Happy Graduation, Tim!

Sorry I can’t be there to celebrate with you. We’re proud of you and amazed that you actually finished high school. At times we thought this day would never come!

Love you, little brother!

Reminders that I work in a hospital in rural Africa...

1.I ask a coworker, “What did you do on your vacation?” They tell me they plowed the fields and planted their crops
2.Man came to the hospital because he was bitten by a black mamba snake
3. 14 and 15 year old girls having babies is a frequent occurrence
4. Coworkers charge their cell phones and flashlights at work because they don’t have electricity at home
5. People ask me, “How do you fetch water in America?” I tell them that everyone has water piped into their house. They laugh in disbelief
6. Little girl falls down the steps and breaks her arm. What steps?! Other than the hospital, I have yet to see a flight of stairs in Karungu
7. Hospital parking lot has 4 parking spaces. I have yet to see all 4 spots occupied
8. Each patient has a mosquito net hanging over their bed
9. The hospital laundry is hung outside to dry
10. Toddler was accidentally dropped in the fire by an older sibling. The little girl has burns all over her bottom
11. All garbage is taken to the trash pit where it is burned. Next to the trash pit is the BPP: Body Part Pit. A covered pit for the disposal of arms, legs, placenta, etc.
12. On patient charts it asks for a patients, name, date of birth, village, and chief’s name
13. A man was cutting the grass with a machete when he accidentally sliced his foot

A Harsh Reality

After lunch I returned to work around 2pm. One of the staff told me they were bringing an OPD (Outpatient Department) patient to x-ray for a femur x-ray. Lots of people were standing around in the OPD so I popped my head in to see what was going on. All I could see was a man with a blood stained hospital sheet. Great. I went to the x-ray department, put some latex gloves on and waited.
A 30 year old man named James came in on a stretcher. I pulled back the sheet and cringed. He had split his skin open from his groin to his knee. It was about 14 inches long and 4 inches wide. I could look in the wound and see his muscle and bone which was visibly fractured. Really, there was no need for an x-ray to confirm it but we did one anyway. I slid the cassette underneath his leg on top of a pool of blood, hoping the blood didn’t seep onto the x-ray film. After taking the x-ray I pulled out the cassette and blood streamed off of it. Surprise, the x-ray showed his distal femur split into two pieces! It’s hard to get the full story of what happened with any patient, but apparently James was up in a tree cutting down branches, when a large branch fell on his leg and pinned him. This all happened around 8am, but he didn’t get to the hospital until 2pm. Where was he all that time? Well, this is when you can say, “Sorry, you were born in a third world country. Life isn’t fair.” He was miles away from any kind of road when the accident happened, there is no 911, nobody he knows has a car to come and pick him up. So his friends had to carry him to the nearest road to wait for a ride to the hospital. In this part of the country cars don’t pass by that often. If you’re not on a main route, it could be hours. They first tried to put him on a motorbike (popular form of transportation) but his leg was literally cracked open. So six hours later he finally made it to the hospital by car.
So his leg is split open, broken, and he’s losing lots of blood, now what? He needs surgery as soon as possible to clean out the wound, stop the bleeding, and but his bone back together. We do surgeries here, but this type of orthopedic reconstruction is out of our league. So what hospital can we send him to and how much money does he have for the ambulance ride? It stinks that the amount of money you have determines the level of medical care you receive, but this happens in the US to some extent as well. He doesn’t have the national health insurance either. For 160 Kenyan Shillings ($2USD) a month it covers all medical expenses for your entire family yet most people can’t afford it. When you have to choose between food and insurance, you can’t blame people for not having it.
So it was decided that James was going to Kisii Public Hospital. Kisii is the closest town to us. It’s about 90 km (55 miles) away but it takes a good two hours to get there. We tried to clean out the wound, gave him some antibiotics, and splinted the leg for the car ride to Kisii. Some how it was decided I was going to ride with him the ambulance. Sure, why not send the x-ray tech?!
So in the back of this ambulance is James, me, and 2 of his friends that brought him to the hospital. James speaks no English but one of his friends did which was a big help. The only supplies we have in the ambulance is a shoe box size first aide kit with gauze, syringes, saline, and gloves.

The next two hours were the longest of my life. I prayed that James made it to the hospital alive. The dirt roads here are terrible. They’re full of potholes, bumps, and rocks. It’s like being tossed around like a popcorn kernel in an air popper. Holding on to something is necessary. James’ stretcher bounced off the ground as we tried to go “fast.” I put one hand on his pelvis and the other on his knee, trying to keep his leg attached. With each bump more blood seeped through the gauze, and the white sheet turned red. James cringed in pain with each bump. It was another one of those moments, “Sorry, you were born in a third world country. Life isn’t fair.” By the end of the ride it was a relief for me to see him cringe, at least he was still conscious and feeling the pain. I was afraid with each jolt his femoral artery would burst. His foot was going cold but was still able to wiggle his toes. Along the way his friend wanted to stop and get him a soda because he hadn’t eaten all day. Sorry, no stopping, he desperately needs a blood transfusion not a soda!
At 6pm, 10 hours after the accident we arrived at Kisii Public Hospital. This was my first time seeing a government run hospital. It was disgusting. Think of a hospital from the 1950s and cover it in dirt and dust. That is what this place looked like. I had this idea in my mind that when we arrived medical staff would be eagerly waiting for us. What a silly American idea that was. When I got to the OPD there was nobody that looked like a doctor or a nurse. Everybody was in plain clothes just standing around. I was the only one in hospital scrubs- is this really a hospital? Who is going to help this man? He’s dying. Turns out you have to buy a blank patient chart booklet for 20 KSH (30 cents) before a patient can be seen. It doesn’t matter if you’re dying, you have to go to the other side of the hospital and buy this booklet. So while Duncan, the ambulance driver, went to buy the booklet I was on a mission to find a doctor or a nurse. You would think this was an easy task but it wasn’t. So I got out the x-ray and started showing everybody the femur cracked in half. That kind of received some attention but nothing ever “stat” happens in Kenya. I tried not to be the rude American but his guy has been losing blood since 8am! Finally, with our 20 KSH patient chart we were told to go to Ward 3 to be admitted. But first we had to do other paper work. I pushed James to the ward, while Duncan took care of the politics.
After being at the hospital for 25 minutes I encountered my first doctor and nurse, what a pleasant surprise! They agreed about the blood transfusion but there is a catch. If a patient receives a blood transfusion, a family member or friend of the patient must donate to replenish the blood bank. Sounds simple, but with the HIV rate highest in this part of the country it can be difficult finding a donor. I had another moment of, “Sorry, you were born in a third world country. Life isn’t fair.” So I tried to talk James’ friend into donating but he was hesitant. I would give blood but I donated a few weeks ago. Please, somebody just get him some blood!
I’m not sure what ended up happening. It was time for me to leave, as the doctors took over. Who knows what will happen to James. Will this father of five survive? Will he lose his leg? Will he ever walk again? Sorry, you were born in a third world country. Life isn’t fair.
If you’re at home reading this asking, “What can I do to help?” First off, you can pray for him. Secondly, go donate blood. No, you’re blood isn’t going to save somebody in Africa but it will make a difference. Isn’t a needle stick and 30 minutes of your time worth it when you can save somebody’s life?!

My First Kenyan Wedding

The wedding bells were ringing last Saturday, when three couples tied the knot. I knew some of the brides and grooms because they work at the hospital. The wedding was scheduled to start at 10am, however the bridal party didn’t arrive until 11:00. There were about 10 flower girls and 10 bridesmaids shared between the tree couples, and each had their own maid of honor and best man. The brides wore traditional white dresses and two of them had battery operated flashing tiaras. They looked like they came from a little girl’s princess costume. And the grooms wore suits and ties. They had to be burning up considering it was midday and we were in the same sweltering church that we went to for Easter Vigil. The church is named Kiranda, but I like to call it, “the oven.”

The wedding party processed into church. Pachabel’s Cannon was replaced with drumming, clapping and tambourines. The brides sat scattered among the congregation. I thought this was a little odd considering it was their wedding, and they don’t even get to sit in the front of the church. Turns out, after the Liturgy of the Word, the grooms roam around the church “looking” for their future wife. After “searching” for awhile the best man leads them to their bride. It was cute. The vows were said and the rings were exchanged but they never kissed.

After the three hour ceremony concluded everyone moved to Dala Kiye. Yes, that’s right, the reception was held in the dining hall of an orphanage. The guests feasted on ugali (a warm starchy carbohydrate), chapatti (flatbread), sukuma wiki (cooked leafy greens), goat, and fish. After the meal guests present their presents to the brides and grooms. One of the gifts included a live goat! Now that is something you can’t register for at Target of Macys! Then people started giving speeches. The wedding couples’ parents, grandparents, aunts, uncles, brothers, and sisters all got the chance to talk. So they talked, talked, and talked some more. It was like a never ending toast, except they were missing the champagne. Around 6:00 the gift giving and speeches came to an end. Their was suppose to be dancing but everyone was tired, including the brides and grooms, so they called it a day and everyone went home. My first Kenyan wedding was an interesting experience.

(Thanks to everyone for the birthday wishes! Especially for the letters and packages- Caitlin, Heidi, Claire, Jocelyn, Aunt Barb, Aunt Mary, Aunt Jonna, Mom, thanks so much!)

Holy Saturday

Easter Vigil in the US is the marathon of all church services. Easter Vigil in Africa is even longer. The mass seemed to go on for eternity as I sat in a hot, overcrowded church with a 3 year old on my lap. People were shoulder to shoulder sitting on the wooden benches. The mass was said in Luo which didn’t help matters. About 100 children received baptism. It was an assembly line of sacrament; the water, the chrism, the candle, done. The most miraculous part of the entire night was that nobody caught on fire. The majority of the congregation was children from the area boarding schools and the orphanage, Dala Kiye. No matter how young the child was everyone got to hold a candle, including little Mercy sitting on my lap. I prayed, “Please God, don’t let her light herself on fire.” Luckily, nobody went up in flames.
After 3 ½ hours, church concluded at 12:30am just as it started to rain. The heavens opened and it poured as people left church. It was a relief after roasting in church for all that time. I hitched a ride home with Fr. Julius. About 20 of the kids from Dala Kiye piled into the van too. Slowly we made our way home through the mud and rain. Driving on a muddy road is a lot like driving on ice and snow; you slide easily and have little control over where you’re going. We dropped the kids off at the orphanage and then Fr. Julius offered a ride home to Evans, who lives about 3km further down the road. He gladly accepted considering it was 1am and raining. We were almost to his house when the road turned into a river. A normally small creek had turned into a raging riving flowing across the road. There was no way we could drive or walk across it. We had to turn around and go home- easier said than done. When Fr. Julius tried to turn around, the car tires sunk into the mud. We were stuck. So Evans and I hopped out to push the van. Its one in the morning, raining, thundering, lightening, and I’m wearing a dress trying to push a car out of the mud.Is this really happening?! Thanks to my beastly muscles we pushed the car out of the rut. (Just kidding!) Thank goodness Evans was there to push or else we would have been there all night. So we were unstuck but still headed in the wrong direction. Turning around was impossible so we drove in reverse for about 2km until we reached a paved driveway where we could turn around in.
Finally, at 2am I arrived home, wet, muddy, and tired. It was an eventful Holy Saturday in Karungu. This place never fails to amaze me.

Indian Ocean, here we come!

Christy and I took our first trip last week. We went on a seven day cross country trip to Mombassa, which is on the Indian Ocean. Getting there was a two day event. We left Karungu at 6:30 in the morning and arrived in Nairobi around 4pm. Its amazing to see the soci-economic difference between the two places. We went from dirt roads and tin-roofed huts to skyscrapers and rush-hour traffic like an American city. It was the first time I had see paved roads and traffic lights in almost two months; a very welcomed sight! The next morning we made the 7 hour journey to Mombassa by bus. The drive was so beautiful. Along the roadside we saw monkeys, zebras, gazelles, and elephants. So beautiful!
We spent three nights at Diani Beach, just south of Mombassa. The Indian Ocean is beautiful, white sand and clear blue water. Our Cottage along the beach was home to many monkeys and baboons. One morning we were eating breakfast on our porch and had to run inside because hungry baboons showed up. They invaded our porch in search of food as we watched from inside. The area has such a high monkey population that the community has built rope ladders in the trees, across the roads, so the monkeys are hit crossing the street.
One of the highlights of the trip was riding camels along the beach. It’s a lot like riding a horse except it’s about 12 feet off the ground. The camel sits down, you get on, and then it stands up. Scary! The name of the camel was Obama, just like everything in this country. ( I’ll explain the “Obama mania” another time.) How many people can say they rode a camel along the Indian Ocean?! In the off chance you get to ride a camel, you should definitely do it!
It was exciting to see another part of the country but it’s also good to be back in Karungu. It’s starting to feel like home. All of our co-workers missed us and were excited to hear about our trip. People thought we had gone back to America when they hadn’t seen us for a few days. Leisure travel is unheard of in Karungu. Some people around here have lived in Kenya there entire life and never been to the coast. Many were just satisfied with looking at our pictures.

Polygamy alive and well in Karungu

So today stated off like any other. I was sitting in the x-ray department waiting for patients to come. This guy walks in, shakes my hand, and sits down. The first thing out of his mouth is,” You don’t remember me? I’ve met you before.” I was thinking, “No, I don’t remember you. Tons of people shake my hand, introduce themselves, and chat a little. The only reason you remember is that I am one of three white females in this village. I stick out like a sore thumb.”
We make small talk. His name is Timbay and he lives in Karungu with his wife and two kids. He does some kind of work in the fishing business. His father had four wives. The first wife didn’t produce any sons so he kept on marrying more women. Timbay is the 3rd son of his mother; I’m not quite sure what number wife she was. Wow, four wives?! Polygamy at its finest- no wonder the HIV rate is the highest in the region. One man can have two, three, five partners at one time!
Then Timbay starts asking me questions about relationships. Do I have a husband in the US? He says I should marry an African since I now live in Kenya. Great, I know where this is headed…a marriage proposal. But wait, he’s married and has two kids. That’s right; he proceeded to ask me to be his second wife! In total seriousness he wanted me to marry him. I declined (big surprise!) and told him that his first wife would probably not like it. Just then his wife walks into the room and says it is okay if he marries me too! Note: the first wife has command over the second wife and uses her like a maid. I just laugh in front of the two of them. They claim to be happily married, yet, they want me to join them. I tried to explain to them that in my culture and having more than one partner at the same time is very sinful but it didn’t matter to them. Timbay said he would come back again to see if I changed my mind. Great, I can’t wait to continue this outrageous conversation!
A side note: if I accepted his proposal he would have to pay my parents a dowry (a gift of gratitude in exchange for their daughter.) For a woman like myself, with a college education, a suitable dowry would be about six cows, a few donkeys, and some money. Mom, I am sure you would be thrilled to have some cows and donkeys running around in the backyard in Anderson Township!