Friday, December 31, 2010

Wednesday, December 29, 2010

christmas in kenya....

Christmas Eve camel ride on the beach...
Christmas Day snake killing!? Black Mamba came out of the pool!!! And was promptly done in by the staff at the beach cottages where we were staying. Apparently this snake is the most poisonous in Africa. Wow. It was 6 feet long!!
Boxing Day...ant infestation. One of the boys we were with woke in the night to ants, millions of ants...covering his mosquito net, inside his mosquito net all over him, covering the floor, coming out of the sink. No apparent reason, just decided to march in....
The next day/night we were exploring to make sure the invasion wouldn't be repeated, this led to torching the trail...fireworks used to burn the biggest pile...lots of DOOM (the spray)...etc. So much entertainment! They still made their way back?! Boys weren't sleeping in the same room of course!
Trip home....crazy, arduous journey around trucks, goats, cows, people, speed bumps that are random and everywhere without any paint or warning, lots of passing and many potholes!
Just before leaving the coast we loaded John and Joe onto a "Simba" bus for a trip to Tanzania and Zanzibar for New Year's. At last report they are in a hostel in Zanzibar.

Saturday, December 25, 2010

Friday, December 24, 2010

A Christmas Story...

A patient I have been treating for the past three months named Maria is the subject of my story. She is 30 years old and I admitted her to the ICU in September for a number of serious problems. She was in pulmonary edema with a low blood pressure, on Coumadin with an INR well over 35 with a low HCT requiring emergent blood transfusions, and she had a loud systolic heart murmur. She spent a few weeks in the ICU and ultimately was stabilized and went home. Since that time she has been stable on a mix of medications. An echo showed severe mitral valve stenosis. The valve is so damaged that it is just a matter of time before she decompensates again. This is where a friend of mine comes in. Beth is a doctor from Boston who spent four months working in our ICU and somehow has connections to a group of Italian heart surgeons who do charity care. Maria needs a valve surgery that is not available here in Kenya. She is a rural Kenyan who has never flown on an airplane or had the need for a passport. She speaks no English and has little money. We were able to send her medical information to the heart specialists who agreed that she was a candidate for a heart operation. It just so happens that this Italian group is based in Khartoum, Sudan. The Christmas miracle is that we were able to get Maria a Passport, Visa, plane ticket, and spending money. Three days ago she flew to Sudan by herself and is now in a hospital preparing to have her heart fixed. Merry Christmas

Thursday, December 23, 2010

merry christmas!

Warm greetings for Christmas! We really miss our friends and family right now! Celebrating a holiday here that is normally full of traditional foods, people and activities is very odd and confusing. We keep reminding ourselves that Christmas Eve is tomorrow!!
And so strange to think that the story of the birth of Christ actually happened in a place more like this than any place we have ever celebrated before!? We actually saw a whole bunch of camels today as we drove to the coast! And I saw one in Nairobi on Tues?? Not sure what that was about. That one seemed a bit lost....
In any case, this change in circumstance has caused us to wonder what the coming of Christ means for people in such totally different locations and life experience? There are few outward signs that Christmas is about to be upon us. But we are still often sent off with "Merry Christmas" when we part with someone, and I have had conversations about plans for meals, family gatherings etc.
Warren has noted that the Outpatient Clinics were slower this week, hopefully due to people being distracted by preparations for the imminent holiday??
One thing we are quite clear about...We miss you! We love our family and friends and our familiar celebration. So much of what the coming of Christ means comes to us through those we love!
We aren't suffering...We are in a warm place, have great people around us, and we feel loved and supported from afar as well.
Warren, Sandra, John...and Joe for now as well.;)

Tuesday, December 14, 2010

A week in Mozambique...time with people we love, Yohani, HEAT, dirt, poverty, children, love, connections, heartbreak, HEAT, questions, amazement, conversation, play, mangos, cashews!, celebration, perspective, new friends, physical exhaustion, a beautiful beach, HEAT, rain...and a return...our first return to Kenya as "home".

We traveled to visit Christina, Victor and Yohani Carlos in Nampula, Mozambique. This is our second trip to a country during it's hottest time of the year. I also MOVED during each of 3 pregnancies?! Hmmmm....??? It was so hot that the kids said, "espera!" when we tried to initiate a game...meaning "wait", until the temperature went down a slight bit, just before darkness came at 5pm! As Christina says, "Mozambique is on the wrong time zone!" It gets dark at 5 and light at 5. Wouldn't you think they would want to adjust this...for their own sake? When the world is fully lit and everyone is up working at 5!?...why not push the clock a bit!? But this wasn't the only question raised about life in Mozambique. It is a place ravaged by war, corrupt government, difficult weather, challenging fresh water access, extreme poverty...and on and on...

The piece of land they have along the coast is spectacularly beautiful and with proper care could be a source of great income and enjoyment. As it is, few ever see it or benefit from it.

On the other hand, as always...there are wonderful people living in Mozambique, many of them children. We spent the week with close to 50 children who live with Christina and Victor at on orphanage just on the outskirts of Nampula. They were warm and hospitable, easy to connect to, willing to work with our terrible attempts at communication (Mozambicans speak Portuguese), happy, grateful...Fun!

We got to love on Yohani, Christina and Victor's incredible crowned as the easiest baby I have met so far! He loved us, laughed with and at us, and generally made us feel good in our souls!

We came to a new appreciation of what we have in Kenya...and the timing was perfect. Perspective is important, and especially at certain times! We came back with Joe, a friend of Erika's from her life at UW, who was at the orphanage when we got there. He is fabulous...and John is soaking up the opportunity of his companionship. We hope he sticks around for awhile!

Wednesday, December 1, 2010

another birthday etc....

Some of you may be followers of John's occasional blog. Somehow we succeeded in making his birthday enough of an event that it warranted a post. Wow!
Although it might sound exotic to celebrate a bd in Africa, which it actually is, I don't think it feels that exotic when you would really prefer to be with your sisters and your friends. But hey, school is out...and we made the day into a mini vacation.
After a bit of research we put together a day of eating, golfing and Harry Potter! The golf course was fabulous...much less expensive than such a place at home and with monkeys as an added course challenge...Will he pick the ball up and leave, or just smell it and walk away??
The power only went out once during the movie and the bottles and garbage that were thrown as soon as the lights were out only hit the chairs around us, never us directly?? Seriously. What was that about?
There were a few treats from home that made their way here in other people's suitcases over the past few months...and the day felt complete.

It poured rain here today. I did a full on sprint in my skirt from the hospital, alongside our middle aged and rather overweight property manager....still got completely in dripping!

This was after I spent some time in the newborn nursery where there are 3 sets of twins!? each set sideways and together in little incubators. One had his hand outstretched resting on the belly of his brother. Amazing.

Saturday, November 27, 2010

med notes from warren...

The Casualty/Clinic continues to occupy my time. Kids continue to come in who are sick and at times confusing. A sick newborn came in recently who had been home from the hospital for 7 days. The parents took him to a nearby clinic on day 6 after noticing that the child was febrile, not feeding well, and generally acting sick. They were sent home with a bottle of amoxicillin and came to the hospital the next day after the child continued to decline. The child required a lot of work after it was determined that the accucheck was 1 (that’s around 18 in our lingo). IV access was difficult but an intraosseus line was helpful. Intubation, glucose, fluids, femoral blood stick, CSF, antibiotics and a carry up to the ICU, where I placed the baby on a little German baby vent, all went pretty smoothly. I took out the IO after about an hour when we had another peripheral line. The line had been in the right tibia just below the tubercle and the skin of the lower leg remained loose with no evidence of extravasation, but the leg from the level of the IO down to the foot became very purplish with delayed cap refill. This puzzled me. After removing the line the leg improved, with better color and warmth (what was that about?). However, sometime later in the night the poor child suffered a rather sudden decline leading to a code that ended in the baby’s demise. I was sad for the family and couldn’t help think how unfortunate it was that they had gone to that clinic instead of coming immediately back to the hospital.

On a brighter note, there are twin preemies in the neonatal unit who are 29-30 weeker’s. They came in with bilirubins in the mid twenties shortly after delivery and underwent exchange transfusions through their umbilical veins. They looked pretty terrible with little chests that looked like little birds...all retracting. That was last week and now they are still alive, on NGT feeds and they look like they will make it.

I’m into day 14 of treatment for rabies on a 10 year old boy who was bit by a crazy dog on his porch. The dog subsequently died the next day. I was told that it is possible to collect the dogs head and with the help of the pathologist (which we do have), cut the brain up in the morgue and look for those things you see in rabies; some bodies of something. It all sounded a bit farfetched so I elected to just treat as if the crazy dog did have rabies. Finding the immunoglobulin was difficult; it was found in the Nairobi National Hospital and brought out to Kijabe the next day. This kid is looking great.

Sandra is writing a grant proposal for a new building for outpatient care, which will subsequently allow for expansion of the ER. This seems like a worthwhile endeavor and would provide an opportunity for us to provide care for more people and with more efficiency.

Today we had the privilege of attending our first Kenyan wedding. Two of the young doctors I am working with married each other. We were 3 of the 5 white faces in the crowd. It was great fun.

Friday, November 26, 2010

Saturday, November 20, 2010

holidays approaching??

As we hear of reports of possible snow in Seattle, we enjoy warm sunny days with breezes turning to wind gusts late in the day, a combination that dries our laundry in about an hour on the line, and with an intensity that fades our clothes rapidly if we leave them there too long! Without sunscreen we are quickly over baked, due to the nearness of the equator.

I love this! I love the warm air, the constant supply of summer fruit, the opportunity to easily find warm and intense heat on my skin, the incredible sky that evolves and changes all day long, culminating in a spectacular sunset every single day.

But...we are all missing home now. We left home 3 months ago today. We are ready to see our girls again! (when John was little he used to say, "where are my girls, i miss my girls"...we all feel this way right now!)and we are in denial that the holidays are approaching...partly due to the fact that we don't have a single familiar changes, music, decorations in stores (actually there are a few in Nairobi), festivities filling the calendar...and partly due to the fact that we can't quite imagine them without our friends and family.

John starts a school break in a few days. We look forward to a week with Christina, Victor and Yohani in Mozambique. They are family to us so this visit will fill us up and the timing is perfect.

Monday, November 8, 2010

blog overkill??

Moses heading into Mathare

While running today I decided there was one more thing that I had to blog…overkill for two days or not!

On Sat we went to a huge slum (pop. est. 500,000). We were looking at a project for youth, run by Moses, a young man who lives in the slum, goes to seminary, and submitted a proposal to the Fluid Foundation for a kerosene business idea that he wants to use as a financial project to support the youth program. He is a busy man! And his business has started well. They have as many as 300 customers each day and it has only been a few months since they started!

As we walked through the slum the children were literally following and surrounding us saying “How are you?”, the only English they know. It is the way it was being said that made it quite memorable…I think I thought of it while running today because it would be like if you were counting 1-2-3 while running, or marching in a pre-election parade and chanting, “Yes, we can!” over and over and over…Emphasis on the first and last word.

Finally, I decided to respond with more than a smile and hello…So I said, “Nzuri. Je, na wewe?” (Good, and how are you?) To which I got a shocked look and sentences of response…no longer in English!

Oh dear…now what? I can ask if they like boiled or bbq meat better. Doubt they get either often, if ever. I could ask where they would like to visit…!? Surely a bad question to ask a child without shoes…

My language, but even more…the difference in our experience…really caused me to hesitate about where to go with conversation. Granted, those early phrases in language learning are quite funny. How often do you ask someone what foods they like to eat in the second sentence of your first conversation, or whether they like goat or turkey, or where they would like to go in the world? But these were surely the wrong questions here.

Then we visited Kalyie, an intern from Maryland, working in the slum as an artist. At the start of this particular class she had asked the kids to make lists of things they would like in their dream home. They were in the stage of painting these dream places when we arrived. Their painted houses looked so much like the one I know as my home in Seattle. Trees, space, flowers, windows, doors, sky, grass…

They know. They have an idea of what the good life is. In the context of a place (Moses’ Inspiration Center) where they strive to encourage and support these kids to stay in school, get out of the slum, pursue a better life…It is important to ask… What do you like, what do you want, where will you go? It gave me the tiniest bit of hope that it is possible…perhaps they can.

Sunday, November 7, 2010

Checking in on the medical front from Kijabe

Last week was heavy with RTA’s (road traffic accident’s). One of the unfortunate results of improving roads in Africa is that cars can go much faster and the resulting accidents are more severe. On the weekend a small bus collided with a lorrie it was overtaking and about 13 people came into Kijabe. Three people died and others were admitted with serious injuries. Two days later a similar event brought people into casualty, say around 14, but thankfully no one died. One young man was paralyzed from the waist down and others suffered multiple open fractures. Treating CHI’s (closed head injuries) is a challenge here. We don’t have a CT scanner so you must rely on clinical evaluation, which is a bit like crossing your fingers. I learned an interesting neurosurgery trick the other day: you can screw through the skull, insert a catheter into the ventricle, inject air and take an x-ray. Then you can tell if there is midline shift and be guided in where to drill a burr hole. I had to put a number of joints back into place with all the accidents and had the pleasure of putting my first traumatic posterior hip dislocation back into joint. I have put back innumerable prosthetic hip dislocations at Northwest and thankfully the techniques are no different for traumatic hip dislocations. I have a small pocket pulse ox/heart rate monitor and it works perfectly for cases requiring moderate sedation. I pop it on the finger, inject a little valium/fentanyl and voile, pop goes the joint…after a bit of pulling of course. I have oxygen and suction, as well as airway stuff, so we’re good on that front. I’ve had to learn to live without etomidate or propofyl here, but have come to a new appreciation for the old fashioned standbys.

just a tiny bit of an amazing week!

This week has been our most amazing so far! It is hard to even know what to say about it. Ken Kierstead from Seattle, UPC and the Fluid Foundation…and a friend of many of you, was here in Kenya. He graciously welcomed us into his adventures and plans and what resulted for us were the most incredible experiences…meeting people, seeing projects, making friends…

Last Wed we drove across the Rift Valley in order to join up with Ken, some Kenyan World Concern staff and drivers to take us in 4 wheel drive vehicles across miles and miles of horrid roads, passing giraffe, zebras, ostrich, wildebeests etc etc. until we reached an extremely remote Maasai village where 2-3000 people live! The area would be totally uninhabitable, as was the land all the way from Narok town where we met up with the group, to the village, if it weren’t for a spring which provides an endless source of clean water and makes it possible to have trees, grass, grow crops and live….not lavishly, but survival is possible. There were a few trucks, and a few matatus…otherwise it is all about walking….endless walking! ( I would love to put a pedometer on a Maasai for a day! All our “records” would be smashed immediately for sure!) We had the privilege of seeing a credit union/saving type of project whose start up the Fluid Foundation and World Concern have partnered to support. The concept of saving is so new and unusual, but here they are making headway and catching on. Perhaps the next time there is a drought, as there was for several years only ending about 9 months ago, they will be able to use the money they have put aside to help them keep from starving! It was very exciting to see this catching on. The credit union has almost 300 members as it ends the first year.

I had the pleasure of getting close contact with a young Maasai woman, a member of the board for the project. She stayed close to me and I longed to talk with her. Many of the Maasai are so beautiful. I find myself wanting to stare...which my kids say I do anyway! So this is probably really bad. Finally we were in the car together as we headed back to the village after a goat feast…this is a huge deal in Kenya…getting treated to goat…(Whether you think of it as a treat or not it would be horrible to not partake with gratitude and enthusiasm. Thankfully, Warren and I basically like it.) Anyway, we were in the car with a Maasai who speaks English so we could ask each other a few questions. She asked me, “is he your husband?” and I asked her if she was married and if she had children. She was and had two, ages 2 and 6. Then she asked me if I had children. (John was not with us) I told her about them and their ages…She clapped her hand over her mouth…shocked and realizing that I am OLD!;) It is hard to tell ages of people you don’t see often…as in other races and cultures!! We have the same problem. I was guessing at that point that she was about Alison’s age….and when I asked, exactly right. I later learned that she is someone’s second wife…

The separation of language…painfully limiting. I could have spent days and nights talking with her…hearing her story, learning about her life and culture, asking her about her hopes and dreams. Instead I went home with a wee connection that indicated that we wished for more…and a beautiful beaded necklace that she made which symbolizes that I am a queen or something amazing…and a hope for heaven…and the chance to communicate!!

Later this week I met Frances, a whole blog in himself…but he speaks 23 languages! And I believe him…He was clearly one of the brightest and most alive people I have ever met, and also Rose…who speaks 10…including fluent German, an uncommon sort of addition for a Kenyan.

Some people just get right to it.

Sunday, October 31, 2010

and then it was over...

Ready to go.....

21 at 48....

The three of us ran a 1/2 Marathon as part of the Nairobi Marathon today...21 kilometers! It is my 48th birthday...and this is what I wanted to do?? John was's birthday request, what could he say?
As many of you who know me know...I have always said I wouldn't do longer races, trying to have longevity in my running life...over years, not with miles at one time. Something about being in Kenya...just felt like it was the right thing to do??!
Running here in Kijabe is a challenge. So our "training" consisted of running at elevation, but never going more than our 4 mile distance. 13 miles is a big increase!?!?
Some of you also know of our pedometer addiction. Warren is currently contemplating walking to the gas station for a phone card...He needs only another 2000 steps and he will have 40000!! for the day. His last record was in Rome with Erika...27000 in one day. The thought of walking another 2000 steps sounds incredibly horrible to me. The way Warren looked at the end of the race...maybe he should call it good as well!
As I read over what I have just written I am wondering if we have totally lost our minds...or brain cells to living up too high in the sky!

Thursday, October 28, 2010

out of africa...

Today I finished reading Out of Africa. I think I read it a long time ago, and I love the movie, although the movie is not much like the book. But it is so different reading the book here… an amazing and accurate recollection of this place!

Isak Dinesen basically lived right here, within a few miles of where we are spending our year. Her weather was the same, her views were the same, and the people groups around her were the same.

She starts, In the day-time you felt that you had got high up, near to the sun, but the early mornings and evenings were limpid and restful and the nights were cold.


As she finishes the book she describes her goodbyes, including the grief of saying goodbye to the Kikuyu women on her farm. (Kikuyu are the dominant tribe in Kenya …a very tribally divided place!!...and they are the dominant tribe and language here in Kijabe.) I have also found myself intrigued by the women.

The old Kikuyu women have had a hard life, and have themselves become flint-hard under it.…They were more difficult for any disease to kill off than their men…and they were wilder than the men……They had borne a number of children and had seen many of them die; they were afraid of nothing. They carried loads of firewood---with a rein round their foreheads to steady them---of three hundred pounds, tottering below them, but unsubdued; they worked in the hard ground of their shambas, standing on their heads from the early morning till late in the evening…..And they had a stock of energy in them still; they radiated vitality. The old women took a keen interest in everything…This strength, and love of life in them, to me seemed not only highly respectable, but glorious and bewitching.

Last night Warren was out working on the piki as our neighbor’s helper Aidah walked by, headed home after working all day. I love her. When I need something for my kitchen she happily helps me, when I need to communicate within the local “network” she does it for me, when I look for the strawberry lady she appears because Aidah calls her???...It is like magic, but really it is Aidah. She works so hard but she genuinely feels bad for me when one of us is sick, when we don’t have water, when anything is off…I do think she sees us as more fragile than she is. Which we are! Anyway, Warren offered her a ride home. She already had her arms full, but she asked for a few minutes to cut some grass in a nearby field…with her machete! When Warren met up with her they tied this big load of burlap wrapped grass to the back of the piki , Aidah and her bags got on the back of the bike, and off they went. Warren was gone so long that I was starting to get concerned. When he got home he could not believe how far he had gone…straight up! She walks to the top of the escarpment, loaded like I described, for at least 40 minutes…both directions…every day…6 days/week.

And this morning as she half walked, half jogged by my kitchen window, she purposefully looked for me…and gave the biggest smile and wave…as she always does…

and the game played on????

from a local online news source...

Kenyan Prime Minister Raila Odinga on Sunday sent a message of condolences to relatives and friends of the seven soccer fans who were trampled to death during Saturday night's Kenya Premier League match in Nairobi.

The impatient fans broke into the stadium moments after the match pitting archrivals Gor Mahia and the AFC leopard football clubs began.

Football lovers in the thousands had braved the rainy evening to watch the match between the two teams whose encounters in the local premiership league has historically attracted fanatical supporters to the stadium.

Police and Kenya Red Cross officials said six of the victims were trampled to death as thousands of fans tried to force their way into the Nyayo National Stadium.

The seventh person died at the Kenyatta National Hospital where 11 other fans were undergoing treatment for injuries. AND WE KNOW HOW THIS GOES!

"Our emergency rescue teams are on the ground and they have been able to confirm the deaths of six people whose bodies have been found outside the stadium. They are five males and a female," Kenya Red Cross spokesman Titus Mung'ou said.

"We can also confirm that another person has succumbed to injuries at the Kenyatta National Hospital. That is what we at the Red Cross can say for now because there are several other emergency rescue teams from other organizations involved."

Kenya Football Federation (KFF) chairman Sam Nyamweya says Football Kenya Limited, Kenya Premier league management and the Stadia management board are to blame for being casual about the preparations for the match.

"KFF strongly condemns the mayhem that characterized the otherwise classic match between Kenya's premier soccer clubs (AFC Leopards and Gor Mahia) on Saturday," Nyamweya said in a statement on Sunday.

He called on the government to launch an inquiry to establish what may have caused the stampede during the match between AFC Leopards and Gor Mahia, alleging that tickets for the match were over-printed beyond the capacity of the Nyayo stadium hence the tragedy was inevitable. INEVITABLE??

Earlier this year, football's Word governing body FIFA banned the stadium due to safety and security concerns. Gor Mahia eventually won the game 1-0 following an 87th minute penalty that was converted by Collins Okoth. GAME PLAYED ON??? GOOD TO KNOW THE SCORE!? THE FOOTBALL SCORE AT LEAST, CROWD -7, GAME ON THE FIELD 1-0

A fortnight ago, the Africa Cup of Nations qualifier match between Kenya and Uganda, surging crowds broke the gate to the VIP section of the Nyayo National Stadium but no injuries were reported. WOW...THERE WAS EVEN A TRIAL RUN THAT HADN'T GONE WELL!

Another fan reportedly died in 2005 in another Africa Cup of Nations-cum-2006 World Cup qualifying match between Kenya and Morocco, prompting world football governing body, Fifa, to order the stadium capacity at Nyayo reduced to 26,000 from its 30,000 capacity. OH, A FEW TRIAL RUNS!

BOLD IS MINE OF COURSE...WOW. Life in Kenya....

Wednesday, October 20, 2010

Some Thoughts on Ankles

This last week was interesting in that I relocated two completely dislocated ankles. Two in one week seemed surprising since I relocate an ankle at Northwest about every year or so. The first young man had been in a car accident around three in the morning and friends took him to a nearby hospital. He brought an x-ray that showed a completely laterally dislocated left ankle. The hospital had also fashioned a posterior plaster ankle splint that did a fine job of keeping his leg firmly dislocated. We wouldn’t want the ankle flopping around. He shows up outside the ER around noon in a friend’s car with a referral note from the other hospital. The distal tibia is completely exposed as the skin over the medial malleolus has torn open. I track down a vial of 500mic fentanyl and after 350mics he tolerates me pulling his ankle back into place. He can even wiggle his toes afterwards, and has a good DP pulse. He then went off to the OR for a thorough washout and an ex-fix.
A day or two later another young man shows up straight from a walking injury to his right ankle. He has fallen and suffered a complete medial dislocation with the distal tib/fib exposed and a large skin tear over his lateral malleolus. I find more fentanyl and after giving him 650mics he is still talking on his cell phone but he doesn’t seem to mind when I pull the ankle back into place.
People here are very pain tolerant. They don’t do a lot of screaming/writhing around like I would if I had the same ailment.

Saturday, October 16, 2010

Samuel and family...

Our Maasai friend, Samuel, brought his wife and baby to meet us tonight. They had just been to a staff banquet at the school, where he is a guard, so they were dressed in Western clothing. We had so much fun. Samuel is very interested in all things new and modern...He wanted a Facebook account. So...we set him up. He comes to our house to check his email once in awhile and I am sure it will be Facebook now! He said he knows two other Maasai with Facebook so he was trying to find them.
We took a few pictures to load onto his site...Quite a fun and funny project...
His wife speaks much less English, but she was obviously amused by the whole process.

Wednesday, October 13, 2010

a day in the life...

I was feeling a little down this morning…an email that I read before starting into my day?? The return to our “routine” after a few days away?? The fact that the nursing matron wasn’t there at our “appointed” meeting time…Who knows…
After doing a few errands at the school I headed toward the “dukas” (shops in Swahili and the common name for our shopping area, such as it is!
On my way I ran into Samuel, our Maasai friend who works as a guard for the school. He always greets us with friendly eagerness and openness to chat. We ended up in a conversation about family planning, educating his daughters, preventing early marriage for his children and the cultural challenges of his generation as they seek to help their children have more opportunities for their lives. An obvious privilege to get to be in this conversation!
Then I walked to the vegetable market where my friend Jean followed me out after I made my purchases. I sat on the ground with her where she was taking maize off the cob so it could dry on tarps on the ground…She told me about the different types of foods she cooks and I asked her a million questions. I have no idea what they do with many of the things that are for sale here! I hope we can arrange for her to come and teach me. We can.
After lunch our Swahili teacher, Edward, came. At the end of our lesson we ended up having a chat about differences between here and where we live… He is smart and well informed about many things. He had great questions.
Just before dinner Rachel came over. She was bringing me Samosas. I had fresh cookies so she sat down, ate a few and we had a little chat…about her children and mine, about her husband…who isn’t great, about her very elderly mom…and the funniest…about weight differences in our cultures. She could not believe that thin is considered so beautiful in America. I found a Vanity Fair that Alison gave me for the plane ride and announced…”we will not find one fat, or even chubby person in this magazine…even though America is full of larger people….” She could not believe it…and she did not think those thin people were attractive. She said, “you know, if a woman’s husband leaves her here, they will try to get fatter so he will feel bad and think he shouldn’t have left…” I burst out laughing telling her how we have the same syndrome…just the opposite. The world is crazy…
In the was a perfect day....

Monday, October 11, 2010

Thursday, October 7, 2010

ER thoughts...

The ER is a unique place in any institution and it is no different here at Kijabe Hospital.

There are truisms in ER Medicine that span continents, race, and money:
1. No one who doesn’t have the ER in their blood wants to be in the ER, and lots of people in medicine don’t have it in their blood.
2. There’s no place like the ER to strip away people’s facades and expose who is going to be there when you need them.
3. I’m convinced that the ER is unique in the way the environment encourages connection, dependence, equality of function amongst all the players in the drama, and a sense of “family”.
4. Like any good family, there are many devious subplots in the ER.

For good or bad I am realizing that my goofy personality is starting to come out in the ER here. It has been a month and a half and things have been so new and serious, but just today I noticed that the jokes were starting and people were laughing and situations in the ER were starting to look funny instead of sad and so serious…….I think I’m infecting this place the same way poor Northwest was infected with me. Beware Northwest……the infection will return, and it might be multi-drug resistant and terminal. I’ll Be Back!

we concluded that the petrol was empty!

look closely at labeling on side of truck, and this is with at least 100 people within 50 yards!

Wednesday, October 6, 2010

"Kenyans like everything..."

Today I spent the day in a large van/bus sort of thing with 26 nursing students. We made our way through tea plantations, coffee plantings, banana trees...until we found a very rural health clinic with 3 male community health workers keeping the doors open on a volunteer basis. Their commitment and resolve was amazing, while the attention I drew from the community children was quite humorous. Jane, one of the nursing instructors said to me, "you are like a white elephant that we brought to their town!"...I am just going to focus on the white part...;)
As we were driving along the old hymn "How Great Thou Art" came on the radio in Swahili. The entire bus load sang along.....very cool.
This was quickly followed by Michael Jackson's Beat It, immediately followed by Kenny Roger's and The Gambler...All loudly accompanied by the students...By this time I was incredulous! What kind of a station is this...and how does this work that these students know all of it? Jane,apparently seeing my expression,says, "We are Kenyans. Kenyans like everything..."

Saturday, October 2, 2010


Polepole...slowly in Swahili. (say the e's, like long a) That is a good summary of how things go. Our roof is back in place and the bathroom is usable, although still in progress. At least the tree crashing through led to a new paint job, which is a nice thing. The seemingly old oil based paint that was used for the job might have taken a few years off our lives, or at minimum stolen a few brain cells!, but it does look cleaner and brighter. The paint smelled horrible!! We are pretty sure that they aren't planning to cut down the entire eucalyptus forest behind our apartment, but I am still sort of wondering. The Kenyan habit of telling you what you would like to hear, as opposed to the actual facts, makes me unsure about the "assurance" I have been given regarding this tree cutting business. The chainsawing has been steady for 3 weeks now!!
All that aside...we had a great Piki ride to our friend's place at Mayer's Ranch last night, where we ate an amazing meal and spent the night so that we wouldn't be riding home in the dark. At 7:30 this morning we rode back so that Warren could take over call in the ICU for the weekend. By the time we got to our place at 8a we had seen many birds, a dik-dik darting across the road and a whole family of baboons. They had heard the neighborhood leapard the night before so we were hoping for a sighting, but the word is that you only see a leapard when it is already on you! They have actually seen it there, but not easily or often. It did run off with the smaller of their two dogs once, puncturing him in the throat just exactly in the place that stole his voice!, but their massive Great Dane, Zeus, chased them down and Elvis has been as good as new, although silent! ever since.
I was met with an enthusiastic response from the matron of the nursing school when I offered my services to them for the year. I am meeting with the faculty on Mon at 9a. John has a mid-term break coming up next weekend. He is brewing plans for Piki rides, camping and a climb up Mt Longonot. So he seems to be settling into life here. And I am sure another weekend of call will bring a few more vignettes from Warren.

Friday, September 24, 2010

trees through roof!

John's face said it all as he walked down the hill for lunch..."Hmmm....Wow." And then, "Mom! the bathroom no longer has any privacy!"
Yes, that is our bathroom and bedroom under that hole. Too bad the cutters didn't quite get the fall line right?! Another day in our African adventure...

A few more vignettes....

1-a 35 year old woman comes in complaining of nausea vomiting and abdominal pain for the past few weeks. X-rays show high grade small bowel obstruction. Surgery finds multiple small abscesses; congealed material and small bowel adhered together, requiring side to side re-anastomosis. After seeing her in the ED I reconnect with her in the ICU where she is a few days post-op and I am on call for the weekend. Her breathing worsens over the weekend requiring intubation and her CXR shows evidence of ARDS; not good. I am unable to save her in spite of pressors and respiratory support. I won’t know what she had but I bet it was likely reactivation TB in her abdomen. My Kenyan colleagues tell me that they are seeing more TB in places other than the lung with no history of a prior known TB infection in the lung. Lots of TB around here, without all the isolation paranoia that we have; I won’t be surprised if I turn PPD positive by the time I’m done around here.

2-a 33 year old known diabetic with a history of pneumonia one month ago comes in complaining of increasing shortness of breath. The resident calls and tells me that the patient has pneumonia on the CXR and should do well on oxygen and antibiotics; but maybe a good idea to keep an eye on him in the ICU. I come in to check on him in the Unit and he is breathing 50 times per minute with a believable pulse ox of 66% on mask oxygen. Clearly he’s not talking much and his sugar is high-say around 600. His BP is around 220 systolic which I am glad about since it’s always nice to have more blood pressure than less; that goes for sugar too. But the CXR looks more like CHF than pneumonia and besides the patient is a little puffy. Another intubation and this time out comes pink tinged frothy sputum like a small soda fountain; just like the textbooks said ( I think that’s what they said, at least the lecturer must have said something like that). A little suction, a little lasix, and the sat’s perk right up to 88% which I consider a cure. 4 days later he’s out on the general ward. If you had seen the general wards here at Kijabe that would mean something to you. You’d better basically be ready to go home if you want to survive out on the general ward. Think of the hospital scenes from the English Patient and you have a good mental image; except throw in a little more grime and smell.

A few medical thoughts:
-Try managing ventilated sick patients with no ability to order ABG’s; it’s possible to do.
-Remember my sick newborn that I ventilated and bagged for an hour and never could figure out the old German ventilator? Well a pediatrician came this week for a month and we have two preemies on ventilators, so I got a bit of an in-service on them and now feel confident that I can set up a tiny little baby on a ventilator should I need to.
-Can patients survive without the ability to order vicodin? Yes they can, and they don’t die. I guess they just feel miserable.
-Little sticky electrodes that we use for hooking people up on telemetry monitors are really good things and when you don’t have them it is a problem. I guess they are a donated item; must be expensive.

Wednesday, September 22, 2010

first visitors!

Our beloved friends, Mickey and Carol Berberian, just left. They spent the past 4 days with us and it was wonderful! They were on their way home from accompanying their daughter Christina and Victor as they brought baby Yohani home to Mozambique for the first time! So this was a bonus treat for us...and we are so grateful it could happen!

We heard stories from Mozambique, showed them our new place, drove on crazy roads, walked among the giraffe, zebra, wildebeest, antelope on Crescent Island...and shopped in the Maasai Market. We saw the locales for Out of Africa and Born Free and obsessed about Lord Delamere. They got a good feel for some of the experiences Warren is having at the hospital, as he was working in and around our adventures. They heard of some of the pitfalls of this kind of medicine...and some of the bad outcomes that can come as a result of minimal death, quite a lot of it actually! But they also got to meet some of the wonderful people he is working alongside.

It will be quiet without them here now...unfortunately I doubt they will get by without taking our horrid colds with them, so we will be forefront in their memory for a few more days!

Tonight I will put up pictures from our Crescent Island visit, one of the most surreal, magical...out of this world places I have ever been.

Sunday, September 12, 2010

Sandra's first time driving on the left side/right side of the car/wrong side of the road?

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another kind of outcome...

A Kenyan man comes into the ER agitated, saying, "I have a sick boy outside..." I grab an old wheelchair and walk out with him to find a white truck with two people inside. We don't have any spare stretchers at the time, so three of us help wheel him into "Casualty"(ER) and kick someone healthier off a stretcher. Once on the stretcher the boy is found to be pulseless and apneic and we proceed with a trauma resuscitation...Kenya style. Someone initiates lightweight CPR. I intubate the boy. We establish two IV's quickly with fluids running in, adrenaline is found and given, there is an ancient Zoll defibrillator that actually charges with a whine and delivers a solid shock! I am encouraged by the fact that the machine works. However, it is clear that the teenage boy doesn't. It is a sad moment to realize that he is beyond our help. We can only stop and ask what happened??
Apparently the truck was going down a nearby stretch of road, that is much like driving down a dry river bed, when the boy ran out in front of the truck while collecting firewood. The two men in the truck collected the boy and drove him to the hospital. Here in Kenya it is important that we keep the truck and the driver from leaving the hospital while the driver must walk to the nearest police station and bring the police back to the ER for an investigation. The truck was locked in behind gates in the hospital parking lot. Eventually some police officers did show up, as did some family members. Things seemed surprisingly calm, quiet and low key really. I couldn't understand much of what was going on so I asked one of the residents to tell me what was happening. Apparently the truck driver had to bribe the police at the station before they would come to write a report. The resident said the report stated that the boy was in the truck when it accidentally rolled over.
Clearly police reports aren't about investigating the facts. So much revolves around bribes and manipulating situations so that you can get on with your day. Never mind the loss of life or the long term impact on the family.

Saturday, September 11, 2010

making friends with sammy...

One of our main reasons for coming to Kenya was the hope that we would be able to meet and get to know Kenyans. As obvious as this may sound, it can be challenging when you find yourself on a station with a lot of ex-pat people who are involved in the same work. Although everyone is very friendly, and we learn new names of Kenyans every day, tonight was the first time where someone came over and spent time with us in a way that felt like we might become friends.
This past Thursday Warren and I had the opportunity to ride in the hospital ambulance to a clinic across the Rift Valley where we got to spend the day together seeing patients at a small understaffed and under supported community clinic. Doctors from Kijabe Hospital visit this clinic once each month. We also had a CO intern with us (like a physician assistant in training) and a nutritionist. Most, if not all, of the people we saw there are Maasai. On the way there we saw many of them along the side of the road herding cows and goats, most of them in the traditional bright clothing and beads that we think of due to National Geographic pictures we have seen. Amazing.
One of the patients mentioned that she had a family member who works at Rift Valley Academy as a gate guard. So...last night when Warren and I were on a walk, just before dark, we met Samuel...the family member. He initiated the conversation and we made the connection. We invited him to come over today. This evening he came...with many beautiful beaded things that his wife has made, and full of stories and easy conversation. We had chai and icecream and heard about his life growing up in a Maasai village. His wife and kids are still living in a Maasai village, only a short distance from here, and he goes to be with them on his days off. He is quite eager for us to come to his village and meet his family.
Warren was asking about the animals they come across and where they are. He could not emphasize enough how dangerous elephants are! He must have said this 10 times. Apparently you can run from them if you are running downhill because the elephants ears fall over their eyes and make them blind!? But are in trouble. They are fast and their ears are back against their head! Keep this in mind!
This seems like valuable information and none of our other friends have ever shared this with us!

Monday, September 6, 2010

Baby boy...born Sept 4, Kijabe

First night of call in Kijabe...

Overnight call for the medicine wards and ICU was quiet until a 5:30 phone call. Obonyo, the first year intern, notified me of a full term emergency C-section little boy coming to the ICU. The baby was born blue, with no pulse or respirations. After 5 minutes of CPR, intubation, epinephrine and glucose the baby regained a strong pulse. However he had little respiratory drive and we were bagging him on the way to the ICU. I had no experience with the ancient German ventilators in the ICU. So I just kept bagging the baby and called the doctor on call for Peds. He didn’t have much luck with the ventilators either but he told me that babies here cannot be ventilated for any length of time. They need to breath…or they die. By now I had been bagging the baby for about an hour and he was looking better all the time. He started out dark blue, with just a few retractions, but by now he was looking pink and was starting to breath on his own. We took him to the neonatal unit, took out his breathing tube, gave him a mask with oxygen and I went home hoping he would survive the day.
Today John, Sandra and I stopped in to see how he was doing. The nurse pointed to a vigorous crying baby who looked nothing like the baby I saw yesterday. She had to show me the chart so I could believe it was the same little person. He wasn’t even on oxygen and he looked like he was rooting for a good meal.
Sometimes stories turn out better than imagined.

Sunday, September 5, 2010

weekend with wheels...sort of...

The weekend was one big adventure…both because we got out and about, and because we did it with all the inefficiency of a good solid African experience! Our route to the nearest shopping center became a detour through the heart of Nairobi…which includes huge traffic jams, what feels like millions of people, iffy roads, crazy driving…constant near misses...really harder to believe that you aren’t crashing than it would be to be having multiple crashes! We finally arrived at Village Market, well secured by guards carrying AK47’s and Billy Clubs. This did make the inside quite relaxing. If anyone tries to do anything too crazy there they will pay…at least it appears that way! We hung out, did some grocery shopping and had great food in a food court type of place…Chinese for John and Indian for Warren and I. It seemed like every nationality in the world was represented in that mall…incredible assortment of people…very cool.
Today we decided we would take a drive down into the Rift Valley and try to find some wild animals. We got ourselves all ready, got some directions and ideas from our neighbors here, got in the car ready and excited…Car won’t start. After multiple attempts, jumper cables, additional gasoline...we gave up. We went for a walk , stopped in the hospital for a peek at the baby Warren helped rescue, and I got a blanket and a book and went out under a tree. About that time Warren gave the car one more try…and it starts! At this point we have about 2 ½ hours until dark…one of the major limiters here(does not feel safe to be on the road after dark, and darkness comes at 6:30), so we jumped in the idling car and took off. The first 5 km down to the valley took us nearly 40 minutes on an unbelievable road…(Nicaragua friends: think that river bed we went up to go ziplining!). Another 40 minutes and we were on the shore of Lake Naivasha. As soon as we got to the end of the dock there was a large hippo swimming by! And on our way out we saw zebra, giraffe, an antelope type of creature…and lots and lots of monkeys as we pulled into Kijabe.
No recognition of Labor Day here of course, so we are back to our daily activities tomorrow. I now have a functioning washing machine, John made the tennis team!, and we will be doing what we can to celebrate Warren's bd! I found bd candles on Sat, and will make my first attempt at baking a 7000 feet!, with a completely capricious idea what temperature is happening in there, or how to control it! Should make for another adventure!;)Having a birthday in Africa is probably treat enough!

Thursday, September 2, 2010

warren here...

At the end of one week of African medicine it has already been an experience. Figuring out how I fit in continues to occupy a significant part of my day. I am happy to be interacting with many African MD’s, nurses and CO’s(physician asst’s). Kijabe Hospital is a training center for nurses, medical interns, family practice residents, CO’s…and also has MO’s(medical officers) who continue to work after their internship year as they pursue coveted spots in Kenyan residency programs, which they will have to pay for, rather than get paid like we do in the US. Patients arrive in cars, buses, taxis, carried by family…There aren’t any ambulances to bring people. They arrive in every level of acuity and sickness. In the last few days I have treated infected open fractures, heart failure leading to cardiac arrest and death, a young man with recent pneumonia who shows up with an empyema that we could drain with a chest tube, a young woman treated for malaria with abdominal pain who actually has appendicitis…The Western doctors in the hospital come and go regularly and it is never certain what kind of physicians you will actually have available. Normally there is no radiologist, however, for the next year we will have a great doctor from Toronto who can even do some invasive radiology. For the next 2 months we have an experienced Australian surgeon who can make use of the laporoscope equipment that the hospital already has but can rarely make use of.
For my medical friends, here is a little vignette: 49 year old complains of shortness of breath, weakness and high heart rate for one month. Vital signs: HR 160, O2 sats 80’s and low blood pressure. I asked him, thinking that he couldn’t live like this for more than one day, how long he has actually felt this bad. And he says, “One month”. I don’t believe him. However, he comes with an EKG and a CXR from 3 weeks ago, done at a clinic in Nairobi by a doctor who looks like he is a Hem/Onc specialist. The CXR shows significant CHF and a very large heart. The EKG shows HR 120 and not in sinus rhythm. So what do they do for him? I am not sure, but he also comes with a detailed report from 5 days later of an upper endoscopy. His stomach looked fine. You wouldn’t want to start any cardiac meds of course. So after that I actually believed that he was feeling like this for the past month. He started to decompensate. And, as a good ER doctor, I thought…let’s treat him. Nitroglycerine seems like a good idea, but we don’t have any. I would like IV morphine but, after a call to pharmacy, they are out of that drug. How about an IV beta blocker? We don’t have IV beta blockers, but we have Propranolol PO, so why not? We did have Lasix, and oxygen is a drug. However, in the end, a month of untreated heart failure was too much for him. This is an example of inadequate medication and support and also a lack of appropriate decision making. In contrast, I am working with a 3rd year resident level Kenyan doctor who has a fund of knowledge and ability to come up with complex differential diagnoses that is much more than my ability. It can be astounding to see Kenyan trained physicians who have the ability to function at a high level in a Western hospital but are left working with so few resources and little opportunity. Not to paint Kijabe Hospital as a backword undeveloped facility because in fact it is a true light throughout Eastern Africa; I have treated patients who have traveled from as far as Somalia, Sudan and the far edges of Kenya. Injured people on the streets of Mogadishu know to come to Kijabe.

Wednesday, September 1, 2010

a few photos...

running at elevation...

This morning Warren and I went for our second run since arriving here at Kijabe. 7000 feet in the air makes our efforts quite a bit more challenging...and the course, around the school campus, is full of ups and downs, a few especially steep ups. Our hearts were pounding and we were thinking about how strong we will be if we ever get to the point where we can run the course without stopping and without feeling like our hearts are about to beat out of our throats! Maybe this is a good metaphor for this experience. Life here is a bit more challenging in most areas, but we hope to be stronger for it...?? The people here are certainly stronger than we are in a million ways. Warren has been telling amazing stories about patients already...including the distances they have traveled to be here, the sickness they live with on a chronic basis, and the way he needs to think about cost so as not to burden them with unnecessary bills.
Yesterday our stove was exchanged for one that has a working oven and we happily ate chocolate chip cookies throughout the evening! Warren has been eyeing the rhubarb growing in our "garden" and is hoping for a pie...He kept turning on the broken one and hoping it would turn on if he just waited long enough!
I spent the day in Nairobi learning about food shopping and internet modems. And I saw the American embassy, surrounded by high walls, guards and barbed wire. It looks like a penitentiary. But the previous one was bombed so I guess this is understandable. As we came around the corner to pick up our friend who had gone into the embassy to pick up a letter related to the adoption they are trying to accomplish, a matatu zipped by...and the door flew off! (matatu is the word for the common taxi. they are small mini vans which seat as many as possible and they are everywhere!) The matatu stopped and a few guys ran back to pick up the door! I didn't see if they were able to re-attach it. That seems like a stretch, but who knows?! Maybe this was routine for that particular ride?
My goal is to post a few pictures before the end of today. I think I have enough internet capability for that be determined later!

Monday, August 30, 2010

Off the grid...

Well...I just wrote a whole new post and lost it...emphasizing the situation we are in! We have tips and ideas for getting better internet connection, but it will take a bit of time.
All is well. We are making progress every day. The Kenyans are incredible...totally friendly, sweet acting, open...ready to make our aquaintance.
Warren worked at starting at the hospital today. He made friends with the gate guards...and worked at finding the person he will be alongside in the "casualty" area. Nothing is automatic or obvious. Not a bad thing. Just a new way of relating to life and the world around us.
John started school.
I am on a steep learning curve...with everything! I will go back to Nairobi tomorrow to work on increasing our access to computer and improving our phone situation. Once we have this figured out I will post pictures...and more description!

Thursday, August 26, 2010

remember the phone squawking sound when you logged on to dial up!!?

We are hearing it again here! John asked if this is really how it used to be and how we could do anything on the computer. Remember? We couldn't do much! That is our experience again. Wow, are we ever dependent on the computer! Thankfully we have been learning how this is coped with in this Kijabe world. We aren't the only ones with kids at home and the desire to maintain connection with other places and people....
We hope to have a modem coming on Sat from Nairobi. We will find out if it brings the promised improvements to speed and agility for the computer. If it does...I will post some pictures.
We are in Kijabe and settling into our new home. We have 3 bedrooms, supplies for living...and easy, easy access to both the school and the hospital. We are literally between the two, less than a 5 minute walk from each. John says the school looks like Jurassic it is fenced and guarded. But the inside is so nice...lots of green space for 2 huge fields, a big gym, 3 or 4 tennis courts, outside basketball courts...not bad at all.
Walking through the entrance to the hospital is like walking into an entirely different many people waiting for care! Warren plans to start orienting there on Monday when John will be starting school.
There has been a lot of haze and it is winter here!, but we have been able to catch glimpses of the Rift seen from most spots on the hillside that is Kijabe.
I have heard it has been really warm in Seattle these past days. I would be envious if this was truly winter weather but "Winter" here isn't exactly that. It feels like you want a sweatshirt in the morning and evening but it is warm enough for a t-shirt and shorts during the day. We make a fire in the evening and the temperature is perfect for sleeping....which we are managing to do more of at the right times!

Wednesday, August 25, 2010

2am and sleepless...

The irresistible afternoon nap has not helped with the night time here I am writing at 2am. In a few hours we will be up and making our way to Kijabe and our new home. After a stop for staples at the grocery store our matatu will take us there...about 45 minutes by car. I look forward to feeling less caged. The city is dangerous enough that we are locked in behind the gates of the house, which are behind the gates of the neighborhood, which is surrounded by a wall, which is covered with large loops of electric barbed wire...This makes me feel caged as much as it might deter anyone from coming in. There is a golf course next to this house, but we really can't see it. The walls are too high in order to keep us "safe". Inside the house is quite pleasant, but for someone who likes to walk, run, bike...exercise and move!, this would be a struggle if I had to do it long term. Thankfully we are going to open space and ample opportunity for moving about and getting exercise. The school is ready to start and the hospital is chomping at the bit to get Warren started. We are being encouraged to take the time we need, so I hope we can do that.
We have had the chance already to meet some amazing people...brave, dedicated, committed to what they believe in and loving to the people around them. Yesterday we had chai (morning tea) with a group of people working here in Nairobi. Chai included the delicious tea...but also peanut butter cookies (i think for the Americans;) ) and boiled sweet potatoes. Peeled and served just like that. It seemed an odd food choice at 10:30am but it tasted great...and so healthy! I think I am going to adopt this. I guess a boiled sweet potato at tea will be well received by any Kenyan guest I serve. John was told he can look forward to chai breaks between 10:30-11 every school day as well! I like this system...the whole country stopping for tea....even the doctors stagger their tea breaks so that they can all have one. Nice.
Soon I will post photos of our new home. At this point it is still our 9 red bags!! But our host Peter told me that a family came last year...parents with one son...47 bags and a dog!! Can you imagine?? I guess we are traveling super light in comparison to that situation! What could be in 47 bags??
Miss you all...

Monday, August 23, 2010

A few photos....

We made it!

We are in Nairobi...tucked in our beds. The screeching cat outside our room seems to have decided to move on...and we are going to attempt sleep. The 10 hour time difference will take a few days. Our trip was uneventful, all bags arrived, and our friendly Scottish host was there for us as we exited customs. So, all is well. John had a horrible headache on the trip between London and Nairobi so we are hoping for a better day for him tomorrow! He is sad about being so far from home and Camp Firwood. Thankfully school activities start for him already on Thursday! Tomorrow we will get a look at Nairobi in the daylight.

Thursday, August 19, 2010

48 hours...and counting...

Very sad to say goodbye to many of you. We will miss you!
John is home and frantically making little connections with friends he hasn't seen all summer. He said sad goodbyes to his camp friends on Monday. Lots of transition for him in the next few weeks. He says he is excited....
Next time from Kenya...

Wednesday, August 11, 2010

Saying goodbye to MINNIE....

MINNIE left us last weekend. A very nice couple from Lynnwood came to buy her. I had to make sure that they were as excited about her as I was...and I think they were. I was sad to see her go but grateful for the fact that she held enough value to help us out. (This felt like a good time to practice my photo uploading to blog capability.)
10 more days and we will be leaving. Thank you to all of you who have been sending us off with meals, warm thoughts and contributions!

Saturday, July 10, 2010

6 weeks from today we will head to Kenya! It is coming quickly. Today I met some great people who are here for medical care, but normally live in Kijabe. They have strong ties to the Northwest. She worked at Camp Firwood! And they graduated from Western. They are teachers in the school where John will attend. They could not have been more positive about life in Kijabe, the school, the people, the climate...It made me excited! And their pictures were full of baboons...lots of baboons!

Wednesday, June 16, 2010

June 15, 2010. Working on making a blogspot so we can stay in touch with our friends and family this next year. This is the start....