Monthly Archives: July 2012

Kakamega Rain Forest!

Whitney and I just arrived back from a wonderful weekend at Kagamega Forest, Kenya’s only rain forest.  I thought I would share a photographic tour of our journey to Kakamega, and some highlights from the trip.

The Journey to Kakamega

We left at 8am on Saturday morning toward the forest with four other short term missionaries from Tenwek (Steve – a resident from Duke, William – a medical student from Ghana/Ukraine, Comfort – a banker from Ghana, David – a medical resident from South Korea).  Our drive initially took us past numerous tea fields, similar to what we posted about previously.

Tea pickers working the tea fields.

Our driver, Donald, had arranged for us to visit and tour a tea factory  to learn how black tea was produced since the factory was on the way to the forest.  We visited Chelal Tea Factory, where we were welcomed and treated to a excellent informational tour of the factory.  Here are some pics and highlights from the factory:

Whtiney and I donned our oversized white factory coats, and started the tour!

Left to right, starting from upper left: a) Freshly picked tea leaves are brought to the factory, b) Upon arrival, the bags of tea are transferred off the truck and weighed, c) random sample handfuls from every bag are sorted into different categories, based on the quality of the tea leaf. If the bags do not contain at least 75% of leaves in the highest quality category, then that bag is rejected and sent back, d) after a bag is accepted, the leaves are initially dried slightly for 4-18 hours (not shown) and then go through a cutting/shredding process, fermentation, oxidation, further drying, and sorting into categories based on particle size, appearance, and quality. In this picture, the tea leaves have been cut/shredded, and are starting the fermentation.

More pics from the factory. On this collage of pictures, the tea further changes color via fermentation/oxidation/dehydration and eventually ends up a dark black color. Following the extraction of the finished product, the tea is made and a quality control inspector samples each grade of tea for taste, color, texture etc. in the tasting room. Following the tour of the factory, we were taken to their wood burning furnace which aids in the drying process. They had thousands and thousands of wood logs to support the wood burning. They use Eucalyptus trees which grow quickly, and for every tree that is cut down, a new one is planted to ensure sustainability. Finally, after the tour, we were treated to a delicious cup of chai, and I must say, this tea certainly passed my taste test!

We finished the tour at about 11am and met Donald at the car.  We anticipated having another 2-3 hour drive prior to arriving at Kakamega.  Unfortunately, we had some serious car trouble and could not get the car started.  We ended up stranded at the Tea Factory for 2+ hours while awaiting for Donald to take a motorcycle taxi (called Boda Bodas) to a nearby town to purchase a part that was the suspected culprit.  While waiting, we chatted with many of the friendly tea workers and learned more about Kenyan culture, traditions, politics etc.  I was impressed with their incredible hospitality.  Fortunately the car did eventually start, and we were back on our way.

Pushing the car in the Chelal parking lot as it was blocking delivery of the tea leaves. We enlisted the help of a few others and were eventually able to move the car uphill and out of the way.

While waiting to leave, dozens of kids came to the factory fence and observed/followed us everywhere we went

The journey continues…

After getting back on the road, we drove through various small villages, past many dukas (small roadside stands selling produce or other basic supplies).  The tea fields that dominate the Tenwek landscape became less prominent as we drove north, and were replaced by sugarcane as the dominant agriculture product.  A few more pics…

A road-side stand selling banana clusters

A Kenyan sugar cane field

After harvesting, the sugar cane is transported to a nearby sugar factory. We saw dozens and dozens of sugar cane loads being carried. Small loads are actually transported by bicycle, or even on the top of someones head while they walk to the nearest factory.

Unfortunately, about an hour or so from Kakamega, our car stalled again and we had another 1+ hour delay.  With the help of a local mechanic, we were able to get going again, although the delays made the trip a bit more exhausting.  Once going again, we next drove through the Nandi Hills, which are the home to many of the famous, elite Kenyan distance runners.  On this trip, we didn’t see too many runners…maybe they are all in London!  Here are a few pics from the Nandi region:

The Nandi hills

Nandi Hills again visible in the background

Kakamega Rain Forest

Well, after a long journey, we arrived to Kakamega rainforest and I must say, it was well worth the wait.  400 years ago, this forest spread across much of the central belt of Africa, but with settlement, the forest largely disappeared.  Kakamega is now a protected rainforest in Western Kenya featuring immense, ancient hardwood trees, an extensive network of vines, orchids, innumerable other plants, and a diverse array of butterflies, tropical birds, and monkeys.  We stayed in authentic bandas (small thatched roof huts) designed in the Luhya tradition (the Kenyan tribe that occupies this region).  The bandas are maintained by an environmental/educational group called KEEP.  The bandas offered a truly authentic Kenyan experience as this is the type of home in which many people in Kenya live.  Additionally, it only cost ~8 dollars per night per person, so it was tough to beat that price.  A few pictures of our accommodation is shown below:

Whitney and I next to our authentic banda!

Whitney hanging out in the banda. Ours included four single beds (with bedding included!), 4 mosquito nets, a coffee table, toilet paper, and…well, thats it!

The roof of our hut!

Around our campsite, was a group of about 20 Blue Monkeys.  They were a riot to watch as they jumped from one branch to the next, eating leaves, and glancing down at us every now and then.  It was dusk when we arrived, so the lighting was poor, but here is a representative picture and short video of one of the monkeys.

A Kakamega Blue Monkey!

 


http://youtu.be/999aw1y2o-c

Hike to Lirhanda Peak

The next morning, we met our guide, Abraham, at 5am for a sunrise hike to Lirhanda Hill, which is the highest point of the forest at ~5200 feet above sea level.  It was pitch dark when we left, so we all had flashlights to navigate through the forest.  It rained overnight, so the paths were quite soft and muddy, which made navigation a bit more challenging!  On the way, we encountered a Jackal, but did not get a great view of it due to the darkness.  By the time we reached the top of the hill, it was nearly sunrise.  Unfortunately, it was a cloudy morning, so sunrise did not make a dazzling appearance, however, the views from the top were still quite spectacular!  Here are a few examples:

One of the first views from the top!

It was cool to see the fog settling over the forest

another view from Lirhanda

Whitney and I at the top

A group picture overlooking Kakamega

On our way down from Lirhanda, we stopped at this bat cave. Bravely, we all entered to the back of the cave. We were joined there by a group of hammer-headed fruit bats, much to the displeasure of some in our group! They were harmless, but we certainly didn’t stay long in the cave once seeing the bats.

We next hiked through the rain forest where we encountered hundreds and hundreds of monkeys, birds of all different colors and sounds, butterflies, and amazing trees, ferns, and other types of plants.  Our guide, Abraham, was amazing!  It seemed that he knew the name, habitat, and behaviors of all of the different species.  He also could speak to the birds!  He was able to make many different bird calls to match the different species.  On many occasions, he would hear a bird, and start calling back and forth with the bird until we found the bird he was calling.  It was impressive!  We actually did two hikes with Abraham, with a breakfast in between. Here are a few pics of the forest, monkeys, and a few samples of the birds we saw:

Whitney walking next to our guide in the forest

The Blue Headed Bee-eater.

I don’t remember the name of these. I think they were called “Horned Billed…something”

Another view of the forest!

A few flowers we came across

Standing next to a centuries old massive sandpaper tree. It gets its name since the leaves are rough and feel exactly like sandpaper.

 

Our guide Abraham inside a Fig Tree. This tree was about 600 years old. Fig trees are often hollow inside because they are parasitic trees and grow on and around their hosts until the host inside dies. The host then decomposes over time leaving an empty cavity inside the fig tree.

Kakamega Monkeys:

Here are some representative pictures of some of the monkeys we saw:

These are the famous Black and White Colobus monkeys! They have long black tails with a fuzzy white ball at the end of the tail. They are known for their great leaping ability, and we enjoyed watching them jump far distances from one branch to the other. They apparently can cover up to 100 feet with one leap!!  Can you see all four in this picture?

Two more Colobus monkeys

The Red-Tailed monkey. Typically it spends its time high in the canopy, but this fella came down for a visit!

Two blue monkeys in a tree. These two, along with about two dozens others, were hanging in the trees just above our bandas.

Whitney looking up at a Blue Monkey with another Blue Monkey observing in the background.

Another Blue Monkey

Fortunately, our trip back was much less eventful without any car trouble!  Thanks for taking the time to view some of our pics.  I will post again in a few days regarding some more interesting and exciting medical cases that I have been a part of, and Whitney will share soon about some of her interesting experiences at the school!  Blessings!!

 

 

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“You are married? But you have no children? Why?”

Hi there!  Whitney here.  This post is a few thoughts about one of my cultural observances here so far.

I have been asked the questions listed in the title of this post by almost every Kenyan I’ve met here.  The first time I realized it was confusing and odd for Kenyans to learn I was married, but without kids, was when I was speaking with Amy, who works at a duka near the hospital selling fresh produce.  She introduced me to her three year-old, Victor, and asked me if I had any kids, to which I responded “No.”  Later that day I was walking with Scott and introduced him to Amy as my husband.  The next day when Amy saw me she asked, “When did you and Daktari (Kiswahili for doctor)  go to marry?”  “You mean, when did we get married?” I responded to Amy assuming she accidentally used the wrong verb tense in her sentence.  She shook her head and asked again.  Perplexed, I answered her that we had already been married for four years and that we were married in June of 2008.  Amy’s eyes grew wide with comprehension and disbelief upon hearing this.  “You are saying you married for four years?” she asked.  “Yes,”  I responded, happy that she understood.  Amy explained, “I didn’t understand the other day.  I thought you not married since you have no children.”  At this point, I think I looked away and shrugged bashfully.  After a pause, she asked the question that was preying on her mind, “Why you not have any children?”  Her tone and body language indicated that she could have been either sad or worried for me and was ready to comfort me.  I then explained to her, as clearly as I could so she would understand, a reason or two for why we decided to wait to have kids.

This encounter happened the first week here, since then I’ve had multiple similar conversations.  When traveling to a community health clinic with a woman named Jane, she recounted a story to me of how she didn’t become pregnant until nine months after she was married and her mother grew very worried about her forcing her to drink some bitter, herbal drink thinking it would help her get pregnant.

Then, this weekend I hiked with some missionaries and interns to the top of Mount Motigo (the one Scott did earlier and posted about) and at the top there was a group of school kids.  I spoke with them and they asked me where my mother was. (Kenyans think I’m quite a bit younger than I am–a good self-esteem boost!)  I responded that she was in the USA and I came with my husband.  The next question was “Where are your children?”

The school children at the top of Mount Motigo

Me explaining that I don’t have kids. 😉

I mentioned this story yesterday to some teachers in the staff room at school. (I’ve been helping and teaching at a primary school here–I love it!)  Surprised, Janeth (a science and Kiswahili teacher who is my age) asked why I did not have children.  Samuel (a math teacher) cut in and said “What!?  I thought you had two or three!”  “Really?” I said.  Samuel replied, “Yes, it is a given.  That is why I never asked you if you had kids because I ‘knew’ you did.”  Wanting to better understand the reason for this belief, I asked why people here think you have kids as soon as you get married.  Janeth’s response was a quick, but solemn, “It is a must.”  “But why?” I pushed only to have her say with more emphasis “It is a must.”  Perplexed, I looked around the room for further explanation.  I learned that it is an big honor to have children and culturally it is a woman’s duty to bear children for her husband.  In some tribes, like the Maasai, the number of children you have signifies your wealth and family status, even though having so many children can overstretch the families budget.  Also, a few generations back it was widely accepted for a wife to pick out a second, younger wife for her husband so the younger wife could bear him even more children.  The younger wife’s relationship to the elder wife would be that of a servant to a master, with the husband ruling over them both.  This is because in Kenyan culture the groom’s family must pay a high price (up to ten cows) to the bride’s family for their daughter.  Thus, it has been expected that the bride will work hard for the groom and serve the groom.  When the elder wife would pick a younger wife, it was elder wife who paid a price to the younger bride’s family, in a sense, “buying” the younger wife.  Elder wives picked younger wives because if they did not pick one, then the husband might grow restless and pick a mistress for himself.  Thus, however humiliating or painful it would be, it was better for the elder wife to have her choice of girl/woman and to have the formal arrangement of second wife and rule over her.  These traditions of multiple wives are no longer practiced immediately around Tenwek, but do still exist in a few parts of Kenya.  Due to these traditions, it is still very important in the culture today to get pregnant and have children as soon as possible after getting married.

So that is what I have learned about this so far.  What do you think?  Questions?

I hope you enjoyed this “Cultural Observance: Part I” installment of Tenwek Files. Until next time!

Peace to you and in you,

Whitney

P.S. We are going with a group this weekend to Kakamega Rainforest this weekend and are quite excited! Hopefully we’ll have some good pictures!

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First Weekend on Call

Greetings!  Scott here.

Well, I just finished my first call weekend, and although it was a bit crazy and hectic, I survived, as did almost all of the patients.  The call weekends here a tough, however, since you are on call for 48 consecutive hours, and the only medicine doctor available.  Therefore, I had to cover the entire medical service, all the medicine consults, the ICUs, and all new admissions.  In total, that included rounding on ~60 patients a day, which was exhausting, exciting, and of course interesting.  I am slowly adapting to the lack of resources, and am learning on the go.  I thought I would share a few brief stories below:

-On Saturday, we had a women present with a severe nose bleed.  She had severe thrombocytopenia (low platelets) which prevented the bleeding from stopping.  In the U.S., we could give a transfusion of platelets, but we do not have platelets here.  Instead, in order to give platelets, a relative has to donate blood to be given.  No relative was available with matching blood type.  We proceeded to pack her nose with gauze, and held pressure, but she continued to bleed into her mouth, suggesting the bleed was coming from the posterior (back part) of the nose.  In the States, we would use a “Rhino Rocket” (device that goes into the nose) or have the vessels cauterized by an ENT specialist.  Unfortunately, she was losing blood fast and was developing hypovolemic shock (very low blood pressure) from the blood loss.  On a whim, I grabbed a new Foley catheter (the type that goes into the bladder and is used to drain urine).  I placed the catheter through her nose and into the back of her throat.  Following that I was able to blow up the balloon of the Foley in the back of her throat, pull the Foley back out her nose, and the balloon caught against the back of the nose, compressing the bleeding spot.  The bleeding stopped with this contraption long enough for us to be able to tranfuse her!

There have been several other situations in which I have been stretched medically, and have done things I have not previously done such as bone marrow biopsies, administering chemotherapy (typically done by oncologists…we don’t have them here), and I even did a pericardiocentesis.  This procedure is typically done by trained cardiologist under imaging guidance, but again, no cardiologists here.  We had a woman with a large buildup of fluid in the sac around the heart (likely from TB) causing pericardial tamponade, which means the fluid is making it difficult for the heart  to beat.  We attempted to treat the TB with hopes she would improve, but she worsened, and actually coded.  I had read how to do the procedure just that day, and actually performed the procedure following the code.  I inserted a syringe under the ribs, pointed toward the heart, advanced (praying I would not hit the lungs, blood vessels, or heart itself.  Eventually, I reached the pericardial sac, and we were able to drain a few hundred milliliters of fluid and she initially improved, but unfortunately died two days later.

She was only 35, and she joined several other very young patients that have passed away.  Amazingly, a few patients have gone against this trend, as we have had a 100 year old, 115 year old, and believe it or not, a 120 year old patient on service.  It is crazy to think that the 120 year old patient was born in 1892, which likely makes her one of the oldest, if not the oldest living person in the world right now!  She is still going too, after being discharged this weekend!

The daily death here can be difficult, but it offers a chance for amazing spiritual conversations and prayers with the patients and their family.  The majority of patients are Christians, but many patients are not believers.  In fact, just today, we had a 24 yo patient, with advanced cancer, give his life to Christ.  He did not grow up Christian, but has been coming to Tenwek for the last few months for his care.  He said that he noticed something different about the nurses, doctors, students, janitors, administration here, and he wanted to know what it was.  He told us today, that he has discovered that what this “difference” was, was the love and peace of Jesus Christ.  Today during our conversation, he told us that he wanted to give his life fully to Christ.  We prayed with him, and he accepted Jesus as his savior!  Praise God!  It is amazing how as Christians, whether a doctor, nurse, teacher, custodian, administrator, business person, or anything else, our attitudes, conversations, and love can reflect Christ to the world.

There is so much more I want to share, but I once again have become quite long winded.  Next post, I will share about a truly miraculous story of healing that I witnessed over the weekend, but I will save that for another time!

Anyways, thanks for reading if you made it this far.  Below, I just wanted to share a few pics from a hike that Whitney and I did last week with a few other visiting missionaries.

Blessings,

Scott

Whitney and I after reaching the river near Tenwek.

 

Here I am at a different part of the river with William, a visiting medical student from Ghana.

On our way back from the hike, we somehow ended up in a cow pasture, we needed to reach the gate in the background of the picture, however, there were several cows, and most notably one very large bull blocking the way. We opted to turn around and find a different way back, rather than mess with that bull!

We ran in to theses three adorable kids on our way back.

Waterfall just below the Tenwek hydroelectric dam.

 

 

 

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Kenyan Dinner and a Day Out

Hello everybody!  Whitney here.

First, thanks to all of you who have been praying for Romano.  We have good news to report!  He is recovering well, and Scott said he actually was transferred out of the ICU today, which is a step toward leaving the hospital.  Praise God!

Life moves so quickly!  It is hard to blog about everything and do it all justice.  Below is my brief attempt to fill you in on a few of our recent happenings!

Last Friday evening we were invited to Pete and Lisa Kuyaya’s house for a Kenyan dinner (they are Kenya natives).  They are two of the nicest people I think I’ve ever met!  On Wednesday of last week Scott and I were attempting to squeeze a quick walk in before it got dark at 7:00PM.  On our way, we were admiring a home with beautiful flowers growing all around it.  As we stood there, Lisa, the Volunteer Staff Coordinator at Tenwek, came down the dirt road and greeted us and we realized that this was her home.  We complimented her on the flowers and she laughed and joked and said their were more plants inside the house.

Some of Lisa’s flowers

Or at least I thought she was joking until she invited us in for chai, Kenya’s national drink.  (Ok, I made the “national drink” part up, but it should be as it is impossible to go a day without chai!)  We accepted the invitation and we soon saw that she was not joking about having more plants inside.  Pots and vines were everywhere.  Vines were trained up the ceiling and over and across to the other side of the room.  One could make a game of finding which pot a vine originated from!

Pete and Maria playing on the deck.

Once seated, Lisa’s daughter, Maria, who is in third grade, prayed for our chai (so sweet!) and then Lisa served us the best chai we have had thanks to her fresh cow’s milk (unlike the usual unrefrigerated, ultra-pasturized milk that is common here that I think it tastes awfully funky) and a Tea Masala blend of spices which made the tea taste more like Indian chai.  Soon enough, Pete, Lisa’s husband who is a dentist at Tenwek, was describing the wonderful food Lisa makes and how she is a great cook.  Well, of course I had to find out all about what she makes and how she makes it.  In the end, Pete suggested a Friday night duo supper where the two “expert cooks” would make the food (Lisa the Kenyan meal and I a dessert) and the two “expert eaters” (Pete and Scott) would do their share of eating.  It is thus how Scott and I were invited to our first Kenyan meal in a Kenyan home and we looked forward to Friday night with great anticipation.

The meal on Friday did not disappoint!  Lisa made so many dishes it was like a grand buffet!  There was beef stew, beef stir fry, chapatis (like tortillas) with carrot and cilantro shreds inside the dough, sukuma wiki (cooked kale), cooked cabbage with cilantro, sauteed green beans and julienned carrots, a tomato and pickled ginger chutney, a tomato chutney with sultannas, Mukenye (mashed sweet potato and beans), Matoke(boiled and mashed green bananas) served with a peanut sauce, a lettuce salad with carrots and avocado, and homemade mango-pineapple juice.

Starting from the bottom to the top:  cabbage with cilantro, chapatis, beef stew, sauteed carrots and green beans, beef stir fry, avocado-carrot lettuce salad, a tomato chutney (hiding behind the spoon handle), peanut sauce, matoke, mukenye, another tomato chutney, and sukuma wiki.

It was all so good and fresh with almost all of the vegetable dishes coming straight from her garden–and if not her garden, then a farm a few miles away.  Except for the chutneys, none of the foods had any additional spices or seasoning.  I have been told by another Kenyan that lack of seasoning, besides salt, is common because historically spices have been expensive and thus they were never incorporated into the Kenyan cuisine (except on the coast of Kenya due to trade and the proximity to India).

Me and Maria

For dessert, I made this fudgy chocolate cake set in a pool of orange curd from this recipe with a variation of these espresso meringues crushed over top of the cake for texture.  I used my precious Ghiradelli chocolate chips I brought from the States (which I think my mom bought me for Christmas!) for the cake and I had to borrow beaters and an oven (my oven ran out of gas–terrible timing) to make the meringue cookies.  In the end though it was all worth it and I’m so glad I went the extra mile because Lisa’s meal, and endless leftovers, were such a blessing to us!

Daktari (Doctor) Pete proudly shows us the green bananas used to make the matoke.

The next day, on Saturday, Scott and I went with a group of other visiting medical staff to a town called Kericho (1-2 hours away) for a day trip.  On the way we passed by beautiful countryside, followed by gorgeous tea plantation fields, and then ended at the Tea Hotel in Kericho for lunch.  Below is a bunch of pictures (most taken while driving) so you can hopefully get a good idea how pretty the countryside is here and learn a few cultural tidbits.  Enjoy!

The countryside surrounding Tenwek. Sorry for the large proportion of road in this picture! Scott took this picture out of the car’s back right window and you drive on the left side of the road here!

 

The road behind.

A tea picker with a full basket of tea leaves on his/her head.

I really like this picture

. . . and this one too.

 

Some cows on the side of the road. Cows are everywhere here, they’re as plentiful as the squirrels are in North Carolina, only they are bigger and sometimes accompanied by a mean and dangerous looking bull so it is best to be careful. That said, I wonder if Kenyans ever tip cows over while they sleep like Iowans . . . thoughts? I think I may have to do some investigating.

Ok, so I know the dirt road here and in the picture above look relatively smooth, but trust me, we NEEDED this vehicle. Don’t leave home without one! The roads are so rough, riveted, rocky, rrrr-something and full of potholes, that you are constantly tossed and jostled around. These cars are also useful for when it rains and the roads turn to mud.

 

Our driver, Donald, stopped just before we drove through this river saying, “Just one minute,” as he got out of the car and disappeared into the trees on the side of the road (AKA-nature called). Scott and Allen (a prosthetician) looked at each other and decided to do likewise.  Unfortunately, there are no reststops or bathrooms for girls to use!

Luckily, there were these two little boys on the side of the road with a panga (a machete-like sword) who could, um, protect us?

 

A close-up. I can see why my friend wants to adopt a Kenyan child every time she comes here. They’re beautiful.  P.S. the boots the child in red is wearing are called “gum boots.”

The beautiful scenery continues . . .

 

Loving it!

 

Tea plantation workers with baskets on their backs on a British tea plantation. As we drove by many people, like the guy on the left in yellow, eagerly waved to us as we drove by, often with fists full of tea leaves. In fact, so many people eagerly waved to us on the back-country, dirt road that we took, that it felt a bit like we could have been on a float in a small-town parade throwing candy to the kids or something. Perhaps people along the rough road we took don’t see many muzungus (white people) forging their way through, or perhaps Kenyans are just that friendly.

Ok, do you see the uniformity of the trees in the distance here? These trees are also planted and harvested by the tea plantations and are used in the making the tea. The trees they use grow this tall in only five years and every time they harvest a “field” they plant new trees. Once harvested, they cut the tall skinny trunk up into four foot pieces and uniformly stack them high like a Jenga game until they are burned and used to dry out the tea leaves.

The trees in the very distant background of this picture (beyond the uniform ones) are part of the Mau Forest where some elephants live. Sadly, we didn’t see any. 😦

Identical houses of the plantation workers, some are rectangular like these, other groupings are circular like the traditional Kipsigis hut.

Perfect plantation fields

And again

Here we were on smooth road going at a reasonable pace and I felt divine with the sun on my face, the wind tossing my hair, beauty all around, and no worries.  Life was good, and then Scott snapped this pic of me. I think I look like Crazy Horse, what do you think?

The Crazy Horse Memorial in the Black Hills of South Dakota. 

Me outside of the Tea Hotel in Kericho where we had lunch.

The girls at the table.

 

Monkeys played on the rooftops while we ate.

 

Another monkey pic!

The garden and grounds in the back of the Tea Hotel

Thanks for viewing!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Inspiration!

Romano, director of a Make Way Partners orphanage in a dangerous area of Sudan, was nearing the Kenyan-(South) Sudan border.  Attacks from bandits are commonplace in this no-man’s land.  They target the driver first and once the vehicle stops, they kill everyone inside the vehicle and then take all of their belongings.  In this area, there is no political agenda to it; they are only “opportunists” looking for money by taking advantage of the influx in traffic including refugees coming from Sudan and humanitarian aid workers going to Sudan.  The problem is, many people in that region carry a gun, some are bandits, and others use their gun to protect themselves and their cattle from the bandits.  It is hard to tell the difference until it is too late.

Riding in the car with him was an “escort” (an armed soldier whose job it is to protect and ward off any ambushes from the bandits) along with a few passengers he had picked up along the way needing a ride from one region to another.  His agenda today was to pick up his colleague and friend, Peter (a man who designs and constructs orphanages and safe-houses in Sudan for Make Way Partners), and bring him back to where he had come from.

Suddenly, there was a CRACK as a shot rang out in the sky, followed by another, which was accompanied by a scorching pain in his upper abdomen.  He had been shot.  Romano’s escort ducked, hiding himself and forgetting his duty.  One of the passengers grabbed the escort’s gun and fired four shots back scaring the bandits and making them flee.  Another passenger knew how to drive and resumed Romano’s driving and drove them away to safety.  What a miracle to have such brave and knowledgeable passengers!

Meanwhile, in Nairobi, Eugenio, a logistician for Make Way Partners, received a phone call from Peter saying that Romano had not arrived. There was also a report that the driver of a car in the area had been shot by bandits.  Eugenio did not know that this same driver in the report was Romano, but he had an urgent sense that it was.  He called Phillip, a colleague and lifelong friend of Romano, who happened to be in a northwestern city of Kenya.  Phillip is an evangelist for Make Way Partners who brings the hope of the gospel, and provides aid to hurting people in Darfur, the Nuba Mountains, and other unstable areas in Sudan.   After Eugenio explained what he knew to Phillip, he and Phillip decided Phillip should go try to find this car with the driver who was shot.  Phillip went out from the city and indeed, he found the car and the driver was Romano.

Romano had lost a lot of blood and was fading in and out of consciousness.  He needed to be taken to a hospital quickly.  In order to get him the care he needed, Eugenio chartered a flight through a friend and AIM mission pilot, Kelly.  Kelly and Eugenia flew to northern Kenya and picked up Romano, Phillip, Peter, and a nurse to tend to Romano.  They hoped to fly to Tenwek hospital, the closest mission hospital with an airstrip, but the sun was quickly setting and landing a plane on a rough, unpaved, unlit runway in the dark is not exactly safe.  If they didn’t make it in time to Tenwek, their only other option was to press on to Kijabe, another mission hospital.  Kijabe does not have an airstrip nearby like Tenwek, and Romano would have to survive a rough ambulance mountain drive to get to Kijabe.  Nairobi was out of the question because the hospitals there would not treat Romano (especially a Sudanese) without upfront payment upon admission and by the time Eugenio would be able to get enough cash together, Romano could bleed to death on a stretcher.  Tenwek was by far the preferred option.

The sun had set, but the pilot felt the urgency to get Romano admitted into a hospital fast.  He decided to try and land at Tenwek anyway.  As they landed, one of the tires on the plane exploded as they met the runway, making for a very rough landing.  Praise God, everyone on board was ok.  Romano was bought to Tenwek and operated upon last night.  He is currently recovering well in Tenwek’s ICU.  Please continue to keep him in your prayers.  He and his wife have two young boys and his wife is weeks away from delivering their third child.

This account was told to Scott, myself, and Steve (another Duke resident) by Eugenio, Phillip, Peter, and Kelly across the guesthouse’s community kitchen table at 10:00 at night as they ate their first meal of the day.  Amazed at their story, I asked them if they would be able to continue their orphanage work in Sudan since it seemed, to me, so dangerous to get there. (They have started three orphanages there, one 650 kid orphanage in Darfur, one 250 kid orphanage near the border of Uganda, and their newest one in the Nuba Mountains where Sudan rains bombs down daily.)  In response to my question, they laughed.  Of course they would continue.  The danger in the region where Romano was shot seemed little in comparison to what they have already, and are currently, living through in the places where they have built orphanages in Sudan.   In awe, I just stared back with my right eyebrow raised at these Super Men, these warriors.  Ever humble, their reply was, “We are only following God.”

Prompted and prodded by our questions, these men patiently and humbly shared many stories with us about the daily dangers they face, the miraculous stories of God’s healing and protection, the thousands of orphans that have been saved, as well as the countless orphans and sex slaves yet to be rescued.  These men are an incredible example to all of us of what it means to follow Jesus no matter what the cost (even if the cost is life itself), and to seek justice for the poor, wounded, and vulnerable people of the world.  These men exemplify James 1:27:  “Religion that God our father considers pure and blameless is this:  to look after the orphans and widows in their distress, and to keep oneself from being polluted by the world”.  Please continue to pray for the amazing work they are doing!

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Please Pray

Hello,

Scott and I have been profoundly impacted tonight after meeting and spending time with Eugenia, Peter, Phillip, and Kelly.  These four men continually risk their lives serving God as members of Make Way Partners and Samaritan’s Purse.  Right now their colleague and friend, Romano, is being treated at Tenwek Hospital after being shot near the Sudan/Kenyan border by bandits as he was driving to pick up Peter.  Please click this link to read more about this story and please pray for Romano’s healing and for those who are treating him.  We will provide more details about this story, our discussions with these men, and updates on Romano’s surgery in the morning.  Thank you for your prayers!!!  To God be the glory.

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Catching up!

This is Scott, it has been awhile since I last posted so I thought I would give a quick update on some of the things that we have been up to over the several days.

Last weekend, I had the opportunity to join a few other visiting missionaries for a morning hike up to Motigo Mountain.  The hike passes over a nearby waterfall, and through the countryside of a mountain.  On the way up we passed by small family homes, and were joined by close to a dozen Kenyan children who hiked all the way up the mountain.  Ed, a visiting gastroenterologist, brought peppermint candy to give to the kids, but even after it was gone, they continued to follow us, ask questions, press on our white skin, etc.  It was a bit of a hazy day, but the 360 degree view from the top was beautiful.  The mountains and hillsides are full of tea, corn, and various other vegetable plots, as well as cows, donkeys, etc.  Here are a few pics from the hike:

A view of Tenwek Campus from the top of Motigo.

Another view from Mantigo

Myself, Steve and the group of kids that followed us up the mountain. Steve is also a Duke resident (medicine-pediatrics) so it has been fun having him here to share this experience.

On our way back, we crossed this little stream, and met this nice woman with her kids. She was doing her laundry in the water here.

Pig/Goat Roast

While I was hiking, Whitney was helping proctor the surgery residents’ yearly exam.  Afterwards, they invited us to attend a pig/goat roast celebration on Sunday.  One of the first year residents, Seno, grew up on a pig/goat farm, and had the animals slaughtered on the day of the roast.  He butchered the animals, and spent hours attending to the grill in preparation for the feast.  The food was absolutely amazing!  It reminded me of a Southern style barbecue with the pork and the presence of coleslaw, but with a Kenyan twist as we also had spice-coated potatoes, fresh salsa, beets, and of course, ugali, which is the Kenyan staple dish.  Ugali is made of cornmeal, and is rather bland and flavorless, but it picks up the flavors of whatever it is served with.  Prior to the meal, we played foosball, basketball, volleyball, and even Twister with some of the residents.  Afterwards, we played all kinds of crazy games. The residents were a lot of fun, and they made us feel right at home.  Here are a few pics from the fun night:

Seno working the grill!

Clockwise from top left: Goat legs keeping warm on the small grill, my excited rib smile, Some of the spread with ugali in the top center underneath the pot, Scott playing fooseball with the residents, Whitney and the residents doing a laugh-inducing action mimicking game, Residents playing Twister for their first time ever.

Hmm, are you able to tell whose plate is whose? Hint: the plate on the left has several chunks of goat meat, giant pig ribs, a large heap of BBQ sauce, a multitude of potatoes, (and was the not the first plate consumed by this individual). The plate on the right is neatly organized, colorful and with precise vegetable:meat ratios of each. (The white you see on one of the plates is ugali, it’s sliceable, like store-bought polenta.)

The wards

Regarding, the hospital, I am slowly becoming more comfortable taking care of the diseases commonly seen here.  The heart disease, diabetes, and cancers commonly seen in the states, are replaced here by AIDS, meningitis, and TB among others.  My second call night was yesterday, and was more hectic than the first.  We had one patient who had a severe PCP pneumonia (infection seen in advanced HIV) and her oxygen levels were slowly dropping throughout the night.  By 3am, her O2 levels were at 50% (normal is >90%) despite us giving her 100% oxygen by a face mask.  In this situation, the only way to try to oxygenate her, is to intubate her and place her on a breathing machine.  The only problem is, I had not intubated anyone since my third year medical school anesthesia rotation, since at Duke, intubations are done by pulmonologists and respiratory therapists.  Usually when you intubate someone, you first aggressively use a bag to blow extra oxygen in their lungs until it reaches 100%, since you have to sedate them and they stop breathing while you are placing the tube.  An additional problem was the fact that despite bagging her for 45 minutes, we still couldn’t get her oxygen levels over 80%.  This is a very bad sign.  Finally, we had to go for it.  I asked God to help me place the tube where it needed to go, and was nervous, but trusted he would help!  Fortunately I was able to get the tube in, but she ultimately passed away several hours later as her lungs still would not allow her to receive oxygen.

That night we had a few more cases of meningitis, pneumonia, and an unfortunate young girl who was brought by her mother from another hospital.  She had been at that hospital for 3-4 weeks, and has been having 20-30 seizures per day, and has been more or less comatose since then.  She was actively seizing on arrival, and continued during the night.  I had her on nearly every anti-seizure medication we have, along with multiple antibiotics, and it still was not preventing her seizures.  In the morning, I consulted with a few of the long term physicians to ask their opinion but we were all stumped.  We all went to the bedside, and did the only thing left that we could think of…we asked God for wisdom as well as healing.  I am happy to report, she has not seized for >48 hours.  She is still not responsive, so please keep her in your prayers!

Scott


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A Morning Reflection

Written and photographed on 7/8/12 by Whitney

Off of our balcony at 6:30 AM:  The first hints that the sun will soon be coming

Wow!  Oh Lord, the whole earth proclaims your glory!  The heavens alight!

The sun announces its coming with banners of blues and oranges, then yellows and pinks, followed by golden gilded clouds.

My heart begins to flutter sensing your majesty and beauty.  You must be so beautiful Lord to have created such beauty in the world.

Do you love me?

Do you forgive me?

My heart ponders these questions that plague my mind this cool morning as I watch your majesty rise.

I ask forgiveness for yesterday’s sins.

Oh create in me a clean heart, O God, and renew a right spirit with in me!

Please, I long to be in your presence, to be in communion with you again. 

Hide your face from my sins and remove my shame.

It is only my pride that keeps shame here now, for you have blotted out all my iniquities and have made me as pure and white as the throne you sit on, as your Son that stands before you!

Suddenly, shadows are cast beneath me as the world around me is lit and I begin to feel a steady warmth.

I look up, your sun has risen!

In this moment you speak to my soul, my questions are answered.

I feel the piercing warmth of your love and with that I know my sins are forgiven as your light fills my inner being.

Indeed, you have restored in me the joy of your salvation and uphold me with a willing spirit.

Mmmm.

Thank you Lord.

To you be the glory.  Hallelujah!

References: Psalm 51:9-12, Psalm 51:7 with Revelation 7:9-10, Revelation 20:11, Daniel 7:9, Revelation 1:14

6:54AM, aperture: f/4.5

6:55AM, aperture: f/4.6

6:56AM, aperture: f/4.5

7:00AM, aperture: f/4.6

7:01AM, aperture: f/9.2

7:01AM, aperture: f/9.4

7:01AM, aperture: f/11.2

7:02AM, aperture: f/4.6

7:04AM, aperture: f/9.2

Almost there! 7:07AM, aperture: f/8

46 minutes after the sun first came over the horizon, at the end of my quiet time. “. . .His face was shining like the sun in all of its brilliance”  Revelation 1:16.  7:54AM, aperture: f/8.8

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A day at the hospital

Scott here.  Well, what an interesting, amazing, and crazy first few days at Tenwek.  First, if interested, the typical work day for me looks like the following:

7:30-8:30: Round on patients in the Intensive Care Unit

8:30 -9:30: Morning report.  Typically someone will give a presentation on a variety of medical issues.

9:30-10:30: Interns round on the rest of the patients.  We help manage the most acutely ill.

10:30-11:00: CHAI TIME!  This is a fun tradition here.  At 10:30 am every day, the hospital essentially stops and everyone breaks for chai which provides a nice break from the busy schedule.  The internal medicine team meets in a small room with the attendings, interns and med. students.  One of the interns typically opens in prayer and then we discuss any deaths from the previous day, as well as any important issues.

11:00-1:30:  We round on all of the patients on the male and female medical wards, usually 40-45 patients. Sometimes the wards are extra crowded requiring patients to share beds or even sleep on the floor.

1:30-2:30:  Lunch

2:30-end of the day: There are a variety of things going on in the afternoon.  I help the interns with procedures or issues, intermittently check on our ICU patients to adjust meds, ventilator settings etc., see patients in clinic or in Casualty (the ER here is called casualty).

Standing in front of the Casualty (ER) entrance.

If not on call, the day typically ends around 5:30-6:30, however, call nights are different.  At Tenwek, I am considered a consultant, which is the equivalent to an attending physician in the U.S.  Basically, that means I have a team of Kenyan interns and medical students who are admitting patients, placing orders, managing issues, and presenting the patients to myself and the other consultants.  Currently, we have three other consultants including two long term staff, and a visiting physician from Canada, however, our numbers will dwindle to two including myself within a few weeks, which will greatly increase the work load.

My first day was a whirlwind, with a high number of acutely sick patients.  Although the cost of medical care here is very minimal (a hospital admission may cost only 20-30 dollars per day),  this is still a significant chunk of their income, so they often present late in their illness as they try to avoid coming to the hospital.

We see a large variety of diseases here, some are similar to the U.S., but the most common diseases here, are  rare in America.  Thus far, I have seen a large number of cases of tuberculosis, several people with meningitis, and an extremely high number of patients with AIDS/HIV (probably >50% of patients) and complications from this disease.  We also have a high rate of esophageal cancer, rheumatic heart disease, and lymphoma among other various diseases.

Mural painted just outside the entrance to the men’s and women’s medical wards.

My first night, I was on call.  It was quite busy until about midnight.  I had several interesting admissions, most of which we were able to stabilize and they are all doing well.  One patient had a large pleural effusion (fluid around the lung) which was causing significant respiratory distress.  With pleural effusions, the initial treatment consists of performing a thoracentesis which is a procedure done to drain the fluid by inserting a needle/drain into the lung cavity to remove the fluid and allow the lung to properly function.  In the U.S., we have a kit that allows for fast and relatively easy removal by aspirating 100 mL at a time.  Here, however, the largest syringe we had available was only 10 mL.  She had more than 1000 mL of fluid around her lungs, so I had to draw out 10 mL of fluid at a time, and do this 100 times in order to remove enough fluid!  It took forever, but she was a good sport and was definitely feeling better afterwards.

Most other admissions that night, we were able to stabilize and improve.  Unfortunately, one of the patients that was admitted a few days prior, passed away.  I was actually walking by the medical wards, and a nurse grabbed me to inform me a patient was not breathing.  On arrival, he was not breathing and did not have a pulse.  With his family there, we had to inform them that he had died.  He was only 41, and likely died from complications of kidney failure, as there is no dialysis available here, and it is only available in a few cities in the country.  After informing the family and offering my condolences, I was amazed at their peace about his death.  This patient had been suffering for some time according to his family.  He was an active believer in Christ, and although his mortal body failed him here, his family knows that where he is going is so much grander than here.  He is going to be with the Lord, where there will be only joy and singing.  I called the chaplain, and we prayed together in English as well as their native Kipsigis tongue as this man went to be with God.

When I made it back to the guesthouse that night, I reflected on this patient.  Although I wished we could have somehow healed him, I rejoice in the fact that he knew Christ and is now in Heaven.  That night, I read Isaiah chapter 35 which really spoke to my heart about the reassurance we have in Christ, and the  joy of the redeemed that awaits this patient, as well as all who believe.   What an amazing visual picture of what awaits us!!

Isaiah 35 (starting at v. 5)

5 Then will the eyes of the blind be opened
and the ears of the deaf unstopped.
Then will the lame leap like a deer,
and the mute tongue shout for joy.
Water will gush forth in the wilderness
and streams in the desert.
The burning sand will become a pool,
the thirsty ground bubbling springs.
In the haunts where jackals once lay,
grass and reeds and papyrus will grow.

And a highway will be there;
it will be called the Way of Holiness;
it will be for those who walk on that Way.
The unclean will not journey on it;
wicked fools will not go about on it.
No lion will be there,
nor any ravenous beast;
they will not be found there.
But only the redeemed will walk there,
10     and those the Lord has rescued will return.
They will enter Zion with singing;
everlasting joy will crown their heads.
Gladness and joy will overtake them,
and sorrow and sighing will flee away.

Well, I think that is enough for today.  Sorry about the length of this post, I will aim for a shorter entry next time!  Whitney and I are off to a pig and goat roast now put on by the surgical residents.  We were invited after Whitney proctored their end of the year exam yesterday…should be interesting.

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Chamage!

Hello!  Whitney here.

First, thanks for all of your guesses as to what animal was pictured in our last post!  It was quite fun seeing some of your answers and I’m afraid the animal is not nearly as exotic as many of you thought!  Helen was right, the animal was a cow (or “cattle” as she said).  I took a picture of it because it was the  skinniest cow I had ever seen–you could count every one of its ribs!

Thursday was our first full day at Tenwek and I had the opportunity to go with a missionary doctor’s wife to a women’s meeting that she was putting on this week for all of the women who do her Bible studies in the surrounding area.  She started in 2006 with 5 women who were literate and could speak English, and God just went “Bam!” and now the Bible study has grown to 2000 women!  Praise God!  It is not at all what she expected to happen, but indeed, she is glad it did.  She teaches the original members of her first Bible study the month’s lessons in one day and then they teach Overall Leaders and then the Overall Leaders teach the Leaders who then teach the members once a week.  Follow that?

Anyway, God has greatly blessed this ministry and this whole week she’s been traveling to different towns and meeting all of the members of the Bible studies in that town’s vicinity.  A guest speaker from the US as been speaking to the women at these meetings.  Yesterday, we went to a town called Silibwet and the church we met in was cramped full of people with standing room only in the back, and outside women stood along the windows and poked their heads in so they could hear the speaker.  I think there was at least 400 women there.

The view from the back of the church

I absolutely loved this experience.  It lasted from 10:30AM until 4:00PM.  The first two hours were just introductions of the different Bible study groups there.  Each introduction consisted of a few songs led by that group as well as some “testimonies.” I was amazed at the patience the Kenyan women had for this and I think they could have gone on all day!  The speaker spoke from noon to 1:00PM about growing up in Christ and not remaining “baby Christians.”  At 1:00PM there was an hour lunch break in which everyone was fed rice and beans, and then the program resumed again with more songs, a drama, and concluded with the speaker talking for another hour with practical instruction on how to read the Bible on your own and have a daily quiet time.  This is something that very few of the women do now, but is critical for them to grow deeper in their faith and understanding of God and his will.  Almost all of the women pledged at the end of the meeting to start having a daily quiet time!   Please pray for them and that they can fight the devil’s daily distractions in order to make time to sit in their Father’s presence and soak it up!

It was fun to see so many Kenyan women in community together, learning about God, and worshiping God.  One of the things that was the most fun for me was getting pulled up on stage by a Kenyan women and joining them in their group’s song and dance.  Below I have a very short clip of the beginning of this song which, as soon as they were all on stage they started doing actions to and then, shortly after that, I was pulled up on stage.  I joined them, mimicking their actions and trying to sing this song to the great delight and laughter of all the women in the room!

http://youtu.be/s4XwbVOnvyE

Besides their patience, I was also very impressed with the number of verses these women could recite by memory!  They all had to memorize 16 verses in order to “win” their first ever Bible and have continued memorizing a new verse every two weeks.  Honestly, they put me to shame in this department!

The meeting ended with more singing and I was once again called up on stage along with the other Mzungus (white people) and this time I was given my first kanga from an African. I felt very honored!

Here I am with my new kanga! The Kenyan woman next to me in the picture who is quite blurry is Paris and she was the translator for the meeting and one of the first members of the Bible study.

After the meeting, at least one hundred women eagerly came up to me to shake my hand using their traditional handshake (you alternate gripping their hand like a normal handshake and then like you would grip someone’s hand if you were going to arm-wrestle them).  I also greeted about fifty women in which you face each other and each person pats the other with their right hand on the back of their left shoulder and then you lean in to the left (still keeping a distance of maybe 10 inches from their face–this is not French bisous!) and then to the right.  This second greeting was one of the actions to the song I had to dance to so I had this one down pat!  No matter what physical greeting was used, everyone would say “Chamage!”  (cha-ma-gay) which is the Kipsigis greeting of hello.  Literally translated, I’ve been told it means something like “How much do you love yourself today?” and if you love yourself, or a feeling happy, then you say “Mising.” back to the first person who said “Chamage?”

I thought this little girl’s outfit was so cute with her bunny hat, bright orange fur lined coat, and her fancy purple dress. Even some grown women there were wearing what looked to be pink, satin, full-length prom-like dresses. Perhaps it’s their “Sunday best”?  I’m not sure about this yet because I’ve also seen men herding cattle in their suits so maybe they just dress nice whenever?  Does anybody know?

Thanks for reading!  As I write this I’m currently proctoring a national exam for the Kenyan surgical residents here at the hospital, after this I’ll make supper for Scott and I for the first time since we’ve arrived–wish me luck!  Scott should have a post up in the next day or so about some of his experiences so far in the hospital so stay tuned.

Goodbye for now!

~Whitney

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