Sunday, April 10, 2011

Back to life and Good bye

So this is my final blog post. I hope you have enjoyed reading my blog. It has been good for me to write and when I start scrapbooking all my pictures these posts will end up in the pages. I am settling back into life here. I have moved in with a friend - will soon start looking for my own place (if you know of a good one bedroom preferably in the West End let me know), I bought a car and worked a few days at the hospital.

Life is back to normal, I guess, except I am not the same. I picked up a little bit of Kenyan culture and my friend looks at me funny when I say sorry, even when it is not my fault - very Kenyan. I have been tempted to say Kenyan phrases like si jooey, and Sawa sawa (not sure about the spelling) for I don't know and ok. Working at the hospital is just like before, in some ways it seems like I never left. Except when I was at a ventilator in-service and I learned that the vent has a back up battery - good, I thought, then when the power goes out we don't have to bag. Then I remembered I am back in Canada and the power at the hospital (almost) never goes out. It also is strange what is normal to me now. I was talking to the staff here and saying that in Tenwek we would often have two babies (occasionally three) in the same warmer - they thought this was very strange, to me this seems perfectly normal. I am also getting used to assessing white patients again - they are much easier because they change colour. It was very hard to see if a Kenyan was jaundiced, cyanotic, mottled etc. unlike white people who change colour.

It has been great to see my friends here again, and enjoy take out. However I miss Kenya, the people, the hospital, the weather etc. I wonder what God has in store for my future. There is a strong possibility that I will go back, probably longer. So I will look into the logistics of that. Those of you here, don't worry that I will be leaving again so soon. It will take at least a year or two for me to figure things out. For those of you in Kenya who wish I would come sooner - pole (Swahili for sorry). I hope you enjoyed this blog. Thanks to my editor for making this understandable. I am done blogging until I have more adventures at Tenwek. Anyone reading this who has questions about Tenwek or respiratory mission work feel free to e-mail me at . Thank you and goodbye.

Tuesday, April 5, 2011

Coming Home

As promised in my last post I am writing about culture shock and coming home. My last week was a week of goodbyes at Tenwek, a goodbye party with all the missionaries at Tenwek, goodbye to the church, goodbye to Sunday school class and youth group on Sunday, goodbye to the hospital staff on Wednesday. A walk Wednesday afternoon to say a last goodbye to the missionaries.  A goodbye supper Wednesday night followed by the last fire on the porch. Thursday was the last goodbye to friends before hopping in the van and heading off to the airport. 
Great friends
Sunday School Class

My ICU nurse friends

I was able to car pool with a few other people flying out so we hired a van and off we went. Travel in Kenya is always interesting between the matatus full of people and the donkey carts. We had no trouble until we reached the town of Narok, where nothing was moving. We wove our way to the front of the congestion and discovered that people had blocked off the bridge. Our driver went off to see what was up I don’t know if i got the whole story but the jist of it was that the businessman were protesting (by blocking off the road) due to the flooding that occurred yesterday – they wanted money.  Soon after we learned what was going on, the riot police showed up and for our safety the driver took us back about a mile. Here we sat. There was no way around the blockage with the exception of driving through the river, which some people were driving through. However, we were not in a large vehicle and the driver did not think we could make it through the river that just flooded. Our option was sit there or head back to Tenwek and to Nairobi over Kericho than Nakuru – a 6 hour detour. Nairobi is only ~2 hours from Narok so we sat.
As we sat, I realized how much I have changed in the last few months, the old me would have been worried for my safety, and very stressed about making it to my flight on time. Instead I found my flight itinerary to make sure I had the travel agent`s number (I did) and then layed down to take a nap (I had only slept five hours the night before).  I dozed for  a bit, listened to my iPod and we waited. I figured as long as we made it out of Narok by 4:30 we should be ok to get our flights. God was good, after sitting for two hours we started to move half an hour before my requested time of 4:30. Being that we were in Kenya, traffic doesn't all start to move in a nice orderly fashion, all goes at once in the lane, the ditch and the lane where the oncoming traffic would be coming in just a few minutes. But hey, oncoming traffic is taking up all the lanes as well. Like all the kids cramming around the door after recess and no one actually moving. Somehow, everyone eventually got sorted out, we drove out of the ditch that we thought would be quicker (we being the driver) and proceeded on our way.
From then on the trip was uneventful. I got on my flight and proceeded home without any trouble. I slept the first flight, and I was entertained on the 2nd flight with the movies – Voyage of the Dawn Treader (I have the book almost memorized so I was disappointed by the movie), Gulliver's Travels as well as the new (as in most recent) Indiana Jones.
Mom and Dad met me at the airport with the words: glad your flight was on time, we have to go there is a snow storm coming in. I had hoped this was an April Fools joke – but nope the world is still white here. We managed to make it home before the storm but the weekend has been white and the temperature hovering around freezing – I should have stayed longer at Tenwek.

The view from my parents front door - winter.
 I have had a few days at Mom and Dad’s and am enjoying the luxuries of being back in Canada. One of the first things I did when I got home was poured myself a glass of nice cold milk – my first in `six months. Wonderful. Mom sent me to do groceries and I managed to drive on the right side of the road and other than a strange impulse to buy chocolate chips, pens and Ziploc bags the reverse culture shock has not hit me too bad. I am sure it will hit me harder when I return to work on Thursday.

Sunday, April 3, 2011

Emotional good-byes and a question

A few hours ago Tenwek had a goodbye party for me. It was a lot of fun to see everyone together - I heard that there were 49 people. It is hard to believe that I have only been here for 6 months. I have built friendships here that will last a life time. I enjoyed the time together but it was also sad, when my friends were talking about how helpful I was here and proceeded to pray for me and my future I almost cried. I kept my farewell words short for fear I would start to cry. Those of you who know me well know that I do not cry often.
Writing this now I am crying, for a few reasons it is 130am and I am tired, the evening was emotional draining, as well as an emotional goodbye party,  I just got back from the hospital where a baby just died - despite intubation, epinephrine and CPR ,we could not get this baby back. This is not just any baby this was the son of a staff member I have seen her many times in the last few months waddling around with her pregnant belly. I don't know the lady's name, but as I was doing CPR in the nursery at 1am I cried for this mama. When I and the doctor explained to the mama that despite our best efforts her son was gone she cried, as did I.
I am saying goodbye to my friends and community here at Tenwek but that grief is nothing compared to the pain this mama is going through. As I walked down the hill I asked a question that I know has been asked many times before. Why God? Why does this mama have to say goodbye so soon to this child she barely got to know.
I wish I had a good answer to this I have heard a few different ones throughout my life. We must understand that evil is in this world. Satan is present and knows how to hit us the hardest and where it hurts. Is not God more powerful than Satan? Could He have not saved this baby? I know God could have but evil will not be totally gone from us until we reach Heaven. God has also already rescued this baby just like he has rescued all of us, on the cross He died for us. We celebrate this in a few weeks at Easter and the promise of everlasting life will be complete when we are with Him in Heaven.

I stopped writing this on Sunday morning at 2 am, and went to bed, I am resuming this post the following Saturday. Last Sunday was a busy Sunday with saying goodbye at church, Sunday school, helping a friend with bible quizzing and youth group. Through this time I thought about what I had written in this post. Writing was therapeutic for me at 2am and then came the question can I finish this post and publish it or does it ask questions that should not be asked.

 I don’t like the latter part of this question I believe in God and his sovereignty, his love, his grace and his power. If I believe this how can I be scared to tackle this question? I do not have any formal biblical education so I don’t know how I can answer it but I after some thoughts and discussion with a friend here are some thoughts (in addition to the ones that were previously mentioned). I was given a book by a friend EPIC by John Eldridge, I was reading this on my flight home (yes I am back in Alberta I will blog about reverse culture shock later) he talks about how everyone’s life is a story, and we don’t know how it will go but God does and he has wonderful things planned for us.

It is hard to imagine something good coming out of the loss of a newborn but I do not know the end of this story God does. God also gives us peace to get through the hard times. God wants us to come to him with our struggles. Me asking this question is pulling me closer to God.  God knows the big picture, I don’t. Does this answer the question? It is possible that my former English teachers would fail me for a poor argument. However I know through faith that Jesus is Lord and that he loves us and there is an eternal reward in which the sufferings of the world will no longer matter.

Wednesday, March 23, 2011

Can I Leave?

I am writing this post with only six more days of work left until I leave back to Canada. I am coming home - this is a fact and I am looking forward to seeing my family and friends as well as going to fast food restaurants. However, I am sad to go. I have made many good friends and have loved my time here. I am also worried about what will happen when I go.

To illustrate that fact here is what happened today:
I was awoken up by my pager at 6:30am - the patient was not doing well and the resident would like some help. I got up the hill and find a patient who was not doing well - his heart rate was 170, respiratory rate was 50 and SpO2 was 75. I did what every RT does and fiddled with the vent settings for a bit with no improvement - take a listen to his chest and I discover that the air entry is poor. Asked about a CXR - the portable machine is broken. I then took the patient off and bagged - amazingly he was easy to bag (his PIP was 40). Thinking the machine was broken, I swapped out machines - seemed to help for a little while but then same problem again. We paralyzed him and finally he settled. This man has a head injury and was breathing so fast that the ventilators (both of which I tried) could not keep up. We managed to get this all sorted out in time for 730am rounds and 8am M&M (morbidity and mortality).

After M&M, I sneaked away from the hospital to have some breakfast - finished just in time as my pager went off, they needed my help in the nursery. Up the hill I climbed to discover the resident bagging a sick baby with poor SpO2 we bagged the baby for a while but we were unable to save him. I comforted the Mom and said a prayer with her and the chaplain. As I was leaving, I was told they were having trouble with a one year old on the pediatric floor. Off I went and found a grunty 1 year old just maintaining his SpO2 on a non-rebreather at 15lpm. So we took him to ICU - after making a stop off in x-ray to take a chest film as the machine was broken. In ICU he did not look much better and we were debating about intubating him or not; we went for a compromise and put him on CPAP. How do you CPAP a one year old in Kenya? You take your home BiPAP machine and an adult nasal mask and you are good to go. The child looked really cute (only a RT would say a kid looked cute with a mask). The SpO2 maintained and at a reasonable level and the child was able to rest his breathing muscles.

That done I was able to escape for lunch and some computer work. Came back after lunch to check up on the previous patients and teach the new visiting Doctor how to use our ventilators. I had a scheduled lecture for 3:15pm but was told (at 2:45pm) that the lecturer for 4:15pm was unable to make it so could I do her presentation as well. So off I went, reviewed her lecture (on Trach care) and gave lectures all afternoon. The day ended with a quick round to see how things were going. I headed into Casualty (ER) and saw two patients receiving side stream neb treatments - set up like a pipe. I was so excited as the nurse had set them up properly. Maybe I can leave after all.

So sorry if I bored and confused all you non medical people. Really, I am worried about how the staff and more importantly the patients will do when I am gone.
On a lighter note I had a great week last week my friend J was here and I had a great time working with her as well as taking of to the coast – Indian Ocean. I celebrated my birthday there and enjoyed a surprise birthday party from my friends at Tenwek when I returned. We have also been blessed with rain in the last week which means the grass is green, crops can now grow and the hydroelectric dam can give me power. On a sadder note my computer screen has died – I have been able to borrow the guesthouse computer but has made it difficult to post pictures on the blog – sorry, when I am back I will post some.

Monday, March 7, 2011

Culture Shock in Kijabe

I am starting this post on Friday – I am currently in Nairobi relaxing at the Mennonite Guest House – a great place to stay.  I am looking forward to supper in 20 minutes. I have heard the food here is great. As I alluded to in my last post, I spent the last week in Kijabe. Kijabe is a mission station, I have heard it is one of the largest mission stations in Africa (no clue if this is true) however it is made up of:
~Kijabe Hospital which includes Bethany Kids Hospital;
~Cure Hospital
~Moffet Bible College
~Rift Valley Academy (RVA) – a Christian boarding school where many MK’s (missionary kids) attend, including a handful from Tenwek.

Having a mission station this large means a lot of wazungu (white people) as well as white culture.  Kijabe is even higher elevation than Tenwek and is built on a hill with the beautiful Rift Valley opening up, I spent evening watching the sunset and I felt like I was on the top of the world. It is also colder in Kijabe (I had been told this but it is the dry warm season now so I have not suffered) as well as windy. A beautiful location.
The Great Rift Valley - a small part of it anyway

I arrived at Kijabe on Friday night and settled in with the wonderful family that was letting me stay with them (Thanks Ls). I also got a tour of the hospital – which I will talk about later. Saturday morning, I woke up on time to do rounds in the hospital with the intensivist before he left for a month and then it was off to RVA.  It was an exciting weekend as the boys’ basketball teams and the girls’ soccer teams were having a tournament. It was like being in high school again cheering for the boys b-ball (it reminded me of the ICHS games vs PBHS) and eating all sorts of good food. Being at RVA was strange – so many white people, a good Saturday anyway, and the boys’ basketball team got first, I think the girls’ soccer team got second.
Soccer on the top of the world

Sunday was church I felt like I was back in Canada – with such a large mission compound they create their own church community and fill it – I did not count but there seemed to be 400 people and 95% white/Asian. Talk about culture shock. This trip prepared me for the reverse culture shock I will experience when I get back to Canada in April. The rest of the week was spent at the hospital.

Kijabe is a mission hospital with a slightly smaller patient load than Tenwek (this fact may be wrong but I was told Kijabe had about 200 patients and I think Tenwek is 300). Kijabe is closer to Nairobi and the city influence plays into the culture. The culture at Tenwek is African and this is reflected in the work as nothing is rushed and orders are not always completed. Kijabe was different as the staff are more influenced by Nairobi culture which has more western influence. This improved the nursing care delivered to the patients. Aside from this Kijabe is much like Tenwek – they are limited by the tests they can perform due to cost or availability, there are things that we can still not do. |We were still in Kenya -  no cath lab for the lady having an MI.
I had wanted to go to Kijabe to see how it is different from Tenwek and this was accomplished. I also went with the request to do some teaching to the ICU nurses. The plan was to do five lectures (one a day) but this being Kenya I ended up doing three – which was fine as well. I also was able to complete some tasks similar to what I do at Tenwek.  I glued baggers back together, taught the visiting Drs how to use the ventilator (all servo 900C), explored their storage room and found myself asking: why would you donate this to a mission hospital and then spend the money to ship it here – example being disposable toilet seat cover, for those of you who have traveled you may have seen the beautiful pit toilets that are common – there is no seat to put a cover on. Anyway the ICU nurse and I had a good laugh, she is also enjoying the one pair of insoles that someone put in a box, now her feet don’t hurt. Anyway I have regressed, I spent time similar to the way I spend it at Tenwek but without a pager – although I did hand out my cell phone number. The week at the Kijabe was good but I was a little homesick for my friends and community at Tenwek – being so large I felt that Kijabe did not have the tight knit community that I experience here at Tenwek. It was great to come back and get hugs from my friends, it felt like coming home.
Kijabe ICU

It’s now Monday and I am back at Tenwek and back to work – the post-op esophagectomy lady with SpO2 in the mid-high 80s and us putting off intubating her hoping she will pull through on 100% 0xygen (actually more like 80% because that is what comes out of the wall). We also have a high number of burn patients lately.  Our ICU has a young boy and a young lady both with severe facial burns, both with trachs. Please pray for them as they recover that we can keep infection away as well as the psychological challenges they will face.

I will end here.  I will hopefully blog again soon but my friend J is coming to Tenwek on Wednesday which I am super excited about but may pull me away from my computer.

I will finish this with one last prayer and thanksgiving request – my computer is dying. A friend was thankfully able to fix it after my screen died, so I pray that it will last until I make it back to Alberta.

Wednesday, February 23, 2011


This is only my second post for February. Where has the time gone? I have been thinking more about time recently. How much more time do I have with my new friends before they return to the States? How much time do I have until I go to Kijabe (actually as I am revising this it is Sunday and I am already at Kijabe)? How much time until my friend comes to visit? And the worst question how much time do I have left before I have to say good bye to Tenwek and return to Canada? Time flies. I am looking forward to some of these things, hoping they come soon and others I wish I could put off for a few months. It reminds me of when I was younger and Oma (grandma) would come and visit in September – my brother and I could not wait for her to come and time would not go fast enough but on the other hand the same time Oma came was when school started and we wished summer would go on forever. Time – it is a good thing it is out of our control – and in God’s hands.

I am not looking forward to these goodbyes and am looking at the busyness that I will have in the next month (I return to Canada March 31). There are many projects that I have procrastinated that I need to complete. I need to leave more knowledge with the staff so they are able to get by without me. I have been trying to do my job in a way that is more educational than me just doing things – I think I may be in trouble in a few months when I actually have to do the work rather than just explain how to do it .

I also wonder if there will be a time when I come back. I often find myself saying if/when I come back I will do ____. I am sure I will know all in God’s time but please pray that his plan for my future – wherever that may be will be revealed to me, and that I will have peace with it.
Those of you who are on Facebook may have seen that I have been spending my time in various ways – some friends and I took off for a weekend and did something I never thought I would do - we rafted the Nile – wow what an experience if you are ever in Uganda I suggest you do it – it is amazing.

I have also been busy at the hospital – figuring out how the ventilator works – after 4½ months I have finally figured out that one of our ventilators is backwards SIMV means AC and AC means SIMV – I think (I miss the Evita). I have also, finally, started to work on basic instruction manuals for the vents, something I should have done long ago but procrastinated. We have had a real ICU this past week with 6 very sick patients please pray for them for me, we currently have a young man in the unit who is 30 years old, he has severe heart failure and has been on Dopamine for over a week. This morning he was sitting up brushing his teeth, while on 15mcg/kg/min of Dopamnine – his blood pressure 60/35, we don’t know what to do with him, if he were in Canada we send him to a Cardiac surgery unit and he would be in line for a crazy surgery or transplant or something. Here we will have to eventually turn the Dopamine off and then he will die – how do you do this to a completely conscious young man. We did manage to turn the dopamine off, his BP is still very low but his kidneys are functioning and he says he is fine. Last week we also lost another young man to Guillain-Barre, I found this difficult as back home we would trach him and ventilate him for a few months and then get him into rehab and his chance of survival would be reasonable. Here the decision was made not to intubate as the likely hood of him surviving our ICU care for a prolonged period of time (high likelihood of VAP, bed sores, other nosocomial infections etc) the fact that he also was immune-suppressed made this highly likely. We were also wary of giving him a ventilator for months – we only have 3 and if one patient ties one up for such a length of time then we are in trouble.

I have also been asked to update on the quadruplets born after Christmas – I am sorry to say they are now the quad-triplets, we lost one of the girls a few weeks ago, the other 2 girls were also battling some infections but appear to be getting stronger. The little boy is doing fine (strange, as girl neonates tend to do better than boys). Please continue to pray for these babies as well as all the other patients in the hospital.

I was hoping to add some pictures to this post but I am having some difficulties with internet so next time.

Monday, February 7, 2011

Perspective and pictures

Looking back at this week it has been a different sort of week. It has been good to reflect. It was a quieter week at the hospital, usually when things are quieter I go home and work on various projects. That was a little more difficult this week as we have been having power issues at Tenwek. The hospital has had power but the homes do not have the same reliable backup system and so when we had problems with the hydroelectric dam this week we were in the dark. The worst part about no power is no computer or internet; this can make things frustrating. However being without power is OK, I kept reminding myself that many Kenyans do not have regular power. We bought some more candles and things were just fine – although I did escape to the guesthouse where there was power. I am not one who is good at keeping up with current events (having no TV or Radio makes this worse) however I have heard that parts of North America have been hit with horrible snow storms. I am sure there are people there who are without power as well. Here when the power goes out the water still works, we stay warm (no heat to go out) the stove still works (gas) so it is OK. I have memories of being on the farm with no power – cooking and boiling water on the camp stove outside in -20 Celcius. Despite it being OK here to be with out power I am still happy to have it fixed and back on.

Friday I was invited to go mudding – I am sure you are thinking driving a big 4X4 vehicle through the mud in Kenya – not what I envision a missionary in Africa doing – well we did drive a big 4X4 but not through the mud. We drove to a nearby church and mudded a house. I have seen many mud homes in my travels but this is the first time I got to help make one. The local church and Tabitha bible study (started by one of the missionaries here) are helping a family build a home. Myself as well as a few other ladies here were invited to go help – mudding is a ladies only job. We were doing the third layer of mud the first two had been done previously and allowed to dry. I am not sure how exactly the first 2 layers go or what exactly they are made of. But the third layer was clay, dug from about 5-6 feet down and than mixed with water. This mud was than brought to us in five gallon pails and we smeared it on the walls. I learned there is a technique to this and I don’t know if I was very good but they did not fire me. The trick was to use the palm of the hand to smear the mud and get it in the cracks while sliding your hand up to make it smooth. I don’t know how smooth my part was but thankfully they have one final layer to go (made with white dirt from the river) and they can make it look pretty. This was a lot of fun, we had many Kenyan children observing us, I don’t think they have ever seen wazungus (white people) “playing” in the mud before. It was also great to be a part of the community and help out. 
getting it all covered, dark is done light still needs to be done.

muddy hands in front of the house, all the layers on the outside of the house are done

I was really tempted to start a mud fight

Hard at work with a young Kenyan watching us

More of the audience

The ladies in the pit hard at work making the mud

I recently read the book When Helping Hurts by Steve Corbett and Brian Fikkert, this book talks about how to help in a way that is helpful to all involved and to not just take over and do something for the people but focus instead on communities helping their own. This description does not do it justice, I recommend anyone going on a mission short or long to read it. I was thinking about this as I helped and was shown by the ladies the proper way to mud. I was one of them not the Canadian coming in and asking why we just don’t hang drywall.

Friday evening was a different evening. Six of us hiked up to Motigo, local high point, to camp. The group consisted of a real live mountain guide, a real live eagle scout, a real live (token) Kenyan, a real live dreamer, a real live southern gal and a real live Canadian (me). We are a fun group and after rounding up some sleeping bags, tents and firewood we were off. The timing worked well and we were able to watch the sunset from a beautiful clearing.
The children wanting to see the picture I took


The path

 The hike up went well and was interesting, we saw six people all riding on the same Piki (motorbike) the previously seen record was five. This was an entire family so some of them were little but amazing anyway. We did not see a cow in the back of a Toyota Corrola like last time though. After we reached the top we set up camp and made a fire. The s'mores had to wait though. All the children who had followed us up helped with the fire and remained. We had some fun with the kids - a young boy who said his name was Petunia (I hope he was kidding) after we had all gathered around the fire said - this country I come from is very cold. Needless we had a good laugh. The stars were beautiful as it was a clear moonless night. The children did eventually leave allowing us to enjoy some s'mores and good conversation, until the wind picked up and we put the fire out as we did not want to start a grass fire - the problem with camping at the peak: no shelter from the wind.

I think our buddy Petunia is the one beside the white guy

The ladies enjoying the early morning sunrise

All of us at the top before we headed back down

We hiked down Sunday morning in time to shower and head off to church. It was a lot of fun. I have decided that the sky is one of God's most glorious pieces of art. It is amazing that such a beautiful picture is painted for us twice each day.

I would like to end this blog with a request. Toshiba has generously donated a CT scanner to Tenwek. This is a wonderful donation as currently the nearest CT scanner is about 3 hours away. As we have no air ambulance or even paramedics and this transport is much to dangerous for many of our patients so we end up doing "cut" scans or just wait and see. Anyway the need for the scan is high we have the machine but Tenwek still needs to cover the price of the building to house it as well as the technology to support it. We hope to have the scan operational by early summer but we are still in need of $300 000 USD in funds. Here is where you come in please give - click on this link where you can give online at the WGM website. Please e-mail me (this is my spam e-mail address so if you have other addresses for me use the others one but I will respond to this one as well, it just may take more time) if you have any questions.

Tuesday, January 25, 2011

Back to Work

The last few blogs have been filled with a lot of excitement. For a few weeks in a row I don’t think I had put in any five day weeks - with Mom and Dad coming, Christmas, Nairobi Visa trip and Kenyan Holidays. All that is over now and it is time to get back to work.

When we returned from safari I had thought of taking the rest of the day off as it was the last evening with my parents however, it was so busy that I could not just sit by. Mom and I took off to the hospital and Dad was content with his book in hand. Mom had a great experience as we intubated a fellow in casualty (ER) we almost coded a patient in ICU – I made Mom bag. There was also the desaturation of another ICU patient to the 60-70s, mom got to see me in action as I lectured the student nurse (he had written down the low vitals for the last hour and did not do anything about it) and as I turned down the new packaged non-rebreather mask for the one that had been bleached multiple times – this was all in less than two hours. I managed to escape the hospital for a few hours and chat with them a bit until the pager went off and I went up to set up a previously unused ventilator on a patient. The page came just as I had invited a friend to join the three of us for supper. The three of them did enjoy supper, I joined in late. All in a afternoon at Tenwek.

I feel like there are trends at Tenwek just like there are back home. I have noticed a few different trends recently, I had bagging afternoon where after a quiet morning I spent the afternoon bagging various patients: one with decreased SpO2 and three others who had coded. Sadly none of the codes survived, especially difficult as two of the codes where pediatric patients.
Bagging afternoon led to fixing bagger day. Tenwek reuses almost all their respiratory equipment. This includes baggers (ambu baggers as we like to call them here regardless of brand) that are designed for single patient use. As they are single patient use they are not made to last as long but stand up remarkably well, however there are a few styles that have a port on the patient side designed for a pressure manometer or delivering medications – this makes sense as long as you have the cap however after the tenth time something is cleaned the cap disappears giving us a leak when we bag. I realized this problem soon after I came to Tenwek and would remedy it with putting my finger there or plugging it with the cap off a sharp. However, I was the only one doing this meaning patients were only bagged effectively if I was around – as there is only one of me and I am not always around a permanent solution was in order. I asked the electrician who functions as biomed for something to fill the hole with that would with stand up to multiple jikings (jik is our word for bleach). I was given a 2 part epoxy and off I went finding every bagger I could and filling the holes. I am pleased to say that it has worked well, we no longer have a leak. I am still walking around with epoxy in my lab coat pocket so that I can catch the ones I have missed – one more thing to carry, lab coats do come in handy.

I have been busy with multiple lectures, as well new interns have started at Tenwek and after three years of medical school with minimal practicum they are quite green. This is in addition to the other teaching I am doing. Last week was busy with a lecture to the nurses about high flow cold nebs and venturis on Monday, Tuesday was a lecture to the interns on low flow oxygen, followed by a Wednesday lecture to the nurse anesthetists on ventilation by pathophysiology.  A busy week. The lecture to the nurses was the hardest as venturi and entrainment are difficult concepts and there is a lot of room for error but overall I think it went well.

Besides new interns at the hospital January has brought a lot of visiting staff to the hospital as well. This makes me busier in two ways, the first is visiting staff are not familiar with our (ancient) ventilators and need education as well they are used to having a RT around. I also am more willing to help out the short term visiting staff as they leave before I do meaning they will not be left in a lurch when I am gone, in comparison to the long term staff who need to get by without me in a few month. All in all I end up helping out a little more – but that is fine. The other part of having visiting staff here is a lot more (young single) people to hang out with. I have spent evenings hanging out, learning how to play racquetball, playing settlers and going for walks. Weekends have been games of ultimate Frisbee and hikes up Motigo. This had been wonderful I am enjoying getting to know everyone and the games are a lot of fun – I think I need to keep at it as I am out of shape. Racquetball was right before bagging day and my forearm was sore.

            Being busy both socially and at work has taught me to prioritize things. This has changed up my routine and it has been great. I now have to schedule time to take for God – this has been wonderful and I should have made myself do it years ago instead of leaving what time I have left at the end of the day, making time for God and setting it aside for him had brought so much more meaning and insight into my walk with God. Please pray for me as I take this time to get to know God better and inquire his plan for my life

Ultimate Frisbee - Waiting for the next play

I am gonna say I caught this one and then we scored (really I have no clue)

everyone laughing after the Frisbee hit "A" in the head
Still laughing - see even the Kenyan kids are laughing

Wednesday, January 19, 2011

Can you see it

I have been back from the Mara for more than a week and it is high time I tell you about the trip rather than just the journey getting there. If you saw on the map on my previous post Fairmont Mara Safari club is right outside of the park. This did not limit our experience one bit. We stayed in large tents situated along the Mara river in which a lot of hippos live. I would sit at our table having lunch and I would watch the hippos in the river. At one point a large bird landed on the back of the hippo, probably thinking it was a rock. The hippo did not like being treated as a rock and "jumped" up it was quite exciting, all while I was enjoying my soup.
The days on the safari are a little structured with two game drives a day: one from 6:30am-8:30am and the other from 3:30-6:30. Getting up early may not sound like a holiday but being able to see the sunrise and watch the active game in the cool morning hours is beautiful and well worth it. The time between game drives is spent at the resort where my parents and I would go for walks to see more hippos, read a book, take a nap and enjoy the wonderful meals prepared for us - yum.
The game drives were of course the highlight of the trip. We had an excellent driver who could spot the wildlife from a kilometer away. At one point we were driving through the bush and he pointed out a lion deep in the bush quite far away. How he saw it while navigating the mud amazed me, practice I guess. We saw all the Big Five (name given to the five animals hardest to shoot when hunting, now refers to the top five animals to see - lion, elephant, cape buffalo, leopard and rhinoceros) except the leopard - although we did see 2 cheetahs which look similar to leopards. Rather than post all my pictueres - you can look at them here on facebook (you should have access even if you are not on facebook). However, here are five of my favourites.
Mom and baby, baby was almost as big as mom

I think giraffes are one of my favorite animals

Those of you who were in Junior high art with me know how much I love sunrises
 The trip back was much less exciting than the trip there, only two hours. Then it was back to work at the hospital which had gotten really busy in my absence, five ventilated patients at one point - usually we max out at three. On Friday I said good-bye to Mom and Dad who are now seeing some more of Kenya before they head home next week sometime. It was great that they could come and see what I do here and meet many of my friends and co-workers here.

Friday, January 14, 2011

Rescued by the Masai Warrior and Canada Post

As you probably read in my last post Mom and Dad are here and you can not come to Kenya without going on Safari. So Monday morning we took off for a few days. Tenwek has a deal set up with the Fairmont Mara Safari club which gives Tenwek visitors a deal so off we went.

We were picked up at the hospital by a driver arranged by someone at Tenwek. I had not met this driver but assumed all was good so off we went. A little while down the road I asked the driver if he had been there before and he said yes - we went on a field trip when I was in school. This had me a little concerned but in his broken English (my 8 year old neighbour spoke better English than him) said he knew the way. Drivers are common here as many of us don't drive and every time I have one I simply say go here and they go, no need for me to give directions as they just know where to go, this is good as I have yet to learn my way around here.

Anyway we continued on myself giving the driver the benefit of the doubt, however I was getting a little worried as my Dad said, "we are going to Fairmont, right?" because the sign we just passed said Fairmont. We asked the driver and he responded with no this way is fine - and you have to trust the driver right. So off we went we eventually turned off the highway (at Narok for those who know the area) and headed south it was a paved road with lots of potholes - the same one I think we had taken to Olderkesi. Anyway, we eventually turned off to a bumpy gravel road being unsure I texted a friend of mine at Tenwek asking if going down a bumpy road was normal she responded with yes but we should be there in 10 minutes. Ten minutes later there was no end in sight. We then asked the driver what was going on and he responded with, "I turned late so now we have to detour a little bit." A little bit was an understatement the gravel road ended at a Masai village, an hour or more later. Here I was quite concerned as the Masai  men told us we had a long way to go - and the road had reached a deadend. A decision made was to put a Masai warrior in the car to guide us to our destination. The man climbed into the car and off we went backroading in our little Toyota (car, 2 wheel drive) we went through a river, through the mud and all sorts of other places that would have been a lot of fun in a quad but not the most enjoyable in the back of a little car at 3pm which you have been stuck in since 9:30 am (read no lunch or bathroom breaks). The amount of crazy places we went through it was amazing we made it through. There were many times that we would go through something and I would just pray that God would get us through as I envisioned being stranded and lost in the middle of the mara for a few days. Here are a few pictures of our experience
The Masai man who led us through 100km of bush, without him we might still be there

The Road - this is a better section, we may have driven through the puddle on the left if not this one others like it.
The route I think we took is in yellow, destination in red, all approximate as I had no clue where we were. I know we came from Narok and went through Talek, which there was no road to and I don't think we ever entered the actual park.
This was an adventure we were rescued by the Masai warrior and eventually met by one of the vehicles from Fairmont where the staff member was wearing a Canada post shirt, so he gets some credit in the rescue. We were met at the lodge with a late lunch (it was now 5pm) and showed to our tents. For those of you thinking drive for 7 hours and sleep in a tent - no way, The drive is only supposed to take 2 1/2 hours and as for the tent this is what the inside looked like.

Beautiful - and behind the curtains is the en suite
So the first day of the trip done, we had missed our afternoon game drive although on our round-a-bout trip to the lodge we did see some wildebeest and ostriches. I will blog again soon about the rest of the trip it was exciting as well but a much better form of excitement.

Sunday, January 9, 2011

Mom and Dad are here

I am writing this Sunday evening and I hear that all my family and friends in Alberta are stuck in a blizzard, and even some church services have been cancelled and the roads are horrid. I will pray for you all and in the meantime enjoy the beautiful weather here.

My parents have been very supportive of my trip to Kenya and the work I am doing here. When I told them things were falling into place for me to go my parents responded with: we will come visit. So Tuesday I went into Nairobi and picked them up at the airport after a long wait of seeing them through the glass while they were picking up their baggage I could finally give them a hug.
The next day after a stop at Nakumatt we headed of to Tenwek
Dad excited to see a bag of Red beans in Nairobi
Mom and Dad experienced  the long drive to Tenwek - beautiful at one point as you look down and across the Rift Valley and drive down through it - pictures do not do justice. Once we arrived at Tenwek is was time to walk around meet some people and get settled in.
The next day was a tour of the hospital where Mom and Dad had Chai with the ICU nurses as well as saw the nursery including the quadruplets (please pray for the quads as they have an infection) Mom also was able to watch a C-section in the afternoon. Dad was more than happy to stay as far away from the hospital as possible and talk to the yard men.
Mom and Dad at the Waterfall

Enjoying Chai and Mandazi in ICU with the staff
A day at the hospital done, Friday we went for a walk, being in a Rural part of Kenya ladies wear skirts, so Mom and I hiked in our skirts
Our hike brought us to the top of Motigo the local high point and it is great to see the view you can see previous pictures of Motigo here. I was quite happy that we made it to the top and that we did not get lost as I had always hiked it with people who  knew the way and never paid a lot of attention to the direction we were going.

Those of you who know my parents well know how much they (Dad) loves to see farms. There was never a family trip without touring a farm whether it was the San Joquin Valley in California or a dairy in Ontario or a green house in Holland. A vacation was not complete without it. Therefore when I heard my parents were coming to visit I found a farm to visit. Saturday we took off to Kericho were we had a tour of a large tea farm, factory and a green house full of roses, it was great to see a different side of Kenya and see how tea is made.
Heather and I in the tea

Harvesting the tea by machine, much of it is still hand plucked.
Tea and trees as far as you can see all run by the same company

At the end of the tour we stopped for some lunch we were quite excited to see burgers on the menu I ordered the beef burger, Dad the pineapple burger and Heather the cheese burger. When our food (finally) arrived I had a normal hamburger, Dad had a burger with pineapple - no meat and Heather, well she got a cheeseburger - no meat she had ordered cheese. Many surprises in Kenya.

So this is Marie blogging now. The next time I hike in Kananaskis, will I wear a long skirt? Today was so special, I still am pinching myself to see if it is real. After church we were invited to a co-worker'  for chai. We walked over hill and dale, and he met us at the end of the path which lead to where he and his wife lived. It was about a 20 minute walk, which he and his wife make daily to work at the hospital. What a beautiful commute. Both have very good jobs. He owns a small farm which produces far more than he can eat. For instance, he grew three varieties of dry beans which yielded 50kg in total each. They eat some and sell the rest.We visited in his home and felt very blessed by each others company. They are so happy to own land. They hire people to help with harvesting, because they work full time. Someone milks the two cows and pans out the milk. I think of the lifestyle of a couple in Canada where both have good jobs--quite different.

Monday, January 3, 2011

New Years and Laughs

Life here is becoming more and more routine. I celebrated New Years here by playing games and there were even fireworks, very similar to home however as midnight approached we did not have a TV to turn on and therefore picked someones watch and counted down. The watch we picked was 15 seconds slower than the watch down the hill so we heard them shout and cheer a little before we did. We will never know who was really right. Regardless I did welcome the New Year 10 hours earlier than all my Albertan friends. Happy New year to all.
I mentioned in a previous blog how I moved a month ago and have a new roommate. Last week a piece of her luggage arrived (big complicated mess at the airport)  and it was like another Christmas (almost as exciting as the Quadruplets). The best part was the new curtains I am not a very stylish person and window coverings are not super high on priority list however one of the windows in my room had a hideous set of curtains, they were not even the same length so I was very excited to take them down. My friends and I had some fun with the curtains as you can see here.
I think someday I may regret that I posted this.
We find plenty to do to keep us entertained here. Yesterday I attempted to go for a run and realized how out of shape I am I think I need to train some more.

Life at the hospital continues on, we are getting some more visiting staff coming the next few weeks as well as new interns (first year residents) starting so I think my pager will be going off a little more than usual. Today I was asked to do some MDI teaching, this is something that I do back home as well, however this being Kenya it was slightly more complicated. Aerochambers are expensive so we stock very few and never give them away. We usually use a plastic coke bottle converted into a spacer. I realized that we were all out of spacers so I went home to make one - cutting off the neck of the bottle was easy (this made the mask part as it is for a baby) however have you ever tried to cut into the bottom of a plastic pop bottle - it is hard so here is what I ended up doing

I heated up the knife on the gas stove, I tried a candle but it was not hot enough
Then I cut/melted a hole onto the bottom of the soda bottle
So now that I had an aerochamber I found my patient and showed them how to use it, done. This worked so well I think I may just start a side business.

Anyway life continues to go on here and I am quite excited as tomorrow my parents fly in. It will be great to see them again, they will be here for  a few weeks so I am sure I will have more pictures to share with you as we go on safari and tour a tea farm together.