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 baby...now 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!

john on the top of the rift valley, mt longonot

 

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 soaked...as 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.

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.

Thanksgiving in Kenya

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 reminder...weather 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.

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.