Updates from Home and Abroad

Thank you so much for all who have been praying for me. It means so much. Given some of the challenges I faced even prior to coming to Kenya I suspected that my time here would be met with unusual difficulties. I got a call from my mom on Sunday night. My parents were in Phoenix at a conference this last weekend when my dad had to be admitted to the hospital for severe kidney stones. The stones are too large to pass on their own and are affecting both kidneys. He had surgery that day and they were able to put a stent in one side, but were unable to remove the stones. The imaging he had done revealed an inflamed pancreas as well. The doctors felt that he was stable enough to return home the next day so that he could continue treatment in SD. Please be praying for him and for his doctors to have wisdom in his treatments. It is always so hard to have family members sick and hurting and to be so far away. Having a medical background makes me want to be there to help, look over test results and talk with the doctors even more. However, I know God wants me here and there is much work to be done. I pray that Satan is not using this as a distraction and an attack because of the work that I am doing. Bedbugs and personal injury I can handle, but attacks on my family are much more challenging.

With that being said it is becoming more clear to me why God placed me here and now. There is a big CMDA medical conference going on in Nairobi this week. Doctors from all over Africa are attending. It is a really good time of renewal, learning and connecting for the physicians. Christina, the OBGYN doc that I told you about earlier is one of the people attending this conference. With her gone the load of the maternity ward has to be taken up by those still here. I am now in charge of rounding on the maternity patients in the morning, coming up with their daily treatment plans and discharging them when they are ready to go home. It is really great to feel like I can take some of the load off the other doctors and contribute in this way. I wanted to come here to learn, but also to serve and God has found a way to use this mere medical student to serve the other doctors here. This also helps to throw me into the world of the patients even more which gives me greater exposure to their needs and understanding of how to help. In between seeing OB patients I am also spending more time on the pediatric ward. This is really giving me the opportunity to see more and understand some very critical pediatric medicine in a third world setting. Pneumonia is really common here and it can become difficult to decide which patients need oxygen when only one tank is available or what antibiotics to give when the hospital has just run out of your first, second and third choice.

Late last week I was able to do my first breech c-section delivery and my first tubal. A friend of mine took pictures. I will have to upload them on the blog when I get back home. I cannot believe how much I am learning in such a short amount of time. Breech deliveries are something I am really hoping to get a lot of exposure to. We don't see them as often in the US and they are more difficult and have greater risk which makes them super important to learn and to learn well.

Getting ready to do a c-section with Dr. Christina (the OBGYN) before she left for Nairobi. Notice there is another case going on in the background. With only on operating room, if an emergency comes up we often just bring the second patient into the room and do the cases side by side.

Success!

I was on call last Friday night when there was a 2am c-section that needed to be done. The mother had ruptured her uterus, but thankfully we were able to get the baby out in time and both mom and baby are doing well. This mother has had 2 other c-sections which increases the risk of uterine rupture significantly. As of this point she has decided she still desires more children which makes me just take a big breath because she will likely rupture again and next time she and her baby may not be so lucky. There is so much of the culture here that I don't understand. This mother already has 5 children. I think I feel more confused than anything at times. I am learning to just accept whatever decision they make and support them through it knowing that I can't possibly understand all of the dynamics that go into their choice.

On Saturday I had the morning and afternoon off so my roommates, me and one of the surgical residents got up at 6am to climb Kipkanor. Kipkanor is a local mountain and landmark of the area. The view from the back of the house I am staying at frames it perfectly. It is a 14 mile hike round trip and you gain 2,500 feet in elevation. I was definitely sore the next day, but it was an incredible experience to walk through the forest and see the view from the top. My typical thoughts of Africa are usually dry, tall grass and hot savanahs. Our view of Africa on Saturday resembled more of a tropical forest with bamboo patches lining the trail.

Hiking the trail up to the top of Kipkanor...so beautiful!

Made it! Sitting at the top with my roommates Ariella and Amber.

On Sunday one of the nurses invited us to attend church with her. It was a little bit of a hike to get there, but I so much enjoy worshiping with Kenyans. Worship becomes a full body experience as every song is sung at the top of your lungs and is accompanied by dancing and hand motions. The children did a special song for us and my heart just warmed. The Lord loves these people so much and I can't imagine how much joy it must bring Him to have a whole group of poverty stricken children dressed in their "Sunday best" singing praises to Him. Sunday night the staff of the hospital got together for Bible study. What a special time. We sang worship songs together and then one of the doctors led the study. There are very few things I enjoy more than sitting around with a bunch of believers with one guitar and just singing the night away. Our God is so good.

Rhoda and I at the hospital. The hospital chapel is the building just behind us. Rhoda is the nurse that invited us to go to church with her.

Yesterday we had two intra-uterine fetal demises (IUFDs). The patients came to the hospitals and their babies were no longer alive. This is so common here, but still so difficult. The women still have to go through labor and deliver though they know that they will not be going home with a child. It makes my heart ache. One of these women had a transverse baby meaning that the baby was laying sideways which made the delivery even more difficult and painful. The OR ran out of anesthesia yesterday so c-section was really not an option. There was one patient we were going to induce yesterday because she is is much past her due date, but we ended up sending her home because if things did not go well and she needed a section we would not be able to help her unless we did her surgery under local anesthesia...painful for everyone. Helping the poor comes with challenges when the patients cannot pay their bills and thus the hospital cannot afford anesthetic. We are praying that more will arrive soon as it is supposed to be on its way, but must pass through a lot of red tape including taxes and government stops. I am praying that no emergency c-sections need to be done until then.

The community here at the hospital is amazing. Word got out that my birthday is on Thursday and they are already planning to have a party. I am so blessed. I was expecting for my birthday to completely pass me by and had in fact forgotten about it. Food and even ingredients for a cake are hard to come by, but the people are so generous. I cannot believe what they are planning. It will definitely be a day to remember and I cannot think of a better place to spend it.

Thank you all for your prayers. My family and I definitely need to be covered in them. Please continue to pray that God would use me, teach me and grow me.