"Miracles at Tenwek"

Time for more updates from this week. Can't believe it's already Friday and that I'm half-way through my trip already. overall this has been a very eventful and special week at the hospital as it is the transition for all of the interns and residents from one year to the next. There have been many graduation ceremonies and the new class of interns has arrived (Think July in the US!)  Individuals from the Tenwek Hospital Board and the fundraising organization, Friends of Tenwek (based in North Carolina by the way!), are also here to join in on the festivities and plan for the new year.

Wednesday Jan. 13 started off with a wonderful multidisciplinary morning conference. Wednesdays are actually non-medial conferences but rather devotionals, and are the most highly attended by all of the staff. We were blessed to receive an inspirational message by pastor Craker, the gentleman who is a missionary in Taiwan I mentioned earlier and who knows one of the long term missionary doctors here. He spoke about the Christian Church in China. Although Christians are a minority and Christianity remains a persecuted religion, by sheer numbers it is the largest Christian nation in the world! He talked about the framework of leadership in the underground church and how the gospel is spread throughout China. It is comprised of "Gate-Keepers" who oversee Leaders, who then oversee the church members. As new individuals are mentored, they then assume the role of leaders and continue to build the Christian church. He related this leadership model to that of the New Testament, with Paul serving as a gate keeper and Timothy his leader. He encouraged us to adopt this same concept of sharing Christ ourselves, passing along the good news from one person or generation to the next, with each receiver then becoming a teacher, "passing the spiritual baton."

How wonderful and refreshing it was to start the day off in the hospital with a sermon, and such an inspirational one at that! How amazing to set the tone of the day off on the right path.

You then, my child, be strengthened by the grace that is in Christ Jesus, 2 and what you have heard from me in the presence of many witnesses entrust to faithful men[a] who will be able to teach others also. 2 Timothy 2:1-2

Baby Dorothy. My miracle baby! 24 hours old. 

Later that afternoon was a very memorable and perhaps one of the scariest moments of my residency career thus far when I performed CPR for the first time (yes really!) on a newborn and successfully resuscitated her. My intern and I were called to the OR due to a fetus in distress that was requiring an emergent C-section delivery. I was expecting to need to provide some resuscitation but not the challenge that would ensue. The baby was blue, limp, and lifeless without any cry, respiratory effort, or heart rate. It had been over a year since my last NICU rotation but I was glad that I had re-familiarized myself with some basic resuscitation skills over the last week. After bagging the infant was unsuccessful, we then began CPR. I was thankful to have a very experienced intern who confidently began compressions. We continued CPR for about 5 minutes and gave epinephrine, fluids, and calcium. The entire time I was sweating and praying to God to help us revive this baby and guide me with what to do. Just when I began to doubt whether we'd be able to regain a heart-beat in this child one of the nurses detected a pulse. Soon we were able to transport the baby to the NICU on just a bit of supplemental oxygen with nasal cannula. I couldn't believe the miracle I had just been a part of and the honor of being able to save this child's life. I know it was God working through us all that were part of the resuscitation team. I will never forget the experience. We soon learned that the mother had likely had a placental abruption and that all of her former 5 pregnancies had failed in-utero. Finally she was able to bring a child into the world. Although still sick and potentially with some brain injury from the long period without oxygen, the baby girl, now named Dorothy, is doing remarkably well.

Wen (med student from US) and I with one of my Peds patients. 

That night I was on call and thankfully the rest of the night was quite calm and I was able to get some sleep while my wonderful intern Betsy took care of a few things on the wards.

"Vicki"

Sitting at my desk now I am both mentally, emotionally and physically exhausted at the roller coaster of joy and tribulations I've experienced over the past 3 days. I've also had some great times of connecting meaningfully with people here.

Here's a report from Tuesday Jan. 12:

Work was thankfully quite calm and I had a great opportunity late morning over "Chai" to get to know Dr. Terer, the family medicine physician who is one of the attendings on Peds right now. He is such a wise and kind human being, not to mention a talented and skilled physician. We chatted a lot about the importance of the spiritual health of our patients and he talked on and on about how important it is to pray for patients and to address the spiritual component of their illnesses. He prays everyday for his patients. He actually began as a nurse in the nursery/NICU and then decided to become a physician. He was in charge of resident education at Tenwek for a while and then decided to complete a masters in family medicine (equivalent to a residency). His heart is in Ob and Peds but he attends on surgery and medicine as well, and he also works in many satellite clinics in the community where he has gathered quite a following. He is highly revered by the staff and patients and entire community surrounding Tenwek, which I know he is embarrassed to admit. He even delivered babies of some of the nurses on the Peds wards. We even got around to talking about my personal life and I was humbled by his prayers for my spiritual health, professional success,  and even for my relational health and future spouse! (He offered that I meet his younger brother....haha)

I noted his approach to holistic and family centered care later that day in the NICU when he noticed that the mother of a baby had a foley (bladder catheter) bag peeking underneath her hospital gown, a detail I'm sure everyone else had not noticed. He took the time to inquire about her medical condition and plan of care. 

The wise Dr. Elijah Terer and over Chair. My favorite time of day!

Joining a few of my patients out in the sun

Isack and his beautiful new "mother" at his orphanage. Glad he got to go home today!

Timothy, one of the medical students on Peds.

Little Mark and his family. His family patiently waiting as we try to figure out why he has heart failure. We awaiting his family to find funds so he can get a chest CT.

A few local girls I stumbled upon as they came home from school

Tuesday finished off as a day of very memorable adventure and spontaneity. After work I went wandering the nearby shops and after spotting a local tailor decided to inquire about whether it was possible if she or someone nearby could make a Kenyan skirt for me. I have been drawn to the beautiful, colorful skies and dresses I've seen many of the women wear here and have been wanting to have one made from some local fabric. I asked the woman and she said she could definitely make one for me. A girl that spends time at a shop nearby saw my need and immediately offered to help. She remembered me from a few days ago when I was looking for an ATM! Her name is Vicki and she is a true angel, one of the sweetest people I've met. She advised that I look at one of two nearby towns, Bomet or Silibwet for fabric and she offered to go with me to find fabric right then and there! We ended up taking a "Boda Boda" or small motorcycle/moped vehicle that many of the locals use for transportation. I've been wanted to try one and was so glad to have someone to share the experience! We actually rode together not he same one, wind in our hair, along the beautiful 10 min. drive to Bomet. The view of the valley at dusk was just breathtaking. The best part wast that the ride only cost 80 Kenyan shillings, or $0.80 US dollars! She guided me through the town to the fabric shop and after much debate finally chose two pieces of cloth among a throng of beautiful fabric of diverse patterns. The way back to Tenwek we actually took a van and she had to sit on my lap due to the crowded vehicle, and passed through another local town called Silibwet. The sunset was just gorgeous. 

I learned a lot about Vicki in our short visit together and am so inspired, encouraged by her amazing story. 21 yo now, she was an orphan for much of her life and lived at a orphanage from at the age of about 12-18. As a  was actually a patient at Tenwek for quite some time as a child due to severe burns. Her uncles refused to pay her medical bills or care for her after recovery, and one of the local missionary doctors here took it upon himself personally to help her. She was taken in by some local women here for awhile, but unfortunately one of them was sometimes unkind. She then went to the orphanage and received her education by a family who owned the home and a nearby school. She now lives by herself in Tenwek and supports herself. For a while she taught bible classes at the church. She frequently returns to the orphanage to spend time with and encourage the other children there. She offered to take me there one of these upcoming days! I'm so excited!! The amazing thing is that she is just so joyful and at peace and so thankful for the blessings in her life. Rather than turn away from God, she praises Him and seeks to glorify Him with her life. She is so selfless and giving and willing to drop everything to help a stranger in need. She even offered to go back to the town to by some more material needed for the skirts while I was at work the next day!

Just a few short minutes with her and I realized how much I have to be thankful for and how I really don't deserve to complain about anything! 

My beautiful new friend Vicki!

Getting ready to ride the Boda Boda!

Typical early evening scene in village outside Tenwek

"New Year, New adventures"

Things have been quite eventful the last few days, so much to write. I wish I could share every detail and facet of my experiences with all of you not here to experience it. I will share a few things from this past weekend before I try to get some sleep on my call night.

On Sunday I had a lovely breakfast with some of the other short term medical volunteers at a lady named Barbara's home. She is a nurse and now in charge of the nursing school at Tenwek--she's been here since 1981! Amazing! We had a fancy breakfast with a beautiful swedish danish too pretty to eat, scrambled eggs, and pumpkin spice coffee. :) We were accompanied by a couple who are long term missionaries in Taiwan and are friends with one of the long term missionary doctors here. They are here primarily to finally meet the Kenyan man whom their missionary daughter recently married. There entire family is involved in reaching lost people--their other daughter plans to be a missionary in Nepal!

Church at Tenwek was great. It was a bit empty at first, but about 20 min into the service the entire room was filled, about 50% occupied by children! The worship was simple but very spirited and powerful. Mostly English but some beautiful songs in Swahili. The message was Joshua chapter 1. The pastor applied the message of courage to our approach for the new year. Trusting God with the changes, challenges, and adventures this new year will bring. In church I learned about a scripture memory program for kids that lasts for several months. Hundreds of kids attend and memorize scripture at each week and there's a huge competition at the end. I wish I had participated in something like that growing up!

This Book of the Law shall not depart from your mouth, but you shall meditate on it day and night, so that you may be careful to do according to all that is written in it. For then you will make your way prosperous, and then you will have good success. Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go" Joshua 1:8-9, ESV

After church there was an amazing lunch at a lady named Anna's home. She is Japanese and works as an OR nurse and has been here for the past 10 years. She made the most delicious Japanese food I've ever had. Such a genuinely, kind and selfless woman. It also amazes me that so many people from across the world are drawn to serve at Tenwek. Not just the US but Europe and quite a few from Asia. I also met the wife of Dr. Bemm, the primary pediatrician who serves here. He is now back in the US for a bit longer. I met his 4 adopted Kenyan children Ellie, Esther, Shaddi (short for Shadrack-so cute!), and Hannah. They seem like such well-adjusted kids and love each other and the Bemm's biological children. The Bemm family has been at Tenwek for close to 15 years rarely makes it home. to the US or have other family visit. They have truly made this place their new home and embrace the people here as their new family in Christ.

The Bemm children: Hannah, Ellie, Shaddi, Esther

A few other short term volunteers and I planned to hike up the local mountain (Montigo) after lunch but the weather got the best of us. We thought a quick rainstorm would pass through, but as we veneered out the drizzle turned into a steady downpour. Despite raincoats and umbrellas we were soaked and muddy and turned around about 1/3 of the way. Although cold and wet and muddy when we returned, it was still a fun and memorable adventure, and I have to admit that the river in the rainstorm conveyed a special mystique and awe.

A couple other of the new volunteers include a retried orthopedic surgeon from Arizona, Dr. Kevin Baum and a retired radiologist, Linda Hippenhammer from Minnesota who helped start the CT program. Eeka, an ob-gyn from Illinois also joined us for a couple weeks for her first experience here. The CT program is a highly complex partnership between Tenwek and a group of volunteer Christian radiologists in the US who read and interpret scans sent to them. Linda informed us that the interpretation of the CTs is often very different between the Americans and Kenyan physicians. Sometimes the way appendicitis, for instance, presents on CT in Kenya vastly different and unrecognizable to US radiologists. I'm so glad Linda is here now as there are many cases (to be discussed soon!) that expertise in CT reading has come in handy.

Beautiful missionary compound

Children playing in tree house at missionary compound

Esther, Ellie and I. We got along well--especially our love of the movie Frozen!

Tenwek falls, setting off on hike before the downpour

Trying to brave the rain

"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

"Tenwek Medicine 101. The Same, Yet Different. "

Over the past two days I have been amazed and overwhelmed as become immersed in Kenyan medical care, and the particulars of healthcare at Tenwek.

Tenwek itself, although quite rudimentary compared to the standards of developed countries, really is quite sophisticated. It has 300+ beds, several ORs, outpatient clinics, an Endoscopy suite, eye and dental clinic, and community outreach. It now houses residency programs for Kenyan doctors in general surgery, orthopedic surgery, OB-gyn, and family medicine. Tenwek recently adopted an electronic medical record which is quite amazing as many health care organizations in the US still are are on paper.

I am serving on the Pediatric service during my stent here, which includes the general pediatric wards, NICU, as well as pediatric patients needing higher levels of care including the ICU and the "HDU" for High-Dependency Unit (similar to our "Step Down Units").  I serve as a senior resident/attending physician and work with Kenyan interns. Internship here is actually a one year program where trainees spend 3 months in each of the 4 main disciplines (surgery, Peds, Medicine, Ob-Gyn) and after that can practice independently as general practitioners or then go on to residency in particular specialties. I am working with 3 wonderful interns and am so thankful for them! They are incredibly smart and hard-working and I am so amazed at how much they are able to learn and accomplish in one year. They are on 24 hr call every few days with no post-call break, and don't even complain!

I am working with an attending named Dr. Gabriel Opondo who is filling in for the US long-term missionary Pediatrician this month. He just finished his peds residency and is unbelievably smart. His knowledge of general peds, specialty medicine, neonatal, and ICU medicine is astounding and I am learning so much from him.  There are no neurologists, infectious disease doctors, or intensivists here, but he confidently manages seizure disorders, HIV, tuberculosis, and malaria, and ventilators.  Another attending, Dr. Elijah Terer, is a family medicine physician but with a great deal of pediatric background and also so talented and gracious. He began rounds on my first day praying over a patient in the ICU, which was such a humbling and refreshing way to start the day.

It has been quite overwhelming the past couple of days as I try to familiarize myself with the many patients on the service as well as learn about the different medical protocols, medications, daily schedule in the hospital and of course the many diseases that I am unaccustomed to in the U.S. I worry that by the time I become familiar with everything it will be time to leave!


A difference here I noticed immediately is the lack of privacy for patients as the wards resemble the classic structure of multiple beds in a row without separate rooms. Although hard to imagine patients and families hearing about the medical problems and sensitive diagnoses of the other patients, I think it helps to create and sense of community and emotional support among the families. The family involvement is also something quite striking, with most children having at least one or more family members at their bedside constantly. Family members are a key part of nursing care as well and usually take part in feeding their children throughout the day. Infectious control is also something that is not nearly as stringent here as in the US. Although hand-sanitizer abounds in every room, there are no mandates that providers sanitize between patients and no-one wears contact precaution gowns or masks. Only TB patients are isolated.

One half of the Peds Ward. Many family members at bedside of the patients.

Despite some of the aforementioned differences, at Tenwek they are extremely resourceful and creative, making the most of the often rudimentary equipment and technology they have. For instance, they use steel weights hanging from bedposts to support the limbs of orthopedic patients, and use simple graduated cylinders turned upside down in a water-filled beaker to deliver positive pressure to infants (their version of bubble CPAP).

Our typical day on the wards consists of rounding at 9 am.This is typically preceded by a multidisciplinary morning conference but has will not start until next week due to many transitions in the hospital the first week of the new year. We round on the general pediatric wards/ICU patients in the morning until lunch time at 1pm and then come back to the NICU around 2 pm to round on those patients. The intern and supervising physician on call see patients in the ED (called "Casualty")  or patients in the maternal child-health clinic who may need to be admitted. We also go to deliveries and C-sections.

One of the features of the day that I have already grown to love is the daily "Chai Time" at 10 am. All of the hospital employees take a break to drink delicious chai tea and sometimes pastries. It is a great time to stop and relax and enjoy each other's company. I so wish we could adopt something like this in the US! During the lunch hour I have lunch at the guest house or am hosted by one of the long-term missionaries. Lunches are prepared by hired cooks and so far have been delicious!

Encouraging mural at the entrance to the Peds Ward

Chapel at the entrance to the Hospital. I'll attend church here on Sundays. 

I have seen a wide range of medical cases so far, some very familiar to what I've seen in the US (e.g., reactive airway disease, pneumonia, meningitis, pyelonephritis (kidney infection)), but there have been many rare cases of diseases I've either never encountered or never seen to such severity. For instance, there is a patient just discharged today after a month of hospitalization for tetanus. He was intubated for 25 days and has made a miraculous recovery. In the past few days he has had his breathing tube removed, eating a regular diet, and walking up and down the halls with physical therapy!

A few other interesting/memorable cases thus far:

Anjellah, a 6 yo girl admitted for seizures due to cerebral malaria (severe malaria affecting the brain). I can recall only one case of malaria in the US and never to this degree of illness.

Victor, a 13 yo boy with a brain hemorrhage and abscess in the ICU whom we are treating for suspected meningo-encephalitis (inflammation of brain/spinal cord). He remains paralyzed on the right side and overall not making major progress. It is frustrating that we cannot figure out the underlying cause and have minimal resources left to pursue.

Susan, a 15 yo girl with severe hepatosplenomegaly (enlarged spleen and liver) and pancytopenia (reduced blood counts) of unknown cause. She needs a transfusion before it is safe to biopsy her spleen and do a bone marrow biopsy, but the blood bank is OUT OF BLOOD and we are now relying on her family for donation. Possible causes include leukemia or leishmaniasis (tropical parasitic infection that I've only read about in text books!)

Perhaps the most memorable and heart-renching case so far is a 5 yr old little boy named Ezra who is extremely emaciated (weighing 26 lbs) and malnourished from the combined effects of HIV and tuberculosis. He was also treated for possible malaria as well. His mother was HIV positive and now deceased, as well as three of his siblings. He and is one living sibling are being cared for by his grandparents. Although he is stable now, it is very likely that he will survive another 6 months due to his extreme malnourishment and constant risk of superinfection. I spoke with his grandmother yesterday via his nurse as an interpreter and told her I was praying for healing and most of all God's peace and comfort. She does go to church regularly and I believe she is a Christian.

What I have learned through Ezra's situation and several others, is the that Kenyan people in general seem to be very emotionally distressed by such trying situations. Maybe they have just seen and experienced so much suffering in their lives, but they also seem to be at peace and hold no grudges against medical providers or especially God. After losing her daughter and several grandchildren to a devastating disease I can't imagine not feeling angry or resentful or victimized. I will continue to pray that this precious child receive miraculous healing but most importantly, that God's glory be revealed through his life.

Ezra and his grandmother

Another sweet boy and his mother. He was a little camera shy but enjoyed the Spiderman sticker I gave him. 

Dennis, a cute 2 yo boy excited to be discharged home. 

"Karibu! Welcome to Tenwek"

Yesterday I made the trek from Nairobi to Tenwek hospital where I'll be spending the next 3.5 weeks. I had a lovely and very memorable 4 hour drive over the Kenyan countryside to the hospital, just outside of a  small town in Northwestern Kenya called Bomet. I was driven by a delightful, friendly, and warm-hearted Kenyan man named Ephraim. I took advantage of the opportunity to pick his mind about the Kenyan culture, including healthcare, government, agriculture, food, and spiritual life. He taught me so much including several Swahili words; we joked that he was my Kenyan "tutor." I also helped him with some of his English pronunciation although I found his English to be quite good. 

I was amazed at stories he told me about his childhood growing up in rural Kenya in a family of 8 children. I heard about his days spent trekking to the water hole for bathing and washing clothes, rabbit and guinea fowl hunting with the dogs, and grazing donkeys. He is a strong believer in Christ and is the son of a pastor. His brother is also a pastor and missionary to a Muslim tribe in Northern Kenya. He started an agricultural program there which he used as an opportunity to build a relationship before sharing the Gospel. Many people there are opening their hearts to Jesus! I found it very refreshing to talk with Ephraim, such a peaceful and content man, which I have found to characterize many of the Kenyan people I have encountered so far. He talked about not letting trials get him down, but pressing on and looking at the positive. He even described being totally calm and at peace when he drives in traffic! Such the opposite of the U.S. I wish I could adopt more of that kind of peaceful, joyful spirit despite my surroundings. 

After arriving at Tenwek I settled into my apartment at the visitor's guest house, which is quite nice and charming!  Complete with a desk area that has a view of the beautiful grounds. The entire living quarter area is surrounded by gorgeous, well-manicured gardens itself is nestled in the majestic Great Rift Valley. Shortly after my arrival I had a tour/orientation of the hospital and received my call schedule and pager. I had lunch at a missionary doctors' home, the Many's. Dr. Heath Many is a general surgeon and his wife and Ob-Gyn who is now a full time home school teacher for their young children. They left their private practices in the US 1.5 years ago to serve here. I can't imagine the challenge and sacrifice of leaving behind their established lives and uprooting everything to come out here with their family. They are such gracious and kind people and made me feel right at home. 

I will continue this story tomorrow as I am now having difficulty with the internet and can't upload pictures. 

Ephraim and I, a "Mzungu." (non-derogatory word for white person)

Just arriving into the Great Rift Valley

Entering Tenwek Hospital grounds! (Tenwek is believed to be a short name for "Ten Weeks," the length of time it took a man to arrive here). 

My room in the guest house. Complete with bug nets! Thankfully no mosquitoes, only some pesky flies. 

View from my desk. Not too shabby.

View from my guest room of the beautiful landscaping

"I've Arrived in Africa!"

Wow, can't believe I'm actually in AFRICA! Doesn't seem like it when I'm sitting here but when I mentally visualize a world globe and think about being on the other side of the world in this huge African continent its hard to believe and feels so

far away and doesn't seem real. The journey here was long but bearable. Flights actually passed by quickly with sleeping and movies (one of which was the Intern, which I highly recommend by the way). In preparation for my time of medical service here, there was of course a call for a medical personnel shortly after take off from the US to Qatar when a woman fainted. Two experienced ER nurses and a couple other physicians were on the scene but I felt compelled to stay and help out for a while. Likely vasovagal episode or dehydration and she felt just fine with some fluids and rest.

I was worried that I would miss my flight from Qatar to Nairobi as there was a LONG security line for transferring passenger and I only had an hour before boarding and the "last call" boarding was before I was even close to the vicinity of the terminal. I ran from one end of the airport to the other, praying I would make it in time, and thankfully ended up making it well before the last passengers were trickling in. Praise God!  I will say that during my brief stop at the Doha Airport in Qatar before  heading to Nairobi it was hard to believe I was actually in "The Middle East" and that we flew over such daunting places as Syria, Iraq, and other regions that are all to frequently on the news.

Passing through the Nairobi airport customs, quite the opposite of the expansive, luxury shopping mall like atmosphere of the Doha airport, was surprisingly relatively smooth and seamless.  My friendly and kind driver was there promptly to take me to the hotel. He is one of several Kenyan gentleman here I've already encountered who are impressively polite, courteous and chivalrous.

The hotel, Amani Garden Inn (former Mennonite Guest House) is quaint hotel set in a lusch, beautiful garden. The grounds are just lovely. I even had time for afternoon tea outside while it was still warm. Just my type of place. I went for a short walk and had dinner at a different nearby hotel with a cool outdoor patio. One cool aspect of the Inn is the Christian influence. There is a labryinth in the garden and a sign inside the hotel explained the significance of its symbolism of "spiritual labyrinths." The labyrinth being a place where there is no specific agenda or path but a place where one goes to escape the word around and meet and commune with God in the center, in prayer. Here one is safe and secluded from the world, worries, and hustle and bustle of the outside. As one leaves the labyrinth, or that time of intimate communal with God, then he or she can enter the world again at the other side, refreshed and with a sense of grounding and peace. Pretty cool metaphor! Apparently there are entire books written about the subject.

Tomorrow I look forward in anticipation and some nervousness about the journey to Tenwek and getting oriented at the hospital. I find myself wondering if I will know enough to be able to provide care for the severely ill children, especially premature babies, I will encounter, and if I will be able to teach the residents there something.

I continue to try to surrender to god and know that he will give me the strength and ability to survive each day and utilize my hands, feet, and mind to do his work. He has gotten me through so many big and small challenges already and I know He will continue to do so. I pray for a passion to serve God and share and demonstrate the love of Christ to the staff, patients, and locals I meet over the next few weeks.