Wednesday, October 16, 2019

Preparing to Go Back, WHY?

The Lord willing in three months, I will be back on Kenyan soil. I have enjoyed the last 6+ months in Canada. I have a comfortable apartment, a convenient LRT (subway) ride to work, I am enjoying being able to visit with my family often, go for coffee and supper with friends. I have a job where I am challenged but not stressed. I work with a fun group of people. I get paid well, and I don't need to raise support for it. So why would I want to leave?

There are a few answers to this question:

- I have a great place to live in Kenya too, it's comfortable, I have great neighbours, and I can walk to work, and home for lunch too.

- Family is farther away (and that is hard) but I have great community, kids who call me Aunt Annette, friends who I can call at any time. I am thankful for technology that helps me to keep in touch with the family that is far away.

- Work is the same in Kenya, in some ways, but different in others.  I am working in a Pediatric Intensive Care Unit in Alberta. On weekdays when I show up to work here there are two pediatric intensivists working, a few peds residents and one pediatric fellow (finished residency and getting more training in ICU care). Each critical patient has a nurse assigned to them with specific training in pediatric critical care. For our 16 bed ICU, we have three respiratory therapists assigned each shift.
When needed, the pediatric team of physicians can consult pediatric pulmonology, or infectious disease, or endocrine or oncology or...

-Contrast this to Tenwek: when I show up at work there are one or two pediatricians for all the pediatric patients (20-30 on the wards, ~30 in the nursery, a line up in outpatient and a few in the ICU). We have interns working who are with us for one year of training in adult medicine, pediatrics, obstetrics, and surgery. At the end of their training year, they are helpful but at the beginning they need a lot of guidance. We have one or two family residence on the pediatrics service helping out. When the service gets stuck they can talk to the pediatric surgeons, they can talk to the adult intensivist, they can talk to a smattering of other staff or they can send an e-mail home with questions.

-For respiratory therapists at Tenwek - there is one, and I am not just caring for the pediatric patients, I am helping out wherever I can.  When I go back to Kenya, the hope is to do more formal teaching so one day, hopefully soon, there will be more than just me.

So all this comes together to show need but there is more.

Eric Liddel, an Olympic Gold medal winner in running,  said: "God made me fast and when I run I feel His pleasure".

Frederich Buechner said, "The place God calls you to is the place where your deep gladness and the world's deep hunger meet."

Together both of these bring me to Kenya. At risk of sounding proud I will say I am a good respiratory therapist, when I work in respiratory caring for patients or teaching others I feel God's pleasure. When I look around I see the need in Kenya. Pulling this all together, Kenya fits for me.

So I will go back, this next term will be three or four years. I am excited for what this term will look like. I am looking forward to greeting old friends and meeting new ones. I am nervous about what will be waiting for me, how will things have fared while I was away. I am hoping I am prepared.

I ask for your help. This can be done in a few ways:

1.  Prayers, Tenwek is great but hard. To give some perspective in the last six months working in the PICU and floors, I have seen 2-3 deaths of children. In Tenwek, I sometimes see that many in a week. Including adults in my count (I don't keep track as that is too depressing) 2-3 deaths a day is normal. So pray for God to encourage me. If you want some perspective of this I recommend you read a book called "Promises in the Dark" by friend and fellow missionary Eric Mclaughlin.

2. I also need financial support. The hospital does not pay me so my salary and other expenses must be raised. Donations are easy just follow the instructions in the post below this one.

There are a few more reasons to go back to Kenya. The weather is lovely all the time and it is beautiful. Below are some favourite pictures. If you ever find yourself in Kenya send me a message and maybe we can meet up.


What A Strange Bird

2 of my Favourite animals together in the wild


I took this picture just outside my door. 


Colubus monkey (4 hours away in the rainforest)



Monday, September 30, 2019

Giving 2019

Thank You for supporting this ministry. You will receive a tax receipt for donations, just follow the instructions below. 
I ask you to consider regular scheduled giving, it is easy to do and will help sustain the ministry. 

Canadians - Give via Into All the World

Ministry vs Personal - When you donate there is an option between Project and support. Both are tax-deductible. Project covers expenses beyond my salary ie travel, materials, equipment, fees etc. Support is my monthly salary. You may choose whichever you like. If needed I can transfer between funds. 

Electronic Funds Transfer, Credit card, Cheque, E-transfer
Use this IATW Form.

Web:
https://app.etapestry.com/onlineforms/IntoAlltheWorldInc/donate.html
Select my name from the drop-down list and fill in the information.


Americans - Give via World Gospel Mission


Check, credit Card
Use this WGM Form

Web:
https://www.wgm.org/volunteer/lievaart


Thank you for your prayers and support

Friday, November 24, 2017

All I want for Christmas is...

So Christmas is coming and while I am away from a lot of the commercialization that surrounds the North American Christmas season the thoughts of what I want for Christmas is on my mind. This year I am asking for something big and I am asking for your help.

This year all I want for Christmas is New Ventilators. 


These are not for me personally although I do have a collection of medical supplies in my house. Currently my desk is covered with Laryngoscope blades, I tripped over my spirometer that I store under my bed and this bag of CPAP masks is getting in the way. (Don't worry all this stuff will be used by the hospital). The new ventilators I am asking for will be utilized well. We have already ordered two and plans are to order four more.

Since I arrived in 2010 Tenwek has managed to get by with a collection of donated machines, over time some of these machines would break in a way neither I nor Bio-Med could fix and they would join the broken pile. Since I have arrived we have gotten four 'new to us' machines. Three of these were already 15+years old and one quickly became extra parts for the other two.

We still have a few machines with us that have been here for (way) too long. Two of them always alarm "check diagnostics", one no longer delivers PEEP which is needed for 90% of patients. (Yes my fellow RT's: really 100% need PEEP but head injuries and overdoses do OK with no PEEP.) Now if this was your family member would you want them on a machine made in 1981 and is also found in museums (not a lie) or would you want them on a machine that alarms and no one knows why? DO you want them on a machine that says "No PEEP must keep at 0". While we have been able to provide safe care to the patients a change is needed. So we are working with a distributor to purchase six 'new to us' machines. Two are going to the cardiac surgery area and have already been paid for but the other four will be used in our general population.

Are you willing to help me with this Christmas present? Four machines and shipping will be expensive but will help sustain the ICU and HDU in Tenwek for many more years. Some funds are already in my account but I am giving you the opportunity to help. To give you an idea of cost - I was thinking of buying a car but since I am borrowing another family's car while they are in the States for a year I figured this would be a better use of the funds. So if you want to help - it's easy click the "to donate" button on the side and follow the directions, you will even get a tax receipt. Then send me an e-mail or Facebook message letting me know that the donation is for this purpose. If by chance (that would really be a miracle) I raise more than needed the extra funds will go to preventative maintenance of these machines.

I have also added some pictures to show the new machine and old machines.
The New Machine - We already have one,  it will be great to have more. Isn't it beautiful?

Old machine from 1981, we actually have two of these, this one with some trouble but the other actually works well. You may notice this is the same brand as the new ones we are buying hopefully they will also hold up for 30+ years

another older machine, notice the 0.00 in the top middle. That is supposed to read the amount of air the patient is breathing. A helpful value, however it does not work (despite replacing the sensor). 

Sunday, October 8, 2017

Unique Talents one learns on the mission field

So living in Kenya has taught me a few things that I probably would not have learned back in Canada.  I thought I would share a few of them here.

  • Ability to look at the gas burning in the bottom of my oven and know if the temp is set to 350F or 450F necessary as the temperature regulation looks identical to the ones on the stove, no numbers.
  • Able to drive (a standard) while dodging motor bikes, potholes, people, cows, donkeys and other cars.
  • Can now distinguish the difference between Thompson Gazelles, Impala, and Grants Gazelles. 
  • Can give a speech with a few minutes notice, although my 4-H days taught me this.
  • Can hear a ventilator alarm from a different part of the hospital or through the phone line and know what the problem is.
  • Able to go shopping only every 6 weeks, with the exception of a few staples and veggies and not starve.
  • Complete a recipe with multiple substitutions, see why above, and it still tastes good. 
  • Speak to patients in various languages. My Swahili is coming along well, but some patients only speak a local tribal language - Kipsigis, interestingly my 15-20 kipsigis words include cough, don't bite, breathe, breathe by yourself and lie down (relax). I guess you learn what you need to. 
  • How long it takes for me to get cabin fever - 6 -7 weeks. With elections happening we were told to sit tight. So here I am, after not leaving Tenwek for 7 weeks and I am going a little crazy. I guess I know my limit.
  • Able to quickly get to know and work with a new phsyician, dancing the line between advising them what do do and telling them what to do. We have about 150 medical visitors a year so a lot of hello's and good-byes
  • I'm sure the list is longer but that's all that comes to mind right now. 

Wednesday, March 1, 2017

Ghana, Non-Medical missions

So I am a little behind but I thought I should write a bit about my time in Ghana. I am serving with an organisation called Reach Beyond.  Missions are full of confusion so they second me to the organisation known as World Gospel Mission (WGM) that I work with at Tenwek. Anyway, Reach Beyond divides up the world into regions and I am part of the Sub Saharan Africa region. A few times a month I have been meeting via Skype with the other missionaries in the region. It was time to meet in person and with visitors from the American HQ coming out to Ghana it was a good time to go. So beginning of January I took off for a few days.

I enjoyed my time in Ghana. I got to meet the rest of the team and their families, the children who had previously been annoying shrieks over voice Skype were now fun to play with. I also enjoy visiting other parts of Africa. Africa is a huge continent with diverse cultures. When travelling across the continent it is interesting to see what is similar and different. Nairobi has much more western malls and fast food than Accra, Ghana but in Accra you can safely walk after dark.

While meeting the rest of the team in person was the best part of the trip, I really enjoyed seeing the non-medical side of missions. The rest of the Reach Beyond group on the team are not medical but do radio. It was really great to see the work going on. Christian broadcasts going out in local language, spreading the good news of the Gospel, another group who has recorded audio bibles in 300+ languages, visits to a community where the water source was a puddle and with some help from reach beyond and a visiting team, a well was put in. Changing the health of a community. The medical side of missions is great, however I enjoyed the exposure to another side, which is also great.
Rather than say more I will share a few photos
I did do some medical work, assisted a nurse in putting a dressing on the finger of one of the boys in the village.

Just like Kenya the kids love photos and strange looking people with white skin and red hair.

Recording live for the radio, we all were in the room trying to be quiet. 

It's a jungle

The DJ at work.

Cocoa beans -yum.

Village's old water source.

New water source, tastes good I drank it fresh from the tap.




Friday, February 3, 2017

Rain

So I have become someone who always annoys me - people who have a blog and don't keep it updated. So sorry, I have a good reason and I will use this reason to write a blog post.

Life here in Kenya has become normal, when I arrived in Kenya years ago everything was different and exciting. From new language, a different culture, a different hospital and different responsibilities. All of this gave plenty of material to blog about. I have not blogged about it all but it now seems normal. When visitors come and get excited about the baboons on the side of the road or are dismayed by the high number of suicide attempts or I explain to a guest what we should and don't have to use filtered water for, it is all just normal life now.

Writing about normal life is boring. I keep reminding myself that even though I find my life boring (as in normal) it may still be interesting to you. So I will write about something so normal here but it still makes me shake my head. That is RAIN.

When you read about Kenya in guide books or online you will read about the rainy season and the dry season. How the rains come March through  June and August through October, or maybe about the December short rains. That the rest is dry. However this is crazy in my experience - it rains most weeks, except January, January is dry unless it rains. Why you may ask?  Two reasons: first Tenwek is at a high altitude and therefore gets more rains, second is climate change, now I don't want to get in to an argument about global warming but in Kenya the weather has gone from predictable to unpredictable. The locals tell me they used to be able to say what day the rains would start, now it's just confusing.

So those of you who think I live in a dreary wet drizzly climate couldn't be farther from the truth. Here when it rains - it pours, maybe for 5 min maybe for an hour but then the sun comes out again. I am sure there is a five degree difference between rain and no rain.

SO how does rain affect life here:

Because when it rains it pours - never, ok rarely, a little drizzle - no one goes anywhere. You wait. I have come home for lunch and had my lunch extended by 20 min waiting for the rain to stop, it never rains for long. A walk to the hospital even with an umbrella and I could get drenched.
Some days at the hospital it may be slow for me and I think one more thing and then I will work on things at home, then it starts to pour so I work longer or vice versa, if it has been an on and off rainy afternoon I may go home early if there is a break in the rain. Or there are days like yesterday where I decide to run home in the rain and get completely soaked. You know the type of soaked where you don't even walk through the house but are thankful you live alone and the curtains are closed so you leave the wet clothes in the entrance.

I don't complain about the rain, it's normal and as a farm girl I know about the importance of rain. Much of Kenya right now is experiencing a drought. So while the rains have started here at Tenwek (it's no longer January) parts of the country remain dry. So join me in praying for rain for those suffering from drought.

How's that I don't write for months and then all I talk about is rain? Pathetic, I know.


Saturday, July 9, 2016

life update and why you should get your tetanus shot

So my plan has been to write a post once a month. I have failed again. Sorry. Since I last wrote I made a quick trip to Canada to attend a friend's wedding and see family. It was great to see everyone there again, if I missed connection with you I am sorry. I have joked that I am the missionary that never leaves as since arriving in Kenya in January I have made 2 trips back to Canada. The February trip, as you know was unexpected. This trip that I just took was planned already in January, and I am so thankful for that. I don't have any further trips planned so it will probably be a year before I am back in Canada. It was hard to be home without mom but also good to connect with my family. I have found since coming back I have progressed further out of the grief. The other day at work I was singing. I used to do that often but not in the last few months. It is good to feel more normal although I am sure there are times when it will seem to bog me down again. 

Work at the hospital continues and I would like to share a challenge that does not exist in Canada but is one of the hardest things about working here. Healthcare at Tenwek and many mission hospitals is often referred to as working in a resource limited setting. That limitation of resources vary vastly on the spectrum and Tenwek is a better equipped resource limited hospital. However we still have to be judicious concerning our use of this equipment. For me a weekly question is the use of our ventilators. We currently have 5 working ventilators (1 broke while away and I still can’t find a replacement part). When a patient is placed on a ventilator that means we can not use that machine for someone else so decisions need to be made about how appropriate this is. 

Let me share a story about this. A few weeks ago I got to work to discover a child with Tetanus had deteriorated over night and was placed on a ventilator. Tetanus is an ugly disease - so please get your vaccine. If it progresses to the point of needing a ventilator the chance of survival is poor, but there is still a chance and without the ventilator in this case the child would have died. So the decision was made and we continued to care for this child. Tetanus means the child may need a machine for 2-3 weeks. Therefore we are unable to use the machine to care for other patients with this machine (although I have 4 more) meaning other patients may die or may not. There are weeks when I only have 1-2 patients on a machine and some when all are in use. 
So here we were with this child on the machine. Praying, treating and hoping he will recover. 
However there is a second resource limitation here - the families resource. Staying in the ICU is an expensive treatment. About $100/day or more. That is cheap by western standards but if you only make 5$/day this is a lot. With all your funds going to pay the hospital bill still not being enough some families have to sell their land to pay the bill. Yes, Tenwek is a mission hospital and does provide care to all patients and we have a fund to help patients when needed but a large amount still falls onto the family and their community. So back to my patient after 2 weeks on the machine he died. Now not only is the family grieving a loss their savings have also been depleted. Limited resource is hard. 

Now a few weeks later I get a page, another child also with Tetanus, not doing well. Now what do we do. We have a ventilator available - do we use it? Is this a good choice? Again the family has no money? Transferring to another hospital is not an option as the government hospitals will also charge and require a large deposit up front. These decisions I hate. A colleague of mine once said “don’t make a decision based on what happened to your last patient” not sure if he was quoting someone else but we took this advice. We decided to put the child on the ventilator and 24 hours she is doing a little better and she came off the veniltator, not on purpose the tube fell out but momentarily stable. So we observe. She may need the ventilator again she may not. She may live or she may not. 


In closing - a public service announcement: this is the 3rd child with tetanus in a few weeks, 2 have died and the 3rd we still don't know. Please, wherever you live, ensure you have your tetanus shot.