"Moments of Sunshine"

The past couple of days I definitely feel like I'm getting a bit more acclimated to the hospital and some of the logistics here, but still realizing more and more how much there is to learn. I have had a full range of experiences--scary, confusing, enlightening, awe-inspiring, and comforting experiences. Above all God has shown his amazing provision and his creative spirit!

Yesterday was my first day on call and I was definitely worried headed into it. Although busy initially I was very thankful that the admissions I had were patients I could at least initially stabilize and manage comfortably on my own. The intern I was on call with was also stellar and was a life saver! Everyone was so supportive and other attending physicians kindly offered their assistance should I need it. Thankfully no codes.  There was one scary situation however in which I encountered my first child with a Tet spell. This 3 yo child has a severe congenital heart disease that causes deoxygenated blood to bypass the lungs and be redelivered to the rest of his body. In the United States is usually repaired during infancy. We were called to the echo lab to find a child in respiratory distress and stating 36% on room air (extremely low for the non-medical!!). We quickly told the mom to put him in the "knee to chest" position and she abruptly carried him over to the ED where we gave supplemental oxygen and fluids. I was relieved that my well-seasoned attending Dr. Opongo was still there to assist and remind me of a few medications that can help to reduce the abnormal blood flow. He stabilized overnight back to his baseline, but it was hard to believe that according to the parents, the child goes into similar episodes like this on a regular basis at home when he is stressed and they simply allow him to rest and "wait it out." In the US I can't imagine most parents not brining their child to emergency care immediately upon any such distress. The parents were informed that the condition may not be operable but they are still entertaining options. There is also a cardiac surgery team coming from the US next month and hopefully, I pray, they will accept him as a surgical candidate after seeing his echocardiogram. He is stable for now and will likely go home tomorrow, but I anticipate only a matter of time before he returns.

One of my favorite patients Gilbert

Making a great recovery. About to go home after a month long hospital stay for tetanus.

Night in the Maternity ward with my new friend Jennifer (middle) and mother of baby (right) I'm seeing in the NICU. 

Post-Call Chai!

Soaking up the sun with beautiful Anjellah and her mother 

The precious Mishel! She looks like a little queen! 

I admitted a couple patients with nausea and vomiting and another severely malnourish little girl with abdominal distention that is likely to due some type of mass (possibly a tumor). There was also a little girl with anemia who was admitted for a blood transfusion.  As many children here, she was presumed to have iron deficiency-a product of malnutrition and often time parasitic infections. It is amazing how the people's bodies are acclimated to living with such significant anemia and only come in for transfusions when they are severely low (about 1/3 of the normal value).

Yesterday I was surprised and blessed to have the time to engage in conversation with some of my fellow medical providers and get to know them more personally. I talked for a while with one of the interns during "chai time" about his background and reason for becoming a doctor and he was very interested in what my expectations of Kenya were and what my impressions had been thus far. I told him that despite the difference in resources and some of the medical practices, I found the more laid back atmosphere and the resourcefulness very enlightening. Late last night I also went into the maternity ward to talk to the mother's of one of the NICU babies and started chatting with a very kind L&D nurse named Jennifer. She was very interested in my background, family, and my family's farm back home and I showed her lots of pictures on my phone. She said that despite a successful career as an OR nurse in a more urban hospital she decided to come to Tenwek because of the mission philosophy and wanted to work at a place that seeks to glorify Christ as its end, not make a profit. So encouraging to see her heart of service and desire to help her own people. An uplifting time in a long and tiring night.

After getting off post-call this morning I had a nice day soaking up the sun and took a nice long walk around the grounds to the waterfall. It is actually a dam that supplies the power to the hospital, a true God-send. I was a bit lost and asked directions to a teenage boy who kindly guided me to the waterfall and then all the way back to the guest house. He is an example of most people I've met here, who are so friendly and hospitable to strangers, glad to go out of their way/agenda to offer a helping hand to visitors (at least American girls :) ) I learned that he is the oldest of 6 children and studying architecture and likes to play guitar and soccer. His mother is a teacher at the nearby boarding school.

One cool experience on the walk was seeing a group of dozens of butterflies resting on a moist rock enclave. When sensing my presence they all scattered at the same time, dancing in the air. A beautiful reminder of God's presence and beauty. Lots of beautiful wildflowers and lusch greenery along the path, as well as numerous children who stopped to wave "Hi, how are you!" then giggle and run away. :)

I also went walking to some nearby shops selling local crafts and fresh produce. Lots of delicious looking mangoes, tomatoes, avocado. I bought a basket from an older woman from the local Kipsigis tribe (see below).

Tonight was low key with dinner at the guest house and ended with a fun game played with some of the other volunteers called "Wits and Wagers."

Tomorrow I look forward to a day off and attending church at Tenwek.

Mercy and her son at her shop outside the hospital.

Local woman very proud to show off the basket she made that I bought from her

Taking time to appreciate God's simple beauty 

At Tenwek waterfall

Fruit stands and shops on outskirts of Tenwek Hospital