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.

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. 

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 90^th 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

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. 

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

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.

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.