next thought was how do I track this fellow down. I met some nurses who had done ICU training in Eldoret and they again confirmed – yes there is a guy who is an RT in Eldoret. Now I really wanted to track him down.
Back in 2011 I worked at Tenwek with a nurse who since moved to Eldoret, so I tracked down his number, called him, reminded him who I was and asked him for this RT’s number. He was happy to help. So now we finally connected, a brief conversation on the phone was the beginning. Now that I knew there was three of us we needed to have a meeting.
It took some organizing to get all three of us together – wait make that four of us. The fellow in Eldoret knew a fourth RT. So we met up in Nakuru for an afternoon of chatting and planning. To all meet was great. To know we were not alone. M from Eldoret has been here the longest – since early 2010. So saying I was the only RT back then was a lie. The other two ladies have arrived in the last year and are looking for jobs. We sat around the table sharing challenges of working here and where we see the profession going. We decided it would be a good idea to create an association so we are working on creating the Kenyan Association of Respiratory Therapists (KART) – makes for a fun acronym, when I created the Facebook group Facebook wanted to associate it with MarioKart. Anyway I am excited for the future of respiratory therapy in this country, and may have more updates to come.
 
4 RT's in Kenya
Drivers License
Driving is something normal for most Canadians. You turn 16 and away you go ; your license gives you freedom. Driving here is a little different and not something I have yet had the opportunity to do here in Kenya but a few weeks ago I took a step in the right direction and got my driver’s license.
                This was something I planned to do a year ago but did not think was possible. I was told before I got my license I would need a work permit. That did not come through until about October (I think). However also to get my license I thought I needed an international licence which, in Kenya, expires after 6 months. Since my work permit took 9 months the international license had expired. Therefore I thought I was out of luck unless I wanted to take the driving test and I really did not want to do that. But than a few months ago I got some good news since Kenya and Canada are both part of the commonwealth they would recognize my Canadian license to get a Kenyan license. Yay.
                So while I was in Nakuru for the above mentioned meeting I went to get my licence. It went something like this. Got dropped of outside of building and go up five flights of stairs to KRA (Kenya Revenue Agency) office. There is an elevator but I was told it often was broken, since I did not want to get stuck in elevator I took the stairs. Upon arrival in office, I saw random people lining/gathering in various places and I had no clue where I was to go. I talked to a security guard who points me to a desk so I joined the line/mob and finally get to see the lady. She looked at my papers and told me I need photocopies. Before coming I had photocopied what I thought I needed but apparently I needed more. So I went down 5 flights of stairs where I got photocopies done. I then ran across the street to buy a pen as the one in my purse disappeared and I did not think I would find one upstairs. The stationary shop was excited when I walked in to buy a pen and started showing me all these fancy pens. They were disappointed when I told them I wanted a normal one.
                Pen in hand I went back up flight of stairs and filled out the form then joined the line – security had turned it into a more organized line at this point. Got to front of line and gave my passport, ID card, Canadian driver’s license and form to lady. She dropped it in a pile and told me to sit. Sitting and making sure my pile of documents did not disappear I was called up again. Now I was told to pay 700ksh. I reached for my wallet and she said no not here, you have to pay at the bank. So given all my documents plus deposit info I went down the stairs and down the block to the bank. It was now 1230 and since the office closes at 1pm for lunch I was told not to come back until 2. Stood in line at the bank, thankfully they had a line just for people like me doing KRA deposits. Now with a hour to kill I went for lunch, which worked out well as I was hungry. Lunch done I headed back to the office, up five flights of stairs again,  and sat in a different line. Yes I said sit. Since it was always a long wait it was benches and chairs that formed the line and you would slide down a seat every time you someone got served. Much more comfortable than standing. So finally got to the front of the line and got my driver’s license, actually I got a sheet of paper. My real license should be mailed to me in the next few months.
Now that that’s done I just need to work up the courage to drive. Have not had a chance yet  but maybe when I get back from vacation.


Mount Longonot, again
Last week I climbed Mount Longonot again. The first time was with some friends in language school, the second time was when my parents and friends visited and now the third time was with some staff from the hospital. Each time has had its own flavour. This time we left early in the morning with the 40+ of us piling into the bus. Out of the 40 some of us, I think only 2 had been there before one of the nurses and myself. When we arrived at the mountain we got ourselves sorted out and climbing. From what I gathered hiking is not a common hobby among my co-workers. When you walk to work most days, do lots of manual labour and have lots to keep you busy hiking for fun does not make the most sense. I heard a few people say we paid so we could walk. That all being said I think everyone had a good time. Most of us made it to the top, even two young girls who managed to go all by themselves although my friend Ann and I gave them some help for the last ½ km.


I have always been impressed about how “smart” my Kenyan colleagues look. Now “smart” is  a term here not meaning wise but looking good, clean, well put together etc. It does not matter where I am I always feel slightly under dressed. Climbing Longonot was no different I had on an old pair of runners, capris and a T-shirt. My friends were beside me hiking in dresses, suits, sandals, dress shoes and they managed to “stay smart” looking. That is a talent I don’t think I will ever have.
Up we go 




After the climb we headed to Lake Naivasha. We managed to see some birds, but no hippos. I’m a little glad that we did not see hippos as we took a boat ride and I think if in the right mood it would not take much for a hippo to tip the boat. It was a fun day and I enjoyed seeing everyone outside of the hospital environment. 

Monday, July 14, 2014

Guest Blogger - Jess's Perspective

A few weeks ago I had a lovely young lady, who is going into nursing school, spend sometime with me. It was a fairly average week in terms of workload and she wrote about it and gave me permission to share it here. So here is Jess's Perspective

     Ever since I read Ann Voskamp’s book, One Thousand Gifts, I’ve tried to practice looking at my everyday experiences through a different lens. Instead of just going through the motions and being sucked into our agenda-driven society, I want to be able to slow down and thank God for the little blessings as well as the big. With this goal in mind, I began writing 5 “gifts” that I'd noticed from the day in a journal each night. Looking back through it months later, they’ve included everything from “5. sun, beaming through fall leaves and bouncing off shiny horses’ coats" to “483. Hilarious family dinners.” Pretty random, I know, but this exercise has helped me shift my thinking and truly enjoy each day.
 
     Well, this past week at Tenwek Hospital in Kenya, I was faced with a challenge. How could I possibly find things to be thankful for in a place filled with pain and death? How am I supposed to find beauty in suffering? Is there only good in the medical success stories, or is there a gift in the sad endings too? Because I shadowed a respiratory therapist, this was a particularly challenging question that I had to face. I realized part way through the week why it seemed like almost all the patients we saw died. Any patients who begin to get better are transferred out of ICU, Casualty (their ER) and HDU (high dependency unit), and we don’t typically see or treat them again. Respiratory therapists only care for the patients who aren’t able to breathe well, so to put it frankly, I saw a lot of death.
  
        Here is a window into what my days were like… I wrote these notes in my journal one evening. "I hold the hand of an elderly man who reaches out looking into my eyes longingly, only to find out the next morning that he had died. We walk outside. Sitting in the sun is a patient who attempted suicide over 6 weeks ago and had all medical odds against him, but is going home today with his caring family. “We Treat, Jesus Heals,” I think to myself.  Next stop, HDU.  At bed 1, I cringe as I hold the swollen, crinkly head of an unconscious  5 year old child with a broken skull who has hit by a motorcycle while walking home from school. Annette re-tapes the tube going down his throat. In the nearby ward, I perform CPR on a woman with AIDS... no heartbeat, it’s been too long. Time for lunch break. We eat, then head back up the hill to see how things have progressed. A woman in ICU with severe epiglottitis  finally gets extubated, and is able to talk again. The first thing she says? "Praise the Lord!" “I've just gotta hold on to victories like this," I think to myself. We walk to Casualty. On bed 6 is a young man, my age, who has just arrived following a car accident. The staff member who is bagging (breathing for him) is paged. I offer to take over and he agrees. Several minutes later, it is decided that his brain damage is too severe. We need to let him go. Walking out of the room, I meet the gaze of his anxious, questioning brother and try my best not to let my face give away the devastating outcome. Back in ICU, the possibility of survival for the small boy with pneumonia is looking grim, the doctors and staff circle up and pray for the Lord’s healing."
 
     Exhausted by the emotional roller coaster yet? I know, it doesn’t take long. Yet this is what these doctors and nurses deal with all day, every day. I admire their work. I wonder, how do they process it all?
 
      I listen to the horrifying screams of an 8 year old girl suffering from the painful spasms that tetanus brings and find myself at a loss for what such a precious, fading life could reveal about God. What is there to be thankful for in such places of sadness and pain? Surely there is more to be learned than the consequences of pain and death that occur because of the depravity of mankind.
There is a sense of raw humanity in this place. Pain and death unite the young, the old, the rich and the poor. They have the ability to bring us all to our knees, crying out for relief…and when everything is stripped away, all that remains is Christ. It is a depth of pain and sadness that I don’t claim to have experienced personally. I don’t know their grief, but I feel like I’m just beginning to envision the depth of peace and comfort that the Holy Spirit provides when a child of God is at the end of everything he knows to do.
There’s nothing I can say to take away these people’s suffering. There is nothing to do but sit and cry with them… but I know that in the midst of the pain and the loss, when we're brought to our knees, we are held by our Maker.
 
     As for my question of what the gift could be…there is no simple answer. I can’t simplify it to a line in my journal as number 987... but I know it’s there. It’s there because I’ve heard the testimonies of those who have been brought lower than they ever could have imagined. I know because of the way that God speaks to and comforts me when I’m merely watching it.
     Sometimes after a day in the hospital I like to take a little walk down the dirt road to the sewing ministry. It’s refreshing to see healthy children happily skipping down the road...to remind myself that God gives joy and health, and to hug dear sisters in Christ.
   
     The contrast of my time in Tenwek’s community and at the hospital has really echoed a quote I recently read in the book, When Helping Hurts. The author explains, "Our perspective should be less about how we are going to fix the materially poor and more about how we can walk together, asking God to fix both of us” (79). The raw humanity I saw in the hospital stripped away any remaining dividers I saw between myself and the people of Kenya. Physically AND spiritually, we’re all broken to the point of no repair. We are left with nothing but to cry “Abba, Father!” begging Him to rescue us from our state of despair. Our only response can be one of awe. Awe of our need and His redemption. This is what unites us.
 
 “Rejoice with those who rejoice. Weep with those who weep.”  Romans 12:15
"He will wipe away every tear from their eyes; and there will no longer be any death; there will no longer be any mourning, or crying, or pain; the old things have passed away. And He who sits on the throne said, "Behold, I am making all things new."" Revelation 21:4










Tuesday, June 24, 2014

Whose house is it anyway,



The other day I was walking home from work and saw the fellow who works for the neighbours walk into my house – I barely missed a step as I remembered I gave my extra key to the neighbours so they could use my washing machine – and he was doing their wash.

A few months ago I came home walked into my kitchen and found the 2 year old son of one of the missionaries in my kitchen; he looked at me as if to say “what are you doing here?”. The lady who watches with him was chatting with the lady who helps me out two days a week and so of course he came along.
Two weeks ago I had a friend and her two daughters stay with me and during the day we had about ten people using my home for a home base. They were part of a team of nursing students spending a few days at Tenwek.
Today while home for lunch J, the lady who helps me around the house is making stew for the group I am having for bible study tomorrow tonight. When I get home I will make a stirfry for some missionaries who are passing through, one of whom is sleeping in my bedroom.
As I am sitting here, I hear some talking outside of my door the guys from industrial have brought down a a cylinder of propane as mine ran out.
This Saturday my house is going to be invaded by 10-15 interns as we are having a pizza night. I have told them if they want pizza they must come early to help me make it – some of the guys groaned at this so I did give them the option of washing the dishes after, we will see how it goes.
So whose house is this, When I moved to Tenwek I requested not to have a roommate. I love having people around me but when you have a roommate you need to respect their space and their needs and the amount of busyness going on  this week is one thing to do to myself but something else to do to something else. Also I do need time alone and since my house is always so busy the times when it's great to be able to just spend a few moments alone.
So whose house is this – well it's God’s house. It’s a space I have been given to use, many people use their gifts and talents for many uses, but I think God has given me this wonderful space of my current home to share. To use/develop my gift of hospitality to his Glory.

My house from the front door, living room, and dining room, the bright lights are coming from the kitchen.



Tuesday, June 17, 2014

Do I tell you about...

So I apologize it been a long time since I have written. Things here no longer seem new or different, it is easy to write about those things. I have been here long enough that the lines are becoming blurred. So what do I write about?

Do I tell you that I am hoping to get my driver’s license? I am looking into making trips all by myself into Bomet, town a few KM down the road. That I am excited about the opportunity to drive again but at the same time scared. What side of the road do I drive on? What if the police stop me? Do I still remember to drive a stick?

Do I tell you about the patient I lost last week? The pregnant mom who was on a ventilator with bad lungs  (ARDS), when she pulled out her own breathing tube we could not get her intubated and  back on full support (PEEP =20) before her heart stopped. We did CPR on this mom for 10-15min before deciding that the chance of getting her back was minimal so we decided to save the baby instead. The doctors quickly cut out the baby. We stopped trying to save mom and worked on baby instead. I was not the only one crying as this all took place. When I heard that new born baby cry at last some hope. I have gone to visit this little girl daily and Praise the Lord for her life but mourn the life of her momma, and struggle with what ifs and if onlys.

Do I tell you about the good-byes I’m saying as missionaries are leaving on to the USA for a few months to a year so they can raise support? As my trip back to Canada will be in March, I may not see some of these missionaries again until I return in 2016.

Do I tell you about the frustration I feel when after being a year I have not been able to get some things completed, and I start to wonder is there ever a chance of changing things from how they have always been?

Do I tell you about the fact that I’m tired and wish there was more hours in a day to get everything done, but other times I wonder if I spent my time better I would be able to get things done?

Do I tell you about the joy I feel when a patient who recovered from sepsis and ARDS is sitting in a chair and asking for a drink of water?

Well this blog post got long, with all sorts of things. I guess I do have something to say.

Friday, May 9, 2014

Hard days, ambulance rides and a smile

So it’s been a tough few days we have had a few unexpected deaths of children and young people. When things are hard I cling to 2 things
1.       Despite it all God is Sovereign and I will continue to praise him.
2.        I remember the ones who get better. So walking home today I met someone who brought a smile on my face.
I met this father a few months ago he had come into casualty looking bad. Without going into the medical details we thought he may have had a bleed in his brain. He had stopped breathing once in ER and as we did not know the cause we were worried it could happen again. He needed a CT scan and the machine at Tenwek was broken. As transport was going to be a few hours someone needed to go who could place a breathing tube, if necessary. So that person was me, I ran home to get some food (wish I hadn't) and cell phone credit. I knew that our ambulance would not have all the supplies I needed if he stopped breathing so I filled a basket with everything I needed to keep him breathing.

We (the nurse and I) loaded up the patient in the ambulance. His wife accompanied us and off we went. We had one monitor - the SpO2 monitor that lives in my pocket, and no IV pumps. Off we went to our 6 hour trip. A few miles down the road we stopped to swap oxygen tanks, one was empty and they had just picked up a few from the next town. O2 tanks picked up, we were set until our next stop. Our patient was awake and in a lot of pain. His wife (who was with us) called some family who lived down the road. We stopped and they gave us some pillows. From there is was smooth sailing as smooth as it can be riding backwards in an Ambulance on curvy roads, and roads under construction. My stomach was unhappy, thankfully the windows would open so I could stick my head out.

Throughout the trip (all 6 hours) I was happy that our patient was doing well, we safely arrived at our destination met a wonderful neurosurgeon and got a CT scan. We were pleased to see the scan was clear. Still with a question of what had happened that morning we traveled back to Tenwek for further tests. We could not find IV fluids in the ambulance so I went to the hospital pharmacy where we were getting the tests done and bought a few bags of IV fluids, and some pain killers. Not a question asked. Not routine for a transport in America, but it was really no different than stopping at the grocery store and buying some flour and sugar.

The trip back was uneventful, we thanked God for safe travel in the dark. The patient never had another episode and went home. I have seen him walking around the Tenwek and today when I saw him it brought a smile to my face. I don’t know what happened, maybe God healed him, maybe it was a strange migraine. But seeing his smile today was exactly what I needed.

Thursday, April 24, 2014

One day

So since coming back from Cameroon I have been busy.  I was only back for a week and a half before I left to the coast for the missions annual retreat. A time of spiritual encouragement and meetings. Even though I had just been back for a short time, the time away was much needed as the hospital was very busy for that week and a half. Now retreat is done and I am back at Tenwek. Since December my life has been busy with one event after another, Trip to Lodwar, friends' visit, family visit, Cameroon and then retreat. It was a very enjoyable albeit busy few months. Now things are back to normal, and it is different not to finish one thing and immediately start preparing for the next.
I have been busy at the hospital. Here is just how one day last week went.
7am – meet in ICU to start surgical rounds, however miss rounds as asked to see patient who is hypoxic. Go see said patient and start him on biPAP.
7:30 – Join medical rounds.
8:00 – decide to check on bipap patient before heading to devotions, get distracted by very loud flow meter and go into medical ward. See that they are coding patient and help out.
8:30 – code is done, it did not go well, head up to devotions.
8:40 – get called to another code in the same ward, code said patient. Again unsuccessful.
9:30-11:00 – Check on ICU/HDU patients, enjoy some chai.
11:00 – while seeing an asthmatic in casualty a patient comes in with a swollen neck and difficulty  breathing. Observe him and help rally the troops so we can get him in the OR to put a tube in. 
1:00 – patient has tube in so I go for lunch.
2:00 – patient is out of theater and we are suspecting anthrax. Settle him in HDU and explain to the nurses how his tube needs to stay in.
3:00 – look for patient I was supposed to do spriometry on, can’t figure out what patient it is as the computer charting system is down.
3:30 sit down with nursing students who attended code this morning.
3:45 get paged out of debriefing session as a peds patient has arrived from other hospital, intubated as he has some sort of airway burns.
4:15 get called in casualty that anthrax patient woke up and pulled out his tube, yes the tube that was hard to put in and really needed to stay. Grab some staff from casualty and go to HDU – thankfully, anesthesia manages to get tube in again.
5:15 return to casualty and discover that the 2 year old managed to take out his tube, he is having trouble breathing, we struggle to re-intubate as he is awake and the drugs we are giving him to sleep are not working.
7:00 after anesthesia, with some propofol, comes and gets the tube in we get the patient settled in ICU. He is on my new vent the Servo 300 and I explain to the staff how the machine works
7:35 run home, change and grab stuff for bible study.
7:45-10:00 attend a great bible study with the interns here, we talk about our attitude and being humble.
10:00 come home, realize I forgot to turn on the hot water heater so kill time for 30 min so I can take a hot shower.
10:45 – Go to bed.
11:00 – pager goes off, the nurses are having trouble with one of the vents. Go back to the hospital get the vent working get the patient settled and happy.
12:00 – Go to bed, again. This time I was able to stay in bed until 7am when it was time to go for another day.

So that is just a taste of what life is like. Some days are crazy like the one I just shared others are a lot more calm.  Please say a prayer for us at Tenwek the next two weeks as many of the long term doctors are going to a conference and the hospital will be covered by a few of us here, some recently graduated doctors and visting doctors from the USA. I fear my next few weeks will keep  getting busier.


Saturday, April 12, 2014

God's Timing

I have been back from Cameroon for a few weeks now. A week and a half after I got back I took off to the coast with most of the other Tenwek missionaries for a retreat, a time of rest and spiritual renewal. I will write about life back at Tenwek soon but first I want to share with you some more about my time in Cameroon.

I was thankful for the three weeks I spent at Mbingo. It was good to get to know the staff there and help out where I could as they do not yet have an ICU and ventilators operating. I was able to bring them a bipap machine. A bipap machine gives pressure via a mask to help patients oxygenate better and make their breathing easier. During my time at Mbingo, there were two ladies who probably would not have survived if they had not been able to use that machine.

I heard about the first patient over supper from the OB doctor.  He talked about a lady who was about to deliver. This mom has a heart defect that is so bad she developed something called Eisenminger Syndrome. Delivering a baby with this condition has a 50% chance of mortality for the mother. When I heard about this lady my first question was – does she know The Lord? That evening before her c-section she accepted Christ as her saviour. The next day the OB team delivered the baby who was thankfully healthy. Mom did OK for the first few days but after about a week she developed massive pulmonary edema.  We were able to help her breathing with the bipap giving medications time to work. She was on the bipap for a few days and was than able to go home to her family. She still has heart and lung problems but hopefully she will be able to be a mother for her children for a few more years. I am thankful that this lady was given life both in Christ and here on earth.

The second lady went on the bipap machine two hours after the first lady came off. I had not yet packed it away as I was not sure if the first patient would still need it. However, the second patient was also in severe pulmonary edema. Her kidneys had shut down and she had not made urine for a few days. Her blood pressure was extremely high and the extra fluid was flooding her lungs. I placed her on the bipap and shewas immediately  breathing  easier. The machine kept her alive long enough so we could get some fluid off, her blood pressure improved  and her lungs stopped flooding. By morning she was smiling and feeling better. I pray her kidneys start to work on their own.

I find God’s timing amazing, had these ladies come in a few weeks earlier they would probably have not survived. I was bringing in a machine that they had not used before, I had the opportunity to show it to the nursing students I was teaching and then I had the opportunity  to show how well the machine can work. As uncomfortable as the mask and machine sound and feel to a healthy individual we all saw first hand how a sick patient welcomes the assistance that the machine gave.
Practicing putting the bipap on, I made a good patient. 

The Bipap at work

Sunday, March 16, 2014

more time at Mbingo

I am writing this after a full 2 weeks in Cameroon. The main reason for my coming has been teaching and I have been enjoying my time in the classroom I have discovered the difference between an occasional lecture and actually teaching a classroom of students. It makes sense to invest in my students; what I teach them today I will build on tomorrow. I have enjoyed getting beyond the practical application and getting to the why and physiology behind what I do every day. Last week the students had a quiz, I have not seen the results yet- the real teacher is marking them, but I am afraid I have discovered that a quiz evaluates the quality and clarity of my teaching more so than it evaluates my students' ability to study. The concepts I taught were not in the book they had, they may not have had access to the internet to look something up if they did not understand the lecture notes they took and the handout I gave them was all they had.
All that being said I am really enjoying teaching. It is fun to get to know my students like most classrooms there are a mix: a few jokers, the one who asks tough questions and the quiet ones who make you wonder how much is sticking. Class is only 2 hours a day and then the students are released for the practical part of the training. Half the group is put to work in the surgical ward and can be busy with various tasks. The other 6 are sent to work in recovery room. There is a little more time here and I have been using it to help the students practice various skills or explain different things as the recovery room has easy access to the OR and I have more time than I do at Tenwek. I have also been able to see parts of a few surgeries, which has been fun.

My "Lungs" used for a demonstration, I thought it was quite ingenious. 
In my time away from hospital I am catching up with my friend A. who is a surgical resident in the USA. We met in 2011 when I was at Tenwek and she came for 2 months as a medical student. We became great friends then and have stayed in touch over the years. When I was asked to come to Cameroon, March was good timing on my schedule and when I heard A. was also planning to come to Mbingo in March the timing just could not be better. A. being a surgical resident is putting in long hours but when we are both off we have enjoyed taking hikes in the beautiful hills surrounding Mbingo. Yesterday the small sprinkling of rain turned into a downpour and we got soaked. I am not sure what the Cameroonians thought of 2 white ladies running in the rain, they were all under shelter waiting it out. But we enjoyed it anyway. This afternoon we took another hike we were not quite sure of the way but some friendly children pointed out the path to us, once we were a little way up they decided to guide us all the way up. It was a beautiful hike and thankfully we stayed dry.  

Mbingo hospital
A. and 2 of our guides on the top enjoying the view. Notice the boy sitting on the tire, he carried it all the way up with him.

Our guides getting even higher and climbing the tree

We went all the way to the top of this beautiful hill


Saturday, March 8, 2014

Seeing More of Africa

 A few weeks ago if you had asked me how much of Africa I had traveled to the answer would be 2 countries (Kenya and Uganda). Since then that number has doubled as I have been able to spend some time in Tanzania and Cameroon.
Tanzania was a holiday. In my last post I talked about the visitors I had, they invited me to accompany them to Zanzibar, an Island of Tanzania for a holiday. This was a welcome vacation and I enjoyed the history of stone town, snorkeling, for the first but definitely not the last time, swimming, and getting some sun. This was also a great time to catch up with mom and dad and the other visitors without the stresses of everyday life or a pager calling me away. The trip ended with a little stress because as the plane landed in Nairobi a fellow had a seizure, I helped him out and then gathered my stuff and got off the plane. I knew good-byes would be at the airport but we did not realize they would be right on the tarmac. I had to board a bus to head to the baggage area and mom and dad went the other way to catch their flight back to Canada. We hugged and shed some tears on the tarmac and I unfortunately missed a few good-byes as some of my visitors has already headed into the terminal. I guess this prevented a long drawn out good-bye but it was tough. However I am so fortunate to have friends and family who enjoy travel and came all the way to see me.





relaxing at the coast

Cameroon is a trip for work, I am writing this now between writing a protocol for sputum induction and preparing a lecture on V/Q mismatch. I have been here for 1 week, out of a total of 3, working at a hospital called Mbingo. Mbingo is a mission hospital that is growing. They are in the process of opening an ICU and asked if I was willing to come out to help with some education. I have enjoyed the time here and getting to know the culture in this part of Africa. I have been teaching my students Swahili as I keep accidently speaking it so I have decided to teach them a word a day here's what we got so far:
Sawa – ok
Asante – thank you
Karibu – (you're) welcome
Habari za Asubuhi – good morning

Here in Cameroon they speak French or pidgin english so that is awesome. I have no clue what is being said. It is interesting to see the similarities and differences in the cultures of east and west Africa. I have had a chance to eat fou fou and jema jema (not sure about spelling) which is their version of ugali and sukuma wiki which in English is corn mush and greens. These are the staple foods in both places and are similar. There are parts of the culture that are different in Kenya, I have learned,  when visiting someone it is impolite to leave without them releasing you first; here in Cameroon it is like Canada where if you are leaving you say thank-you and go. I am looking forward to getting to know the people here better.

Thursday, February 20, 2014

More Visitors

A few weeks ago life here got a little more interesting for a while, not that it has been boring. One Saturday afternoon 2 vans pulled up to Tenwek filled with 10 Canadians. Now living among Kenyans and Americans is good but I do enjoy interacting with fellow Canadians. There weren't just any Canadian but special ones. Mom and Dad, 3 couples from my church in Taber and an aunt and uncle from Ontario. This was special.
The whole group was here from Saturday to Wednesday morning. They slept at a rustic guesthouse down the hill but meals and life in general happened at my place. We were able to squeeze 11 of us around the table and had many hands to do the dishes. Games of cards were played, discussions were had by candlelight – there was no power and Tenwek was explored.
I enjoyed showing my guests a slice of my life here from a hospital tour, to walks around the area and meeting many of the wonderful people that make life here at Tenwek what it is.

Ladies in skirts heading up to the hospital

The walk to visit a friend for Sunday afternoon tea

They all took off for a day to see a pineapple farm

Lunch in the hospital cafeteria

All 11 of us


Wednesday morning 8 of the visitors left for a safari in the Maasai Mara which gave me a few quieter days with Mom and Dad. I took Mom to work with me and sent Dad to the neighbours to fix a door knob. The 3 of us enjoyed the time to ourselves but it was still busy as I was working during the day and ended up hosting bible study in the evening, but Mom and Dad enjoyed bible study as well. Friday afternoon the 8 came back with stories of lions, cheetahs, and zebras after a wonderful safari. We had one last night at Tenwek before arising early the next morning to go climb Mount Longonot. I had climbed Longonot a year ago and remembered it being alright but could not remember how long it took. The day before left I was getting a nervous wondering if we would have enough time to climb it. I was happy to arrive and see the sign 3km to the summit – OK 6 hours round trip this we can do.  A few were not up for a 6km hike so they stayed back and enjoyed the sun but the rest of us enjoyed the view from the top – looking across to lake Naivasha, down into the crater and across the escarpment. From there it was back to Nairobi. After church on Sunday Aunt J. and I returned to Tenwek and the others took off on their next adventure. Aunt J and I have had a nice quiet week here at Tenwek her helping out here and there and finishing her book and me tying up some loose ends before the next adventure starts. Which is right around the corner

Aunt J. and I are joining the visitors in Zanzibar  for a few days of holiday. After this I say a final good-bye to Mom, Dad and guests and they fly home. The next da, rather than head back to Tenwek, I  will hop on a plane to Cameroon. I am going to Mbingo hospital which is a Christian hospital that Samaritans Purse also works with. They invited me to come out to do some education as they are moving toward opening an ICU. I am looking forward to the time there, but will miss the community and familiarity of Tenwek.
Mom and I at the top of Longonot

Saturday, January 25, 2014

The Tenwek I call home is running out of room

So I’m starting this post while taking an extended lunch break, why – it is pouring outside. I thought the rainy season was over but I would be soaked to the bone if I tried to walk back to work right now, even if I had an umbrella as the rain is coming sideways. Yesterday, the rain and wind came together so hard that a large tree limb broke off. I was glad no one was under it and that the staff cleaned it up as soon as the rain slowed. This rain is necessary for the plants to grow and keep the Tenwek I call home green. About a month ago I blogged about the Africa you think I live in (but don’t) so this is a follow up to that post as I am writing about the Tenwek I call home.
Tenwek is in rural Kenya halfway between Nairobi and lake Victoria and is in tea country – this means we drink a lot of tea, always with lots of milk and sugar as well as grow lots of tea. Fields full of tea bushes are a beautiful site. Many of the local people are farmers growing corn, beans, potatoes etc. They also may work at the hospital, a bank or a store. People get around in their own vehicles, walk, take a taxi or bus or hire a motor bike driver to get around. They speak a mixture of kipsigis (local tribal language), Swahili and English.
The misty hills

A tea farm about 30 min from tenwek

The view from the road leading to the hospital

Tenwek however is something different in the midst of Kipsigis land. It is a large hospital that provides care for the area as well as trains Kenyan physicians, from all over Kenya. We have the ability to not only teach medicine but disciple many in their faith. Here are some of the physician groups that we train.
  • ·         Clinical Officers (CO’s) – CO’s have their schooling at formal institutions but come out here for 1 year for their clinical internship they spend time in OB, Medicine, Pediatrics and surgery. We have 8 of these at a time
  • ·         Medical Officers (MO’s) – MO’s have completed medical school but come to us for their intern year, like the CO’s they spend time learning/working in each of the services OB, Medicine, Pediatrics and surgery. We also have 8 of these at a time.
  • ·         Family Practice Residents – After completing their MO intern year Kenyan physician’s can work for a few years before going into residency. We train 2 residents per year in Family practice which is a 3 year program, so that is another 6 people.
  • ·         Surgical Residents – Tenwek trains surgical residents as part of PAACS (Pan African Academy of Christian Surgeons) We have 2 per year in general surgery, and we just started an Ortho program which is another 2 per year so we have 14 surgical residents (if the math is confusing one year we took in 4 General surgery residents) and once the ortho residency fill up we will have 20 residents.
  • ·         Medical Students – as part of their MO training we have med students come out for a few months this is about 10 at a time
  • ·         Others – There are also other visiting African residents that spend time at Tenwek. As Tenwek is one of a few mission hospitals to have an ICU other residents come to learn here for a few months from other training locations in Africa. We also have residents coming to learn ophthalmology. So we probably have 2 of these at a time.

Every one listed here is African and they are all at Tenwek for training if you total up the numbers that is 48 people that we are training, and as the programs get full we will be getting more. Also some of these individuals are married and many  have children. With all this going on we are running out of housing. It is the hospital's responsibility to find housing for all these people and our current housing has run out. There are plans to build a new complex to house these trainees and we would appreciate your help. Would you be willing to make a donation so we can continue to house and therefore continue to train high quality doctors for Kenya and Africa?
Some of the trainees gathering for bible study at Dr W's house. 

World Gospel Mission has an account set up specifically for this project. If you are an American you will get a tax receipt, if you are Canadian unfortunately you will not but I hope that will not prevent you from giving to this important project. To give either follow this link https://www.wgm.org/tenwek-hospital-housing or send a cheque to World Gospel Mission
note: for Tenwek Housing Account #125-35006

Donor Services
World Gospel Mission
PO Box 948
Marion, IN  46952-0948


Thank You.


The proposed building to house 44 people. 

Sunday, January 19, 2014

VISITORS

I have now been in Kenya for over a year it has been over a year since I have seen my family but I just had a visit from some great friends. I have known Janelle, Kayla and Nella since 2005 when we all went to NAIT and studied Respiratory Therapy together. Through the years we have remained great friends and are the type of friends who due to work, travel, and just general busyness we may go a while without all being together but when we get together again we pick up right where we left off.
Time here with the ladies was fun. Janelle and Nella had an extra adventure getting here as their flights were delayed and then baggage trouble but I was so glad when they all made it to Tenwek. There was an invasion of Canadians and RT's at the hospital as we were able to work all together for a few days. It was fun to have other RT’s to bounce ideas off of. The extra hands also came in handy one morning as we had a power outage for ~30 min and each RT could take an area ICU, HDU, RR and breathe for the patients by squeezing the bag until the ventilators worked again. It was a crash course in how to use the Servo 900C for Janelle; you will have to ask her how it went.
With the extra RT’s at the hospital we did some additional teaching for the nurses and doctors and were able to sort through the equipment rooms in ICU and HDU. Throwing out old/unusable supplies and making the routinely used supplies easier to find.
Nella organizing,

So many little pieces

No time in Kenya is complete without Chai

Creating some tasty food. 

More Chai

The Canadian RT invasion

A trip to Kenya is not really complete without enjoying the beautiful animals that God has placed here so the 4 of us went on a 2 day safari to Maasai Mara. This was a wonderful time. While there I realized this is probably the first time in a year where I did not feel stressed. I am not saying I am stressed out all the time here but living in a culture that is not your own it is sometimes difficult to completely relax. Times when I have gone away to Nairobi or my travels to visit friends I have always had things to do or not been able to completely relax. To be a tourist in a place where I did not have to worry about food, transport, or what language I was speaking was a wonderful vacation. Never mind the wonderful food we ate and the amazing animals and just beauty of the Mara.
Rather than go into more details I will end here with some pictures of the awesomeness.
How close have you been to a Rhino?

 

Just me and  some Cheetahs 

I love giraffes

God paints a beautiful picture every evening. 

Lovely ladies

A baby Elephant was one of the highlights of the safari

One last beautiful sunset.