Kenyatta National Hospital, Civil Unrest, and Other Loose Ends.

I'm home! Back to rain, and Starbucks, and safe-to-drink tap water! I'm wading thru jet lag, and trying to process memories and adjust back to my super privileged lifestyle. It's surreal, even my own bed feels unfamiliar.

Kenyatta National Hospital was our clinical home for our month in Nairobi. It is a giant public hospital (depending on who you ask, there are 1500-2000 beds at Kenyatta, and all are consistently filled). I got to see the pediatrics ward, the ICU, the HIV center (Comprehensive Care Clinic) and the cardiology clinic.  

Pediatrics was the most foreign. There were 2 nurses for 58 patients! Their assessments at the beginning of the shift were essentially just to verify that all the patients were there. They gave medications and changed a few dressings, but with those kinds of ratios, they relied on families for most of the patient care. It was kind of tragic, because Kenyan nurses are very well trained and very well qualified. They know that they should be giving better care, but there are not resources available to do what is best for the patients. 

Shortages plagued all units. All three days I was in the ICU, there were no clean sheets and only a few blankets. IV medications are run without pumps because there are no working pumps to be found. They don't even have diaper wipes! The nurses were creative, innovative, and so good at making due with the few resources they have!

I took care of baby Catherine all three days in the ICU. She had meningoencephalitis with frequent absence seizures. She had ups and downs while I was there, but Tuesday, she got worse and worse through the course of my shift. I was heart broken to come in the Wednesday morning and find she had coded over night. She seemed to recover Wednesday, but I have no idea what her prognosis is. In the end, even with great training and good medications, sometimes all we can do is keep the patient calm and comfortable and pray. I spent most of Wednesday rubbing her little head and softly cooing to her. I hope I never forget what she sounded like and felt like.

A total bright spot and my favorite experience at KNH was the Comprehensive Care Clinic. They care for all the needs of patients with HIV. They have counselors, primary care providers, nutritionists, pharmacists and nurses there to meet the comprehensive needs of 20,000 patients for free! We learned so much and were so warmly welcomed by every department! The care they provide is amazing and so needed!

Cardiology was fun too! I got to perform EKGs, watch echos and even go into the cath lab. I really like hearts, so it was very exciting for me!

On our last Wednesday in Nairobi, traffic was extraordinarily bad! After we got out of our immediate neighborhood, we noticed strange things, like buses driving the wrong way down the street and hundreds upon hundreds of people walking. At the main road into town, things got worse. Cars were totally stopped and pedestrians were streaming by us on all sides. "What's happening?" we asked each other. "Is this a protest?" None of the pedestrians seemed overtly hostile, but it was a little scary to be a very conspicuous van full of white people in a crowd of thousands with no idea what was going on. Our driver, Kevin, parked in the middle of the street and hopped out to investigate. I don't know that I've ever felt so vulnerable as I did in those few minutes. Was there a political crisis? A bombing? Did we need to get to the American Embassy for safety? 

It turned out to be a matatu strike (matatus are 14 passenger vans that serve as the public transportation in Kenya). One hundred twenty matatus had blocked the main road into town and the other matatus had kicked out all their passengers. The hoards of pedestrians were not angry rioters, but stranded people on their way to work. Kevin took us to a police station to wait out the strike. "You never know who will take advantage of a situation like this," he said. I sat in the grass and played games on my phone for about an hour, while the police towed the matatus and started traffic moving. We ended up only being about a forty five minutes late to our shifts at the hospital. It was an interesting and fairly painless look into the inner workings of Kenya. There was no violence, no mass protests, it was pretty orderly. I've been telling my family all along how safe Kenya is, and this incident totally proved my point!

Our last week in Kenya was both sad and great. We had dinner every night with a different group of friends. It's a testament to the warmth and openness of Kenyans that we could be in the country only a month and make such impactful and amazing friendships! I cried and cried when we said goodbye to our driver, Mesh, and our nurse friend, Emily, but our goodbye dinner with Dr. Sadera and his family was pure joy.  Dr. Sadera is the amazing, generous doctor who put his license on the line and called in some favors to get us into Kenyatta. He and his wife, Elizabeth, hosted our last night in Nairobi. They sang Maasai songs and danced Maasai dances to entertain us. They provided a feast, including goat meat that Dr. Sadera personally slaughtered for us. And maybe best of all, Elizabeth taught us to make real Kenyan tea! 

We were so blessed to be befriended by beautiful, generous, caring people! They made my adventure in Kenya everything I wanted and more! I can't express how rewarding this trip was. I went with an open mind and a desire to serve, but as I predicted, I took away so much more than I gave. I feel forever impacted. I hope to hold on to the joy and warmth of the Kenyan people, even in the midst of struggle. I hope to hang on the gratitude for all I have been given. Mostly though, I hope to hang on the the incredible friendships that were forged in this month of hard work and foreign circumstances!

Is pre-jet lag a thing?

As I type, it is 3:43 am, and I am WIDE awake. We leave in two days, so maybe this is pre-jet lag? Actually, I think this insomnia is totally attributable to my stress about leaving Kenya. We've had such an incredible adventure here, and I'm desperately sad to leave. 

A lot of what we've done here is difficult to relay - the subtle cultural differences, the smells, the erratic driving conditions really cannot be described and must be experienced - but everybody's watched enough nature shows to get how excited I was to go on safari on the Maasai Mara last weekend!

The Mara is in the southwest corner of Kenya about a 6 hour drive from Nairobi. The first two hours are smooth sailing, no traffic jam, a gorgeous view of the Rift Valley, well maintained roads, but don't let that lull you into a belief that it is an easy journey! The last 75 km are so rough that it takes 4 hours to navigate them! The road is so rough and treacherous that our secondary driver, Kevin, pretended to be sick so that he didn't have to take us (he confessed to me on Monday that his "heart was filled with fear" at the thought of driving us to the Mara)! It was so rough that my motion sickness medication gave out, as our bodies rattled and quaked and our heads flopped from side to side, but we made it! Apparently, you can fly from Nairobi to the Mara relatively comfortably, but you miss some amazing scenery and the chance to watch some truly incredible driving!

After we arrived and found accommodations (which is a whole other story), we went to bed early to recover from the journey and be ready for our big safari day!

Some really generous friends pulled some strings to waive our $90 per person park entry fee! Again, this is an example of how many people have gone above and beyond to help us have a good experience here. The warmth and generosity of the Kenyan people cannot be overstated! We have been so blessed to make many friends and been so welcomed! I will miss the people so much more than the sunshine, the beautiful countryside, the fulfillment that comes with doing good.

Inside the park, the road improved! We popped the roof of our van up and were immediately greeted by herds of grazing zebra, gazelle and wildabeast! 

We spent all day in the park and saw almost all the important animals. We missed rhinos, cheetahs and leopards, but saw about 15 lions and probably 100 elephants! What a day! What a place! What an experience! We kept looking over at each other and saying "we're in Africa!" It was such a nice way to spend the last weekend of our trip, and it really felt like a reward for all the hard work we've been doing! 

"Courage dear heart"

We have seen quite a lot of good in Kenya. The land is beautiful. The people are warm and eager to welcome visitors. The sunsets are so unbelievably beautiful they defy description!

Last week, we were immersed in some of the bad.

Thursday, we went to Dandora, the dump site. Acres and acres of trash towers above the humble roof tops, putrifying the air and poisoning the people. The mountain of garbage used to spill into a school playground, making kids sick, until a German NGO built a wall to protect them. Now, the students don't play right in the trash, just in it's shadow.

We watched the kids play and returned their greetings as the stench of the rotting garbage turned our stomachs. Another example of the juxtaposition in Kenya; cheerful kids playing feet from such a mess.

Thursday was bad, but my heart was truly broken Friday. We went into Kibera, the largest slum in East Africa (maybe the world). About 1.3 million people are squeezed into an area of 5 miles. There is no plumbing and very little electricity. People can live their whole lives, birth, work, marriage, raising kids without ever leaving the slum, without ever seeing a tree or breathing fresh air.

We drove maybe a mile into Kibera through a sea of corrugated metal buildings before the streets became too narrow to pass. Then we (including our 3 armed guards - the slum is not a safe place) walked down narrow, twisting alleys to a little school to conduct a health camp. Each new alley brought new, terrible sights and smells. The filth, the garbage, the senseless poverty were almost paralysing. At one point, I just stopped in the middle of the path fighting back tears. How can people survive this? How do you get up and fight another day, when you make $1 a day and your slum lord charges you $25 a month for rent? 

We saw about 200 patients in a tiny school room. Almost every child had respiratory symptoms from the awful, close, smokey air they breathe. (Our lungs hurt after just a couple hours there.) Many, many patients had communicable skin conditions, like scabies and ring worm. Most also had intestinal parasites.

Like the last health camps, it was sweaty and exhausting work. Like the last health camps, it was worth it. We are here to light a candle, instead of just cursing the dark. We are here to love and serve, and I feel so honored to be able to come alongside those who serve in these terrible circumstances every day. It's awful and life changing and can only be faced with great courage, but there is hope...

The school that hosted our camp is an amazing example of fortitude and service. It started when a Kibera pastor's wife, Mary, saw all the young children home alone all day with no food while their parents worked. Mary couldn't stand to see them waste away, so she began wheeling a wheelbarrow full of beans and rice through the streets, feeding children as she went. Eventually, she began gathering the children in one place and teaching them songs and Bible stories. Now, they have a school building and feed and teach 125 preschoolers to first graders! Mary and all the teachers are volunteers. They don't make any money; they are just there as an act of service to the community. And it is an amazing, joyful oasis in the middle of the worst place I've ever seen.

Way Out West

Our trip to Western Kenya continued Saturday with a visit to a Shikusa Boys' Prison, home to about 300 boys aged 16-18. Shikusa is a surprisingly cheerful place. Although, I may not have an accurate picture of things because seeing a van full of cute, American nurses may have contributed to the smiles on the boys' faces; we did get a few wolf whistles when we entered. The superintendent, Chacha, is clearly deeply invested in the boys and really wants prison to be a chance for rehabilitation. The boys can go to school, learn furniture making, farming, and a variety of other trades. Some of them may actually end up in better situations after prison than before!

After introductions, we did a medical camp for the prisoners. While we triaged and treated a variety of infections (including one super awkward moment involving genital warts), a group of boys volunteered to wash our van. This small act of service really touched me. I think it is indicative of the positive tone of the prison and a true testament to the leadership there!

Saturday afternoon, we visited a school for the deaf. The kids were so excited to receive us that they started jumping up and done as soon as the van turned into their driveway. They were so sweet and so grateful. It was such a joy to see their smiles! My favorite part was that they all wanted to pose for pictures and then see them. They were total hams!

Sunday morning might have been one of my favorite parts of the weekend. We went to a local church in Kakamega, and let me tell you, Kenyans know how to worship. At one point during the music, a whole bunch of people made a conga line and started waving their chairs over their heads. It was pandemonium, in a good way!  Church was great people watching! Especially great was the tenderness of men with the children! Many Kenyan men are distant fathers, both geographically and emotionally. The men in this church are loving daddies. As a total daddy's girl myself, I know how important a father's love is! Again, I attribute this small, but great, thing to good leadership. Respect for the family is ingrained in this church. It felt so nice and homey.

On the way home, we made our driver stop at the Equator for a few pictures and even a dance.  It was such a fun, touristy thing to do! 

We got back to Nairobi late Monday night so tired and so changed. Spending a weekend giving so much was draining, but so refreshing! Bringing hope to the desperate and coming alongside the needy is true religion and comes with great rewards!

Down the Rabbit Hole

It's hard to know where to begin with this post. I feel like I've lived a lifetime since I left Seattle and like I came back to Nairobi a totally different person than I was five days ago. I feel like Alice when the catipillar asks who she is. I thought I knew who I was last week; now I'm not so sure.

Last Thursday, we drove a LONG way west from Nairobi to Majengo.  We saw all the archetypical African images, zebras, gazelle, people selling things on the side of the road,women carrying loads on their heads.... We even passed the Rift Valley! It is beautiful and green outside the city. The air is fresh and just humid enough to fill your lungs with sweetness.

Friday, we did a medical camp with World COMP at the local widows' center. Life for a Kenyan widow is very difficult because her husband's family often claims all his property and may even cast the widow out. She is left with no assets, very little skill, and children to feed. The widows ministry in Majengo is a group of about 700 widows who have banded together to improve their lives and their positions. They hosted our medical camp at their soon-to-be complete three story building that will host a number of money making enterprises for this desperately needy group of women and their children. 

The World COMP mini medical camp was staffed by Kenyan clinicians, nurses and pharmacists, who graciously let us participate. We triaged, treated and dispensed medications for at least 450 needy people in about 7 hours. It was a hot, busy, and deeply fulfilling day! I earned every drop of spear that rolled down my back and made my shirt smell like a REALLY filthy athletic sock! (The shower Friday night, despite oscillating between glacially cold and scalding hot and having the water pressure of a leaky faucet, was the very best of my life!)

Interacting with desperate people and, in some small way, making their lives better is why I got into nursing! Every twinge of back pain, every drop of sweat, every moment of feeling overwhelmed by neediness was repaid a thousand fold by the smiles and gratitude as I measured vital signs, looked deep into  beautiful, brown eyes and prayed to my God for intervention in their lives. This is why I'm here; this is what I want to do! How do I go home and live a normal, suburban life after this?

Kiswahili for Mzungus

Today, Wednesday, was our first day in the hospital. We are working at Kenyatta National Hospital, which is a 2000 bed, high acuity facility. It is the biggest hospital in East Africa, and they receive all the patients too sick for other hospitals in the region. I got placed on the pediatric floor today! It was so inspiring to see how the nurses innovate and adapt and provide care, despite their limited resources. I asked a nurse about a procedure and her response was "Honey, this is Africa." All the nurses I met today were incredibly dedicated and hard working and eager to improve health care in Kenyatta.

The patients were pretty adorable and reminded me that all over the world, kids are kids. Chloe and I quickly made friends of a crowd of boys who followed us all over the ward, playing with our stethoscopes and hand sanitizer. 

One of the nurses I met today told me to go mingle with patients while she charted. "Just go say hello," she said. "Some of them might speak English." It was kind of a surprise to me how few children speak English. The official national languages of Kenya are Kiswahili and English. Most people speak Kiswahili at home. Luckily, our awesome driver, Mesh, has been working hard to ensure that by the time we leave Kenya we all have a basic understanding of Kiswahili. 

Every morning he greets us "Habari Yasabui (how are you this morning)?" And expects us to reply "missuri (good)."  He gives us lists of words while we're stuck in the jam, and is super good at answering all our Kenya related questions. Despite his best efforts, I know just enough Kiswahili to respond when people shout "Mzungu (white person, literally aimless wanderer)" with a "jambo" and a cheerful smile.

Tuesday, we visited an orphanage and a workshop where women make jewkery and clothing. The clothing company, Judith and James, is run by a group of widows and supervised by our host, Nikki Hyodo. The jewelry company is run by a Texan, who gives a group of poor women a good wage and a lot of skills. The orphanage, or children's home, was super clean and nice and it was clear how deeply the staff and volunteers cared for the kids. It was fun to play with babies and school agers there!

We're heading out to the bush to do a medical camp tomorrow morning. We will be assisting Kenyan doctors and nurses with all sorts of screenings and interventions. It should definitely be an experience! Pray that the 8 hour car ride doesn't do me in though!