Update from Scott

Hello. As I am sitting down to write this, I am just finishing a plate of leftover goat rib curry stew.  Yes, goat ribs.  We had our first experience at a Kenyan butcher shop this past weekend.  In Kenya, almost all meat is purchased at local butcher shops.  The butchers typically slaughter a cow or goat, hang it in the window of their little shops (unrefrigerated) and will then cut pieces for customers as they visit.  The cow/goat typically will hang in the window for 1-3 days until all of the meat is gone.  Whitney had been apprehensive about buying meat that wasn’t refrigerated, and I think was also grossed out a bit seeing an animal just hanging in a window.  Nonetheless, our friend and driver, Antony, who is a Kenyan native, took us to his favorite two butchers who he assured us were very reliable, and their meat is always fresh.  We proceeded to buy a kg of steak from the cow butcher (we ate this a few days ago in delicious steak enchiladas with homemade enchilada sauce) and a kg of goat ribs from the goat butcher.  Here are a few pics from the butcher:

The first butcher cutting off “steak”. In Kenya, there doesn’t really seem to be a concept of particular cuts of meet, such as T-bone, ribeye, etc. Rather, you just ask for “steak” and they cut the tender and best cuts of the meat. We got one kg (2.2 lbs) for around 200 shillings (about $2.50).

Picture of our goat ribs being butchered!

On the wards

Things have been especially busy at the hospital the last few weeks, which is likely in part why I have had such a long delay since my last post.  When I arrived to Tenwek, I recall being amazed at how sick and acute patients seemed to be when presenting, often coming to the hospital with advanced disease and near death.  Well, over the past two weeks, the overall sickness of patients is actually even worse than it was in July.  In one 7 day span last week, on the medical service alone we had 17 patients pass away from a variety of illnesses.  That week was emotionally, physically, and spiritually challenging.  As a physician, death is something that certainly we experience and learn to cope with, but it is never easy.

Last night, I was on call, and it was a very busy, and emotionally taxing call night.  In the morning we had a fairly young patient (40s) pass away.  She had advanced HIV, tuberculosis, and had developed bone marrow failure, presumably related to her TB or HIV.  This was her third admission of the summer, and she had been slowly declining.  On this admission, she was very anemic, with a hemoglobin of 4 (normal is ~12-15).  We had been trying to transfuse her for the last few days, but there was no blood left in the blood bank (this is a very common problem as Kenyan law forbids hospitals to conduct blood drives) and she had no family around to donate.  Eventually, she just stopped breathing.  Later on in the evening, I had just arrived home from dinner when I received the dreaded “999” page, which signifies a code blue on one of my patients.  I sprinted back up the hill to the hospital, where one of our interns was doing chest compressions in attempts to resuscitate the patient.  Eventually, after intubation, several rounds of CPR, and some medications we use in codes, we were able to get a pulse back.  He was not breathing on his own, so he needed to be placed on a ventilator.  Of course, our four ventilators in the hospital were all taken, and there were no ICU beds available.  I ran up to the ICU while our intern was bagging the patient (bagging is a way to manually ventilate someone prior to placing them on a breathing machine).  In the ICU, I attempted a T-piece trial on one of our patients, which is a quick way to see if they are able to come off of the vent.  My hope was that we would be able to remove that patient from the vent, and use that vent for the patient who had just coded on the medical ward.  He unfortunately failed the test, so again we were stuck in a situation with the patient who had just coded whose only way to survive was with a breathing machine, but no available machines.  One solution would be to have the family bag the patient throughout the night until a vent came available, but that is a terrible situation, and not at all ideal.  When I returned to the patient, he had lost his pulse again, but again with CPR we were able to get a pulse back.  His labs arrived, and he was profoundly anemic (from a GI bleed) and desperately needed blood.  We found blood that matched in the blood bank, but he is a Jehovah’s Witness and he had previously refused blood products, until finally agreeing just a few hours prior to coding.  In the process of all of this, he coded a few more times, and eventually passed away while we were still trying to figure out a reasonable plan.  He was only 33.  It was very sad to see someone so young and previously healthy pass away.

In total yesterday, we had five patients die, which is the most I have ever had in one day.  We had two men in their 90s pass away from pneumonia.  These deaths had been expected as they were both very sick.  They were both Christians and now can leave their suffering behind.  Our final patient that died last night was a 40 year old who had been healthy, but apparently drank some local brewed alcohol and was found later in the day unconscious.  When he arrived he was cold, and not breathing with no pulse.  We attempted resuscitation but were unsuccessful, as he likely had died hours before being brought in.  I learned today that these cheap, off market local brews are becoming a big problem.  Apparently, they use formalin, and sometimes even add antiretrovirals (meds use to treat HIV) to the brew.  The drinks are very strong and toxic, and likely why this patient passed away, although we will never know for sure.

As always, we had several other interesting admissions yesterday.  One patient had a tumor the size of a grapefruit in her  right lung.  She was very hypoxic and in respiratory distress when she came in.  She still is having trouble breathing, and I had a long discussion regarding the current status, likely diagnosis, and prognosis with the patients family today…which was approximately 40-50 family members.  We otherwise admitted a woman with cryptococcal meningitis, another with diabetic ketoacidosis, a woman with a stomach ulcer causing her to throw up blood, a man with acute liver failure, a woman with heart failure, a young pregnant woman with pulmonary tuberculosis, and finally a man with severe abdominal pain (still don’t know why).  All of these patients seem to have made some improvement today, so hopefully they will get better!

Fortunately, despite our limitations, we still can do a lot here at Tenwek, many of our patients do get better and are able to hear about Jesus.  We continue to treat many patients that appear hours from dying, but through aggressive treatment and monitoring, we are able to get them stabilized, and eventually well enough to walk out of the hospital!  Also, we have had two female patients give their life to Christ this week.  I feel incredibly blessed to have the opportunity to treat sick, vulnerable, and dying patients and to serve as an ambassador for Christ.  Certainly, especially at Tenwek, the challenges are ever present with extremely sick patients, and often limited diagnostic or therapeutic resources, however, the rewards of treating and ministering to these patients are indescribable.  The Lord reminds me daily why He has called me to medicine.  This time at Tenwek has been one of the most rewarding in my life, and my faith continues to grow as God reveals his glory sometimes through miraculous healings, sometimes through taking in the breathtaking creation He has made, sometimes through quiet times with Him, and even through the peace and comfort He provides to patients and their families when they leave this world to enter eternity with God.  As my faith grows, and I see the word of God becomes more alive, my desire to share this treasure with others grows.  These past few days, I have been reading the book of Jeremiah.  In chapter 20, Jeremiah is growing weary due to being ridiculed, mocked, and insulted for preaching the word of God (which are things that have always hindered me from sharing my faith with others).  Yet, despite this despair, Jeremiah says this in verse 9:

  “But if I say,

“I will not mention him or speak any more in his name,”

his word is in my heart like a fire, a fire shut up in my bones.

I am weary of holding it in; indeed I cannot.

I pray that as the Lord continues to engrave his word on my heart, that I too will be unable to hold it in!  Thanks reading some of my random thoughts from the past few days.  I hope to blog again soon, so hopefully will not have such a long time period between my next entry.  I am on call this weekend, so please pray for wisdom and compassion as I treat our patients.  Thanks!

Scott

Starting with me then moving clockwise: Me, Dennis (Intern), Mugalla (Fam. Med 3rd year resident), Matilda (medicine consultant-long term staff), James (med. student), Jane (intern), Meshack (Intern), Kibet (Fam. Med. first year resident), Darlene (critical care fellow visiting from Mayo), Isaiah (intern). I love this team!

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Our Masai Mara Safari

Wow.  So Scott and I just had one of the best weekend of our lives, just below the weekend we got married of course!  This is going to be so hard to put into words, so instead we’re just going to bombard you with pictures.  So, grab a cup a chai, sit back, and enjoy!

Last Friday morning we left Tenwek for the Masai Mara.  The Masai Mara, in southwest Kenya, is Kenya’s (and possibly all of Africa) most famous game reserve and safari destination.  After a two-hour and fifteen minute drive (most of which was on a rocky dirt road) we arrived at our lodge, Ngerende Island Lodge which is almost completely surrounded by the Mara River with many hippos and crocodiles living in the river.  Ngerende is a luxurious safari lodge that normally we would not be able to afford, however, they graciously provide Tenwek missionaries with an incredible discount.  Before our car had even come to a stop, we were greeted by these guys.

Some Masai Warriors encircled our car and greeted us as our luggage was quickly whisked away to our room by butlers.

One of the Masai warriors promptly took our camera and clicked away snapping many photos and even doing a few short films as they led us to the lodge.

Upon reaching the lodge entrance they did their traditional Masai dance which involves jumping as high as one possibly can.  You can watch this video to see them jump and here their chanting song.

Then they had us give it a try!

Scott jumping high like the Masai

Giving it a go. Unfortunately, I’ve never been known for my astounding vertical leap.

After this traditional dance, the Masai all shook our hands goodbye and when we turned towards the lodge we were greeted with cool washcloths scented with eucalyptus oil to wipe the dust from our hands and faces, and given a glass with freshly made mango-pineapple juice with a sprig of mint.  Once finished with our juice, our own personal private butler, Evans, showed us to our tent.  Well, maybe I should say “tent” as it is really more of a luxury suite!

The view of our tent that meets you at the door.  We hadn’t been in our room more than 10 seconds and Scott was already checking out the river.

Scott heard a noise while out on our back porch and looked down and saw this little guy waiting to greet us.

The view from the opposite side of the room looking towards the entry door.

The view from our porch. The bathroom with the soaking tub and a shower with the fancy “rain-like” shower head are to the immediate left. There is only one robe hanging here because Scott had already eagerly tried on the other one when I took this picture. 😉

On the left: Scott enjoying the view of the river in his Egyptian cotton bath robe. Top right: Another view from our room. The bathroom entrance is through the swinging doors. Bottom right: I am lounging in a super comfortable lounge chair while watching the hippos below.

After getting settled in our room, Evans (our butler) met us at the lodge to lead us to our lunch destination.  He arranged for us to have our first lunch at Ngerende under a beautiful thatched roof hut overlooking the Mara River with dozens of hippos lazily basking in the sun or soaking in the river. We had a wonderful lunch with a Mediterranean feta salad, a grilled duck stir fry, and strawberry mouse for dessert!

Enjoying the view, the food, and the company!

A few of the hippos we saw. The little one is less than one week old!

Another shot of the hippos! This one is showing off his grill!

Sitting by the pool overlooking the Mara River and hippos as we wait for Evans to bring our dessert course.

A Nile Crocidile nearby the group of hippos

Here is a video of the hippos, please note that Scott and I crack up and laugh every time we watch this video because we think we sound so flaky!  It is at a great cost to my personal pride to post this here, but I am doing so at Scott’s request so you can see the hippos.

After our tasty and refreshing private lunch, we were ready to get back in a car and bounce along rocky terrain, only this time we would be on a game drive discovering animals in the wild! We met Matthew, our guide and game driver, and he took us on our first ever safari!  We saw thousands of animals and took so many pictures, but we will just share a few to give a general idea of the drive.

The first animal we came across on our afternoon game drive. Little did we know that over the next two days, we would literally see thousands and thousands of zebra. Their stripe pattern really is a thing of beauty.

A couple of Masai giraffes.  Giraffes are my favorite!

Two giraffes reaching up to have some dinner!

I love giraffes. Have I mentioned I love giraffes?  I could post so many picture of giraffes, but I will try to move on!

A female ostrich running through the plains.

A male ostrich chasing the female shown above!

A female ostrich protecting her nest.  We learned that these eggs were laid by different female partners of the male and then the male choses his “best” female to sit on the nest for him during the day, and then during the night he sits on the nest.

In the Mara there are many groups of Impala. A group of Impala contains one dominant male and a few dozen females (without antlers) who the male breeds with. Here, the two male Impalas battled for dominance to determine who gets to control the group of females. The one on the right was the victor!

A Grant’s Gazelle with its long antlers. Many Acacia trees can be seen in the background.

Thomson’s gazelles. These are extremely numerous in the Mara and one can spot groups of these basically at any time. The baby seen here, was not more than 1 day old!

This is a Topi. You can often spot them standing on top of a termite mound looking for predators.  They have a shiny coat with bluish coloration along the upper legs. Our guide refers to the colors as the topi’s blue jeans.

We next encountered a group of 30+ African Buffalo. Apparently these are some of the meanest and most dangerous animals in Africa.

We then went to a rhino reserve where we got out of the car and walked with a park ranger to see the rhinos. . .who were not in a fence!

The White Rhinoceros. These animals are among the most endangered animals in Africa. This particular one weighs over 7,000 pounds!

This picture was taken about 10 feet from the rhino behind us. Of course, on multiple occasions I (and also the park ranger once) had to holler at Scott to back up as he more than once got too close for comfort!

Pumba! We saw many, many warthogs on our various game drives. Each sighting prompted our van to sing…”If I was a young warthooooog!” (from the Lion King movie)

Our first lion! We saw this one toward the end of our first game drive.

A close up!

As the sun was setting, we found these four giraffes on the horizon with gazelles and wildebeests in the foreground!

On the way back from the first game drive, we had the opportunity to witness a gorgeous African sunset

Another picture of the sun setting over the savannah.

Sunset, with an acacia tree and zebra of course!

At the end of our game drive we were taken back to the lodge and our “tent” where Evans had filled our bath with steaming hot water, bubbles, and amazing smelling Eucalyptus oils.  He also started a crackling fire in our fireplace so our suite was warm and cozy when we got back.  The bath felt like I was at a spa.  The heat of the bath did wonders to loosen up tense muscles from a day of driving on dirt “roads,” the smell of the bath oils were calming, and the occasional grunts, snorts, and bellows from the hippos in the river below were an amusing reminder that I was on safari in Africa.  By the time I reluctantly left that soaking tub of bliss, I only had time to sit in front of the fire in a leather, wing-backed chair for a full five seconds before Scott, hungry and ever puntual, pulled me up and out the door to enjoy an amazing five course dinner in the lodge served to us by Evans.

The next morning, Saturday morning, we woke up early, had our three course breakfast at 6:30AM and left for the Maasai Mara on an all-day game drive where we hoped to see a wildebeest crossing. Again, here is a tiny sampling of a few of the things we saw:

This is a jackal.  Now you know what a jackal is.

These hippos we found out of the water. They typically come out at night to graze on the grass, and return to the water in the morning where they remain for the rest of the day to keep cool and sleep on the shore.   Apparently, they eat something like 170 pounds of grass each night!

These are wildebeests, the most abundant animal in the Mara.  Our driver joked that they were made with “left-overs.” They have the long face and tail of a horse, the horns of a buffalo, and the body of an antelope.  What do you think?

Everywhere we looked there were thousands of wildebeests. In total, we likely saw more than one million of these animals.

We came across this mama lioness nursing her adorable little cubs

Another image of the cubs

In this video you can see the lion cubs squirming and working hard to get their fill of milk.

Next, we found a group of vultures scavenging a dead animal. This bird (not sure the name of it, it’s different than the normal vultures) came away with what looks to be a piece of small intestine or maybe the trachea. Sorry, it’s kind of gross!

Wildebeests on the move, with vultures in the tree taking notice!

We came across a group of wildebeests standing on our path and soon we had the whole heard on the move running away from our car.  It felt like we were herding cattle.  Below is a video.

Another female lion resting in the shade during the mid-day heat.  No male lions seen yet!

The Great Wildebeest/Zebra Migration

The great migration is deemed one of the seven natural wonders of the world!  Each year, 2-3 million wildebeests (and hundreds of thousands of zebra) migrate from the Sarengeti in Tanzania, into the Masai Mara in search of vegetation and water.  As they arrive in the Mara, they have to cross the treacherous Mara River. In the river lurks many massive Nile Crocodiles, ready to devour these animals.  The migration occurs annually, typically in August-September.  During these months, the Mara savannah is literally carpeted with zebra and wildebeests.  When groups of animals reach the river, they often will stand at the banks for days before proceeding to cross. Therefore, it makes witnessing this spectacle very hit or miss, as nobody knows which days they will cross.  Well, we arrived at the river and there were thousands of wildebeests and zebra.  We parked our vehicle, and waited hopefully (yet trying not to get our hopes up too much) that we could be one of the lucky ones to witness this.  Sure enough, after about 45 minutes of waiting, one brave zebra decided to go for it and took the plunge, thereby opening the floodgates.  We watched in awe as thousands of zebra and wildebeests braved the water to cross to the other side.  In the process, we watched as two wildebeests were taken by crocodiles, and another broke his right hind leg and was unable to make it past the shore of the river.  After watching the crossing for about 45 minutes, a woman in our safari van actually had to hold back a few tears as this was a one of her dreams to see the crossing, and here she was experiencing it.  It really was an amazing thrill.  Here are a few pics and a short video clip:

Zebra and wildebeests jumping into the river.

This guy leapt out of the water.  Note the crocodile on the shore on the left side of the picture.

Zebra and Wildebeests moving to the river to cross

More animals joining in on the fun!

We saw several crocodiles on the bank and in the water.  Here, this zebra narrowly escaped becoming this crocodile’s lunch.  In the background, you can see hippos, and more crocs.

It is kind of hard to see, but here, on the left part of the picture, you can make out a crocodile’s jaw and teeth as he is taking down a wildebeest.

Here’s a video of the crossing to give you a better idea.

An example of the thousands of animals on display at all times.

More zebras!  The one on the left is younger as its stripes have a brown color and its coat is more shaggy.

After viewing the various animals and the river crossing all morning, we had worked up quite an appetite.  We were told that we would be having lunch in the Mara, which we figured would include a picnic/sack lunch type of deal.  To our surprise we were brought to a beautiful spot under the shade tree with views of the river, as well as views of the many animals roaming the plains.  Even Evans was there to greet us and serve us an octopus/seaweed delicious salad, a chicken and Sobe noodle main dish, and finished with an amazing grilled pineapple dessert.

Our picnic lunch in the middle of the savannah

Evans, our butler, explaining the menu.  We loved Evans!!  He was so sweet, nice, friendly, warm, hospitable, and ready to do anything to make our experience just that much better. We enjoyed getting to known him, and of course, appreciated all of his help!

After lunch, we resumed our safari and continued to be wowed by all that we saw.  Here are a few more pics:

Close up shot of another African buffalo.  Their horns remind me of a hairdo with a center-part and maybe Pippy Longstocking pig-tails.

We were taken to a more wooded area and came across 13 elephants.  Beautiful, enormous animals!  Here is an adult and a child.

Elephant strolling along.

The bird here is a Lilac-Breasted Roller.  When it flies, its neon blue color is absolutely radiant!  Another elephant is just behind the bird.

I like this picture for its layers. In the right foreground is the Lilac Breasted Roller, then a young elephant, then three zebra, and in the very back is wildebeest and zebra herds.

Our first male lion!  The king of the jungle!  I was just itching to see a male lion after seeing three females before we found this guy with his girl. He even stood up to greet us and smiled!  Or maybe he was barring his teeth and warning us to stay back.

Settling back in, he began groom himself so he would look nice for his lady friend when she woke up.

On our way back from the game drive, we had yet to see a Cheetah, Scott’s favorite animal.  They can be hard to see in the tall grass.  We were searching intently, and sure enough, in the distance we spotted something, and as we approached, we found this cheetah, feasting on a freshly killed young Eland (similar to antelope).

Just look at those eyes! Love it! Not to mention the blood splatters on his nose and the piece of flesh hanging off of his lower canine tooth.

Staring down and standing over the kill like the haughty cat he is!  (Truthfully I think he got up to look at a jackal nearby and make sure the jackal did not intend to cut in on his meal.)

So, perhaps I should put a warning before this video that it may not be suitable for all audiences.  This is a video of the cheetah ripping flesh out of the young eland.

After an amazing day on safari, we eventually made it back to the lodge, and again, Evans had a hot bath prepared.  We got cleaned up and made our way to dinner where we had stuffed peppers with a delicious filling involving mushrooms (Scott’s favorite), smooth potato leak soup with our names written in the soup, frozen grapes in a wine granita, roasted turkey, and finished with a lemon panna cotta.  Yum!!

A few pics from dinner!

We woke up early the next morning, Evans gave us hot cups of chai, and we headed out for our final game drive.  We were treated to a beautiful sunrise, and of course, countless animals.  Here are just a few more pics:

An Afican sunrise.  Just like the sunset from the first night, there’s an acacia tree and zebras!

The sun just peaking over the mountains.

A giraffe frolicking in the distance among acacia trees.

We observed a group of Topi (shown previously) all staring, motionless at something.  We drove closer to investigate, and sure enough, found another Cheetah.  We watched it for quite sometime as it prowled through the plains.

A little closer up

Staring contest!  Sorry to interfere with your hunt!

We again loved seeing all of the beautiful surroundings and animals.  We were brought back to the lodge, where Evans surprised us by having a private table set for us at another beautiful setting right on top of the Mara river.  We were treated to multiple fresh, tropical fruit smoothies (all grown on site), eggs, sausage, bacon, beans, pancakes, toast, tea, fresh fruit, and a yogurt parfait.  After we could eat no more, we finally had to pack up, and head home.  We were so sad to leave and joked many times that day that we needed to devise a way to stay forever.  It was an amazing weekend getaway, and something that neither of us will ever forget!  Thanks for viewing some of our pictures.

Blessings,

Whitney

Final breakfast.

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Walk in My Shoes for a Day

Ha! Hi world!  I feel like it’s been so long since I (Whitney) have posted!  For the past three weeks or so I have been working at a local, private primary school here, mostly teaching six-grade math, and I have absolutely loved the experience!  Since it has been so long since I’ve written, and because I’ve never yet written about my typical day here, I figured it is time I do so!  I’ve provided lots of detail so you can hopefully get a good picture in your head and put yourself “in my shoes.”

Every morning I wake up at 6:32AM and once awake, there’s no going back to sleep because the excited and insistent chatter of the birds is too loud at this time in the morning to allow for such indulgences.  Don’t get me wrong, the birds sound beautiful actually, their songs are just not always welcome when I am really tired and only want to sleep more.  Throwing back the mosquito net behind our bed’s headboard, I greet Scott, who is usually just getting on the computer with breakfast in hand, clicking through ESPN’s website, the Hawkeye fan website, and responding to any new email fellowship interview invitations.  I plod over to the bathroom, wash my face with tap water, brush my teeth with triple-filtered water, and choke down my dreaded doxycycline pill for malaria on either the first or second try.  I then hurry to get dressed and get some food into my stomach before the doxycycline has a chance to make me nauseous.

With food in hand, I impatiently throw open the curtains covering our four big windows eager for the sunlight to light our dim studio apartment.  Unfortunately for Scott, this usually means he has to be extra careful when he comes out of the shower in order not to expose himself to the people passing by on the dirt road below.  Settling down at our desk, I do my devotions and check my email.

At 7:45 AM I pack my bag with a notebook, a red pen I bought for marking student’s papers, an umbrella in anticipation of afternoon rains, and my wallet with a couple hundred shillings (1 dollar = ~82 shillings) to buy some produce in the afternoon from my favorite duka vendors.

Produce dukas lining the road in front of the hospital entrance. Boda bodas can be seen on the far right.

As I walk up the road past the hospital, various boda boda (motorbike taxis) and taxi drivers call out to me asking me where I’m going and if I need a ride to the town of Bomet.   I shake my head, smile and thank them as I continue my quick pace past the crouched mamas lighting their jikos, which are small clay pots for lighting charcoal and grilling/cooking food (often ears of corn).   Reaching the gate of the school, I take a moment to take in the view of the valley below the school and the hills beyond.  Praise God!

The view from the school’s gate in the morning.

I carefully make my way down the muddy path to the school, wave a greeting to the kitchen staff as I pass buy the “cafeteria,” say “hi” to the curious children poking their heads out of their classrooms observing everything about me on that particular day, and continue down to the staff room.

The school “cafeteria” and kitchen. One of the cooks is under the awning to the right. They usually prep and chop the vegetables there.

When I enter the staff room, I make the rounds and shake the hand of everyone present there greeting them in English, Kiswahili, or Kipsigis.  To not shake the hand of everyone present would be rude.  Some teachers ask me “Amu ne gaa?” (I’m just writing that how it sounds, not sure about the spelling!) to see if I remember the Kipsigis they taught me the week before.  “Mising” I reply, knowing they have asked how my home is.  If I hear “Amu ne” followed by “boiyot” I know they are asking how my husband is.  Luckily for me, the correct response to any of these inquiries is always “Mising” which is the equivalent of “good” or “well”!  Upon hearing this correct response, or any bit of Kipsigis or Swahili that they have taught me, their faces break into huge smiles and they say, “Look at her!  Look at her!  She knows Kipsigis!”  Which, really, is a gross overstatement as I only know a few phrases, but it makes me happy to see them so proud.

The empty staff room. I sit at the end of the second table on the left where you can see my grey Iowa Tennis water bottle.

After greeting all the teachers, I sit down next to Madam Sarah, the Standard Two teacher (second grade). If I forget to take a coffee cup before sitting down, one of the teachers is up, out of his or her chair, bringing me a cup and pouring me a hot, sweet cup of chai from a thermos.  It is a must to drink chai.  I settle in, wrapping my hands around the warm cup of chai and listen to the general Kipsigis babble until I ear a word of English, or a conversation becomes so funny or a topic so hotly debated that they stop and explain to me what they were talking about so I can either join in on the laughter or give my opinion on the debated matter.

At 8:10AM the bell rings, I ask five different teachers for a piece of chalk, we finally find one, and I’m off to teach Standard Six maths (they put an “s” on the end of “math” here when they spell it and they pronounce it too when they say “maths.”)  When I walk into the class there is still a general exclamation of excitement when they see that it is I, the visitor, who is going to teach them that day, even though I have been teaching them for 3-4 weeks now.  This excitement is soon hushed, as they remember they are supposed stand up and be quiet until greeted when a teacher enters the room.  “Good morning class!” I say, and in unison they respond “Good morning Mrs. Whitney.”  “How are you?” I ask.  “We are fine, thank you and how are you today?” they all respond in rhythm.  I answer thoughtfully with a reason and look around the room to gauge their reaction to my non-mechanical response.  I start to explain what we are going to do that day in class and invariably, I find myself wondering why they are still standing, and it is only then that I remember that I must ask them to sit before they will take their seats.  I ask them to sit, “Thank you Teacher” they all respond to the sound of wooden chairs scraping the cement floor as they sit down.

Setting a folder on my “desk,” I look down to unclasp it and take out copies of the test they took the week before.  Within seconds brown hands, palm-up, are laid across my desk belonging to eager students who want to help pass out the tests for me.  I split the pile in half and chose two students to pass them out.  Once everyone has a test, I ask if anyone would like to review a problem in questions one through five, questions five through ten, and so on.  Usually my most vocal students in class (about six students) will shout out a number and in between their requests I’ll hear a small, staccato request to do another number.  When I look in that student’s direction to confirm his or her request, they almost always bashfully turn away and look down at their desk pretending that they never made such a “ridiculous” request.  “Hold on, hold on!” I say as I raise my hands to quiet the other students petitioning for question number nine.  “I heard a ‘seven’ so let’s do that one first.”  Question seven is comparatively easy and it will not take long to explain. Besides, if that student was brave enough to ask, I reason I should reward their bravery by working through their requested problem number. I write the equation on the chalkboard asking the students prompting questions as I solve the problem at times pausing to ask “Can I do this?” when I see a potential place that the student might go awry and make a mistake while solving the problem.  Sometimes these questions stump them and other times I hear a resounding “No” or “Yes.”

For harder problems, like this number nine, I take time before solving the problem to explain the logic behind why one should go about solving the problem a certain way.  When I ask the students for my first step of what I should do, my smartest, most vocal ones may raise their hands high in the air, sure of their answer, and when called on, will stand up before speaking and then give me the correct answer.  When I ask the follow-up question of “Why did you decide to do that?” there is usually a pause where the students exchange glances with each other and I repeat, “Can anyone tell me why you do this?  Why would you set up to solve the problem in this way?”  Eventually, a hand will timidly rise up only halfway and when I call on them with an encouraging smile, they stand up, lean over their desk towards me, and whisper their answer to me.  Often I don’t understand what they are saying on the first try because their whisper is too soft and their African-English accent too thick.  I walk to within a few feet of their desk and ask them to repeat themselves. When they finish telling me their answer, and I pause evaluating whether or not their answer makes sense and if I can build off of it, their eyes fill with hope and the question “So, am I right?” flashes across their expression.  Now, I am not necessarily one to always coo over children or melt at their “puppy-dog” expressions, but this questioning expression, with their big, hopeful eyes, is so beautiful and precious I just want to bottle it up and take it home with me!

Once the problem is set up with the correct numbers in place, we move our way through simplifying fractions, performing multiplication and long division. The classroom comes alive while we work through this and is abuzz with instructions and steps for me on what to do next and what number to write where as the children race to tell me the next step.  As the class ends, the children thank me and ask me to come again.

My six grade class this past Wednesday, the day of their Closing Ceremonies (the last day of their second term). The boy in black and white plaid is not in my class, he is the older brother of the boy, Brian, standing next to him, who tied for first place in the class standings along with the other Brian in my class.

I told my students to do a “funny picture” and this is what they did! Can you pick out the boys and girls in either of these pictures? It is a school rule that the girls must keep their hair very short and cannot wear any type of jewelry.

Back in the staff room I mark tests and homework for other teachers and chat with them.  At 10:40AM to 11:30AM is morning break and the teachers are served chai again while the students are served “porridge” (which is like a super-sweet, runny, Malt-O-Meal that you drink from a cup).  Before taking chai, one of the teachers prays and blesses the chai.  At lunch time, 1:00PM, teachers will take turns voluntarily serving each other and someone will always pray before lunch too.  I love that they always stop to pray and thank God for what he has provided them.  They do not take it for granted.

Lunch is brought into the teacher’s staff room by kitchen staff in two big, insulated, crockpot-looking containers with either ugali (a solid mass of cooked cornmeal) or rice in the biggest container, and in the other container will be a salty broth with either cabbage, cabbage and beans, beans and carrots, or kale with a few small bits of beef and tomato.  Metal plates, spoons, and glasses are brought to the staff room in a yellow, plastic, five-gallon bucket.  Water is poured from a giant, metal teapot.

One of the school’s cooks in the kitchen part of the cafeteria stirring a giant pot of ugali with and equally giant stick. Behind him you can see the kale (sukuma wiki) piled up and ready to be cooked.

After serving myself lunch (I often do this now because if I don’t I’m usually served a massive slice of ugali that is impossible for any non-Kenyan to finish), I settle into my chair next to Madam Sarah ready for stimulating conversation. Often the conversation at lunchtime results in some sort of debate over a cultural, political, or biblical issue.  These debates are all in fun and always result in a lot of laughter.  The Deputy Head Teacher, (and my favorite teacher) Mr. Koech, is usually behind them as he is wise, but also loves to joke, laugh, and spur people on just to get a rise out of them and start a debate with them.  Mr. Koech will battle and battle for his opinion and stance he has taken on the issue and will eventually appeal to me and cry, “Wheetney!  Cahn you believe dem?!  Leesten, Leeeeesten what dey are say-ing-to-me!” with the last four syllables of the sentence punctuated with rhythmic staccato.  He will then tell me his side of the debate, always with interjections and protests from the other side, and I will be left to give my opinion like I am somebody wise whose opinion is highly sought.  Personally, I love it, but I do have to be careful not grow proud and think that I am actually wise!  Mostly, they are just interested to hear a Westerner’s opinion about bridal prices, women serving men in certain instances, whether a church should pay for a potential pastor’s education, why Kenya doesn’t have sprinters like Jamaica or the USA, what is the best way to cure a cold  (they use a lot of herbal medicine here), how many kids a family should have (in general they think one should have a lot more kids than we do on average in the US!), what factors should determine the goal number of children, whether to hold to the tradition that husbands should not be present at birth and should not see their wives and their new child until two weeks after the birth because traditionally that is a thing for the “women” (the mother-in-law, the mother, the sisters, etc.), how to determine how much one should tithe to the church, and, most recently, whose fault it is that the standardized tests the district’s students took had so many errors and questions without correct answers and who is responsible to fix it.  I absolutely soak up these conversations as I often end up learning much about the culture and current state of things in Kenya that I would not otherwise understand.

Mr. Koech, up to his usual antics, teasing Miss. Janeth Bii because she wouldn’t do “cheers” with him with her coke bottle and celebrate with him on the last day of the term. So, Mr. Koech took her bottle and did “cheers” with himself over and over again to show Madam Janeth “how it was done.”  Madam Janeth is looking down, laughing and just slightly embarrassed.

In the afternoon, I am scheduled to teach PE, Creative Arts, and Social Studies for a teacher who is away for a few weeks.  Before the students took their district tests, PE and Creative Arts were replaced with Maths since these two subjects are not tested on the standardized tests.  Now, since their tests are done, I have been able to take my grade six students outside for PE.  When I announced on the first day after tests that we would go outside for PE the classroom erupted in cheers, followed by “Please, will you get the long rope for us?  “No!”, they say, “Will you get the ball for us?  The ball!  The ball!”  In the last week I have attempted (to the great delight of the kids) to play in their jump-rope games to which they sing funny, rhyming songs to while they jump, and cheer for the goals and break-up the skirmishes during their competitive football (soccer) games.  I have also been impressed at what the girls are able to do even thought they wear such long, athletic-movement-inhibiting dresses for their school uniforms.

Some younger children playing football (soccer) during their morning break.

Children playing

For Creative Arts, I attempted to teach them how to indicate shadows by shading on a drawing, but I think maybe that was a little advanced for them.  Finally, for Social Studies, after reviewing their district test and I realized that the only question that I 100% knew the answer to was “Which cultural practice should we NOT protect and continue?” (The answer was “A. Female circumcision.”) Furthermore, since I had no idea what the best growing conditions for sisal were, I did not know what country Ol Donyo is located, nor did I know which African trading leagues Kenya is a part of, I decided to “expand” their social studies beyond Africa, namely to the United States, by letting the students ask me questions about US history, culture, government, and geography.  By the end of the class I had a map of the US drawn on the board labeled with every major mountain range and river (they loved the spelling of “Mississippi”) labeled on the map along with where certain cash crops grew and, of course, the state of South Dakota was drawn in when I was asked about snow.  George Washington was expounded upon, the national anthem sung to the background sound of little giggles (I sung it as best as I could anyway! They returned the favor and all proudly stood up and sang me the Kenyan national anthem in English and then in Kiswahili—I loved this), and then I finished my social studies presentation by shocking them all by declaring that myself, nor any of my friends in my 2000-student high school owned any cows.  They responded by telling me, each and everyone, how many cows their family owns.

Me with my students. I gave one of my students, Ezra, our brand new, one-day-old camera (yeah, the camera we brought to Kenya is officially kaput) to take this picture and told him to be very careful. He had about five guys all huddled around him as they tried to help him compose the picture and then successfully take the picture by pushing the button at the top halfway to focus and then all the way down to take the picture. I’d say they did a pretty good job for their first time taking a picture!

At the end of the day, I have one last cup of chai with the teachers before heading home around 4:40PM.  I am tired from the day and as I walk home, I usually find myself daydreaming about what cookie or cake I will indulge in when I get home before starting supper.  “Ah, cilantro, I need to buy cilantro if I’m going to make a version of Vietnamese Banh Mi in order to get rid or our plethora of carrots,” I think to myself when James calls out to me from his duka.  I walk up to him and greet him with a handshake.  He hands me a two-liter orange Fanta bottle filled with fresh cow milk (milked just this morning) and Scott’s dress shoe that I gave him to take to be repaired. I pay him 120 shillings in exchange, 80 (about $1) for the milk and 40 for the shoe repair, which looks great.  He and I joke and small chat for a while and when I turn to leave he instructs me to greet Scott and pass his well wishes onto him.

James’ duka. It is the white one on the left of the orange duka

I continue down the road, wave hi to Betty and her 9-month old son, Victor, telling her I wore the skirt she made for me just the day before and told everyone who complimented me that she had made it.

Betty, sewing my skirt with an old-fashioned, self-powered (with a rocking foot pedal) sewing machine.

Further down I wave to Viola who owns a duka that sells ready-made clothes, then I pass by Nick, whom I can always recognize thanks to his missing front tooth, and he calls out a greeting from inside his general store-like duka, so I stop in and chat with him and his young, twenty-something friends about my day and the fact that I’m carrying milk in a Fanta bottle.

My “milk” bottle, filled with fresh cows milk, ready to be strained and boiled twice.

Leaving there, I make my last stop, before heading home into the Tenwek Hospital compound, at Mercy’s produce duka.

Scott with Mercy at her stall. Here he is buying the biggest avocado we have ever eaten.

“Hello my friend,” she says warmly as she greets me with a handshake.  I return the greeting and offer one to her two and a half-year-old son Caleb who is strapped onto her back with a kanga.  I inform Mercy I’m in need of cilantro.  The bunch of cilantro is only ten shillings so she tempts me into buying a pineapple as well for 60 shillings total.  She then produces a worn school notebook from underneath her stall and shows me her handwritten recipe for Mandazi (fried doughnut-like things).  I’m impressed yet again at her memory, thoughtfulness, and promptness in getting me the things I mention I would like.  She has already sourced eggs from grass-fed hens for me, as well as passion fruit when I have not seen it anywhere else.  I take her notebook to copy the recipe promising to return it tomorrow.  I bid Mercy a good evening and pray to God to protect and provide for Mercy and her son Caleb, thanking him for the amazing person that Mercy is proving to be and for the great faith that she has.

Finally, around 5:30PM I reach home, have a frosted banana cookie while checking my email, and then begin grating carrots.

Some more school pictures:

The top three students from class six receiving an award during the Closing Ceremonies

The students congratulating those who were in the top of class six. They said a little phrase with actions that goes like this: “From our hearts, we measure and measure and clap and give to you.” For the actions they touch their hearts (you can see some students doing this) and then they hold their hands wide to “measure and measure” and then they clap their hands together and extend their clasped hands towards those they are honoring.

The teachers at the Closing Ceremonies. From L to R: Mr. Mutai (Science), Mr. Kirui (Math), Mrs. Mosonik (English and Kiswhili), Mr. Ngeno (Social Studies), Mr. Ngetich (Head Teacher), Miss. Bii (Kiswahili and Science), Mrs. Kanduyuwah (3rd grade).

Some of my sixth grade boys during the Closing Ceremonies. I thought they looked like models so I snuck some pictures of them. Note the sweater tied around the neck of the boy on the left, the crossed legs of the two boys toward the right, the socks pulled knee high on the front boy with his top two buttons unbuttoned and his arm slung casually over the back of the chair.

The boys again. This time with three boys with their legs crossed (I think this is so cute) and a handsome frown from the center one.

As always, thanks for reading!

~Whitney

P.S. Since you’ve made it this far I wanted to let you know that  Scott and I just got back today after a weekend in the Masai Mara on safari and it was WHOAH.   More on that later with pictures galore!

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Miracle at Tenwek!

Hello all!  Scott again.  I wanted to share a story from the medical ward. 

The patient I want to share about is a patient whom I will call Harrison.  Harrison is a delightful young man in his early 30s who came to us with considerable shortness of breath and hypoxia (low blood oxygen saturations).  After taking a history, performing a physical exam, reviewing his chest xray, and having his sputum evaluated in the lab, we diagnosed him with tuberculosis and started treating him for this.  Incidentally, his labwork revealed severe kidney failure.  The kidney has many jobs, including getting rid of potassium and maintaining an optimal pH (acid-base status) in the body.  Since his kidneys were failing, he had a profound elevation in his potassium, and was severely acidotic.  The cause of his kidney failure was quite unclear, and our investigation did not reveal a cause.  Unfortunately, despite our initial treatment approach, his kidney function had worsened the next day, and his potassium level and pH had reached dangerous levels.  At this point, seemingly the only available option was dialysis.  However, in Kenya, dialysis is only offered in two cities, and is extremely expensive, with few able to afford it.  I explained to him that without dialysis, I was worried his heart would develop an arrhythmia and he would likely not survive (this is what commonly occurs when potassium reaches his level), and his ECG was already showing abnormalities from his potassium. 

We next had a family meeting with his wife, brothers, sisters, and parents.  He and his family are primarily farmers, and were already in hard times financially as much of their maize (corn) crop had been wiped out by a fungus.  They determined that if they sold a few of their cows, they would be able to raise enough money for at least three dialysis sessions with hope for eventual improvement in his kidney function.  I hated to put his family in financial hardship, but he was so young, and I was really hopeful that dialysis would possibly be merely temporary if his kidney function improved.  I called the referral hospital in Eldoret, a city a few hours away to arrange the transfer, but they said it would be several hours before they would be able to accept him.

Next, I updated the family on the situation and told them it would be a few hours before he would be able to be transferred.  By this time, I had developed a nice rapport with the patient and his family and we discussed various other life issues, which was made easier by their excellent proficiency in English.  He and his family were people of tremendous faith in the Lord, and they were trusting God for a miraculous healing, and trusted that his will would be done.  Before I left, they asked me if I would be willing to pray for him.  Here at Tenwek, we commonly pray with our patients, but it struck me that despite knowing he was very ill, I had not taken the time to pray for this patient.  I proceeded to pray, and I must say, while praying something came over me.  It was as if words were coming out with such ease, and with more confidence than I had ever prayed.  I knew from a medical standpoint, based on everything I have ever learned and experienced, that urgent dialysis was needed.  Yet, for some reason, I thought God was revealing his glory through this patient.  After praying, I left and prayed again by myself for God to intervene for this patient.  I sensed he was moving, so I grabbed a needle, and lab tube, and went back into the patients room to re-draw blood to recheck his kidney function (even though we had just checked four hours earlier).  I brought the tube to the lab, and just waited in the lab for the results to return.  In my head I knew it was silly to expect his kidney function to suddenly improve without any intervention, but yet I held onto that glimmer of faith, that maybe, somehow, God was actually really going to intervene.

Anyways, 30 minutes later, the technician had finished running the sample.  He handed me the printout of his labs.  My eyes went right to his creatinine, which the lab we used to measure kidney function…the higher the creatinine, the worse the kidney function.   His creatinine had dropped by more than half, meaning his kidney function had more than doubled!  Additionally, his potassium levels had considerably dropped,and his acidosis was much better!!   I honestly could not believe what I was seeing with my eyes!  This sort of thing does not just happen.  With essentially little to no treatment, over those past four hours, his kidney function suddenly and rapidly improved.  There was no medical explanation for what I was witnessing, and only God could be behind what was happening.  I was so excited to tell the patient the results, however, on the way back to his room, I honestly was overcome with emotion.  I will admit that I found a bathroom, locked the door, and just broke down after experience the glory of God revealed in this way!  Finally, I gained my composure, and delivered some of the best news I have ever been able to share with a patient.  There was so much joy in that room, and we all gave thanks to God for what he had done. We cancelled the transfer to Eldoret as he no longer required dialysis.   I eventually left the room, did several fist pumps and was able to proceed with the rest of the day.  I will never ever forget those moments, and my faith continues to expand in new ways.  The Tenwek motto indeed was true…We treat, but Jesus heals!  I am happy to say that over the next 48 hours, his kidney function completely normalized, his potassium levels are normal, as is his pH.  Also, he was weaned off oxygen and is completing his TB treatment.  He returned yesterday for his 10 day followup from discharge, and continues to do amazingly well with absolutely no symptoms.  Praise God!!

As I left the hospital that day, a motorcycle taxi (called a boda boda) crossed the road right in front of me.  Many of the boda bodas will have a message of some sort on the rear of the bike.  This particular bike had on its bumper, “Jeremiah 33:3.”  When I got home, I read this verse which reads, “Call to me and I will answer you and show you great and unsearchable things you do not know.”  This was such a fitting verse to end the day, and I am sure it was God’s way of reminding me to continue to call out to Him, and he will continue to reveal himself to me in new ways!

Thanks again for reading and sharing with me in celebrating another Miracle at Tenwek!  I have another incredible story from just today of a really amazing recovery in one of our patients, but I will save it for another time. God Bless!

 

Scott

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Myself and Dennis, a Kenyan intern, rounding on the medical ward.

 

 

 

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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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